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Kristensson J, Longoni F, Östberg P, Rödseth Smith S, Åke S, Saldert C. Anomia in left hemisphere stroke, multiple sclerosis and Parkinson's disease - a comparative study. Disabil Rehabil 2024; 46:2294-2316. [PMID: 37296078 DOI: 10.1080/09638288.2023.2219902] [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] [Received: 02/21/2022] [Revised: 04/14/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE To explore quantitative and qualitative features of anomia in participants with left-hemisphere stroke, Parkinson's disease, or multiple sclerosis. MATERIALS AND METHODS This descriptive cross-sectional study compares signs of anomia within and across participants (n = 87), divided into four groups; moderate to severe anomia after stroke (MSAS, n = 19), mild anomia after stroke (MAS, n = 22), PD (n = 19) and MS (n = 27). Aspects analysed include naming accuracy and speed, the nature of incorrect responses, semantic and phonemic verbal fluency, information content in re-telling, and the relationship between test results and self-reports on word-finding difficulties and communicative participation. RESULTS All groups had impaired verbal fluency, prolonged response times and reduced information content in re-telling. The MSAS group had significantly more signs of anomia than the other groups. Results from the other groups overlapped on a MAS-PD-MS continuum. Both semantically and phonologically incorrect responses were common in the stroke groups, while semantically incorrect ones predominated in the PD and MS groups. All four groups reported a similar negative impact on self-perceived communicative participation. Correlations between self-reports and test results were inconsistent. CONCLUSIONS Anomia features have quantitative and qualitative similarities and differences across neurological conditions.
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Affiliation(s)
- Joana Kristensson
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Francesca Longoni
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Per Östberg
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Signe Rödseth Smith
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sabina Åke
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Charlotta Saldert
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Tabari F, Berger JI, Flouty O, Copeland B, Greenlee JD, Johari K. Speech, voice, and language outcomes following deep brain stimulation: A systematic review. PLoS One 2024; 19:e0302739. [PMID: 38728329 PMCID: PMC11086900 DOI: 10.1371/journal.pone.0302739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) reliably ameliorates cardinal motor symptoms in Parkinson's disease (PD) and essential tremor (ET). However, the effects of DBS on speech, voice and language have been inconsistent and have not been examined comprehensively in a single study. OBJECTIVE We conducted a systematic analysis of literature by reviewing studies that examined the effects of DBS on speech, voice and language in PD and ET. METHODS A total of 675 publications were retrieved from PubMed, Embase, CINHAL, Web of Science, Cochrane Library and Scopus databases. Based on our selection criteria, 90 papers were included in our analysis. The selected publications were categorized into four subcategories: Fluency, Word production, Articulation and phonology and Voice quality. RESULTS The results suggested a long-term decline in verbal fluency, with more studies reporting deficits in phonemic fluency than semantic fluency following DBS. Additionally, high frequency stimulation, left-sided and bilateral DBS were associated with worse verbal fluency outcomes. Naming improved in the short-term following DBS-ON compared to DBS-OFF, with no long-term differences between the two conditions. Bilateral and low-frequency DBS demonstrated a relative improvement for phonation and articulation. Nonetheless, long-term DBS exacerbated phonation and articulation deficits. The effect of DBS on voice was highly variable, with both improvements and deterioration in different measures of voice. CONCLUSION This was the first study that aimed to combine the outcome of speech, voice, and language following DBS in a single systematic review. The findings revealed a heterogeneous pattern of results for speech, voice, and language across DBS studies, and provided directions for future studies.
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Affiliation(s)
- Fatemeh Tabari
- Human Neurophysiology and Neuromodulation Laboratory, Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, United States of America
| | - Joel I. Berger
- Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America
| | - Oliver Flouty
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, United States of America
| | - Brian Copeland
- Department of Neurology, LSU Health Sciences Center, New Orleans, LA, United States of America
| | - Jeremy D. Greenlee
- Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America
- Iowa Neuroscience Institute, Iowa City, IA, United States of America
| | - Karim Johari
- Human Neurophysiology and Neuromodulation Laboratory, Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, United States of America
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Sousa NMF, Diniz JDFG, Galvão AP, Brucki SMD. Cognitive profile of patients with and without speech impairment in Parkinson's disease. Dement Neuropsychol 2023; 17:e20220093. [PMID: 38028381 PMCID: PMC10666554 DOI: 10.1590/1980-5764-dn-2022-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 12/01/2023] Open
Abstract
Cognitive functions have been the subject of studies evaluating the pathophysiological mechanism of speech control. Objective To compare the groups of patients with and without speech disorders with cognitive assessment, demographic, and clinical data (disease duration, functionality, and motor symptoms). Methods Retrospective, cross-sectional study. Patients were evaluated using the Addenbrooke's Cognitive Examination III and neuropsychological tests. The following speech subsystems were analyzed: articulation, phonation, resonance, and prosody, through auditory-perceptual evaluation (based on the Protocol for the Evaluation of Acquired Speech Disorders in Individuals with Parkinson's Disease - PADAF Protocol tests), observing aspects of speech programming and execution. The patients were distributed into three subgroups (normal cognition, mild cognitive impairment, and dementia). After speech evaluation, they were divided into two subgroups (with and without speech disorders). Results A total of 150 patients participated in this study, 104 men and 46 women, 63.58 (8.81) years of age, 11.03 (4.00) years of schooling, 6.61 (4.69) years of disease progression, and with the highest proportion of individuals in stage I-II of the Hoehn & Yarh (H&Y) scale (86, or 57.33%). Statistically significant differences were observed between subgroups with and without speech alteration. Worse performance was verified in the Trail Making Test (TMT) TMT-Δ and a tendency of difference in the TMT-B of the subgroup with speech disorders, in addition to worse severity of motor symptoms (H&Y) and cognitive complaints. Conclusion Individuals with speech disorders brought more frequent cognitive complaints and impairment below expected in tests assessing executive functions. Future studies, with stratification by type of speech disorder, are necessary to contribute to and validate these results.
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Affiliation(s)
| | | | | | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
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D’Ascanio S, Piras F, Banaj N, Assogna F, Pellicano C, Bassi A, Spalletta G, Piras F. Narrative discourse production in Parkinson's disease: Decoupling the role of cognitive-linguistic and motor speech changes. Heliyon 2023; 9:e18633. [PMID: 37576215 PMCID: PMC10415819 DOI: 10.1016/j.heliyon.2023.e18633] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction the interplay between neuropsychological and communicative abilities in Parkinson's disease (PD) has been relatively overlooked, and it is not entirely understood which difficulties are consequent to impaired motor control, and which have a linguistic/cognitive basis. Here, we examined narrative discourse in PD using a multi-level analysis procedure considering sentence-level (productivity, lexical-grammatical processing) and discourse-level processes (narrative organization, informativeness), and partialling out patients' motor speech impairments. The interaction between cognitive (i.e. linguistic and executive) and communication abilities was also investigated. Methods Twenty-nine PD subjects in the mild stage of the disease were compared to 29 matched healthy comparators (HC) on quantitative measures of narrative discourse derived from two picture description tasks. Multivariate (considering articulation rate and educational attainment as covariates) and univariate (with group membership as independent variable) analyses of variance were conducted on separate linguistic domains. The contribution of executive/linguistic abilities to PD's narrative performance was explored by multiple regression analyses on narrative measures significantly differentiating patients from HC. Results significant reductions in patients were observed on measures of productivity (less well-formed words, shorter sentences) and informativeness (fewer conceptual units, less informative elements, lower number of details) and these alterations were explained by variations in linguistic abilities (action and object naming) rather than executive abilities. Articulation rate and educational attainment did not impact the observed reduced productivity and under-informativeness. Conclusion referential narrative discourse is altered in PD, regardless of motor impairments in speech production. The observed reductions in productivity/informativeness aspects of narratives were related to naming abilities and in particular to verbs processing, consistently with the neurocognitive model of motor language coupling. Since narratives are amenable to recurrent and automated analysis for the identification of linguistic patterns potentially anticipating the development of PD and the onset of cognitive deterioration, discourse abilities should be quantitatively and repeatedly profiled in the disorder.
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Affiliation(s)
- Sara D’Ascanio
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nerisa Banaj
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesca Assogna
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Clelia Pellicano
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Andrea Bassi
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Federica Piras
- Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
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Smith KM, Demers-Peel M, Manxhari C, Stepp CE. Voice Acoustic Instability During Spontaneous Speech in Parkinson's Disease. J Voice 2023:S0892-1997(23)00176-5. [PMID: 37500359 PMCID: PMC10808279 DOI: 10.1016/j.jvoice.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND In people with Parkinson's disease (PwPD), both motor and cognitive deficits influence voice and other aspects of communication. PwPD demonstrate vocal instability, but acoustic declines over the course of speaking are not well characterized and the role of cognition on these declines is unknown. We examined voice acoustics related to speech motor instability by comparing the first and the last utterances within a speech task. Our objective was to determine if mild cognitive impairment (MCI) status was associated with different patterns of acoustic change during these tasks. METHODS Participants with PD (n = 44) were enrolled at University of Massachusetts Chan Medical School and classified by gold-standard criteria as normal cognition (PD-NC) or mild cognitive impairment (PD-MCI). The speech was recorded during the Rainbow Passage and a picture description task (Cookie Theft). We calculated the difference between first and last utterances in fo mean and standardized semitones (STSD), cepstral peak prominence-smoothed (CPPS), and low to high ratio (LH). We used t-tests to compare the declines in acoustic parameters between the task types and between participants with PD-NC versus PD-MCI. RESULTS Mean fo, fo variability (STSD) and CPPS declined from the first to the last utterance in both tasks, but there was no significant difference in these declines between the PD-NC and PD-MCI groups. Those with PD-MCI demonstrated lower fo variability on the whole in both tasks and lower CPPS in the picture description task, compared to those with PD-NC. CONCLUSIONS Mean and STSD fo as well as CPPS may be sensitive to PD-MCI status in reading and spontaneous speech tasks. Speech motor instability can be observed in these voice acoustic parameters over brief speech tasks, but the degree of decline does not depend on cognitive status. These findings will inform the ongoing development of algorithms to monitor speech and cognitive function in PD.
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Affiliation(s)
- Kara M Smith
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, Massachusetts; NeuroNexus Institute, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
| | - Meaghan Demers-Peel
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Christina Manxhari
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, Massachusetts; NeuroNexus Institute, University of Massachusetts Chan Medical School, Worcester, Massachusetts; Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts
| | - Cara E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts
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Martínez-Nicolás I, Martínez-Sánchez F, Ivanova O, Meilán JJG. Reading and lexical-semantic retrieval tasks outperforms single task speech analysis in the screening of mild cognitive impairment and Alzheimer's disease. Sci Rep 2023; 13:9728. [PMID: 37322073 PMCID: PMC10272227 DOI: 10.1038/s41598-023-36804-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023] Open
Abstract
Age-related cognitive impairment have increased dramatically in recent years, which has risen the interes in developing screening tools for mild cognitive impairment and Alzheimer's disease. Speech analysis allows to exploit the behavioral consequences of cognitive deficits on the patient's vocal performance so that it is possible to identify pathologies affecting speech production such as dementia. Previous studies have further shown that the speech task used determines how the speech parameters are altered. We aim to combine the impairments in several speech production tasks in order to improve the accuracy of screening through speech analysis. The sample consists of 72 participants divided into three equal groups of healthy older adults, people with mild cognitive impairment, or Alzheimer's disease, matched by age and education. A complete neuropsychological assessment and two voice recordings were performed. The tasks required the participants to read a text, and complete a sentence with semantic information. A stepwise linear discriminant analysis was performed to select speech parameters with discriminative power. The discriminative functions obtained an accuracy of 83.3% in simultaneous classifications of several levels of cognitive impairment. It would therefore be a promising screening tool for dementia.
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Affiliation(s)
| | | | - Olga Ivanova
- Faculty of Philology, University of Salamanca, 37008, Salamanca, Spain
| | - Juan J G Meilán
- Faculty of Psychology, University of Salamanca, 37008, Salamanca, Spain
- Institute of Neuroscience of Castilla y León, 37007, Salamanca, Spain
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Patel S, Grabowski C, Dayalu V, Testa AJ. Speech error rates after a sports-related concussion. Front Psychol 2023; 14:1135441. [PMID: 36960009 PMCID: PMC10027790 DOI: 10.3389/fpsyg.2023.1135441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/13/2023] [Indexed: 03/09/2023] Open
Abstract
Background Alterations in speech have long been identified as indicators of various neurologic conditions including traumatic brain injury, neurodegenerative diseases, and stroke. The extent to which speech errors occur in milder brain injuries, such as sports-related concussions, is unknown. The present study examined speech error rates in student athletes after a sports-related concussion compared to pre-injury speech performance in order to determine the presence and relevant characteristics of changes in speech production in this less easily detected neurologic condition. Methods A within-subjects pre/post-injury design was used. A total of 359 Division I student athletes participated in pre-season baseline speech testing. Of these, 27 athletes (18-22 years) who sustained a concussion also participated in speech testing in the days immediately following diagnosis of concussion. Picture description tasks were utilized to prompt connected speech samples. These samples were recorded and then transcribed for identification of errors and disfluencies. These were coded by two trained raters using a 6-category system that included 14 types of error metrics. Results Repeated measures analysis of variance was used to compare the difference in error rates at baseline and post-concussion. Results revealed significant increases in the speech error categories of pauses and time fillers (interjections/fillers). Additionally, regression analysis showed that a different pattern of errors and disfluencies occur after a sports-related concussion (primarily time fillers) compared to pre-injury (primarily pauses). Conclusion Results demonstrate that speech error rates increase following even mild head injuries, in particular, sports-related concussion. Furthermore, the speech error patterns driving this increase in speech errors, rate of pauses and interjections, are distinct features of this neurological injury, which is in contrast with more severe injuries that are marked by articulation errors and an overall reduction in verbal output. Future studies should consider speech as a diagnostic tool for concussion.
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Affiliation(s)
- Sona Patel
- Department of Speech-Language Pathology, Seton Hall University, Nutley, NJ, United States
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- *Correspondence: Sona Patel,
| | - Caryn Grabowski
- Department of Speech-Language Pathology, Seton Hall University, Nutley, NJ, United States
| | - Vikram Dayalu
- Department of Speech-Language Pathology, Seton Hall University, Nutley, NJ, United States
| | - Anthony J. Testa
- Center for Sports Medicine, Seton Hall University, South Orange, NJ, United States
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Andrade EIN, Manxhari C, Smith KM. Pausing before verb production is associated with mild cognitive impairment in Parkinson's disease. Front Hum Neurosci 2023; 17:1102024. [PMID: 37113321 PMCID: PMC10126398 DOI: 10.3389/fnhum.2023.1102024] [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: 11/18/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Background Cognitive dysfunction and communication impairment are common and disabling symptoms in Parkinson's Disease (PD). Action verb deficits occur in PD, but it remains unclear if these impairments are related to motor system dysfunction and/or cognitive decline. The objective of our study was to evaluate relative contributions of cognitive and motor dysfunction to action verb production in naturalistic speech of patients with PD. We proposed that pausing before action-related language is associated with cognitive dysfunction and may serve as a marker of mild cognitive impairment in PD. Method Participants with PD (n = 92) were asked to describe the Cookie Theft picture. Speech files were transcribed, segmented into utterances, and verbs classified as action or non-action (auxiliary). We measured silent pauses before verbs and before utterances containing verbs of different classes. Cognitive assessment included Montreal Cognitive Assessment (MoCA) and neuropsychological tests to categorize PD participants as normal cognition (PD-NC) or mild cognitive impairment (PD-MCI) based on Movement Disorders Society (MDS) Task Force Tier II criteria. Motor symptoms were assessed using MDS-UPDRS. We performed Wilcoxon rank sum tests to identify differences in pausing between PD-NC and PD-MCI. Logistic regression models using PD-MCI as dependent variables were used to evaluate the association between pause variables and cognitive status. Results Participants with PD-MCI demonstrated more pausing before and within utterances compared to PD-NC, and the duration of these pauses were correlated with MoCA but not motor severity (MDS-UPDRS). Logistic regression models demonstrated that pauses before action utterances were associated with PD-MCI status, whereas pauses before non-action utterances were not significantly associated with cognitive diagnosis. Conclusion We characterized pausing patterns in spontaneous speech in PD-MCI, including analysis of pause location with respect to verb class. We identified associations between cognitive status and pausing before utterances containing action verbs. Evaluation of verb-related pauses may be developed into a potentially powerful speech marker tool to detect early cognitive decline in PD and better understand linguistic dysfunction in PD.
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Affiliation(s)
| | - Christina Manxhari
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Kara M. Smith
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, United States
- NeuroNexus Institute, University of Massachusetts Chan Medical School, Worcester, MA, United States
- *Correspondence: Kara M. Smith,
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Ngo QC, Motin MA, Pah ND, Drotár P, Kempster P, Kumar D. Computerized analysis of speech and voice for Parkinson's disease: A systematic review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107133. [PMID: 36183641 DOI: 10.1016/j.cmpb.2022.107133] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Speech impairment is an early symptom of Parkinson's disease (PD). This study has summarized the literature related to speech and voice in detecting PD and assessing its severity. METHODS A systematic review of the literature from 2010 to 2021 to investigate analysis methods and signal features. The keywords "Automatic analysis" in conjunction with "PD speech" or "PD voice" were used, and the PubMed and ScienceDirect databases were searched. A total of 838 papers were found on the first run, of which 189 were selected. One hundred and forty-seven were found to be suitable for the review. The different datasets, recording protocols, signal analysis methods and features that were reported are listed. Values of the features that separate PD patients from healthy controls were tabulated. Finally, the barriers that limit the wide use of computerized speech analysis are discussed. RESULTS Speech and voice may be valuable markers for PD. However, large differences between the datasets make it difficult to compare different studies. In addition, speech analytic methods that are not informed by physiological understanding may alienate clinicians. CONCLUSIONS The potential usefulness of speech and voice for the detection and assessment of PD is confirmed by evidence from the classification and correlation results.
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Affiliation(s)
| | - Mohammod Abdul Motin
- Biosignals Lab, RMIT University, Melbourne, Australia; Department of Electrical & Electronic Engineering, Rajshahi University of Engineering & Technology, Rajshahi 6204, Bangladesh
| | - Nemuel Daniel Pah
- Biosignals Lab, RMIT University, Melbourne, Australia; Universitas Surabaya, Indonesia
| | - Peter Drotár
- Intelligent Information Systems Lab, Technical University of Kosice, Letna 9, 42001, Kosice, Slovakia
| | - Peter Kempster
- Neurosciences Department, Monash Health, Clayton, VIC, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Dinesh Kumar
- Biosignals Lab, RMIT University, Melbourne, Australia.
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Specific pattern of linguistic impairment in Parkinson's disease patients with subjective cognitive decline and mild cognitive impairment predicts dementia. J Int Neuropsychol Soc 2022:1-9. [PMID: 36226685 DOI: 10.1017/s1355617722000571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Parkinson's disease patients with subjective cognitive decline (PD-SCD) and mild cognitive impairment (PD-MCI) have an increased risk of dementia (PDD). Thus, the identification of early cognitive changes that can be useful predictors of PDD is a highly relevant challenge. Posterior cortically based functions, including linguistic processes, have been associated with PDD. However, investigations that have focused on linguistic functions in PD-MCI are scarce and none of them include PD-SCD patients. Our aim was to study language performance in PD-SCD and PD-MCI. Moreover, language subcomponents were considered as predictors of PDD. METHOD Forty-six PD patients and twenty controls were evaluated with a neuropsychological protocol. Patients were classified as PD-SCD and PD-MCI. Language production and comprehension was assessed. Follow-up assessment was conducted to a mean of 7.5 years after the baseline. RESULTS PD-MCI patients showed a poor performance in naming (actions and nouns), action generation, anaphora resolution and sentence comprehension (with and without center-embedded relative clause). PD-SCD showed a poor performance in action naming and action generation. Deficit in action naming was an independent risk factor for PDD during the follow-up. Moreover, the combination of deficit in action words and sentence comprehension without a center-embedded relative clause was associated with a greater risk. CONCLUSIONS The results are of relevance because they suggest that a specific pattern of linguistic dysfunctions, that can be present even in the early stages of the disease, can predict future dementia, reinforcing the importance of advancing in the knowledge of linguistic dysfunctions in predementia stages of PD.
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Rogalski Y, Key-DeLyria SE, Hazamy A, Altmann LJP. Global Coherence and Cognition in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2962-2977. [PMID: 35930682 PMCID: PMC9911095 DOI: 10.1044/2022_jslhr-21-00442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/31/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study compared global coherence (GC) in individuals with Parkinson's disease (PD) to a healthy older adult (HOA) group during single (sitting) and dual (stationary cycling) tasks. Additionally, it explored the relationship between GC and cognition in PD. METHOD Thirty-seven individuals with PD and 19 HOAs participated in the prospective, cross-sectional study. Participants completed discourse monologues elicited using published prompts while seated and while pedaling a stationary bicycle. Four rating levels of GC were analyzed (GC1 = no relationship to the topic, GC2 = remote relationship, GC3 = conditional relationship, and GC4 = complete relationship) using a published protocol with good interrater reliability and test-retest stability. Participants completed a battery of cognitive tasks, from which four latent factors were extracted: processing speed, working memory, inhibition, and updating. RESULTS Linear mixed modeling identified significant effects of GC level and GC level interactions with group, processing speed, and inhibition. The Group × GC Level interaction reflected that the PD group had a higher proportion of GC2 and GC1 utterances and fewer GC4 utterances than the HOA group. No differences between single and dual task conditions were found. Faster speed of processing predicted more GC4 utterances, whereas slower speed of processing predicted more G1 utterances. Better inhibition predicted fewer GC2 utterances. Group also predicted GC4 and GC2 proportions. CONCLUSIONS Individuals with PD experienced greater difficulties with GC than HOAs. Processing speed and inhibition contributed significantly to GC across groups. Analysis of GC should be considered an informative addition to assessment of communicative effectiveness in PD. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20416056.
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Affiliation(s)
- Yvonne Rogalski
- Department of Speech-Language Pathology and Audiology, Ithaca College, NY
| | | | - Audrey Hazamy
- Department of Communication Arts, Sciences, and Disorders, Brooklyn College, NY
| | - Lori J P Altmann
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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Ambadi PS, Basche K, Koscik RL, Berisha V, Liss JM, Mueller KD. Spatio-Semantic Graphs From Picture Description: Applications to Detection of Cognitive Impairment. Front Neurol 2021; 12:795374. [PMID: 34956070 PMCID: PMC8696356 DOI: 10.3389/fneur.2021.795374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Clinical assessments often use complex picture description tasks to elicit natural speech patterns and magnify changes occurring in brain regions implicated in Alzheimer's disease and dementia. As The Cookie Theft picture description task is used in the largest Alzheimer's disease and dementia cohort studies available, we aimed to create algorithms that could characterize the visual narrative path a participant takes in describing what is happening in this image. We proposed spatio-semantic graphs, models based on graph theory that transform the participants' narratives into graphs that retain semantic order and encode the visuospatial information between content units in the image. The resulting graphs differ between Cognitively Impaired and Unimpaired participants in several important ways. Cognitively Impaired participants consistently scored higher on features that are heavily associated with symptoms of cognitive decline, including repetition, evidence of short-term memory lapses, and generally disorganized narrative descriptions, while Cognitively Unimpaired participants produced more efficient narrative paths. These results provide evidence that spatio-semantic graph analysis of these tasks can generate important insights into a participant's cognitive performance that cannot be generated from semantic analysis alone.
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Affiliation(s)
- Pranav S. Ambadi
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - Kristin Basche
- Division of Geriatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Rebecca L. Koscik
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Visar Berisha
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - Julie M. Liss
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - Kimberly D. Mueller
- Division of Geriatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
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Diaz-Galvan P, Ferreira D, Cedres N, Falahati F, Hernández-Cabrera JA, Ames D, Barroso J, Westman E. Comparing different approaches for operationalizing subjective cognitive decline: impact on syndromic and biomarker profiles. Sci Rep 2021; 11:4356. [PMID: 33623075 PMCID: PMC7902653 DOI: 10.1038/s41598-021-83428-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 01/31/2023] Open
Abstract
Subjective cognitive decline (SCD) has been proposed as a risk factor for future cognitive decline and dementia. Given the heterogeneity of SCD and the lack of consensus about how to classify this condition, different operationalization approaches still need to be compared. In this study, we used the same sample of individuals to compare different SCD operationalization approaches. We included 399 cognitively healthy individuals from a community-based cohort. SCD was assessed through nine questions about memory and non-memory subjective complaints. We applied four approaches to operationalize SCD: two hypothesis-driven approaches and two data-driven approaches. We characterized the resulting groups from each operationalization approach using multivariate methods on comprehensive demographic, clinical, cognitive, and neuroimaging data. We identified two main phenotypes: an amnestic phenotype characterized by an Alzheimer's Disease (AD) signature pattern of brain atrophy; and an anomic phenotype, which was mainly related to cerebrovascular pathology. Furthermore, language complaints other than naming helped to identify a subgroup with subclinical cognitive impairment and difficulties in activities of daily living. This subgroup also showed an AD signature pattern of atrophy. The identification of SCD phenotypes, characterized by different syndromic and biomarker profiles, varies depending on the operationalization approach used. In this study we discuss how these findings may be used in clinical practice and research.
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Affiliation(s)
- Patricia Diaz-Galvan
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Ferreira
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nira Cedres
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Farshad Falahati
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Juan Andrés Hernández-Cabrera
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain
| | - David Ames
- grid.1008.90000 0001 2179 088XAcademic Unit for Psychiatry of Old Age (St. Vincent’s Health), University of Melbourne, Kew, VIC Australia ,grid.429568.40000 0004 0382 5980National Ageing Research Institute, Parkville, VIC Australia
| | - Jose Barroso
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain
| | - Eric Westman
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,grid.13097.3c0000 0001 2322 6764Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Darling-White M, Huber JE. The Impact of Parkinson's Disease on Breath Pauses and Their Relationship to Speech Impairment: A Longitudinal Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1910-1922. [PMID: 32693630 PMCID: PMC8740572 DOI: 10.1044/2020_ajslp-20-00003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 05/12/2023]
Abstract
Purpose The purposes of this longitudinal study were to (a) examine the impact of Parkinson's disease (PD) progression on breath pause patterns and speech and linguistic errors and (b) determine the extent to which breath pauses and speech and linguistic errors contribute to speech impairment. Method Eight individuals with PD and eight age- and sex-matched control participants produced a reading passage on two occasions (Time 1 and Time 2) 3 years and 7 months apart on average. Two speech-language pathologists rated the severity of speech impairment for all participants at each time. Dependent variables included the location of each breath pause relative to syntax and punctuation as well as the number of disfluencies and mazes. Results At Time 1, there were no significant differences between the groups regarding breath pause patterns. At Time 2, individuals with PD produced significantly fewer breath pauses at major syntactic boundaries and periods as well as significantly more breath pauses at locations with no punctuation than control participants. Individuals with PD produced a significantly greater number of disfluencies than control participants at both time points. There were no significant differences between the groups in the number of mazes produced at either time point. Together, the number of mazes and the percentage of breath pauses at locations with no punctuation explained 50% of the variance associated with the ratings of severity of speech impairment. Conclusion These results highlight the importance of targeting both respiratory physiological and cognitive-linguistic systems in order to improve speech production in individuals with PD.
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Affiliation(s)
- Meghan Darling-White
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Jessica E. Huber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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15
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Magee M, Copland D, Vogel AP. Motor speech and non-motor language endophenotypes of Parkinson’s disease. Expert Rev Neurother 2019; 19:1191-1200. [DOI: 10.1080/14737175.2019.1649142] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Michelle Magee
- Centre for Neuroscience of Speech, The University of Melbourne, Victoria, Australia
| | - David Copland
- School of Health & Rehabilitation Sciences, Centre for Clinical Research, University of Queensland, Queensland, Australia
| | - Adam P. Vogel
- Centre for Neuroscience of Speech, The University of Melbourne, Victoria, Australia
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany & Center for Neurology, University Hospital Tübingen, Germany
- Redenlab, Australia
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Smith KM, Caplan DN. Communication impairment in Parkinson's disease: Impact of motor and cognitive symptoms on speech and language. BRAIN AND LANGUAGE 2018; 185:38-46. [PMID: 30092448 DOI: 10.1016/j.bandl.2018.08.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 07/21/2018] [Accepted: 08/02/2018] [Indexed: 06/08/2023]
Abstract
Communication impairment is common in Parkinson's disease (PD) and may have both motor speech control and cognitive-linguistic underpinnings. The neurobiology of communication impairment in PD is poorly understood, and work is needed to disentangle the relative contributions of motor and cognitive dysfunction. In clinical practice, cognitive-linguistic impairments are often overlooked despite the large body of research on this topic in neurocognitive and linguistics literature. In this review, we will discuss the roles of motor speech changes, cognitive and linguistic impairment, and other related functions in the communication disabilities of individuals with PD. We will describe the various types of communication difficulties in PD and tools for measuring these symptoms. We will discuss specific deficits that may further understanding of the neurobiology of communication impairment in PD, including voice and speech acoustic changes, linguistic processing and production difficulties, and pausing. We will emphasize the importance of an interdisciplinary approach and the patient perspective on daily communication in guiding future research.
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Affiliation(s)
- Kara M Smith
- University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - David N Caplan
- Massachusetts General Hospital, 175 Cambridge Street, Boston, MA 02114, USA.
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