Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies
IntroductionThis study aimed to determine the characteristics of aphasic mild cognitive impairment (aphasic MCI), which is characterized by a progressive and relatively prominent language impairment compared with other cognitive impairments, in the prodromal phase of dementia with Lewy bodies (DLB)....
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-04-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1128566/full |
| _version_ | 1797854159866691584 |
|---|---|
| author | Hiroyuki Watanabe Hiroyuki Watanabe Hiroyuki Watanabe Sakura Hikida Sakura Hikida Manabu Ikeda Manabu Ikeda Etsuro Mori Etsuro Mori |
| author_facet | Hiroyuki Watanabe Hiroyuki Watanabe Hiroyuki Watanabe Sakura Hikida Sakura Hikida Manabu Ikeda Manabu Ikeda Etsuro Mori Etsuro Mori |
| author_sort | Hiroyuki Watanabe |
| collection | DOAJ |
| description | IntroductionThis study aimed to determine the characteristics of aphasic mild cognitive impairment (aphasic MCI), which is characterized by a progressive and relatively prominent language impairment compared with other cognitive impairments, in the prodromal phase of dementia with Lewy bodies (DLB).MethodsOf the 26 consecutive patients with aphasic MCI who had been prospectively recruited at our hospital, 8 patients were diagnosed with prodromal DLB and underwent language, neurological, neuropsychological, and neuroimaging (N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography; IMP-SPECT) testing. Three of these patients also underwent cholinesterase inhibitor therapy with donepezil.ResultsIn our aphasic MCI cohort, the clinical diagnosis of probable prodromal DLB accounted for more than 30% of cases; therefore, the presence of language impairment in prodromal DLB was not very uncommon. Five patients were diagnosed with progressive anomic aphasia and three with logopenic progressive aphasia. Anomic aphasia was characterized by apparent anomia but relatively preserved repetition and comprehension ability and logopenic progressive aphasia by anomia, phonemic paraphasia, and impaired repetition. IMP-SPECT revealed hypoperfusion of the temporal and parietal lobes in the left hemisphere in all but one patient. All patients who underwent cholinesterase inhibitor therapy with donepezil showed improvement in general cognitive function, including language function.DiscussionThe clinical and imaging features of aphasic MCI in prodromal DLB are similar to those observed in Alzheimer's disease. Progressive fluent aphasia, such as progressive anomic aphasia and logopenic progressive aphasia, is one of the clinical presentations in prodromal state of DLB. Our findings provide further insight into the clinical spectrum of prodromal DLB and may contribute to the development of medication for progressive aphasia caused by cholinergic insufficiency. |
| first_indexed | 2024-04-09T20:02:24Z |
| format | Article |
| id | doaj.art-c15337b45c694d8e84d3fc8e3ae5630b |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T20:02:24Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-c15337b45c694d8e84d3fc8e3ae5630b2023-04-03T04:22:05ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11285661128566Aphasic mild cognitive impairment in prodromal dementia with Lewy bodiesHiroyuki Watanabe0Hiroyuki Watanabe1Hiroyuki Watanabe2Sakura Hikida3Sakura Hikida4Manabu Ikeda5Manabu Ikeda6Etsuro Mori7Etsuro Mori8Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, JapanDepartment of Psychiatry, Osaka University Graduate School of Medicine, Suita, JapanBrain Function Center, Nippon Life Hospital, Osaka, JapanDepartment of Psychiatry, Osaka University Graduate School of Medicine, Suita, JapanBrain Function Center, Nippon Life Hospital, Osaka, JapanDepartment of Psychiatry, Osaka University Graduate School of Medicine, Suita, JapanBrain Function Center, Nippon Life Hospital, Osaka, JapanDepartment of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, JapanBrain Function Center, Nippon Life Hospital, Osaka, JapanIntroductionThis study aimed to determine the characteristics of aphasic mild cognitive impairment (aphasic MCI), which is characterized by a progressive and relatively prominent language impairment compared with other cognitive impairments, in the prodromal phase of dementia with Lewy bodies (DLB).MethodsOf the 26 consecutive patients with aphasic MCI who had been prospectively recruited at our hospital, 8 patients were diagnosed with prodromal DLB and underwent language, neurological, neuropsychological, and neuroimaging (N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography; IMP-SPECT) testing. Three of these patients also underwent cholinesterase inhibitor therapy with donepezil.ResultsIn our aphasic MCI cohort, the clinical diagnosis of probable prodromal DLB accounted for more than 30% of cases; therefore, the presence of language impairment in prodromal DLB was not very uncommon. Five patients were diagnosed with progressive anomic aphasia and three with logopenic progressive aphasia. Anomic aphasia was characterized by apparent anomia but relatively preserved repetition and comprehension ability and logopenic progressive aphasia by anomia, phonemic paraphasia, and impaired repetition. IMP-SPECT revealed hypoperfusion of the temporal and parietal lobes in the left hemisphere in all but one patient. All patients who underwent cholinesterase inhibitor therapy with donepezil showed improvement in general cognitive function, including language function.DiscussionThe clinical and imaging features of aphasic MCI in prodromal DLB are similar to those observed in Alzheimer's disease. Progressive fluent aphasia, such as progressive anomic aphasia and logopenic progressive aphasia, is one of the clinical presentations in prodromal state of DLB. Our findings provide further insight into the clinical spectrum of prodromal DLB and may contribute to the development of medication for progressive aphasia caused by cholinergic insufficiency.https://www.frontiersin.org/articles/10.3389/fneur.2023.1128566/fullLewy body diseaseAlzheimer's diseasemild cognitive impairmentprimary progressive aphasiacholinesterase inhibitor |
| spellingShingle | Hiroyuki Watanabe Hiroyuki Watanabe Hiroyuki Watanabe Sakura Hikida Sakura Hikida Manabu Ikeda Manabu Ikeda Etsuro Mori Etsuro Mori Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies Frontiers in Neurology Lewy body disease Alzheimer's disease mild cognitive impairment primary progressive aphasia cholinesterase inhibitor |
| title | Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies |
| title_full | Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies |
| title_fullStr | Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies |
| title_full_unstemmed | Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies |
| title_short | Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies |
| title_sort | aphasic mild cognitive impairment in prodromal dementia with lewy bodies |
| topic | Lewy body disease Alzheimer's disease mild cognitive impairment primary progressive aphasia cholinesterase inhibitor |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1128566/full |
| work_keys_str_mv | AT hiroyukiwatanabe aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT hiroyukiwatanabe aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT hiroyukiwatanabe aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT sakurahikida aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT sakurahikida aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT manabuikeda aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT manabuikeda aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT etsuromori aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies AT etsuromori aphasicmildcognitiveimpairmentinprodromaldementiawithlewybodies |