Objective

To assess longitudinal patterns of brain functional MRI (fMRI) activity in a case of prodromal semantic variant of a primary progressive aphasia (svPPA).

Methods

Clinical, cognitive and neuroimaging data (T1-weighted and task-based fMRI during silent naming [SN] and object knowledge [OK]) were obtained at baseline, month 8 and month 16 from a 49-year-old lady presenting with anomias and evolving to overt svPPA in 8 months.

Results

At baseline, the patient showed isolated anomias and mild left anterior temporal pole atrophy. During SN–fMRI, she showed bilateral temporal and left inferior frontal gyri (iFG) activations. During OK–fMRI, we observed normal performance and the recruitment of bilateral posterior hippocampi, iFG and left middle orbitofrontal gyrus (mOFG). At month 8, the patient received a diagnosis of svPPA and showed isolated right iFG activity during SN–fMRI, and a borderline performance during OK–fMRI together with a disappearance of mOFG recruitment. At the last visit (after 7-month language therapy), the patient showed a stabilization of naming disturbances, and, compared to previous visits, an increased left iFG recruitment during SN–fMRI. During OK–fMRI, she performed abnormally and did not show the activity of mOFG and iFG. Across all visits, brain atrophy remained stable.

Conclusions

This case report showed longitudinal fMRI patterns during semantic-related tasks from prodromal to overt svPPA. Frontal brain recruitment may represent a compensatory mechanism in patients with early svPPA, which is likely to be reinforced by language-therapy. Brain fMRI is more sensitive compared with structural MRI to detect progressive brain changes associated with disease and treatment.

中文翻译：

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早期功能性MRI改变在原发性进行性失语症的前驱性语义变异中：纵向病例报告。

目的

评估在原发进行性失语症（svPPA）的前驱语义变异的情况下脑功能MRI（fMRI）活动的纵向模式。

方法

临床，认知和神经影像学数据（在无声命名[SN]和对象知识[OK]期间进行T1加权和基于任务的功能性核磁共振成像）是在基线，第8和16个月从一位出现了厌食症的49岁女士那里获得的。在8个月内演变为公开的svPPA。

结果

在基线时，患者表现出孤立的异常和轻度的左颞颞前极萎缩。在SN-fMRI期间，她表现出双侧颞叶和左下额回（iFG）激活。在OK-fMRI期间，我们观察到正常表现以及双侧后海马，iFG和左中眶额回（mOFG）的募集。在第8个月，患者被诊断为svPPA，在SN-fMRI期间表现出孤立的正确iFG活动，在OK-fMRI期间表现出临界状态，而mOFG募集消失。在最后一次访视时（7个月的语言治疗后），患者表现出命名障碍的稳定，并且与以前的访视相比，在SN-fMRI期间左iFG募集增加。在OK-fMRI期间，她表现异常，未显示mOFG和iFG的活性。在所有造访中

结论

该病例报告显示了从前驱性到公开svPPA的语义相关任务期间的纵向功能磁共振成像模式。额叶大脑募集可能代表早期svPPA患者的一种补偿机制，而语言疗法可能会增强这种机制。与结构MRI相比，脑功能磁共振成像对检测与疾病和治疗相关的进行性脑部改变的敏感性更高。