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原发性进行性失语症:走向病理生理学综合。

Primary Progressive Aphasia: Toward a Pathophysiological Synthesis.

机构信息

Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK.

Division of Psychology and Language Sciences, University College London, London, UK.

出版信息

Curr Neurol Neurosci Rep. 2021 Feb 4;21(3):7. doi: 10.1007/s11910-021-01097-z.

Abstract

PURPOSE OF REVIEW

The term primary progressive aphasia (PPA) refers to a diverse group of dementias that present with prominent and early problems with speech and language. They present considerable challenges to clinicians and researchers.

RECENT FINDINGS

Here, we review critical issues around diagnosis of the three major PPA variants (semantic variant PPA, nonfluent/agrammatic variant PPA, logopenic variant PPA), as well as considering 'fragmentary' syndromes. We next consider issues around assessing disease stage, before discussing physiological phenotyping of proteinopathies across the PPA spectrum. We also review evidence for core central auditory impairments in PPA, outline critical challenges associated with treatment, discuss pathophysiological features of each major PPA variant, and conclude with thoughts on key challenges that remain to be addressed. New findings elucidating the pathophysiology of PPA represent a major step forward in our understanding of these diseases, with implications for diagnosis, care, management, and therapies.

摘要

综述目的

原发性进行性失语症(PPA)这一术语指的是一组不同的痴呆症,其表现为突出的、早期的言语和语言问题。它们给临床医生和研究人员带来了相当大的挑战。

最近的发现

在这里,我们回顾了诊断三种主要 PPA 变体(语义变体 PPA、非流利/语法障碍变体 PPA、失语法变体 PPA)的关键问题,同时也考虑了“片段”综合征。接下来,我们考虑了评估疾病阶段的问题,然后讨论了 PPA 谱中蛋白病的生理表型。我们还回顾了 PPA 中核心中枢听觉损伤的证据,概述了与治疗相关的关键挑战,讨论了每种主要 PPA 变体的病理生理学特征,并就仍需解决的关键挑战进行了思考。阐明 PPA 病理生理学的新发现是我们理解这些疾病的重要一步,对诊断、护理、管理和治疗都有影响。

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