Connected speech production in three variants of primary progressive aphasia
Connected speech production in three variants of primary progressive aphasia
复制标题
DOI：
10.1093/brain/awq129
复制
发表时间：
2010-07-01
期刊：
影响因子：
14.5
通讯作者：
Gorno-Tempini, Maria Luisa
中科院分区：
文献类型：
--
作者：
Wilson, Stephen M.;Henry, Maya L.;Gorno-Tempini, Maria Luisa
原发性进行性失语症是一种临床综合征，定义为孤立于言语和/或语言的进行性缺陷，并可根据运动言语、语言和认知特征分为非流利、语义和逻辑开放变体。原发性进行性失语症患者的连接语音通常被简单地分为“流利”或“不流利”，然而流利性是一个多维结构，包括诸如语速、短语长度、发音敏捷性和句法结构等特征，这些特征并不总是受到平行影响。在这项研究中，我们的第一个目标是提高连接语音生产的表征在每一个变异的原发性进行性失语症，通过量化语音输出沿着一些运动的语音和语言的维度同时。其次，我们的目的是确定神经解剖学相关的变化沿着这些不同的尺寸。我们记录、转录和分析了50例原发性进行性失语患者的语音样本，沿着神经退行性疾病和正常对照组。患者进行了磁共振成像扫描，并使用基于体素的形态测量来识别萎缩与运动语言和语言特征显著相关的区域。非流利变体患者的语音样本的特点是速度慢，失真，句法错误和复杂性降低。与此相反，患者的语义变异表现出正常率和很少的语音或句法错误，但表现出封闭类词，代词和动词的比例增加，和更高的频率名词，反映词汇检索缺陷。在患者的logopenic变量，语速（一个常见的代理流畅性）是中间的其他两个变量之间，但失真和句法错误是不太常见的比在非流畅的变体，而词汇访问比语义变体受损。言语率降低与前、后语言区的广泛萎缩有关，但具体缺陷与解剖学相关性更强。额叶与运动言语和句法过程，前颞区和下颞区与词汇检索，后颞区与语音错误和其他几种类型的中断流畅性。这些研究结果表明，连接语音生产的多维量化是必要的，以充分表征每个主要进行性失语症变体的语音模式之间的差异，并揭示连接语音的特定方面和语音生产的神经网络的特定组件之间的关联。
Primary progressive aphasia is a clinical syndrome defined by progressive deficits isolated to speech and/or language, and can be classified into non-fluent, semantic and logopenic variants based on motor speech, linguistic and cognitive features. The connected speech of patients with primary progressive aphasia has often been dichotomized simply as 'fluent' or 'non-fluent', however fluency is a multidimensional construct that encompasses features such as speech rate, phrase length, articulatory agility and syntactic structure, which are not always impacted in parallel. In this study, our first objective was to improve the characterization of connected speech production in each variant of primary progressive aphasia, by quantifying speech output along a number of motor speech and linguistic dimensions simultaneously. Secondly, we aimed to determine the neuroanatomical correlates of changes along these different dimensions. We recorded, transcribed and analysed speech samples for 50 patients with primary progressive aphasia, along with neurodegenerative and normal control groups. Patients were scanned with magnetic resonance imaging, and voxel-based morphometry was used to identify regions where atrophy correlated significantly with motor speech and linguistic features. Speech samples in patients with the non-fluent variant were characterized by slow rate, distortions, syntactic errors and reduced complexity. In contrast, patients with the semantic variant exhibited normal rate and very few speech or syntactic errors, but showed increased proportions of closed class words, pronouns and verbs, and higher frequency nouns, reflecting lexical retrieval deficits. In patients with the logopenic variant, speech rate (a common proxy for fluency) was intermediate between the other two variants, but distortions and syntactic errors were less common than in the non-fluent variant, while lexical access was less impaired than in the semantic variant. Reduced speech rate was linked with atrophy to a wide range of both anterior and posterior language regions, but specific deficits had more circumscribed anatomical correlates. Frontal regions were associated with motor speech and syntactic processes, anterior and inferior temporal regions with lexical retrieval, and posterior temporal regions with phonological errors and several other types of disruptions to fluency. These findings demonstrate that a multidimensional quantification of connected speech production is necessary to characterize the differences between the speech patterns of each primary progressive aphasic variant adequately, and to reveal associations between particular aspects of connected speech and specific components of the neural network for speech production.