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Novakova L, Gajdos M, Markova J, Martinkovicova A, Kosutzka Z, Svantnerova J, Valkovic P, Csefalvay Z, Rektorova I. Language impairment in Parkinson’s disease: fMRI study of sentence reading comprehension. Front Aging Neurosci 2023; 15:1117473. [PMID: 36967818 PMCID: PMC10033839 DOI: 10.3389/fnagi.2023.1117473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
Parkinson’s disease (PD) affects the language processes, with a significant impact on the patients’ daily communication. We aimed to describe specific alterations in the comprehension of syntactically complex sentences in patients with PD (PwPD) as compared to healthy controls (HC) and to identify the neural underpinnings of these deficits using a functional connectivity analysis of the striatum. A total of 20 patients PwPD and 15 HC participated in the fMRI study. We analyzed their performance of a Test of sentence comprehension (ToSC) adjusted for fMRI. A task-dependent functional connectivity analysis of the striatum was conducted using the psychophysiological interaction method (PPI). On the behavioral level, the PwPD scored significantly lower (mean ± sd: 77.3 ± 12.6) in the total ToSC score than the HC did (mean ± sd: 86.6 ± 8.0), p = 0.02, and the difference was also significant specifically for sentences with a non-canonical word order (PD-mean ± sd: 69.9 ± 14.1, HC-mean ± sd: 80.2 ± 11.5, p = 0.04). Using PPI, we found a statistically significant difference between the PwPD and the HC in connectivity from the right striatum to the supplementary motor area [SMA, (4 8 53)] for non-canonical sentences. This PPI connectivity was negatively correlated with the ToSC accuracy of non-canonical sentences in the PwPD. Our results showed disturbed sentence reading comprehension in the PwPD with altered task-dependent functional connectivity from the right striatum to the SMA, which supports the synchronization of the temporal and sequential aspects of language processing. The study revealed that subcortical-cortical networks (striatal-frontal loop) in PwPD are compromised, leading to impaired comprehension of syntactically complex sentences.
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Affiliation(s)
- Lubomira Novakova
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czechia
| | - Martin Gajdos
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czechia
| | - Jana Markova
- Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia
| | - Alice Martinkovicova
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Zuzana Kosutzka
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Jana Svantnerova
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Peter Valkovic
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Zsolt Csefalvay
- Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia
| | - Irena Rektorova
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czechia
- *Correspondence: Irena Rektorova,
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The Cognitive and Language Profile of Dementia with Lewy Bodies. Am J Alzheimers Dis Other Demen 2022. [DOI: 10.1177/15333175221106901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia with Lewy bodies (DLB) is a major neurocognitive disorder (MNCD) that is primarily characterized by motor, cognitive, and behavioral symptoms. Although not dominant in the clinical portrait of DLB, impairments affecting language processing have been reported. It is sometimes challenging to differentiate DLB from Alzheimer’s disease and dementia associated with Parkinson’s disease in clinical practice. Therefore, a better comprehension of the typical clinical presentation of DLB may be useful to ease the medical diagnosis. In this article, current data on cognitive and language disorders in DLB are reported, with special attention paid to their primary or secondary functional origin. The main elements that should be considered for the neuropsychological and speech-language assessment of individuals with possible or proven DLB are also highlighted. Additional studies are needed, especially for language impairment, to obtain a more accurate portrait of the clinical presentation of DLB and characterize its progression.
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Suárez‐González A, Cassani A, Gopalan R, Stott J, Savage S. When it is not primary progressive aphasia: A scoping review of spoken language impairment in other neurodegenerative dementias. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12205. [PMID: 34485677 PMCID: PMC8409087 DOI: 10.1002/trc2.12205] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Progressive difficulties with spoken language occur across the spectrum of degenerative dementia. When not a primary presenting and dominant symptom, language difficulties may be overlooked in favor of more prominent cognitive, behavior, or motor deficits. The aim of this scoping review is to examine the extent and nature of the research evidence describing (1) the spoken language impairments found in non-language led dementias, (2) their impact on everyday living, and (3) the reported language interventions. METHODS We searched PubMed, MEDLINE, OVID-EMBASE, PsycINFO, and SpeechBITE using terms related to spoken language for the following dementia types: Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), cortico-basal syndrome (CBS), behavior variant frontotemporal dementia (bvFTD), early-onset Alzheimer's disease (EOAD), posterior cortical atrophy (PCA), and motor neuron disease associated with FTD (MND+FTD). Risk of bias was assessed with the QualSyst tool. RESULTS Seventy-three eligible studies were included. A wide range of spoken language impairments were reported, involving both linguistic (e.g., syntactic processing) and other cognitive (e.g., sustained attention) underlying mechanisms. Although the severity of these deficits was scarcely reported, in some cases they manifested as non-fluent, dynamic, and global aphasias. No papers in the review described either the impact of these language impairments on everyday living or language therapies to treat them. DISCUSSION There is a need to understand better the level of disability produced by language impairment in people living with non-language-led dementias. Our findings suggest three calls for action: (1) research studies should assess the clinical relevance of any spoken language deficits examined, (2) both linguistic and cognitive underlying mechanisms should be fully described (to inform the design of effective language and behavioral interventions), and (3) trials of language therapy should be conducted in those groups of individuals where significant language impairment is proved.
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Affiliation(s)
- Aida Suárez‐González
- Dementia Research CentreUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Alice Cassani
- Discipline of PsychologyWashington Singer LaboratoriesUniversity of ExeterExeterUK
| | - Ragaviveka Gopalan
- Discipline of PsychologyWashington Singer LaboratoriesUniversity of ExeterExeterUK
| | - Joshua Stott
- Research Department of ClinicalEducational and Health PsychologyUniversity College LondonLondonUK
| | - Sharon Savage
- School of PsychologyUniversity of NewcastleNewcastleNew South WalesAustralia
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Korsnes MS. Performance on the mini-mental state exam and the Montreal cognitive assessment in a sample of old age psychiatric patients. SAGE Open Med 2020; 8:2050312120957895. [PMID: 32963783 PMCID: PMC7488925 DOI: 10.1177/2050312120957895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 08/20/2020] [Indexed: 12/29/2022] Open
Abstract
Objective: This study assesses to what extent the Mini-Mental State Exam and the Montreal Cognitive Assessment scores may predict the presence of dementia in a sample of typical old age psychiatric patients who may or may not have temporally or permanently reduced cognitive abilities. Methods: A total of 141 inpatients completed the Mini-Mental State Exam and the Montreal Cognitive Assessment at arrival. All patients were subsequently diagnosed during their stay at the age-psychiatric unit. Receiver operating characteristics and analysis of variance were used to compare the results of the two tests for different patient groups. Results: The Montreal Cognitive Assessment is slightly more sensitive and specific than the Mini-Mental State Exam for dementia prediction. Age, sex, and education only account for approximately 2% of the variance in both tests. Patients with more than one diagnosis across the diagnostic groups included in this study (dementia, psychoses, affective disorder, and depression) performed significantly poorer on both tests than patients with a single diagnosis. Conclusions: Both tests are efficient in detecting cognitive impairment, but neither test can effectively exclude other reasons for low test results in our sample of elderly psychiatric patients. The sensitivity for ruling out dementia is 27 points for the Mini-Mental State Exam and 23 points for the Montreal Cognitive Assessment in the current patient sample.
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Smith KM, Caplan DN. Communication impairment in Parkinson's disease: Impact of motor and cognitive symptoms on speech and language. BRAIN AND LANGUAGE 2018; 185:38-46. [PMID: 30092448 DOI: 10.1016/j.bandl.2018.08.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 07/21/2018] [Accepted: 08/02/2018] [Indexed: 06/08/2023]
Abstract
Communication impairment is common in Parkinson's disease (PD) and may have both motor speech control and cognitive-linguistic underpinnings. The neurobiology of communication impairment in PD is poorly understood, and work is needed to disentangle the relative contributions of motor and cognitive dysfunction. In clinical practice, cognitive-linguistic impairments are often overlooked despite the large body of research on this topic in neurocognitive and linguistics literature. In this review, we will discuss the roles of motor speech changes, cognitive and linguistic impairment, and other related functions in the communication disabilities of individuals with PD. We will describe the various types of communication difficulties in PD and tools for measuring these symptoms. We will discuss specific deficits that may further understanding of the neurobiology of communication impairment in PD, including voice and speech acoustic changes, linguistic processing and production difficulties, and pausing. We will emphasize the importance of an interdisciplinary approach and the patient perspective on daily communication in guiding future research.
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Affiliation(s)
- Kara M Smith
- University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - David N Caplan
- Massachusetts General Hospital, 175 Cambridge Street, Boston, MA 02114, USA.
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Magdalinou NK, Golden HL, Nicholas JM, Witoonpanich P, Mummery CJ, Morris HR, Djamshidian A, Warner TT, Warrington EK, Lees AJ, Warren JD. Verbal adynamia in parkinsonian syndromes: behavioral correlates and neuroanatomical substrate. Neurocase 2018; 24:204-212. [PMID: 30293517 PMCID: PMC6234546 DOI: 10.1080/13554794.2018.1527368] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Verbal adynamia (impaired language generation, as during conversation) has not been assessed systematically in parkinsonian disorders. We addressed this in patients with Parkinson's dementia, progressive supranuclear palsy and corticobasal degeneration. All disease groups showed impaired verbal fluency and sentence generation versus healthy age-matched controls, after adjusting for general linguistic and executive factors. Dopaminergic stimulation in the Parkinson's group selectively improved verbal generation versus other cognitive functions. Voxel-based morphometry identified left inferior frontal and posterior superior temporal cortical correlates of verbal generation performance. Verbal adynamia warrants further evaluation as an index of language network dysfunction and dopaminergic state in parkinsonian disorders.
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Affiliation(s)
- Nadia K Magdalinou
- a Reta Lila Weston Institute of Neurological Studies , UCL Institute of Neurology , London , UK
| | - Hannah L Golden
- b Dementia Research Centre , UCL Institute of Neurology , London , UK
| | - Jennifer M Nicholas
- b Dementia Research Centre , UCL Institute of Neurology , London , UK.,c Department of Medical Statistics , London School of Hygiene and Tropical Medicine , London , UK
| | - Pirada Witoonpanich
- b Dementia Research Centre , UCL Institute of Neurology , London , UK.,d Division of Neurology, Department of Medicine, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | | | - Huw R Morris
- e Department of Clinical Neuroscience , UCL Institute of Neurology , London , UK
| | - Atbin Djamshidian
- a Reta Lila Weston Institute of Neurological Studies , UCL Institute of Neurology , London , UK
| | - Tom T Warner
- a Reta Lila Weston Institute of Neurological Studies , UCL Institute of Neurology , London , UK
| | | | - Andrew J Lees
- a Reta Lila Weston Institute of Neurological Studies , UCL Institute of Neurology , London , UK
| | - Jason D Warren
- b Dementia Research Centre , UCL Institute of Neurology , London , UK
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Macoir J, Fossard M, Lefebvre L, Monetta L, Renard A, Tran TM, Wilson MA. Detection Test for Language Impairments in Adults and the Aged-A New Screening Test for Language Impairment Associated With Neurodegenerative Diseases: Validation and Normative Data. Am J Alzheimers Dis Other Demen 2017; 32:382-392. [PMID: 28639484 PMCID: PMC10852687 DOI: 10.1177/1533317517715905] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
To date, there is no quick screening test that could be used during routine office visits to accurately assess language disorders in neurodegenerative diseases. To fill this important gap, we developed the Detection Test for Language impairments in Adults and the Aged (DTLA), a quick, sensitive, standardized screening test designed to assess language disorders in adults and the elderly individuals. In Study 1, we describe the development of the DTLA. In Study 2, we report data on the DTLA's validity and reliability. Finally, in Study 3, we establish normative data for the test. The DTLA has good convergent and discriminant validity as well as good internal consistency and test-retest reliability. Norms for the DTLA obtained from a sample of 545 healthy, community-dwelling, French-speaking adults from 4 French-speaking countries (Belgium, Canada (Quebec), France, and Switzerland) are provided. The development, validation, and standardization of the DTLA constitute a significant effort to meet the need for a language screening test adapted to neurodegenerative diseases.
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Affiliation(s)
- Joël Macoir
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche, Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Marion Fossard
- Institut des sciences du langage et de la communication, Université de Neuchâtel, Neuchâtel, Switzerland
| | - Laurent Lefebvre
- Service de Psychologie cognitive et Neuropsychologie, Université de Mons, Mons, Belgium
| | - Laura Monetta
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche, Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Antoine Renard
- Centre Leennaards de la Mémoire, Université de Lausanne, CHUv Lausanne, Switzerland
| | - Thi Mai Tran
- Département d’orthophonie, Faculté de Médecine, Université de Lille, France
| | - Maximiliano A. Wilson
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche, Institut universitaire en santé mentale de Québec, Québec, Canada
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Contribution of language studies to the understanding of cognitive impairment and its progression over time in Parkinson’s disease. Neurosci Biobehav Rev 2017; 80:657-672. [DOI: 10.1016/j.neubiorev.2017.07.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/28/2017] [Accepted: 07/27/2017] [Indexed: 11/24/2022]
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Zhong J, Pan P, Dai Z, Shi H. Voxelwise meta-analysis of gray matter abnormalities in dementia with Lewy bodies. Eur J Radiol 2014; 83:1870-4. [PMID: 25043498 DOI: 10.1016/j.ejrad.2014.06.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 06/19/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Increasing neuroimaging studies have revealed brain gray matter (GM) atrophy by voxel-based morphometry (VBM) studies in patients with dementia with Lewy bodies (DLB) relative to healthy controls. However, the spatial localization of GM abnormalities reported in the existing studies is heterogeneous. Here, we aimed to investigate concurrence across VBM studies to help clarify the structural abnormalities underpinning this condition. METHODS A systematic search for VBM studies of DLB patients and healthy controls published in PubMed database from January 2000 to March 2014 was conducted. A quantitative meta-analysis of whole-brain VBM studies in DLB patients and healthy controls was performed by means of Anisotropic Effect Size version of Signed Differential Mapping (AES-SDM) software package. RESULTS Seven studies comprising 218 DLB patients and 219 healthy controls were included in the present study. Compared to healthy subjects, the patients group showed consistent decreased GM in right lateral temporal/insular cortex and left lenticular nucleus/insular cortex. The results remained largely unchanged in the following jackknife sensitivity analyses. Meta-regression analysis indicated an increased probability of finding brain atrophy in left superior temporal gyrus in patients with lower MMSE scores. CONCLUSIONS The present meta-analysis quantitatively demonstrates a characteristic pattern of GM alternations that contributed to the understanding of pathophysiology underlying DLB. Future studies will benefit from employing meta-analytical comparisons to other dementia subtypes with solid evidence to extend these findings.
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Affiliation(s)
- JianGuo Zhong
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - PingLei Pan
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - ZhenYu Dai
- Department of Radiology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China
| | - HaiCun Shi
- Department of Neurology, Affiliated Yancheng Hospital of Southeast University, Yancheng, PR China.
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Cholerton B, Larson EB, Baker LD, Craft S, Crane PK, Millard SP, Sonnen JA, Montine TJ. Neuropathologic correlates of cognition in a population-based sample. J Alzheimers Dis 2014; 36:699-709. [PMID: 23666176 DOI: 10.3233/jad-130281] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Many cognitively normal older adults have underlying neuropathologic changes of Alzheimer's disease (AD), vascular brain injury (VBI), or Lewy body disease (LBD), which confer an increased risk of dementia. The current study focused on the association between multiple neuropathologic indices and performance on specific cognitive domains in a community sample of older adults. Of 438 participants in the Adult Changes in Thought population-based study of brain aging who were autopsied, 363 subjects had cognitive testing at their final study visit and were included. Associations were measured between performance on the Cognitive Abilities Screening Instrument prior to death and neuropathologic endpoints, including AD neuropathologic changes, LBD, cerebral amyloid angiopathy, and measures of VBI. Braak stage for neurofibrillary tangles, lower brain weight, and VBI as measured by cerebral cortical microvascular lesions (μVBI) explained a significant proportion of the variance associated with global cognitive test performance (R2 = 0.31, p < 0.0001) both in the entire sample and when analysis was restricted to non-demented subjects (R2 = 0.23, p < 0.0001). Specific cognitive domains were differentially related to neuropathologic lesion type: memory and executive function with AD pathologic changes and cortical μVBI, executive function with subcortical μVBI, and visuospatial construction with LBD. Thus, neuropathologic lesions of LBD and μVBI are associated with poorer cognitive performance over and above AD neuropathologic changes in subjects without dementia in this cohort. These findings underscore that cognitive impairment is a complex convergent trait that has important implications for clinical investigation and medical management of older adults.
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Affiliation(s)
- Brenna Cholerton
- Geriatric Research, Education, & Clinical Center, Veterans Affairs Puget Sound Health Care System, 9600 Veterans Drive SW, Tacoma, WA 98493, USA.
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Ash S, Xie SX, Gross RG, Dreyfuss M, Boller A, Camp E, Morgan B, O'Shea J, Grossman M. The organization and anatomy of narrative comprehension and expression in Lewy body spectrum disorders. Neuropsychology 2012; 26:368-84. [PMID: 22309984 PMCID: PMC3348419 DOI: 10.1037/a0027115] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Patients with Lewy body spectrum disorders (LBSD) such as Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies exhibit deficits in both narrative comprehension and narrative expression. The present research examines the hypothesis that these impairments are due to a material-neutral deficit in organizational executive resources rather than to impairments of language per se. We predicted that comprehension and expression of narrative would be similarly affected and that deficits in both expression and comprehension of narrative would be related to the same anatomic distribution of prefrontal disease. METHOD We examined 29 LBSD patients and 26 healthy seniors on their comprehension and expression of narrative discourse. For comprehension, we measured accuracy and latency in judging events with high and low associativity from familiar scripts such as "going fishing." The expression task involved maintaining the connectedness of events while narrating a story from a wordless picture book. RESULTS LBSD patients were impaired on measures of narrative organization during both comprehension and expression relative to healthy seniors. Measures of organization during narrative expression and comprehension were significantly correlated with each other. These measures both correlated with executive measures but not with neuropsychological measures of lexical semantics or grammar. Voxel-based morphometry revealed overlapping regressions relating frontal atrophy to narrative comprehension, narrative expression, and measures of executive control. CONCLUSIONS Difficulty with narrative discourse in LBSD stems in part from a deficit of organization common to comprehension and expression. This deficit is related to prefrontal cortical atrophy in LBSD.
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Affiliation(s)
- Sharon Ash
- University of Pennsylvania, Philadelphia, PA, USA.
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