Progressive apraxia of speech: delays to diagnosis and rates of alternative diagnoses.
Diagnostic delay
Frontotemporal dementia
Primary progressive aphasia
Progressive apraxia of speech
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
09
02
2021
accepted:
26
04
2021
revised:
24
04
2021
pubmed:
5
5
2021
medline:
5
11
2021
entrez:
4
5
2021
Statut:
ppublish
Résumé
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. 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. 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). 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 33945003
doi: 10.1007/s00415-021-10585-8
pii: 10.1007/s00415-021-10585-8
pmc: PMC8566317
mid: NIHMS1711737
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4752-4758Subventions
Organisme : NIDCD NIH HHS
ID : R01 DC012519
Pays : United States
Organisme : Foundation for the National Institutes of Health
ID : R01-DC14942
Organisme : Foundation for the National Institutes of Health
ID : R01-DC010367
Organisme : NIDCD NIH HHS
ID : R01 DC014942
Pays : United States
Organisme : Foundation for the National Institutes of Health
ID : R01-DC12519
Organisme : NINDS NIH HHS
ID : R01 NS089757
Pays : United States
Organisme : NIDCD NIH HHS
ID : R01 DC010367
Pays : United States
Organisme : Foundation for the National Institutes of Health
ID : R01-NS89757
Informations de copyright
© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.
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