Clinical, cognitive and anatomical evolution from nonfluent progressive aphasia to corticobasal syndrome: a case report

Neurocase. 2004 Dec;10(6):426-36. doi: 10.1080/13554790490894011.


Recent clinical and pathological studies have suggested that frontotemporal lobar degeneration (FTLD) and corticobasal syndrome (CBS) show clinical and pathological overlap. We present four years of longitudinal clinical, cognitive and anatomical data in the case of a 56-year-old woman, AS, whose clinical picture evolved from FTLD to CBS. For the first three years, AS showed a progressive speech and language disorder compatible with a diagnosis of the nonfluent aphasia variant of FTLD. At year four, 10 years after her first symptom, AS developed the classical clinical signs of CBS, including alien limb phenomenon and dystonia. Voxel-based morphometry (VBM) applied to AS's four annual scans showed progression of atrophy from the inferior posterior frontal gyrus, to the left insula and finally to the medial frontal lobe. This case demonstrates the clinical overlap between FTLD and CBS and shows that the two can appear in the same patient at different stages of the disease in relation to the progression of anatomical damage.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aphasia, Broca / pathology*
  • Aphasia, Broca / psychology*
  • Apraxias / etiology
  • Apraxias / psychology
  • Basal Ganglia / pathology*
  • Basal Ganglia Diseases / etiology
  • Basal Ganglia Diseases / psychology
  • Cognition / physiology
  • Disease Progression
  • Dystonia / etiology
  • Dystonia / psychology
  • Female
  • Frontal Lobe / pathology*
  • Handwriting
  • Humans
  • Language Tests
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neurodegenerative Diseases / pathology*
  • Neurodegenerative Diseases / psychology*
  • Neuropsychological Tests
  • Phantom Limb / etiology
  • Phantom Limb / psychology
  • Psychomotor Performance / physiology
  • Speech / physiology