Differences in aphasia syndromes between progressive supranuclear palsy–Richardson’s syndrome, behavioral variant frontotemporal dementia and Alzheimer’s dementia

Language impairments, hallmarks of speech/language variant progressive supranuclear palsy, also occur in Richardson’s syndrome (PSP-RS). Impaired communication may interfere with daily activities. Therefore, assessment of language functions is crucial. It is uncertain whether the Aachen Aphasia Test...

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Published in:Journal of Neural Transmission Vol. 129; no. 8; pp. 1039 - 1048
Main Authors: Ransmayr, Lucia, Fuchs, Alexandra, Ransmayr-Tepser, Sibylle, Kommenda, Romana, Kögl, Mariella, Schwingenschuh, Petra, Fellner, Franz, Guger, Michael, Eggers, Christian, Darkow, Robert, Mangesius, Stephanie, Ransmayr, Gerhard
Format: Journal Article
Language:English
Published: Vienna Springer Vienna 01.08.2022
Subjects:
Medicine
Medicine & Public Health
Neurology
Neurology and Preclinical Neurological Studies - Original Article
Neurosciences
Psychiatry
Behavioral variant frontotemporal dementia
Non-fluent agrammatic primary progressive aphasia
Progressive supranuclear palsy
Alzheimer’s dementia
Cognitive impairment
ISSN:0300-9564, 1435-1463, 1435-1463
Online Access:Get full text
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Summary:Language impairments, hallmarks of speech/language variant progressive supranuclear palsy, also occur in Richardson’s syndrome (PSP-RS). Impaired communication may interfere with daily activities. Therefore, assessment of language functions is crucial. It is uncertain whether the Aachen Aphasia Test (AAT) is practicable in PSP-RS, behavioral variant frontotemporal dementia (bvFTD) and Alzheimer’s dementia (AD) and language deficits differ in these disorders. 28 PSP-RS, 24 AD, and 24 bvFTD patients were investigated using the AAT and the CERAD-Plus battery. 16–25% of all patients failed in AAT subtests for various reasons. The AAT syndrome algorithm diagnosed amnestic aphasia in 5 (23%) PSP-RS, 7 (36%) bvFTD and 6 (30%) AD patients, Broca aphasia in 1 PSP-RS and 1 bvFTD patient, Wernicke aphasia in 1 bvFTD and 3 (15%) AD patients. However, aphasic symptoms resembled non-fluent primary progressive aphasia in 14 PSP-RS patients. In up to 46% of PSP-RS patients, 61% of bvFTD and 64% of AD patients significant impairments were found in the AAT subtests spontaneous speech, written language, naming, language repetition, language comprehension and the Token subtest. The CERAD-Plus subtest semantic fluency revealed significant impairment in 81% of PSP-RS, 61% of bvFTD, 44% of AD patients, the phonemic fluency subtest in 31, 40 and 31%, respectively. In contrast to bvFTD and AD, severity of language impairment did not correlate with cognitive decline in PSP-RS. In summary, the patterns of aphasia differ between the diagnoses. Local frontal language networks might be impaired in PSP-RS, whereas in AD and bvFTD, more widespread neuropathology might underly language impairment.
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ISSN:0300-9564
1435-1463
1435-1463
DOI:10.1007/s00702-022-02524-2