Linguistic markers in Parkinson’s disease (Smith et al., 2018)

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 S1. Baseline characteristics of Parkinson’s disease (PD) with mild cognitive impairment (MCI) and normal cognition (NC). Supplemental Material S2. Correlations between clinical, neuropsychological, and linguistic biomarkers and word-finding difficulty (WFD) symptoms.Supplemental Material S3. Transcription conventions.Smith, K. M., Ash, S., Xie, S. X., & Grossman, M. (2018). Evaluation of linguistic markers of word-finding difficulty and cognition in Parkinson’s disease. Journal of Speech, Language, and Hearing Research, 61, 1691–1699. https://doi.org/10.1044/2018_JSLHR-L-17-0304

目的：帕金森病（PD）患者日常对话中常见的早期认知症状，如找词困难（WFD），但研究受限于缺乏可行的量化测量方法。语言分析，集中于言语中的停顿，可能产生帕金森病中认知和沟通障碍的指标。本研究旨在评估半结构化言语中的语言标记与WFD症状及认知功能之间的关系。方法：使用Praat软件分析了53例无痴呆的帕金森病患者和23例老年对照者的“饼干盗窃”图片描述的语音录音。进行了蒙特利尔认知评估（MoCA；Nasreddine等，2005）、类别命名流畅性和命名对抗测试。完成了评估WFD症状和认知日常生活活动工具性问卷。我们通过皮尔逊相关性和多元回归模型确定了以下关系：（a）停顿长度和位置，（b）MoCA评分，以及（c）WFD症状。结果：与对照者相比，帕金森病患者在话语中有更多停顿，每分钟单词数较少，完整句子比例较低。帕金森病-轻度认知障碍与正常认知之间的停顿存在显著差异（p < .001）。每分钟单词数和完整句子比例在多元回归模型中预测MoCA。动词前的停顿与患者报告的WFD症状严重程度相关（p = .006）。结论：包括话语中的停顿在内的语言标记区分了具有轻度认知症状的帕金森病患者与老年对照者。这些标记与痴呆发生前的整体认知功能相关。动词前的停顿和语法标记可能指示早期认知症状，如WFD，这些症状可能干扰功能性沟通。补充材料S1：帕金森病（PD）轻度认知障碍（MCI）和正常认知（NC）的基线特征。补充材料S2：临床、神经心理学和语言生物标志物与找词困难（WFD）症状之间的相关性。补充材料S3：转录规范。Smith, K. M.，Ash, S.，Xie, S. X.，& Grossman, M.（2018）。帕金森病中找词困难和认知的语言标记评估。言语、语言和听力研究杂志，61，1691–1699。https://doi.org/10.1044/2018_JSLHR-L-17-0304