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Wandell CJ, Torres K. Exploring the utility of process scores in elucidating the role of cognitive and affective factors that influence verbal fluency performance in Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-12. [PMID: 38828539 DOI: 10.1080/23279095.2024.2359446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
OBJECTIVES Cognitive and affective factors have been implicated in verbal fluency (VF) performance in Parkinson's disease (PD). This exploratory study aimed to investigate the relationships between cognitive and affective variables on traditional ("core") and "process" (error and interval) scores of VF and elucidate unique information these scores may provide regarding mechanisms underlying VF. METHODS Sixty-two PD patients without dementia completed clinical neuropsychological examinations consisting of attention, processing speed, language, executive functioning, visuospatial, memory, and mood measures. Hierarchical regression and negative binomial regression analyses were used to evaluate relationships between outcome and predictor variables. RESULTS Generativity results revealed that processing speed and working memory explained up to 34% of the variance of total letter fluency responses (p = <.001) and processing speed explained 24% of the variance for total semantic fluency (p = .003). For category switching generativity, only age predicted 20% of the variance (p = .01). Two executive functioning measures were negatively associated with error production over the duration (b = -.055, p = .028; b = -.062, p = .004) and final 45-second interval (b = -.072, p = .003; b = -.044, p = .033) of the category switching task. In the initial 15-second task interval, a positive predictive relationship between error production and indifference apathy (b = .616, p = .044) was demonstrated. CONCLUSIONS Findings demonstrate the potential utility of "process" scores in detecting subtle cognitive impairment in Parkinson's disease patients without dementia and tentatively evidence the role of indifference apathy in task initiation.
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Affiliation(s)
- Catie J Wandell
- Veterans Afffairs Puget Sound Healthcare System, Seattle, WA, USA
| | - Karen Torres
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
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Cholerton BA, Poston KL, Yang L, Rosenthal LS, Dawson TM, Pantelyat A, Edwards KL, Tian L, Quinn JF, Chung KA, Hiller AL, Hu SC, Montine TJ, Zabetian CP. Semantic fluency and processing speed are reduced in non-cognitively impaired participants with Parkinson's disease. J Clin Exp Neuropsychol 2021; 43:469-480. [PMID: 34355669 DOI: 10.1080/13803395.2021.1927995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Parkinson's disease (PD) is associated with a range of cognitive deficits. Few studies have carefully examined the subtle impacts of PD on cognition among patients who do not meet formal criteria for MCI or dementia. The aim of the current study was thus to describe the impact of PD on cognition in those without cognitive impairment in a well-characterized cohort.Methods: Non-cognitively impaired participants (122 with PD, 122 age- and sex-matched healthy volunteers) underwent extensive cognitive testing. Linear regression analyses compared diagnostic group performance across cognitive measures. For cognitive tasks that were significantly different between groups, additional analyses examined group differences restricting the group inclusion to PD participants with mild motor symptoms or disease duration less than 10 years.Results: Processing speed and semantic verbal fluency were significantly lower in the PD group (B = -3.77, 95% CIs [-5.76 to -1.77], p < .001, and B = -2.02, 95% CIs [-3.12, -0.92], p < .001, respectively), even after excluding those with moderate to severe motor symptoms (B = -2.73, 95% CIs [-4.94 to -0.53], p = .015 and B = -2.11, 95% CIs [-3.32 to -0.91], p < .001, respectively) or longer disease duration (B = -3.89, 95% CIs [-6.14 to -1.63], p < .001 and B = -1.58, 95% CIs [-2.78 to -0.37], p = .010, respectively). Semantic verbal fluency remained significantly negatively associated with PD diagnosis after controlling for processing speed (B = -1.66, 95% CIs [-2.79 to -0.53], p = .004).Conclusions: Subtle decline in specific cognitive domains may be present among people diagnosed with PD but without evidence to support a formal cognitive diagnosis. These results suggest the importance of early awareness of the potential for diminishing aspects of cognition in PD even among those without mild cognitive impairment or dementia.
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Affiliation(s)
- Brenna A Cholerton
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Laurice Yang
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ted M Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Neurodegeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen L Edwards
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Lu Tian
- Department of Biomedical Data Science, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Joseph F Quinn
- Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Health Care System, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Kathryn A Chung
- Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Health Care System, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Amie L Hiller
- Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Health Care System, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Shu-Ching Hu
- Geriatric Research Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Cyrus P Zabetian
- Geriatric Research Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
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Tremblay C, Macoir J, Langlois M, Cantin L, Prud'homme M, Monetta L. The effects of subthalamic deep brain stimulation on metaphor comprehension and language abilities in Parkinson's disease. BRAIN AND LANGUAGE 2015; 141:103-109. [PMID: 25577507 DOI: 10.1016/j.bandl.2014.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 10/20/2014] [Accepted: 12/15/2014] [Indexed: 06/04/2023]
Abstract
The effects of subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) on different language abilities are still controversial and its impact on high-level language abilities such as metaphor comprehension has been overlooked. The aim of this study was to determine the effects of STN electrical stimulation on metaphor comprehension and language abilities such as lexical and semantic capacities. Eight PD individuals with bilateral STN-DBS were first evaluated OFF-DBS and, at least seven weeks later, ON-DBS. Performance on metaphor comprehension, lexical decision, word association and verbal fluency tasks were compared ON and OFF-DBS in addition to motor symptoms evaluation. STN stimulation had a significant beneficial effect on motor symptoms in PD. However, this stimulation did not have any effect on metaphor comprehension or any other cognitive ability evaluated in this study. These outcomes suggest that STN stimulation may have dissociable effects on motor and language functions.
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Affiliation(s)
- Christina Tremblay
- Faculté de médecine, Département de réadaptation, Université Laval, 1050, ave de la Médecine, Québec, QC G1V 0A6, Canada; Institut Universitaire en Santé Mentale de Québec, 2601, rue de la Canardière, Québec, QC G1J 2G3, Canada.
| | - Joël Macoir
- Faculté de médecine, Département de réadaptation, Université Laval, 1050, ave de la Médecine, Québec, QC G1V 0A6, Canada; Institut Universitaire en Santé Mentale de Québec, 2601, rue de la Canardière, Québec, QC G1J 2G3, Canada.
| | - Mélanie Langlois
- Clinique des troubles du mouvement, Hôpital de l'Enfant-Jésus, 1401, 18(e) rue, Québec, QC G1J 1Z4, Canada.
| | - Léo Cantin
- Clinique des troubles du mouvement, Hôpital de l'Enfant-Jésus, 1401, 18(e) rue, Québec, QC G1J 1Z4, Canada.
| | - Michel Prud'homme
- Clinique des troubles du mouvement, Hôpital de l'Enfant-Jésus, 1401, 18(e) rue, Québec, QC G1J 1Z4, Canada.
| | - Laura Monetta
- Faculté de médecine, Département de réadaptation, Université Laval, 1050, ave de la Médecine, Québec, QC G1V 0A6, Canada; Institut Universitaire en Santé Mentale de Québec, 2601, rue de la Canardière, Québec, QC G1J 2G3, Canada.
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Murray LL, Rutledge S. Reading comprehension in Parkinson's disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 23:S246-S258. [PMID: 24686432 DOI: 10.1044/2014_ajslp-13-0087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Although individuals with Parkinson's disease (PD) self-report reading problems and experience difficulties in cognitive-linguistic functions that support discourse-level reading, prior research has primarily focused on sentence-level processing and auditory comprehension. Accordingly, the authors investigated the presence and nature of reading comprehension in PD, hypothesizing that (a) individuals with PD would display impaired accuracy and/or speed on reading comprehension tests and (b) reading performances would be correlated with cognitive test results. METHOD Eleven adults with PD and 9 age- and education-matched control participants completed tests that evaluated reading comprehension; general language and cognitive abilities; and aspects of attention, memory, and executive functioning. RESULT The PD group obtained significantly lower scores on several, but not all, reading comprehension, language, and cognitive measures. Memory, language, and disease severity were significantly correlated with reading comprehension for the PD group. CONCLUSION Individuals in the early stages of PD without dementia or broad cognitive deficits can display reading comprehension difficulties, particularly for high- versus basic-level reading tasks. These reading difficulties are most closely related to memory, high-level language, and PD symptom severity status. The findings warrant additional research to delineate further the types and nature of reading comprehension impairments experienced by individuals with PD.
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