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Ramage AE, Greenslade KJ, Cote K, Lee JN, Fox CM, Halpern A, Ramig LO. Narrative analysis in individuals with Parkinson's disease following intensive voice treatment: secondary outcome variables from a randomized controlled trial. Front Hum Neurosci 2024; 18:1394948. [PMID: 38841124 PMCID: PMC11150807 DOI: 10.3389/fnhum.2024.1394948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/18/2024] [Indexed: 06/07/2024] Open
Abstract
Communication is often impaired in individuals with Parkinson's disease (PD), typically secondary to sensorimotor deficits impacting voice and speech. Language may also be diminished in PD, particularly for production and comprehension of verbs. Evidence exists that verb processing is influenced by motor system modulation suggesting that verb deficits in PD are underpinned by similarities in the neural representations of actions that span motor and semantic systems. Conversely, subtle differences in cognition in PD may explain difficulty in processing of complex syntactic forms, which increases cognitive demand and is linked to verb use. Here we investigated whether optimizing motor system support for vocal function (improving loudness) affects change in lexical semantic, syntactic, or informativeness aspects of spoken discourse. Picture description narratives were compared for 20 Control participants and 39 with PD, 19 of whom underwent Lee Silverman Voice Treatment (LSVT LOUD®). Treated PD narratives were also contrasted with those of untreated PD and Control participants at Baseline and after treatment. Controls differed significantly from the 39 PD participants for verbs per utterance, but this difference was largely driven by untreated PD participants who produced few utterances but with verbs, inflating their verbs per utterance. Given intervention, there was a significant increase in vocal loudness but no significant changes in language performance. These data do not support the hypothesis that targeting this speech motor system results in improved language production. Instead, the data provide evidence of considerable variability in measures of language production across groups, particularly in verbs per utterance.
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Affiliation(s)
- Amy E. Ramage
- Department of Communication Sciences and Disorders, Durham, NH, United States
- Interdisciplinary Program in Neuroscience and Behavior, University of New Hampshire, Durham, NH, United States
| | | | - Kaila Cote
- Department of Communication Sciences and Disorders, Durham, NH, United States
| | - Jessica N. Lee
- Department of Communication Sciences and Disorders, Durham, NH, United States
| | | | | | - Lorraine O. Ramig
- LSVT Global, Inc., Tucson, AZ, United States
- Teachers College, Columbia University, Communication Sciences and Disorders, New York, NY, United States
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Kim H, Obermeyer J, Wiley RW. Written discourse in diagnosis for acquired neurogenic communication disorders: current evidence and future directions. Front Hum Neurosci 2024; 17:1264582. [PMID: 38273880 PMCID: PMC10808624 DOI: 10.3389/fnhum.2023.1264582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
Purpose We aimed to perform the first review of research focusing on written discourse performance in people with acquired neurogenic communication disorders. In studies from 2000 onward, we specifically sought to determine: (1) the differences between patient populations and control groups, (2) the differences between different patient populations, (3) longitudinal differences between patient populations, and (4) modality differences between spoken and written discourse performance. Methods We completed a thorough search on MEDLINE, Embase, Cochrane, APAPsycinfo, Web of Science, and Scopus databases. We identified studies that focus on written discourse performance in people with aphasia, primary progressive aphasia, mild cognitive impairment, and Alzheimer's disease. Results Nineteen studies were identified from the review of literature, some of which addressed more than one of our review questions. Fifteen studies included a comparison between clinical populations and controls. Six studies compared different characteristics of patient populations. Three studies reported changes over time in progressive disorders. Six studies targeted different modalities of discourse. Conclusion Differences in linguistic features by patient populations are not yet clear due to the limited number of studies and different measures and tasks used across the studies. Nevertheless, there is substantial evidence of numerous linguistic features in acquired neurogenic communication disorders that depart from those of healthy controls. Compared to the controls, people with aphasia tend to produce fewer words, and syntactically simpler utterances compared to the controls. People with Alzheimer's disease produce less information content, and this feature increases over time, as reported in longitudinal studies. Our review imparts additional information that written and spoken discourse provide unique insights into the cognitive and linguistic deficits experienced by people with aphasia, Alzheimer's disease, mild cognitive impairment and primary progressive aphasia and provide targets for treatment to improve written communication in these groups.
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Affiliation(s)
- Hana Kim
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL, United States
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jessica Obermeyer
- Department of Communication Sciences and Disorders, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Robert W. Wiley
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States
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G S A, Ponniah RJ. The Modularity of Dysgraphia. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2023; 52:2903-2917. [PMID: 37930468 DOI: 10.1007/s10936-023-10029-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
Research regarding dysgraphia, an impairment in writing, is attaining more attention in recent times. The existing studies on dysgraphia draw insights from cognitive, behavioural, neurological, and genetic fields of knowledge. However, these multiple studies on dysgraphia fail to illustrate how these cognitive, behavioural, neurological, and genetic systems interact and intersect in dysgraphia. Therefore, the studies could not offer a comprehensive understanding of dysgraphia. In order to fill this gap, the review attempts to study dysgraphia using the notion of modularity by accommodating insights from cognitive, behavioural, neurological, and genetic aspects of dysgraphia. Such a profound understanding could facilitate an early diagnosis and holistic intervention towards dysgraphia.
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Affiliation(s)
- Aiswarya G S
- Department of Humanities and Social Sciences, National Institute of Technology, Tiruchirappalli, 620015, Tamil Nadu, India
| | - R Joseph Ponniah
- Department of Humanities and Social Sciences, National Institute of Technology, Tiruchirappalli, 620015, Tamil Nadu, India.
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Fernandes CP, Montalvo G, Caligiuri M, Pertsinakis M, Guimarães J. Handwriting Changes in Alzheimer's Disease: A Systematic Review. J Alzheimers Dis 2023; 96:1-11. [PMID: 37718808 DOI: 10.3233/jad-230438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Handwriting is a complex process involving fine motor skills, kinesthetic components, and several cognitive domains, often impaired by Alzheimer's disease (AD). OBJECTIVE Provide a systematic review of handwriting changes in AD, highlighting the effects on motor, visuospatial and linguistic features, and to identify new research topics. METHODS A search was conducted on PubMed, Scopus, and Web of Science to identify studies on AD and handwriting. The review followed PRISMA norms and analyzed 91 articles after screening and final selection. RESULTS Handwriting is impaired at all levels of the motor-cognitive hierarchy in AD, particularly in text, with higher preservation of signatures. Visuospatial and linguistic features were more affected. Established findings for motor features included higher variability in AD signatures, higher in-air/on-surface time ratio and longer duration in text, longer start time/reaction time, and lower fluency. There were conflicting findings for pressure and velocity in motor features, as well as size, legibility, and pen lifts in general features. For linguistic features, findings were contradictory for error patterns, as well as the association between agraphia and severity of cognitive deficits. CONCLUSIONS Further re-evaluation studies are needed to clarify the divergent results on motor, general, and linguistic features. There is also a lack of research on the influence of AD on signatures and the effect of AD variants on handwriting. Such research would have an impact on clinical management (e.g., for early detection and patient follow-up using handwriting tasks), or forensic examination aimed at signatory identification.
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Affiliation(s)
- Carina Pereira Fernandes
- NCForenses Institute, Porto, Portugal
- Instituto Universitario de Investigación en Ciencias Policiales (IUICP), Universidad de Alcalá, Alcalá de Henares, Spain
| | - Gemma Montalvo
- Instituto Universitario de Investigación en Ciencias Policiales (IUICP), Universidad de Alcalá, Alcalá de Henares, Spain
- Universidad de Alcalá, Departamento de Química Analítica, Química Física e Ingeniería Química, Alcalá de Henares, Spain
| | - Michael Caligiuri
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Michael Pertsinakis
- Ingeniería Química, Alcalá de Henares, Spain
- City Unity College, Athens, Greece
| | - Joana Guimarães
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
- MedInUP - Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal
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González-Nosti M, Cuetos F, Martínez C. Evolution of Writing Impairment in Spanish Patients with Alzheimer's Disease. Curr Alzheimer Res 2020; 17:845-857. [PMID: 33280596 DOI: 10.2174/1567205017666201204162837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/01/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although some studies suggest that writing difficulties may be one of the early symptoms of Alzheimer's disease (AD), they have been scarcely studied compared to oral language. Particularly noteworthy is the paucity of longitudinal studies that enable the observation of writing impairment as cognitive decline progresses. OBJECTIVE The aim of this study was to examine the characteristics of writing in patients with AD and to monitor the deterioration of their performance over a follow-up period. METHODS Sixty-four participants (half with AD and half healthy elderly) were compared in a word and pseudo-word dictation task. Patients were evaluated every 6 months over a 2.5 year follow-up period. RESULTS The evolution of patient performance and error profile shows a typical pattern of deterioration, with early damage to the lexical pathway, which later extends to the phonological pathway and eventually affects peripheral processes. CONCLUSION These results confirm the presence of writing difficulties from the early stages of AD, supporting the value of this task for early diagnosis. Furthermore, it allows us to explain the contradictory data obtained in previous investigations.
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Macoir J, Fossard M, Lefebvre L, Monetta L, Renard A, Tran TM, Wilson MA. Detection Test for Language Impairments in Adults and the Aged-A New Screening Test for Language Impairment Associated With Neurodegenerative Diseases: Validation and Normative Data. Am J Alzheimers Dis Other Demen 2017; 32:382-392. [PMID: 28639484 PMCID: PMC10852687 DOI: 10.1177/1533317517715905] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
To date, there is no quick screening test that could be used during routine office visits to accurately assess language disorders in neurodegenerative diseases. To fill this important gap, we developed the Detection Test for Language impairments in Adults and the Aged (DTLA), a quick, sensitive, standardized screening test designed to assess language disorders in adults and the elderly individuals. In Study 1, we describe the development of the DTLA. In Study 2, we report data on the DTLA's validity and reliability. Finally, in Study 3, we establish normative data for the test. The DTLA has good convergent and discriminant validity as well as good internal consistency and test-retest reliability. Norms for the DTLA obtained from a sample of 545 healthy, community-dwelling, French-speaking adults from 4 French-speaking countries (Belgium, Canada (Quebec), France, and Switzerland) are provided. The development, validation, and standardization of the DTLA constitute a significant effort to meet the need for a language screening test adapted to neurodegenerative diseases.
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Affiliation(s)
- Joël Macoir
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche, Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Marion Fossard
- Institut des sciences du langage et de la communication, Université de Neuchâtel, Neuchâtel, Switzerland
| | - Laurent Lefebvre
- Service de Psychologie cognitive et Neuropsychologie, Université de Mons, Mons, Belgium
| | - Laura Monetta
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche, Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Antoine Renard
- Centre Leennaards de la Mémoire, Université de Lausanne, CHUv Lausanne, Switzerland
| | - Thi Mai Tran
- Département d’orthophonie, Faculté de Médecine, Université de Lille, France
| | - Maximiliano A. Wilson
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche, Institut universitaire en santé mentale de Québec, Québec, Canada
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Sil’kis IG, Markevich VA. The influence of acetylcholine, dopamine, and GABA on the functioning of the corticostriatal neuronal network in Alzheimer’s and Parkinson’s diseases: A hypothetical mechanism. NEUROCHEM J+ 2017. [DOI: 10.1134/s1819712416040103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Suárez-González A, Lehmann M, Shakespeare TJ, Yong KXX, Paterson RW, Slattery CF, Foulkes AJM, Rabinovici GD, Gil-Néciga E, Roldán-Lora F, Schott JM, Fox NC, Crutch SJ. Effect of age at onset on cortical thickness and cognition in posterior cortical atrophy. Neurobiol Aging 2016; 44:108-113. [PMID: 27318138 PMCID: PMC4926954 DOI: 10.1016/j.neurobiolaging.2016.04.012] [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] [Received: 12/04/2015] [Revised: 03/30/2016] [Accepted: 04/16/2016] [Indexed: 11/16/2022]
Abstract
Age at onset (AAO) has been shown to influence the phenotype of Alzheimer's disease (AD), but how it affects atypical presentations of AD remains unknown. Posterior cortical atrophy (PCA) is the most common form of atypical AD. In this study, we aimed to investigate the effect of AAO on cortical thickness and cognitive function in 98 PCA patients. We used Freesurfer (v5.3.0) to compare cortical thickness with AAO both as a continuous variable, and by dichotomizing the groups based on median age (58 years). In both the continuous and dichotomized analyses, we found a pattern suggestive of thinner cortex in precuneus and parietal areas in earlier-onset PCA, and lower cortical thickness in anterior cingulate and prefrontal cortex in later-onset PCA. These cortical thickness differences between PCA subgroups were consistent with earlier-onset PCA patients performing worse on cognitive tests involving parietal functions. Our results provide a suggestion that AAO may not only affect the clinico-anatomical characteristics in AD but may also affect atrophy patterns and cognition within atypical AD phenotypes.
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Affiliation(s)
- Aida Suárez-González
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK; Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain.
| | - Manja Lehmann
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK; Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Timothy J Shakespeare
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Ross W Paterson
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Alexander J M Foulkes
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Gil D Rabinovici
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Eulogio Gil-Néciga
- Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain
| | | | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
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