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Gallée J, Volkmer A, Whitworth A, Hersh D, Cartwright J. Applications of the R.A.I.S.E. Assessment Framework to Support the Process of Assessment in Primary Progressive Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-11. [PMID: 38896883 DOI: 10.1044/2024_ajslp-24-00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
PURPOSE To establish the extent to which person-centered processes are integrated in assessment procedures, the Relationship, Assessment, Inclusion, Support, Evolve (R.A.I.S.E.) Assessment framework was used to evaluate measures that are typically used when assessing people living with primary progressive aphasia (PPA). METHOD Forty-five assessment tools were evaluated through the lens of the five R.A.I.S.E. principles: building the client-clinician Relationship, Assessment choices, Including the client and care partners, providing Support, and Evolving procedures to match client capability and progression. The principles were operationalized as questions for raters to evaluate whether a measure met this aspect of the R.A.I.S.E. Assessment framework. RESULTS Ten measures commonly used in the assessment of people living with PPA met all R.A.I.S.E. principles. These measures centered upon the elicitation of naturalistic discourse, conversation, client self-report, and clinician ratings. Thirteen measures did not meet any of the criteria, and represented standardized evaluation procedures do not provide the opportunity to connect to the client, elicit or provide feedback or support, nor to adapt in response to need or performance. CONCLUSIONS Whether using standardized or informal assessment tools, a relational and qualitative approach to providing assessment is paramount to promote client success and therapeutic engagement. We provide guidance through the R.A.I.S.E. framework on practices to cultivate person-centered processes of assessment in the care of people living with PPA.
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Affiliation(s)
- Jeanne Gallée
- Department of Medicine, University of Washington, Seattle
- Alzheimer's Disease Research Center, University of Washington, Seattle
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Anna Volkmer
- Division of Psychology and Language Science, University College London, United Kingdom
| | - Anne Whitworth
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Deborah Hersh
- Speech Pathology, Curtin School of Allied Health, Curtin University, Perth, Western Australia
| | - Jade Cartwright
- School of Health Sciences, University of Tasmania, Launceston, Australia
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Tran EB, Vonk JMJ, Casaletto K, Zhang D, Christin R, Marathe S, Gorno-Tempini ML, Chang EF, Kleen JK. Development and validation of a nonverbal consensus-based semantic memory paradigm in patients with epilepsy. J Int Neuropsychol Soc 2024:1-9. [PMID: 38616725 DOI: 10.1017/s1355617724000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Brain areas implicated in semantic memory can be damaged in patients with epilepsy (PWE). However, it is challenging to delineate semantic processing deficits from acoustic, linguistic, and other verbal aspects in current neuropsychological assessments. We developed a new Visual-based Semantic Association Task (ViSAT) to evaluate nonverbal semantic processing in PWE. METHOD The ViSAT was adapted from similar predecessors (Pyramids & Palm Trees test, PPT; Camels & Cactus Test, CCT) comprised of 100 unique trials using real-life color pictures that avoid demographic, cultural, and other potential confounds. We obtained performance data from 23 PWE participants and 24 control participants (Control), along with crowdsourced normative data from 54 Amazon Mechanical Turk (Mturk) workers. RESULTS ViSAT reached a consensus >90% in 91.3% of trials compared to 83.6% in PPT and 82.9% in CCT. A deep learning model demonstrated that visual features of the stimulus images (color, shape; i.e., non-semantic) did not influence top answer choices (p = 0.577). The PWE group had lower accuracy than the Control group (p = 0.019). PWE had longer response times than the Control group in general and this was augmented for the semantic processing (trial answer) stage (both p < 0.001). CONCLUSIONS This study demonstrated performance impairments in PWE that may reflect dysfunction of nonverbal semantic memory circuits, such as seizure onset zones overlapping with key semantic regions (e.g., anterior temporal lobe). The ViSAT paradigm avoids confounds, is repeatable/longitudinal, captures behavioral data, and is open-source, thus we propose it as a strong alternative for clinical and research assessment of nonverbal semantic memory.
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Affiliation(s)
- Edwina B Tran
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Jet M J Vonk
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Kaitlin Casaletto
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Da Zhang
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Raphael Christin
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Siddharth Marathe
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Edward F Chang
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Jonathan K Kleen
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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Jiskoot LC, Poos JM, van Boven K, de Boer L, Giannini LAA, Satoer DD, Visch-Brink EG, van Hemmen J, Franzen S, Pijnenburg YAL, van den Berg E, Seelaar H. The ScreeLing: Detecting Semantic, Phonological, and Syntactic Deficits in the Clinical Subtypes of Frontotemporal and Alzheimer's Dementia. Assessment 2023; 30:2545-2559. [PMID: 36799220 PMCID: PMC10623607 DOI: 10.1177/10731911231154512] [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] [Indexed: 02/18/2023]
Abstract
The ScreeLing is a screening instrument developed to assess post-stroke aphasia, via the linguistic levels Syntax, Phonology, and Semantics. It could also be a useful test for the clinical subtypes of frontotemporal dementia (FTD) and Alzheimer's dementia (AD), as specific and often selective disorders are expected. Its ability to differentiate between the clinical subtypes of FTD and AD is, however, still unknown. We investigated differences in ScreeLing total and subscores, linguistic-level disorders' relationship with disease severity, and classification abilities, in patients with behavioral variant FTD (bvFTD; n = 46), patients with primary progressive aphasia (PPA; n = 105) (semantic variant primary progressive aphasia [svPPA], non-fluent variant primary progressive aphasia [nfvPPA], and logopenic variant primary progressive aphasia [lvPPA], AD [n = 20] and controls [n = 35]). We examined group differences in ScreeLing total and subscores, and one-, two- or three-level linguistic disorders using one-way analyses of covariance (ANCOVAs) or Quade's rank ANCOVA. We used frequency analyses to obtain the occurrence of the linguistic-level disorders. We determined sensitivity and specificity by the area under the curve by receiver-operating characteristics analyses to investigate classification abilities. The total score was lower in patients (bvFTD: 63.8 ± 8.5, svPPA: 58.8 ± 11.3, nfvPPA: 63.5 ± 8.4, lvPPA: 61.7 ± 6.6, AD: 63.8 ± 5.5) than controls (71.3 ± 1.0) (p < .001). Syntax subscores were lower in svPPA (19.4 ± 4.6; p < .001) and lvPPA (20.3 ± 3.2; p = .002) than controls (23.8 ± 0.4). Phonology subscores were lower in lvPPA (19.8 ± 2.6) than bvFTD (21.7 ± 2.8) (p = .010). Semantics subscores were lowest in svPPA (17.8 ± 5.0; p < .002). A selective phonological disorder was most prevalent in lvPPA (34.9%). The higher the disease severity, the more linguistic-level disorders. The optimal cutoff for the total score was 70, and 23 for all three subscores. Good classification abilities were found for the Semantics (svPPA vs. bvFTD), Phonology (lvPPA vs. svPPA), and Syntax (nfvPPA vs. lvPPA) subscores. This easy to administer test gives information about language processing with the potential to improve differential diagnosis in memory clinics and in the future potentially also clinical trial planning.
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Affiliation(s)
- Lize C. Jiskoot
- Erasmus University Medical Center, Rotterdam, the Netherlands
- University College London, UK
| | - Jackie M. Poos
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Liset de Boer
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | | | - Judy van Hemmen
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sanne Franzen
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | - Harro Seelaar
- Erasmus University Medical Center, Rotterdam, the Netherlands
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Roelofs A. Word production and comprehension in frontotemporal degeneration: A neurocognitive computational Pickian account. Cortex 2023; 163:42-56. [PMID: 37058880 DOI: 10.1016/j.cortex.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/27/2023] [Accepted: 03/09/2023] [Indexed: 04/03/2023]
Abstract
Over a century ago, Arnold Pick reported deterioration of word production and comprehension in frontotemporal degeneration, now a common finding. Individuals with semantic dementia (SD) and behavioral variant frontotemporal dementia (bvFTD) present with word retrieval difficulty, while their comprehension is less affected. Computational models have illuminated naming and comprehension in poststroke and progressive aphasias, including SD, but there are no simulations for bvFTD. Here, the WEAVER++/ARC model, previously applied to poststroke and progressive aphasias, is extended to bvFTD. Simulations tested the hypothesis of a loss of activation capacity in semantic memory in SD and bvFTD, caused by network atrophy (Pick, 1908a). The outcomes revealed that capacity loss explains 97% of the variance in naming and comprehension of 100 individual patients. Moreover, capacity loss correlates with individual ratings of atrophy in the left anterior temporal lobe. These results support a unified account of word production and comprehension in SD and bvFTD.
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Roelofs A. Accounting for word production, comprehension, and repetition in semantic dementia, Alzheimer's dementia, and mild cognitive impairment. BRAIN AND LANGUAGE 2023; 238:105243. [PMID: 36868157 DOI: 10.1016/j.bandl.2023.105243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/27/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
It has been known since Pick (1892, 1904) that word retrieval is commonly impaired in left temporal lobe degeneration. Individuals with semantic dementia (SD), Alzheimer's dementia (AD), and mild cognitive impairment (MCI) present with word retrieval difficulty, while comprehension is less affected and repetition is preserved. Whereas computational models have elucidated performance in poststroke and progressive aphasias, including SD, simulations are lacking for AD and MCI. Here, the WEAVER++/ARC model, which has provided neurocognitive computational accounts of poststroke and progressive aphasias, is extended to AD and MCI. Assuming a loss of activation capacity in semantic memory in SD, AD, and MCI, the simulations showed that severity variation accounts for 99% of the variance in naming, comprehension, and repetition at the group level and 95% at the individual patient level (N = 49). Other plausible assumptions do less well. This supports a unified account of performance in SD, AD, and MCI.
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Affiliation(s)
- Ardi Roelofs
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Thomas van Aquinostraat 4, 6525 GD Nijmegen, The Netherlands.
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Roelofs A. A neurocognitive computational account of word production, comprehension, and repetition in primary progressive aphasia. BRAIN AND LANGUAGE 2022; 227:105094. [PMID: 35202892 DOI: 10.1016/j.bandl.2022.105094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 12/15/2021] [Accepted: 02/13/2022] [Indexed: 06/14/2023]
Abstract
Computational models have elucidated word production, comprehension, and repetition in poststroke aphasia syndromes, but simulations are lacking for primary progressive aphasia (PPA) resulting from neurodegenerative disease. Here, the WEAVER++/ARC model, which has previously been applied to poststroke aphasia, is extended to the three major PPA variants: nonfluent/agrammatic, semantic, and logopenic. Following a seminal suggestion by Pick (1892/1977) and modern empirical insights, the model assumes that PPA arises from a progressive loss of activation capacity in portions of the language network with neurocognitive epicenters specific to each PPA variant. Computer simulations revealed that the model succeeds reasonably well in capturing the patterns of impaired and spared naming, comprehension, and repetition performance, at both group and individual patient levels. Moreover, it captures the worsening of performance with progression of the disease. The model explains about 90% of the variance, lending computational support to Pick's suggestion and modern insights.
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Affiliation(s)
- Ardi Roelofs
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands.
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