RESUMO
Accumulating evidence indicates action naming may rely more on frontal-subcortical circuits, and noun naming may rely more on temporal cortex. Therefore, noun versus action fluency might distinguish frontal and subcortical dementias from cortical dementias primarily affecting temporal and/or parietal cortex such as Alzheimer's disease (AD). We hypothesized patients with subcortical dementia, e.g., normal pressure hydrocephalus (NPH) and patients with dementias predominantly affecting frontal cortex, e.g., behavioral variant frontotemporal dementia (bv-FTD) and progressive nonfluent aphasia (PNFA) have more difficulty on action fluency versus noun fluency (e.g., animal naming). Patients with AD, who have temporo parietal cortical dysfunction, should have more difficulty on noun versus verb fluency. A total of 234 participants, including healthy controls (n = 20) and patients diagnosed with NPH (n =144), AD (n = 33), bv-FTD (n = 22) or PNFA (n =15) were administered animal fluency, action fluency, and letter fluency tasks, and the Mini-Mental State Examination (MMSE, to control for dementia severity). NPH and bv-FTD/PNFA patients had significantly higher MMSE scores and animal fluency than AD patients (after adjusting for age), but their action fluency tended to be lower than in AD. Only NPH and bvFTD/PNFA patients showed significantly lower action verb than animal fluency. Results provide novel evidence that action naming relies more on frontal-subcortical circuits while noun naming relies more on temporoparietal cortex, indicating action verb fluency may be more sensitive than noun fluency, particularly for detecting frontal-subcortical dysfunction.
Assuntos
Doença de Alzheimer/fisiopatologia , Demência/fisiopatologia , Demência Frontotemporal/fisiopatologia , Idioma , Desempenho Psicomotor/fisiologia , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rede Nervosa/fisiopatologia , Testes Neuropsicológicos , Comportamento Verbal/fisiologiaRESUMO
BACKGROUND AND PURPOSE: Diffusion-perfusion mismatch has been used to estimate salvageable tissue and predict potential for recovery in acute stroke. Location of the salvageable tissue may be as important as volume or percentage in predicting potential for recovery of specific functions. Impaired naming, a common and disabling deficit after left hemisphere stroke, is often associated with tissue dysfunction of left Brodmann area (BA) 37, posterior inferior temporal cortex. We tested the hypothesis that the presence of diffusion-perfusion mismatch within left BA 37 predicts probability and extent of short-term improvement of naming. METHODS: One hundred five patients with acute left hemisphere ischemic stroke had diffusion-weighted imaging, perfusion-weighted imaging, a test of picture naming, and other language tests at admission and 2 to 4 days later. Linear regression was used to determine whether diffusion-perfusion mismatch in any BA in language cortex, total volume of mismatch, or diffusion or perfusion abnormality predicted degree of improvement in naming by days 3 to 5. RESULTS: The presence of >20% diffusion-perfusion mismatch in left BA 37 and total volumes of diffusion and perfusion abnormality at day 1 each independently predicted degree of improvement in naming. Mismatch in this area did not predict the degree of improvement in other language tests or the NIH Stroke Scale in this study. CONCLUSIONS/RELEVANCE: Diffusion-perfusion mismatch in left Brodmann area 37 was strongly associated with acute improvement in naming, independently of volume or percentage of total mismatch or diffusion or perfusion abnormality. These data indicate that mismatch in a particular area is a marker of salvageable tissue and an important predictor of potential for recovery of functions that depend on that area. Location of mismatch before treatment may help to predict potential benefits of reperfusion.
Assuntos
Isquemia Encefálica/fisiopatologia , Imagem de Difusão por Ressonância Magnética/métodos , Recuperação de Função Fisiológica , Traumatismo por Reperfusão/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Afasia/fisiopatologia , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recuperação de Função Fisiológica/fisiologia , Traumatismo por Reperfusão/diagnóstico , Traumatismo por Reperfusão/patologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/patologia , Lobo Temporal/patologia , Lobo Temporal/fisiologiaRESUMO
1. The activities of phosphotyrosine, phosphothreonine and phosphoserine phosphatases were measured at various time periods in Friend murine erythroleukaemic (MEL) cells. 2. Effects of DMSO (dimethyl sulphoxide) and HMBA (hexamethylene bisacetamide), inducers of differentiation, were examined. 3. The activities of all three enzymes showed cyclic variation when measured on a daily basis over a period of several days; this was also the case when phosphothreonine phosphatase was determined in cells treated with DMSO or HMBA and when phosphoserine phosphatase was assayed after stimulation of the cells with HMBA. 4. Evidence for rhythmic variation in phosphotyrosine phosphatase activities was also obtained when the activities were determined at hourly intervals both in control cells and those treated with HMBA. 5. The time-dependent changes observed could be significant in that control of dephosphorylation may possibly be achieved by altering the rhythms.