Prosodic and phonetic subtypes of primary progressive apraxia of speech
Prosodic and phonetic subtypes of primary progressive apraxia of speech
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DOI：
10.1016/j.bandl.2018.06.004
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发表时间：
2018-09-01
影响因子：
2.5
通讯作者：
Josephs, Keith A.
中科院分区：
文献类型：
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作者：
Utianski, Rene L.;Duffy, Joseph R.;Josephs, Keith A.
原发性进行性语言失用症（PPAOS）是一种临床综合征，其中语言失用是神经退行性疾病的初始指征。先前的研究发现，PPAOS在额回、中央前皮层和辅助运动区（SMA）存在代谢低下、灰质萎缩和白质束变性。最近的临床观察表明可能存在两种不同的PPAOS亚型。语音PPAOS的主要特征是扭曲的声音替换。韵律型PPAOS的主要特点是语速慢、分段。分析了人口统计学、临床和神经影像学数据（MRI、DTI和FDG-PET）来验证这些亚型并探索解剖相关性。语音亚型表现为双侧SMA、中央前回和小脑小腿受累。韵律型表现出更多的局灶性累及SMA和右小脑上蒂。这些发现提供了越来越多的证据，证明在可靠确定的AOS主要临床特征的差异与不同的影像学模式相关，与严重程度无关。
Primary progressive apraxia of speech (PPAOS) is a clinical syndrome in which apraxia of speech is the initial indication of neurodegenerative disease. Prior studies of PPAOS have identified hypometabolism, grey matter atrophy, and white matter tract degeneration in the frontal gyri, precentral cortex, and supplementary motor area (SMA). Recent clinical observations suggest two distinct subtypes of PPAOS may exist. Phonetic PPAOS is characterized predominantly by distorted sound substitutions. Prosodic PPAOS is characterized predominantly by slow, segmented speech. Demographic, clinical, and neuroimaging data (MRI, DTI, and FDG-PET) were analyzed to validate these subtypes and explore anatomic correlates. The Phonetic subtype demonstrated bilateral involvement of the SMA, precentral gyrus, and cerebellar crus. The Prosodic subtype demonstrated more focal involvement in the SMA and right superior cerebellar peduncle. The findings provide converging evidence that differences in the reliably determined predominant clinical characteristics of AOS are associated with distinct imaging patterns, independent of severity.