Quantification of motor speech impairment and its anatomic basis in primary progressive aphasia
Quantification of motor speech impairment and its anatomic basis in primary progressive aphasia
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DOI：
10.1212/wnl.0000000000007367
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发表时间：
2019-04-23
期刊：
影响因子：
9.9
通讯作者：
Green, Jordan R.
中科院分区：
文献类型：
--
作者：
Cordella, Claire;Quimby, Megan;Green, Jordan R.
目的评价定量言语测量是否能有效地识别和监测原发性进行性失语（PPA）患者的运动性言语障碍（MSI），并探讨PPA MSI的神经解剖学基础。在每个时间点测量发音率（AR），一种来自自发言语的定量测量。在基线时收集MRI。评估了PPA亚型之间基线AR的差异，按严重程度水平分开。进行线性混合效应模型，以评估1年期间PPA亚型之间AR下降率的组间差异。皮质厚度测量从基线MRI被用来测试假设皮质萎缩和MSI.ResultsBaseline AR之间的关系减少非流畅的变体PPA（nfvPPA）的患者相比，其他PPA亚型和控制，即使在疾病的轻度阶段。纵向结果显示，与逻辑缺失和语义变体亚组相比，nfvPPA组1年内AR下降率更高。减少基线AR与左半球运动前区和补充运动cortics.ConclusionsThe AR措施皮质萎缩是一个有效的定量指标MSI检测MSI在轻度疾病阶段和跟踪下降MSI纵向。AR测量还表明运动语音特定皮质区域的解剖定位。我们的研究结果表明，这种定量测量MSI可能有实用价值的诊断评估和监测MSI的PPA。
ObjectiveTo evaluate whether a quantitative speech measure is effective in identifying and monitoring motor speech impairment (MSI) in patients with primary progressive aphasia (PPA) and to investigate the neuroanatomical basis of MSI in PPA.MethodsSixty-four patients with PPA were evaluated at baseline, with a subset (n = 39) evaluated longitudinally. Articulation rate (AR), a quantitative measure derived from spontaneous speech, was measured at each time point. MRI was collected at baseline. Differences in baseline AR were assessed across PPA subtypes, separated by severity level. Linear mixed-effects models were conducted to assess groups differences across PPA subtypes in rate of decline in AR over a 1-year period. Cortical thickness measured from baseline MRIs was used to test hypotheses about the relationship between cortical atrophy and MSI.ResultsBaseline AR was reduced for patients with nonfluent variant PPA (nfvPPA) compared to other PPA subtypes and controls, even in mild stages of disease. Longitudinal results showed a greater rate of decline in AR for the nfvPPA group over 1 year compared to the logopenic and semantic variant subgroups. Reduced baseline AR was associated with cortical atrophy in left-hemisphere premotor and supplementary motor cortices.ConclusionsThe AR measure is an effective quantitative index of MSI that detects MSI in mild disease stages and tracks decline in MSI longitudinally. The AR measure also demonstrates anatomic localization to motor speech-specific cortical regions. Our findings suggest that this quantitative measure of MSI might have utility in diagnostic evaluation and monitoring of MSI in PPA.