Progressive apraxia of speech: delays to diagnosis and rates of alternative diagnoses.

Autor: Dang J; Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.; Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, USA., Graff-Radford J; Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA., Duffy JR; Department Neurology Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA., Utianski RL; Department Neurology Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA., Clark HM; Department Neurology Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA., Stierwalt JA; Department Neurology Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA., Whitwell JL; Department of Radiology, Mayo Clinic, Rochester, MN, USA., Josephs KA; Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA., Botha H; Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. Botha.Hugo@mayo.edu.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2021 Dec; Vol. 268 (12), pp. 4752-4758. Date of Electronic Publication: 2021 May 04.
DOI: 10.1007/s00415-021-10585-8
Abstrakt: Background: Progressive apraxia of speech (PAOS) is a neurodegenerative disorder of speech programming distinct from aphasia and dysarthria, most commonly associated with a 4-repeat tauopathy. Our objective was to better understand the reasons for possible delays or diagnostic errors for patients with PAOS.
Methods: Seventy-seven consecutive PAOS research participants from the Neurodegenerative Research Group were included in this study. The medical records for these patients were reviewed in detail. For each speech-related visit, data such as the chief complaint, clinical findings, and neuroimaging findings were recorded.
Results: Apraxia of speech was the initial diagnosis in 20.1% of participants at first evaluation noted in the historical record. Other common diagnoses included primary progressive aphasia (PPA) (20.1%), dysarthria (18.18%), MCI/Dementia (6.5%), and motor neuron disease (3.9%). It took a median of 2.02 (range: 0.16-8.18) years from symptoms onset for participants to receive an initial diagnosis and 3.00 (range: 0.49-9.42) years to receive a correct diagnosis. Those who were seen by a speech-language pathologist (SLP) during their first documented encounter were more likely to be correctly diagnosed with PAOS (37/48) after SLP consultation than those who were not seen by an SLP on initial encounter (5/29) (p < 0.001).
Conclusion: Approximately 80% of patients with PAOS were imprecisely diagnosed at their first visit, with it taking a median of 3 years from symptom onset to receiving a diagnosis of PAOS. Being seen by a speech-language pathologist during the initial evaluation increased the likelihood of a correct apraxia of speech diagnosis.
(© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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