Omental therapy for primary progressive aphasia with tau negative histopathology: 3 year study.
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.
Shankle
William R
WR
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
Hara
Junko
J
Bjornsen
Lynda
L
Gade
George F
GF
Leport
Peter C
PC
Ali
Mir B
MB
Kim
Jinho
J
Raimo
Maryellen
M
Reyes
Linda
L
O'Heany
Terence
T
Mena
Ismael
I
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
D019275:Radiopharmaceuticals; D016875:tau Proteins