bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2024-853bekhterev-963Research ArticleВ ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУGUIDELINES FOR THE PRACTITIONERПредставление клинического случая логопенической формы синдрома первичной прогрессирующей афазии в дебюте болезни АльцгеймераPresentation of a clinical case of the logopenic form of the syndrome of primary progressive aphasia in the onset of Alzheimer’s diseasehttps://orcid.org/0000-0001-9881-5942КоцюбинскаяЮ. В.KotsiubinskayaYu. V.

Коцюбинская Юлия Вадимовна, к.м.н., ведущий научный сотрудник отделения реабилитации больных психоневрологического профиля

Санкт-Петербург, ул. Бехтерева, 3; индекс 193019

Yulia V. Kotsiubinskaya

Saint Petersburg

platonk-juliak@yandex.ruhttps://orcid.org/0009-0006-0658-4301КайгородцевМ. А.KaigorodtsevM. A.

Кайгородцев Михаил Андреевич, ординатор-невролог отделения реабилитации больных психоневрологического профиля

Санкт-Петербург, ул. Бехтерева, 3; индекс 193019

Michail A. Kaigorodtsev

Saint Petersburg

mihail45region@gmail.comhttps://orcid.org/0000-0003-4480-0280СитникЛ. И.SitnikL. I.

Ситник Лариса Ивановна, клинический психолог отделения реабилитации больных психоневрологического профиля

Санкт-Петербург, ул. Бехтерева, 3; индекс 193019

Larisa I. Sitnik

Saint Petersburg

platonk-juliak@yandex.ruhttps://orcid.org/0000-0001-6002-2015МихайловВ. А.MikhailovV. A.

Михайлов Владимир Алексеевич, д.м.н., главный научный сотрудник и научный руководитель отделения реабилитации психоневрологических больных

Санкт-Петербург, ул. Бехтерева, 3; индекс 193019

Vladimir A. Mikhailov

Saint Petersburg

VLADMIKH@yandex.ruhttps://orcid.org/0009-0004-1180-9283КолесоваЮ. П.KolesovaYu. P.

Колесова Юлия Павловна, к.м.н., зав. отделением, научный сотрудник отделения лечения пограничных психических расстройств и психотерапии

Санкт-Петербург, ул. Бехтерева, 3; индекс 193019

Yulia P. Kolesova

Saint Petersburg

yulia_leo@mail.ruНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М. БехтереваРоссияV.M. Bekhterev National Research Medical Center for Psychiatry and NeurologyRussian Federation20242504202458298106Copyright © Коцюбинская Ю.В., Кайгородцев М.А., Ситник Л.И., Михайлов В.А., Колесова Ю.П., 20242024Коцюбинская Ю.В., Кайгородцев М.А., Ситник Л.И., Михайлов В.А., Колесова Ю.П.Kotsiubinskaya Y.V., Kaigorodtsev M.A., Sitnik L.I., Mikhailov V.A., Kolesova Y.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/963

Представлено описание клинического случая логопенической формы синдрома первичной прогрессирующей афазии в дебюте болезни Альцгеймера. Заболевание проявлялось в виде нарушений речи и письма, резкого расстройства трудовых навыков с сохранением самообслуживания и ориентации, аффективных колебаний, в связи с чем предполагалась диагностика когнитивных функций и психопатологических изменений, а также проведение инструментального исследования. Проведена дифференциальная диагностика с заболеваниями психического спектра, различными нейродегенеративными заболеваниями, сосудистым поражением головного мозга. Однако характер проявления заболевания, а также имеющиеся особенности нарушений когнитивных функций и речевых нарушений позволили предположить логопенический вариант синдрома первично прогрессирующей афазии (ППА), а наличие общего когнитивного снижения и прогрессирование заболевания в короткие сроки — болезнь Альцгеймера с атипичным началом.

A description of a clinical case of the logopenic form of the syndrome of primary progressive aphasia in the onset of Alzheimer’s disease is presented. The disease manifested itself in the form of 

speech and writing disorders, a sharp disorder in labor skills with the preservation of self-service and orientation, affective fluctuations, in connection with which it was supposed to diagnose cognitive functions, psychopathological changes and instrumental research. Differential diagnostics with mental spectrum diseases, various neurodegenerative diseases, vascular lesions of the brain were carried out. However, the nature, as well as the existing features of cognitive impairment and speech impairment of the manifestation of the disease, suggested a logopenic warrant of the PPA syndrome, and the presence of a general cognitive decline and disease progression in a short time was Alzheimer’s disease with an atypical onset.

деменцияпервично прогрессирующая афазиялогопенический вариант первично прогрессирующей афазиипсевдодеменциямеланхолическая деменциякогнитивные нарушенияболезнь Альцгеймерадепрессияафазияdementiaprimary progressive aphasialogopenic variant of primary progressive aphasiapseudodementiamelancholic dementiacognitive impairmentAlzheimer's diseasedepressionaphasiaReferencesЛитвиненко И.В., Колмакова К.А., Емелин А.Ю., Лобзин В.Ю. Первичные прогрессирующие афазии: клинико-генетическая гетерогенность и сложность диагностики. Анналы клинической и экспериментальной неврологии. 2021;15(4):66-77.Litvinenko IV, Kolmakova КA, Emelin АY, Lobzin VY. Primary progressive aphasias: clinical and genetic heterogeneity and diagnostic difficulties. Annaly klinicheskoj i eksperimentalnoj nevrologii. 2021;15(4):66-77. (In Russ.). http//doi.org/10.14412/2074-2711-2019-1-4-11.Михайлов В.А., Коцюбинская Ю.В., Сафонова Н.Ю., Ананьева Н.И., Стулов И.К. Первичная прогрессирующая афазия. Неврология, нейропсихиатрия, психосоматика. 2019;11(1):4-11.Mikhailov VA, Kotsiubinskaya YuV, Safonova NYu, Ananeva NI, Stulov IK. Primary progressive aphasia. Nevrologiya, nejropsihiatriya, psihosomatika. 2019;11(1):4-11. (In Russ.). http//doi.org/10.14412/2074-2711-2019-1-4-11Парфенов В.А. Ведение пациентов с когнитивными нарушениями. Неврология, нейропсихиатрия, психосоматика. 2023;15(1):97-102.Parfenov VA. Management of patients with cognitive impairment. Nevrologiya, nejropsihiatriya, psihosomatika. 2023;15(1):97-102. (In Russ.). http//doi.org/10.14412/2074-2711-2023-1-97-102.Степкина Д.А., Захаров В.В., Яхно Н.Н. Синдром первичной прогрессирующей афазии. Неврологический журнал. 2014;19(5):22-28.Stepkina DA, Zakharov VV, Yakhno NN. Syndrome of primary progressive aphasia. Nevrologicheskij zhurnal. 2014;19(5):22-28. (In.Russ.).Berrios GE. «Depressive pseudodementia» or «Melancholic dementia»: a 19th century view. J Neurol Neurosurg Psychiatry. 1985;48(5):393-400. http//doi.org/10.1136/jnnp.48.5.393.Berrios GE. «Depressive pseudodementia» or «Melancholic dementia»: a 19th century view. J Neurol Neurosurg Psychiatry. 1985;48(5):393-400. http//doi.org/10.1136/jnnp.48.5.393.Bora E, Harrison BJ, Yücel M, Pantelis C. Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychol Med. 2013;43(10):201726. http//doi.org/10.1017/S0033291712002085.Bora E, Harrison BJ, Yücel M, Pantelis C. Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychol Med. 2013;43(10):201726. http//doi.org/10.1017/S0033291712002085.Brodaty H, Connors MH. Pseudodementia, pseudopseudodementia, and pseudodepression. Alzheimers Dement (Amst). 2020;12(1):e12027. http//doi.org/10.1002/dad2.12027.Brodaty H, Connors MH. Pseudodementia, pseudopseudodementia, and pseudodepression. Alzheimers Dement (Amst). 2020;12(1):e12027. http//doi.org/10.1002/dad2.12027.Channon S. Executive dysfunction in depression: the Wisconsin Card Sorting Test. J Affect Disord. 1996;39(2):107-14. http//doi.org/10.1016/0165-0327(96)00027-4.Channon S. Executive dysfunction in depression: the Wisconsin Card Sorting Test. J Affect Disord. 1996;39(2):107-14. http//doi.org/10.1016/0165-0327(96)00027-4.Channon S, Green PS. Executive function in depression: the role of performance strategies in aiding depressed and non-depressed participants. J Neurol Neurosurg Psychiatry. 1999;66(2):162-71. http//doi.org/10.1136/jnnp.66.2.162.Channon S, Green PS. Executive function in depression: the role of performance strategies in aiding depressed and non-depressed participants. J Neurol Neurosurg Psychiatry. 1999;66(2):162-71. http//doi.org/10.1136/jnnp.66.2.162.Cherbuin N, Kim S, Anstey KJ. Dementia risk estimates associated with measures of depression: a systematic review and meta-analysis. BMJ Open. 2015;5(12):e008853. http//doi.org/10.1136/bmjopen-2015-008853.Cherbuin N, Kim S, Anstey KJ. Dementia risk estimates associated with measures of depression: a systematic review and meta-analysis. BMJ Open. 2015;5(12):e008853. http//doi.org/10.1136/bmjopen-2015-008853.Connors MH, Quinto L, Brodaty H. Longitudinal outcomes of patients with pseudodementia: a systematic review. Psychol Med. 2019;49(5):727737. http//doi.org/10.1017/S0033291718002829.Connors MH, Quinto L, Brodaty H. Longitudinal outcomes of patients with pseudodementia: a systematic review. Psychol Med. 2019;49(5):727737. http//doi.org/10.1017/S0033291718002829.Giacomucci G, Polito C, Berti V, Padiglioni S, Galdo G, Mazzeo S, et al. Beyond impairment of language: empathy deficit in logopenic variant of Primary Progressive Aphasia (P5-6.002). Neurology. 2023;100(17 Supplement 2)0259. http//doi.org/10.1212/WNL.0000000000201837Giacomucci G, Polito C, Berti V, Padiglioni S, Galdo G, Mazzeo S, et al. Beyond impairment of language: empathy deficit in logopenic variant of Primary Progressive Aphasia (P5-6.002). Neurology. 2023;100(17 Supplement 2)0259. http//doi.org/10.1212/WNL.0000000000201837Gorno-Tempini ML, Dronkers NF, Rankin KP, Ogar JM, La Phengrasamy, Rosen HJ, et. al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol. 2004;55(3):335-346.Gorno-Tempini ML, Dronkers NF, Rankin KP, Ogar JM, La Phengrasamy, Rosen HJ, et. al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol. 2004;55(3):335-346.Gorno-Tempini ML, Hillis AE, Weintraub S, Kertesz A, Mendez M, Cappa SF, et al. Classification of Primary Progressive Aphasia and Its Variants. Neurology. 2011;76:1006–1014. http//doi.org/10.1212/WNL.0b013e31821103e6Gorno-Tempini ML, Hillis AE, Weintraub S, Kertesz A, Mendez M, Cappa SF, et al. Classification of Primary Progressive Aphasia and Its Variants. Neurology. 2011;76:1006–1014. http//doi.org/10.1212/WNL.0b013e31821103e6Gorno-Tempini ML, Ogar JM, Brambati SM, Wang P, Jeong JH, Rankin KP, et al. Anatomical correlates of early mutism in progressive nonfluent aphasia. Neurology. 2006;67(10):1849-51. http//doi.org/10.1212/01.wnl.0000237038.55627.5bGorno-Tempini ML, Ogar JM, Brambati SM, Wang P, Jeong JH, Rankin KP, et al. Anatomical correlates of early mutism in progressive nonfluent aphasia. Neurology. 2006;67(10):1849-51. http//doi.org/10.1212/01.wnl.0000237038.55627.5bGray JW, Rattan AI, Dean RS. Differential diagnosis of dementia and depression in the elderly using neuropsychological methods. Arch Clin Neuropsychol. 1986;1(4):341-9.Gray JW, Rattan AI, Dean RS. Differential diagnosis of dementia and depression in the elderly using neuropsychological methods. Arch Clin Neuropsychol. 1986;1(4):341-9.Hart RP, Kwentus JA, Taylor JR, Hamer RM. Productive naming and memory in depression and Alzheimer’s type dementia. Arch Clin Neuropsychol. 1988;3(4):313-22.Hart RP, Kwentus JA, Taylor JR, Hamer RM. Productive naming and memory in depression and Alzheimer’s type dementia. Arch Clin Neuropsychol. 1988;3(4):313-22.Kral VA, Emery OB. Long-term follow-up of depressive pseudodementia of the aged. Can J Psychiatry. 1989;34(5):445-6. http//doi.org/10.1177/070674378903400515.Kral VA, Emery OB. Long-term follow-up of depressive pseudodementia of the aged. Can J Psychiatry. 1989;34(5):445-6. http//doi.org/10.1177/070674378903400515.Kiloh LG. Pseudo-dementia. Acta Psychiatr Scand. 1961;37(4):336-51. http//doi.org/10.1111/j.1600-0447.1961.tb07367.x.Kiloh LG. Pseudo-dementia. Acta Psychiatr Scand. 1961;37(4):336-51. http//doi.org/10.1111/j.1600-0447.1961.tb07367.x.La Rue A. Patterns of performance on the Fuld Object Memory Evaluation in elderly inpatients with depression or dementia. J Clin Exp Neuropsychol. 1989;11(4):409-22. http//doi.org/10.1080/01688638908400902.La Rue A. Patterns of performance on the Fuld Object Memory Evaluation in elderly inpatients with depression or dementia. J Clin Exp Neuropsychol. 1989;11(4):409-22. http//doi.org/10.1080/01688638908400902.Leyton CE, Savage S, Irish M, Schubert S, Piguet O, Ballard KJ, Hodges JR. Verbal Repetition in Primary Progressive Aphasia and Alzheimer’s Disease. J. Alzheimer’s Dis. 2014;41(2):575–585. http//doi.org/10.3233/JAD-132468.Leyton CE, Savage S, Irish M, Schubert S, Piguet O, Ballard KJ, Hodges JR. Verbal Repetition in Primary Progressive Aphasia and Alzheimer’s Disease. J. Alzheimer’s Dis. 2014;41(2):575–585. http//doi.org/10.3233/JAD-132468.Makaretz SJ, Quimby M, Collins J, Makris N, McGinnis S, Schultz A, et al. Flortaucipir tau PET imaging in semantic variant primary progressive aphasia. J Neurol Neurosurg Psychiatry. 2018;89(10):1024-1031. http//doi.org/10.1136/jnnp-2017-316409.Makaretz SJ, Quimby M, Collins J, Makris N, McGinnis S, Schultz A, et al. Flortaucipir tau PET imaging in semantic variant primary progressive aphasia. J Neurol Neurosurg Psychiatry. 2018;89(10):1024-1031. http//doi.org/10.1136/jnnp-2017-316409.Mendez MF. Early-onset Alzheimer Disease and Its Variants. Continuum: Lifelong Learning in Neurology. 2019;25(1):34-51. http//doi.org/10.1212/CON.0000000000000687.Mendez MF. Early-onset Alzheimer Disease and Its Variants. Continuum: Lifelong Learning in Neurology. 2019;25(1):34-51. http//doi.org/10.1212/CON.0000000000000687.Mesulam MM, Wieneke C, Thompson C, Rogalski E, Weintraub S. Quantitative classification of primary progressive aphasia at early and mild impairment stages. Brain. 2012;135(5):1537-1553. http//doi.org/10.1093/brain/aws080.Mesulam MM, Wieneke C, Thompson C, Rogalski E, Weintraub S. Quantitative classification of primary progressive aphasia at early and mild impairment stages. Brain. 2012;135(5):1537-1553. http//doi.org/10.1093/brain/aws080.Mesulam MM. Primary progressive aphasia and the language network: The 2013 H. Houston Merritt Lecture. Neurology. 2013;81(5):456-462. http//doi.org/10.1212/WNL.0b013e31829d87df.Mesulam MM. Primary progressive aphasia and the language network: The 2013 H. Houston Merritt Lecture. Neurology. 2013;81(5):456-462. http//doi.org/10.1212/WNL.0b013e31829d87df.Quaranta D, Di Tella S, Marra C, Gaudino S, L’Abbate F, Silveri MC. Neuroanatomical Correlates of Semantic Features of Narrative Speech in Semantic and Logopenic Variants of Primary Progressive Aphasia. Brain Sci. 2022;12(7):910. http//doi.org/10.3390/brainsci12070910Quaranta D, Di Tella S, Marra C, Gaudino S, L’Abbate F, Silveri MC. Neuroanatomical Correlates of Semantic Features of Narrative Speech in Semantic and Logopenic Variants of Primary Progressive Aphasia. Brain Sci. 2022;12(7):910. http//doi.org/10.3390/brainsci12070910Rogalski E, Cobia D, Harrison TM, Wieneke C, Thompson CK, Weintraub S, Mesulam MM. Anatomy of language impairments in primary progressive aphasia. J Neurosci. 2011;31(9):3344-50. http//doi.org/10.1523/JNEUROSCI.5544-10.2011.Rogalski E, Cobia D, Harrison TM, Wieneke C, Thompson CK, Weintraub S, Mesulam MM. Anatomy of language impairments in primary progressive aphasia. J Neurosci. 2011;31(9):3344-50. http//doi.org/10.1523/JNEUROSCI.5544-10.2011.Satz P, Van Gorp WG, Soper HV, Mitrushina M. WAIS-R marker for dementia of the Alzheimer type? An empirical and statistical induction test. J Clin Exp Neuropsychol. 1987;9(6):767-74. http//doi.org/10.1080/01688638708405215.Satz P, Van Gorp WG, Soper HV, Mitrushina M. WAIS-R marker for dementia of the Alzheimer type? An empirical and statistical induction test. J Clin Exp Neuropsychol. 1987;9(6):767-74. http//doi.org/10.1080/01688638708405215.Small GW, Liston EH, Jarvik LF. Diagnosis and treatment of dementia in the aged. West J Med. 1981;135(6):469-81.Small GW, Liston EH, Jarvik LF. Diagnosis and treatment of dementia in the aged. West J Med. 1981;135(6):469-81.Spinelli EG, Mandelli ML, Miller ZA. Typical and atypical pathology in primary progressive aphasia variants. Ann Neurol. 2017;81(3):430–443. http//doi.org/10.1002/ana.24885.Spinelli EG, Mandelli ML, Miller ZA. Typical and atypical pathology in primary progressive aphasia variants. Ann Neurol. 2017;81(3):430–443. http//doi.org/10.1002/ana.24885.Wasim A, McConathy JE, Natelson LM, Middlebrooks EH. Neuroimaging of Primary Progressive Aphasia Variants. Neurographics 2018; 8:1–6. https://doi.org/10.3174/ng.1700052.Wasim A, McConathy JE, Natelson LM, Middlebrooks EH. Neuroimaging of Primary Progressive Aphasia Variants. Neurographics 2018; 8:1–6. https://doi.org/10.3174/ng.1700052.Woolley JD, Khan BK, Murthy NK, Miller BL, Rankin KP. The diagnostic challenge of psychiatric symptoms in neurodegenerative disease: rates of and risk factors for prior psychiatric diagnosis in patients with early neurodegenerative disease. J Clin Psychiatry. 2011;72(2):126-33. http//doi.org/10.4088/JCP.10m06382oli.Woolley JD, Khan BK, Murthy NK, Miller BL, Rankin KP. The diagnostic challenge of psychiatric symptoms in neurodegenerative disease: rates of and risk factors for prior psychiatric diagnosis in patients with early neurodegenerative disease. J Clin Psychiatry. 2011;72(2):126-33. http//doi.org/10.4088/JCP.10m06382oli.

The authors declare that there are no conflicts of interest present.