Relationships between ¹⁸F-THK5351 Retention and Language Functions in Primary Progressive Aphasia

BACKGROUND AND PURPOSE: There are three distinct subtypes of primary progressive aphasia (PPA): the nonfluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA). We sought to characterize the pattern of [¹⁸F]-THK5351 retention across all three subtypes and determine the topography of [¹⁸F]-THK5351 retention correlated with each neurolinguistic score. METHODS: We enrolled 50 participants, comprising 13 PPA patients (3 nfvPPA, 5 svPPA, and 5 lvPPA) and 37 subjects with normal cognition (NC) who underwent 3.0-tesla magnetic resonance imaging, [¹⁸F]-THK5351 positron-emission tomography scans, and detailed neuropsychological tests. The PPA patients additionally participated in extensive neurolinguistic tests. Voxel-wise and region-of-interest-based analyses were performed to analyze [¹⁸F]-THK5351 retention. RESULTS: The nfvPPA patients exhibited higher [¹⁸F]-THK5351 retention in the the left inferior frontal and precentral gyri. In svPPA patients, [¹⁸F]-THK5351 retention was elevated in the anteroinferior and lateral temporal cortices compared to the NC group (left>right). The lvPPA patients exhibited predominant [¹⁸F]-THK5351 retention in the inferior parietal, lateral temporal, and dorsolateral prefrontal cortices, and the precuneus (left>right). [¹⁸F]-THK5351 retention in the left inferior frontal area was associated with lower fluency scores. Comprehension was correlated with [¹⁸F]-THK5351 retention in the left temporal cortices. Repetition was associated with [¹⁸F]-THK5351 retention in the left inferior parietal and posterior temporal areas, while naming difficulty was correlated with retention in the left fusiform and temporal cortices. CONCLUSIONS: The pattern of [¹⁸F]-THK5351 retention was well matched with clinical and radiological findings for each PPA subtype, in agreement with the anatomical and functional location of each language domain.

¹⁸F-THK5351 PET Imaging in Nonfluent-Agrammatic Variant Primary Progressive Aphasia

BACKGROUND AND PURPOSE: To analyze 18F-THK5351 positron emission tomography (PET) scans of patients with clinically diagnosed nonfluent/agrammatic variant primary progressive aphasia (navPPA). METHODS: Thirty-one participants, including those with Alzheimer's disease (AD, n=13), navPPA (n=3), and those with normal control (NC, n=15) who completed 3 Tesla magnetic resonance imaging, 18F-THK5351 PET scans, and detailed neuropsychological tests, were included. Voxel-based and region of interest (ROI)-based analyses were performed to evaluate retention of 18F-THK5351 in navPPA patients. RESULTS: In ROI-based analysis, patients with navPPA had higher levels of THK retention in the Broca's area, bilateral inferior frontal lobes, bilateral precentral gyri, and bilateral basal ganglia. Patients with navPPA showed higher levels of THK retention in bilateral frontal lobes (mainly left side) compared than NC in voxel-wise analysis. CONCLUSIONS: In our study, THK retention in navPPA patients was mainly distributed at the frontal region which was well correlated with functional-radiological distribution of navPPA. Our results suggest that tau PET imaging could be a supportive tool for diagnosis of navPPA in combination with a clinical history.

Pure Word Deafness in a Patient with Early-Onset Alzheimer's Disease: An Unusual Presentation

BACKGROUND AND PURPOSE: The occurrence of PWD in neurodegenerative disease is very rare, and this is the first report of it being related to early-onset AD. We describe a patient with early-onset Alzheimer's disease (AD) who presented with pure word deafness (PWD). CASE REPORT: The patient had experienced PWD for 2 years, followed by other cognitive deficits suggestive of parietotemporal dysfunction. Brain imaging including 18FDG-PET and [11C] PIB-PET supported the diagnosis of AD. CONCLUSIONS: Our case highlights the clinical variability that characterizes early-onset AD.

Seoul Neuropsychological Screening Battery-Dementia Version (SNSB-D): A Useful Tool for Assessing and Monitoring Cognitive Impairments in Dementia Patients

The Seoul Neuropsychological Screening Battery (SNSB) is one of the standardized neuropsychological test batteries widely used in Korea. However, it may be a bit too lengthy for patients with decreased attention span; and it does not provide the score of global cognitive function (GCF), which is useful for monitoring patients longitudinally. We sought to validate a dementia version of SNSB (SNSB-D) that was shorter than the original SNSB and contained only scorable tests with a GCF score of 300. We administered SNSB-D to patients with mild cognitive impairment (MCI) (n=43) and Alzheimer's disease (AD) (n=93), and normal controls (NC) (n=77). MCI and AD groups had GCF scores significantly different from NC group, and GCF scores were able to distinguish patients with Clinical Dementia Rating of 0.5 and 1. Test-retest reliability was high, with a correlation coefficient of 0.918 for AD, 0.999 for MCI, and 0.960 for NC. The GCF score significantly correlated with the Mini-Mental State Examination (MMSE). Through ROC-curve analysis, GCF scores were found to yield more accurate diagnoses than the MMSE. The SNSB-D is a valid, reliable tool for assessing the overall cognitive function, and can be used to monitor cognitive changes in patients with dementia.

Language Profiles of Transcortical Aphasia

BACKGROUND: The term "transcortical aphasia" is applied to primary lesions not involving the receptive and expressive language areas, but rather the areas connected to the association cortex. By definition, patients with transcortical aphasia can repeat what they have heard, but they have difficulty producing spontaneous speech or understanding speech. This paper reports the clinical features of stroke patients with transcortical aphasia to delineate the language profiles of its subtypes. METHODS: Eighty patients with stroke were divided into three subtypes of transcortical aphasia: transcortical sensory aphasia, transcortical motor aphasia, and mixed transcortical aphasia. A Korean version of the Western Aphasia Battery was used to compare the subdomains of language ability among the three groups. RESULTS: The patients showed a relatively preserved repetition ability, but the performances in repetition and generative naming, and the aphasia quotient were highest in the transcortical sensory aphasic group, followed by the transcortical motor aphasic and mixed transcortical aphasic groups. CONCLUSIONS: The present study provides detailed information on the language profiles of the three subtypes of transcortical aphasia, which can be differentiated based on the aphasia quotient and generative naming scores.

The Effects of Meridian Massage on the Functions of upper Limbs and Depression of Hemiplegic Patients / 재활간호학회지

Meridian massage is originated from oriental medical manipulation, and it has been mainly applied to as pain and paralysis. The purpose was to develop new method of nursing care for help hemiplegic patients to recover their functions of upper limbs and to reduce depressions. This study was carried out between 8. March, and 8. June. 2000 and the subjects of the study were .60 hemiplegic stroke patients who were participants at a hospitalized in K oriental medical center. The experimental group(30) and the control group(30) were assigned by means of participation order. The experimental group took meridian massage on affected upper limb for 10 minutes daily for 2 weeks. We evaluated muscle power and endurance with band from AVIVA company.: range of motion with goniometer: shoulder pain with visual analogue scale: swelling with Jeweiers ring measurement of Dirette: depression with self-rating depression scale translated into Korean by Yang(1982). Data were analyzed by SPSS PC and the results are described below. The experimental group showed better muscle power and endurance than control group. Range of motiont of affected shoulder improved significantly in experimental group. Also, the experimental group showed less shoulder pain. hand edema. depression than control group. In this study, we observed that meridian massage is an effective nursing care in improving the function of upper limb and managing depression of stroke patients.