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Lowit A, Thies T, Steffen J, Scheele F, Roheger M, Kalbe E, Barbe M. Task-based profiles of language impairment and their relationship to cognitive dysfunction in Parkinson's disease. PLoS One 2022; 17:e0276218. [PMID: 36301842 PMCID: PMC9612451 DOI: 10.1371/journal.pone.0276218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 10/03/2022] [Indexed: 11/05/2022] Open
Abstract
Objective Parkinson’s Disease (PD) is associated with both motor and non-motor problems, such as cognitive impairment. Particular focus in this area has been on the relationship between language impairment and decline in other cognitive functions, with the literature currently inconclusive on how the nature and degree of language impairment relate to cognition or other measures of disease severity. In addition, little information is available on how language problems identified in experimental task set-ups relate to competency in self-generated language paradigms such as picture description, monologues or conversations. This study aimed to inform clinical management of language impairment in PD by exploring (1) language performance across a range of experimental as well as self-generated language tasks, (2) how the relationship between these two aspects might be affected by the nature of the cognitive and language assessment; and (3) to what degree performance can be predicted across the language tasks. Methods 22 non-demented people with PD (PwPD) and 22 healthy control participants performed a range of cognitive and language tasks. Cognitive tasks included a screening assessment in addition to tests for set shifting, short term memory, attention, as well as letter and category fluency. Language was investigated in highly controlled grammar tasks as well as a Sentence Generation and a Narrative. Results The study highlighted impaired ability in set-shifting and letter fluency in the executive function tasks, and a higher rate of grammatical and lexical errors across all language tasks in the PD group. The performance in the grammar task was linked to set shifting ability, but error rates in Sentence Generation and Narrative were independent of this. There was no relevant relationship between performances across the three language tasks. Conclusions Our results suggest that there is a link between executive function and language performance, but that this is task dependent in non-demented PwPD. This has implications for the management of language impairment in PD, both for assessment and for designing effective interventions.
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Affiliation(s)
- Anja Lowit
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
- * E-mail:
| | - Tabea Thies
- Department of Phonetics, University of Cologne, Cologne, Germany
| | - Julia Steffen
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Franziska Scheele
- Department of Medical Psychology, Neuropsychology and Gender Studies, University Hospital Cologne, Cologne, Germany
| | - Mandy Roheger
- Department of Medical Psychology, Neuropsychology and Gender Studies, University Hospital Cologne, Cologne, Germany
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies, University Hospital Cologne, Cologne, Germany
| | - Michael Barbe
- Department of Neurology, University Hospital Cologne, Cologne, Germany
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2
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Magnante AT, Ord AS, Holland JA, Sautter SW. Neurocognitive functioning of patients with early-stage Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-12. [PMID: 35931087 DOI: 10.1080/23279095.2022.2106865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Parkinson's disease (PD) is a neurological disorder commonly associated with motor deficits. However, cognitive impairment is also common in patients with PD. Cognitive concerns in PD may affect multiple domains of neurocognition and vary across different stages of the disease. Extant research has focused mainly on cognitive deficits in middle to late stages of PD, whereas few studies have examined the unique cognitive profiles of patients with early-stage PD. This study addressed this gap in the published literature and examined neurocognitive functioning and functional capacity of patients with de novo PD, focusing on the unique pattern of cognitive deficits specific to the early stage of the disease. Results indicated that the pattern of cognitive deficits in patients with PD (n = 55; mean age = 72.93) was significantly different from healthy controls (n = 59; mean age = 71.88). Specifically, tasks related to executive functioning, attention, and verbal memory demonstrated the most pronounced deficits in patients with early-stage PD. Clinical implications of these findings are discussed.
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Affiliation(s)
- Anna Theresa Magnante
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Anna Shirokova Ord
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Jamie A Holland
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Scott W Sautter
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
- Hampton Roads Neuropsychology Inc., Virginia Beach, VA, USA
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Templeton JM, Poellabauer C, Schneider S. Towards Symptom-Specific Intervention Recommendation Systems. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1621-1631. [PMID: 35491802 DOI: 10.3233/jpd-223214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Mobile devices and their capabilities (e.g., device sensors and human-device interactions) are increasingly being considered for use in clinical assessments and disease monitoring due to their ability to provide objective, repeatable, and more accurate measures of neurocognitive performance. These mobile-based assessments also provide a foundation for the design of intervention recommendations. OBJECTIVE The purpose of this work was to assess the benefits of various physical intervention programs as they relate to Parkinson's disease (PD), its symptoms, and stages (Hoehn and Yahr (H&Y) Stages 1-5). METHODS Ninety-five participants (n = 70 PD; n = 25 control) completed 14 tablet-based neurocognitive functional tests (e.g., motor, memory, speech, executive, and multi-function) and standardized health questionnaires. 208 symptom-specific digital features were normalized to assess the benefits of various physical intervention programs (e.g., aerobic activity, non-contact boxing, functional strength, and yoga) for individuals with PD. While previous studies have shown that physical interventions improve both motor and non-motor PD symptoms, this paper expands on previous works by mapping symptom-specific neurocognitive functionalities to specific physical intervention programs across stages of PD. RESULTS For early-stage PD (e.g., H&Y Stages 1 & 2), functional strength activities provided the largest overall significant delta improvement (Δ= 0.1883; p = 0.0265), whereas aerobic activity provided the largest overall significant delta improvement (Δ= 0.2700; p = 0.0364) for advanced stages of PD (e.g., H&Y Stages 3-5). CONCLUSIONS As mobile-based digital health technology allows for the collection of larger, labeled, objective datasets, new ways to analyze and interpret patterns in this data emerge which can ultimately lead to new personalized medicine programs.
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Affiliation(s)
- John Michael Templeton
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Christian Poellabauer
- School of Computing & Information Sciences, Florida International University, Miami, FL, USA
| | - Sandra Schneider
- Department of Communicative Sciences & Disorders, St. Mary's College, Notre Dame, IN, USA
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Templeton JM, Poellabauer C, Schneider S. Enhancement of Neurocognitive Assessments Using Smartphone Capabilities: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e15517. [PMID: 32442150 PMCID: PMC7381077 DOI: 10.2196/15517] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/26/2019] [Accepted: 03/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Comprehensive exams such as the Dean-Woodcock Neuropsychological Assessment System, the Global Deterioration Scale, and the Boston Diagnostic Aphasia Examination are the gold standard for doctors and clinicians in the preliminary assessment and monitoring of neurocognitive function in conditions such as neurodegenerative diseases and acquired brain injuries (ABIs). In recent years, there has been an increased focus on implementing these exams on mobile devices to benefit from their configurable built-in sensors, in addition to scoring, interpretation, and storage capabilities. As smartphones become more accepted in health care among both users and clinicians, the ability to use device information (eg, device position, screen interactions, and app usage) for subject monitoring also increases. Sensor-based assessments (eg, functional gait using a mobile device's accelerometer and/or gyroscope or collection of speech samples using recordings from the device's microphone) include the potential for enhanced information for diagnoses of neurological conditions; mapping the development of these conditions over time; and monitoring efficient, evidence-based rehabilitation programs. OBJECTIVE This paper provides an overview of neurocognitive conditions and relevant functions of interest, analysis of recent results using smartphone and/or tablet built-in sensor information for the assessment of these different neurocognitive conditions, and how human-device interactions and the assessment and monitoring of these neurocognitive functions can be enhanced for both the patient and health care provider. METHODS This survey presents a review of current mobile technological capabilities to enhance the assessment of various neurocognitive conditions, including both neurodegenerative diseases and ABIs. It explores how device features can be configured for assessments as well as the enhanced capability and data monitoring that will arise due to the addition of these features. It also recognizes the challenges that will be apparent with the transfer of these current assessments to mobile devices. RESULTS Built-in sensor information on mobile devices is found to provide information that can enhance neurocognitive assessment and monitoring across all functional categories. Configurations of positional sensors (eg, accelerometer, gyroscope, and GPS), media sensors (eg, microphone and camera), inherent sensors (eg, device timer), and participatory user-device interactions (eg, screen interactions, metadata input, app usage, and device lock and unlock) are all helpful for assessing these functions for the purposes of training, monitoring, diagnosis, or rehabilitation. CONCLUSIONS This survey discusses some of the many opportunities and challenges of implementing configured built-in sensors on mobile devices to enhance assessments and monitoring of neurocognitive functions as well as disease progression across neurodegenerative and acquired neurological conditions.
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Affiliation(s)
- John Michael Templeton
- Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Christian Poellabauer
- Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Sandra Schneider
- Department of Communicative Sciences and Disorders, Saint Mary's College, Notre Dame, IN, United States
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Cognitive profile of non-demented Parkinson's disease: Meta-analysis of domain and sex-specific deficits. Parkinsonism Relat Disord 2018; 60:32-42. [PMID: 30361136 DOI: 10.1016/j.parkreldis.2018.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 09/24/2018] [Accepted: 10/12/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Better awareness of the cognitive domains affected in non-demented Parkinson's Disease (PD) should improve understanding of cognitive disease mechanisms. A complete understanding of the cognitive areas impaired in non-demented PD is hindered because most studies use small clinical samples without comparison to healthy controls. This meta-analysis examined cumulative evidence across studies to determine if there were impairments in non-demented PD in the three cognitive domains thought to be most widely affected in PD: frontal executive, visuospatial, and verbal memory. Because there are well-documented sex differences in PD, a second objective was to explore sex differences in these findings. METHODS MEDLINE, EMBASE and PsycINFO databases were searched (1988-March 2017). Random effects models were used to compute and compare effect sizes of differences between PD patients and controls within cognitive domains. Sex differences in effect sizes were also examined in these comparisons. Moderating factors including age, disease duration, motor symptom severity, levodopa dosage, and depression were examined through meta-regression. RESULTS PD patients showed deficits of moderate effect sizes in all three cognitive domains relative to controls. Significant sex differences were observed only for frontal executive abilities, with male PD patients showing greater deficits than female PD patients relative to controls. No moderators of effect sizes were identified in the domain specific overall or sex-segregated meta-analyses. CONCLUSIONS Results indicate that non-demented PD patients have deficits of moderate magnitude in frontal executive, verbal memory, and visuospatial abilities. Our findings of greater frontal executive deficits in males warrant further confirmation.
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Calvo N, Ibáñez A, Muñoz E, García AM. A core avenue for transcultural research on dementia: on the cross-linguistic generalization of language-related effects in Alzheimer's disease and Parkinson's disease. Int J Geriatr Psychiatry 2018; 33:814-823. [PMID: 28370288 DOI: 10.1002/gps.4712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 03/02/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Language is a key source of cross-cultural variability, which may have both subtle and major effects on neurocognition. However, this issue has been largely overlooked in two flourishing lines of research assessing the relationship between language-related neural systems and dementia. This paper assesses the limitations of the evidence on (i) the neuroprotective effects of bilingualism in Alzheimer's disease and (ii) specific language deficits as markers of Parkinson's disease. DESIGN First, we outline the rationale behind each line of research. Second, we review available evidence and discuss the potential impact of cross-linguistic factors. Third, we outline ideas to foster progress in both fields and, with it, in cross-cultural neuroscience at large. RESULTS On the one hand, studies on bilingualism suggest that sustained use of more than one language may protect against Alzheimer's disease symptoms. On the other hand, insights from the embodied cognition framework point to syntactic and action-verb deficits as early (and even preclinical) markers of Parkinson's disease. However, both fields share a key limitation that lies at the heart of cultural neuroscience: the issue of cross-linguistic generalizability. CONCLUSION Relevant evidence for both research trends comes from only a handful of (mostly Indo-European) languages, which are far from capturing the full scope of structural and typological diversity of the linguistic landscape worldwide. This raises questions on the external validity of reported findings. Greater collaboration between linguistic typology and cognitive neuroscience seems crucial as a first step to assess the impact of transcultural differences on language-related effects across neurodegenerative diseases. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Noelia Calvo
- Institute of Philosophy, School of Philosophy, Humanities and Arts
- , National University of San Juan, San Juan, Argentina.,Faculty of Psychology, National University of Córdoba, Córdoba, Argentina.,Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council, Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile.,Centre of Excellence in Cognition and its Disorders, Australian Research Council (ARC), Sydney, Australia
| | - Edinson Muñoz
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council, Buenos Aires, Argentina.,Faculty of Education, National University of Cuyo, Mendoza, Argentina
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7
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Contribution of language studies to the understanding of cognitive impairment and its progression over time in Parkinson’s disease. Neurosci Biobehav Rev 2017; 80:657-672. [DOI: 10.1016/j.neubiorev.2017.07.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/28/2017] [Accepted: 07/27/2017] [Indexed: 11/24/2022]
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8
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Speech disorders in Parkinson’s disease: early diagnostics and effects of medication and brain stimulation. J Neural Transm (Vienna) 2017; 124:303-334. [PMID: 28101650 DOI: 10.1007/s00702-017-1676-0] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/04/2017] [Indexed: 01/31/2023]
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9
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Lancioni G, Singh N, O'Reilly M, Sigafoos J, D'Amico F, Sasanelli G, Denitto F, Lang R. Technology-aided leisure and communication: Opportunities for persons with advanced Parkinson's disease. Dev Neurorehabil 2016; 19:398-404. [PMID: 25826719 DOI: 10.3109/17518423.2014.1002637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This study investigated whether simple technology-aided programs could be used to promote leisure and communication engagement in three persons with advanced Parkinson's disease. METHOD The programs included music and video options, which were combined with (a) text messaging and telephone calls for the first participant, (b) verbal statements/requests, text messaging, and reading for the second participant, and (c) verbal statements/requests and prayers for the third participant. The participants could activate those options via hand movement or vocal emission and specific microswitches. RESULTS All three participants were successful in activating the options available. The mean cumulative frequencies of option activations were about five per 15-min session for the first two participants and about four per 10-min session for the third participant. CONCLUSION The results were considered encouraging and relevant given the limited amount of evidence available on helping persons with advanced Parkinson's disease with leisure and communication.
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Affiliation(s)
- Giulio Lancioni
- a Department of Neuroscience and Sense Organs , University of Bari , Bari , Italy
| | - Nirbhay Singh
- b Medical College of Georgia, Georgia Regents University , Augusta , GA , USA
| | - Mark O'Reilly
- c Department of Special Education , University of Texas at Austin , Austin , TX , USA
| | - Jeff Sigafoos
- d Department of Educational Psychology , Victoria University of Wellington , Wellington , New Zealand
| | - Fiora D'Amico
- e S. Raffaele Medical Care Center , Alberobello , Italy
| | | | | | - Russell Lang
- g Department of Curriculum Instruction , Texas State University , San Marcos , TX , USA
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García AM, Carrillo F, Orozco-Arroyave JR, Trujillo N, Vargas Bonilla JF, Fittipaldi S, Adolfi F, Nöth E, Sigman M, Fernández Slezak D, Ibáñez A, Cecchi GA. How language flows when movements don't: An automated analysis of spontaneous discourse in Parkinson's disease. BRAIN AND LANGUAGE 2016; 162:19-28. [PMID: 27501386 DOI: 10.1016/j.bandl.2016.07.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 04/20/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
To assess the impact of Parkinson's disease (PD) on spontaneous discourse, we conducted computerized analyses of brief monologues produced by 51 patients and 50 controls. We explored differences in semantic fields (via latent semantic analysis), grammatical choices (using part-of-speech tagging), and word-level repetitions (with graph embedding tools). Although overall output was quantitatively similar between groups, patients relied less heavily on action-related concepts and used more subordinate structures. Also, a classification tool operating on grammatical patterns identified monologues as pertaining to patients or controls with 75% accuracy. Finally, while the incidence of dysfluent word repetitions was similar between groups, it allowed inferring the patients' level of motor impairment with 77% accuracy. Our results highlight the relevance of studying naturalistic discourse features to tap the integrity of neural (and, particularly, motor) networks, beyond the possibilities of standard token-level instruments.
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Affiliation(s)
- Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Av. Rivadavia 1917, C1033AAJ Buenos Aires, Argentina; Faculty of Elementary and Special Education (FEEyE), National University of Cuyo (UNCuyo), Sobremonte 74, C5500 Mendoza, Argentina.
| | - Facundo Carrillo
- National Scientific and Technical Research Council (CONICET), Av. Rivadavia 1917, C1033AAJ Buenos Aires, Argentina; Department of Computer Science, School of Sciences, University of Buenos Aires, Pabellón I, Ciudad Universitaria, C1428EGA Buenos Aires, Argentina
| | - Juan Rafael Orozco-Arroyave
- Faculty of Engineering, University of Antioquia, Calle 67 N° 53-108, C1226 Medellín, Colombia; Pattern Recognition Lab, Friedrich-Alexander-Universität, Martensstrasse 3, 91058 Erlangen-Nürnberg, Germany
| | - Natalia Trujillo
- Neuroscience Group, Faculty of Medicine, University of Antioquia, Calle 62 N° 52-59, C1226 Medellín, Colombia; School of Public Health, University of Antioquia, Calle 62 N° 52-59, C1226 Medellín, Colombia
| | - Jesús F Vargas Bonilla
- Faculty of Engineering, University of Antioquia, Calle 67 N° 53-108, C1226 Medellín, Colombia
| | - Sol Fittipaldi
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB Buenos Aires, Argentina
| | - Federico Adolfi
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB Buenos Aires, Argentina
| | - Elmar Nöth
- Pattern Recognition Lab, Friedrich-Alexander-Universität, Martensstrasse 3, 91058 Erlangen-Nürnberg, Germany
| | - Mariano Sigman
- Laboratory of Integrative Neuroscience, Torcuato Di Tella University, Av. Figueroa Alcorta 7350, C1428BCW Buenos Aires, Argentina
| | - Diego Fernández Slezak
- National Scientific and Technical Research Council (CONICET), Av. Rivadavia 1917, C1033AAJ Buenos Aires, Argentina; Department of Computer Science, School of Sciences, University of Buenos Aires, Pabellón I, Ciudad Universitaria, C1428EGA Buenos Aires, Argentina
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1860, C1126AAB Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Av. Rivadavia 1917, C1033AAJ Buenos Aires, Argentina; Universidad Autónoma del Caribe, Calle 90, N° 46-112, C2754 Barranquilla, Colombia; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Diagonal Las Torres 2640, Santiago, Chile; Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), 16 University Avenue, Macquarie University, Sydney, NSW 2109, Australia
| | - Guillermo A Cecchi
- Computational Biology Center, IBM, T.J. Watson Research Center, Yorktown Heights, 1101 Kitchawan Rd., Yorktwon Heights, New York, NY 10598, USA
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Asakawa T, Fang H, Sugiyama K, Nozaki T, Kobayashi S, Hong Z, Suzuki K, Mori N, Yang Y, Hua F, Ding G, Wen G, Namba H, Xia Y. Human behavioral assessments in current research of Parkinson's disease. Neurosci Biobehav Rev 2016; 68:741-772. [PMID: 27375277 DOI: 10.1016/j.neubiorev.2016.06.036] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 12/22/2022]
Abstract
Parkinson's disease (PD) is traditionally classified as a movement disorder because patients mainly complain about motor symptoms. Recently, non-motor symptoms of PD have been recognized by clinicians and scientists as early signs of PD, and they are detrimental factors in the quality of life in advanced PD patients. It is crucial to comprehensively understand the essence of behavioral assessments, from the simplest measurement of certain symptoms to complex neuropsychological tasks. We have recently reviewed behavioral assessments in PD research with animal models (Asakawa et al., 2016). As a companion volume, this article will systematically review the behavioral assessments of motor and non-motor PD symptoms of human patients in current research. The major aims of this article are: (1) promoting a comparative understanding of various behavioral assessments in terms of the principle and measuring indexes; (2) addressing the major strengths and weaknesses of these behavioral assessments for a better selection of tasks/tests in order to avoid biased conclusions due to inappropriate assessments; and (3) presenting new concepts regarding the development of wearable devices and mobile internet in future assessments. In conclusion we emphasize the importance of improving the assessments for non-motor symptoms because of their complex and unique mechanisms in human PD brains.
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Affiliation(s)
- Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan; Department of Psychiatry, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan.
| | - Huan Fang
- Department of Pharmacy, Jinshan Hospital of Fudan University, Shanghai, China
| | - Kenji Sugiyama
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Takao Nozaki
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Susumu Kobayashi
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Zhen Hong
- Department of Neurology, Huashan Hospital of Fudan University, Shanghai, China
| | - Katsuaki Suzuki
- Department of Psychiatry, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Norio Mori
- Department of Psychiatry, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Yilin Yang
- The First People's Hospital of Changzhou, Soochow University School of Medicine, Changzhou, China
| | - Fei Hua
- The First People's Hospital of Changzhou, Soochow University School of Medicine, Changzhou, China
| | - Guanghong Ding
- Shanghai Key laboratory of Acupuncture Mechanism and Acupoint Function, Fudan University, Shanghai, China
| | - Guoqiang Wen
- Department of Neurology, Hainan General Hospital, Haikou, Hainan, China
| | - Hiroki Namba
- Department of Neurosurgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu-city, Shizuoka, Japan
| | - Ying Xia
- Department of Neurosurgery, The University of Texas McGovern Medical School, Houston, TX 77030, USA.
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12
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Galaz Z, Mekyska J, Mzourek Z, Smekal Z, Rektorova I, Eliasova I, Kostalova M, Mrackova M, Berankova D. Prosodic analysis of neutral, stress-modified and rhymed speech in patients with Parkinson's disease. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 127:301-317. [PMID: 26826900 DOI: 10.1016/j.cmpb.2015.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 12/16/2015] [Accepted: 12/25/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Hypokinetic dysarthria (HD) is a frequent speech disorder associated with idiopathic Parkinson's disease (PD). It affects all dimensions of speech production. One of the most common features of HD is dysprosody that is characterized by alterations of rhythm and speech rate, flat speech melody, and impairment of speech intensity control. Dysprosody has a detrimental impact on speech naturalness and intelligibility. METHODS This paper deals with quantitative prosodic analysis of neutral, stress-modified and rhymed speech in patients with PD. The analysis of prosody is based on quantification of monopitch, monoloudness, and speech rate abnormalities. Experimental dataset consists of 98 patients with PD and 51 healthy speakers. For the purpose of HD identification, sequential floating feature selection algorithm and random forests classifier is used. In this paper, we also introduce a concept of permutation test applied in the field of acoustic analysis of dysarthric speech. RESULTS Prosodic features obtained from stress-modified reading task provided higher classification accuracies compared to the ones extracted from reading task with neutral emotion demonstrating the importance of stress in speech prosody. Features calculated from poem recitation task outperformed both reading tasks in the case of gender-undifferentiated analysis showing that rhythmical demands can in general lead to more precise identification of HD. Additionally, some gender-related patterns of dysprosody has been observed. CONCLUSIONS This paper confirms reduced variation of fundamental frequency in PD patients with HD. Interestingly, increased variability of speech intensity compared to healthy speakers has been detected. Regarding speech rate disturbances, our results does not report any particular pattern. We conclude further development of prosodic features quantifying the relationship between monopitch, monoloudness and speech rate disruptions in HD can have a great potential in future PD analysis.
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Affiliation(s)
- Zoltan Galaz
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Jiri Mekyska
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Zdenek Mzourek
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Zdenek Smekal
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Irena Rektorova
- First Department of Neurology, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic; Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic.
| | - Ilona Eliasova
- First Department of Neurology, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic; Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic
| | - Milena Kostalova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic; Department of Neurology, Faculty Hospital and Masaryk University, Jihlavska 20, 63900 Brno, Czech Republic
| | - Martina Mrackova
- First Department of Neurology, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic; Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic
| | - Dagmar Berankova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic
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