{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:58:57Z","timestamp":1762325937571,"version":"3.41.2"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002283","name":"Alzheimer\u2019s Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002283","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000320","name":"Alzheimer's Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000320","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015873","name":"National Brain Appeal","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015873","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017510","name":"UK Dementia Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017510","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009270","name":"Invention for Innovation","doi-asserted-by":"publisher","award":["NIHR204280"],"award-info":[{"award-number":["NIHR204280"]}],"id":[{"id":"10.13039\/501100009270","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Dysphagia is an important feature of neurodegenerative diseases and potentially life\u2010threatening in primary progressive aphasia (PPA) but remains poorly characterized in these syndromes. We hypothesized that dysphagia would be more prevalent in nonfluent\/agrammatic variant (nfv)PPA than other PPA syndromes, predicted by accompanying motor features, and associated with atrophy affecting regions implicated in swallowing control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a retrospective case\u2013control study at our tertiary referral centre, we recruited 56 patients with PPA (21 nfvPPA, 22 semantic variant [sv]PPA, 13 logopenic variant [lv]PPA). Using a pro forma based on caregiver surveys and clinical records, we documented dysphagia (present\/absent) and associated, potentially predictive clinical, cognitive, and behavioural features. These were used to train a machine learning model. Patients' brain magnetic resonance imaging scans were assessed using voxel\u2010based morphometry and region\u2010of\u2010interest analyses comparing differential atrophy profiles associated with dysphagia presence\/absence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Dysphagia was significantly more prevalent in nfvPPA (43% vs. 5% svPPA and no lvPPA). The machine learning model revealed a hierarchy of features predicting dysphagia in the nfvPPA group, with excellent classification accuracy (90.5%, 95% confidence interval\u2009=\u200977.9\u2013100); the strongest predictor was orofacial apraxia, followed by older age, parkinsonism, more severe behavioural disturbance, and more severe cognitive impairment. Significant grey matter atrophy correlates of dysphagia in nfvPPA were identified in left middle frontal, right superior frontal, and right supramarginal gyri and right caudate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dysphagia is a common feature of nfvPPA, linked to underlying corticosubcortical network dysfunction. Clinicians should anticipate this symptom particularly in the context of other motor features and more severe disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16370","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T06:15:05Z","timestamp":1719036905000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dysphagia in primary progressive aphasia: Clinical predictors and neuroanatomical basis"],"prefix":"10.1111","volume":"31","author":[{"given":"Salvatore","family":"Mazzeo","sequence":"first","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London  London UK"},{"name":"Research and Innovation Centre for Dementia\u2013CRIDEM University of Florence, Azienda Ospedaliera\u2013Universitaria Careggi  Florence Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"},{"name":"IRCCS Policlinico San Donato  San Donato Milanese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eoin","family":"Mulroy","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Jiang","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Lassi","sequence":"additional","affiliation":[{"name":"BioRobotics Institute and Department of Excellence in Robotics and AI Scuola Superiore Sant'Anna  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy C. S.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-6492","authenticated-orcid":false,"given":"Chris J. D.","family":"Hardy","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan D.","family":"Rohrer","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason D.","family":"Warren","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Volkmer","sequence":"additional","affiliation":[{"name":"Department of Psychology &amp; Language Sciences University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31821103e6"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8762-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13415"},{"key":"e_1_2_10_5_1","unstructured":"HardyCJD Taylor\u2010RubinC TaylorB et\u00a0al.Symptom\u2010led staging for primary progressive aphasia [Internet].2023; 2023.03.13.23286972 [cited 2023 Mar 22]. Available from:https:\/\/www.medrxiv.org\/content\/10.1101\/2023.03.13.23286972v1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0213825"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000113729.77161.C9"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1471301218797240"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.06.018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2021.1961805"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12131"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.2001.85.2.938"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-023-10613-x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.07.010"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/1735-1995.183997"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28731"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1980-57642009DN20200005"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827f0fd1"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26987"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.11.049"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-016-9758-y"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5371-4"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.01.021"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.09.015"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awu223"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282x20200060"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-016-0712-3"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-023-10570-5"},{"issue":"5","key":"e_1_2_10_29_1","first-page":"22","article-title":"Dysphagia in parkinsonism: prevalence, predictors and correlation with severity of illness fasting","volume":"68","author":"Shilimkar Y","year":"2020","journal-title":"J Assoc Physicians India"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-019-10073-2"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25341"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2022.10.010"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.0412"},{"key":"e_1_2_10_34_1","first-page":"1","article-title":"Influences of motor speech impairments on the presentation of dysphagia in progressive supranuclear palsy","volume":"26","author":"Petroi\u2010Bock D","year":"2023","journal-title":"Int J Speech Lang Pathol"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24885"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.1931"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-021-01101-x"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10388-z"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)02068-0"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neucli.2008.04.004"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.14214"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460-6984.12495"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T11:49:12Z","timestamp":1722599352000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,21]]},"references-count":41,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/ene.16370"],"URL":"https:\/\/doi.org\/10.1111\/ene.16370","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"type":"print","value":"1351-5101"},{"type":"electronic","value":"1468-1331"}],"subject":[],"published":{"date-parts":[[2024,6,21]]},"assertion":[{"value":"2024-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16370"}}