Pure word deafness: a case report of an atypical manifestation of Alzheimer's disease.

BACKGROUND: Auditory agnosia refers to the impairments in sound recognition despite intact hearing and written language abilities. When auditory agnosia is specific to spoken language, it can be indicated as pure word deafness (PWD), which is characterized by the isolated difficulty in understanding spoken language, despite preserved reading comprehension, recognition of nonverbal sounds, and production of written and spoken language. CASE: A middle-aged man with a high level of education developed a progressive speech disorder initially characterized by isolated phonemic errors during spontaneous speech and later enriched by difficulties in comprehending long sentences. The patient's past medical history was unremarkable except for hypertension. The neuropsychological picture was suggestive of PWD, while cerebrospinal fluid (CSF) analyses lead to a biomarker-based diagnosis of Alzheimer's disease (AD). PWD remained the prevalent cognitive deficit over the subsequent 4 years. CONCLUSIONS: This case report shows that the presence of isolated auditory agnosia or PWD should prompt consideration of a diagnosis of AD. It also suggests that the spectrum of atypical presentations of early-onset AD may be larger than what we currently think.

The Combination of Metabolic Posterior Cingulate Cortical Abnormalities and Structural Asymmetries Improves the Differential Diagnosis Between Primary Progressive Aphasia and Alzheimer's Disease.

Differential diagnosis between primary progressive aphasia (PPA) and Alzheimer's disease (AD) could be difficult if based on clinical grounds alone. We evaluated the combination of proton MR spectroscopy of posterior cingulate cortex (PCC) and quantitative structural imaging asymmetries to differentiate PPA from AD patients. A greater left-lateralized temporo-parietal atrophy (higher accuracy for the PCC, 81.4%) and metabolic neurodegenerative changes in PCC (accuracy 76.8%) was demonstrated in PPA versus AD. The combined multiparametric approach increased the accuracy to 94%in the differential diagnosis between these two neurodegenerative diseases.

Food pleasantness affects visual selective attention.

Fundamental to adaptive behaviour is the ability to select environmental objects that best satisfy current needs and preferences. Here we investigated whether temporary changes in food preference influence visual selective attention. To this end, we exploited the fact that when a food is eaten to satiety its motivational value and perceived pleasantness decrease relative to other foods not eaten in the meal, an effect termed sensory-specific satiety. A total of 26 hungry participants were fed until sated with one of two palatable foods. Before and after selective satiation, participants rated the pleasantness of the two foods and then viewed the same as stimuli on a computer screen while attention was assessed by a visual probe task. Results showed that the attentional bias for the food eaten decreased markedly from pre- to postsatiety, along with the subjective pleasantness for that food. By contrast, subjective pleasantness and attentional bias for the food not eaten did not show any such decrease. These findings suggest that the allocation of visual selective attention is flexibly and rapidly adjusted to reflect temporary shift in relative preference for different foods.