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口颜面失用症在原发性进行性失语症中。

Buccofacial apraxia in primary progressive aphasia.

机构信息

Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.

Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

出版信息

Cortex. 2023 Jan;158:61-70. doi: 10.1016/j.cortex.2022.10.010. Epub 2022 Nov 11.

Abstract

Buccofacial apraxia (BFA) is associated with nonfluent/agrammatic variant primary progressive aphasia (nfvPPA) as well as with the severity of apraxia of speech (AOS), a core symptom of nfvPPA. However, an association with agrammatism has not been established. The aim of this study was to examine the association between BFA and agrammatism in nfvPPA and to determine differences in atrophic regions in primary progressive aphasia (PPA) with and without BFA. Seventy-four patients with PPA were recruited, including 34, 15, 10, and 15 patients with nfvPPA, semantic variant PPA, logopenic variant PPA, and unclassified PPA, respectively. All patients underwent language examination and BFA evaluations. Voxel-based morphometry (VBM) was performed to determine whether atrophy of a specific lesion correlated with the presence of BFA. BFA was observed in 20 and 3 patients with nfvPPA and unclassified PPA, respectively. In a comparison of patients with nfvPPA with and without BFA, the BFA group showed significantly worse spontaneous speech and writing in the Western Aphasia Battery. The agrammatism ratio or the ratio of agrammatic errors to the total number of particles was higher in the BFA group; however, the severity of prosodic and phonetic components of AOS did not differ between the two groups. VBM showed that the severity of BFA correlated with atrophy of the opercular and triangular areas of the inferior frontal gyrus to a part of the left middle frontal gyrus. BFA has a different anatomical basis from AOS in patients with nfvPPA and that BFA is characterized by more anterior degeneration compared to that of AOS.

摘要

口颜面失用症(BFA)与非流利/语法障碍型原发性进行性失语症(nfvPPA)以及言语失用症(AOS)的严重程度相关,AOS 是 nfvPPA 的核心症状。然而,与语法障碍的关联尚未建立。本研究旨在检查 nfvPPA 中 BFA 与语法障碍之间的关联,并确定具有和不具有 BFA 的原发性进行性失语症(PPA)的萎缩区域的差异。招募了 74 名 PPA 患者,包括 34 名、15 名、10 名和 15 名 nfvPPA、语义变体 PPA、词首失读变体 PPA 和未分类 PPA 患者。所有患者均接受语言检查和 BFA 评估。进行基于体素的形态测量学(VBM)以确定特定病变的萎缩是否与 BFA 的存在相关。在 nfvPPA 和未分类 PPA 患者中分别观察到 20 名和 3 名患者存在 BFA。在 nfvPPA 患者中具有和不具有 BFA 的患者之间的比较中,BFA 组在西方失语症成套测验中表现出明显更差的自发性言语和书写。BFA 组的语法障碍比率或语法错误与粒子总数的比率更高;然而,两组之间 AOS 的韵律和语音成分的严重程度没有差异。VBM 显示,BFA 的严重程度与下额回的外侧和三角区域以及左额中回的一部分的萎缩相关。与 nfvPPA 患者的 AOS 相比,BFA 具有不同的解剖学基础,并且与 AOS 相比,BFA 的特征在于更靠前的变性。

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