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- Title
Progressive apraxia of speech: delays to diagnosis and rates of alternative diagnoses.
- Authors
Dang, Johnny; Graff-Radford, Jonathan; Duffy, Joseph R.; Utianski, Rene L.; Clark, Heather M.; Stierwalt, Julie A.; Whitwell, Jennifer L.; Josephs, Keith A.; Botha, Hugo
- Abstract
Background: Progressive apraxia of speech (PAOS) is a neurodegenerative disorder of speech programming distinct from aphasia and dysarthria, most commonly associated with a 4-repeat tauopathy. Our objective was to better understand the reasons for possible delays or diagnostic errors for patients with PAOS. Methods: Seventy-seven consecutive PAOS research participants from the Neurodegenerative Research Group were included in this study. The medical records for these patients were reviewed in detail. For each speech-related visit, data such as the chief complaint, clinical findings, and neuroimaging findings were recorded. Results: Apraxia of speech was the initial diagnosis in 20.1% of participants at first evaluation noted in the historical record. Other common diagnoses included primary progressive aphasia (PPA) (20.1%), dysarthria (18.18%), MCI/Dementia (6.5%), and motor neuron disease (3.9%). It took a median of 2.02 (range: 0.16–8.18) years from symptoms onset for participants to receive an initial diagnosis and 3.00 (range: 0.49–9.42) years to receive a correct diagnosis. Those who were seen by a speech-language pathologist (SLP) during their first documented encounter were more likely to be correctly diagnosed with PAOS (37/48) after SLP consultation than those who were not seen by an SLP on initial encounter (5/29) (p < 0.001). Conclusion: Approximately 80% of patients with PAOS were imprecisely diagnosed at their first visit, with it taking a median of 3 years from symptom onset to receiving a diagnosis of PAOS. Being seen by a speech-language pathologist during the initial evaluation increased the likelihood of a correct apraxia of speech diagnosis.
- Subjects
DELAYED diagnosis; SPEECH apraxia; DIAGNOSIS; SPEECH disorders; MOTOR neuron diseases; SYMPTOMS
- Publication
Journal of Neurology, 2021, Vol 268, Issue 12, p4752
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-021-10585-8