Connected speech as a marker of disease progression in autopsy-proven Alzheimer's disease.
Connected speech as a marker of disease progression in autopsy-proven Alzheimer's disease.
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DOI：
10.1093/brain/awt269
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发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Garrard P
中科院分区：
文献类型：
--
作者：
Ahmed S;Haigh AM;de Jager CA;Garrard P
虽然情景记忆困难的隐伏史是阿尔茨海默病的典型症状，但详细的神经心理学分析经常显示其他认知领域的缺陷，包括语言。我们小组之前的研究表明，在典型的阿尔茨海默病的早期阶段，语言变化可能反映在连接的语言产生上。本研究的目的是确定连接语言的特征，这些特征可用于检查阿尔茨海默病损伤的纵向概况。在一项关于衰老和痴呆症的纵向队列研究中，研究人员从15名前参与者那里获得了连接语言的样本，这些参与者在生前被诊断出患有阿尔茨海默病，并在死后得到证实。所有患者在转变为可能的阿尔茨海默病状态之前的6至18个月内均符合轻度认知障碍的临床和神经心理学标准。在这些患者的一个子集中，神经心理学数据是可用的，无论是在转化为阿尔茨海默病的时候，还是在疾病严重程度从轻度发展到中度之后。这些患者的连接语音样本在疾病后期进行了检查。使用Cookie盗窃图片描述任务获得口语样本。使用句法复杂性、词汇内容、语音生成、流畅性和语义内容对样本进行分析。个案分析显示，在阿尔茨海默病的前症阶段，语言的细微变化是明显的，三分之二的轻度认知障碍患者在连接语言方面表现出显著但异质性的变化。然而，轻度认知障碍阶段的损害并不一定导致轻度或中度疾病阶段的缺陷，这表明非语言影响了某些方面的表现。对这些措施的后续检查显示，在句法复杂性、语义和词汇内容方面，疾病的三个阶段有显著的线性趋势。研究结果表明，首先，在一部分阿尔茨海默病患者的前症阶段就可以检测到语言完整性的渐进式破坏，其次，语义和词汇内容以及句法复杂性的测量最能捕捉到在疾病的连续临床阶段中语言障碍的整体进展。识别前驱阿尔茨海默病的疾病特异性语言障碍可以增强临床医生区分可能的阿尔茨海默病与可归因于衰老的变化的能力，而纵向评估可以为治疗试验中的疾病监测提供一种简单的方法。
Although an insidious history of episodic memory difficulty is a typical presenting symptom of Alzheimer’s disease, detailed neuropsychological profiling frequently demonstrates deficits in other cognitive domains, including language. Previous studies from our group have shown that language changes may be reflected in connected speech production in the earliest stages of typical Alzheimer’s disease. The aim of the present study was to identify features of connected speech that could be used to examine longitudinal profiles of impairment in Alzheimer’s disease. Samples of connected speech were obtained from 15 former participants in a longitudinal cohort study of ageing and dementia, in whom Alzheimer’s disease was diagnosed during life and confirmed at post-mortem. All patients met clinical and neuropsychological criteria for mild cognitive impairment between 6 and 18 months before converting to a status of probable Alzheimer’s disease. In a subset of these patients neuropsychological data were available, both at the point of conversion to Alzheimer’s disease, and after disease severity had progressed from the mild to moderate stage. Connected speech samples from these patients were examined at later disease stages. Spoken language samples were obtained using the Cookie Theft picture description task. Samples were analysed using measures of syntactic complexity, lexical content, speech production, fluency and semantic content. Individual case analysis revealed that subtle changes in language were evident during the prodromal stages of Alzheimer’s disease, with two-thirds of patients with mild cognitive impairment showing significant but heterogeneous changes in connected speech. However, impairments at the mild cognitive impairment stage did not necessarily entail deficits at mild or moderate stages of disease, suggesting non-language influences on some aspects of performance. Subsequent examination of these measures revealed significant linear trends over the three stages of disease in syntactic complexity, semantic and lexical content. The findings suggest, first, that there is a progressive disruption in language integrity, detectable from the prodromal stage in a subset of patients with Alzheimer’s disease, and secondly that measures of semantic and lexical content and syntactic complexity best capture the global progression of linguistic impairment through the successive clinical stages of disease. The identification of disease-specific language impairment in prodromal Alzheimer’s disease could enhance clinicians’ ability to distinguish probable Alzheimer’s disease from changes attributable to ageing, while longitudinal assessment could provide a simple approach to disease monitoring in therapeutic trials.
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影响因子：
3.3
作者：
Forbes-McKay, KE;Venneri, A
通讯作者：
Venneri, A
DOI：
10.1044/jshr.3702.399
发表时间：
1994-04-01
期刊：
JOURNAL OF SPEECH AND HEARING RESEARCH
影响因子：
--
作者：
BROOKSHIRE, RH;NICHOLAS, LE
通讯作者：
NICHOLAS, LE
影响因子：
3.2
作者：
Garrard, P;Ralph, MAL;Hodges, JR
通讯作者：
Hodges, JR
影响因子：
9.9
作者：
MCKHANN, G;DRACHMAN, D;STADLAN, EM
通讯作者：
STADLAN, EM
影响因子：
2.4
作者：
Bondi, MW;Serody, AB;Salmon, DP
通讯作者：
Salmon, DP