初级渐进性失语症中的失语症:临床预测因素和神经解剖学的基础
Salvatore Mazzeo1,2,3,4, Eoin Mulroy1, Jessica Jiang1
1Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
European journal of neurology
|July 16, 2024
概括
消化不良或吞困难在非流利/语法变异初级渐进性失言症 (nfvPPA) 中很常见. 它是由运动特征预测的,如口腔面部无力症,并与大脑缩有关.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 语音语言病理学 语言病理学
背景情况:
- 缺食症是神经退行性疾病的一个严重症状,特别是初级渐进性失言症 (PPA).
- 它在PPA亚型中的患病率和预测因素仍未得到充分描述.
研究的目的:
- 为了调查PPA亚型中的食障碍患病率.
- 为了确定临床预测因素和神经解剖学相关的PPA.
- 为了测试这种假设,在非流利/语法变体PPA (nfvPPA) 中,失调更常见,并且与运动特征和特定的大脑缩有关.
主要方法:
- 在56名PPA患者 (21名 nfvPPA,22名 svPPA,13名 lvPPA) 的回顾性病例控制研究中.
- 通过护理人员调查和临床记录记录记录的消化不良症.
- 在临床,认知和行为特征上训练的机器学习模型.
- 基于voxel的形态测量和MRI扫描的兴趣区域分析,以评估大脑缩.
主要成果:
- 与svPPA (5%) 和lvPPA (0%) 相比,nfvPPA (43%) 的食障碍的发生率明显高.
- 机器学习模型在nfvPPA中预测食障碍时达到90.5%的准确性,其中 orofacial apraxia,年龄,帕金森症和认知/行为严重程度作为关键预测因素.
- 在nfvPPA中灰质缩与消化不良相关,包括左中额头,右上额头,右上边缘回转和右尾巴.
结论:
- 缺食症是 nfvPPA 的一个频繁且显著的症状.
- 这些发现突显了 nfvPPA 中的消化不良,皮质皮层网络功能障碍和运动特征之间的联系.
- 临床医生应主动查nfvPPA患者的食障碍,特别是那些运动缺陷和晚期疾病的患者.
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