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Masala C, Loy F, Pinna I, Manis NA, Ercoli T, Solla P. Olfactory Function as a Potential Predictor of Cognitive Impairment in Men and Women. BIOLOGY 2024; 13:503. [PMID: 39056696 PMCID: PMC11274230 DOI: 10.3390/biology13070503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/23/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Different previous studies indicated olfactory function as a predictor of several types of cognitive impairment, in particular related to neurodegenerative disease. However, scanty data are available on the role of odor threshold (OT), odor discrimination (OD), and odor identification (OI) as a predictor of cognitive impairment. The aim of this study was to evaluate potential correlations between each factor of the olfactory function versus each specific cognitive domain of the Montreal Cognitive Assessment (MoCA) test on healthy subjects in relation to gender and age. METHODS Sniffin' Sticks and MoCA tests were used to determine olfactory function and cognitive abilities, respectively. RESULTS In men, significant correlations were found in OT versus language index score and OI versus language and executive index score, while in women, OD and OI were correlated to visuospatial index score. CONCLUSIONS Our data suggested that olfactory function (OT, OD, and OI) may be considered a predictor for cognitive impairment in relation to gender and age.
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Affiliation(s)
- Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Francesco Loy
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Ilenia Pinna
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Nicoletta Aurora Manis
- Department of Biomedical Sciences, University of Cagliari, SP 8 Cittadella Universitaria, 09042 Monserrato, Italy; (F.L.); (I.P.); (N.A.M.)
| | - Tommaso Ercoli
- Neurological Unit, AOU Sassari, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy; (T.E.); (P.S.)
| | - Paolo Solla
- Neurological Unit, AOU Sassari, University of Sassari, Viale S. Pietro 10, 07100 Sassari, Italy; (T.E.); (P.S.)
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Huang X, Wu J, Zhang N, Teng J, Yang Q, Zhang Y, Yin T, Zhou W, Fan D, Ye S. Smell loss is associated with cognitive impairment in amyotrophic lateral sclerosis patients. CNS Neurosci Ther 2024; 30:e14851. [PMID: 38978196 PMCID: PMC11230928 DOI: 10.1111/cns.14851] [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: 04/09/2024] [Revised: 06/20/2024] [Accepted: 06/28/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Smell loss significantly impacts the quality of life in patients. However, there is limited research on smell loss in individuals with amyotrophic lateral sclerosis (ALS), and the correlation between smell loss and cognitive impairment is unclear. This study aimed to investigate the correlation between smell loss and cognition impairment in ALS patients. METHODS The study included 216 ALS patients. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) and smell identification test specifically for the Chinese population (CSIT) were administered to evaluate participants' cognitive and olfactory function, respectively. RESULTS After covarying for age, sex, BMI, education level, degree of hunger, dietary bias, eagerness for food, stress, smoking status, alcohol consumption, and upper respiratory tract infection (URTI) or rhinitis, CSIT scores were significantly correlated with ECAS scores (r = 0.162, p = 0.028), especially the ALS-specific scores (r = 0.158, p = 0.031). Even after excluding patients with URTI or rhinitis, the results were similar. CSIT scores were significantly correlated with ECAS scores (r = 0.224, p = 0.011), especially the ALS-specific scores (r = 0.205, p = 0.019). CONCLUSION In patients with ALS, smell loss is significantly correlated with cognitive impairment, particularly frontotemporal dysfunction. Cognitive dysfunction may lead to worse olfactory performance in ALS patients.
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Affiliation(s)
- Xin Huang
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Jieying Wu
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Nan Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Jinghong Teng
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Qiong Yang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
- Key Laboratory for Neuroscience, National Health Commission/Ministry of Education, Peking University, Beijing, China
| | - Yingshuang Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Tielun Yin
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Wen Zhou
- State Key Laboratory of Brain and Cognitive Science, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
- Key Laboratory for Neuroscience, National Health Commission/Ministry of Education, Peking University, Beijing, China
| | - Shan Ye
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
- Key Laboratory for Neuroscience, National Health Commission/Ministry of Education, Peking University, Beijing, China
- Department of Neurology, Yan'an Hospital of Traditional Chinese Medicine, Yan'an, China
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Ryan B, O’Mara Baker A, Ilse C, Brickell KL, Kersten HM, Williams JM, Addis DR, Tippett LJ, Curtis MA. The New Zealand Genetic Frontotemporal Dementia Study (FTDGeNZ): a longitudinal study of pre-symptomatic biomarkers. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Brigid Ryan
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Ashleigh O’Mara Baker
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Christina Ilse
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Kiri L. Brickell
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Hannah M. Kersten
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Joanna M. Williams
- Department of Anatomy, University of Otago, Dunedin, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Donna Rose Addis
- School of Psychology, University of Auckland, Auckland, New Zealand
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Lynette J. Tippett
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
| | - Maurice A. Curtis
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand, Rangahau Roro Aotearoa, New Zealand
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Cha H, Kim S, Son Y. Associations Between Cognitive Function, Depression, and Olfactory Function in Elderly People With Dementia in Korea. Front Aging Neurosci 2022; 13:799897. [PMID: 35087394 PMCID: PMC8787281 DOI: 10.3389/fnagi.2021.799897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022] Open
Abstract
Early detection is important for delaying or preventing cognitive impairment. Since olfactory dysfunction and depression are common symptoms of cognitive dysfunction, they may serve as measurable risk indicators. This study was designed to identify the relationship between olfaction, depression, and each domain of cognitive function in elderly dementia patients in South Korea. Study participants were 108 patients who visited the outpatient clinic between March and September 2019. More significant impairment of olfactory function was found in those with mild (7.48 ± 1.28) or moderate (7.37 ± 2.22) test scores of the Expanded Clinical Dementia Rating (CDR) scale than in those with questionable scores (20.58 ± 6.18). The language domain of cognitive function, age, and education level showed 39.2% explanatory power for olfactory function (F = 5.591, p < 0.001). It is expected that assessment of olfactory function in elderly people can lead to the early detection, diagnosis, and treatment of dementia. Furthermore, it is important for future studies to confirm the relationship between each domain of cognitive function and olfactory function according to the type of dementia and to establish criteria for screening dementia in order to utilize olfactory function as a clinical marker.
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Affiliation(s)
- Hyegyeong Cha
- Department of Nursing, Namseoul University, Cheonan-si, South Korea
| | - Sisook Kim
- Department of Nursing, Namseoul University, Cheonan-si, South Korea
| | - Yedong Son
- College of Nursing, Woosuk University, Wanju-gun, South Korea
- *Correspondence: Yedong Son,
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Murdaca G, Banchero S, Tonacci A, Nencioni A, Monacelli F, Gangemi S. Vitamin D and Folate as Predictors of MMSE in Alzheimer's Disease: A Machine Learning Analysis. Diagnostics (Basel) 2021; 11:diagnostics11060940. [PMID: 34073931 PMCID: PMC8225187 DOI: 10.3390/diagnostics11060940] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 12/13/2022] Open
Abstract
Vitamin D (VD) and micronutrients, including folic acid, are able to modulate both the innate and the adaptive immune responses. Low VD and folic acid levels appear to promote cognitive decline as in Alzheimer’s disease (AD). A machine learning approach was applied to analyze the impact of various compounds, drawn from the blood of AD patients, including VD and folic acid levels, on the Mini-Mental State Exam (MMSE) in a cohort of 108 patients with AD. The first analysis was aimed at predicting the MMSE at recruitment, whereas a second investigation sought to predict the MMSE after a 4 year follow-up. The simultaneous presence of low levels of VD and folic acid allow to predict MMSE, suggestive of poorer cognitive function. Such results suggest that the low levels of VD and folic acid could be associated with more severe cases of cognitive impairment in AD. It could be hypothesized that simultaneous supplementation of VD and folic acid could slow down the progression of cerebral degeneration at least in a subset of AD individuals.
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Affiliation(s)
- Giuseppe Murdaca
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (G.M.); (S.B.); (A.N.); (F.M.)
- Ospedale Policlinico San Martino IRCCS, 16132 Genoa, Italy
| | - Sara Banchero
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (G.M.); (S.B.); (A.N.); (F.M.)
- Ospedale Policlinico San Martino IRCCS, 16132 Genoa, Italy
| | - Alessandro Tonacci
- Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), 56124 Pisa, Italy
- Correspondence: ; Tel.: +39-050-3152175
| | - Alessio Nencioni
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (G.M.); (S.B.); (A.N.); (F.M.)
- Ospedale Policlinico San Martino IRCCS, 16132 Genoa, Italy
| | - Fiammetta Monacelli
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (G.M.); (S.B.); (A.N.); (F.M.)
- Ospedale Policlinico San Martino IRCCS, 16132 Genoa, Italy
| | - Sebastiano Gangemi
- School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
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Parvand M, Rankin CH. Is There a Shared Etiology of Olfactory Impairments in Normal Aging and Neurodegenerative Disease? J Alzheimers Dis 2021; 73:1-21. [PMID: 31744002 DOI: 10.3233/jad-190636] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
As we age, our olfactory function declines. In addition to occurring in normal aging, more rapid decrement of olfactory decline has been associated with several neurodegenerative diseases including Alzheimer's disease (AD) and Parkinson's disease (PD). It has been argued that since olfactory deficits occur less frequently or are absent in diseases such as progressive supranuclear palsy, corticobasal degeneration, and multiple system atrophy, olfactory deficits can be used for differential diagnoses of AD and PD. The purpose of this review is to provide a survey of current knowledge about the molecular bases and differential patterns of olfactory deficits present in normal aging, AD, and PD. As substantial research has been conducted in this area, the majority of the content of this review focuses on articles published in the past decade. We hypothesize that olfactory deficits in normal aging, AD, and PD may have different underlying causes, and propose the use of model organisms with small, tractable nervous systems and/or easy to manipulate genomes to further investigate the cellular mechanisms responsible for these deficits.
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Affiliation(s)
- Mahraz Parvand
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Catharine H Rankin
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Delgado-Losada ML, Bouhaben J, Delgado-Lima AH. Development of the Spanish Version of Sniffin's Sticks Olfactory Identification Test: Normative Data and Validity of Parallel Measures. Brain Sci 2021; 11:216. [PMID: 33578970 PMCID: PMC7916642 DOI: 10.3390/brainsci11020216] [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: 01/15/2021] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 12/22/2022] Open
Abstract
The Sniffin' Sticks Olfactory Identification Test is a tool for measurement of olfactory performance developed in Germany and validated in several countries. This research aims to develop the Spanish version of the Sniffin' Sticks Olfactory Identification Test and obtain normative values for the Spanish population. The parameters are free recall and subjective intensity of odorants are included. The influence of possible demographic covariates such as sex, age, smoking, or educational level are analyzed, and the items that best discriminate are studied. In addition, the internal structure validity of the blue and purple versions is studied as a parallel measure, and a cultural adaptation of the purple version is carried out. For this, three independent samples of normosmic healthy volunteers were studied. To obtain normative values, the sample was of 417 participants (18-89 years). For the internal structure validity study of both versions, the sample was 226 (18-70 years), and for familiarity of the purple version, the sample was 75 participants (21-79 years). Results indicated that men and women and smokers and non-smokers perform equally. However, differences were found as age progresses, being more pronounced after 60 years old in all three measurements of the identification test. This research also provides the items that best discriminate in the blue version and a cultural adaptation for the purple version. In conclusion, the Sniffin' Sticks Odor Identification Test is a suitable tool for olfactory assessment in the Spanish population. The instrument has been expanded with two new scores, and normative data as a function of age are provided. Its parallel version also seems appropriate for testing, as items have been culturally adapted and evidence of internal structure validity for both versions is reported.
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Affiliation(s)
- María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (J.B.); (A.H.D.-L.)
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Spanish Validation for Olfactory Function Testing Using the Sniffin' Sticks Olfactory Test: Threshold, Discrimination, and Identification. Brain Sci 2020; 10:brainsci10120943. [PMID: 33297359 PMCID: PMC7762307 DOI: 10.3390/brainsci10120943] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 12/14/2022] Open
Abstract
The assessment of olfactory function is becoming increasingly relevant, especially in cases of cognitive decline (i.e., neurodegenerative diseases), where olfactory alterations may be relevant as potential early biomarkers. The Sniffin' Sticks Olfactory Test, developed in Germany and validated in several countries, is an objective measure of olfactory performance. This study aims to validate this test in a Spanish sample. This study included 209 healthy normosmic volunteers (154 females and 55 males) aged between 20 to 79 years (mean age = 50.11 ± 15.18 years) as the normative sample. From this group, 22 participants were retested in order to obtain test-retest reliability evidence. Odor familiarity for descriptors in the olfactory identification test was also studied on an independent healthy sample (n = 69), and required cultural modifications were applied. Results indicate that men and women, as well as smokers and non-smokers, performed equally in every test. However, significant differences were found between age groups in every score. The general trend is that olfactory function progressively decreases as a function of age, the elderly group (+60 years) being the one with the lowest scores. In conclusion, this normative data, in addition to the test's cultural modifications, allows the Sniffin' Sticks Olfactory Test to be administered on a Spanish population.
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Carnemolla SE, Hsieh JW, Sipione R, Landis BN, Kumfor F, Piguet O, Manuel AL. Olfactory dysfunction in frontotemporal dementia and psychiatric disorders: A systematic review. Neurosci Biobehav Rev 2020; 118:588-611. [PMID: 32818582 DOI: 10.1016/j.neubiorev.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a progressive neurodegenerative disease. Diagnosis of FTD, especially the behavioural variant, is challenging because of symptomatic overlap with psychiatric disorders (depression, schizophrenia, bipolar disorder). Olfactory dysfunction is common in both FTD and psychiatric disorders, and often appears years before symptom onset. This systematic review analysed 74 studies on olfactory function in FTD, depression, schizophrenia and bipolar disorder to identify differences in olfactory dysfunction profiles, focusing on the most common smell measures: odour identification and discrimination. Results revealed that FTD patients were severely impaired in odour identification but not discrimination; in contrast, patients diagnosed with schizophrenia showed impairments in both measures, while those diagnosed with depression showed no olfactory impairments. Findings in bipolar disorder were mixed. Therefore, testing odour identification and discrimination differentiates FTD from depression and schizophrenia, but not from bipolar disorder. Given the high prevalence of odour identification impairments in FTD, and that smell dysfunction predicts neurodegeneration in other diseases, olfactory testing seems a promising avenue towards improving diagnosis between FTD and psychiatric disorders.
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Affiliation(s)
| | - Julien Wen Hsieh
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Rebecca Sipione
- Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Basile N Landis
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Fiona Kumfor
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Olivier Piguet
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Aurélie L Manuel
- The University of Sydney, Brain & Mind Centre, Sydney, Australia.
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Zangrandi A, Mioli A, Marti A, Ghidoni E, Gasparini F. Multimodal semantic battery to monitor progressive loss of concepts in the semantic variant of primary progressive aphasia (svPPA): an innovative proposal. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:438-454. [PMID: 32573335 DOI: 10.1080/13825585.2020.1782826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Semantic variant primary progressive aphasia (svPPA) is a rare neurodegenerative disease characterized by a progressive loss of semantic knowledge. Patients with svPPA show anomia, impaired word comprehension, poor object recognition, and difficulties in retrieving semantic information. svPPA is also a unique "natural" model that allows clinicians and cognitive neuroscientists to study the organization of semantic memory because only semantic knowledge is affected in the initial period of the disease, with relative sparing of other cognitive domains. In the clinical practice, semantic memory is commonly tested only with verbal tests. The aim of the present study was to preliminary test a new Multimodal Semantic Battery developed in our laboratory, which comprised 11 subtests designed to assess the semantic knowledge of multiple items via all input modalities. The battery was administered twice, over four years, to a patient diagnosed with svPPA. We found that when extensively tested with multiple tests, in some cases, he was still able to recall semantic features of the items that otherwise would not have emerged with standard semantic tests. These results are discussed for the clinical practice: monitoring semantic memory through all modalities in a practical and reliable way could be useful for both clinicians and experimental researchers to better investigate the breakdown of semantic knowledge.
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Affiliation(s)
- Andrea Zangrandi
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
| | - Alessandro Mioli
- Research Unit of Neurophysiology and Neuroengineering of Human-Technology Interaction, Università Campus Bio-Medico , Rome, Italy
| | - Alessandro Marti
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
| | - Enrico Ghidoni
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
| | - Federico Gasparini
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
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