medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-037medsovet-9979Research ArticleКОГНИТИВНЫЕ РАССТРОЙСТВАCOGNITIVE DISRODERSЛогопеническая форма первичной прогрессирующей афазии вследствие болезни АльцгеймераThe logopenic form of primary progressive aphasia due to Alzheimer’s diseasehttps://orcid.org/0000-0003-2424-3245ГришинаД. А.GrishinaD. A.

Гришина Динара Александровна - к.м.н., доцент кафедры нервных болезней Института клинической медицины имени Н.В. Склифосовского.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Dinara A. Grishina - Cand. Sci. (Med.), Associate Professor of the Department of Nervous Diseases, Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119048

dstepkina@mail.ruhttps://orcid.org/0000-0003-3524-3494ГринюкВ. В.GrinyukV. V.

Гринюк Владислав Владимирович - к.м.н., доцент кафедры нервных болезней Института клинической медицины имени Н.В. Склифосовского.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Vladislav V. Grinyuk - Cand. Sci. (Med.), Associate Professor of the Department of Nervous Diseases, Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119048

grinukvladislav@gmail.comhttps://orcid.org/0009-0000-8639-0721ПрокопенкоП. Е.ProkopenkoP. E.

Прокопенко Полина Евгеньевна - ординатор кафедры нервных болезней Института клинической медицины имени Н.В. Склифосовского.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Polina E. Prokopenko - Resident of the Department of Nervous Diseases, Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119048

propollina@gmail.comhttps://orcid.org/0009-0008-8598-0955КуправаТ. Ш.KupravaT. Sh.

Куправа Текла Шалвовна - студент лечебного факультета Института клинической медицины имени Н.В. Склифосовского.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Tekla Sh. Kuprava - Student of the Faculty of Medicine, Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119048

teklakuprava03@gmail.comПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202619042026034855Copyright © Гришина Д.А., Гринюк В.В., Прокопенко П.Е., Куправа Т.Ш., 20262026Гришина Д.А., Гринюк В.В., Прокопенко П.Е., Куправа Т.Ш.Grishina D.A., Grinyuk V.V., Prokopenko P.E., Kuprava T.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9979

Болезнь Альцгеймера (БА) редко диагностируется в нашей стране, что во многом связано с плохой информированностью врачей о ее симптомах и клинических формах. Логопеническая форма первичной прогрессирующей афазии (ЛППА) является редкой формой БА и характеризуется изолированными речевыми нарушениями на ранних стадиях. Представлено клиническое наблюдение пациентки 70 лет с ЛППА вследствие БА. Несмотря на доминирование нарушений речи в клинической картине, пациентка длительное время наблюдалась с диагнозом «цереброваскулярное заболевание». Признаки выраженной атрофии головного мозга по данным МРТ и значительное снижение содержания β-амилоида в цереброспинальной жидкости позволили установить диагноз БА как причину ЛППА. Своевременная диагностика ЛППА затруднена из-за клинического сходства с другими формами ППА. Отличительной чертой ППА является поиск нужного слова во время построения речевого высказывания, что приводит к замедлению речи. При этом понимание обращенной речи, ее грамматический строй и артикуляция остаются сохранными. Возникновение данного дефекта речи связано с дисфункцией «фонологической петли». Для лучшей систематизации характерных особенностей ЛППА в статье представлены клинические, инструментальные и патоморфологические характеристики различных форм ППА. Ранняя диагностика ЛППА важна как для своевременного назначения доступных симптоматических препаратов и проведения немедикаментозной терапии, так и для определения показаний к патогенетической терапии, направленной на профилактику прогрессирования БА.

Alzheimer’s disease (AD) is rarely diagnosed in our country, which is largely due to the poor awareness of doctors about its symptoms and clinical forms. The logopenic variant of primary progressive aphasia (lvPPA) represents a rare presentation of AD and is characterized by isolated language impairment in the early stages. A clinical case of a 70-year-old patient with lvPPA due to AD is presented. Despite the prevailance of speech impairment in her clinical picture, for long she was observed for cerebrovascular disease. Signs of severe brain atrophy according to MRI data and a significant decrease in the beta-amyloid content in the cerebrospinal fluid made it possible to diagnose AD as the cause of lvPPA. Timely diagnosis of lvPPA is difficult due to its clinical similarity to other forms of lvPPA. A hallmark of PPA is word-finding difficulty during speech production, resulting in slowed speech. Comprehension of spoken language, grammatical structure, and articulation remain preserved. This language deficit is associated with dysfunction of the “phonological loop”. Clinical, instrumental, and pathomorphological characteristics of different PPA variants are described to provide a more systematized view on lvPPA. Early diagnosis of lvPPA is important both for the timely prescription of available symptomatic treatments, implementation of non-pharmacological therapy, and for defining indications for pathogenetic therapy aimed at preventing progression of AD.

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The authors declare that there are no conflicts of interest present.