Trying to tell a tale - Discourse impairments in progressive aphasia and frontotemporal dementia
Trying to tell a tale - Discourse impairments in progressive aphasia and frontotemporal dementia
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DOI：
10.1212/01.wnl.0000210435.72614.38
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发表时间：
2006-05-09
期刊：
影响因子：
9.9
通讯作者：
Grossman, M
中科院分区：
文献类型：
--
作者：
Ash, S;Moore, P;Grossman, M
目的：评估额颞叶痴呆（FTD）患者的话语能力。研究方法：作者要求患有进行性非流利性失语症（PNFA）、语义性痴呆（SemD）和社会行为和执行功能障碍（SOC/EXEC）的非失语症患者讲述一本无字儿童图画书的故事。结果：作者在所有三组患者中发现了显著的话语障碍。此外，这两个群体之间存在着重要的质的差异。PNFA患者的输出量较少，每分钟产生的叙述字数最少。SemD患者难以检索讲述他们的叙述所需的单词。虽然没有失语症，但SOC/EXEC患者在组织叙述时有很大的困难，他们不能有效地表达故事的重点。这种赤字与执行资源的措施，需要有组织的精神搜索的表现不佳。此外，在SOC/EXEC患者中，叙述组织与皮质萎缩的相关性在右额叶和前颞叶脑区显著。结论：非失语性额颞叶痴呆患者的日常沟通障碍的社会行为和执行功能障碍，部分是由于一个显着的赤字与右额颞叶疾病相关的话语组织。进行性失语症患者的语言障碍是造成言语障碍的主要原因。
Objective: To assess discourse in patients with frontotemporal dementia (FTD). Methods: The authors asked patients with progressive nonfluent aphasia (PNFA), patients with semantic dementia (SemD), and nonaphasic patients with a disorder of social comportment and executive functioning (SOC/EXEC) to narrate the story of a wordless children's picture book. Results: The authors found significant discourse impairments in all three groups of patients. Moreover, there were qualitatively important differences between the groups. Patients with PNFA had the sparsest output, producing narratives with the fewest words per minute. Patients with SemD had difficulty retrieving words needed to tell their narratives. Though not aphasic, patients with SOC/EXEC had profound difficulty organizing their narratives, and they could not effectively express the point of the story. This deficit correlated with poor performance on a measure of executive resources requiring an organized mental search. In addition, a correlation of narrative organization with cortical atrophy in patients with SOC/EXEC was significant in right frontal and anterior temporal brain regions. Conclusions: Impaired day-to-day communication in nonaphasic frontotemporal dementia patients with a disorder of social comportment and executive functioning is due in part to a striking deficit in discourse organization associated with right frontotemporal disease. Difficulty with discourse in progressive aphasia is due largely to the language impairments of these patients.