The Japanese journal of neuropsychology

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ArticleTitle	Impact of semantic loss on compulsive stereotypic behavior; from a longitudinal observation of a semantic dementia patient
Language	J
AuthorList	Hideaki Shimizu¹⁾, Kenjiro Komori²⁾, Yasutaka Toyota³⁾, Taku Yoshida³⁾, Shinichiro Ochi¹⁾, Takaaki Mori¹⁾, Manabu Ikeda⁴⁾
Affiliation	¹⁾Department of Neuropsychiatry, Ehime University Graduate School of Medicine ²⁾Office of Psychology, Department of Psychiatry, Juzen-Yurinoki Hospital ³⁾Department of Psychiatry, Niihama Foundation Hospital ⁴⁾Department of Psychiatry, Osaka University Graduate School of Medicine
Publication	Japanese Journal of Neuropsychology: 35 (4), 225-237, 2019
Received	Nov 27, 2017
Accepted	Aug 30, 2019
Abstract	In semantic dementia (SD), there is usually asymmetrical temporal lobe atrophy. Difficulties in naming and recognition of words with surface dyslexia on kanji-word reading [gogi-aphasia] are the most prominent symptoms in the patients with the left-dominant temporal lobe atrophy. The right hemisphere as well as orbitofrontal cortex which is the main pathological lesion in behavioral variant of frontotemporal dementia (bvFTD) are getting a lot of attention as the neural basis of social recognition to cause social behavior disorders. We observed remarkable stereotypic behaviors without generalized cognitive decline during a four-year follow up of right-handed 54-year-old male patient with left-dominant SD presenting with typical clinical picture of gogi-aphasia, however any behavioral and psychological symptoms were not apparent at the beginning. They had more complicated and compulsive features than those with bvFTD, and associated with social behavioral disorders (ie: on medical leave from job, he often went to the office at an early hour and monopolized the duplicator all the morning for a bulk of drill paper). We proposed three factors causing such compulsive stereotypic behaviors in SD; 1) fear for the loss of vocabulary due to gogi-aphasia and tendency to obsession for coping behaviors due to anxiety associated with it, 2) narrowing of semantic understanding of objects with progressive semantic memory impairment and behavioral goal due to executive dysfunction associated with language, 3) loss of viewpoints of the other person and increasing indifference to his own deficits appeared in an early stage. Therefore, our longitudinal observation suggests that persistent stereotypic behaviors with SD were also involved in anterior temporal lobe atrophy which deteriorated semantic memory and executive function.
Keywords	semantic dementia, semantic memory, gogi-aphasia, stereotypic behavior, anterior temporal lobe