Rohrer, J.D.;
Rossor, M.N.;
Warren, J.D.;
(2010)
Apraxia in progressive nonfluent aphasia.
Journal of Neurology
, 257
(4)
pp. 569-574.
10.1007/s00415-009-5371-4.
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Abstract
The clinical and neuroanatomical correlates of specific apraxias in neurodegenerative disease are not well understood. Here we addressed this issue in progressive nonfluent aphasia (PNFA), a canonical subtype of frontotemporal lobar degeneration that has been consistently associated with apraxia of speech (AOS) and in some cases orofacial apraxia, limb apraxia and/or parkinsonism. Sixteen patients with PNFA according to current consensus criteria were studied. Three patients had a corticobasal syndrome (CBS) and two a progressive supranuclear palsy (PSP) syndrome. Speech, orofacial and limb praxis functions were assessed using the Apraxia Battery for Adults-2 and a voxel-based morphometry (VBM) analysis was conducted on brain MRI scans from the patient cohort in order to identify neuroanatomical correlates. All patients had AOS based on reduced diadochokinetic rate, 69% of cases had an abnormal orofacial apraxia score and 44% of cases (including the three CBS cases and one case with PSP) had an abnormal limb apraxia score. Severity of orofacial apraxia (but not AOS or limb apraxia) correlated with estimated clinical disease duration. The VBM analysis identified distinct neuroanatomical bases for each form of apraxia: the severity of AOS correlated with left posterior inferior frontal lobe atrophy; orofacial apraxia with left middle frontal, premotor and supplementary motor cortical atrophy; and limb apraxia with left inferior parietal lobe atrophy. Our findings show that apraxia of various kinds can be a clinical issue in PNFA and demonstrate that specific apraxias are clinically and anatomically dissociable within this population of patients.
| Type: | Article |
|---|---|
| Title: | Apraxia in progressive nonfluent aphasia |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00415-009-5371-4 |
| Publisher version: | http://dx.doi.org/10.1007/s00415-009-5371-4 |
| Language: | English |
| Additional information: | © The Authors 2009. This article is published with open access at Springerlink.com. The article is published under the Creative Commons Attribution Noncommercial License, which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited; please see http://creativecommons.org/licenses/by-nc/2.5 |
| Keywords: | Progressive nonfluent aphasia, primary progressive aphasia, frontotemporal dementia, frontotemporal lobar degeneration |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/20068 |
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