Transition of distinctive symptoms of semantic dementia during longitudinal clinical observation.
OBJECTIVE
The aim of this study is to examine the clinical symptoms in a number of semantic dementia (SD) patients and to reveal the longitudinal progression and clinical course of these distinctive symptoms of SD.


METHODS
19 consecutive SD patients were examined. Symptoms were classified into 23 distinct categories: behavioral symptoms, language and cognitive symptoms and symptoms concerning the impairment of activities of daily living (ADL). We divided patients into two subgroups, left- and right-dominant SD, and compared the onset of each symptom.


RESULTS
Language impairments occurred as the initial symptom in 16 cases. At the first examination, all cases showed both anomia and impairment of word comprehension. By around 3 years after onset, almost all language impairments were observed. Approximately 3-5 years after onset, prosopagnosia and behavioral symptoms appeared. Around the period when the loss of the language faculty and apathy became remarkable, impairment of ADL appeared. Patients spent all day in bed at this stage. Moreover, prosopagnosia appeared significantly earlier in right-dominant SD.


CONCLUSIONS
Our findings clarify the progression of distinctive symptoms of SD patients. It is necessary to create a treatment strategy for SD patients with such a disease-specific course of SD.
Kashibayashi
Tetsuo
T
Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan.
Ikeda
Manabu
M
Komori
Kenjiro
K
Shinagawa
Shunichiro
S
Shimizu
Hideaki
H
Toyota
Yasutaka
Y
Mori
Takaaki
T
Ishikawa
Tomohisa
T
Fukuhara
Ryuji
R
Ueno
Shu-ichi
S
Tanimukai
Satoshi
S
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D000849:Anomia / Q000523:psychology; D001519:Behavior / Q000502:physiology; D003071:Cognition / Q000502:physiology; D003704:Dementia / Q000523:psychology*; D004493:Education; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007406:Interview, Psychological; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020238:Prosopagnosia / Q000523:psychology; D012727:Sex Characteristics; D013239:Stereotyped Behavior; D014705:Verbal Behavior