Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia
Apraxia of Speech and Phonological Errors in the Diagnosis of Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia
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DOI：
10.1044/1092-4388(2012/11-0323
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发表时间：
2012-10-01
影响因子：
2.6
通讯作者：
Hodges, John R.
中科院分区：
文献类型：
--
作者：
Croot, Karen;Ballard, Kirrie;Hodges, John R.
目的：原发性进行性失语的国际共识诊断标准（PPA; Gorno-Tempini et al., 2011）将言语失用（AOS）作为非流利/语法性PPA的2个核心特征之一，并将语音错误或缺乏运动言语障碍作为言语缺失性PPA的特征。我们研究了AOS和音系错误作为这些变异标记的敏感性和特异性，并研究了AOS、音系错误和c标记匹兹堡化合物B (PiB)-正电子发射断层扫描（PET）成像结果与假定的阿尔茨海默病型病理之间的关系。方法：对23名PPA患者进行PiB-PET成像，分别由1名对诊断不知情的评分者和2名对PiB-PET结果不知情的评分者评定为语用障碍和语音障碍。结果：失用特征对不流利/语法性PPA具有高敏感性，语音错误对词性PPA具有高敏感性；然而，语音错误对词源缺失性PPA的特异性较低。在PiB成像中，9名主要AOS患者中有8人返回阴性结果，而没有或可疑AOS的参与者返回阳性结果，有或没有语音错误。结论：关注AOS和语音错误可能有助于克服目前诊断PPA的国际共识标准中排除诊断的一些固有局限性。
Purpose: The International Consensus Criteria for the diagnosis of primary progressive aphasia (PPA; Gorno-Tempini et al., 2011) propose apraxia of speech (AOS) as 1 of 2 core features of nonfluent/agrammatic PPA and propose phonological errors or absence of motor speech disorder as features of logopenic PPA. We investigated the sensitivity and specificity of AOS and phonological errors as markers for these variants and also investigated the relationship between AOS, phonological errors, and findings on C-labeled Pittsburgh Compound B (PiB)-positron emission tomography (PET) imaging associated with putative Alzheimer-type pathology.Method: Connected speech and word repetition in 23 people with PPA who underwent PiB-PET imaging were rated for apraxic versus phonological disruption by 1 rater who was blind to diagnosis and by 2 raters who were blind to PiB-PET results.Results: Apraxic characteristics had high sensitivity for nonfluent/agrammatic PPA, and phonological errors had high sensitivity for logopenic PPA; however, phonological errors showed lower specificity for logopenic PPA. On PiB imaging, 8 of 9 people with predominant AOS returned negative results, whereas participants with no or questionable AOS with and without phonological errors returned positive results.Conclusions: Attention to AOS and phonological errors may help counter some of the inherent limitations of diagnosis-by-exclusion in the current International Consensus Criteria for diagnosing PPA.