title: A potential protective effect in multilingual patients with semantic dementia: two case reports of patients speaking Taiwanese and Japanese.
abstract: OBJECTIVE
  Several reports have suggested that multilingualism has a protective effect against semantic dementia. Here, we provide further evidence for this effect.
  The patient was a 75-year-old right-handed Taiwanese woman who had retired after working as a tailor. She was able to speak Taiwanese, Japanese and Mandarin Chinese fluently until 5 years ago. She gradually developed symptoms of profound anomia and difficulty with word-finding. Her mother tongue was Taiwanese and she had learned Japanese as her first symbolized language. She had used Mandarin Chinese for most of her life, but depended on Japanese to read and write (such as reading a newspaper and keeping accounts). However, she could now speak only very simple Taiwanese and Japanese, and could recognize only simple Japanese characters. SECOND: The patient was a 62-year-old right-handed man who had worked as an ironworker. He could speak Taiwanese and Mandarin Chinese fluently until 5 years ago. His mother tongue was Taiwanese. After 5 years of language deterioration, he was unable to communicate with his family members or recognize any characters, including numbers. SPECT RESULTS: Brain perfusion ECD SPECT (Tc-99m-ethyl cysteinate dimer single-photon emission computed tomography) showed less perfusion in the multilingual patient (Case #1) than in the bilingual patient (Case #2). Neuropsychological tests also demonstrated a slower rate of degeneration in the multilingual patient.
  
  
  CONCLUSIONS
  We speculate that reading and writing in Japanese had a greater impact on the semantic system in Case #1. Thus, this patient showed relatively less degeneration or functional inactivity, as shown by perfusion in the frontal lobe, and this might be due to the persistent activation involved in multilingualism.
authors.affiliation: Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Yi-Chien
authors.initials: YC
authors.lastname: Liu
authors.forename: Ping-Keung
authors.initials: PK
authors.lastname: Yip
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Fan
authors.forename: Kenichi
authors.initials: K
authors.lastname: Meguro
mesh_terms: D000368:Aged; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D057174:Frontotemporal Lobar Degeneration / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D007806:Language Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D009483:Neuropsychological Tests; D015609:Organotechnetium Compounds; D013624:Taiwan; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; C059659:technetium Tc 99m bicisate; D003545:Cysteine