Dementia with aphasia and mirror phenomenon: examination of the mechanism using neuroimaging and neuropsychological find
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CASE REPORT
Open Access
Dementia with aphasia and mirror phenomenon: examination of the mechanism using neuroimaging and neuropsychological findings: a case report Aiko Osawa1*, Shinichiro Maeshima2, Hidenori Arai3 and Izumi Kondo1
Abstract Background: Aphasia often appears in persons living with dementia; however, aphasia and the mirror phenomenon are rarely present at the same time. Case presentation: Here, we report a case of fluent conversation with a person in a mirror or a magazine, and examine the underlying mechanism using brain imaging and neuropsychological findings. We found that the appearance of the mirror phenomenon may be associated with a visuospatial dysfunction caused by a decreased function of the posterior region of the right temporal and parietal lobe. Moreover, active talking to a person in a mirror or a person in a magazine could be associated with disinhibition caused by a decline in bilateral frontal lobe function. Conclusions: This case represents a very valuable and interesting presentation because it is the first report of a long-term follow-up of the course of dementia using neurological imaging, and of the neuropsychological analysis of the mechanism of conversation with a mirror image combined with aphasia. Keywords: Mirror phenomenon, Aphasia, Dementia, Neurological imaging, Neuropsychological analysis
Background The “mirror phenomenon” is the phenomenon of interacting with one’s mirrored self-image by misidentifying one’s own reflection in the mirror as another person, by talking or handing something to the image. Since its first report by Kahn (1925) [1], studies have addressed the mirror phenomenon in Alzheimer’s disease, traumatic brain injury, and vascular dementia and have reported a prevalence of 2.3–5.4% [2–5]. Conversely, aphasia is a core symptom of dementia, and communication problems often appear after the middle stage of this disease.
Here, we report a case of Wernicke’s aphasia with acquired stuttering (AS) that exhibited a specific speech pattern after the appearance of the mirror phenomenon during the course of dementia with aphasia. Moreover, based on imaging findings, we also studied the mechanism underlying the mirror phenomenon, as well as the effects of this phenomenon on conversation.
* Correspondence: [email protected] 1 Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan Full list of author information is available at the end of the article
History of the present illness
Case presentation The present case was a right-handed female with 12 years of education who had been sociable and talkative.
At the age of 68, the patient was referred to our hospital because she occasionally burnt her food while cooking.
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original
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