PMC9243420_01
Results of the speech audiogram. The curve marked with a solid black line is the reference speech recognition curve and that between the curves marked with black dashed lines on both sides of it represent the normal range. The speech recognition scores of the right ear are marked by red circles and those of the left ear are marked by a blue cross, and those are connected by solid lines of the same color with marks. Both are out of the normal range, and the maximum recognition score in the phonetically balanced word list of the right ear is 75% at 65 dB and that of the left ear is 80% at 65 dB.
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The speech audiogram revealed significantly impaired speech recognition relative to the normal range advocated by the Japanese Audiological Society (Figure 1).
Brain magnetic resonance imaging (MRI), voxel-based morphometry on brain MRI (VBM), and single-photon emission computed tomography (SPECT). (A) Brain MRI showing left-sided predominant atrophy, especially in Heschl's gyrus, superior temporal gyri (STG), and the anterior and medial temporal areas; (B) VBM showing the significantly smaller gray matter volume areas in the bilateral STG, plana temporale, Rolandic area and frontal inferior opercula, and the left supramarginal gyrus of the patient compared with those observed in patients with typical svPPA (disease controls). The colored bars indicate the Z-values; (C) SPECT data analyzed with three-dimensional stereotactic surface projections showing predominant hypoperfusion of the temporal lobe, especially at the anterior temporal area and middle and inferior temporal gyrus. Hypoperfusion is expanded to the temporoparietal junction in the left hemisphere. The colored bars indicate the Z-values.
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Trio (Siemens Medical Solutions United States, Inc., PA, United States). Three-dimensional magnetization-prepared rapid acquisition with gradient echo (3D-MPRAGE) images demonstrated diffuse cerebral atrophy, which was especially marked in the anterior and medial parts of the left temporal lobe (Figure 2A). The Z-score map is exhibited in Figure 2B. There was hypoperfusion from the temporal to the parietal lobes of the left hemisphere, with a more intense reduction from the anterior temporal lobe to the middle and inferior temporal gyri (Figure 2C).