Background

Primary progressive aphasia (PPA) is a clinical syndrome including a group of neurodegenerative disorders that present with language impairment. We hypothesised that impairment in reading prosody may be present in a subgroup of patients with PPA, and particularly non-fluent PPA (nfvPPA), because of the impairment of key brain regions involved in the pathophysiology of speech dysprosody and reading observed in these patients.

Methods

Ninety-five participants were evaluated using a narrative text comprising several declarative, exclamatory, and interrogative sentences, as well as a comprehensive language protocol. Patients were also examined with ¹⁸F-fluorodeoxyglucose positron emission tomography imaging.

Results

Impairment was more frequent and more severe in patients with nfvPPA, especially in the subgroup of patients with Apraxia of Speech (AOS). Patients with nfvPPA, mainly those with AOS, showed lower values in several pitch variables. Statistically significant differences were also observed in sentence duration, reading times, and types of error. A regression model including mean length of utterances, time after full stops, number of pauses, and number of pitch variables below the mean, correctly classified 70–71.3% of patients. When combined with sentence repetition task, the percentage of patients correctly classified was 96.2% and 92.4%, respectively, for each classification. The left frontal lobe was the region most strongly correlated with reading prosody parameters. Specific tasks displayed additional correlations with the left parietal and occipital lobes; right frontal lobe, thalamus, and caudate; and right cerebellum.

Conclusion

Reading prosody is relevant in PPA diagnosis and classification. Because reading prosody may be quantified, it is amenable to use in diagnosis and follow-up. We found neuroimaging correlation with metabolism in the left frontal lobe, as well as in other regions including the right frontal lobe, basal ganglia, and cerebellum, which suggests that these may be the main brain regions involved in prosodic control in patients with PPA.

中文翻译：

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原发进行性失语症的非流利型和低语型阅读韵律。

背景

原发性进行性失语症（PPA）是一种临床综合征，包括出现语言障碍的一组神经退行性疾病。我们假设PPA患者，尤其是非流利PPA（nfvPPA）患者的亚组中可能存在阅读韵律障碍，这是由于这些患者的言语障碍和阅读病理生理学中涉及的关键大脑区域受损。

方法

评估了95名参与者的叙述性文本，其中包括几个陈述性，感叹性和疑问句，以及全面的语言协议。还对患者进行了¹⁸ F-氟脱氧葡萄糖正电子发射断层显像检查。

结果

nfvPPA患者尤其是言语失用症（AOS）患者亚组中，损伤更为频繁且更为严重。患有nfvPPA的患者（主要是患有AOS的患者）在多个音调变量中显示出较低的值。在句子持续时间，阅读时间和错误类型上也观察到统计学上的显着差异。包括平均发声时长，完全停止后的时间，暂停次数以及音调变量低于平均值的回归模型，正确地将70-71.3％的患者分类。当结合句子重复任务时，正确分类的患者百分比分别为96.2％和92.4％。左额叶是与阅读韵律参数最相关的区域。具体任务显示出与左顶叶和枕叶的其他相关性。右额叶，丘脑和尾状；和右小脑。

结论

阅读韵律与PPA的诊断和分类有关。由于阅读韵律可以量化，因此可用于诊断和随访。我们发现左额叶以及其他区域（包括右额叶，基底神经节和小脑）的代谢与神经成像相关，这表明这些可能是PPA患者进行韵律控制的主要大脑区域。