Jennifer L Whitwell1, Stephen D Weigand2, Joseph R Duffy2, Heather M Clark2, Edythe A Strand2, Mary M Machulda2, Anthony J Spychalla2, Matthew L Senjem2, Clifford R Jack2, Keith A Josephs2. 1. From the Department of Radiology (J.L.W., A.J.S., M.L.S., C.R.J.), Department of Health Sciences Research (Biostatistics) (S.D.W.), Department of Neurology (Speech Pathology) (J.R.D., H.M.C., E.A.S.), Department of Psychiatry & Psychology (Neuropsychology) (M.M.M.), Department of Information Technology (M.L.S.), and Department of Neurology (Behavioral Neurology and Movement Disorders) (K.A.J.), Mayo Clinic, Rochester, MN. Whitwell.jennifer@mayo.edu. 2. From the Department of Radiology (J.L.W., A.J.S., M.L.S., C.R.J.), Department of Health Sciences Research (Biostatistics) (S.D.W.), Department of Neurology (Speech Pathology) (J.R.D., H.M.C., E.A.S.), Department of Psychiatry & Psychology (Neuropsychology) (M.M.M.), Department of Information Technology (M.L.S.), and Department of Neurology (Behavioral Neurology and Movement Disorders) (K.A.J.), Mayo Clinic, Rochester, MN.
Abstract
OBJECTIVE: To determine whether baseline clinical and MRI features predict rate of clinical decline in patients with progressive apraxia of speech (AOS). METHODS: Thirty-four patients with progressive AOS, with AOS either in isolation or in the presence of agrammatic aphasia, were followed up longitudinally for up to 4 visits, with clinical testing and MRI at each visit. Linear mixed-effects regression models including all visits (n = 94) were used to assess baseline clinical and MRI variables that predict rate of worsening of aphasia, motor speech, parkinsonism, and behavior. Clinical predictors included baseline severity and AOS type. MRI predictors included baseline frontal, premotor, motor, and striatal gray matter volumes. RESULTS: More severe parkinsonism at baseline was associated with faster rate of decline in parkinsonism. Patients with predominant sound distortions (AOS type 1) showed faster rates of decline in aphasia and motor speech, while patients with segmented speech (AOS type 2) showed faster rates of decline in parkinsonism. On MRI, we observed trends for fastest rates of decline in aphasia in patients with relatively small left, but preserved right, Broca area and precentral cortex. Bilateral reductions in lateral premotor cortex were associated with faster rates of decline of behavior. No associations were observed between volumes and decline in motor speech or parkinsonism. CONCLUSIONS: Rate of decline of each of the 4 clinical features assessed was associated with different baseline clinical and regional MRI predictors. Our findings could help improve prognostic estimates for these patients.
OBJECTIVE: To determine whether baseline clinical and MRI features predict rate of clinical decline in patients with progressive apraxia of speech (AOS). METHODS: Thirty-four patients with progressive AOS, with AOS either in isolation or in the presence of agrammatic aphasia, were followed up longitudinally for up to 4 visits, with clinical testing and MRI at each visit. Linear mixed-effects regression models including all visits (n = 94) were used to assess baseline clinical and MRI variables that predict rate of worsening of aphasia, motor speech, parkinsonism, and behavior. Clinical predictors included baseline severity and AOS type. MRI predictors included baseline frontal, premotor, motor, and striatal gray matter volumes. RESULTS: More severe parkinsonism at baseline was associated with faster rate of decline in parkinsonism. Patients with predominant sound distortions (AOS type 1) showed faster rates of decline in aphasia and motor speech, while patients with segmented speech (AOS type 2) showed faster rates of decline in parkinsonism. On MRI, we observed trends for fastest rates of decline in aphasia in patients with relatively small left, but preserved right, Broca area and precentral cortex. Bilateral reductions in lateral premotor cortex were associated with faster rates of decline of behavior. No associations were observed between volumes and decline in motor speech or parkinsonism. CONCLUSIONS: Rate of decline of each of the 4 clinical features assessed was associated with different baseline clinical and regional MRI predictors. Our findings could help improve prognostic estimates for these patients.
Authors: Jennifer L Whitwell; Jia Xu; Jay Mandrekar; Bradley F Boeve; David S Knopman; Joseph E Parisi; Matthew L Senjem; Dennis W Dickson; Ronald C Petersen; Rosa Rademakers; Clifford R Jack; Keith A Josephs Journal: Neurobiol Aging Date: 2012-04-11 Impact factor: 4.673
Authors: M L Gorno-Tempini; A E Hillis; S Weintraub; A Kertesz; M Mendez; S F Cappa; J M Ogar; J D Rohrer; S Black; B F Boeve; F Manes; N F Dronkers; R Vandenberghe; K Rascovsky; K Patterson; B L Miller; D S Knopman; J R Hodges; M M Mesulam; M Grossman Journal: Neurology Date: 2011-02-16 Impact factor: 9.910
Authors: Jennifer L Whitwell; Joseph R Duffy; Edythe A Strand; Rong Xia; Jay Mandrekar; Mary M Machulda; Matthew L Senjem; Val J Lowe; Clifford R Jack; Keith A Josephs Journal: Brain Lang Date: 2013-03-28 Impact factor: 2.381
Authors: Maria Luisa Gorno-Tempini; Ryan C Murray; Katherine P Rankin; Michael W Weiner; Bruce L Miller Journal: Neurocase Date: 2004-12 Impact factor: 0.881
Authors: Keith A Josephs; Joseph R Duffy; Edyth A Strand; Jennifer L Whitwell; Kenneth F Layton; Joseph E Parisi; Mary F Hauser; Robert J Witte; Bradley F Boeve; David S Knopman; Dennis W Dickson; Clifford R Jack; Ronald C Petersen Journal: Brain Date: 2006-04-13 Impact factor: 13.501
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Authors: Jennifer L Whitwell; Scott A Przybelski; Stephen D Weigand; Robert J Ivnik; Prashanthi Vemuri; Jeffrey L Gunter; Matthew L Senjem; Maria M Shiung; Bradley F Boeve; David S Knopman; Joseph E Parisi; Dennis W Dickson; Ronald C Petersen; Clifford R Jack; Keith A Josephs Journal: Brain Date: 2009-09-17 Impact factor: 13.501
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Authors: Rene L Utianski; Joseph R Duffy; Heather M Clark; Edythe A Strand; Sarah M Boland; Mary M Machulda; Jennifer L Whitwell; Keith A Josephs Journal: Am J Speech Lang Pathol Date: 2018-11-21 Impact factor: 2.408
Authors: Rene L Utianski; Peter R Martin; Hugo Botha; Christopher G Schwarz; Joseph R Duffy; Ronald C Petersen; David S Knopman; Heather M Clark; Alissa M Butts; Mary M Machulda; Clifford R Jack; Val J Lowe; Jennifer L Whitwell; Keith A Josephs Journal: Cortex Date: 2019-11-19 Impact factor: 4.027
Authors: Jennifer L Whitwell; Chase A Stevens; Joseph R Duffy; Heather M Clark; Mary M Machulda; Edythe A Strand; Peter R Martin; Rene L Utianski; Hugo Botha; Anthony J Spychalla; Matthew L Senjem; Christopher G Schwarz; Clifford R Jack; Farwa Ali; Anhar Hassan; Keith A Josephs Journal: Mov Disord Clin Pract Date: 2019-05-29
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