Phonemic paraphasia and word finding difficulty appears in a patient with dementia with Lewy bodies (DLB): a comparative analysis to logopenic variant of primary progressive aphasia (LPA)

Abstract

A 79-year-old right-handed man presented to us because of forgetfulness, visual hallucinations and difficulties in word finding. A neurological examination showed no Parkinsonism. He scored 17 on the Mini-Mental State Examination, and showed inattention, perseveration, recent memory deficits and constructional disturbances on the neuropsychological assessment. His speech was fluent with no speech apraxia or agrammatism, but there were many phonemic paraphasias and marked difficulties in word finding both in his running speech and responses to language tasks. He scored 72.5 of Aphasia Quotient in the Western Aphasia Battery. His language comprehensions were normal both for words and syntax. His repetition of a sentence was disturbed by the deficit of phonological short term memory, as well as phonemic paraphasia. The length of a sentence influenced his auditory comprehension, and the difficulties appeared in a sentence with 3 words or more. The dopamine transporter (DAT) SPECT showed mild hypoaccumulations in the striatum, and ¹²³I-iodoamphetamine (¹²³I-IMP) SPECT showed hypoperfusion predominantly in the left lateral parieto-temporal area. He showed a clinical syndrome consistent with probable dementia with Lewy bodies (DLB), and his aphasia syndrome was similar to that of logopenic variant of primary progressive aphasia (LPA).