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Klusek J, Will E, Christensen T, Caravella K, Hogan A, Sun J, Smith J, Fairchild AJ, Roberts JE. Social Communication Delay in an Unbiased Sample of Preschoolers With the FMR1 Premutation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2316-2332. [PMID: 38889222 PMCID: PMC11253810 DOI: 10.1044/2024_jslhr-23-00580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/20/2023] [Accepted: 04/15/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE The Fragile X Messenger Ribonucleoprotein-1 (FMR1) premutation (FXpm) is a genetic variant that is common in the general population and is associated with health symptoms and disease in adulthood. However, poor understanding of the clinical phenotype during childhood has hindered the development of clinical practice guidelines for screening and intervention. Given that social communication difficulties have been widely documented in adults with the FXpm and are linked with reduced psychosocial functioning, the present study aimed to characterize the communication profile of the FXpm during early childhood. METHOD Eighteen children with the FXpm who were identified through cascade testing (89%) or screening at birth (11%) were compared to 21 matched typically developing children, aged 2-4 years. Participants completed standardized assessments of language (Mullen Scales of Early Learning) and adaptive communication (Vineland Adaptive Behavior Scales-II). Social communication was rated from seminaturalistic interaction samples using the Brief Observation of Social Communication Change. RESULTS Children with the FXpm showed delayed social communication development, with the magnitude of group differences highlighting social communication as a feature that distinguishes children with the FXpm from their peers (p = .046, ηp2 = .12). The groups did not differ on the standardized language and adaptive communication measures (ps > .297, ηp2s < .03). CONCLUSIONS Early screening and treatment of social communication delays may be key to optimizing outcomes for children with the FXpm. Further research is needed to replicate findings in a larger sample, delineate the trajectory and consequences of social communication difficulties across the life span in the FXpm, and determine the potential epidemiological significance of FMR1 as a mediator of developmental communication differences within the general population.
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Affiliation(s)
- Jessica Klusek
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia
| | - Elizabeth Will
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia
| | - Thomas Christensen
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia
| | - Kelly Caravella
- Department of Psychiatry, Carolina Institute for Developmental Disabilities, The University of North Carolina at Chapel Hill School of Medicine
| | - Abigail Hogan
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia
| | - Jennifer Sun
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia
| | - Jenna Smith
- Department of Psychology, University of South Carolina, Columbia
| | | | - Jane E. Roberts
- Department of Psychology, University of South Carolina, Columbia
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Nys BL, Wong W, Schaeken W. Some scales require cognitive effort: A systematic review on the role of working memory in scalar implicature derivation. Cognition 2024; 242:105623. [PMID: 37857056 DOI: 10.1016/j.cognition.2023.105623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/21/2023]
Abstract
If some inferences require cognitive effort, could that mean, that all of them do? The scalar term "some" has long fascinated academics from various backgrounds, as it can be interpreted either purely semantically, as "some and possibly all", or pragmatically, as "some and not all". The pragmatic reading implies the generation of what is called a scalar implicature. While scientific investigation of such implicatures has given rise to many potential explanations of the "pragmatic enrichment" phenomenon behind them, the debate between the two dominant frameworks-the literal-first and the default accounts-has not convincingly been settled. With the birth of a new interdisciplinary field, appropriately dubbed experimental pragmatics, the last 20 years have led to a substantial amount of new empirical data on scalar implicatures. In this ongoing investigation, the loading and measuring of Working Memory has become an important experimentation tool, as it allows to test the contrasting hypotheses with regard to the cognitive effort of implicature generation, which are made by the two main theoretical accounts. The current systematic review evaluates the relevant literature until March 08, 2022 in an attempt to shed light on the role of Working Memory in implicature derivation. A comprehensive search, and two-step review procedure yielded a sample of 18 studies, containing data of 23 relevant experiments. Findings were bundled in a narrative synthesis and combined through two separate meta-analyses. Our results support the literal-first account, by showing that the derivation of scalar implicatures is a cognitively effortful process that is sensitive to changes in the available Working Memory resources. However, as the reported effects are relatively weak and capricious, we argue that the development of more sophisticated paradigms and eventually, stronger theories within the field, will be crucial in order to both fully understand the current results and set-up fruitful future research.
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Affiliation(s)
- Bojan Luc Nys
- Faculty of Arts, KU Leuven, Belgium; Faculty of Psychology and Educational Sciences, KU Leuven, Belgium.
| | - Wai Wong
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium; Faculty of Engineering Technology, KU Leuven, Belgium
| | - Walter Schaeken
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
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3
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Sensory Involvement in Amyotrophic Lateral Sclerosis. Int J Mol Sci 2022; 23:ijms232415521. [PMID: 36555161 PMCID: PMC9779879 DOI: 10.3390/ijms232415521] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/19/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022] Open
Abstract
Although amyotrophic lateral sclerosis (ALS) is pre-eminently a motor disease, the existence of non-motor manifestations, including sensory involvement, has been described in the last few years. Although from a clinical perspective, sensory symptoms are overshadowed by their motor manifestations, this does not mean that their pathological significance is not relevant. In this review, we have made an extensive description of the involvement of sensory and autonomic systems described to date in ALS, from clinical, neurophysiological, neuroimaging, neuropathological, functional, and molecular perspectives.
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Alduais A, Al-Qaderi I, Alfadda N, Alfadda H. Pragmatics: Mapping Evidence on Enhancing Children’s Use of Linguistic and Non-Linguistic Capacities for Interactive Communication. CHILDREN 2022; 9:children9091318. [PMID: 36138626 PMCID: PMC9497313 DOI: 10.3390/children9091318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 11/17/2022]
Abstract
New-born infants communicate from the first minute they come to life. This non-linguistic and non-verbal capacity to interact from the first day they come to life enables them to express their needs and evidence their typical development. This capacity to interact develops to include linguistic and non-linguistic use of verbal and non-verbal interaction, that is, pragmatics. Because pragmatics is heterogeneously structured of semiotic, cognitive, motor and sensory elements so it is vital to ensure successful human interaction. The other language elements (i.e., phonological, morphological, syntactic and semantic) are essential inputs for this human interaction outcome (i.e., pragmatics). Accordingly, this study sought to map evidence that pragmatics can enhance children’s use of linguistic and non-linguistic capacities for interactive communication. This was addressed by conducting bibliometric and scientometric analyses of 6554 documents from Scopus, 1167 from WOS and 11,230 from Lens between 1939 and 2022. We analysed the past, present and future developments of the field of pragmatics using bibliometric and scientometric indicators. The scientometric analysis was conducted using CiteSpace 5.8.R3 and VOSviewer 1.6.18 software, which enabled the tabulation, visualisation and measurement of the impact of central influencers in the field of pragmatics. In the light of our results, pragmatics continues to expand in order to understand human interaction in a deeper way and to enhance children’s typical interactions with the environment around them. The group should also include adults or elderly people whose pragmatic language skills have been impaired due to any acquired or developmental disorder, such as a brain injury.
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Affiliation(s)
- Ahmed Alduais
- Department of Human Sciences, University of Verona, 37126 Verona, Italy
- Correspondence:
| | - Issa Al-Qaderi
- Institute of English Studies, University of Warsaw, 01-445 Warsaw, Poland
| | - Najla Alfadda
- Department of English Language and Translation, King Saud University, Riyadh 11451, Saudi Arabia
| | - Hind Alfadda
- Department of Curriculum and Instruction, King Saud University, Riyadh 11362, Saudi Arabia
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Bambini V, Agostoni G, Buonocore M, Tonini E, Bechi M, Ferri I, Sapienza J, Martini F, Cuoco F, Cocchi F, Bischetti L, Cavallaro R, Bosia M. It is time to address language disorders in schizophrenia: A RCT on the efficacy of a novel training targeting the pragmatics of communication (PragmaCom). JOURNAL OF COMMUNICATION DISORDERS 2022; 97:106196. [PMID: 35526293 DOI: 10.1016/j.jcomdis.2022.106196] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Language and communication disruptions in schizophrenia are at the center of a large body of investigation. Yet, the remediation of such disruptions is still in its infancy. Here we targeted what is known to be one of the most damaged language domains in schizophrenia, namely pragmatics, by conducting a pragmatics-centered intervention with a randomized controlled trial design and assessing also durability and generalization. To the best of our knowledge, this is the first study with these characteristics. METHODS Inspired by the Gricean account of natural language use, we tailored a novel treatment addressing the pragmatics of communication (PragmaCom) and we tested its efficacy in a sample of individuals with schizophrenia randomized to the experimental group or to an active control group. The primary outcome with respect to the efficacy of the PragmaCom was measured by changes in pragmatic abilities (as evaluated with the global score of the Assessment of Pragmatic Abilities and Cognitive Substrates test) from baseline to 12 weeks and at 3-month follow-up. The secondary outcome was measured by changes in metaphor comprehension, abstract thinking, and global functioning from baseline to 12 weeks and at 3-month follow-up. RESULTS Relative to the control group, at post-test the PragmaCom group showed greater and enduring improvement in global pragmatic skills and in metaphor comprehension. At follow-up, these improvements persisted and the PragmaCom exerted beneficial effects also on functioning. CONCLUSIONS Despite the limited sample size, we believe that these findings offer initial yet encouraging evidence of the possibility to improve pragmatic skills with a theoretically grounded approach and to obtain durable and clinically relevant benefits. We argue that it is time that therapeutic efforts embrace communicative dysfunctions in order to improve illness outcome.
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Affiliation(s)
- Valentina Bambini
- Department of Humanities and Life Sciences, University School for Advanced Studies IUSS Pavia, Italy.
| | - Giulia Agostoni
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Tonini
- Department of Humanities and Life Sciences, University School for Advanced Studies IUSS Pavia, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ilaria Ferri
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jacopo Sapienza
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Martini
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Cuoco
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Cocchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Bischetti
- Department of Humanities and Life Sciences, University School for Advanced Studies IUSS Pavia, Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Bosia
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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Parola A, Bosco FM. EXPRESS: An eye-tracking investigation of the cognitive processes involved in the comprehension of simple and complex communicative acts. Q J Exp Psychol (Hove) 2022; 75:1976-1995. [PMID: 35084282 DOI: 10.1177/17470218221079629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Indirect speech acts communicate more than their literal meaning, and their comprehension relies on the listener's ability to draw the appropriate inferences in a given context. We used eye-tracking to investigate the cognitive processing involved in the comprehension of simple (direct) and complex (unconventional indirect) communicative acts, a more general distinction that applies not only to sincere speech acts, but also to irony and deceit. We recorded the eye movements of 40 participants while they read 60 stories (20 sincere, 20 deceitful, 20 ironic) consisting of a context and a target answer. For each story, we created two different contexts so that the same identical target answer was a simple (direct) and a complex (unconventional indirect) communicative act, respectively. We also assessed the indirectness of simple and complex communicative acts, as well as participants' working memory (WM) and Theory of Mind (ToM). Eye-pattern analysis showed that complex communicative acts were more difficult to understand than simple acts; differences between simple and complex acts held for all the pragmatic phenomena investigated, though processing differences were greater for sincere acts than for irony and deceit. We found a role of indirectness and ToM in the pragmatic processing of simple and complex acts, whereas the role of WM was modest. The present findings underscore the importance of adopting an encompassing theory that can account for different types of indirect speech acts, such as sincere, deceitful and ironic acts; they also suggest the importance of assessing individual differences in inferential and cognitive abilities.
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Affiliation(s)
- Alberto Parola
- Department of Linguistics, Semiotics and Cognitive Science, Aarhus University, Aarhus, Denmark 1006.,The Interacting Minds Center - Institute of Culture and Society, Aarhus University, Aarhus, Denmark.,Dipartimento di Psicologia, Università degli Studi di Torino, Torino, Italy
| | - Francesca M Bosco
- Dipartimento di Psicologia, Università degli Studi di Torino, Torino, Italy 9314.,Dipartimento di Psicologia, Università degli Studi di Torino, and Centro Interdipartimentale di Studi Avanzati di Neuroscienze - NIT, Torino, Italy
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7
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Nash Y, Sitty M. Non-Motor Symptoms of Amyotrophic Lateral Sclerosis: A Multi-Faceted Disorder. J Neuromuscul Dis 2021; 8:699-713. [PMID: 34024773 DOI: 10.3233/jnd-210632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease characterized by progressive degeneration of motor pathways. A growing body of evidence from recent years suggests that ALS results in a wide range of non-motor symptoms as well, which can have a significant impact on patients' quality of life. These symptoms could also, in turn, provide useful information as biomarkers for disease progression, and can shed insight on ALS mechanisms. Here we aim to review a wide range of non-motor symptoms of ALS, with emphasis on their importance to research and clinical treatment of patients.
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Affiliation(s)
- Yuval Nash
- Tel Aviv Youth University, The Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
| | - Michal Sitty
- Clalit Health Services, Kiryat Ono, Israel.,Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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8
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Parola A, Gabbatore I, Berardinelli L, Salvini R, Bosco FM. Multimodal assessment of communicative-pragmatic features in schizophrenia: a machine learning approach. NPJ SCHIZOPHRENIA 2021; 7:28. [PMID: 34031425 PMCID: PMC8144364 DOI: 10.1038/s41537-021-00153-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 03/18/2021] [Indexed: 02/04/2023]
Abstract
An impairment in pragmatic communication is a core feature of schizophrenia, often associated with difficulties in social interactions. The pragmatic deficits regard various pragmatic phenomena, e.g., direct and indirect communicative acts, deceit, irony, and include not only the use of language but also other expressive means such as non-verbal/extralinguistic modalities, e.g., gestures and body movements, and paralinguistic cues, e.g., prosody and tone of voice. The present paper focuses on the identification of those pragmatic features, i.e., communicative phenomena and expressive modalities, that more reliably discriminate between individuals with schizophrenia and healthy controls. We performed a multimodal assessment of communicative-pragmatic ability, and applied a machine learning approach, specifically a Decision Tree model, with the aim of identifying the pragmatic features that best separate the data into the two groups, i.e., individuals with schizophrenia and healthy controls, and represent their configuration. The results indicated good overall performance of the Decision Tree model, with mean Accuracy of 82%, Sensitivity of 76%, and Precision of 91%. Linguistic irony emerged as the most relevant pragmatic phenomenon in distinguishing between the two groups, followed by violation of the Gricean maxims, and then extralinguistic deceitful and sincere communicative acts. The results are discussed in light of the pragmatic theoretical literature, and their clinical relevance in terms of content and design of both assessment and rehabilitative training.
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Affiliation(s)
- Alberto Parola
- grid.7048.b0000 0001 1956 2722Department of Linguistics, Semiotics and Cognitive Science, Aarhus University, Aarhus, Denmark ,grid.7605.40000 0001 2336 6580Department of Psychology, University of Turin, Turin, Italy
| | - Ilaria Gabbatore
- grid.7605.40000 0001 2336 6580Department of Psychology, University of Turin, Turin, Italy
| | | | - Rogerio Salvini
- grid.411195.90000 0001 2192 5801Instituto de Informática, Universidade Federal de Goiás, Goiânia, GO Brasil
| | - Francesca M. Bosco
- grid.7605.40000 0001 2336 6580Department of Psychology, University of Turin, Turin, Italy ,grid.7605.40000 0001 2336 6580Centro Interdipartimentale di Studi Avanzati di Neuroscienze–NIT, University of Turin, Turin, Italy
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9
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Bambini V, Van Looy L, Demiddele K, Schaeken W. What is the contribution of executive functions to communicative-pragmatic skills? Insights from aging and different types of pragmatic inference. Cogn Process 2021; 22:435-452. [PMID: 33786706 DOI: 10.1007/s10339-021-01021-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 02/20/2021] [Indexed: 02/07/2023]
Abstract
The role of executive functions in supporting the pragmatics of communication has been extensively examined in clinical populations, but is still under-explored in healthy aging. In this study we addressed the role of executive skills, including inhibition, working memory, and cognitive flexibility, in older adults' communicative-pragmatic abilities. Pragmatics was extensively assessed by measuring the understanding of figurative language, narrative texts, humor, and implicatures. A hierarchical regression analysis using composite scores evidenced a global effect of executive functions on communicative-pragmatic abilities, beyond demographic and theory of mind aspects. More fine-grained analyses showed that working memory was the strongest predictor of all pragmatic tasks. Specifically, comprehending narratives and humor seemed to capitalize primarily upon working memory, whereas figurative language and implicatures relied on working memory and to some extent cognitive flexibility. Conversely, inhibition did not stand out as a robust predictor of pragmatics. We argue that working memory allows for the simultaneous consideration of multiple pieces of information needed for pragmatic inferencing, and that only once working memory has played its role other executive aspects, such as cognitive flexibility and inhibition, might come into play. Overall, this study highlights the diverse role of executive skills in pragmatics in aging, and more generally contributes to shed light on pragmatic competence in older adults.
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Affiliation(s)
- Valentina Bambini
- Center for Neurocognition, Epistemology and Theoretical Syntax (NEtS), University School for Advanced Studies IUSS Pavia, Piazza della Vittoria 15, 27100, Pavia, Italy.
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10
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Baraldi MA, Avanzino L, Pelosin E, Domaneschi F, Di Paola S, Lagravinese G. Pragmatic abilities in early Parkinson's disease. Brain Cogn 2021; 150:105706. [PMID: 33761383 DOI: 10.1016/j.bandc.2021.105706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/01/2022]
Abstract
Language impairment in Parkinson's disease (PD) has been investigated at different levels of linguistic skills. Only a few studies dealt with pragmatic abilities in PD, and these suggest an impairment of pragmatic skills, which might affect quality of life. However, previous studies enrolled patients with heterogeneous symptom severity. The goal of this study is twofold: first, to investigate whether pragmatic skills are compromised at the early stage of PD; second, to explore whether an early pragmatic impairment is explained by a decay of a specific cognitive function. We assessed pragmatic abilities (discourse production, comprehension of narratives, humour, and figurative language), and a cluster of cognitive functions (memory, verbal fluency, inhibition, shifting, and ToM) in a sample of early PD patients and a group of age-matched healthy controls. Early PD patients showed impaired general pragmatic skills (the ability to perform different pragmatic tasks in language production and comprehension), as well as a deficit in the production and comprehension individual scores. Our results suggest that good general cognitive skills (a good overall cognitive level) and high education support patients' pragmatic competence. Inhibitory processes have been found to predict patients' ability to understand figurative language, such as metaphors, and this might be related to frontal lobe dysfunctions.
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Affiliation(s)
- Maria Alice Baraldi
- Department of Educational Sciences (DISFOR), Psychology Unit, Corso Podestà 2, University of Genoa, 16128 Genoa, Italy.
| | - Laura Avanzino
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Experimental Medicine (DIMES), Section of Human Physiology, Via Leon Battista Alberti 2, University of Genoa, 16132 Genoa, Italy.
| | - Elisa Pelosin
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), Largo Daneo 3, University of Genoa, 16132 Genoa, Italy.
| | - Filippo Domaneschi
- Laboratory of Language and Cognition, Via Balbi 30, University of Genoa, 16126 Genoa, Italy.
| | - Simona Di Paola
- Laboratory of Language and Cognition, Via Balbi 2, University of Genoa, 16126 Genoa, Italy.
| | - Giovanna Lagravinese
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), Largo Daneo 3, University of Genoa, 16132 Genoa, Italy.
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11
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Bambini V, Tonini E, Ceccato I, Lecce S, Marocchini E, Cavallini E. How to improve social communication in aging: Pragmatic and cognitive interventions. BRAIN AND LANGUAGE 2020; 211:104864. [PMID: 33137591 DOI: 10.1016/j.bandl.2020.104864] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 07/21/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
Among all aspects of the linguistic and communicative competence, pragmatics seems especially vulnerable in aging, due also to cognitive decline. However, pragmatics has never been considered as an intervention target in healthy aging. Here we tested the effects of a novel training program to improve pragmatics (PragmaCom) in older adults, compared with an active cognitive control group in a randomized-controlled-trial design. Both the PragmaCom group and the control group improved in pragmatic skills such as understanding metaphors and avoiding off-topic speech, indicating that it is possible to improve pragmatics in aging both with a specific training and with a cognitive training. Individual cognitive factors predicted pragmatic improvement in the control group, while in the PragmaCom group benefits were less dependent on individual characteristics. We discuss the results in terms of pragmatic plasticity, highlighting the importance of these findings for promoting older adults' social communication and well-being.
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Affiliation(s)
- Valentina Bambini
- Center for Neurocognition, Epistemology and Theoretical Syntax (NEtS), University School for Advanced Studies IUSS Pavia, Piazza della Vittoria 15, 27100 Pavia, Italy.
| | - Elisabetta Tonini
- Center for Neurocognition, Epistemology and Theoretical Syntax (NEtS), University School for Advanced Studies IUSS Pavia, Piazza della Vittoria 15, 27100 Pavia, Italy
| | - Irene Ceccato
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Via Luigi Polacchi 11, 66100 Chieti, Italy
| | - Serena Lecce
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy
| | - Eleonora Marocchini
- Laboratory of Language and Cognition, University of Genoa, Via Balbi 30, 16128 Genoa, Italy
| | - Elena Cavallini
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy
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12
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Bambini V, Bischetti L, Bonomi CG, Arcara G, Lecce S, Ceroni M. Beyond the motor account of amyotrophic lateral sclerosis: Verbal humour and its relationship with the cognitive and pragmatic profile. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:751-764. [PMID: 32725835 DOI: 10.1111/1460-6984.12561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/16/2020] [Accepted: 06/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Amyotrophic Lateral Sclerosis (ALS) was traditionally described as a disease restricted to the motor system. However, recent findings suggested that it also affects cognition, especially executive functions, social cognition, language and pragmatics. A relevant issue in current research is thus the description of the cognitive phenotype of ALS and the identification of the most vulnerable aspects. AIMS The focus was on a communicative phenomenon placed at the crossroads of pragmatic and other cognitive domains, namely humour, which till now has been poorly explored in ALS. The first aim was to investigate whether ALS is associated with impairments in understanding and appreciating jokes. The second aim was to explore the predictors of humour comprehension and appreciation in patients, to confirm the involvement of pragmatic skills and to explore the role of other cognitive and clinical aspects. METHODS & PROCEDURES A total of 30 non-demented patients with ALS and 27 controls were assessed with a task of verbal humour comprehension and appreciation, including two types of jokes: phonological and mental. We also administered a battery of pragmatic and other language tasks, and cognitive and socio-cognitive tasks. Mixed-effects models were used to test differences in the humour task between the two groups. Multiple regressions determined the best predictors of humour comprehension and appreciation in patients. OUTCOMES & RESULTS Patients obtained lower comprehension accuracy scores than controls in the humour task, independently of the type of joke. Conversely, patients and controls did not differ in joke appreciation and both rated mental jokes as funnier than the phonological ones. Patients' comprehension accuracy was predicted by pragmatic skills and ALS severity, whereas appreciation was predicted by several clinical variables and, to a smaller extent, by language skills. CONCLUSIONS & IMPLICATIONS The findings suggest that humour is a very vulnerable aspect in ALS, and that impairment in humour comprehension might be part of the larger cognitive impairment, being linked to pragmatic impairment. Clinical variables were also important, especially in relation to humour appreciation. More generally, these data speak in favour of pragmatics as a relevant aspect to sketch the cognitive phenotype of ALS. On the practical level, these findings point to the need of supporting communication at large, not only motor-related aspects such as dysarthria but also social-pragmatic aspects such as understanding jokes, to increase well-being in ALS. What this paper adds What is already known on this subject The literature of the last decades has shown that ALS comes with impairment in several cognitive domains, affecting especially executive functions as well as language. There is also initial evidence that the pragmatics of communication and humour comprehension are impaired, although non-serious talk has been documented in conversational interaction among people with ALS. What this paper adds to existing knowledge This study offers compelling evidence of an impairment in the comprehension of jokes in ALS, whereas the appreciation of joke funniness seems to be spared. The study also highlights the interplay of cognitive factors (especially pragmatics) and clinical factors (related to disease severity) in predicting the patients' performance in the humour task. What are the potential or actual clinical implications of this work? The study's findings call for the need of increased awareness among scholars as well as practitioners and caregivers of the profile of humour comprehension and appreciation in ALS. On a practical level, we highlight the need of assessing humour comprehension and adapting the communicative style accordingly. Second, we recommend that intervention programmes targeting communication in ALS go beyond speech-related difficulties and include pragmatic aspects such as humour. Considering the important communicative and social function of humour, as well as its use as a coping strategy, humour interventions are key to improve the quality of life of individuals with ALS.
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Affiliation(s)
- Valentina Bambini
- Center for Neurocognition, Epistemology and Theoretical Syntax, University School for Advanced Studies IUSS, Pavia, Italy
| | - Luca Bischetti
- Center for Neurocognition, Epistemology and Theoretical Syntax, University School for Advanced Studies IUSS, Pavia, Italy
| | | | | | - Serena Lecce
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
| | - Mauro Ceroni
- Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy
- Neurological Institute Mondino Foundation, Pavia, Italy
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Luzzi S, Baldinelli S, Ranaldi V, Fiori C, Plutino A, Fringuelli FM, Silvestrini M, Baggio G, Reverberi C. The neural bases of discourse semantic and pragmatic deficits in patients with frontotemporal dementia and Alzheimer's disease. Cortex 2020; 128:174-191. [DOI: 10.1016/j.cortex.2020.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 06/15/2019] [Accepted: 03/05/2020] [Indexed: 12/13/2022]
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14
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Chanial C, Basaglia-Pappas S, Jacqueline S, Boulange A, Gourdon C, Donya S, Fagnou S, Laurent B, Camdessanche JP, Borg C. Assessment of implicit language and theory of mind in multiple sclerosis. Ann Phys Rehabil Med 2020; 63:111-115. [DOI: 10.1016/j.rehab.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 02/18/2019] [Accepted: 08/24/2019] [Indexed: 12/13/2022]
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15
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Białkowska J, Mroczkowska D, Huflejt ME, Wojtkiewicz J, Siwek T, Barczewska M, Maksymowicz W. COMPLEX TREATMENT OF AMYOTROPHIC LATERAL SCLEROSIS PATIENT. Acta Clin Croat 2019; 58:757-766. [PMID: 32595261 PMCID: PMC7314291 DOI: 10.20471/acc.2019.58.04.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Amyotrophic lateral sclerosis is a progressive and fatal degenerative neuromuscular disease with few if any treatment options and physical rehabilitation addressing specific deficits is the most frequent form of therapy. Patients also suffer from depression and increased anxiety. Our purpose was to assess the neurorehabilitation effectiveness in a patient with amyotrophic lateral sclerosis who underwent stem cell transplantation but refused physiotherapy due to depression. Disease progression was followed using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale bimonthly for six months pre- and then post-stem cell transplantation. Psychological traits were assessed using six standardized tests. Quantitative electroencephalogram diagnostics was performed before the first and after the last neurofeedback session, and sessions were conducted on a 3-times-a-week basis. The physiotherapy protocol included proprioceptive neuromuscular facilitation, electrical modalities unit applied to the lumbar spine area, and breathing, relaxation and walking exercises, among others. Increased motivation and marked decrease in the pain level was associated with the patient's willingness to complete physiotherapy, which resulted in improvements in most neuromuscular deficits and in increased respiratory capacity. During the 12 post-rehabilitation months, progression of the disease decelerated, and a positive behavioral change was noted. The study suggested that neurofeedback could be used as a neurorehabilitation component of the personalized complex rehabilitation protocol in patients with amyotrophic lateral sclerosis.
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Affiliation(s)
| | - Dorota Mroczkowska
- 1Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Clinical University Hospital, Olsztyn, Poland; 3Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 4Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Margaret E Huflejt
- 1Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Clinical University Hospital, Olsztyn, Poland; 3Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 4Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Joanna Wojtkiewicz
- 1Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Clinical University Hospital, Olsztyn, Poland; 3Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 4Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Tomasz Siwek
- 1Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Clinical University Hospital, Olsztyn, Poland; 3Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 4Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Monika Barczewska
- 1Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Clinical University Hospital, Olsztyn, Poland; 3Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 4Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Wojciech Maksymowicz
- 1Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Clinical University Hospital, Olsztyn, Poland; 3Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 4Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
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16
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Montemurro S, Mondini S, Signorini M, Marchetto A, Bambini V, Arcara G. Pragmatic Language Disorder in Parkinson's Disease and the Potential Effect of Cognitive Reserve. Front Psychol 2019; 10:1220. [PMID: 31275189 PMCID: PMC6593041 DOI: 10.3389/fpsyg.2019.01220] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/08/2019] [Indexed: 12/13/2022] Open
Abstract
It is known that patients with Parkinson's Disease (PD) may show deficits in several areas of cognition, including speech and language abilities. One domain of particular interest is pragmatics, which refers to the capacity of using language in context for a successful communication. Several studies showed that some specific aspects of pragmatics - both in production and in comprehension - might be impaired in patients with PD. However, a clear picture of pragmatic abilities in PD is still missing, as most of the existing studies focused on specific aspects of the pragmatic competence rather than on sketching a complete pragmatic profile. Moreover, little is known on the potential role of protective factors in compensating the decline of communicative skills as the disease progresses. The present study has two aims: (1) to provide a complete picture of pragmatic abilities in patients with PD, by using a comprehensive battery (Assessment of Pragmatic Abilities and Cognitive Substrates, APACS) and by investigating the relationship with other aspects of cognitive functioning (e.g., working memory and Theory of Mind) and (2) to investigate whether Cognitive Reserve, i.e., the resilience to cognitive impairment provided by life experiences and activities, may compensate for the progressive pragmatic deficits in PD. We found that patients with PD, compared to healthy matched controls, had worse performance in discourse production and in the description of scenes, and that these impairments were tightly correlated with the severity of motor impairment, suggesting reduced intentionality of engaging in a communicative exchange. Patients with PD showed also an impairment in comprehending texts and humor, suggesting a problem in inferring from stories, which was related to general cognitive impairment. Notably, we did not find any significant difference between patients and controls in figurative language comprehension, a domain that is commonly impaired in other neurodegenerative diseases. This might be indicative of a specific profile of pragmatic impairment in patients with PD, worth of further investigation. Finally, Cognitive Reserve measures showed a high degree of association with pragmatic comprehension abilities, suggesting that the modification of life-styles could be a good candidate for compensating the possible problems in understanding the pragmatic aspects of language experienced by patients with PD.
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Affiliation(s)
- Sonia Montemurro
- Department of General Psychology, University of Padua, Padua, Italy.,Human Inspired Technology Research Centre, University of Padua, Padua, Italy
| | - Sara Mondini
- Department of General Psychology, University of Padua, Padua, Italy.,Human Inspired Technology Research Centre, University of Padua, Padua, Italy
| | | | - Anna Marchetto
- Gruppo Veneto Diagnostica e Riabilitazione, Padua, Italy
| | - Valentina Bambini
- Center for Neurocognition, Epistemology and Theoretical Syntax, University School of Advanced Studies IUSS, Pavia, Italy
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17
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Christidi F, Karavasilis E, Rentzos M, Kelekis N, Evdokimidis I, Bede P. Clinical and Radiological Markers of Extra-Motor Deficits in Amyotrophic Lateral Sclerosis. Front Neurol 2018; 9:1005. [PMID: 30524366 PMCID: PMC6262087 DOI: 10.3389/fneur.2018.01005] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/06/2018] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is now universally recognized as a complex multisystem disorder with considerable extra-motor involvement. The neuropsychological manifestations of frontotemporal, parietal, and basal ganglia involvement in ALS have important implications for compliance with assistive devices, survival, participation in clinical trials, caregiver burden, and the management of individual care needs. Recent advances in neuroimaging have been instrumental in characterizing the biological substrate of heterogeneous cognitive and behavioral deficits in ALS. In this review we discuss the clinical and radiological aspects of cognitive and behavioral impairment in ALS focusing on the recognition, assessment, and monitoring of these symptoms.
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Affiliation(s)
- Foteini Christidi
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | - Michail Rentzos
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Second Department of Radiology, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Evdokimidis
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Peter Bede
- Computational Neuroimaging Group, Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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18
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Carotenuto A, Cocozza S, Quarantelli M, Arcara G, Lanzillo R, Brescia Morra V, Cerillo I, Tedeschi E, Orefice G, Bambini V, Brunetti A, Iodice R. Pragmatic abilities in multiple sclerosis: The contribution of the temporo-parietal junction. BRAIN AND LANGUAGE 2018; 185:47-53. [PMID: 30110668 DOI: 10.1016/j.bandl.2018.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/09/2018] [Accepted: 08/02/2018] [Indexed: 06/08/2023]
Abstract
Recent studies showed that multiple sclerosis (MS) patients might experience communicative deficits, specifically in pragmatics (i.e., the ability to integrate the context-dependent aspects of language). A crucial region for pragmatics is the temporo-parietal junction, in particular the so-called Geschwind's area (GA), which is involved in high-level language processes, including the comprehension of narratives, metaphor, and irony. We evaluated the relationship between pragmatic abilities, measured through the Assessment of Pragmatic Abilities and Cognitive Substrates (APACS) test, and the functional connectivity (FC) of the bilateral GAs, assessed through a seed-based analysis of Resting-State fMRI in patients with MS. A positive correlation was observed between APACS scores and the FC for both the right and the left GA and the paracingulate cortex. Our findings suggest that the brain FC for social communication involves connections extending over both hemispheres, including right and left GAs and right and left paracingulate cortex, possibly impaired in patients with MS. This study offers preliminary evidence for future researches enrolling also a control sample to explore the involvement of GA in pragmatics in neurological disorders as well as in healthy conditions.
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Affiliation(s)
- Antonio Carotenuto
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
| | - Mario Quarantelli
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | | | - Roberta Lanzillo
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Ilaria Cerillo
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Enrico Tedeschi
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Giuseppe Orefice
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Valentina Bambini
- Center for Neurocognition, Epistemology and Theoretical Syntax (NETS), University School for Advanced Studies IUSS, Pavia, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Rosa Iodice
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
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19
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Cappelli G, Noccetti S, Arcara G, Bambini V. Pragmatic competence and its relationship with the linguistic and cognitive profile of young adults with dyslexia. DYSLEXIA (CHICHESTER, ENGLAND) 2018; 24:294-306. [PMID: 29993159 DOI: 10.1002/dys.1588] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/19/2018] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
The study assessed the pragmatic skills of 19 well-compensated Italian-speaking young adults with dyslexia compared with controls. A comprehensive pragmatic assessment tool was employed, targeting production and comprehension (Assessment of Pragmatic Abilities and Cognitive Substrates [APACS]). Participants were also administered a series of standardized tests to assess verbal and non-verbal cognitive abilities, including executive functions and social cognition tests. Data were analysed with the aim of understanding whether pragmatic abilities are compromised in dyslexia and of exploring associations between pragmatic performance and other cognitive domains. The performance of the dyslexia group was poorer than that of the control group in both expressive and receptive modalities. Data showed diffuse problems across several domains, with the greatest challenge posed by inferring nonliteral meanings, which indicates that pragmatic inefficiency is an important aspect of the linguistic and communicative profile of dyslexia in adulthood. Explorative correlations highlighted a relation between pragmatic performance and reading and vocabulary abilities, as well as between pragmatics and working memory. This suggests that pragmatic difficulties are strongly tied to the most distinctive aspects of dyslexia, namely, phonological awareness, verbal short-term memory, pseudo-word repetition, whereas the link with high-level executive functions and Theory of Mind is negligible.
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Affiliation(s)
- Gloria Cappelli
- Department of Philology, Literature and Linguistics, University of Pisa, Pisa, Italy
| | - Sabrina Noccetti
- Department of Philology, Literature and Linguistics, University of Pisa, Pisa, Italy
| | | | - Valentina Bambini
- Center for Neurocognition and theoretical Syntax (NEtS), University School for Advanced Studies IUSS Pavia, Pavia, Italy
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20
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Schaeken W, Van Haeren M, Bambini V. The Understanding of Scalar Implicatures in Children With Autism Spectrum Disorder: Dichotomized Responses to Violations of Informativeness. Front Psychol 2018; 9:1266. [PMID: 30083124 PMCID: PMC6064869 DOI: 10.3389/fpsyg.2018.01266] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 07/02/2018] [Indexed: 12/13/2022] Open
Abstract
This study investigated the understanding of underinformative sentences like "Some elephants have trunks" by children with autism spectrum disorder (ASD). The scalar term 'some' can be interpreted pragmatically, 'Not all elephants have trunks,' or logically, 'Some and possibly all elephants have trunks.' Literature indicates that adults with ASD show no real difficulty in interpreting scalar implicatures, i.e., they often interpret them pragmatically, as controls do. This contrasts with the traditional claim of difficulties of people with ASD in other pragmatic domains, and is more in line with the idea that pragmatic problems are not universal. The aim of this study was to: (a) gain insight in the ability of children with ASD to derive scalar implicatures, and (b) do this by assessing not only sensitivity to underinformativeness, but also different degrees of tolerance to violations of informativeness. We employed a classic statement-evaluation task, presenting optimal, logical false, and underinformative utterances. In Experiment 1, children had to express their judgment on a binary option 'I agree' vs. 'I disagree.' In Experiment 2, a ternary middle answer option 'I agree a bit' was also available. Sixty-six Flemish-speaking 10-year-old children were tested: 22 children with ASD, an IQ-matched group, and an age-matched group. In the binary judgment task, the ASD group gave more pragmatic answers than the other groups, which was significant in the mixed effects logistic regression analysis, although not in the non-parametric analysis. In the ternary judgment task, the children with ASD showed a dichotomized attitude toward the speaker's meaning, by tending to either fully agree or fully disagree with underinformative statements, in contrast with TD children, who preferred the middle option. Remarkably, the IQ-matched group exhibited the same pattern of results as the ASD group. Thanks to a fine-grained measure such as the ternary judgment task, this study highlighted a neglected aspect of the pragmatic profile of ASD, whose struggle with social communication seems to affect also the domain of informativeness. We discuss the implications of the dichotomized reaction toward violations of informativeness in terms of the potential role of ASD and of cognitive and verbal abilities.
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Affiliation(s)
- Walter Schaeken
- Laboratory of Experimental Psychology, KU Leuven, Leuven, Belgium
| | - Marie Van Haeren
- Laboratory of Experimental Psychology, KU Leuven, Leuven, Belgium
| | - Valentina Bambini
- Center for Neurocognition, Epistemology and theoretical Syntax (NEtS), University School for Advanced Studies IUSS Pavia, Pavia, Italy
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21
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Woolley SC, Rush BK. Considerations for Clinical Neuropsychological Evaluation in Amyotrophic Lateral Sclerosis. Arch Clin Neuropsychol 2018; 32:906-916. [PMID: 29028904 DOI: 10.1093/arclin/acx089] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 09/14/2017] [Indexed: 12/11/2022] Open
Abstract
The clinical neuropsychologist has the opportunity to be uniquely involved in the evaluation and treatment of individuals with amyotrophic lateral sclerosis (ALS). We review the current literature that defines cognitive and behavioral symptoms in ALS, including current knowledge of the neuropathological and genetic underpinning for these symptoms. There are unique considerations for clinical neuropsychological evaluation and clinical research in ALS and we highlight these in this review. Specifically, we shed light on special factors that contribute to our understanding of cognitive and behavioral impairment in ALS, including co-morbid symptoms, differential diagnosis, and considerations for longitudinal tracking of phenotypes. We discuss the rationale for proposing a specific approach to such as cognitive screening, test selection, response modality consideration, and test-retest intervals. With this didactic overview, the clinical neuropsychologist has the potential to learn more about the heterogeneous presentation of motor and neuropsychological symptoms in ALS. Furthermore, the reader has the opportunity to understand what it takes to develop a valid assessment approach particularly when the phenotype of ALS remains undefined in some regards. This clinical practice review sets the stage for the clinical neuropsychologist to further contribute to our clinical and scientific understanding of ALS and cognition.
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Affiliation(s)
| | - Beth K Rush
- Mayo Clinic Florida, Department of Psychiatry and Psychology, 4500 San Pablo Road, Jacksonville, FL 32224, USA
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22
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Rapp AM, Felsenheimer AK, Langohr K, Klupp M. The Comprehension of Familiar and Novel Metaphoric Meanings in Schizophrenia: A Pilot Study. Front Psychol 2018; 8:2251. [PMID: 29354082 PMCID: PMC5760836 DOI: 10.3389/fpsyg.2017.02251] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 12/11/2017] [Indexed: 12/13/2022] Open
Abstract
Miscomprehension of nonliteral (“figurative”) language like metaphors, proverbs, idioms, and ironic expressions by patients with schizophrenia is a phenomenon mentioned already in historical psychiatric descriptions. However, it was only recently that studies did differentiate between novel and conventional metaphors, a factor that is known to influence the difficulty of comprehension in healthy subjects. Further, familiarity with stimuli is an important factor for comprehension, which was not recommended in utmost previous studies. In this study, 23 patients with DSM IV schizophrenia and 19 healthy control subjects performed a newly-developed German metaphor comprehension test with three types of stimuli: novel metaphors, conventional German metaphors, and meaningless statements. During the test procedure, participants indicated familiarity with the stimulus and then matched the meaning with one out of four given alternatives. Familiarity rankings did not significantly differ between patients and control subjects. However, on descriptive level, there was a tendency for healthy controls to be more familiar with conventional metaphors than schizophrenic patients. Further, comprehension of conventional and novel metaphors differed significantly between the groups, with higher performance in healthy controls. Considering only those metaphors that had been ranked as familiar, patients only revealed significant lower performance opposed to controls regarding novel metaphors, while they did not differ in conventional metaphors. Taken together, the results indicate that patients with schizophrenia might show an altered way of comprehension in novel metaphors, leading to more misunderstandings. However, their previously reported impairments in conventional metaphors might rather be due to a lack of familiarity with the stimuli—making conventional metaphors to novel metaphors in the individual case.
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Affiliation(s)
- Alexander M Rapp
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Anne K Felsenheimer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Karin Langohr
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Magdalena Klupp
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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Carotenuto A. Look beyond the door, not through the keyhole: evidence from a cognitive assessment including social cognition evaluation in multiple sclerosis. Eur J Neurol 2017; 25:205-206. [PMID: 29053891 DOI: 10.1111/ene.13482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- A Carotenuto
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy.,Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, IoPPN, King's College London, London, UK
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24
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Carotenuto A, Arcara G, Orefice G, Cerillo I, Giannino V, Rasulo M, Iodice R, Bambini V. Communication in Multiple Sclerosis: Pragmatic Deficit and its Relation with Cognition and Social Cognition. Arch Clin Neuropsychol 2017; 33:194-205. [DOI: 10.1093/arclin/acx061] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 06/09/2017] [Indexed: 12/13/2022] Open
Affiliation(s)
- Antonio Carotenuto
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | | | - Giuseppe Orefice
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Ilaria Cerillo
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Valentina Giannino
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Mario Rasulo
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Rosa Iodice
- Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy
| | - Valentina Bambini
- Center for Neurocognition, Epistemology and theoretical Syntax (NEtS), School of Advanced Studies IUSS, Pavia, Italy
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Strong MJ, Abrahams S, Goldstein LH, Woolley S, Mclaughlin P, Snowden J, Mioshi E, Roberts-South A, Benatar M, HortobáGyi T, Rosenfeld J, Silani V, Ince PG, Turner MR. Amyotrophic lateral sclerosis - frontotemporal spectrum disorder (ALS-FTSD): Revised diagnostic criteria. Amyotroph Lateral Scler Frontotemporal Degener 2017; 18:153-174. [PMID: 28054827 PMCID: PMC7409990 DOI: 10.1080/21678421.2016.1267768] [Citation(s) in RCA: 563] [Impact Index Per Article: 80.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 11/15/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Abstract
This article presents the revised consensus criteria for the diagnosis of frontotemporal dysfunction in amyotrophic lateral sclerosis (ALS) based on an international research workshop on frontotemporal dementia (FTD) and ALS held in London, Canada in June 2015. Since the publication of the Strong criteria, there have been considerable advances in the understanding of the neuropsychological profile of patients with ALS. Not only is the breadth and depth of neuropsychological findings broader than previously recognised - - including deficits in social cognition and language - but mixed deficits may also occur. Evidence now shows that the neuropsychological deficits in ALS are extremely heterogeneous, affecting over 50% of persons with ALS. When present, these deficits significantly and adversely impact patient survival. It is the recognition of this clinical heterogeneity in association with neuroimaging, genetic and neuropathological advances that has led to the current re-conceptualisation that neuropsychological deficits in ALS fall along a spectrum. These revised consensus criteria expand upon those of 2009 and embrace the concept of the frontotemporal spectrum disorder of ALS (ALS-FTSD).
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Affiliation(s)
- Michael J Strong
- a Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry , London , Ontario , Canada
| | - Sharon Abrahams
- b Department of Psychology, School of Philosophy, Psychology & Language Sciences , Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh , Edinburgh , UK
| | - Laura H Goldstein
- c King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience , London , UK
| | - Susan Woolley
- d Forbes Norris MDA/ALS Research Centre, California Pacific Medical Centre , San Francisco , CA , USA
| | - Paula Mclaughlin
- e Western University , Schulich School of Medicine & Dentistry , London , ON , Canada
| | - Julie Snowden
- f Greater Manchester Neuroscience Centre , Salford Royal NHS Trust and University of Manchester , Manchester , UK
| | - Eneida Mioshi
- g Faculty of Medicine and Health Sciences , University of East Anglia , Norwich , UK
| | - Angie Roberts-South
- h Northwestern University , Roxelyn and Richard Pepper Department of Communication Sciences and Disorders , Evanston , IL , USA
| | - Michael Benatar
- i Department of Neurology , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Tibor HortobáGyi
- j Department of Neuropathology , Institute of Pathology, University of Debrecen , Debrecen , Hungary
| | - Jeffrey Rosenfeld
- k Department of Neurology , Loma Linda University School of Medicine , Loma Linda , CA , USA
| | - Vincenzo Silani
- l Department of Neurology and Laboratory Neuroscience - IRCCS Istituto Auxologico Italiano, Department of Pathophysiology and Transplantation , 'Dino Ferrari' Centre, Università degli Studi di Milano , Milan , Italy
| | - Paul G Ince
- m Sheffield Institute for Translational Neuroscience, Department of Neuroscience , The University of Sheffield , Sheffield , UK , and
| | - Martin R Turner
- n Nuffield Department of Clinical Neurosciences , University of Oxford , Oxford , UK
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Bosco FM, Parola A, Sacco K, Zettin M, Angeleri R. Communicative-pragmatic disorders in traumatic brain injury: The role of theory of mind and executive functions. BRAIN AND LANGUAGE 2017; 168:73-83. [PMID: 28161678 DOI: 10.1016/j.bandl.2017.01.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/19/2016] [Accepted: 01/23/2017] [Indexed: 06/06/2023]
Abstract
Previous research has shown that communicative-pragmatic ability, as well as executive functions (EF) and Theory of Mind (ToM), may be impaired in individuals with traumatic brain injury (TBI). However, the role of such cognitive deficits in explaining communicative-pragmatic difficulty in TBI has still not been fully investigated. The study examined the relationship between EF (working memory, planning and flexibility) and ToM and communicative-pragmatic impairment in patients with TBI. 30 individuals with TBI and 30 healthy controls were assessed using the Assessment Battery of Communication (ABaCo), and a set of cognitive, EF and ToM, tasks. The results showed that TBI participants performed poorly in comprehension and production tasks in the ABaCo, using both linguistic and extralinguistic means of expression, and that they were impaired in EF and ToM abilities. Cognitive difficulties were able to predict the pragmatic performance of TBI individuals, with both executive functions and ToM contributing to explaining patients' scores on the ABaCo.
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Affiliation(s)
- Francesca M Bosco
- Center for Cognitive Science, Department of Psychology, University of Turin, Italy; Institute of Neurosciences of Turin, Italy
| | - Alberto Parola
- Center for Cognitive Science, Department of Psychology, University of Turin, Italy.
| | - Katiuscia Sacco
- Center for Cognitive Science, Department of Psychology, University of Turin, Italy; Institute of Neurosciences of Turin, Italy
| | | | - Romina Angeleri
- Department of Psychology, University of New Mexico, NM, United States
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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: 136] [Impact Index Per Article: 19.4] [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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Roberts A, Savundranayagam M, Orange JB. Non-Alzheimer Dementias. PERSPECTIVES IN PRAGMATICS, PHILOSOPHY & PSYCHOLOGY 2017. [DOI: 10.1007/978-3-319-47489-2_14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Baggio G, Granello G, Verriello L, Eleopra R. Formal Semantics in the Neurology Clinic: Atypical Understanding of Aspectual Coercion in ALS Patients. Front Psychol 2016; 7:1733. [PMID: 27867369 PMCID: PMC5095610 DOI: 10.3389/fpsyg.2016.01733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 10/20/2016] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of the motor system with subtle adverse effects on cognition. It is still unclear whether ALS also affects language and semantics, and if so, what aspects and processes exactly. We investigated how ALS patients understand verb phrases modified by temporal preposition phrases, e.g., "To watch TV for half an hour." Interpretation here requires operations such as aspectual coercion that add or delete elements from event structures, depending on temporal modifiers, and constraints on coercion, which make combinations with certain modifiers not viable. Using a theoretically-motivated experimental design, we observed that acceptance rates for aspectual coercion were abnormally high in ALS patients. The effect was largest for the more complex cases of coercion: not those that involve enrichment of event structures ("To switch on the TV in half an hour," where a number of failed attempts must be included in the interpretation) but those that, if applied, would result in deletion of event structure elements ("To repair the TV for half an hour"). Our experimental results are consistent with a deficit of constraints on coercion, and not with impaired semantic processes or representations, in line with recent studies suggesting that verb semantics is largely spared in ALS.
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Affiliation(s)
- Giosuè Baggio
- Language Acquisition and Language Processing Lab, Norwegian University of Science and TechnologyTrondheim, Norway
| | - Giulia Granello
- Neurology Unit, Azienda Ospedaliero Universitaria Ospedali RiunitiTrieste, Italy
| | - Lorenzo Verriello
- Neurology Unit, Azienda Ospedaliero Universitaria Santa Maria della MisericordiaUdine, Italy
| | - Roberto Eleopra
- Neurology Unit, Azienda Ospedaliero Universitaria Santa Maria della MisericordiaUdine, Italy
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Bambini V, Arcara G, Bechi M, Buonocore M, Cavallaro R, Bosia M. The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. Compr Psychiatry 2016; 71:106-120. [PMID: 27653782 DOI: 10.1016/j.comppsych.2016.08.012] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/01/2016] [Accepted: 08/21/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Impairments in specific aspects of pragmatic competence, supporting the use of language in context, are largely documented in schizophrenia and might represent an indicator of poor outcome. Yet pragmatics is rarely included in clinical settings. This paper aims to promote a clinical consideration of pragmatics as a target of assessment and intervention. We investigated the frequency of the pragmatic deficit, its cognitive substrates, and the relation with quality of life. METHODS Pragmatic abilities were compared in a sample of patients with schizophrenia and healthy controls based on a comprehensive pragmatic test (APACS). We assessed also for psychopathology, cognition, social cognition, and quality of life. We explored the co-occurrence of deficits in different domains, and we used multiple regressions to investigate the effect of cognition and social cognition on pragmatics, and of pragmatics on quality of life. RESULTS Pragmatic abilities, especially comprehending discourse and non-literal meanings, were compromised in schizophrenia, with 77% of patients falling below cutoff. Pragmatic deficit co-occurred with cognitive or socio-cognitive deficits in approximately 30% of cases. Multiple regression analysis confirmed the interplay of cognition and social cognition in pragmatic behavior. Quality of life was predicted by symptoms and by pragmatic abilities. CONCLUSIONS The high frequency of impairment suggests that the pragmatic deficit is a core feature of schizophrenia, associated with quality of life. Cognitive and socio-cognitive abilities might represent necessary though not sufficient building blocks for the acquisition of pragmatic abilities throughout development. Therefore, a more precise incorporation of pragmatics in the description of the pathology is of high clinical and translational relevance.
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Affiliation(s)
- Valentina Bambini
- Center for Neurocognition, Epistemology and theoretical Syntax, Scuola Universitaria Superiore IUSS Pavia, Piazza della Vittoria 15, 27100, Pavia, Italy.
| | - Giorgio Arcara
- IRCCS Fondazione Ospedale San Camillo, Via Alberoni 70, Lido di Venezia (Venezia), Italy.
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy.
| | - Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy.
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy.
| | - Marta Bosia
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy; Vita Salute San Raffaele University, Via Olgettina, 58, 20132, Milano, Italy.
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