Logopenic型进行性失语五例的临床、神经心理学及影像特征分析

Clinical, neuropsychology and neuroimaging features of Logopenic progressive aphasia

目的研究Logopenic型进行性失语(LPA)的临床表现、神经心理学和影像特点。方法对5例患者进行病史、临床查体、神经心理学、语言评估和血液、脑脊液检查,以及头颅磁共振(MRI)、氟18-氟脱氧葡萄糖(FDG)、PET/CT或SPECT,碳11-匹兹堡复合物B(PIB)PET/CT检查。结果 5例LPA患者为自发语言和命名过程中单个词语的取词困难,语言复述和复杂长句理解障碍,伴语音错语和记忆力减退。头颅MRI示左侧颞顶叶明显萎缩。FDG-PET显示左侧额、颞、顶和枕叶葡萄糖代谢减低。2例患者显示皮质淀粉样蛋白沉积。结论取词困难是LPA语言损害的核心特点,详细的包含语言测评的神经心理学检查和头颅影像学有利于LPA诊断。

Objective To clarify the clinical,neuropsychology and neuroimaging characteristics ofLogopenic progressive aphasia;Method Five patients had detailed evaluations that include clinical history,neurological examination,and neuropsychological tests.They underwent routine laboratory blood tests,brain MRI andPIB-PET,either FDG-PET or SPECT.Results In LPA,single-word retrieval in spontaneous speech and naming wereimpaired,repetition and complicated sentences comprehension were affected.Consistent with phonemic paraphasiaand memory decline.Imaging abnormalities in the left temporo-parietal junction area of both MRI and FDG-PET weredetected.Two cases showed cortical amyloid deposition.Conclusion The core feature of Logopenic progressiveaphasia(LPA)is word retrieval impaired.Neuropsychological evaluation and neuroimaging have been shown to bevaluable in the diagnosis of LPA.