The Landscape Montage Technique for diagnosing frontotemporal dementia starting as primary progressive aphasia: a case report

Abstract

Background: The Landscape Montage Technique was originally developed by Hisao Nakai, a Japanese psychiatrist, to pursue the possibility and application of a psychotherapeutic approach using drawing for patients with schizophrenia. Drawing was initially adopted to evaluate patients with an impaired ability for verbal expression, particularly for the diagnosis and treatment of patients with schizophrenia. Since its development, the Landscape Montage Technique has been utilized in various clinical settings throughout Japan. This study aimed to evaluate the psychiatric conditions of a patient diagnosed as having primary progressive aphasia using the Landscape Montage Technique at a 3-year follow-up. Case presentation: We present the case of a 64-year-old, right-handed Japanese woman initially diagnosed as having logopenic variant primary progressive aphasia or logopenic aphasia. At a 3-year follow-up, logopenic aphasia progressed to behavioral variant frontotemporal dementia or frontotemporal dementia. According to her husband, she began to have speech difficulties approximately 5 years before her first visit. The results of neurocognitive tests suggested mild cognitive impairment or early stages of dementia. Her clinical dementia rating score was 0.5, suggesting a diagnosis of mild cognitive impairment. She had a Raven's Colored Progressive Matrices score of 31 out of 36, which indicated a nonverbal cognitive ability that was greater than the 90th percentile for her age. The Japanese Standard Language Test of Aphasia, which was performed at two points during the followup, indicated the possibility for a diagnosis of primary progressive aphasia given the progression of her aphasia. Based on her clinical symptoms and Japanese Standard Language Test of Aphasia results, a diagnosis of logopenic variant primary progressive aphasia was established. Magnetic resonance imaging revealed severe predominant left frontal and anterior temporal atrophy, as well as bilateral parietal atrophy. Amyloid beta deposition was negative. At the 3-year follow-up, logopenic variant primary progressive aphasia had progressed to behavioral variant frontotemporal dementia. However, the Landscape Montage Technique allowed for the diagnosis of behavioral variant frontotemporal dementia only 2 years after baseline. Conclusions: The present study showed that the Landscape Montage Technique can be useful for diagnosing behavioral variant frontotemporal dementia that starts as logopenic variant primary progressive aphasia at earlier stages.

Longitudinal study of primary progressive aphasia in a patient with pathologically diagnosed Alzheimer’s disease: a case report

“…Our study had several limitations: (1) we presented only one case of aphasia progression in a Japanese-speaking patient with AD, and (2) we used the SLTA to evaluate aphasia, including agrammatism. The SLAT, which was developed during predecessor conferences of the Japan Society for Higher Brain Dysfunction, is only available in Japanese and is commonly used only in Japan [ 4 ]. Because Japanese grammar is very different from that of other languages, the definition of “agrammatism” is also very different.…”

“…The Japanese Standard Language Test of Aphasia (SLTA) was also performed at each of the four time points [ 4 , 5 ]. The SLTA was developed in Japan and consists of 26 items for evaluating aphasia; the test kit is commonly used and easily available in Japan [ 4 , 5 ]. The results of the SLTA are shown in Table 2 .…”

Progressive amnestic cognitive impairment in a middle-aged patient with developmental language disorder: a case report

“…However, the concrete mechanism for this progression cannot yet be described. The Landscape Montage Technique, which is one of the well-known art therapy techniques, may help evaluate the current patient’s clinical implications and diagnose him at an earlier stage [ 12 ].…”

Structural Brain Network Correlated with Reading Impairment in Alzheimer’s Disease

“…Language function of AD patients was estimated by the Standard Language Test of Aphasia (SLTA) [16, 17]. SLTA is a test battery containing 26 items and was originally developed as a test of multiple domains of Japanese language function, such as auditory comprehension, reading, naming, writing, and dictation of letters and sentences (Table 2).…”