Kelly Brianna E, Shehab Al Amira Safa
Neurology, NYU Langone Health, New York 10016, USA.
Arch Clin Neuropsychol. 2025 Aug 25;40(6):1266-1274. doi: 10.1093/arclin/acaf030.
This study reports a case of primary progressive aphasia (PPA) in a multilingual Haitian American individual. Earlier literature has suggested that cases of PPA in multilingual individuals are relatively rare. Several factors complicate the assessment of language dysfunction and diagnosis of PPA in multilingualism, including age of language acquisition, degree of proficiency, language representation in the bilingual brain, and limited availability/validity of tests/norms for bilinguals.
This is a 69-year-old right-handed trilingual (French/English/Haitian Creole) Haitian American female with 16 years of education. Difficulties with word finding and speech production emerged two years prior to evaluation. Language was assessed with select subtests of the Boston Diagnostic Aphasia Examination (BDAE-3), Boston Naming Test (BNT), and Verbal Fluency. Positron emission tomography-computed tomography imaging displayed large areas of hypometabolism in the left and right frontal, temporal, and parietal lobes, with the left areas being more greatly impacted.
Neuropsychological testing showed impairments in visual and auditory naming, verbal fluencies, sentence repetition, and word reading. Reading comprehension and repetition of single words were relatively spared. There were deficits in learning/memory, visuospatial functioning, and processing speed. Speech was dysfluent with occasional agrammatism and mild dysarthria.
Overlapping characteristics of both logopenic and non-fluent/agrammatic variants of PPA were evident. Patient's neuroimaging findings and clinical presentation suggest an advanced PPA syndrome. Cognitive/brain reserve and a globalized language representation, theorized in bilingual individuals, could be considered as contributors to the trajectory of her deficits. This case study contributes to the growing literature on PPA in diverse populations and multilingual individuals.
本研究报告了一例多语言海地裔美国个体患原发性进行性失语（PPA）的病例。早期文献表明，多语言个体患PPA的病例相对罕见。多种因素使多语言环境下语言功能障碍的评估和PPA的诊断变得复杂，包括语言习得年龄、熟练程度、双语大脑中的语言表征，以及针对双语者的测试/常模的可用性/有效性有限。
这是一名69岁的右利手三语（法语/英语/海地克里奥尔语）海地裔美国女性，接受过16年教育。在评估前两年出现了找词和言语表达困难。使用波士顿诊断性失语检查（BDAE - 3）、波士顿命名测试（BNT）和言语流畅性的选定子测试对语言进行评估。正电子发射断层扫描 - 计算机断层扫描成像显示左、右额叶、颞叶和顶叶有大面积代谢减低，左侧区域受影响更大。
神经心理学测试显示视觉和听觉命名、言语流畅性、句子复述和单词阅读受损。阅读理解和单个单词的复述相对保留。学习/记忆、视觉空间功能和处理速度存在缺陷。言语不流畅，偶尔出现语法错误和轻度构音障碍。
PPA的语义性失语和非流利性/语法缺失性变体的重叠特征明显。患者的神经影像学结果和临床表现提示为晚期PPA综合征。双语个体中理论上存在的认知/大脑储备和全球化语言表征可被视为其缺陷发展轨迹的促成因素。本病例研究为关于不同人群和多语言个体中PPA的文献不断增加做出了贡献。
