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Garcia-Guaqueta DP, Botha H, Utianski RL, Duffy JR, Clark H, Meade G, Machulda MM, Dickson DW, Pham NTT, Whitwell JL, Josephs KA. Clinicopathologic and Neuroimaging Correlations of Nonverbal Oral Apraxia in Patients With Neurodegenerative Disease. Neurology 2024; 103:e209717. [PMID: 39079070 PMCID: PMC11286287 DOI: 10.1212/wnl.0000000000209717] [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: 01/30/2024] [Accepted: 05/31/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Nonverbal oral apraxia (NVOA) is the inability to plan, sequence, and execute voluntary oromotor movements in the absence of weakness. In the context of neurodegenerative disease, it remains unclear whether it is linked to a specific underlying pathologic, clinical, or neuroimaging finding. Thus, we aimed to assess the clinicopathologic and neuroimaging associations of NVOA. METHODS We conducted a retrospective study of autopsy-confirmed patients previously assessed through an NVOA evaluation tool with a previously published cutpoint to screen for NVOA. We compared demographic and clinical characteristics and postmortem pathology between those who developed NVOA and those who did not. We also compared clinicopathologic characteristics in mild vs greater than mild NVOA and early vs late-emerging NVOA. SPM12 was used to assess patterns of gray matter loss in NVOA vs non-NVOA with age and sex included as covariates. RESULTS A total of 104 patients (median age at symptom onset 63 years, 43% female) were included in the study. 63 (60.6%) developed NVOA. NVOA appeared at a median of 4.3 years from symptom onset. 29% developed NVOA within the first 3 years. Primary progressive apraxia of speech and the nonfluent variant of primary progressive aphasia were the most common baseline diagnoses in the NVOA group while progressive supranuclear palsy (PSP) syndrome and logopenic progressive aphasia (LPA) were the most common in patients without NVOA. Atrophy of the left lateral and medial posterior frontal cortex was related to NVOA. The most common pathologies associated with NVOA were PSP (36.5%) and corticobasal degeneration (CBD) (33.3%). In patients without NVOA, PSP (26.8%) and other pathologies (26.8%) were the most frequent. 11% of patients with NVOA had persistently mild NVOA and were more likely to have baseline diagnoses of LPA, PSP syndrome, or semantic dementia. The most frequent pathologies in this group were Alzheimer disease and PSP. The pathologic associations of greater than mild NVOA were CBD and PSP. DISCUSSION NVOA is present in several clinical syndromes. It is most associated with PSP and CBD. NVOA is a manifestation of left lateral and medial posterior frontal cortex damage rather than a particular pathology.
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Affiliation(s)
- Danna P Garcia-Guaqueta
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Hugo Botha
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Rene L Utianski
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Joseph R Duffy
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Heather Clark
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Gabriela Meade
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Mary M Machulda
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Dennis W Dickson
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Nha Trang Thu Pham
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Jennifer L Whitwell
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
| | - Keith A Josephs
- From the Department of Neurology (D.P.G.-G., H.B., R.L.U., J.R.D., H.C., G.M., K.A.J.), and Department of Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; Department of Neuroscience (Neuropathology) (D.W.D.), Mayo Clinic, Jacksonville, FL; and Department of Radiology (N.T.T.P., J.L.W.), Mayo Clinic, Rochester, MN
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Badihian N, Gatto RG, Satoh R, Ali F, Clark HM, Pham NTT, Whitwell JL, Josephs KA. Clinical and neuroimaging characteristics of primary lateral sclerosis with overlapping features of progressive supranuclear palsy. Eur J Neurol 2024; 31:e16320. [PMID: 38686979 PMCID: PMC11227385 DOI: 10.1111/ene.16320] [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] [Received: 02/14/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND PURPOSE Primary lateral sclerosis (PLS) is a neurodegenerative disorder that primarily affects the central motor system. In rare cases, clinical features of PLS may overlap with those of progressive supranuclear palsy (PSP). We investigate neuroimaging features that can help distinguish PLS with overlapping features of PSP (PLS-PSP) from PSP. METHODS Six patients with PLS-PSP were enrolled between 2019 and 2023. We compared their clinical and neuroimaging characteristics with 18 PSP-Richardson syndrome (PSP-RS) patients and 20 healthy controls. Magnetic resonance imaging, 18F-flortaucipir positron emission tomography (PET), quantitative susceptibility mapping, and diffusion tensor imaging tractography (DTI) were performed to evaluate eight brain regions of interest. Area under the receiver operating characteristic curve (AUROC) was calculated. RESULTS Five of the six PLS-PSP patients (83.3%) were male. Median age at symptom onset was 61.5 (52.5-63) years, and all had mixed features of PLS and PSP. Volumes of the pallidum, caudate, midbrain, and cerebellar dentate were smaller in PSP-RS than PLS-PSP, providing good discrimination (AUROC = 0.75 for all). The susceptibilities in pallidum, midbrain, and cerebellar dentate were greater in PSP-RS compared to PLS-PSP, providing excellent discrimination (AUROC ≥ 0.90 for all). On DTI, fractional anisotropy (FA) in the posterior limb of the internal capsule from the corticospinal tract was lower in PLS-PSP compared to PSP-RS (AUROC = 0.86), but FA in the superior cerebellar peduncle was lower in PSP-RS (AUROC = 0.95). Pallidum flortaucipir PET uptake was greater in PSP-RS compared to PLS-PSP (AUROC = 0.74). CONCLUSIONS Regional brain volume, tractography, and magnetic susceptibility, but not tau-PET, are useful in distinguishing PLS-PSP from PSP.
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Affiliation(s)
| | | | - Ryota Satoh
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Farwa Ali
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
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Langerscheidt F, Wied T, Al Kabbani MA, van Eimeren T, Wunderlich G, Zempel H. Genetic forms of tauopathies: inherited causes and implications of Alzheimer's disease-like TAU pathology in primary and secondary tauopathies. J Neurol 2024; 271:2992-3018. [PMID: 38554150 PMCID: PMC11136742 DOI: 10.1007/s00415-024-12314-3] [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] [Received: 01/25/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/01/2024]
Abstract
Tauopathies are a heterogeneous group of neurologic diseases characterized by pathological axodendritic distribution, ectopic expression, and/or phosphorylation and aggregation of the microtubule-associated protein TAU, encoded by the gene MAPT. Neuronal dysfunction, dementia, and neurodegeneration are common features of these often detrimental diseases. A neurodegenerative disease is considered a primary tauopathy when MAPT mutations/haplotypes are its primary cause and/or TAU is the main pathological feature. In case TAU pathology is observed but superimposed by another pathological hallmark, the condition is classified as a secondary tauopathy. In some tauopathies (e.g. MAPT-associated frontotemporal dementia (FTD), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and Alzheimer's disease (AD)) TAU is recognized as a significant pathogenic driver of the disease. In many secondary tauopathies, including Parkinson's disease (PD) and Huntington's disease (HD), TAU is suggested to contribute to the development of dementia, but in others (e.g. Niemann-Pick disease (NPC)) TAU may only be a bystander. The genetic and pathological mechanisms underlying TAU pathology are often not fully understood. In this review, the genetic predispositions and variants associated with both primary and secondary tauopathies are examined in detail, assessing evidence for the role of TAU in these conditions. We highlight less common genetic forms of tauopathies to increase awareness for these disorders and the involvement of TAU in their pathology. This approach not only contributes to a deeper understanding of these conditions but may also lay the groundwork for potential TAU-based therapeutic interventions for various tauopathies.
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Affiliation(s)
- Felix Langerscheidt
- Institute of Human Genetics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931, Cologne, Germany
| | - Tamara Wied
- Institute of Human Genetics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931, Cologne, Germany
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, Von-Liebig-Str. 20, 53359, Rheinbach, Germany
| | - Mohamed Aghyad Al Kabbani
- Institute of Human Genetics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931, Cologne, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Gilbert Wunderlich
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Center for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany
| | - Hans Zempel
- Institute of Human Genetics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931, Cologne, Germany.
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931, Cologne, Germany.
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Koga S, Martin NB, Dickson DW. Evaluating the performance of large language models: ChatGPT and Google Bard in generating differential diagnoses in clinicopathological conferences of neurodegenerative disorders. Brain Pathol 2024; 34:e13207. [PMID: 37553205 PMCID: PMC11006994 DOI: 10.1111/bpa.13207] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
This study explores the utility of the large language models (LLMs), specifically ChatGPT and Google Bard, in predicting neuropathologic diagnoses from clinical summaries. A total of 25 cases of neurodegenerative disorders presented at Mayo Clinic brain bank Clinico-Pathological Conferences were analyzed. The LLMs provided multiple pathologic diagnoses and their rationales, which were compared with the final clinical diagnoses made by physicians. ChatGPT-3.5, ChatGPT-4, and Google Bard correctly made primary diagnoses in 32%, 52%, and 40% of cases, respectively, while correct diagnoses were included in 76%, 84%, and 76% of cases, respectively. These findings highlight the potential of artificial intelligence tools like ChatGPT in neuropathology, suggesting they may facilitate more comprehensive discussions in clinicopathological conferences.
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Affiliation(s)
- Shunsuke Koga
- Department of NeuroscienceMayo ClinicJacksonvilleFloridaUSA
- Present address:
Department of Pathology and Laboratory MedicineHospital of the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Yuan Y, Mao X, Pan X, Zhang R, Su W. Kinetic Ensemble of Tau Protein through the Markov State Model and Deep Learning Analysis. J Chem Theory Comput 2024; 20:2947-2958. [PMID: 38501645 DOI: 10.1021/acs.jctc.3c01211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
The ordered assembly of Tau protein into filaments characterizes Alzheimer's and other neurodegenerative diseases, and thus, stabilization of Tau protein is a promising avenue for tauopathies therapy. To dissect the underlying aggregation mechanisms on Tau, we employ a set of molecular simulations and the Markov state model to determine the kinetics of ensemble of K18. K18 is the microtubule-binding domain of Tau protein and plays a vital role in the microtubule assembly, recycling processes, and amyloid fibril formation. Here, we efficiently explore the conformation of K18 with about 150 μs lifetimes in silico. Our results observe that all four repeat regions (R1-R4) are very dynamic, featuring frequent conformational conversion and lacking stable conformations, and the R2 region is more flexible than the R1, R3, and R4 regions. Additionally, it is worth noting that residues 300-310 in R2-R3 and residues 319-336 in R3 tend to form sheet structures, indicating that K18 has a broader functional role than individual repeat monomers. Finally, the simulations combined with Markov state models and deep learning reveal 5 key conformational states along the transition pathway and provide the information on the microsecond time scale interstate transition rates. Overall, this study offers significant insights into the molecular mechanism of Tau pathological aggregation and develops novel strategies for both securing tauopathies and advancing drug discovery.
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Affiliation(s)
- Yongna Yuan
- School of Information Science & Engineering, Lanzhou University, South Tianshui Road, Lanzhou 730000, Gansu, China
| | - Xuqi Mao
- School of Information Science & Engineering, Lanzhou University, South Tianshui Road, Lanzhou 730000, Gansu, China
| | - Xiaohang Pan
- School of Information Science & Engineering, Lanzhou University, South Tianshui Road, Lanzhou 730000, Gansu, China
| | - Ruisheng Zhang
- School of Information Science & Engineering, Lanzhou University, South Tianshui Road, Lanzhou 730000, Gansu, China
| | - Wei Su
- School of Information Science & Engineering, Lanzhou University, South Tianshui Road, Lanzhou 730000, Gansu, China
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Josephs KA, Josephs KA. Prosopagnosia: face blindness and its association with neurological disorders. Brain Commun 2024; 6:fcae002. [PMID: 38419734 PMCID: PMC10901275 DOI: 10.1093/braincomms/fcae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/25/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
Loss of facial recognition or prosopagnosia has been well-recognized for over a century. It has been categorized as developmental or acquired depending on whether the onset is in early childhood or beyond, and acquired cases can have degenerative or non-degenerative aetiologies. Prosopagnosia has been linked to involvement of the fusiform gyri, mainly in the right hemisphere. The literature on prosopagnosia comprises case reports and small case series. We aim to assess demographic, clinical and imaging characteristics and neurological and neuropathological disorders associated with a diagnosis of prosopagnosia in a large cohort. Patients were categorized as developmental versus acquired; those with acquired prosopagnosia were further subdivided into degenerative versus non-degenerative, based on neurological aetiology. We assessed regional involvement on [18F] fluorodeoxyglucose-PET and MRI of the right and left frontal, temporal, parietal and occipital lobes. The Intake and Referral Center at the Mayo Clinic identified 487 patients with possible prosopagnosia, of which 336 met study criteria for probable or definite prosopagnosia. Ten patients, 80.0% male, had developmental prosopagnosia including one with Niemann-Pick type C and another with a forkhead box G1 gene mutation. Of the 326 with acquired prosopagnosia, 235 (72.1%) were categorized as degenerative, 91 (27.9%) as non-degenerative. The most common degenerative diagnoses were posterior cortical atrophy, primary prosopagnosia syndrome, Alzheimer's disease dementia and semantic dementia, with each diagnosis accounting for >10% of this group. The most common non-degenerative diagnoses were infarcts (ischaemic and haemorrhagic), epilepsy-related and primary brain tumours, each accounting for >10%. We identified a group of patients with non-degenerative transient prosopagnosia in which facial recognition loss improved or resolved over time. These patients had migraine-related prosopagnosia, posterior reversible encephalopathy syndrome, delirium, hypoxic encephalopathy and ischaemic infarcts. On [18F] fluorodeoxyglucose-PET, the temporal lobes proved to be the most frequently affected regions in 117 patients with degenerative prosopagnosia, while in 82 patients with non-degenerative prosopagnosia, MRI revealed the right temporal and right occipital lobes as most affected by a focal lesion. The most common pathological findings in those with degenerative prosopagnosia were frontotemporal lobar degeneration with hippocampal sclerosis and mixed Alzheimer's and Lewy body disease pathology. In this large case series of patients diagnosed with prosopagnosia, we observed that facial recognition loss occurs across a wide range of acquired degenerative and non-degenerative neurological disorders, most commonly in males with developmental prosopagnosia. The right temporal and occipital lobes, and connecting fusiform gyrus, are key areas. Multiple different pathologies cause degenerative prosopagnosia.
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Affiliation(s)
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
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Nakamura K, Kuroha Y, Hatakeyama M, Kimura AM, Nakamura Y, Murakami Y, Watanabe M, Igarashi H, Takahashi T, Shimada H. Corticobasal syndrome mimicking Foix-Chavany-Marie syndrome with suggested 4-repeat tauopathy by tau PET. BMC Geriatr 2023; 23:838. [PMID: 38087192 PMCID: PMC10714444 DOI: 10.1186/s12877-023-04564-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Corticobasal syndrome (CBS) is a neurodegenerative disease diagnosed based on clinical manifestations such as asymmetrical parkinsonism, limb apraxia, and speech and language impairment. The background pathology of CBS is commonly a variety of proteinopathies, but association with cerebrovascular disease has also been reported. Foix-Chavany-Marie syndrome (FCMS) is a rare neurological disorder characterized by facio-pharyngo-glossal diplegia with automatic-voluntary movement dissociation presenting with bilateral paresis of the facial, lingual, pharyngeal and masticatory muscles. FCMS is commonly attributable to stroke. Transactive response DNA binding protein of 43 kD (TDP-43) proteinopathy is also known as the pathological background of FCMS, while the pathological background of the majority of CBS cases consists of diverse tauopathies instead of TDP-43 proteinopathy. In this report, we describe a case mimicking FCMS that was finally diagnosed as CBS with suggested 4-repeat tauopathy. CASE PRESENTATION A 68-year-old female started experiencing difficulty speaking followed by difficulty writing, and especially texting, several years before her visit. Her impairment had been gradually worsening, and she came to our hospital. On neurological examination, she demonstrated the facial apraxia, frontal lobe dysfunction, and upper motor neuron signs. She presented some characteristics suggestive of FCMS. Her symptoms exhibited rapid progression and myoclonus, parkinsonism, and left-side dominant cortical sensory deficit occurred, resulting in the fulfillment of diagnostic criteria for CBS after 9 months. Tau PET imaging displayed notable ligand uptake in the brainstem, subthalamic nuclei, basal ganglia, and bilateral subcortical frontal lobe, suggesting that her pathological background was 4-repeat tauopathy. As a result of her progressive dysphagia, she became unable to eat and passed away after 12 months. CONCLUSION We hereby present an atypical case of CBS showing clinical features mimicking FCMS at first presentation. TDP-43 proteinopathy was suspected based on the clinical symptoms in the early stages of the disease; however, the clinical course and imaging findings including tau PET suggested that her pathological background was 4-repeat tauopathy.
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Affiliation(s)
- Kosei Nakamura
- Department of Neurology, Clinical Neuroscience Branch, Brain Research Institute, Niigata University, Niigata, Japan
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Yasuko Kuroha
- Department of Neurology, NHO Nishiniigata Chuo Hospital, Niigata, Japan
| | - Masahiro Hatakeyama
- Department of Neurology, Clinical Neuroscience Branch, Brain Research Institute, Niigata University, Niigata, Japan
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Atsushi Michael Kimura
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Yukimi Nakamura
- Department of Integrated Neuroscience, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yoshihiro Murakami
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Masaki Watanabe
- Department of Biological Magnetic Resonance, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hironaka Igarashi
- Department of Biological Magnetic Resonance, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Tetsuya Takahashi
- Department of Neurology, NHO Nishiniigata Chuo Hospital, Niigata, Japan
| | - Hitoshi Shimada
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan.
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan.
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Hoag T, Koga S, Dickson DW, Kumar R. Globular glial tauopathy presenting clinically as atypical parkinsonism with dementia: A clinicopathological case report. Clin Park Relat Disord 2023; 9:100210. [PMID: 37521817 PMCID: PMC10372361 DOI: 10.1016/j.prdoa.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
•Globular Glial Tauopathy presents as atypical parkinsonism with dementia.•Globular Glial Tauopathy is underrecognized among movement disorders specialists.•Globular Glial Tauopathy type III without preferential language dysfunction or semantic dementia.
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Affiliation(s)
- Thomas Hoag
- Rocky Mountain Movement Disorders Center, 701 E Hampden Ave Ste 510, Englewood, CO 80113, United States
| | - Shunsuke Koga
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States
| | - Dennis W. Dickson
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States
| | - Rajeev Kumar
- Rocky Mountain Movement Disorders Center, 701 E Hampden Ave Ste 510, Englewood, CO 80113, United States
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Utianski RL, Josephs KA. An Update on Apraxia of Speech. Curr Neurol Neurosci Rep 2023; 23:353-359. [PMID: 37269450 PMCID: PMC10629164 DOI: 10.1007/s11910-023-01275-1] [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: 05/08/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE OF REVIEW Apraxia of speech (AOS) is a motor speech disorder that has long been recognized to occur secondary to acute neurologic insults and, more recently, to neurodegenerative diseases as a harbinger for progressive supranuclear palsy and corticobasal syndrome. This article reviews recent findings regarding the clinic phenotypes of AOS, neuroimaging correlates, and the underlying disease processes. RECENT FINDINGS Two clinical subtypes of AOS map onto two underlying 4-repeat tauopathies. New imaging techniques have recently been applied to the study of progressive AOS. There is no data on the impact of behavioral intervention, although studies of nonfluent/agrammatic primary progressive aphasia that include patients with AOS suggest some benefit in speech intelligibility and maintenance. While recent findings suggest subtypes of AOS exist that are linked to molecular pathology and have important implications for disease progression, further research is needed to assess outcome of behavioral and other types of intervention.
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Affiliation(s)
- Rene L Utianski
- Department of Neurology, Mayo Clinic College of Medicine and Science, 200 1St Street S.W., Rochester, MN, 55905, USA
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic College of Medicine and Science, 200 1St Street S.W., Rochester, MN, 55905, USA.
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