title: Omental therapy for primary progressive aphasia with tau negative histopathology: 3 year study.
abstract: OBJECTIVE
  Omentum transposition surgery (OT) applied to various neurodegenerative disorders has produced clinically significant improvement, which may be due to omentally-derived factors. To evaluate the clinical effect of left hemisphere OT in a primary progressive aphasia (PPA) patient, 3 year follow-up data were analysed.
  
  
  METHODS
  Left hemisphere OT was performed on a 68-year-old male with PPA, characterized by moderate dementia and severe expressive aphasia with relatively preserved comprehension, object recognition and visual-spatial abilities. He was longitudinally assessed with cognitive, functional, behavioral and brain HMPAO SPECT measures pre-OT, at baseline and every 3-6 months for 34 months.
  
  
  RESULTS
  All measures improved above baseline for >20 months and persisted at or above baseline for 34 months. Cortical activity increased by a maximum of 21% underneath transposed omentum and in synaptically connected areas, and persisted in >50% of the cortex for at least 12 months. Subjectively, family members observed improved verbal and non-verbal communication.
  
  
  CONCLUSIONS
  OT produced a sustained, beneficial treatment effect in PPA and warrants further clinical and basic research to identify explanatory factors.
authors.affiliation: Fountain Valley Regional Hospital and Medical Center, Fountain Valley, CA, USA; Department of Cognitive Science, University of California at Irvine, Irvine, CA, USA; The Shankle Clinic, Irvine, CA, USA. rshankle@shankleclinic.com
authors.forename: William R
authors.initials: WR
authors.lastname: Shankle
authors.forename: Junko
authors.initials: J
authors.lastname: Hara
authors.forename: Lynda
authors.initials: L
authors.lastname: Bjornsen
authors.forename: George F
authors.initials: GF
authors.lastname: Gade
authors.forename: Peter C
authors.initials: PC
authors.lastname: Leport
authors.forename: Mir B
authors.initials: MB
authors.lastname: Ali
authors.forename: Jinho
authors.initials: J
authors.lastname: Kim
authors.forename: Maryellen
authors.initials: M
authors.lastname: Raimo
authors.forename: Linda
authors.initials: L
authors.lastname: Reyes
authors.forename: Terence
authors.initials: T
authors.lastname: O'Heany
authors.forename: Ismael
authors.initials: I
authors.lastname: Mena
mesh_terms: D000368:Aged; D001037:Aphasia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D007839:Functional Laterality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008606:Mental Processes / Q000502:physiology; D009483:Neuropsychological Tests; D009852:Omentum / Q000000981:diagnostic imaging / Q000601:surgery*; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D016875:tau Proteins / Q000378:metabolism
chemical_list: D019275:Radiopharmaceuticals; D016875:tau Proteins