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Primary progressive apraxia
Authors:Kondo Masaki
Institution:Department of Neurology, Kyoto Prefectural University of Medicine, Japan.
Abstract:Similar to primary progressive aphasia, primary progressive apraxia has been considered to cause slowly progressive apraxia without dementia and to be a dependent disease. Of the 3 cases reported by De Renzi in 1986, 1 case showed slowly progressive apraxia without dementia. Since then, cases of primary progressive apraxia have been reported occasionally. Studies on primary progressive apraxia indicate that not only focal lesions caused by vascular disease or brain trauma but also lesions caused by neurodegenerative disease can cause apraxia alone, thereby supporting the hypothesis that apraxia-associated neurodegeneration may develop in cases of primary progressive apraxia. The pathogenesis of primary progressive apraxia is yet to be elucidated. Clinical features of primary progressive apraxia are not precisely distinguishable from those of corticobasal degeneration (CBD); further, previous studies have indicated that the brain pathology observed in primary progressive apraxia is consistent with that in Alzheimer disease (AD) or Pick disease. "Primary" progressive apraxia may be intrinsically different from slowly progressive apraxia that is associated with CBD, AD, or Pick disease and may show specific pathological findings. On the other hand, primary progressive apraxia may not be a dependent disease but a syndrome characterized by prolonged neurodegeneration that is observed in various degenetive dementias such as CBD, AD, or Pick disease.
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