Akhmadullina Diliara R, Konovalov Rodion N, Shpilyukova Yulia A, Nevzorova Kseniya V, Fedotova Ekaterina Yu, Illarioshkin Sergey N
Research Center of Neurology, Moscow, Russia.
Front Hum Neurosci. 2024 Dec 4;18:1486809. doi: 10.3389/fnhum.2024.1486809. eCollection 2024.
Non-fluent variant of primary progressive aphasia (nfvPPA) is a neurodegenerative disorder with a predominantly speech and language impairment. Apraxia of speech and expressive agrammatisms along with decreased speech fluency and impaired grammar comprehension are the most typical disorder manifestations but with the course of the disease other language disturbances may also arise. Most studies have investigated these symptoms individually, and there is still no consensus on whether they have similar or different neuroanatomical foundations in nfvPPA. In addition, only few works have focused on the functional connectivity correlates. The aim of our study was to simultaneously investigate functional and structural brain-language associations in one group of nfvPPA.
Twenty eight patients were enrolled and underwent brain MRI and language assessment. Apraxia of speech, expressive and receptive agrammatisms, repetition, naming and single word comprehension correlates were identified using voxel-based morphometry and resting-state functional MRI (ROI-to-ROI analysis).
Among the structural correlates, the most common were inferior frontal gyrus (was associated with fluency, both expressive and receptive agrammatisms) and supramarginal gyrus (apraxia of speech, receptive agrammatisms, naming and repetition). Apart from that, neuroanatomical foundations were different for each of the core nfvPPA language domains, including superior parietal lobule involvement in fluency, temporoparietal areas in receptive agrammatisms and supplemental motor area in apraxia of speech. Functional correlations were even more diverse. In general, connectivity decrease between temporoparietal structures was more typical for expressive and receptive agrammatisms, single word comprehension and naming, while apraxia of speech, fluency and repetition showed connectivity disruption mainly among the frontoparietal region and subcortical structures. Overall, extensive structural and functional changes are involved in the development of language and speech disturbances in nfvPPA with distinctive neuroanatomical foundations for each domain.
原发性进行性失语的非流畅型（nfvPPA）是一种主要表现为言语和语言障碍的神经退行性疾病。言语失用和表达性语法缺失，以及言语流畅性下降和语法理解受损是最典型的疾病表现，但随着疾病的发展，也可能出现其他语言障碍。大多数研究都是单独研究这些症状，对于它们在nfvPPA中是否具有相似或不同的神经解剖学基础，目前仍未达成共识。此外，只有少数研究关注功能连接相关性。我们研究的目的是在一组nfvPPA患者中同时研究大脑与语言的功能和结构关联。
招募了28名患者，对其进行脑部MRI检查和语言评估。使用基于体素的形态学测量和静息态功能MRI（ROI-ROI分析）确定言语失用、表达性和接受性语法缺失、复述、命名和单词理解的相关性。
在结构相关性方面，最常见的是额下回（与流畅性、表达性和接受性语法缺失相关）和缘上回（言语失用、接受性语法缺失、命名和复述）。除此之外，nfvPPA每个核心语言领域的神经解剖学基础都不同，包括参与流畅性的顶上小叶、参与接受性语法缺失的颞顶区域以及参与言语失用的辅助运动区。功能相关性更加多样。一般来说，颞顶结构之间的连接减少在表达性和接受性语法缺失、单词理解和命名中更为典型，而言语失用、流畅性和复述则主要表现为额顶区域和皮质下结构之间的连接中断。总体而言，nfvPPA中语言和言语障碍的发展涉及广泛的结构和功能变化，每个领域都有独特的神经解剖学基础。
