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Kim YS, Kim YE, Choung YH, Kim H, Kim HJ, Jung NY, Lee SM, Kim EJ, Moon SY. Pearls & Oy-sters: Familial Verbal Auditory Agnosia Due to C9orf72 Repeat Expansion. Neurology 2023; 101:e2046-e2050. [PMID: 37648532 PMCID: PMC10662987 DOI: 10.1212/wnl.0000000000207832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/19/2023] [Indexed: 09/01/2023] Open
Abstract
Chromosome 9 open reading frame 72 (C9orf72) gene pathogenic variants have been typically associated with frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), but recent studies suggest their involvement in other disorders. This report describes a family with an autosomal dominant pattern of inheritance of progressive verbal auditory agnosia due to GGGGCC repeat expansion in C9orf72. A 60-year-old right-handed male truck driver presented with slowly progressive poor speech perception for 8 years, which became most troublesome when receiving verbal orders over the phone. He had difficulty recognizing single-syllable spoken words beyond his hearing loss but had no problem understanding complex written language. He had a heterozygous pathogenic variant carrying 160 hexanucleotide repeats in the C9orf72 gene. His family history included his deceased mother with similar symptoms that had progressed over 30 years, as well as his older brother and youngest sister who experienced speech perception difficulty beginning in their early fifties. His asymptomatic younger brother had a heterozygous 2 repeat in the C9orf72 gene, while his symptomatic youngest sister had a heterozygous 159 repeat. The patient and his sister exhibited more pronounced cortical thinning in the frontotemporoparietal areas. The discrepancy observed between the distribution of atrophy and the presentation of symptoms in patients with C9orf72 pathogenic repeat expansion may be attributable to the slow progression of their clinical course over time. The variable symptom presentation of C9orf72 pathogenic repeat expansion highlights the importance of considering this pathogenic variant as a potential cause of autosomal dominant degenerative brain diseases beyond FTD and ALS.
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Affiliation(s)
- Yoon Seob Kim
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Young-Eun Kim
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Yun-Hoon Choung
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Hwajung Kim
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Hee Jin Kim
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Na-Yeon Jung
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Sun Min Lee
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Eun-Joo Kim
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - So Young Moon
- From the Departments of Neurology (Y.S.K., H.K., S.M.L., S.Y.M.) and Otolaryngology (Y.-H.C.), Ajou University School of Medicine, Suwon; Department of Laboratory Medicine (Y.-E.K.), Hanyang University College of Medicine, Seoul; Department of Neurology (H.J.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology; and Department of Neurology (E.-J.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea.
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Miceli G, Caccia A. The Auditory Agnosias: a Short Review of Neurofunctional Evidence. Curr Neurol Neurosci Rep 2023; 23:671-679. [PMID: 37747655 PMCID: PMC10673750 DOI: 10.1007/s11910-023-01302-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE OF REVIEW To investigate the neurofunctional correlates of pure auditory agnosia and its varieties (global, verbal, and nonverbal), based on 116 anatomoclinical reports published between 1893 and 2022, with emphasis on hemispheric lateralization, intrahemispheric lesion site, underlying cognitive impairments. RECENT FINDINGS Pure auditory agnosia is rare, and observations accumulate slowly. Recent patient reports and neuroimaging studies on neurotypical subjects offer insights into the putative mechanisms underlying auditory agnosia, while challenging traditional accounts. Global auditory agnosia frequently results from bilateral temporal damage. Verbal auditory agnosia strictly correlates with language-dominant hemisphere lesions. Damage involves the auditory pathways, but the critical lesion site is unclear. Both the auditory cortex and associative areas are reasonable candidates, but cases resulting from brainstem damage are on record. The hemispheric correlates of nonverbal auditory input disorders are less clear. They correlate with unilateral damage to either hemisphere, but evidence is scarce. Based on published cases, pure auditory agnosias are neurologically and functionally heterogeneous. Phenotypes are influenced by co-occurring cognitive impairments. Future studies should start from these facts and integrate patient data and studies in neurotypical individuals.
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Affiliation(s)
- Gabriele Miceli
- Professor of Neurology, Center for Mind/Brain Studies, University of Trento, Trento, Italy.
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Silva G, Gonçalves R, Taveira I, Mouzinho M, Osório R, Nzwalo H. Stroke-Associated Cortical Deafness: A Systematic Review of Clinical and Radiological Characteristics. Brain Sci 2021; 11:1383. [PMID: 34827382 PMCID: PMC8615419 DOI: 10.3390/brainsci11111383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/14/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Stroke is the leading cause of cortical deafness (CD), the most severe form of central hearing impairment. CD remains poorly characterized and perhaps underdiagnosed. We perform a systematic review to describe the clinical and radiological features of stroke-associated CD. METHODS PubMed and the Web of Science databases were used to identify relevant publications up to 30 June 2021 using the MeSH terms: "deafness" and "stroke", or "hearing loss" and "stroke" or "auditory agnosia" and "stroke". RESULTS We found 46 cases, caused by bilateral lesions within the central auditory pathway, mostly located within or surrounding the superior temporal lobe gyri and/or the Heschl's gyri (30/81%). In five (13.51%) patients, CD was caused by the subcortical hemispheric and in two (0.05%) in brainstem lesions. Sensorineural hearing loss was universal. Occasionally, a misdiagnosis by peripheral or psychiatric disorders occurred. A few (20%) had clinical improvement, with a regained oral conversation or evolution to pure word deafness (36.6%). A persistent inability of oral communication occurred in 43.3%. A full recovery of conversation was restricted to patients with subcortical lesions. CONCLUSIONS Stroke-associated CD is rare, severe and results from combinations of cortical and subcortical lesions within the central auditory pathway. The recovery of functional hearing occurs, essentially, when caused by subcortical lesions.
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Affiliation(s)
- Gracinda Silva
- Faculty of Medicine and Biomedical Sciences, Campus de Gambelas, University of Algarve, 8005-139 Faro, Portugal; (G.S.); (M.M.); (R.O.)
| | - Rita Gonçalves
- Southern Physical Medicine and Rehabilitation Center, University Hospital Center of Algarve, 8150-022 São Brás de Alportel, Portugal;
| | - Isabel Taveira
- Intensive Care Unit, University Hospital Center of Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal;
| | - Maria Mouzinho
- Faculty of Medicine and Biomedical Sciences, Campus de Gambelas, University of Algarve, 8005-139 Faro, Portugal; (G.S.); (M.M.); (R.O.)
| | - Rui Osório
- Faculty of Medicine and Biomedical Sciences, Campus de Gambelas, University of Algarve, 8005-139 Faro, Portugal; (G.S.); (M.M.); (R.O.)
- Stroke Unit, University Hospital Center of Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal
| | - Hipólito Nzwalo
- Faculty of Medicine and Biomedical Sciences, Campus de Gambelas, University of Algarve, 8005-139 Faro, Portugal; (G.S.); (M.M.); (R.O.)
- Stroke Unit, University Hospital Center of Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal
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