A 'Mini Linguistic State Examination' to classify primary progressive aphasia.
A 'Mini Linguistic State Examination' to classify primary progressive aphasia.
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DOI：
10.1093/braincomms/fcab299
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发表时间：
2022
影响因子：
4.8
通讯作者：
Garrard P
中科院分区：
文献类型：
--
作者：
Patel N;Peterson KA;Ingram RU;Storey I;Cappa SF;Catricala E;Halai A;Patterson KE;Lambon Ralph MA;Rowe JB;Garrard P
几乎没有可用的方法来定性评估原发性进行性失语患者。通常采用的方法是耗时的、有限的准确性或旨在评估不同的患者群体。本文介绍了一种新的临床测试-迷你语言状态检查-它的独特设计使临床医生能够评估和细分原发进行性失语的经典性和混合性表现。一种新的评估方法(错误分类)的采用极大地扩大了可以从一组标准语言任务中获得的临床信息，并允许定义五维轮廓。54名患者和30名匹配的对照组被纳入研究。语言能力的五个领域(运动语音、语音、语义、句法和工作记忆)通过一系列11种不同的语言分析进行了评估。使用随机森林分类来评估预测原发性进行性失语症亚型的诊断准确性，并创建决策树作为临床分类的指导。随机森林预测模型总体准确率为96%(对数变体的准确率为92%，语义变体的准确率为93%，非流畅变体的准确率为98%)。得到的决策树对91%的参与者进行了正确的分类，这些参与者的数据没有包括在训练集中。迷你语言状态考试是一种新的认知测试，它结合了一种新颖而强大但又直接的评分方法。对其诊断准确性的严格评估证实了原发性进行性失语综合征与临床黄金标准诊断的良好匹配。临床医生采用微型语言状态检查将对临床描述患者的一致性和统一性产生决定性影响。它还将促进基于队列的研究的筛查，包括未来的治疗试验，并适用于描述、量化和监测其他大脑疾病的语言缺陷。Patel等人。提出了一种新的认知测试，用于对原发性进行性失语症进行分类，并在与语言障碍相关的其他脑部疾病中表征语言缺陷。迷你语言状态检查是简短、准确和可重复性的，将有助于在各种临床环境中描述语言障碍。
There are few available methods for qualitatively evaluating patients with primary progressive aphasia. Commonly adopted approaches are time-consuming, of limited accuracy or designed to assess different patient populations. This paper introduces a new clinical test—the Mini Linguistic State Examination—which was designed uniquely to enable a clinician to assess and subclassify both classical and mixed presentations of primary progressive aphasia. The adoption of a novel assessment method (error classification) greatly amplifies the clinical information that can be derived from a set of standard linguistic tasks and allows a five-dimensional profile to be defined. Fifty-four patients and 30 matched controls were recruited. Five domains of language competence (motor speech, phonology, semantics, syntax and working memory) were assessed using a sequence of 11 distinct linguistic assays. A random forest classification was used to assess the diagnostic accuracy for predicting primary progressive aphasia subtypes and create a decision tree as a guide to clinical classification. The random forest prediction model was 96% accurate overall (92% for the logopenic variant, 93% for the semantic variant and 98% for the non-fluent variant). The derived decision tree produced a correct classification of 91% of participants whose data were not included in the training set. The Mini Linguistic State Examination is a new cognitive test incorporating a novel and powerful, yet straightforward, approach to scoring. Rigorous assessment of its diagnostic accuracy confirmed excellent matching of primary progressive aphasia syndromes to clinical gold standard diagnoses. Adoption of the Mini Linguistic State Examination by clinicians will have a decisive impact on the consistency and uniformity with which patients can be described clinically. It will also facilitate screening for cohort-based research, including future therapeutic trials, and is suitable for describing, quantifying and monitoring language deficits in other brain disorders. Patel et al. present a new cognitive test for classifying primary progressive aphasia and characterizing language deficits in other brain disorders associated with language impairment. The Mini Linguistic State Examination is brief, accurate and reproducible, and will be useful in profiling language disorders in a variety of clinical settings.