Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-11T04:18:15.476Z Has data issue: false hasContentIssue false

Agraphia in Korean patients with early onset Alzheimer's disease

Published online by Cambridge University Press:  27 May 2011

Ji Hye Yoon
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Mee Kyung Suh
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Yong Jeong
Affiliation:
Department of Brain and Bioengineering, KAIST, Daejeon, Republic of Korea
Hyun-Jung Ahn
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
So Young Moon
Affiliation:
Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
Juhee Chin
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Sang Won Seo*
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Duk L. Na
Affiliation:
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
*
Correspondence should be addressed to: Sang Won Seo, MD, PhD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135–710, Republic of Korea. Phone: +82-2-3410-1233; Fax: +82-2-3410-0052. Email: sangwonseo@empal.com.

Abstract

Background: Agraphia in Korean patients may be different from agraphia in other patients who use alphabetical writing systems due to the “visuoconstructional script” characteristics of the Korean writing system, Hangul. Patients with early onset Alzheimer's disease (EOAD) have a severe degree of hypometabolism in the parietal area, which is known to be involved in processing visuospatial function. Thus, we explored the diverse error patterns manifested in writing single syllables in Korean patients with EOAD.

Methods: A study sample of 35 patients with EOAD and 18 healthy controls (HC) performed a Hangul writing task. We analyzed the erroneous responses of the subjects according to visuoconstructional and linguistic characteristics. In addition, we evaluated the relationship between Hangul writing and the neuropsychological variables as well as the severity of dementia.

Results: When comparing the total number of erroneous responses between EOAD and HC groups, the performances of EOAD patients were significantly worse than those of HC. EOAD patients demonstrated visuoconstructional errors even in the early stages of the disease. Severity of dementia and multiple cognitive domains such as attention, language, immediate memory, and frontal executive functions significantly correlated with the performance of Hangul writing.

Conclusion: Our findings suggest that patients with EOAD exhibit not only linguistic errors but also visuoconstructional manifestations of agraphia, which are associated with cognitive impairments in the multiple domains.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Appel, J., Kertesz, A. and Fisman, M. (1982). A study of language function in Alzheimer patients. Brain and Language, 17, 7391.Google Scholar
Ardila, A. and Surloff, C. (2006). Dysexecutive agraphia: a major executive dysfunction sign. International Journal of Neuroscience, 116, 653663.CrossRefGoogle Scholar
Baddeley, A. (1986). Working Memory. Oxford: Oxford University Press.Google Scholar
Carthery, M. T., Mattos-Pimenta-Parente, M. A., Nitrini, R., Bahia, V. S. and Caramelli, P. (2005). Spelling tasks and Alzheimer's disease staging. European Journal of Neurology, 12, 907911.Google Scholar
Croisile, B. (1999). Agraphia in Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 10, 226230.Google Scholar
Croisile, B., Camoi, T., Adeleine, P. and Trillet, M. (1995). Spelling in Alzheimer's disease. Behavioural Neurology, 8, 135143.Google Scholar
Croisile, B., Brabant, M. J., Carmoi, T., Lepage, Y., Aimard, G. and Trillet, M. (1996). Comparison between oral and written spelling in Alzheimer's disease. Brain and Language, 54, 361387.CrossRefGoogle ScholarPubMed
Cummings, J. L., Benson, D. F., Hill, M. A. and Read, S. (1985). Aphasia in dementia of the Alzheimer type. Neurology, 35, 394397.Google Scholar
Ellis, A. W. (1982). Spelling and writing (and reading and speaking). In Ellis, A. W. (ed.), Normality and Pathology in Cognitive Functions (pp. 113146). London: Academic Press.Google Scholar
Faber-Langendoen, K., Morris, J. C., Knesevich, J. W., LaBarge, E., Miller, J. P. and Berg, L. (1988). Aphasia in senile dementia of the Alzheimer type. Annals of Neurology, 23, 365370.Google Scholar
Forbes, K. E., Shanks, M. F. and Venneri, A. (2004). The evolution of dysgraphia in Alzheimer's disease. Brain Research Bulletin, 63, 1924.Google Scholar
Graham, N. L. (2000). Dysgraphia in dementia. Neurocase, 6, 365376.Google Scholar
Groves-Wright, K., Neils-Strunjas, J., Burnett, R. and O'Neill, M. J. (2004). A comparison of verbal and written language in Alzheimer's disease. Journal of Communication Disorders, 37, 109130.Google Scholar
Hillis, A. E. and Caramazza, A. (1989). The graphemic buffer and attentional mechanisms. Brain and Language, 36, 208235.CrossRefGoogle ScholarPubMed
Hodges, J. R., Salmon, D. P. and Butters, N. (1993). Recognition and naming of famous faces in Alzheimer's disease: a cognitive analysis. Neuropsychologia, 31, 775788.Google Scholar
Hughes, J., Graham, N., Patterson, K. and Hodges, J. R. (1997). Agraphia in mild dementia of Alzheimer's type. Neuropsychologia, 35, 533545.CrossRefGoogle Scholar
Kang, Y. and Na, D. L. (2003). Seoul Neuropsychological Screening Battery. Incheon: Human Brain Research and Consulting Company.Google Scholar
Kavrie, S. and Neils-Strunjas, J. (2002). Dysgraphia in Alzheimer's disease with mild cognitive impairment. Journal of Medical Speech-Language Pathology, 10, 7385.Google Scholar
Kim, E. J. et al. (2005). Glucose metabolism in early onset versus late onset Alzheimer's disease: an SPM analysis of 120 patients. Brain, 128, 17901801.CrossRefGoogle ScholarPubMed
Kim, H. and Na, D. L. (2004). Normative data on the Korean version of the Western Aphasia Battery. Journal of Clinical and Experimental Neuropsychology, 26, 10111020.Google Scholar
Kwon, J. C., Lee, H. J., Chin, J., Lee, Y. M., Kim, H. and Na, D. L. (2002). Hanja alexia with agraphia after left posterior inferior temporal lobe infarction: a case study. Journal of Korean Medical Science, 17, 9195.Google Scholar
Lambert, J., Eustache, F., Viader, F., Dary, M., Rioux, P. and Lechevalier, B. (1996). Agraphia in Alzheimer's disease: an independent lexical impairment. Brain and Language, 53, 222233.Google Scholar
Lambert, J., Giffard, B., Nore, F., de la Sayette, V., Pasquier, F. and Eustache, F. (2007). Central and peripheral agraphia in Alzheimer's disease: from the case of Auguste D. to a cognitive neuropsychology approach. Cortex, 43, 935951.Google Scholar
Law, S. P. (2004). Writing error of a Cantonese dysgraphic patient and their theoretical implications. Neurocase, 10, 132140.CrossRefGoogle ScholarPubMed
Lezak, M. D. (1985). Neuropsychological Assessment. 3rd edn. New York: Oxford University Press.Google Scholar
Luzzatti, C., Laiacona, M. and Agazzi, D. (2003). Multiple patterns of writing disorders in dementia of the Alzheimer type and their evolution. Neuropsychologia, 41, 759772.Google Scholar
Maeshima, S. et al. (2003). Agraphia with abnormal writing stroke sequences due to cerebral infarction. Brain Injury, 17, 339345.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
McNeil, M. R. and Tseng, C. H. (1990). Acquired neurogenic dysgraphias. InLapointe, L. L. (ed.), Aphasia and Related Neurogenic Language Disorders (pp. 147176). New York: Thieme Medical Publishers, Inc.Google Scholar
Neils, J., Roeltgen, D. P. and Greer, A. (1995). Spelling and attention in early Alzheimer's disease: evidence for impairment of the graphemic buffer. Brain and Language, 49, 241262.Google Scholar
Neils-Strunjas, J., Shuren, J., Roeltgen, D. and Brown, C. (1998). Perseverative writing errors in a patient with Alzheimer's disease. Brain and Language, 63, 303320.Google Scholar
Penniello, M. J. et al. (1995). A PET study of the functional neuroanatomy of writing impairment in Alzheimer's disease: the role of the left supramarginal and left angular gyri. Brain, 118, 697706.Google Scholar
Platel, H., Lambert, J., Eustache, F., Cadet, B., Dary, M. and Viader, F. (1993). Characteristics and evolution of writing impairment in Alzheimer's disease. Neuropsychologia, 31, 11471158.Google Scholar
Rapcsak, S. Z., Arthur, S. A., Bliklen, D. A. and Rubens, A. B. (1989). Lexical agraphia in Alzheimer's disease. Archives of Neurology, 46, 6568.Google Scholar
Roeltgen, D. P. (2003). Agraphia. In Heilman, K. M. and Valenstein, E. (eds.), Clinical Neuropsychology, 4th edn. (pp. 126145). New York: Oxford University Press.Google Scholar
Seo, S. K. (2006). Learner's Dictionary of Korean. Seoul: Shinwon Prime.Google Scholar
Small, J. A. and Sandhu, N. (2008). Episodic and semantic memory influences on picture naming in Alzheimer's disease. Brain and Language, 104, 19.Google Scholar
Yasuda, K., Nakamura, T. and Beckman, B. (2000). Brain processing of proper names. Aphasiology, 14, 10671089.CrossRefGoogle Scholar