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Alzheimer disease and nonfluent progressive aphasia
J D Greene1, K Patterson, J Xuereb
1University Neurology Unit, Addenbrooke's Hospital, Cambridge, England.
Archives of Neurology
|October 1, 1996
Summary
This study documents the first case of progressive nonfluent aphasia in a patient with pathologically confirmed Alzheimer disease (AD). The findings highlight an atypical presentation of AD, challenging typical language deficit patterns.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Alzheimer disease (AD) typically presents with memory decline and fluent anomic aphasia.
- Language deficits in AD are often attributed to lexicosemantic processing impairments.
Observation:
- A 66-year-old man exhibited progressive nonfluent aphasia for 5 years, with deficits in phonology and syntax.
- Neuroimaging showed left perisylvian atrophy, while SPECT scans were normal.
- Postmortem examination revealed Alzheimer disease pathology predominantly in perisylvian language areas.
Findings:
- The patient demonstrated significant impairments in auditory verbal short-term memory, syntax, and phonology.
- Naming errors were characterized by phonological paraphasias.
- Pathological findings showed an atypical distribution of AD pathology, sparing the medial temporal lobe.
Implications:
- This case expands the spectrum of clinical presentations for Alzheimer disease.
- It suggests that nonfluent aphasia can be an initial and predominant symptom of pathologically verified AD.
- Understanding atypical AD presentations is crucial for accurate diagnosis and management.