Introduction Diferential diagnosis among subjects with Primary Progressive Aphasia (PPA) can be challenging. Structural MRI can support the clinical profle. Visual rating scales are a simple and reliable tool to assess brain atrophy in the clinical setting. The aims of the study were to establish to what extent the visual rating scales could be useful in the diferential diagnosis of PPA, to compare the clinical diagnostic impressions derived from routine MRI interpretations with those obtained using the visual rating scale and to correlate results of the scales in a voxel-based morphometry (VBM) analysis. Method Patients diagnosed with primary progressive aphasia (PPA) according to current criteria from two centers—Ospedale Maggiore Policlinico of Milan and Hospital Clínic de Barcelona—were included in the study. Two blinded clinicians evaluated the subjects MRIs for cortical atrophy and white matter hyperintensities using two protocols: routine readings and the visual rating scale. The diagnostic accuracy between patients and controls and within PPA subgroups were compared between the two protocols. Results One hundred ffty Subjects were studied. All the scales showed a good to excellent intra and inter-rater agreement. The left anterior temporal scale could diferentiate between semantic PPA and all other variants. The rater impression after the protocol can increase the accuracy just for the logopenic PPA. In the VBM analysis, the scores of visual rating scales correlate with the corresponding area of brain atrophy. Conclusion The Left anterior temporal rating scale can distinguish semantic PPA from other variants. The rater impression after structured view improved the diagnostic accuracy of logopenic PPA compared to normal read‑ings. The unstructured view of the MRI was reliable for identifying semantic PPA and controls. Neither the structured nor the unstructured view could identify the nonfuent and undetermined variants.

Utility of visual rating scales in primary progressive aphasia / Falgàs, Neus; Sacchi, Luca; Carandini, Tiziana; Montagut, Nuria; Conte, Giorgio; Triulzi, Fabio; Galimberti, Daniela; Arighi, Andrea; Sanchez-Valle, Raquel; Fumagalli, Giorgio Giulio. - In: ALZHEIMER'S RESEARCH & THERAPY. - ISSN 1758-9193. - 16:1(2024), pp. 7301-7312. [10.1186/s13195-024-01442-7]

Utility of visual rating scales in primary progressive aphasia

Fumagalli, Giorgio Giulio
Ultimo
2024-01-01

Abstract

Introduction Diferential diagnosis among subjects with Primary Progressive Aphasia (PPA) can be challenging. Structural MRI can support the clinical profle. Visual rating scales are a simple and reliable tool to assess brain atrophy in the clinical setting. The aims of the study were to establish to what extent the visual rating scales could be useful in the diferential diagnosis of PPA, to compare the clinical diagnostic impressions derived from routine MRI interpretations with those obtained using the visual rating scale and to correlate results of the scales in a voxel-based morphometry (VBM) analysis. Method Patients diagnosed with primary progressive aphasia (PPA) according to current criteria from two centers—Ospedale Maggiore Policlinico of Milan and Hospital Clínic de Barcelona—were included in the study. Two blinded clinicians evaluated the subjects MRIs for cortical atrophy and white matter hyperintensities using two protocols: routine readings and the visual rating scale. The diagnostic accuracy between patients and controls and within PPA subgroups were compared between the two protocols. Results One hundred ffty Subjects were studied. All the scales showed a good to excellent intra and inter-rater agreement. The left anterior temporal scale could diferentiate between semantic PPA and all other variants. The rater impression after the protocol can increase the accuracy just for the logopenic PPA. In the VBM analysis, the scores of visual rating scales correlate with the corresponding area of brain atrophy. Conclusion The Left anterior temporal rating scale can distinguish semantic PPA from other variants. The rater impression after structured view improved the diagnostic accuracy of logopenic PPA compared to normal read‑ings. The unstructured view of the MRI was reliable for identifying semantic PPA and controls. Neither the structured nor the unstructured view could identify the nonfuent and undetermined variants.
2024
1
Falgàs, Neus; Sacchi, Luca; Carandini, Tiziana; Montagut, Nuria; Conte, Giorgio; Triulzi, Fabio; Galimberti, Daniela; Arighi, Andrea; Sanchez-Valle, Raquel; Fumagalli, Giorgio Giulio
Utility of visual rating scales in primary progressive aphasia / Falgàs, Neus; Sacchi, Luca; Carandini, Tiziana; Montagut, Nuria; Conte, Giorgio; Triulzi, Fabio; Galimberti, Daniela; Arighi, Andrea; Sanchez-Valle, Raquel; Fumagalli, Giorgio Giulio. - In: ALZHEIMER'S RESEARCH & THERAPY. - ISSN 1758-9193. - 16:1(2024), pp. 7301-7312. [10.1186/s13195-024-01442-7]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11572/406813
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