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Pl R, Ks G. Cognitive decline assessment using semantic linguistic content and transformer deep learning architecture. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1110-1127. [PMID: 37971395 DOI: 10.1111/1460-6984.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Dementia is a cognitive decline that leads to the progressive deterioration of an individual's ability to perform daily activities independently. As a result, a considerable amount of time and resources are spent on caretaking. Early detection of dementia can significantly reduce the effort and resources needed for caretaking. AIMS This research proposes an approach for assessing cognitive decline by analysing speech data, specifically focusing on speech relevance as a crucial indicator for memory recall. METHODS & PROCEDURES This is a cross-sectional, online, self-administered. The proposed method used deep learning architecture based on transformers, with BERT (Bidirectional Encoder Representations from Transformers) and Sentence-Transformer to derive encoded representations of speech transcripts. These representations provide contextually descriptive information that is used to analyse the relevance of sentences in their respective contexts. The encoded information is then compared using cosine similarity metrics to measure the relevance of uttered sequences of sentences. The study uses the Pitt Corpus Dementia dataset for experimentation, which consists of speech data from individuals with and without dementia. The accuracy of the proposed multi-QA-MPNet (Multi-Query Maximum Inner Product Search Pretraining) model is compared with other pretrained transformer models of Sentence-Transformer. OUTCOMES & RESULTS The results show that the proposed approach outperforms the other models in capturing context level information, particularly semantic memory. Additionally, the study explores the suitability of different similarity measures to evaluate the relevance of uttered sequences of sentences. The experimentation reveals that cosine similarity is the most appropriate measure for this task. CONCLUSIONS & IMPLICATIONS This finding has significant implications for the early warning signs of dementia, as it suggests that cosine similarity metrics can effectively capture the semantic relevance of spoken language. The persistent cognitive decline over time acts as one of the indicators for prevalence of dementia. Additionally early dementia could be recognised by analysis on other modalities like speech and brain images. WHAT THIS PAPER ADDS What is already known on this subject It is already known that speech- and language-based detection methods can be useful for dementia diagnosis, as language difficulties are often early signs of the disease. Additionally, deep learning algorithms have shown promise in detecting and diagnosing dementia through analysing large datasets, particularly in speech- and language-based detection methods. However, further research is needed to validate the performance of these algorithms on larger and more diverse datasets and to address potential biases and limitations. What this paper adds to existing knowledge This study presents a unique and effective approach for cognitive decline assessment through analysing speech data. The study provides valuable insights into the importance of context and semantic memory in accurately detecting the potential in dementia and demonstrates the applicability of deep learning models for this purpose. The findings of this study have important clinical implications and can inform future research and development in the field of dementia detection and care. What are the potential or actual clinical implications of this work? The proposed approach for cognitive decline assessment using speech data and deep learning models has significant clinical implications. It has the potential to improve the accuracy and efficiency of dementia diagnosis, leading to earlier detection and more effective treatments, which can improve patient outcomes and quality of life.
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Affiliation(s)
- Rini Pl
- Sri Sivasubramaniya Nadar College of Engineering, Tamil Nadu, India
| | - Gayathri Ks
- Sri Sivasubramaniya Nadar College of Engineering, Tamil Nadu, India
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Gumus M, Koo M, Studzinski CM, Bhan A, Robin J, Black SE. Linguistic changes in neurodegenerative diseases relate to clinical symptoms. Front Neurol 2024; 15:1373341. [PMID: 38590720 PMCID: PMC10999640 DOI: 10.3389/fneur.2024.1373341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
Background The detection and characterization of speech changes may help in the identification and monitoring of neurodegenerative diseases. However, there is limited research validating the relationship between speech changes and clinical symptoms across a wide range of neurodegenerative diseases. Method We analyzed speech recordings from 109 patients who were diagnosed with various neurodegenerative diseases, including Alzheimer's disease, Frontotemporal Dementia, and Vascular Cognitive Impairment, in a cognitive neurology memory clinic. Speech recordings of an open-ended picture description task were processed using the Winterlight speech analysis platform which generates >500 speech features, including the acoustics of speech and linguistic properties of spoken language. We investigated the relationship between the speech features and clinical assessments including the Mini Mental State Examination (MMSE), Mattis Dementia Rating Scale (DRS), Western Aphasia Battery (WAB), and Boston Naming Task (BNT) in a heterogeneous patient population. Result Linguistic features including lexical and syntactic features were significantly correlated with clinical assessments in patients, across diagnoses. Lower MMSE and DRS scores were associated with the use of shorter words and fewer prepositional phrases. Increased impairment on WAB and BNT was correlated with the use of fewer nouns but more pronouns. Patients also differed from healthy adults as their speech duration was significantly shorter with more pauses. Conclusion Linguistic changes such as the use of simpler vocabularies and syntax were detectable in patients with different neurodegenerative diseases and correlated with cognitive decline. Speech has the potential to be a sensitive measure for detecting cognitive impairments across various neurodegenerative diseases.
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Affiliation(s)
- Melisa Gumus
- Winterlight Labs, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Morgan Koo
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | - Aparna Bhan
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
| | | | - Sandra E. Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
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Malcorra BLC, García AO, Marcotte K, de Paz H, Schilling LP, da Silva Filho IG, Soder R, da Rosa Franco A, Loureiro F, Hübner LC. Exploring Spoken Discourse and Its Neural Correlates in Women With Alzheimer's Disease With Low Levels of Education and Socioeconomic Status. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:893-911. [PMID: 38157526 DOI: 10.1044/2023_ajslp-23-00137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
PURPOSE Early impairments in spoken discourse abilities have been identified in Alzheimer's disease (AD). However, the impact of AD on spoken discourse and the associated neuroanatomical correlates have mainly been studied in populations with higher levels of education, although preliminary evidence seems to indicate that socioeconomic status (SES) and level of education have an impact on spoken discourse. The purpose of this study was to analyze microstructural variables in spoken discourse in people with AD with low-to-middle SES and low level of education and to study their association with gray matter (GM) density. METHOD Nine women with AD and 10 matched (age, SES, and education) women without brain injury (WWBI) underwent a neuropsychological assessment, which included two spoken discourse tasks, and structural magnetic resonance imaging. Microstructural variables were extracted from the discourse samples using NILC-Metrix software. Brain density, measured by voxel-based morphometry, was compared between groups and then correlated with the differentiating microstructural variables. RESULTS The AD group produced a lower diversity of verbal time moods and fewer words and sentences than WWBI but a greater diversity of pronouns, prepositions, and lexical richness. At the neural level, the AD group presented a lower GM density bilaterally in the hippocampus, the inferior temporal gyrus, and the anterior cingulate gyrus. Number of words and sentences produced were associated with GM density in the left parahippocampal gyrus, whereas the diversity of verbal moods was associated with the basal ganglia and the anterior cingulate gyrus bilaterally. CONCLUSIONS The present findings are mainly consistent with previous studies conducted in groups with higher levels of SES and education, but they suggest that atrophy in the left inferior temporal gyrus could be critical in AD in populations with lower levels of SES and education. This research provides evidence on the importance of pursuing further studies including people with various SES and education levels. WHAT IS ALREADY KNOWN ON THIS SUBJECT Spoken discourse has been shown to be affected in Alzheimer disease, but most studies have been conducted on individuals with middle-to-high SES and high educational levels. WHAT THIS STUDY ADDS The study reports on microstructural measures of spoken discourse in groups of women in the early stage of AD and healthy women, with low-to-middle SES and lower levels of education. CLINICAL IMPLICATIONS OF THIS STUDY This study highlights the importance of taking into consideration the SES and education level in spoken discourse analysis and in investigating the neural correlates of AD. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24905046.
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Affiliation(s)
- Bárbara Luzia Covatti Malcorra
- Department of Linguistics, School of Humanities, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Alberto Osa García
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Karine Marcotte
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Hanna de Paz
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Lucas Porcello Schilling
- Graduate Course in Medicine and Healthy Sciences, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Graduate Course in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (InsCer)Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Irênio Gomes da Silva Filho
- Graduate Course in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Ricardo Soder
- Graduate Course in Medicine and Healthy Sciences, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (InsCer)Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Alexandre da Rosa Franco
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline for Psychiatric Research, Orangeburg, NY
- Center for the Developing Brain, Child Mind Institute, New York, NY
- Department of Psychiatry, NYU Grossman School of Medicine, New York
| | - Fernanda Loureiro
- Graduate Course in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Lilian Cristine Hübner
- Department of Linguistics, School of Humanities, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- National Council for Scientific and Technological Development (CNPq), Brasília, DF, Brazil
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Coco MI, Guariglia C, Pizzamiglio L. Unconventionally trendy: The pluralistic endeavour of Cortex into the human cognitive neurosciences. Cortex 2024; 170:101-106. [PMID: 38114360 DOI: 10.1016/j.cortex.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023]
Affiliation(s)
- Moreno I Coco
- Sapienza, Università di Roma, Dipartimento di Psicologia, Roma, Italy; I. R. C. S. S. Fondazione Santa Lucia, Roma, Italy.
| | - Cecilia Guariglia
- Sapienza, Università di Roma, Dipartimento di Psicologia, Roma, Italy; I. R. C. S. S. Fondazione Santa Lucia, Roma, Italy.
| | - Luigi Pizzamiglio
- Sapienza, Università di Roma, Dipartimento di Psicologia, Roma, Italy.
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Robin J, Xu M, Kaufman LD, Simpson W, McCaughey S, Tatton N, Wolfus C, Ward M. Development of a Speech-based Composite Score for Remotely Quantifying Language Changes in Frontotemporal Dementia. Cogn Behav Neurol 2023; 36:237-248. [PMID: 37878468 PMCID: PMC10683975 DOI: 10.1097/wnn.0000000000000356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 04/07/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Changes to speech and language are common symptoms across different subtypes of frontotemporal dementia (FTD). These changes affect the ability to communicate, impacting everyday functions. Accurately assessing these changes may help clinicians to track disease progression and detect response to treatment. OBJECTIVE To determine which aspects of speech show significant change over time and to develop a novel composite score for tracking speech and language decline in individuals with FTD. METHOD We recruited individuals with FTD to complete remote digital speech assessments based on a picture description task. Speech samples were analyzed to derive acoustic and linguistic measures of speech and language, which were tested for longitudinal change over the course of the study and were used to compute a novel composite score. RESULTS Thirty-six (16 F, 20 M; M age = 61.3 years) individuals were enrolled in the study, with 27 completing a follow-up assessment 12 months later. We identified eight variables reflecting different aspects of language that showed longitudinal decline in the FTD clinical syndrome subtypes and developed a novel composite score based on these variables. The resulting composite score demonstrated a significant effect of change over time, high test-retest reliability, and a correlation with standard scores on various other speech tasks. CONCLUSION Remote digital speech assessments have the potential to characterize speech and language abilities in individuals with FTD, reducing the burden of clinical assessments while providing a novel measure of speech and language abilities that is sensitive to disease and relevant to everyday function.
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Affiliation(s)
- Jessica Robin
- Winterlight Labs, Incorporated, Toronto, Ontario, Canada
| | - Mengdan Xu
- Winterlight Labs, Incorporated, Toronto, Ontario, Canada
| | | | - William Simpson
- Winterlight Labs, Incorporated, Toronto, Ontario, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | - Michael Ward
- Alector, Incorporated, San Francisco, California
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Chakrabarty M, Klooster N, Biswas A, Chatterjee A. The scope of using pragmatic language tests for early detection of dementia: A systematic review of investigations using figurative language. Alzheimers Dement 2023; 19:4705-4728. [PMID: 37534671 DOI: 10.1002/alz.13369] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Dementia cases are expected to rise to 81.1 million in 2040. Efforts are underway to develop diagnostic methods to facilitate early detection of the disease. Herein we review research findings focusing on pragmatic dysfunction in patients with dementia and evaluate the usefulness of assessing dementia and its progress with a battery of tests assessing figurative language skills. METHODS A total of 74,778 article titles were identified from EMBASE, PubMed, and Google Scholar databases. After systematic screening, 51 journal articles were selected for the final review. RESULT The review suggests that impaired figurative language might be a marker for early cognitive decline. Different forms of figurative language may be impaired at different stages of the disease and in different types of dementia involving different neuropathologies. CONCLUSION The use of pragmatic tests in combination with the existing diagnostic protocols might increase the probability of early diagnosis. HIGHLIGHTS Pragmatic impairment could be a marker of early cognitive impairment. Figurative language-an important pragmatic aspect-is disrupted in mild cognitive impairment (MCI) and early Alzheimer's disease (AD). Figurative language impairment might precede literal language impairment. Pragmatic tests could be more sensitive than standard neuropsychological tests. Inclusion of pragmatic tests in diagnostic guidelines might bolster early detection.
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Affiliation(s)
- Madhushree Chakrabarty
- Department of Neurology, Institute of Post Graduate Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Nathaniel Klooster
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA
- Hope College, Holland, Michigan, USA
| | - Atanu Biswas
- Department of Neurology, Institute of Post Graduate Medical Education & Research and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Anjan Chatterjee
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA
- Penn Center for Neuroaesthetics, University of Pennsylvania, Goddard Laboratories, Philadelphia, Pennsylvania, USA
- Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Samra K, MacDougall AM, Bouzigues A, Bocchetta M, Cash DM, Greaves CV, Convery RS, van Swieten JC, Seelaar H, Jiskoot L, Moreno F, Sanchez-Valle R, Laforce R, Graff C, Masellis M, Tartaglia MC, Rowe JB, Borroni B, Finger E, Synofzik M, Galimberti D, Vandenberghe R, de Mendonça A, Butler CR, Gerhard A, Ducharme S, Le Ber I, Tiraboschi P, Santana I, Pasquier F, Levin J, Otto M, Sorbi S, Rohrer JD, Russell LL. Language impairment in the genetic forms of behavioural variant frontotemporal dementia. J Neurol 2023; 270:1976-1988. [PMID: 36538154 PMCID: PMC10025186 DOI: 10.1007/s00415-022-11512-1] [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: 10/21/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Behavioural variant fronto-temporal dementia (bvFTD) is characterised by a progressive change in personality in association with atrophy of the frontal and temporal lobes. Whilst language impairment has been described in people with bvFTD, little is currently known about the extent or type of linguistic difficulties that occur, particularly in the genetic forms. METHODS Participants with genetic bvFTD along with healthy controls were recruited from the international multicentre Genetic FTD Initiative (GENFI). Linguistic symptoms were assessed using items from the Progressive Aphasia Severity Scale (PASS). Additionally, participants undertook the Boston Naming Test (BNT), modified Camel and Cactus Test (mCCT) and a category fluency test. Participants underwent a 3T volumetric T1-weighted MRI, with language network regional brain volumes measured and compared between the genetic groups and controls. RESULTS 76% of the genetic bvFTD cohort had impairment in at least one language symptom: 83% C9orf72, 80% MAPT and 56% GRN mutation carriers. All three genetic groups had significantly impaired functional communication, decreased fluency, and impaired sentence comprehension. C9orf72 mutation carriers also had significantly impaired articulation and word retrieval as well as dysgraphia whilst the MAPT mutation group also had impaired word retrieval and single word comprehension. All three groups had difficulties with naming, semantic knowledge and verbal fluency. Atrophy in key left perisylvian language regions differed between the groups, with generalised involvement in the C9orf72 group and more focal temporal and insula involvement in the other groups. Correlates of language symptoms and test scores also differed between the groups. CONCLUSIONS Language deficits exist in a substantial proportion of people with familial bvFTD across all three genetic groups. Significant atrophy is seen in the dominant perisylvian language areas and correlates with language impairments within each of the genetic groups. Improved understanding of the language phenotype in the main genetic bvFTD subtypes will be helpful in future studies, particularly in clinical trials where accurate stratification and monitoring of disease progression is required.
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Affiliation(s)
- Kiran Samra
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Amy M MacDougall
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Caroline V Greaves
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | | | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Lize Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia Universitary Hospital, San Sebastian, Spain
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Caroline Graff
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Bioclinicum, Karolinska Institutet, Solna, Sweden
- Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Daniela Galimberti
- Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
- University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Neurology Service, University Hospitals Leuven, Louvain, Belgium
- Leuven Brain Institute, KU Leuven, Louvain, Belgium
| | - Alexandre de Mendonça
- Laboratory of Neurosciences, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Christopher R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
- Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Essen, Germany
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, QC, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, AP-HP-Hôpital Pitié-Salpêtrière, Paris, France
- Centre de référence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP-Hôpital Pitié-Salpêtrière, Paris, France
- Département de Neurologie, AP-HP-Hôpital Pitié-Salpêtrière, Paris, France
- Reference Network for Rare Neurological Diseases (ERN-RND), Tübingen, Germany
| | | | - Isabel Santana
- University Hospital of Coimbra (HUC), Neurology Service, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Florence Pasquier
- Univ Lille, Lille, France
- Inserm 1172, Lille, France
- CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, Lille, France
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
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Tang SX, Hänsel K, Cong Y, Nikzad AH, Mehta A, Cho S, Berretta S, Behbehani L, Pradhan S, John M, Liberman MY. Latent Factors of Language Disturbance and Relationships to Quantitative Speech Features. Schizophr Bull 2023; 49:S93-S103. [PMID: 36946530 PMCID: PMC10031730 DOI: 10.1093/schbul/sbac145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND AND HYPOTHESIS Quantitative acoustic and textual measures derived from speech ("speech features") may provide valuable biomarkers for psychiatric disorders, particularly schizophrenia spectrum disorders (SSD). We sought to identify cross-diagnostic latent factors for speech disturbance with relevance for SSD and computational modeling. STUDY DESIGN Clinical ratings for speech disturbance were generated across 14 items for a cross-diagnostic sample (N = 334), including SSD (n = 90). Speech features were quantified using an automated pipeline for brief recorded samples of free speech. Factor models for the clinical ratings were generated using exploratory factor analysis, then tested with confirmatory factor analysis in the cross-diagnostic and SSD groups. The relationships between factor scores and computational speech features were examined for 202 of the participants. STUDY RESULTS We found a 3-factor model with a good fit in the cross-diagnostic group and an acceptable fit for the SSD subsample. The model identifies an impaired expressivity factor and 2 interrelated disorganized factors for inefficient and incoherent speech. Incoherent speech was specific to psychosis groups, while inefficient speech and impaired expressivity showed intermediate effects in people with nonpsychotic disorders. Each of the 3 factors had significant and distinct relationships with speech features, which differed for the cross-diagnostic vs SSD groups. CONCLUSIONS We report a cross-diagnostic 3-factor model for speech disturbance which is supported by good statistical measures, intuitive, applicable to SSD, and relatable to linguistic theories. It provides a valuable framework for understanding speech disturbance and appropriate targets for modeling with quantitative speech features.
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Affiliation(s)
- Sunny X Tang
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Glen Oaks, USA
| | - Katrin Hänsel
- Department of Laboratory Medicine, Yale University, New Haven, USA
| | - Yan Cong
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Glen Oaks, USA
| | - Amir H Nikzad
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Glen Oaks, USA
| | - Aarush Mehta
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Glen Oaks, USA
| | - Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, USA
| | - Sarah Berretta
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Glen Oaks, USA
| | - Leily Behbehani
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Glen Oaks, USA
| | - Sameer Pradhan
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, USA
| | - Majnu John
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Glen Oaks, USA
| | - Mark Y Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, USA
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9
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Geraudie A, Battista P, García AM, Allen IE, Miller ZA, Gorno-Tempini ML, Montembeault M. Speech and language impairments in behavioral variant frontotemporal dementia: A systematic review. Neurosci Biobehav Rev 2021; 131:1076-1095. [PMID: 34673112 DOI: 10.1016/j.neubiorev.2021.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
Although behavioral variant frontotemporal dementia (bvFTD) is classically defined by behavioral and socio-emotional changes, impairments often extend to other cognitive functions. These include early speech and language deficits related to the disease's core neural disruptions. Yet, their scope and clinical relevance remains poorly understood. This systematic review characterizes such disturbances in bvFTD, considering clinically, neuroanatomically, genetically, and neuropathologically defined subgroups. We included 181 experimental studies, with at least 5 bvFTD patients diagnosed using accepted criteria, comparing speech and language outcomes between bvFTD patients and healthy controls or between bvFTD subgroups. Results reveal extensive and heterogeneous deficits across cohorts, with (a) consistent lexico-semantic, reading & writing, and prosodic impairments; (b) inconsistent deficits in motor speech and grammar; and (c) relative preservation of phonological skills. Also, preliminary findings suggest that the severity of speech and language deficits might be associated with global cognitive impairment, predominantly temporal or fronto-temporal atrophy and MAPT mutations (vs C9orf72). Although under-recognized, these impairments contribute to patient characterization and phenotyping, while potentially informing diagnosis and management.
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Affiliation(s)
- Amandine Geraudie
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Neurology Department, Toulouse University Hospital, Toulouse, France
| | - Petronilla Battista
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA; Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Via Generale Nicola Bellomo, Bari, Italy
| | - Adolfo M García
- Global Brain Health Institute, University of California, San Francisco, USA; Universidad De San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Isabel E Allen
- Global Brain Health Institute, University of California, San Francisco, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA.
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10
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Geraudie A, Díaz Rivera M, Montembeault M, García AM. Language in Behavioral Variant Frontotemporal Dementia: Another Stone to Be Turned in Latin America. Front Neurol 2021; 12:702770. [PMID: 34447348 PMCID: PMC8383282 DOI: 10.3389/fneur.2021.702770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/12/2021] [Indexed: 12/03/2022] Open
Abstract
Beyond canonical deficits in social cognition and interpersonal conduct, behavioral variant frontotemporal dementia (bvFTD) involves language difficulties in a substantial proportion of cases. However, since most evidence comes from high-income countries, the scope and relevance of language deficits in Latin American bvFTD samples remain poorly understood. As a first step toward reversing this scenario, we review studies reporting language measures in Latin American bvFTD cohorts relative to other groups. We identified 24 papers meeting systematic criteria, mainly targeting phonemic and semantic fluency, naming, semantic processing, and comprehension skills. The evidence shows widespread impairments in these domains, often related to overall cognitive disturbances. Some of these deficits may be as severe as in other diseases where they are more widely acknowledged, such as Alzheimer's disease. Considering the prevalence and informativeness of language deficits in bvFTD patients from other world regions, the need arises for more systematic research in Latin America, ideally spanning multiple domains, in diverse languages and dialects, with validated batteries. We outline key challenges and pathways of progress in this direction, laying the ground for a new regional research agenda on the disorder.
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Affiliation(s)
- Amandine Geraudie
- Neurology Department, Toulouse University Hospital, Toulouse, France
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Mariano Díaz Rivera
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- Agencia Nacional de Promoción Científica y Tecnológica, Buenos Aires, Argentina
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Adolfo M. García
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Faculty of Education, National University of Cuyo, Mendoza, Argentina
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
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11
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Baraldi MA, Avanzino L, Pelosin E, Domaneschi F, Di Paola S, Lagravinese G. Pragmatic abilities in early Parkinson's disease. Brain Cogn 2021; 150:105706. [PMID: 33761383 DOI: 10.1016/j.bandc.2021.105706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/01/2022]
Abstract
Language impairment in Parkinson's disease (PD) has been investigated at different levels of linguistic skills. Only a few studies dealt with pragmatic abilities in PD, and these suggest an impairment of pragmatic skills, which might affect quality of life. However, previous studies enrolled patients with heterogeneous symptom severity. The goal of this study is twofold: first, to investigate whether pragmatic skills are compromised at the early stage of PD; second, to explore whether an early pragmatic impairment is explained by a decay of a specific cognitive function. We assessed pragmatic abilities (discourse production, comprehension of narratives, humour, and figurative language), and a cluster of cognitive functions (memory, verbal fluency, inhibition, shifting, and ToM) in a sample of early PD patients and a group of age-matched healthy controls. Early PD patients showed impaired general pragmatic skills (the ability to perform different pragmatic tasks in language production and comprehension), as well as a deficit in the production and comprehension individual scores. Our results suggest that good general cognitive skills (a good overall cognitive level) and high education support patients' pragmatic competence. Inhibitory processes have been found to predict patients' ability to understand figurative language, such as metaphors, and this might be related to frontal lobe dysfunctions.
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Affiliation(s)
- Maria Alice Baraldi
- Department of Educational Sciences (DISFOR), Psychology Unit, Corso Podestà 2, University of Genoa, 16128 Genoa, Italy.
| | - Laura Avanzino
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Experimental Medicine (DIMES), Section of Human Physiology, Via Leon Battista Alberti 2, University of Genoa, 16132 Genoa, Italy.
| | - Elisa Pelosin
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), Largo Daneo 3, University of Genoa, 16132 Genoa, Italy.
| | - Filippo Domaneschi
- Laboratory of Language and Cognition, Via Balbi 30, University of Genoa, 16126 Genoa, Italy.
| | - Simona Di Paola
- Laboratory of Language and Cognition, Via Balbi 2, University of Genoa, 16126 Genoa, Italy.
| | - Giovanna Lagravinese
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), Largo Daneo 3, University of Genoa, 16132 Genoa, Italy.
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