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Tee BL, Li‐Ying LK, Chen T, Yan CTY, Tsoh J, Chan AL, Wong A, Lo RY, Lu CJ, Sun Y, Wang P, Lee Y, Chiu M, Allen IE, Battistella G, Bak TH, Chuang Y, García AM, Gorno‐Tempini ML. More than a piece of cake: Noun classifier processing in primary progressive aphasia. Alzheimers Dement 2024; 20:2353-2363. [PMID: 38284802 PMCID: PMC11032580 DOI: 10.1002/alz.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/29/2023] [Accepted: 12/31/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown. METHODS We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier. RESULTS Both semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices. DISCUSSION This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers. HIGHLIGHTS Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.
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Affiliation(s)
- Boon Lead Tee
- Memory and Aging CenterUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
- Department of NeurologyDyslexia CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Lorinda Kwan‐Chen Li‐Ying
- Department of Special Education and CounsellingThe Education University of Hong KongHong KongHong Kong
| | - Ta‐Fu Chen
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan R.O.C.
| | - Connie TY Yan
- Department of PsychiatryPrince of Wales Hospital and ShaTin HospitalHong KongHong Kong
- Department of PsychiatryFaculty of MedicineThe Chinese University of Hong KongHong KongHong Kong
| | - Joshua Tsoh
- Department of PsychiatryPrince of Wales Hospital and ShaTin HospitalHong KongHong Kong
- Department of PsychiatryFaculty of MedicineThe Chinese University of Hong KongHong KongHong Kong
| | | | - Adrian Wong
- Division of NeurologyDepartment of Medicine and TherapeuticsChinese University of Hong KongHong KongHong Kong
| | - Raymond Y. Lo
- Department of NeurologyBuddhist Tzu Chi General HospitalHualienTaiwan
| | - Chien Jung Lu
- Department of NeurologyEn Chu Kong HospitalNew Taipei CityTaiwan R.O.C.
| | - Yu Sun
- Department of NeurologyEn Chu Kong HospitalNew Taipei CityTaiwan R.O.C.
| | - Pei‐Ning Wang
- Division of General NeurologyDepartment of Neurological InstituteTaipei Veterans General HospitalTaipeiTaiwan R.O.C.
- School of MedicineNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan R.O.C.
- Brain Research CenterNational Yang‐Ming Chiao‐Tung UniversityHsinChuTaiwan R.O.C.
| | - YiChen Lee
- Department of NeurologyNational Taiwan University HospitalHsinChuTaiwan R.O.C.
| | - Ming‐Jang Chiu
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan R.O.C.
| | - Isabel Elaine Allen
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Giovanni Battistella
- Department of Otolaryngology ‐ Head and Neck SurgeryMassachusetts Eye and Ear and Harvard Medical SchoolBostonMassachusettsUSA
| | - Thomas H. Bak
- School of Philosophy, Psychology and Language Sciences (PPLS)University of EdinburghEdinburghUK
| | - Yu‐Chen Chuang
- Division of General NeurologyDepartment of Neurological InstituteTaipei Veterans General HospitalTaipeiTaiwan R.O.C.
| | - Adolfo M. García
- Global Brain Health InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Cognitive Neuroscience CenterUniversidad de San AndrésBuenos AiresArgentina
- Departamento de Lingüística y LiteraturaFacultad de HumanidadesUniversidad de Santiago de ChileSantiagoChile
| | - Maria Luisa Gorno‐Tempini
- Memory and Aging CenterUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
- Department of NeurologyDyslexia CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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Lukic S, Fan Z, García AM, Welch AE, Ratnasiri BM, Wilson SM, Henry ML, Vonk J, Deleon J, Miller BL, Miller Z, Mandelli ML, Gorno-Tempini ML. Discriminating nonfluent/agrammatic and logopenic PPA variants with automatically extracted morphosyntactic measures from connected speech. Cortex 2024; 173:34-48. [PMID: 38359511 PMCID: PMC11246552 DOI: 10.1016/j.cortex.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/15/2023] [Accepted: 12/12/2023] [Indexed: 02/17/2024]
Abstract
Morphosyntactic assessments are important for characterizing individuals with nonfluent/agrammatic variant primary progressive aphasia (nfvPPA). Yet, standard tests are subject to examiner bias and often fail to differentiate between nfvPPA and logopenic variant PPA (lvPPA). Moreover, relevant neural signatures remain underexplored. Here, we leverage natural language processing tools to automatically capture morphosyntactic disturbances and their neuroanatomical correlates in 35 individuals with nfvPPA relative to 10 healthy controls (HC) and 26 individuals with lvPPA. Participants described a picture, and ensuing transcripts were analyzed via part-of-speech tagging to extract sentence-related features (e.g., subordinating and coordinating conjunctions), verbal-related features (e.g., tense markers), and nominal-related features (e.g., subjective and possessive pronouns). Gradient boosting machines were used to classify between groups using all features. We identified the most discriminant morphosyntactic marker via a feature importance algorithm and examined its neural correlates via voxel-based morphometry. Individuals with nfvPPA produced fewer morphosyntactic elements than the other two groups. Such features robustly discriminated them from both individuals with lvPPA and HCs with an AUC of .95 and .82, respectively. The most discriminatory feature corresponded to subordinating conjunctions was correlated with cortical atrophy within the left posterior inferior frontal gyrus across groups (pFWE < .05). Automated morphosyntactic analysis can efficiently differentiate nfvPPA from lvPPA. Also, the most sensitive morphosyntactic markers correlate with a core atrophy region of nfvPPA. Our approach, thus, can contribute to a key challenge in PPA diagnosis.
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Affiliation(s)
- Sladjana Lukic
- University of California, San Francisco Memory and Aging Center, CA, USA; Ruth S. Ammon College of Education and Health Sciences, Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY, USA.
| | - Zekai Fan
- Heinz College of Information Systems and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Adolfo M García
- Global Brain Health Institute (GBHI), University of California, San Francisco, CA, USA; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Ariane E Welch
- Ruth S. Ammon College of Education and Health Sciences, Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY, USA
| | | | - Stephen M Wilson
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Maya L Henry
- University of Texas at Austin Moody College of Communication, Austin, TX, USA
| | - Jet Vonk
- University of California, San Francisco Memory and Aging Center, CA, USA
| | - Jessica Deleon
- University of California, San Francisco Memory and Aging Center, CA, USA
| | - Bruce L Miller
- University of California, San Francisco Memory and Aging Center, CA, USA
| | - Zachary Miller
- University of California, San Francisco Memory and Aging Center, CA, USA
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Stockbridge MD, Matchin W, DeLuque E, Sharif M, Fridriksson J, Faria AV, Hillis AE. Mary has a little chair: Eliciting noun-modifier phrases in individuals with acute post-stroke aphasia. APHASIOLOGY 2023; 38:771-789. [PMID: 38654898 PMCID: PMC11034753 DOI: 10.1080/02687038.2023.2233739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/30/2023] [Indexed: 04/26/2024]
Abstract
Background Aphasia assessment primarily examines an individual's syntax, nouns, and verbs. However, modifiers, such as adjectives and number words, and bound morphemes can be the subject of considerable difficulty for individuals with aphasia. The Morphosyntactic Generation (MorGen) targets nouns, modifiers, and bound inflectional morphemes in two-word phrases among people with aphasia. Aims The purpose of this work is to provide the first report of the MorGen in hyperacute-acute aphasia. In doing so, we aim to (1) examine the MorGen's concurrent validity with common assessments of aphasia; (2) describe performance in modifiers by people with acute aphasia; and (3) associate MorGen performance with extent of lesioned vascular territories in acute stroke. Methods & Procedures 62 adult English speakers within the first 14 days of left hemisphere ischemic stroke and 61 healthy control participants completed the MorGen. In addition to receiving the MorGen, participants with stroke received the Western Aphasia Battery (WAB), Boston Naming Test, and Hopkins Action Naming Assessment. Clinical MRIs were analyzed for the extent of lesion in the vascular territory of the left anterior, medial, and posterior cerebral artery, as well as the left posterior choroidal and thalamoperforator arteries. Outcomes & Results Aim 1: Performance on the MorGen demonstrated consistently high, significant correlations with that on the WAB, Boston Naming Test, and Hopkins Action Naming Assessment. Aim 2: Individuals who had a stroke but were within functional limits (WFL) on the WAB performed significantly worse than healthy controls on the MorGen, driven by differences in adjective performance. When controlling for aphasia severity, those with fluent aphasia performed significantly better in their production of nouns, plurals, number, size, and color than those who had non-fluent aphasia, but both groups were similarly inclined to omit genitive marking. Aim 3: Lesions in the territory of the temporal branch of the posterior cerebral artery were associated with poorer performance in nouns, size, and color. Lesions in the territory of the anterior cerebral artery were associated with poorer performance in numbers. Conclusions This work highlights the value of the MorGen as a tool for post-stroke language evaluation that complements the skills captured in more widely-used assessments such as the WAB and BNT.
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Affiliation(s)
- Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School
of Medicine, Baltimore, MD 21287
| | - William Matchin
- Department of Communication Sciences and Disorders,
University of South Carolina Arnold School of Public Health, Columbia, SC
29208
| | - Elizabeth DeLuque
- Department of Neurology, Johns Hopkins University School
of Medicine, Baltimore, MD 21287
| | - Massoud Sharif
- Department of Neurology, Johns Hopkins University School
of Medicine, Baltimore, MD 21287
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders,
University of South Carolina Arnold School of Public Health, Columbia, SC
29208
| | - Andreia V. Faria
- Department of Radiology and Radiological Science, Johns
Hopkins University School of Medicine, Baltimore, MD 21287
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School
of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns
Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts
and Sciences, Johns Hopkins University, Baltimore, MD 21218
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Grammar in 'agrammatical' aphasia: What's intact? PLoS One 2022; 17:e0278676. [PMID: 36473005 PMCID: PMC9725141 DOI: 10.1371/journal.pone.0278676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Aphasia following cerebro-vascular accidents has been a primary source of insight for models of language in the brain. However, deviant language patterns in aphasia may reflect processing limitations and cognitive impairment more than language impairment per se. AIMS We sought to obtain new evidence from spontaneous speech in Broca's aphasia (BA) for the intactness of grammatical knowledge, operationalized as the preservation of the basic hierarchical structure of syntactic projections. METHODS & PROCEDURES Speech obtained with the AphasiaBank protocol from 20 people with BA, which were independently rated as also being agrammatic, was analyzed and compared to 20 matched non-brain-damaged controls. We quantified (i) marking of Aspect, Tense, and Modality (A-T-M), which are located at specific (high) layers of the syntactic hierarchy and ordered in relation to one another ([M…[T…[A…]]]); (ii) hierarchies of clausal units ([C…[C]]); (iii) discourse markers embedding clauses, located at the highest layer of the hierarchy; and (iv) attachment of adjuncts at different heights of a given hierarchical syntactic structure. Supplementary evidence was obtained from a typology of errors and from pauses subcategorized according to their hierarchical syntactic position. OUTCOMES & RESULTS Groups did not quantitatively differ on rates of either Aspect or Modality but underproduced T and embedded clauses. Evidence for compensatory effects was seen in both of the latter two cases. While all adjunct types were underproduced in BA, and pauses overproduced, both showed the same relative proportions within both groups. Errors were largely restricted to omissions, of a kind that would also be expected in condensed neurotypical speech. CONCLUSIONS Overall, these patterns support the hypothesis of intactness of grammatical knowledge in BA clinically rated as agrammatic, questioning it as a disease model of language impairment.
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Stockbridge MD, Venezia JH, Vitti E, Tippett DC, Hillis AE. Verb Frequency and Density Drive Naming Performance in Primary Progressive Aphasia. APHASIOLOGY 2022; 37:1964-1980. [PMID: 38155815 PMCID: PMC10752624 DOI: 10.1080/02687038.2022.2142036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Background Recent work has highlighted the utility of the Boston Naming Test and Hopkins Action Naming Assessment (HANA) for distinguishing between semantic (svPPA), logopenic (lvPPA) and non-fluent agrammatic (nfavPPA) variants of primary progressive aphasia (PPA). Aims To determine whether item level differences between variants on when naming verbs on the HANA were able to be accounted for using common variables of lexical interest: word frequency, semantic density, concreteness, or valency. We also examined three specific hypotheses: (1) svPPA and lvPPA may result in increased difficulty with decreased semantic density compared to nfavPPA; (2) svPPA may result in increased difficulty with decreased concreteness; and (3) nfavPPA may result in increased difficulty with high syntactic valency. Methods & Procedures 268 patients with PPA were evaluated using the HANA. A hierarchical Bayesian regression approach was adopted to account for effects of repeated measurement within participants and items. Outcomes & Results The main effects of variant and verb trait were significant in all models, as was the interaction for frequency, semantic density, and valency. Increasing frequency, semantic density, and concreteness led to better performance, while increasing valency led to poorer performance. Low semantic density contributed to greater difficulty in svPPA and lvPPA, but low concreteness did not uniquely impact verb naming in svPPA. Those with nfavPPA had no particular difficulty as a result of valency. Conclusions Prior studies have identified the independent effects of frequency and semantic density on verb naming in PPA, which were confirmed by our analyses, and the best predictions of the data were achieved by combining these dimensions. This investigation complements our previous work highlighting the value of the HANA for efficiently demonstrating verb performance in PPA.
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Affiliation(s)
- Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Jonathan H. Venezia
- VA Loma Linda Healthcare System, Loma Linda, CA 92357
- Department of Otolaryngology & Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, CA 92350
| | - Emilia Vitti
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218
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Verbal and Nonverbal Memory in Neurodegenerative and Stroke Aphasia: Evidence From the Turkish Version of the Three Words Three Shapes Test. Cogn Behav Neurol 2022; 35:49-65. [PMID: 35239599 DOI: 10.1097/wnn.0000000000000294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although language impairment is the most salient feature of cognitive impairment in both primary progressive aphasia (PPA) and stroke aphasia (SA), memory can also be impaired in both patient populations. OBJECTIVE To identify distinctive features of verbal and nonverbal memory processing in individuals with PPA and those with SA. METHOD We gave individuals with PPA (n = 14), those with SA (n = 8), and healthy controls (HC; n = 13) a comprehensive neuropsychological test battery and the Turkish version of the Three Words Three Shapes Test (3W3S-Turkish). The 3W3S-Turkish Test includes five subtests: Copy, Incidental Recall, Acquisition, Delayed Recall, and Recognition. High-resolution brain scans were performed in a subset of individuals with PPA and those with SA. Lesion distribution was limited to the dorsal language areas in the SA group, whereas peak atrophy areas in the PPA group extended beyond the language network, including the medial temporal lobe, precuneus, and posterior/medial portions of the cingulate cortex. RESULTS Both the PPA and SA groups showed impairment in incidental recall, and the PPA group showed additional impairment in delayed recall. Greater impairment for verbal stimuli suggestive of material-specific memory impairment was evident in the PPA group's scores on the Incidental Recall and Delayed Recall subtests. Both aphasia groups retained the acquired information regardless of material type. CONCLUSION Although both aphasia groups shared similarities in the involvement of the dorsal prefrontal working memory/attention network, the PPA group showed greater impairment in delayed recall compared with the SA group.
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Guillén Escamilla JE, Arias García M, Téllez Lamegos J. El uso de pronombres clíticos en hablantes afásicos con agramatismo. Un estudio desde el español. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2022. [DOI: 10.5209/rlog.76383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
El agramatismo es un síntoma de las afasias no fluentes que se manifiesta principalmente en la omisión de palabras función y de sufijos flexivos y derivativos. En este contexto, los clíticos han sido ampliamente estudiados y se ha concluido que también sufren alteraciones; no obstante, estos estudios parten de un criterio sintáctico estrecho y de tareas ad hoc que no reflejan la capacidad real de los hablantes para emplear el sistema lingüístico. Por tal motivo, el objetivo de nuestro trabajo es analizar el uso de clíticos en situaciones comunicativas más naturales para determinar si también en estos escenarios se encuentran alterados. Para tal fin, analizamos el volumen Afasia no fluente del corpus PerLA (Gallardo y Moreno, 2005). Los resultados indican que los hablantes tienen muy pocos problemas para emplear correctamente los clíticos y que los errores se deben a las omisiones de los verbos. Se concluye que este contraste con los resultados previos se debe a la naturaleza del corpus, pues refleja de mejor manera las habilidades conservadas de los pacientes.
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Seckin M, Ricard I, Raiser T, Heitkamp N, Ebert A, Prix C, Levin J, Diehl-Schmid J, Riedl L, Roßmeier C, Hoen N, Schroeter ML, Marschhauser A, Obrig H, Benke T, Kornhuber J, Fliessbach K, Schneider A, Wiltfang J, Jahn H, Fassbender K, Prudlo J, Lauer M, Duning T, Wilke C, Synofzik M, Anderl-Straub S, Semler E, Lombardi J, Landwehrmeyer B, Ludolph A, Otto M, Danek A. Utility of the Repeat and Point Test for Subtyping Patients With Primary Progressive Aphasia. Alzheimer Dis Assoc Disord 2022; 36:44-51. [PMID: 35001030 DOI: 10.1097/wad.0000000000000482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Primary progressive aphasia (PPA) may present with three distinct clinical sybtypes: semantic variant PPA (svPPA), nonfluent/agrammatic variant PPA (nfvPPA), and logopenic variant PPA (lvPPA). OBJECTIVE The aim was to examine the utility of the German version of the Repeat and Point (R&P) Test for subtyping patients with PPA. METHOD During the R&P Test, the examiner reads out aloud a noun and the participants are asked to repeat the word and subsequently point to the corresponding picture. Data from 204 patients (68 svPPA, 85 nfvPPA, and 51 lvPPA) and 33 healthy controls were analyzed. RESULTS Controls completed both tasks with >90% accuracy. Patients with svPPA had high scores in repetition (mean=9.2±1.32) but low scores in pointing (mean=6±2.52). In contrast, patients with nfvPPA and lvPPA performed comparably in both tasks with lower scores in repetition (mean=7.4±2.7 for nfvPPA and 8.2±2.34 for lvPPA) but higher scores in pointing (mean=8.9±1.41 for nfvPPA and 8.6±1.62 for lvPPA). The R&P Test had high accuracy discriminating svPPA from nfvPPA (83% accuracy) and lvPPA (79% accuracy). However, there was low accuracy discriminating nfvPPA from lvPPA (<60%). CONCLUSION The R&P Test helps to differentiate svPPA from 2 nonsemantic variants (nfvPPA and lvPPA). However, additional tests are required for the differentiation of nfvPPA and lvPPA.
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Affiliation(s)
- Mustafa Seckin
- Neurologische Klinik und Poliklinik
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Department of Neurology, İstanbul, Turkey
| | - Ingrid Ricard
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Unversität München
| | | | | | - Anne Ebert
- Neurologische Klinik, Universitätsmedizin Mannheim, Mannheim
| | | | - Johannes Levin
- Neurologische Klinik und Poliklinik
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)
- Munich Cluster for Systems Neurology (SyNergy)
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Lina Riedl
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Carola Roßmeier
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Nora Hoen
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Anke Marschhauser
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Hellmuth Obrig
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Thomas Benke
- Universitätsklinik für Neurologie, Kognitive Neurologie und Neuropsychologie, Innsbruck, Austria
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen
| | - Klaus Fliessbach
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn & Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn
| | - Anja Schneider
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn & Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn
| | - Jens Wiltfang
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Göttingen
| | - Holger Jahn
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Klaus Fassbender
- Neurologische Klinik und Poliklinik, Universität des Saarlandes, KirrbergerStraße, Homburg
| | - Johannes Prudlo
- Klinik für Neurologie und Poliklinik, Universitätsklinikum Rostock, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock
| | - Martin Lauer
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universität Würzburg, Würzburg
| | - Thomas Duning
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-Universität, Münster
| | - Carlo Wilke
- Department of Neurodegenerative Diseases, Centre for Neurology and Hertie-Institute for Clinical Brain Research, University Hospital
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Centre for Neurology and Hertie-Institute for Clinical Brain Research, University Hospital
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen
| | | | - Elisa Semler
- Neurologische Klinik und Poliklinik, Universität Ulm
| | | | | | - Albert Ludolph
- Neurologische Klinik und Poliklinik, Universität Ulm
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm
| | - Markus Otto
- Neurologische Klinik und Poliklinik, Universität Ulm
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Stockbridge MD, Matchin W, Walker A, Breining B, Fridriksson J, Hickok G, Hillis AE. One cat, Two cats, Red cat, Blue cats: Eliciting morphemes from individuals with primary progressive aphasia. APHASIOLOGY 2021; 35:1-12. [PMID: 35002009 PMCID: PMC8735668 DOI: 10.1080/02687038.2020.1852167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/11/2020] [Indexed: 06/14/2023]
Abstract
BACKGROUND Progressive neurodegenerative impairment with central language features, primary progressive aphasia (PPA), can be further distinguished for many individuals into one of three variants: semantic, non-fluent/agrammatic, and logopenic variant PPA. Variants differ in their relative preservation and deficits of language skills, particularly in word finding and grammar. The majority of elicited language assessments used in this population focus on single noun and verb production, while modifiers and inflectional morphemes are far less commonly examined. AIMS The purpose of the present study is to determine whether there was an interaction between PPA variant and production of high-frequency nouns, proper names, modifiers, and bound inflectional morphemes to better understand how the variants differ. METHODS & PROCEDURES Forty-six people with PPA and 47 individuals with no known neurological diagnoses completed a morphosyntactic generation assessment designed to target differential production of high-frequency nouns, proper names, modifiers (number, size, color), and bound inflectional morphemes (plural -s and possessive 's), the Morphosyntactic Generation test (MorGen). Performance is averaged for each of the seven morphosyntactic targets independently, resulting in seven separate performance scores. OUTCOMES & RESULTS Individuals with PPA performed significantly more poorly than controls on the assessed morphemes in a repeated-measures analysis of variance, as well as on each morpheme considered independently via t-test.In a multivariable analysis of variance among PPA variants, the interaction of morpheme and PPA variant was significant, suggesting different variants produced the morphemes with a significantly different pattern of success. When morphemes were considered independently, only production of colour resulted in a significant difference between variants, driven by the performance of individuals with nfavPPA, who performed near-ceiling. When MorGen performance was used to predict PPA variant in a multinomial logistic regression the model was significant, with age, plural -s, noun, and number contributing significantly to the prediction. In a discriminate function analysis, classification of cases was best for agrammatic variant with 70% accuracy. CONCLUSIONS Individuals with PPA, particularly semantic and logopenic variants, demonstrated difficulty on the MorGen compared to controls. The MorGen proved useful in predicting PPA variant. These findings highlight the potential benefit of examining a broader range of morphemes, particularly bound morphemes and modifiers, in addition to the more frequently investigated classes of nouns and verbs when understanding PPA.
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Affiliation(s)
- Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - William Matchin
- Department of Communication Sciences and Disorders, University of South Carolina Arnold School of Public Health, Columbia, SC 29208
| | - Alexandra Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Bonnie Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina Arnold School of Public Health, Columbia, SC 29208
| | - Gregory Hickok
- Department of Cognitive Sciences, Department of Language Science, University of California, Irvine, CA 92697
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218
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Themistocleous C, Webster K, Afthinos A, Tsapkini K. Part of Speech Production in Patients With Primary Progressive Aphasia: An Analysis Based on Natural Language Processing. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:466-480. [PMID: 32697669 PMCID: PMC8702871 DOI: 10.1044/2020_ajslp-19-00114] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/14/2020] [Accepted: 05/13/2020] [Indexed: 06/11/2023]
Abstract
Background Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a progressive decline of language functions. Its symptoms are grouped into three PPA variants: nonfluent PPA, logopenic PPA, and semantic PPA. Grammatical deficiencies differ depending on the PPA variant. Aims This study aims to determine the differences between PPA variants with respect to part of speech (POS) production and to identify morphological markers that classify PPA variants using machine learning. By fulfilling these aims, the overarching goal is to provide objective measures that can facilitate clinical diagnosis, evaluation, and prognosis. Method and Procedure Connected speech productions from PPA patients produced in a picture description task were transcribed, and the POS class of each word was estimated using natural language processing, namely, POS tagging. We then implemented a twofold analysis: (a) linear regression to determine how patients with nonfluent PPA, semantic PPA, and logopenic PPA variants differ in their POS productions and (b) a supervised classification analysis based on POS using machine learning models (i.e., random forests, decision trees, and support vector machines) to subtype PPA variants and generate feature importance (FI). Outcome and Results Using an automated analysis of a short picture description task, this study showed that content versus function words can distinguish patients with nonfluent PPA, semantic PPA, and logopenic PPA variants. Verbs were less important as distinguishing features of patients with different PPA variants than earlier thought. Finally, the study showed that among the most important distinguishing features of PPA variants were elaborative speech elements, such as adjectives and adverbs.
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Affiliation(s)
| | - Kimberly Webster
- Department of Otolaryngology, Johns Hopkins Medicine, Baltimore MD
| | | | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Cognitive Science, Johns Hopkins University, Baltimore MD
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Barbieri E, Litcofsky KA, Walenski M, Chiappetta B, Mesulam MM, Thompson CK. Online sentence processing impairments in agrammatic and logopenic primary progressive aphasia: Evidence from ERP. Neuropsychologia 2021; 151:107728. [PMID: 33326758 PMCID: PMC7875464 DOI: 10.1016/j.neuropsychologia.2020.107728] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Evidence from psycholinguistic research indicates that sentence processing is impaired in Primary Progressive Aphasia (PPA), and more so in individuals with agrammatic (PPA-G) than logopenic (PPA-L) subtypes. Studies have mostly focused on offline sentence production ability, reporting impaired production of verb morphology (e.g., tense, agreement) and verb-argument structure (VAS) in PPA-G, and mixed findings in PPA-L. However, little is known about real-time sentence comprehension in PPA. The present study is the first to compare real-time semantic, morphosyntactic and VAS processing in individuals with PPA (10 with PPA-G and 9 with PPA-L), and in two groups of healthy (22 young and 19 older) individuals, using event-related potentials (ERP). Participants were instructed to listen to sentences that were either well-formed (n = 150) or contained a violation of semantics (e.g., *Owen was mentoring pumpkins at the party, n = 50), morphosyntax (e.g., *The actors was singing in the theatre, n = 50) or VAS (*Ryan was devouring on the couch, n = 50), and were required to perform a sentence acceptability judgment task while EEG was recorded. Results indicated that in the semantic task both healthy and PPA groups showed an N400 response to semantic violations, which was delayed in PPA and older (vs. younger) groups. Morphosyntactic violations elicited a P600 in both groups of healthy individuals and in PPA-L, but not in PPA-G. A similar P600 response was also found only in healthy individuals for VAS violations; whereas, abnormal ERP responses were observed in both PPA groups, with PPA-G showing no evidence of VAS violation detection and PPA-L showing a delayed and abnormally-distributed positive component that was negatively associated with offline sentence comprehension scores. These findings support characterizations of sentence processing impairments in PPA-G, by providing online evidence that VAS and morphosyntactic processing are impaired, in the face of substantially preserved semantic processing. In addition, the results indicate that on-line processing of VAS information may also be impaired in PPA-L, despite their near-normal accuracy on standardized language tests of argument structure production.
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Affiliation(s)
- Elena Barbieri
- Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States.
| | - Kaitlyn A Litcofsky
- Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Matthew Walenski
- Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Brianne Chiappetta
- Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Marek-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, United States; Department of Neurology, Northwestern University, Chicago, IL, United States
| | - Cynthia K Thompson
- Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States; Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, United States; Department of Neurology, Northwestern University, Chicago, IL, United States
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Mack JE, Barbieri E, Weintraub S, Mesulam MM, Thompson CK. Quantifying grammatical impairments in primary progressive aphasia: Structured language tests and narrative language production. Neuropsychologia 2020; 151:107713. [PMID: 33285187 DOI: 10.1016/j.neuropsychologia.2020.107713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 11/06/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This study examined grammatical production impairments in primary progressive aphasia (PPA), as measured by structured tests and narrative samples. We aimed to quantify the strength of the relationship between grammatical measures across tasks, and identify factors that condition it. Three grammatical domains were investigated: overall sentence production, verb morphology, and verb-argument structure. METHODS 77 participants with PPA (34 PPA-G, 16 PPA-L, 15 PPA-S and 12 other) completed a battery of grammatical tests and a narrative language sample was obtained. Accuracy scores were computed for the language tests and the narrative samples were analyzed for both accuracy of selected narrative variables as well as grammatical diversity across the three grammatical domains. Principal components analysis (PCA) and multiple regression were used to examine cross-task relationships for all measures. RESULTS As expected on the basis of classification criteria, accuracy scores were lower for the PPA-G group as compared to the PPA-L and PPA-S participants for overall sentence production and verb morphology, but not argument structure. Grammatical accuracy in narratives strongly predicted overall language test performance in PPA-G, whereas grammatical diversity in narratives did so in PPA-L, and no significant correspondence between narrative and language test performance was found for PPA-S. For individuals with severe grammatical impairments only, error distribution for both morphology and argument structure was strongly associated in structured tasks and narratives. CONCLUSIONS Grammatical production in narrative language predicts accuracy elicited with structured language tests in PPA. However, unique narrative production patterns distinguish PPA by subtype: accuracy for PPA-G, and grammatical diversity for PPA-L. The impairment in PPA-G is likely to reflect a core impairment in grammar whereas that of PPA-L may be closely tied to the word retrieval and verbal working memory deficits that characterize this variant. This underscores the theoretical distinction between PPA-L and PPA-G, as well as the importance of including grammatical diversity measures in analyses of language production, especially for patients who do not display frank agrammatism. Further, the results suggest that measures of domain-specific language deficits (i.e., verb morphology vs. argument structure) are robust across tasks only in individuals with severe grammatical impairments.
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Affiliation(s)
- Jennifer E Mack
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA.
| | - Elena Barbieri
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, USA
| | - M-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
| | - Cynthia K Thompson
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA; Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
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Semantic and lexical features of words dissimilarly affected by non-fluent, logopenic, and semantic primary progressive aphasia. J Int Neuropsychol Soc 2019; 25:1011-1022. [PMID: 31511121 PMCID: PMC6879829 DOI: 10.1017/s1355617719000948] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the effect of three psycholinguistic variables-lexical frequency, age of acquisition (AoA), and neighborhood density (ND)-on lexical-semantic processing in individuals with non-fluent (nfvPPA), logopenic (lvPPA), and semantic primary progressive aphasia (svPPA). Identifying the scope and independence of these features can provide valuable information about the organization of words in our mind and brain. METHOD We administered a lexical decision task-with words carefully selected to permit distinguishing lexical frequency, AoA, and orthographic ND effects-to 41 individuals with PPA (13 nfvPPA, 14 lvPPA, 14 svPPA) and 25 controls. RESULTS Of the psycholinguistic variables studied, lexical frequency had the largest influence on lexical-semantic processing, but AoA and ND also played an independent role. The results reflect a brain-language relationship with different proportional effects of frequency, AoA, and ND in the PPA variants, in a pattern that is consistent with the organization of the mental lexicon. Individuals with nfvPPA and lvPPA experienced an ND effect consistent with the role of inferior frontal and temporoparietal regions in lexical analysis and word form processing. By contrast, individuals with svPPA experienced an AoA effect consistent with the role of the anterior temporal lobe in semantic processing. CONCLUSIONS The findings are in line with a hierarchical mental lexicon structure with a conceptual (semantic) and a lexeme (word-form) level, such that a selective deficit at one of these levels of the mental lexicon manifests differently in lexical-semantic processing performance, consistent with the affected language-specific brain region in each PPA variant.
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14
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Mack JE, Mesulam MM, Rogalski EJ, Thompson CK. Verb-argument integration in primary progressive aphasia: Real-time argument access and selection. Neuropsychologia 2019; 134:107192. [PMID: 31521633 DOI: 10.1016/j.neuropsychologia.2019.107192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Impaired sentence comprehension is observed in the three major subtypes of PPA, with distinct performance patterns relating to impairments in comprehending complex sentences in the agrammatic (PPA-G) and logopenic (PPA-L) variants and word comprehension in the semantic subtype (PPA-S). However, little is known about basic combinatory processes during sentence comprehension in PPA, such the integration of verbs with their subject and object(s) (verb-argument integration). METHODS The present study used visual-world eye-tracking to examine real-time verb-argument integration in individuals with PPA (12 with PPA-G, 10 with PPA-L, and 6 with PPA-S) and neurotypical older adults (15). Two baseline experiments probed eye movement control, using a non-linguistic task, and noun comprehension, respectively. Two verb-argument integration experiments examined the effects of verb meaning on (a) lexical access of the verb's direct object (argument access) and (b) selection of a semantically-appropriate direct object (argument selection), respectively. Eye movement analyses were conducted only for trials with correct behavioral responses, allowing us to distinguish accuracy and online processing. RESULTS The eye movement control experiment revealed no significant impairments in PPA, whereas the noun comprehension experiment revealed reduced accuracy and eye-movement latencies in PPA-S, and to a lesser extent PPA-G. In the argument access experiment, verb meaning facilitated argument access normally in PPA-G and PPA-L; in PPA-S, verb-meaning effects emerged on an atypical time course. In the argument selection experiment, significant impairments in accuracy were observed only in PPA-G, accompanied by markedly atypical eye movement patterns. CONCLUSION This study revealed two distinct patterns of impaired verb-argument integration in PPA. In PPA-S, impaired verb-argument integration was observed in the argument access experiment, indicating impairments in basic semantic combinatory processes which likely relate to damage in ventral language pathways. In contrast, listeners with PPA-G showed marked impairments of argument selection, likely relating to damage to left inferior frontal regions.
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Affiliation(s)
- Jennifer E Mack
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA.
| | - M-Marsel Mesulam
- Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
| | - Emily J Rogalski
- Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, USA
| | - Cynthia K Thompson
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA; Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
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15
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Shechter A, Lipka O, Katzir T. Predictive Models of Word Reading Fluency in Hebrew. Front Psychol 2018; 9:1882. [PMID: 30356726 PMCID: PMC6189333 DOI: 10.3389/fpsyg.2018.01882] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 09/13/2018] [Indexed: 11/13/2022] Open
Abstract
This study examined a multi-componential approach to reading fluency in first and third grade Hebrew speaking children. Measures of naming speed, phonological awareness (PA), morphological awareness (MA), syntax awareness, and vocabulary were administered to first (N = 68) and third (N = 67) graders. Hierarchical regression models revealed that in both grades, naming speed accounted for most of the variance in each model. However, while in the first grade, word reading fluency was also predicted by vocabulary, in the third grade, both PA and MA were significant additional predictors. Predictive models of word reading fluency in Hebrew and applied implications are proposed.
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Affiliation(s)
- Adi Shechter
- Department of Learning Disabilities, Edmond J. Safra Brain Research Center, University of Haifa, Haifa, Israel
| | - Orly Lipka
- Department of Learning Disabilities, Edmond J. Safra Brain Research Center, University of Haifa, Haifa, Israel
| | - Tami Katzir
- Department of Learning Disabilities, Edmond J. Safra Brain Research Center, University of Haifa, Haifa, Israel.,Department of Special Education, Edmond J. Safra Brain Research Center, University of Haifa, Haifa, Israel
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16
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Boschi V, Catricalà E, Consonni M, Chesi C, Moro A, Cappa SF. Connected Speech in Neurodegenerative Language Disorders: A Review. Front Psychol 2017; 8:269. [PMID: 28321196 PMCID: PMC5337522 DOI: 10.3389/fpsyg.2017.00269] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 02/10/2017] [Indexed: 12/12/2022] Open
Abstract
Language assessment has a crucial role in the clinical diagnosis of several neurodegenerative diseases. The analysis of extended speech production is a precious source of information encompassing the phonetic, phonological, lexico-semantic, morpho-syntactic, and pragmatic levels of language organization. The knowledge about the distinctive linguistic variables identifying language deficits associated to different neurodegenerative diseases has progressively improved in the last years. However, the heterogeneity of such variables and of the way they are measured and classified limits any generalization and makes the comparison among studies difficult. Here we present an exhaustive review of the studies focusing on the linguistic variables derived from the analysis of connected speech samples, with the aim of characterizing the language disorders of the most prevalent neurodegenerative diseases, including primary progressive aphasia, Alzheimer's disease, movement disorders, and amyotrophic lateral sclerosis. A total of 61 studies have been included, considering only those reporting group analysis and comparisons with a group of healthy persons. This review first analyzes the differences in the tasks used to elicit connected speech, namely picture description, story narration, and interview, considering the possible different contributions to the assessment of different linguistic domains. This is followed by an analysis of the terminologies and of the methods of measurements of the variables, indicating the need for harmonization and standardization. The final section reviews the linguistic domains affected by each different neurodegenerative disease, indicating the variables most consistently impaired at each level and suggesting the key variables helping in the differential diagnosis among diseases. While a large amount of valuable information is already available, the review highlights the need of further work, including the development of automated methods, to take advantage of the richness of connected speech analysis for both research and clinical purposes.
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Affiliation(s)
- Veronica Boschi
- NETS, Center for Neurocognition, Epistemology and Theoretical Syntax, Institute for Advanced Study-Pavia Pavia, Italy
| | - Eleonora Catricalà
- NETS, Center for Neurocognition, Epistemology and Theoretical Syntax, Institute for Advanced Study-Pavia Pavia, Italy
| | - Monica Consonni
- Third Neurology Unit and Motor Neuron Diseases Center, IRCCS Foundation "Carlo Besta" Neurological Institute Milan, Italy
| | - Cristiano Chesi
- NETS, Center for Neurocognition, Epistemology and Theoretical Syntax, Institute for Advanced Study-Pavia Pavia, Italy
| | - Andrea Moro
- NETS, Center for Neurocognition, Epistemology and Theoretical Syntax, Institute for Advanced Study-Pavia Pavia, Italy
| | - Stefano F Cappa
- NETS, Center for Neurocognition, Epistemology and Theoretical Syntax, Institute for Advanced Study-PaviaPavia, Italy; IRCCS S. Giovanni di Dio FatebenefratelliBrescia, Italy
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Graham NL, Leonard C, Tang-Wai DF, Black S, Chow TW, Scott CJM, McNeely AA, Masellis M, Rochon E. Lack of Frank Agrammatism in the Nonfluent Agrammatic Variant of Primary Progressive Aphasia. Dement Geriatr Cogn Dis Extra 2016; 6:407-423. [PMID: 27790240 PMCID: PMC5075721 DOI: 10.1159/000448944] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background/Aims Frank agrammatism, defined as the omission and/or substitution of grammatical morphemes with associated grammatical errors, is variably reported in patients with nonfluent variant primary progressive aphasia (nfPPA). This study addressed whether frank agrammatism is typical in agrammatic nfPPA patients when this feature is not required for diagnosis. Method We assessed grammatical production in 9 patients who satisfied current diagnostic criteria. Although the focus was agrammatism, motor speech skills were also evaluated to determine whether dysfluency arose primarily from apraxia of speech (AOS), instead of, or in addition to, agrammatism. Volumetric MRI analyses provided impartial imaging-supported diagnosis. Results The majority of cases exhibited neither frank agrammatism nor AOS. Conclusion There are nfPPA patients with imaging-supported diagnosis and preserved motor speech skills who do not exhibit frank agrammatism, and this may persist beyond the earliest stages of the illness. Because absence of frank agrammatism is a subsidiary diagnostic feature in the logopenic variant of PPA, this result has implications for differentiation of the nonfluent and logopenic variants, and indicates that PPA patients with nonfluent speech in the absence of frank agrammatism or AOS do not necessarily have the logopenic variant.
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Affiliation(s)
- Naida L Graham
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Ont., Canada; Toronto Rehabilitation Institute, Toronto, Ont, Canada
| | - Carol Leonard
- Department of Audiology and Speech-Language Pathology, University of Ottawa, Ottawa, Ont, Canada
| | - David F Tang-Wai
- University Health Network Memory Clinic, Toronto Western Hospital, Ont., Canada; Department of Medicine (Neurology), University of Toronto, Ont., Canada
| | - Sandra Black
- Department of Medicine (Neurology), University of Toronto, Ont., Canada; L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada; Rotman Research Institute, University of Toronto, Toronto, Ont., Canada
| | - Tiffany W Chow
- Department of Medicine (Neurology), University of Toronto, Ont., Canada; Rotman Research Institute, University of Toronto, Toronto, Ont., Canada; Department of Psychiatry (Geriatric Psychiatry), University of Toronto, Toronto, Ont., Canada
| | - Chris J M Scott
- L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada
| | - Alicia A McNeely
- L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada
| | - Mario Masellis
- L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Ont., Canada
| | - Elizabeth Rochon
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Ont., Canada; Toronto Rehabilitation Institute, Toronto, Ont, Canada
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Reading words and other people: A comparison of exception word, familiar face and affect processing in the left and right temporal variants of primary progressive aphasia. Cortex 2016; 82:147-163. [PMID: 27389800 DOI: 10.1016/j.cortex.2016.05.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/03/2016] [Accepted: 05/18/2016] [Indexed: 12/12/2022]
Abstract
Semantic variant primary progressive aphasia (svPPA) typically presents with left-hemisphere predominant rostral temporal lobe (rTL) atrophy and the most significant complaints within the language domain. Less frequently, patients present with right-hemisphere predominant temporal atrophy coupled with marked impairments in processing of famous faces and emotions. Few studies have objectively compared these patient groups in both domains and therefore it is unclear to what extent the syndromes overlap. Clinically diagnosed svPPA patients were characterized as left- (n = 21) or right-predominant (n = 12) using imaging and compared along with 14 healthy controls. Regarding language, our primary focus was upon two hallmark features of svPPA; confrontation naming and surface dyslexia. Both groups exhibited naming deficits and surface dyslexia although the impairments were more severe in the left-predominant group. Familiarity judgments on famous faces and affect processing were more profoundly impaired in the right-predominant group. Our findings suggest that the two syndromes overlap significantly but that early cases at the tail ends of the continuum constitute a challenge for current clinical criteria. Correlational neuroimaging analyses implicated a mid portion of the left lateral temporal lobe in exception word reading impairments in line with proposals that this region is an interface between phonology and semantic knowledge.
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Auclair-Ouellet N, Macoir J, Laforce R, Bier N, Fossard M. Regularity and beyond: Impaired production and comprehension of inflectional morphology in semantic dementia. BRAIN AND LANGUAGE 2016; 155-156:1-11. [PMID: 26994740 DOI: 10.1016/j.bandl.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/28/2016] [Accepted: 02/26/2016] [Indexed: 06/05/2023]
Abstract
Studies on inflectional morphology in semantic dementia (SD) have focused on the contrast between the regular and the irregular English past-tense. These studies aimed to contrast the claims of single- and dual-mechanism theories. However, both theories can account for impaired production of irregular verbs observed in SD. According to the dual-mechanism theory, this impairment is related to word-retrieval difficulties, while according to single-mechanism theory it is the consequence of semantic impairment. However, authors suggest that it is time to envision a broader role for semantic memory in the production of semantically encoded aspects of inflectional morphology. This study reports the performance of 10 French-speaking patients with SD in three tasks of inflectional morphology. Their performances were compared to those of a group of 20 age-, gender- and education-matched adults without cognitive impairment. Results show that SD patients had difficulties producing tense and person inflection in verbs and pseudo-verbs, whether regular or pseudo-regular. In a second task in which participants were directly exposed to regularity manipulations, SD patients tended to choose a more typical or predictable alternative over a correctly inflected verb. Results of the third task show that their difficulties in producing semantically encoded aspects of inflection, such as tense, are related to difficulties to understand the semantic content conveyed by inflectional morphemes. Overall, these results support the claim that semantic impairment can cause morphological deficits that do not only affect irregular verbs, but that also have impacts on the production and comprehension of semantic information conveyed by inflectional morphemes.
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Affiliation(s)
- Noémie Auclair-Ouellet
- Faculté de médecine, Université Laval, 1050, avenue de la Médecine, Québec, Québec G1V 0A6, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Québec, Axe des Neurosciences cliniques et cognitives, 2601, de la Canardière, Québec, Québec G1J 2G3, Canada; Institut des sciences du langage et de la communication, Faculté des Lettres et Sciences humaines, Université de Neuchâtel, Rue de la Pierre à Mazel, 7, CH-2000 Neuchâtel, Switzerland.
| | - Joël Macoir
- Faculté de médecine, Université Laval, 1050, avenue de la Médecine, Québec, Québec G1V 0A6, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Québec, Axe des Neurosciences cliniques et cognitives, 2601, de la Canardière, Québec, Québec G1J 2G3, Canada.
| | - Robert Laforce
- Clinique interdisciplinaire de mémoire, Centre hospitalier universitaire de Québec, 1401, 18(e) Rue, Québec, Québec G1J 1Z4, Canada.
| | - Nathalie Bier
- Centre de recherche de l'Institut universitaire de gériatrie, 4565, Chemin Queen-Mary, Montréal, Québec H3W 1W5, Canada.
| | - Marion Fossard
- Institut des sciences du langage et de la communication, Faculté des Lettres et Sciences humaines, Université de Neuchâtel, Rue de la Pierre à Mazel, 7, CH-2000 Neuchâtel, Switzerland.
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Auclair-Ouellet N, Fossard M, Houde M, Laforce R, Macoir J. Production of morphologically derived words in the semantic variant of primary progressive aphasia: preserved decomposition and composition but impaired validation. Neurocase 2016; 22:170-8. [PMID: 26304677 DOI: 10.1080/13554794.2015.1081391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although there is growing interest in inflectional morphology in semantic variant primary progressive aphasia (svPPA), derivational morphology has rarely been studied in this population. This study reports the performance of N.G., a 72-year-old-woman with svPPA in a verb production task designed to entail morphological processing (composition, decomposition) and self-appraisal of her productions. N.G. demonstrated an over-reliance on morphological processing and failures in her appraisal of root/affix combinations that resulted in the production of morphological paraphasias and neologisms. Her performance in lexical decision of verbs and pseudo-verbs points to the involvement of semantic impairment in these difficulties.
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Affiliation(s)
- N Auclair-Ouellet
- a Faculté de médecine , Université Laval , Québec , Canada.,b Axe des Neurosciences cliniques et cognitives , Centre de recherche de l'Institut universitaire en santé mentale de Québec , Québec , Canada.,c Institut des sciences du langage et de la communication, Faculté des Lettres et Sciences humaines , Université de Neuchâtel , Neuchâtel , Switzerland
| | - M Fossard
- c Institut des sciences du langage et de la communication, Faculté des Lettres et Sciences humaines , Université de Neuchâtel , Neuchâtel , Switzerland
| | - M Houde
- d Clinique interdisciplinaire de mémoire , Centre hospitalier universitaire de Québec , Québec , Canada
| | - R Laforce
- d Clinique interdisciplinaire de mémoire , Centre hospitalier universitaire de Québec , Québec , Canada
| | - J Macoir
- a Faculté de médecine , Université Laval , Québec , Canada.,b Axe des Neurosciences cliniques et cognitives , Centre de recherche de l'Institut universitaire en santé mentale de Québec , Québec , Canada
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