Aphasia and related impairments pertaining to FTLD

Abstract

FTLD consists of three clinical types: behavioural variant FTD, progressive non-fluent aphasia (PNFA) and semantic dementia (SD). The latter two types manifest aphasia. Thus, it is quite important to pertinently assess the symptoms of aphasia and related impairments for diagnosis of FTLD. The most important point for diagnosis of PNFA is existence of anarthria/apraxia of speech, which is a focal symptom of the left prefrontal gyrus and underlying white matter. With the progression of the disease word generation and comprehension is deteriorating. SD shows Gogi aphasia when the lesion have predilection of left temporal lober atrophy. We investigated 28 patients without any antecedents causing speech/language impairments, who developed primary progressive aphasia. All the patients underwent a routine neurological and neuropsychological examinations and related symptoms such as orofacial apraxia, frontal lobe signs, dysphasia and so on were assessed. The results indicated that 20 patients were diagnosed as PNFA, and they were subdivided into three clinical groups. One group developed naming impairment and orofacial apraxia in several years after onset, and followed with various frontal symptoms. Another group showed anterior opereculum syndromes within two years after onset. The third group retained pure anarthria/apraxia of speech for many years without any other symptoms.