Objectives: Ipofluency, phonological errors and mild agrammatism are the microlinguistic markers of the logopenic variant-Primary Progressive Aphasia (lvPPA); it is less clear if patients may also experience pragmatic difficulties in the construction of coherent narratives. The present study aimed to describe narrative discourse impairment in patients with lvPPA. Materials: 18 lvPPA patients (mean age 74,56 ± 7,91; 11 males, 7 females) and 18 matched healthy controls (HCs) were enrolled. Speech samples were recorded and transcribed. Method: Connected speech was analyzed according to Marini et al.’s criteria (2011) focusing on microlinguistic (speech rate; well-formed sentence ratio; principal/subordinate clause ratio; closed/open class word ratio; % phonemic and % semantic paraphasias; % fragments) and macrolinguistic (mean length of utterance (MLU); % cohesive errors; % local and global coherence errors, informativeness) measures. A preliminary two-step cluster analysis was conducted to confirm the clustering of HCs and lvPPA patients on the whole performance. A Principal Component Analysis (PCA) was then performed to identify factors explaining measures of micro and macrolinguistic deficits on patients only; factor scores were entered into a cluster analysis to evaluate the presence of different subgroups. Differences between subgroups were tested by one-way ANOVAs. Results: lvPPA patients were significantly different from HCs in both micro and macrolinguistic measures. The PCA performed on patients only (Bartlett’s χ2 = 111.83, p < .0001) showed a first factor accounting for production of % semantic paraphasias, well-formed sentence ratio, MLU, closed/open class words ratio; a second factor accounting for production of % cohesive errors, principal/subordinate clause ratio, informativeness and a third factor for the production of % global coherence errors. The two-step cluster analysis on factorial scores showed a 3-cluster solution. A first cluster (2 cases) had lower speech rate, higher % phonemic and semantic paraphasias, lower % global coherence errors and lower informativeness compared with the second (7 cases); a third cluster (9 cases) had higher % global coherence errors and lower informativeness than the second. Discussion: The cluster analysis displayed subgroups of patients with both micro and macrolinguistic distinctive profiles. Disorders of macrolinguistic components in lvPPA are consistent with a more diffuse cognitive impairment (extending to short-term memory, semantic memory and episodic memory) due to the subtending Alzheimer’s type pathology. Conclusion: Our findings confirm that, at variance with semantic dementia and primary nonfluent aphasia, lvPPA does not correspond to a specific aphasic variant and that also pragmatic features may differentiate subgroups.

Di Tella, S., Ciccarelli, N., Brita, A. C., Rossi, P., Silveri, M. C., Narrative discourse in logopenic variant of PPA: a multi-level approach, Abstract de <<Congress of the Italian Neurological Society>>, (Naples, Italy, 14-17 October 2017 ), <<NEUROLOGICAL SCIENCES>>, 2017; 38 (Supplement): S35-S35 [http://hdl.handle.net/10807/120983]

Narrative discourse in logopenic variant of PPA: a multi-level approach

Di Tella;Sonia; Ciccarelli;Nicoletta; Brita;Anna Clelia; Rossi;Paola; Silveri
2017

Abstract

Objectives: Ipofluency, phonological errors and mild agrammatism are the microlinguistic markers of the logopenic variant-Primary Progressive Aphasia (lvPPA); it is less clear if patients may also experience pragmatic difficulties in the construction of coherent narratives. The present study aimed to describe narrative discourse impairment in patients with lvPPA. Materials: 18 lvPPA patients (mean age 74,56 ± 7,91; 11 males, 7 females) and 18 matched healthy controls (HCs) were enrolled. Speech samples were recorded and transcribed. Method: Connected speech was analyzed according to Marini et al.’s criteria (2011) focusing on microlinguistic (speech rate; well-formed sentence ratio; principal/subordinate clause ratio; closed/open class word ratio; % phonemic and % semantic paraphasias; % fragments) and macrolinguistic (mean length of utterance (MLU); % cohesive errors; % local and global coherence errors, informativeness) measures. A preliminary two-step cluster analysis was conducted to confirm the clustering of HCs and lvPPA patients on the whole performance. A Principal Component Analysis (PCA) was then performed to identify factors explaining measures of micro and macrolinguistic deficits on patients only; factor scores were entered into a cluster analysis to evaluate the presence of different subgroups. Differences between subgroups were tested by one-way ANOVAs. Results: lvPPA patients were significantly different from HCs in both micro and macrolinguistic measures. The PCA performed on patients only (Bartlett’s χ2 = 111.83, p < .0001) showed a first factor accounting for production of % semantic paraphasias, well-formed sentence ratio, MLU, closed/open class words ratio; a second factor accounting for production of % cohesive errors, principal/subordinate clause ratio, informativeness and a third factor for the production of % global coherence errors. The two-step cluster analysis on factorial scores showed a 3-cluster solution. A first cluster (2 cases) had lower speech rate, higher % phonemic and semantic paraphasias, lower % global coherence errors and lower informativeness compared with the second (7 cases); a third cluster (9 cases) had higher % global coherence errors and lower informativeness than the second. Discussion: The cluster analysis displayed subgroups of patients with both micro and macrolinguistic distinctive profiles. Disorders of macrolinguistic components in lvPPA are consistent with a more diffuse cognitive impairment (extending to short-term memory, semantic memory and episodic memory) due to the subtending Alzheimer’s type pathology. Conclusion: Our findings confirm that, at variance with semantic dementia and primary nonfluent aphasia, lvPPA does not correspond to a specific aphasic variant and that also pragmatic features may differentiate subgroups.
Inglese
Di Tella, S., Ciccarelli, N., Brita, A. C., Rossi, P., Silveri, M. C., Narrative discourse in logopenic variant of PPA: a multi-level approach, Abstract de <<Congress of the Italian Neurological Society>>, (Naples, Italy, 14-17 October 2017 ), <<NEUROLOGICAL SCIENCES>>, 2017; 38 (Supplement): S35-S35 [http://hdl.handle.net/10807/120983]
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