Core auditory processing deficits in primary progressive aphasia.
Core auditory processing deficits in primary progressive aphasia.
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DOI：
10.1093/brain/aww067
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发表时间：
2016-06
期刊：
影响因子：
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通讯作者：
Vandenberghe R
中科院分区：
文献类型：
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作者：
Grube M;Bruffaerts R;Schaeverbeke J;Neyens V;De Weer AS;Seghers A;Bergmans B;Dries E;Griffiths TD;Vandenberghe R
非语言听觉处理缺陷对原发性进行性失语症 (PPA) 临床表型的影响程度尚不清楚。格鲁贝等人。揭示了处理非语言刺激的简短序列的时间损伤，特别是在非流利变体中，表明 PPA 的核心中枢听觉损伤。非语言听觉处理缺陷对原发性进行性失语症 (PPA) 临床表型的影响程度尚不清楚。格鲁贝等人。揭示了处理非语言刺激的简短序列的时间损伤，特别是在非流利变体中，表明 PPA 的核心中枢听觉损伤。非语言听觉处理缺陷在多大程度上可能导致原发性进行性失语症的现象尚未确定。我们使用缺乏意义的非语言刺激，对 18 名原发性进行性失语症患者（8 名患有语义变异，6 名患有非流利/语法变异，4 名患有语词减少变异）以及 28 名年龄匹配的健康对照者进行了连续系列的听觉处理的三个关键领域（音调、时间和音色）的评估。我们进一步检查了三个领域的心理声学任务的表现是否与患者的言语和神经心理学特征相关。在群体层面，患者在这三个领域均受到显着损害。患者在处理最多七个音调的短序列方面存在最明显的节律域缺陷。具有非流利变异的患者在群体和个人水平上表现出最明显的缺陷。具有语义变异的一部分患者也受到损害，但程度较轻。具有基因减少变异的患者没有表现出任何明显的损伤。在部分排除执行功能障碍的影响后，非流利和语义变体仍然存在显着缺陷。心理声学测试子集的表现与传统的言语重复测试相关。总之，对于非语言刺激，原发性进行性失语症存在核心中枢听觉障碍。虽然非流利变体的临床特征是运动言语缺陷（输出问题），但音调序列的感知处理明显有缺陷。这可能表明听觉对象工作记忆缺陷的非流利变体同时出现。我们简约地建议改变听觉时序路径，这些路径通常用于处理语音输出和声学输入中的声学序列结构。
The extent to which deficits in non-verbal auditory processing contribute to the clinical phenotype of primary progressive aphasia (PPA) is unclear. Grube et al. reveal impairments in processing the timing of brief sequences of non-linguistic stimuli, particularly in the non-fluent variant, indicative of a core central auditory impairment in PPA. The extent to which deficits in non-verbal auditory processing contribute to the clinical phenotype of primary progressive aphasia (PPA) is unclear. Grube et al. reveal impairments in processing the timing of brief sequences of non-linguistic stimuli, particularly in the non-fluent variant, indicative of a core central auditory impairment in PPA. The extent to which non-linguistic auditory processing deficits may contribute to the phenomenology of primary progressive aphasia is not established. Using non-linguistic stimuli devoid of meaning we assessed three key domains of auditory processing (pitch, timing and timbre) in a consecutive series of 18 patients with primary progressive aphasia (eight with semantic variant, six with non-fluent/agrammatic variant, and four with logopenic variant), as well as 28 age-matched healthy controls. We further examined whether performance on the psychoacoustic tasks in the three domains related to the patients’ speech and language and neuropsychological profile. At the group level, patients were significantly impaired in the three domains. Patients had the most marked deficits within the rhythm domain for the processing of short sequences of up to seven tones. Patients with the non-fluent variant showed the most pronounced deficits at the group and the individual level. A subset of patients with the semantic variant were also impaired, though less severely. The patients with the logopenic variant did not show any significant impairments. Significant deficits in the non-fluent and the semantic variant remained after partialling out effects of executive dysfunction. Performance on a subset of the psychoacoustic tests correlated with conventional verbal repetition tests. In sum, a core central auditory impairment exists in primary progressive aphasia for non-linguistic stimuli. While the non-fluent variant is clinically characterized by a motor speech deficit (output problem), perceptual processing of tone sequences is clearly deficient. This may indicate the co-occurrence in the non-fluent variant of a deficit in working memory for auditory objects. Parsimoniously we propose that auditory timing pathways are altered, which are used in common for processing acoustic sequence structure in both speech output and acoustic input.