Tippett Donna C, Breining Bonnie, Goldberg Emily, Meier Erin, Sheppard Shannon M, Sherry Emily, Stockbridge Melissa, Suarez Adrian, Wright Amy E, Hillis Argye E
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287.
Aphasiology. 2020;34(12):1456-1470. doi: 10.1080/02687038.2019.1670330. Epub 2019 Sep 23.
Individuals with primary progressive aphasia (PPA) develop visuospatial deficits over time, and those with logopenic variant (lvPPA) are at greatest risk of developing such deficits. However, not all previous studies of visuospatial deficits in PPA have ensured equivalent duration of disease across variants and few have measured deficits longitudinally.
The aims of our study were to: 1) investigate differences in baseline visuomotor figure construction, visual figure delayed recall, and figure recognition in PPA variants with similar symptom duration at baseline, and 2) explore patterns of decline in these areas.
METHODS & PROCEDURES: Ninety-three individuals with PPA [39 lvPPA, 24 nonfluent agrammatic PPA (nfaPPA), and 30 semantic variant PPA (svPPA)] were administered the Benson Complex Figure Copy, Benson Complex Figure Delay (Recall), and Benson Figure Recognition. Thirty individuals completed this testing 3 to 47 months post baseline.
OUTCOME & RESULTS: Participants with lvPPA and svPPA showed lower mean scores than those with nfaPPA on visual figure delayed recall at baseline, even though there were no differences in estimated time from disease onset or correlation with disease severity as reflected by naming performance, (2, 90) = 5.78, < .004. Those with nfaPPA performed significantly better than those with lvPPA, Tukey HSD < .05, and those with svPPA, Tukey HSD < .01. There were no differences between variants in rate of decline in visuomotor figure construction, visual figure delayed recall, and figure recognition.
These findings revealed relatively spared visuospatial memory in nfaPPA, which may aid in the differential diagnosis of PPA and contribute to designing therapy or compensatory strategies.
原发性进行性失语（PPA）患者随着时间推移会出现视觉空间缺陷，而具有音韵变异型（lvPPA）的患者出现此类缺陷的风险最高。然而，先前并非所有关于PPA视觉空间缺陷的研究都确保了各变异型疾病持续时间相等，且很少有研究纵向测量缺陷情况。
我们研究的目的是：1）调查在基线时症状持续时间相似的PPA各变异型中，基线视觉运动图形构建、视觉图形延迟回忆和图形识别方面的差异，以及2）探索这些领域的衰退模式。
对93名PPA患者[39名lvPPA、24名非流利性语法缺失型PPA（nfaPPA）和30名语义变异型PPA（svPPA）]进行了本森复杂图形临摹、本森复杂图形延迟（回忆）和本森图形识别测试。30名患者在基线后3至47个月完成了此项测试。
尽管从疾病发作开始的估计时间以及与命名表现所反映的疾病严重程度之间没有差异，（2, 90） = 5.78，P <.004，但在基线时，lvPPA和svPPA患者在视觉图形延迟回忆方面的平均得分低于nfaPPA患者。nfaPPA患者的表现明显优于lvPPA患者，Tukey HSD检验P <.05，也优于svPPA患者，Tukey HSD检验P <.01。在视觉运动图形构建、视觉图形延迟回忆和图形识别的衰退率方面，各变异型之间没有差异。
这些发现揭示了nfaPPA中相对保留的视觉空间记忆，这可能有助于PPA的鉴别诊断，并有助于设计治疗或代偿策略。
