Distinct cerebral perfusion patterns and linguistic profiles in Alzheimer's disease-related primary progressive aphasia.

IF 2.7 4区 医学 Q2 CLINICAL NEUROLOGY
Kazuto Katsuse, Kazuo Kakinuma, Nobuko Kawakami, Shoko Ota, Nanayo Ogawa, Ai Kawamura, Chifumi Iseki, Masashi Hamada, Tatsushi Toda, Minoru Matsuda, Shigenori Kanno, Kyoko Suzuki
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Abstract

Alzheimer's disease (AD)-related primary progressive aphasia (PPA) exhibits considerable heterogeneity in clinical presentation and neuroimaging patterns. No studies have quantitatively assessed cerebral perfusion patterns or systematically evaluated the internal heterogeneity of linguistic and neuroimaging features in this population. This study aimed to investigate cerebral hypoperfusion patterns and elucidate their correlation with diverse linguistic features in patients with AD-related PPA using a data-driven approach. Eleven patients with AD-related PPA and 34 with non-AD-related PPA were categorized based on cerebrospinal fluid biomarkers, and their single-photon emission computed tomography (SPECT) data were analyzed. Cerebral hypoperfusion was assessed across 56 regions of interest (ROIs) covering the entire cerebral hemisphere. Sparse principal component (sPC) analysis was performed on the AD-related PPA group to identify distinct patterns of cerebral perfusion reduction and correlate these components with clinical assessments of linguistic abilities. AD-derived sPCs were identified, reflecting hypoperfusion patterns in the left temporoparietal, frontal, and temporal pole regions, corresponding to regions typically associated with logopenic, nonfluent, and semantic variants. In both AD-PPA and non-AD-PPA, the sPC corresponding to the anterior temporal region was associated with semantic comprehension deficits, whereas that corresponding to the frontal region was linked to nonfluent speech and Kana writing impairment. sPC-based hierarchical clustering revealed clusters corresponding to logopenic, nonfluent, and semantic variants, with the anomic subtype distinguished from logopenic PPA. AD-positive cases were distributed across these clusters, emphasizing AD-PPA heterogeneity. These findings suggested that AD-related PPA heterogeneity is reflected in distinct cerebral perfusion patterns, which correlate with varying linguistic deficits.

阿尔茨海默病相关原发性进行性失语症的不同脑灌注模式和语言特征
阿尔茨海默病(AD)相关的原发性进行性失语(PPA)在临床表现和神经影像学模式上表现出相当大的异质性。没有研究定量评估脑灌注模式或系统评估语言和神经影像学特征在这一人群中的内部异质性。本研究旨在通过数据驱动的方法研究ad相关PPA患者的脑灌注不足模式,并阐明其与多种语言特征的相关性。根据脑脊液生物标志物对11例ad相关PPA患者和34例非ad相关PPA患者进行分类,并对其单光子发射计算机断层扫描(SPECT)数据进行分析。对覆盖整个大脑半球的56个感兴趣区域(roi)进行脑灌注不足评估。对ad相关PPA组进行稀疏主成分(sPC)分析,以确定脑灌注减少的不同模式,并将这些成分与临床语言能力评估相关联。ad衍生的sPCs被识别出来,反映了左颞顶叶、额叶和颞极区域的灌注不足模式,对应于通常与语言缺失、不流畅和语义变异相关的区域。在AD-PPA和非AD-PPA中,对应于前颞区的sPC与语义理解缺陷有关,而对应于额叶区的sPC与不流利的言语和假名书写障碍有关。基于pc的分层聚类揭示了逻辑缺失、非流畅和语义变体对应的聚类,并将反常亚型与逻辑缺失PPA区分开来。ad阳性病例分布在这些集群中,强调AD-PPA的异质性。这些发现表明,ad相关的PPA异质性反映在不同的脑灌注模式中,这与不同的语言缺陷相关。
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来源期刊
Neurological Sciences
Neurological Sciences 医学-临床神经学
CiteScore
6.10
自引率
3.00%
发文量
743
审稿时长
4 months
期刊介绍: Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.
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