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Gajardo-Vidal A, Montembeault M, Lorca-Puls DL, Licata AE, Bogley R, Erlhoff S, Ratnasiri B, Ezzes Z, Battistella G, Tsoy E, Pereira CW, DeLeon J, Tee BL, Henry ML, Miller ZA, Rankin KP, Mandelli ML, Possin KL, Gorno-Tempini ML. Assessing processing speed and its neural correlates in the three variants of primary progressive aphasia with a non-verbal tablet-based task. Cortex 2024; 171:165-177. [PMID: 38000139 PMCID: PMC10922977 DOI: 10.1016/j.cortex.2023.10.011] [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: 05/26/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023]
Abstract
Prior research has revealed distinctive patterns of impaired language abilities across the three variants of Primary Progressive Aphasia (PPA): nonfluent/agrammatic (nfvPPA), logopenic (lvPPA) and semantic (svPPA). However, little is known about whether, and to what extent, non-verbal cognitive abilities, such as processing speed, are impacted in PPA patients. This is because neuropsychological tests typically contain linguistic stimuli and require spoken output, being therefore sensitive to verbal deficits in aphasic patients. The aim of this study is to investigate potential differences in processing speed between PPA patients and healthy controls, and among the three PPA variants, using a brief non-verbal tablet-based task (Match) modeled after the WAIS-III digit symbol coding test, and to determine its neural correlates. Here, we compared performance on the Match task between PPA patients (n = 61) and healthy controls (n = 59) and across the three PPA variants. We correlated performance on Match with voxelwise gray and white matter volumes. We found that lvPPA and nfvPPA patients performed significantly worse on Match than healthy controls and svPPA patients. Worse performance on Match across PPA patients was associated with reduced gray matter volume in specific parts of the left middle frontal gyrus, superior parietal lobule, and precuneus, and reduced white matter volume in the left parietal lobe. To conclude, our behavioral findings reveal that processing speed is differentially impacted across the three PPA variants and provide support for the potential clinical utility of a tabled-based task (Match) to assess non-verbal cognition. In addition, our neuroimaging findings confirm the importance of a set of fronto-parietal regions that previous research has associated with processing speed and executive control. Finally, our behavioral and neuroimaging findings combined indicate that differences in processing speed are largely explained by the unequal distribution of atrophy in these fronto-parietal regions across the three PPA variants.
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Affiliation(s)
- Andrea Gajardo-Vidal
- Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile.
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA; Douglas Mental Health University Institute, Montréal, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, Montréal, QC H3A 1A1, Canada
| | - Diego L Lorca-Puls
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA; Sección de Neurología, Departamento de Especialidades, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Abigail E Licata
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Rian Bogley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Sabrina Erlhoff
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Buddhika Ratnasiri
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Zoe Ezzes
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Giovanni Battistella
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Elena Tsoy
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Christa Watson Pereira
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Jessica DeLeon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Boon Lead Tee
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Maya L Henry
- Department of Speech, Language, and Hearing Sciences, University of Texas, Austin, TX, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Katherine L Possin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
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Novakova L, Gajdos M, Markova J, Martinkovicova A, Kosutzka Z, Svantnerova J, Valkovic P, Csefalvay Z, Rektorova I. Language impairment in Parkinson’s disease: fMRI study of sentence reading comprehension. Front Aging Neurosci 2023; 15:1117473. [PMID: 36967818 PMCID: PMC10033839 DOI: 10.3389/fnagi.2023.1117473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
Parkinson’s disease (PD) affects the language processes, with a significant impact on the patients’ daily communication. We aimed to describe specific alterations in the comprehension of syntactically complex sentences in patients with PD (PwPD) as compared to healthy controls (HC) and to identify the neural underpinnings of these deficits using a functional connectivity analysis of the striatum. A total of 20 patients PwPD and 15 HC participated in the fMRI study. We analyzed their performance of a Test of sentence comprehension (ToSC) adjusted for fMRI. A task-dependent functional connectivity analysis of the striatum was conducted using the psychophysiological interaction method (PPI). On the behavioral level, the PwPD scored significantly lower (mean ± sd: 77.3 ± 12.6) in the total ToSC score than the HC did (mean ± sd: 86.6 ± 8.0), p = 0.02, and the difference was also significant specifically for sentences with a non-canonical word order (PD-mean ± sd: 69.9 ± 14.1, HC-mean ± sd: 80.2 ± 11.5, p = 0.04). Using PPI, we found a statistically significant difference between the PwPD and the HC in connectivity from the right striatum to the supplementary motor area [SMA, (4 8 53)] for non-canonical sentences. This PPI connectivity was negatively correlated with the ToSC accuracy of non-canonical sentences in the PwPD. Our results showed disturbed sentence reading comprehension in the PwPD with altered task-dependent functional connectivity from the right striatum to the SMA, which supports the synchronization of the temporal and sequential aspects of language processing. The study revealed that subcortical-cortical networks (striatal-frontal loop) in PwPD are compromised, leading to impaired comprehension of syntactically complex sentences.
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Affiliation(s)
- Lubomira Novakova
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czechia
| | - Martin Gajdos
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czechia
| | - Jana Markova
- Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia
| | - Alice Martinkovicova
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Zuzana Kosutzka
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Jana Svantnerova
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Peter Valkovic
- Second Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Zsolt Csefalvay
- Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia
| | - Irena Rektorova
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czechia
- *Correspondence: Irena Rektorova,
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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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Theodoros D. Telerehabilitation for Communication and Swallowing Disorders in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:S65-S70. [PMID: 33896848 PMCID: PMC8385517 DOI: 10.3233/jpd-202414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Communication and swallowing disorders are highly prevalent in people with Parkinson's disease (PD). The negative impact of these disorders on the quality of life of the person with PD and their families cannot be underestimated. Despite a demand for speech-language pathology services to support people with PD, many barriers to services exist. Telerehabilitation provides an alternate and complementary approach to in-person therapy that is patient-centered, enables timely assessment and intervention, and facilitates continuity of care throughout the course of the disease. This review explores the telerehabilitation applications designed for the management of the communication and swallowing disorders in PD, addresses the benefits and challenges of telerehabilitation, identifies future research directions, and highlights the potential of new technologies to enhance the management of communication and swallowing disorders and quality of life for people with PD.
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Affiliation(s)
- Deborah Theodoros
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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Theodoros D, Aldridge D, Hill AJ, Russell T. Technology-enabled management of communication and swallowing disorders in Parkinson's disease: a systematic scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:170-188. [PMID: 29923267 DOI: 10.1111/1460-6984.12400] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 05/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Communication and swallowing disorders are highly prevalent in people with Parkinson's disease (PD). Maintenance of functional communication and swallowing over time is challenging for the person with PD and their families and may lead to social isolation and reduced quality of life if not addressed. Speech and language therapists (SLTs) face the conundrum of providing sustainable and flexible services to meet the changing needs of people with PD. Motor, cognitive and psychological issues associated with PD, medication regimens and dependency on others often impede attendance at a centre-based service. The access difficulties experienced by people with PD require a disruptive service approach to meet their needs. Technology-enabled management using information and telecommunications technologies to provide services at a distance has the potential to improve access, and enhance the quality of SLT services to people with PD. AIMS To report the status and scope of the evidence for the use of technology in the management of the communication and swallowing disorders associated with PD. METHODS & PROCEDURES Studies were retrieved from four major databases (PubMed, CINAHL, EMBASE and Medline via Web of Science). Data relating to the types of studies, level of evidence, context, nature of the management undertaken, participant perspectives and the types of technologies involved were extracted for the review. MAIN CONTRIBUTION A total of 17 studies were included in the review, 15 of which related to the management of communication and swallowing disorders in PD with two studies devoted to participant perspectives. The majority of the studies reported on the treatment of the speech disorder in PD using Lee Silverman Voice Treatment (LSVT LOUD® ). Synchronous and asynchronous technologies were used in the studies with a predominance of the former. There was a paucity of research in the management of cognitive-communication and swallowing disorders. CONCLUSIONS & IMPLICATIONS Research evidence supporting technology-enabled management of the communication and swallowing disorders in PD is limited and predominantly low in quality. The treatment of the speech disorder online is the most developed aspect of the technology-enabled management pathway. Future research needs to address technology-enabled management of cognitive-communication and swallowing disorders and the use of a more diverse range of technologies and management approaches to optimize SLT service delivery to people with PD.
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Affiliation(s)
- Deborah Theodoros
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Danielle Aldridge
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Anne J Hill
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Trevor Russell
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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Walenski M, Europa E, Caplan D, Thompson CK. Neural networks for sentence comprehension and production: An ALE-based meta-analysis of neuroimaging studies. Hum Brain Mapp 2019; 40:2275-2304. [PMID: 30689268 DOI: 10.1002/hbm.24523] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 12/14/2018] [Accepted: 12/26/2018] [Indexed: 12/24/2022] Open
Abstract
Comprehending and producing sentences is a complex endeavor requiring the coordinated activity of multiple brain regions. We examined three issues related to the brain networks underlying sentence comprehension and production in healthy individuals: First, which regions are recruited for sentence comprehension and sentence production? Second, are there differences for auditory sentence comprehension vs. visual sentence comprehension? Third, which regions are specifically recruited for the comprehension of syntactically complex sentences? Results from activation likelihood estimation (ALE) analyses (from 45 studies) implicated a sentence comprehension network occupying bilateral frontal and temporal lobe regions. Regions implicated in production (from 15 studies) overlapped with the set of regions associated with sentence comprehension in the left hemisphere, but did not include inferior frontal cortex, and did not extend to the right hemisphere. Modality differences between auditory and visual sentence comprehension were found principally in the temporal lobes. Results from the analysis of complex syntax (from 37 studies) showed engagement of left inferior frontal and posterior temporal regions, as well as the right insula. The involvement of the right hemisphere in the comprehension of these structures has potentially important implications for language treatment and recovery in individuals with agrammatic aphasia following left hemisphere brain damage.
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Affiliation(s)
- Matthew Walenski
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, Illinois.,Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, Illinois
| | - Eduardo Europa
- Department of Neurology, University of California, San Francisco
| | - David Caplan
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Cynthia K Thompson
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, Illinois.,Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, Illinois.,Department of Neurology, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
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Smith KM, Ash S, Xie SX, Grossman M. Evaluation of Linguistic Markers of Word-Finding Difficulty and Cognition in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1691-1699. [PMID: 29955824 PMCID: PMC6195062 DOI: 10.1044/2018_jslhr-l-17-0304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 03/05/2018] [Indexed: 05/10/2023]
Abstract
PURPOSE Early cognitive symptoms such as word-finding difficulty (WFD) in daily conversation are common in Parkinson's disease (PD), but studies have been limited by a lack of feasible, quantitative measures. Linguistic analysis, focused on pauses in speech, may yield markers of impairment of cognition and communication in PD. The objective of this study was to evaluate the relationship of linguistic markers in semistructured speech to WFD symptoms and cognitive function in PD. METHOD Speech recordings of description of the Cookie Theft picture in 53 patients with PD without dementia and 23 elderly controls were analyzed with Praat software. Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005), category naming fluency, and confrontation naming tests were administered. Questionnaires rating WFD symptoms and cognitive instrumental activities of daily living were completed. We determined the relationships between (a) pause length and location, (b) MoCA score, and (c) WFD symptoms, using Pearson's correlations and multivariate regression models. RESULTS Compared with controls, patients with PD had more pauses within utterances as well as fewer words per minute and a lower percentage of well-formed sentences. Pauses within utterances differed significantly between PD-mild cognitive impairment and normal cognition (p < .001). Words per minute and percentage of well-formed sentences were predictive of MoCA in multivariate regression models. Pauses before verbs were associated with patient-reported severity of WFD symptoms (p = .006). CONCLUSIONS Linguistic markers including pauses within utterances distinguish patients with PD with mild cognitive symptoms from elderly controls. These markers are associated with global cognitive function before the onset of dementia. Pauses before verbs and grammatical markers may index early cognitive symptoms such as WFD that may interfere with functional communication. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.6615401.
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Affiliation(s)
- Kara M. Smith
- Parkinson Disease and Movement Disorders Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Neurology, University of Massachusetts Memorial Medical Center/UMass Medical School, Worcester
| | - Sharon Ash
- Department of Neurology and the Penn Frontotemporal Degenerative Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Sharon X. Xie
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Murray Grossman
- Department of Neurology and the Penn Frontotemporal Degenerative Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
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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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Angwin AJ, Dissanayaka NNW, McMahon KL, Silburn PA, Copland DA. Lexical ambiguity resolution during sentence processing in Parkinson's disease: An event-related potential study. PLoS One 2017; 12:e0176281. [PMID: 28475582 PMCID: PMC5419504 DOI: 10.1371/journal.pone.0176281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/07/2017] [Indexed: 12/26/2022] Open
Abstract
Event-related potentials (ERPs) were recorded to investigate lexical ambiguity resolution during sentence processing in 16 people with Parkinson's disease (PD) and 16 healthy controls. Sentences were presented word-by-word on computer screen, and participants were required to decide if a subsequent target word was related to the meaning of the sentence. The task consisted of related, unrelated and ambiguous trials. For the ambiguous trials, the sentence ended with an ambiguous word and the target was related to one of the meanings of that word, but not the one captured by the sentence context (e.g., 'He dug with the spade', Target 'ACE'). Both groups demonstrated slower reaction times and lower accuracy for the ambiguous condition relative to the unrelated condition, however accuracy was impacted by the ambiguous condition to a larger extent in the PD group. These results suggested that PD patients experience increased difficulties with contextual ambiguity resolution. The ERP results did not reflect increased ambiguity resolution difficulties in PD, as a similar N400 effect was evident for the unrelated and ambiguous condition in both groups. However, the magnitude of the N400 for these conditions was correlated with a measure of inhibition in the PD group, but not the control group. The ERP results suggest that semantic processing may be more compromised in PD patients with increased response inhibition deficits.
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Affiliation(s)
- Anthony J. Angwin
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Nadeeka N. W. Dissanayaka
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
- Neurology Research Centre, Royal Brisbane & Women’s Hospital, Brisbane, Queensland, Australia
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Katie L. McMahon
- Centre for Advanced Imaging, University of Queensland, Brisbane, Queensland, Australia
| | - Peter A. Silburn
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - David A. Copland
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
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Murakami H, Momma Y, Nohara T, Mori Y, Futamura A, Sugita T, Ishigaki S, Katoh H, Kezuka M, Ono K, Miller MW, Kawamura M. Improvement in Language Function Correlates with Gait Improvement in Drug-naïve Parkinson's Disease Patients Taking Dopaminergic Medication. JOURNAL OF PARKINSONS DISEASE 2017; 6:209-17. [PMID: 26889633 DOI: 10.3233/jpd-150702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dopaminergic drugs, the gold standard for motor symptoms, are known to affect cognitive function in Parkinson's disease (PD) patients. OBJECTIVE We compared the effects of dopaminergic treatment on motor and cognitive function in drug-naïve patients. METHODS Dopaminergic medication (levodopa, dopamine agonist, selegiline) was given to 27 drug-naïve PD patients and increased to a dose optimal for improved motor symptoms. Patients were tested prior to, and 4-7 months after, drug initiation. Motor function was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). Cognitive function was assessed using both the Japanese version of the Montreal Cognitive Assessment (MoCA-J) and the Neurobehavioral Cognitive Status Examination (COGNISTAT-J). Improvements from baseline for both motor and cognitive assessment were compared. RESULTS Mean score of all motor assessments (UPDRS total score of Parts II and III, and sub-scores of tremor, rigidity, bradykinesia, gait, and postural instability) and certain cognitive assessments (MoCA-J total score and subscore of delayed recall) significantly improved with dopaminergic medication. Gait score improvement showed significant positive correlation with improvement in MoCA-J language domain and in language-comprehension subtests of COGNISTAT-J using Spearman's correlation coefficients. Furthermore, multiple regression analysis showed gait score improvement significantly correlated with improvements in the subtests of language-comprehension in COGNISTAT-J. CONCLUSION There is correlated improvement in both gait and language function in de novo PD patients in response to dopaminergic drugs. Gait and language dysfunction in these patients may share a common pathophysiology linked to dopamine deficits.
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Affiliation(s)
- Hidetomo Murakami
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Yutaro Momma
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Tetsuhito Nohara
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Yukiko Mori
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Akinori Futamura
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Toshihisa Sugita
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Seiichiro Ishigaki
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Hirotaka Katoh
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Machiko Kezuka
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Kenjiro Ono
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
| | - Michael W Miller
- Medical Sciences Training Program, Faculty of Medicine, University of Tokyo, Japan
| | - Mitsuru Kawamura
- Department of Neurology, School of Medicine, Showa University Tokyo, Japan
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11
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Syntax, action verbs, action semantics, and object semantics in Parkinson's disease: Dissociability, progression, and executive influences. Cortex 2015; 69:237-54. [DOI: 10.1016/j.cortex.2015.05.022] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 03/25/2015] [Accepted: 05/18/2015] [Indexed: 12/14/2022]
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Vlagsma TT, Koerts J, Fasotti L, Tucha O, van Laar T, Dijkstra H, Spikman JM. Parkinson's patients' executive profile and goals they set for improvement: Why is cognitive rehabilitation not common practice? Neuropsychol Rehabil 2015; 26:216-35. [PMID: 25693688 DOI: 10.1080/09602011.2015.1013138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Impairments in executive functions (EF) are the core cognitive impairment in patients with Parkinson's disease (PD). Surprisingly, cognitive rehabilitation is not routinely offered to patients with PD. However, in patients with acquired brain injury (ABI), cognitive rehabilitation, in particular strategic executive training, is common practice and has been shown to be effective. In this study, we determined whether PD patients have different needs and aims with regard to strategic executive training than ABI patients, and whether possible differences might be a reason for not offering this kind of cognitive rehabilitation programme to patients with PD. Patients' needs and aims were operationalised by individually set goals, which were classified into domains of EF and daily life. In addition, patients with PD and ABI were compared on their cognitive, in particular EF, profile. Overall, PD patients' goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account.
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Affiliation(s)
- T T Vlagsma
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands
| | - J Koerts
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands
| | - L Fasotti
- b Donders Institute for Brain, Cognition and Behaviour , Radboud University Nijmegen , Nijmegen , The Netherlands.,c Rehabilitation Medical Centre Groot Klimmendaal , Arnhem , The Netherlands
| | - O Tucha
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands
| | - T van Laar
- d Department of Neurology , University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands
| | - H Dijkstra
- e Department of Medical Psychology , Medical Centre Nij Smellinghe , Drachten , The Netherlands
| | - J M Spikman
- a Department of Clinical & Developmental Neuropsychology , University of Groningen , Groningen , The Netherlands.,d Department of Neurology , University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands
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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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Vanhoutte S, De Letter M, Corthals P, Van Borsel J, Santens P. Quantitative analysis of language production in Parkinson's disease using a cued sentence generation task. CLINICAL LINGUISTICS & PHONETICS 2012; 26:863-881. [PMID: 22954366 DOI: 10.3109/02699206.2012.711420] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The present study examined language production skills in Parkinson's disease (PD) patients. A unique cued sentence generation task was created in order to reduce demands on memory and attention. Differences in sentence production abilities according to disease severity and cognitive impairments were assessed. Language samples were obtained from 20 PD patients and 20 healthy control participants matched for age, sex and educational level. In addition, a cognitive test for verbal memory and resistance to cognitive interference was administered. Statistical comparisons revealed significant language changes in an advanced stage of the disease. Advanced PD patients showed a reduction in lexical diversity in notional verbs, which was absent in nouns. Cognitive dysfunctions such as impaired verbal memory are suggested to contribute to the typical noun/verb dissociation in PD patients. In addition, advanced PD patients produced more semantic perseverations, which may be related to set-switching problems. In conclusion, whether language disturbances in PD are the result of non-linguistic cognitive dysfunctions or reflect pure language deficits exacerbated by cognitive impairments, remains a matter of debate. However, the negative impact of cognitive dysfunctions may be important.
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