From the Neuroradiology Division (M.R., G.C.C.), Department of Radiology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York.
Departments of Neurology and Psychiatry (M.L.G.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, The Litwin-Zucker Research Center, Feinstein Institutes for Medical Research, Manhasset, New York.
AJNR Am J Neuroradiol. 2022 Sep;43(9):1230-1243. doi: 10.3174/ajnr.A7613. Epub 2022 Aug 25.
Primary progressive aphasia is a clinically and neuropathologically heterogeneous group of progressive neurodegenerative disorders, characterized by language-predominant impairment and commonly associated with atrophy of the dominant language hemisphere. While this clinical entity has been recognized dating back to the 19th century, important advances have been made in defining our current understanding of primary progressive aphasia, with 3 recognized subtypes to date: logopenic variant, semantic variant, and nonfluent/agrammatic variant. Given the ongoing progress in our understanding of the neurobiology and genomics of these rare neurodegenerative conditions, accurate imaging diagnoses are of the utmost importance and carry implications for future therapeutic triaging. This review covers the diverse spectrum of primary progressive aphasia and its multimodal imaging features, including structural, functional, and molecular neuroimaging findings; it also highlights currently recognized diagnostic criteria, clinical presentations, histopathologic biomarkers, and treatment options of these 3 primary progressive aphasia subtypes.
原发性进行性失语症是一组临床和神经病理学表现多样的进行性神经退行性疾病,以语言障碍为主,常伴有优势半球的萎缩。虽然这种临床实体可以追溯到 19 世纪,但在定义我们目前对原发性进行性失语症的认识方面已经取得了重要进展,目前已经确定了 3 种亚型:流畅性失语变异型、语义性变异型和非流畅/语法障碍变异型。鉴于我们对这些罕见神经退行性疾病的神经生物学和基因组学的理解不断取得进展,准确的影像学诊断至关重要,并对未来的治疗分诊具有重要意义。本综述涵盖了原发性进行性失语症的广泛谱及其多种模态的影像学特征,包括结构、功能和分子神经影像学发现;它还强调了这 3 种原发性进行性失语症亚型的目前公认的诊断标准、临床表现、组织病理学生物标志物和治疗选择。