Language Battery Research Articles

Assessing Relative Linguistic Impairment With Model-Based Item Selection.

A picture naming test is presented that reveals impairment to specific mechanisms involved in the naming process, using accuracy scores on curated item sets. A series of psychometric validation experiments are reported. Using a computational model that enables estimation of item difficulty at the lexical and sublexical stages of word retrieval, two complimentary sets of items were constructed that challenge the respective psycholinguistic levels of representation. The difference in accuracy between these item sets yields the relative linguistic impairment (RLI) score. In a cohort of 91 people with chronic left-hemisphere stroke who enrolled in a clinical trial for anomia, we assessed psychometric properties of the RLI score and then used the new scale to make predictions about other language behaviors, lesion distributions, and functional activation during naming. RLI scores had adequate psychometric properties for clinical significance. RLI scores contained predictive information about spontaneous speech fluency, over and above accuracy. A dissociation was observed between performance on the RLI item sets and performance on the subtests of an independent language battery. Sublexical RLI was significantly associated with apraxia of speech and with lesions encompassing perisylvian regions, while lexical RLI was associated with lesions to deep white matter. The RLI construct was reflected in functional brain activity during naming, independent of overall accuracy, with a respective shift of activation between dorsal and ventral networks responsible for different aspects of word retrieval. The RLI assessment satisfies the psychometric requirements to serve as a useful clinical measure.

Assessment and theoretical interpretation of spoken discourse and cognitive skills in two adolescents with acquired brain injury

Purpose Although discourse assessment is recommended, few tools exist for adolescent acquired brain injury (ABI) and few theories describe the contribution of cognition to discourse impairment. This study explored whether a novel discourse protocol can identify difficulties following ABI and whether a discourse processing model provides a useful account of impairment. Method Using a case-control design, two adolescent males with moderate ABI (12 and 14 years) were compared to a neurotypical sample on a range of language and cognitive assessments. Patterns in performance were interpreted using a theoretical model. Participants completed a standardised omnibus language assessment, discourse assessment, and battery of cognitive tasks. Result Analyses revealed significant differences in discourse and cognition between adolescents with and without ABI. No impairment was detected on a standardised language assessment. Patterns in discourse and cognition aligned with a contemporary model of discourse processing. Conclusion Participants with ABI demonstrated discourse deficits relative to the neurotypical reference sample. The findings demonstrate the value of discourse sampling across multiple genres and analysis of microlinguistic to superstructural features. A structure-building framework (SBF) model, originating in schizophrenia, provides a promising theory with which to interpret discourse impairment and has the potential to inform intervention for discourse in ABI.

STUDY THE RELATIONSHIP BETWEEN THE COGNITIVE ASPECT OF THEORY OF MIND AND UNDERSTANDING IN ORAL LANGUAGE IN ALZHEIMER'S PATIENTS DURING THE MIDDLE STAGE OF THE DISEASE

The ability to infer internal mental states through the behavior is related to the understanding of implicit language statements in interactive situations where the speaker’s intention is public.This study looked at that relationship by answering whether this association persists during aging and after Alzheimer’s. Apply some of the terms of the Theory of mind (Toma) battery and the Oral Language (OLTA) battery designed for the adult. A group of5 individuals with Alzheimer's disease during the middle stage. The results found that the impact relationship is not limited to the group of individuals below the age of maturity, but continues into old age. it would explain the nature of language and cognitive disorders in understanding metaphors such as folk proverbs and the attribution of mental states either through behavior or through language in intermediate Alzheimer’s patients. Keywords:Cognitive side, theory of mind, understanding, oral language, Alzheimer's.

Interpretation of Metaphors and Similarities by Individuals With Cerebellar Lesions

Objective: The cerebellum participates in both the coordination of motor activities and the regulation of mental processes. The symptoms of cerebellar damage are diverse, relatively non-specific, and difficult to systematize. Aim of the study: The aim of this exploratory study was to conduct a neuropsychological diagnosis of hypothetical disorders of selected (meta)linguistic and cognitive processes that are involved in solving problems containing metaphors and similarities. The epidemiology, severity, clinical specificity, and sociodemographic correlates of the analyzed disorders were characterized. Method: The study involved 25 adults with isolated cerebellar injury, most often of vascular origin. Three tests were used: the Polish version of the WAIS-R Similarities Subtest (PL) and two metaphor processing tests from the Polish version of the Right Hemisphere Language Battery (RHLB-PL), i.e. the Written Metaphor Test (TMP) and the Written Metaphor Explanation Test (TWMP). At the outset, the mean values and standard deviations were calculated for the whole group. In addition, each patient's test scores were assessed separately based on the data and norms included in the test manuals. Individual raw scores were replaced with converted scores and expressed in percentiles (similarities subtest) or on a sten scale (metaphor tests). Results: The performance on the WAIS Similarities Subtest was below average in the whole group, with 9 subjects having significant problems with solving the subtest. In turn, the score in the TWMP was determined in the range of 5–6 sten. Although the group’s overall performance in the TWMP did not differ from the norm, the result scored by nearly half of the subjects did not exceed 4 sten. In comparison, the average score on the TMP was relatively high, and low results (<4 sten) were obtained by only 4 patients. An estimated profile analysis (based on the pattern of all test results) showed intra- and inter-individual differences which were clinically illustrated by heterogeneous, often selective disorders of the examined functions. The sociodemographic correlates of test results were age and education. Conclusions: In the majority of patients, various cognitive deficits were implicated in disorders associated with solving problems that contain metaphors and similarities. Disorders in purposeful associative thinking, including inference by analogy and interpretation and verbalization of concepts, were predominant, whereas linguistic knowledge, including comprehension of figurative meanings, was generally unaffected.

Validity and satisfaction in telehealth aphasia assessment: videoconference administration of the Comprehensive Aphasia Test-Hungarian

ABSTRACT Background The demand for telehealth aphasia assessment is increasing, yet only a limited number of instruments’ validity and feasibility in telehealth have been evaluated. The Comprehensive Aphasia Test (CAT) is a widely available language test with established psychometric properties in several languages, including Hungarian. Aims The current study aimed to evaluate the validity of administering the Hungarian version of the CAT (CAT-H) via videoconference and explore the satisfaction of people with aphasia (PWA) with videoconference assessment compared to in-person assessment. Methods & Procedures Twelve PWA with left hemisphere stroke (mean age = 50.83 years, mean post-onset = 19 months), exhibiting mild-to-moderate aphasia, completed both in-person and videoconference assessments using the CAT-H Language Battery. The study used a comparison design, incorporating elements of counterbalancing and blinding. The assessments were conducted by speech-language pathologists (SLPs), with one person leading the in-person assessment and another leading the videoconference assessment for each participant. The order of administration (in-person or videoconference) was counterbalanced across participants. SLPs leading the second assessments were blind to the results of the first assessments. One key adjustment for the videoconference assessment was the utilisation of the screen sharing and/or control sharing features within the videoconferencing software. Participants also filled out a satisfaction questionnaire after each assessment and expressed their preference between the two assessment methods at the end of the study. Intraclass correlation coefficients (ICCs) were calculated to compare the CAT-H modality summary scores and the CAT-H language battery score between in-person and videoconference assessments. Outcomes & Results There was good-to-excellent agreement between in-person and videoconference assessments, with ICCs ranging from 0.80 to 0.96 (p < 0.001) for the CAT-H modalities and an ICC of 0.97 for the CAT-H language battery score. At the individual level, minor inconsistencies were observed in the language battery score between the two assessments. Participants reported high satisfaction with both assessment methods, with satisfaction levels for the videoconference assessment being comparable to those for the in-person assessment. While the majority of participants did not exhibit a preference between the two methods in terms of understanding the clinician, approximately half of them favoured the in-person assessment for expressing themselves and comfort. Conclusions Obtained results suggest that the CAT-H can be effectively administered via videoconference, offering a viable alternative to in-person assessment when necessary. Future studies should replicate these findings with a larger and more diverse study sample, involving participants with moderately severe and severe aphasia.

Language impairment in sporadic and familial (type 8) amyotrophic lateral sclerosis: A comparative study.

Language is frequently affected in patients with sporadic amyotrophic lateral sclerosis (sALS), with reduced performance in naming, syntactic comprehension, grammatical expression, and orthographic processing. However, the language profile of patients with familial type 8 ALS (ALS8), linked to p.P56S VAPB mutation, remains unclear. We investigated language in patients with ALS8 by examining their auditory comprehension and verbal production. We included three groups of participants: (1) patients with sALS (n = 20), (2) patients with familial ALS8 (n = 22), and (3) healthy controls (n = 21). The groups were matched for age, sex, and education level. All participants underwent a comprehensive language battery, including the Boston Diagnostic Aphasia Examination, the reduced Token test, letter fluency, categorical fluency (animals), word definition from the Cambridge Semantic Memory Research Battery, and a narrative discourse analysis. Participants also were evaluated using Addenbrooke's Cognitive Exam-Revised Version, the Hospital Anxiety and Depression Scale, and the ALS Functional Rating Scale-Revised. Compared to controls, sALS and ALS8 patients had impaired performance on oral (syntactic and phonological processing) comprehension and inappropriate discourse cohesion. sALS and ALS8 did not differ in any language measure. There was no correlation between language scores and functional and psychiatric scales. ALS8 patients exhibit language deficits that are independent of motor features. These findings are consistent with the current evidence suggesting that ALS8 has prominent non-motor features.

Guidelines and recommendations for cross-linguistic aphasia assessment: a review of 10 years of comprehensive aphasia test adaptations

ABSTRACT Background Standardised aphasia assessment tools may not always be available in a variety of languages, posing challenges for speech and language therapists to adequately assess and diagnose aphasia in speakers of those languages. In 2013, Working Group 2 (WG2) Aphasia Assessment & Outcomes, part of the Collaboration of Aphasia Trialists network, was formed with the purpose of developing reliable and valid aphasia assessment tools and their cross-linguistic adaptations. Over the past decade, WG2 has undertaken important adaptation projects, including the cross-linguistic adaptation of the Comprehensive Aphasia Test (CAT; Swinburn et al., 2004). Aims This review aims to achieve three objectives: (a) describe the adaptation procedure of the CAT within WG2, (b) summarise common guidelines and recommendations for future adaptations, and (c) provide concrete solutions for specific cross-linguistic and cross-cultural challenges encountered during the adaptation and validation procedures of the CAT. Methods Between 2013 and 2023, WG2 employed a committee approach and fully adapted the CAT into Catalan, Croatian, Dutch, French, Hungarian, Norwegian, Spanish, and Turkish. Further adaptations are in progress for Arabic (Moroccan), Basque, Cantonese Chinese, German, Greek, Icelandic, Lithuanian, Serbian, Slovenian and Swedish. The review comprehensively addresses the linguistic/cultural adaptation and validation procedure for the three components of the battery: the Cognitive screening, the Language battery and the Aphasia Impact Questionnaire. Critical outcomes and some best practice recommendations from psychometric norming and piloting are also discussed. Outcomes and results This review builds upon prior work (Fyndanis et al., 2017) and serves as a practical guide for researchers and clinicians undertaking cross-linguistic adaptations of the CAT, with specific conclusions and recommendations drawn from WG2’s adaptations in 19 languages with diverse typological properties. Building on the work exemplified in this paper, future initiatives can direct their efforts towards adapting the CAT for PWA from different linguistic backgrounds for whom validated assessment instruments may be unavailable. This can be achieved through rigorous systematic adaptation procedures for the establishment of comparable language versions of this tool, valuable for various clinical applications. Such endeavours have the potential to provide access to valuable shared datasets for their use across international aphasia trials, and for comparable clinical work within the aphasiology community.

Language impairments in seropositive and seronegative autoimmune encephalitis

Background and objectiveAutoimmune encephalitis (AE) is a rare neuroinflammatory disease affecting the central nervous system. To examine language functions in patients with different subsets of AE consisting of seropositive and seronegative groups.MethodsFifty-two patients were recruited from neurology departments in Melbourne, Australia, who met clinical criteria for possible AE. Language tests include the Naming Test from the Sydney Language Battery (SydBat), the semantic fluency trial from the Controlled Oral Word Association Test (COWAT), and the Vocabulary and Similarities subtests of the Weschler Abbreviated Scale of Intelligence–Second Edition. The results were standardised with normative data.ResultsThe mean age of our cohort was 52.5 years old, with the average time from hospital admission to recruitment being 38.41 months. At an aggregate level, none of the mean language test z-scores were below normative data. At the patient level, impairment rates were 18.37% for COWAT (animals), 28.57% for SydBat (naming), 4.65% for Similarities, and 4.55% for Vocabulary. Chi-squared goodness of fit tests indicated that observed performances were significantly below expected performances for the SydBat (naming) test (p < 0.0001) and COWAT (animals) (p = 0.004).DiscussionWhile, on average, language functions were within normal limits in patients with AE, but a subgroup exhibited lower performance in semantic fluency and visual confrontation naming, with impairment rates below expected norms. To advance understanding of language in chronic AE patients, exploring the impact of seizure burden, antiseizure medication use, and the relationship of language functions with other cognitive functions is crucial.

Pragmatic competence in people with dual diagnosis: down syndrome and autism spectrum disorder

BackgroundPragmatics is an area that can be affected in a wide variety of disorders. In this sense, Syndromic Autism is defined as a disorder in which a causal link is established between an associated syndrome and Autism Spectrum Disorder (ASD). Likewise, Down Syndrome (DS) is one of the main genetically based syndromes in which ASD is described as one of its possible manifestations. In this direction, people with DS are described as social beings whereas in ASD there seems to be a specific alteration of this domain.MethodsIn this study, pragmatic performance was analysed in a sample of 72 participants, where comparisons were made between the scores obtained by children with ASD (n = 24), with DS (n = 24) and with DS + ASD (n = 24).ResultsThe Social Communication Questionnaire (SCQ), the Block Objective and Criterial Language Battery (BLOC-SR) and the Neuropsychology subtest (NEPSY-II) aimed at Theory of Mind (ToM) identified significant differences between the groups. However, two-to-two comparisons reported no significant differences between DS and DS + ASD.ConclusionsAlthough several studies report differences between the three proposed groups, our data seem to suggest that ASD symptomatology in DS is associated with Intellectual Developmental Disorder (IDD). However, the lack of solid scientific evidence regarding comorbid diagnosis makes further research along these lines indispensable.Trial registrationThis study was approved by the Ethics Committee for Social Research at UCLM with reference CEIS-704,511-L8M4.

Abstract TP78: Characteristics of Verbal and Non-Verbal Cognitive Function in Post-Stroke Aphasia Based on Language-Cognition Neuropsychological Processing Model

Introduction: Post-stroke aphasia (PSA) patients have different levels of phonetic, lexical, semantic, syntactic, and other linguistic domain impairment, and accompanied by non-verbal cognitive impairment. However, the association between verbal and non-verbal cognitive functions is not fully understood.In this study, we used the Chinese Aphasia Language Battery (CALB) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) to fully evaluate the characteristics of verbal and non-verbal cognitive function impairment in PSA patients. Methods: A total of 105 stroke patients were recruited in this study. Language and non-linguistic cognitive impairments were evaluated by CALB and LOTCA, respectively. Patients in the PSA group were subdivided into the fluent aphasia group (FAG) and the non-FAG group. Potential confounders were adjusted in the analysis of covariance. Partial correlation analysis between the subscores of CALB and LOTCA was also performed. Results: This study showed that PSA patients had worse speech analysis ability, vocabulary processing ability, semantic processing ability, syntactic structure conversion ability, and non-verbal cognitive performance(P&lt;0.001). Moreover, the scores of phonetic decoding, phonetic vocabulary production, noun category classification, total LOTCA, orientation, visual perception, motor use, and thinking operation were lower in the non-FAG compared with the FAG (p&lt;0.05). The total score of LOTCA was positively correlated with the aphasia quotient (r=0.637, P&lt;0.001) and scores of speech analysis ability, vocabulary processing ability, semantic processing ability, and syntactic structure conversion ability (r&gt;0; P&lt;0.0005). Conclusions: Based on the language-cognition neuropsychological processing model, this study adopted a comprehensive verbal and non-verbal cognitive assessment set of tests, and found that PSA patients have extensive phonological, lexical, semantic, syntactic, and grammatical processing disorders. Moreover, PSA patients often have more extensive and serious non-verbal cognitive impairments, and the severity of aphasia is significantly positively correlated with the degree of nonverbal cognitive impairment.

Swallowing performance of elderly people and sociodemographic, cognitive and language factors.

To analyze the correlation between swallowing, language and cognition performance and describe the sociodemographic data of elderly people without previous neurological disorders. Analytical cross-sectional study, with non-probabilistic sample for convenience and data collection by telecall. The aspiration screening test (Yale Swallow Protocol) was used to identify and exclude elderly people at risk of aspiration. Then, sociodemographic data were collected, and instruments were applied: activity of daily living (IADLs), risk of dysphagia (EAT-10), cognitive screening (Mini Mental State Examination - MMSE) and language (Montreal-Toulouse Language Battery - MTL-Brazil). The sample consisted of 32 elderly people from the Federal District, with a mean age of 69.00±7.73 years and schooling of 10.00±5.60 years. The scores on the EAT-10, MMSE and MTL Battery instruments were altered in four, 22 and 26 elderly, respectively, indicating, in this case, risk of dysphagia, suggestion of cognitive alteration and language alteration. Regarding food, of the total sample, 13 seniors (40%) complained of needing modified food, as well as 10 of these also obtained MMSE scores suggestive of cognitive alteration. When comparing the groups with and without complaints and/or risk of dysphagia, there was no statistically significant difference in relation to sociodemographic, cognitive and language variables. Binary logistic regression models also showed no statistically significant results. The present study, when correlating the swallowing, language and cognition findings, did not obtain statistically significant results. It was observed that the elderly with swallowing complaints also showed results suggestive of cognitive and language changes in the tests performed, but there was no statistically significant difference in relation to the elderly without complaints or swallowing changes.

Turkish validity and reliability study on the quick aphasia battery.

The quick aphasia battery (QAB), which assesses all areas of language in detail and quickly, was developed in English. It has been shown to be suitable for bedside patients. There is a need for a Turkish bedside test that allows for a comprehensive yet rapid assessment of stroke patients in terms of aphasia. The aim of this study was to create a Turkish version of QAB (QAB-TR) and to determine its validity and reliability in Turkish-speaking patients after a stroke. The study was conducted with 188 people aged 41-88 years. Of these, 37 (19.7%) had aphasia (12 chronic, 25 acute), 53 (28.2%) were acute stroke patients without aphasia, and 98 (52.1%) were healthy controls. Internal consistency and criterion validity, test-retest reliability, and inter-rater reliability of the QAB-TR were performed. The language assessment test for aphasia was used for criterion validity. For the inter-rater reliability of the test, two different speech language therapists (SLP) administered the QAB-TR. For test-retest reliability, 2 weeks later, the same SLP who filled out the QAB-TR the first time was administered the test again. To test the validity of the test, correlations between the items and subsections were determined. Receiver operating characteristic (ROC) analysis was performed to examine the sensitivity and selectivity of the QAB-TR score, and a cut-off value was determined to distinguish patients with aphasia. The inter-rater Krippendorff's alpha value of the QAB-TR total was 0.6754. There was no statistically significant difference (p>.05) between the first and second QAB-TR total scores. The correlation analysis between the QAB-TR subsection scores and the total QAB-TR score (0.244-0.897) revealed statistically significant relationships. The area under the ROC curve was statistically significant and was found to be 0.853 (95% confidence interval: 0.799-0.906). The cut-off point for the QAB score to discriminate between patients with aphasia and those without aphasia was found to be 8.825, with 0.767 sensitivity and 0.765 selectivity (1-0.235). All the study results show that QAB-TR has internal consistency, criterion validity, test-retest reliability, and inter-rater reliability. It can be administered in as little as 15min and provides information about the multidimensional linguistic profiles of individuals. QAB-TR can be used for both clinical and study purposes as a language battery that allows for the measurement of the strengths and weaknesses of Turkish-speaking individuals who have suffered a stroke in basic language areas in acute and chronic periods. It can be easily administered at the bedside for individuals who have just suffered an acute stroke and can facilitate early assessment of individuals in terms of aphasia and early initiation of therapy, if necessary.

The Telephone Language Screener (TLS): standardization of a novel telephone-based screening test for language impairment.

This study aimed at developing and standardizing the Telephone Language Screener (TLS), a novel, disease-nonspecific, telephone-based screening test for language disorders. The TLS was developed in strict pursuance to the current psycholinguistic standards. It comprises nine tasks assessing phonological, lexical-semantic and morpho-syntactic components, as well as an extra Backward Digit Span task. The TLS was administered to 480 healthy participants (HPs), along with the Telephone-based Semantic Verbal Fluency (t-SVF) test and a Telephone-based Composite Language Index (TBCLI), as well as to 37 cerebrovascular/neurodegenerative patients-who also underwent the language subscale of the Telephone Interview for Cognitive Status (TICS-L). An HP subsample was also administered an in-person language battery. Construct validity, factorial structure, internal consistency, test-retest and inter-rater reliability were tested. Norms were derived via Equivalent Scores. The capability of the TLS to discriminate patients from HPs and to identify, among the patient cohort, those with a defective TICS-L, was also examined. The TLS was underpinned by a mono-component structure and converged with the t-SVF (p < .001), the TBCLI (p < .001) and the in-person language battery (p = .002). It was internally consistent (McDonald's ω = 0.67) and reliable between raters (ICC = 0.99) and at retest (ICC = 0.83). Age and education, but not sex, were predictors of TLS scores. The TLS optimally discriminated patients from HPs (AUC = 0.80) and successfully identified patients with an impaired TICS-L (AUC = 0.92). In patients, the TLS converged with TICS-L scores (p = 0.016). The TLS is a valid, reliable, normed and clinically feasible telephone-based screener for language impairment.

Development and Standardization of Persian Language Developmental Battery

Objective In the absence of an age normed developmental battery for Persian, the major objectives of this research are to develop a reliable and valid clinical linguistic battery to collect normative data from 3 to 7-year-old healthy Persian speaking children. The battery can also be used to measure severity of language impairments in 3 to 7-year-old Persian speaking children as compared with their aged matched peers. Materials &amp; Methods Development of this battery is considered as a descriptive tool in which reliability and validity of the normative data were developed in 3 stages. The first version with 9 different sub-tests, 180 items and two descriptive pictures was developed after cultural and linguistic adaptations for the Persian language for different linguistic levels of phonology, morphology, syntax and pragmatics. The first draft was performed using 200 3 to 8-year-old healthy children in Tehran to measure the sensitivity of different tasks of the test for different age groups. This draft was not sensitive for 8-year-old children. The CVR of the first draft of the battery was checked by 3 Persian speaking clinical linguistic experts and 3 expert speech therapists and also was introduced to 20 SLP experts in a clinical linguistic workshop. In the second stage, based on the results and suggestions, necessary corrections were made in the test structure and items. Also, plural morpheme task of the previous version which was not sensitive enough, was removed and a new semantic task (word definition) as a sensitive semantic task used in other developmental language batteries was added to the battery. The results showed that the diagnostic sensitivity of the test for the 8-year-old age group is not satisfactory. The final version of the battery consisted of 9 subtests with 105 items and two descriptive pictures were used to collect normative data from 200 children. To evaluate reliability and validity of the final version, the opinions of 8 speech therapists and linguists were used.and to evaluate the construct validity, the correlation matrix and confirmatory factor analysis and for its validity Cronbach’s alpha were used. The final version of the battery was sent to expert speech therapists in 5 selected target group provinces (Tehran, Mazandaran, Fars, Esfahan and Khorasan) to collect normative data from 1200 3 to 7-year-old typically developement children in available kindergartens and schools. Finally, the collected data for task items and connected speech measures were processed and analyzed using SPSS software, version 20. Results The content validity was 0.78 and test reliability was 0.76. In addition to confirm the construct validity and diagnostic validity of the test, the correlation between the sub-tests and the overall test scores were also significant at the level of 0.01 (with a correlation of 0.20 to 0.83). The norm for each age group was six months and one year and was calculated as a standard score and reported in the tables. Conclusion Finally, the results of the normative data of this battery are proved to be clinically normative as an indication of the level of linguistic development for each age group and also determine the severity of their language impairment. The battery can also be used to measure the efficacy of rehabilitation in 3 to 7-year old Persian speaking children.

Artificial intelligence, language and Neuropsychological measures in Alzheimer’s disease

AbstractBackgroundOne of the current challenges in the field of Alzheimer’s disease (AD) is to identify patients with mild cognitive impairment (MCI) that will convert to AD. Artificial intelligence, in particular machine learning (ML), has established as one of more powerful approach to extract reliable predictors and to automatically classify different AD phenotypes. It is time to accelerate the translation of this knowledge in clinical practice, mainly by using low‐cost features originating from the language and neuropsychological assessment.MethodWe aim at performing a meta‐analytic evaluation of the contribution of ML and language/neuropsychological measures for the automated classification of AD and MCI patients and the prediction of MCIs’ conversion to AD‐type dementia. Specifically, we study, from the results reported by independent studies, whether ML algorithms, trained on a set of language and neuropsychological measures, could be used for the automatic diagnosis of MCI and AD‐type dementia. To tackle the issue of cross‐linguistic sensitivity, this work spans cohorts of speakers from widely different languages. The advantages and issues that should be taken under consideration for translating these approaches into reliable clinical studies are discussed.ResultAlthough a high heterogeneity was observed, this meta‐analysis shows that ML applied to language and neuropsychological measures can lead to a successful automatic classification, being more specific as screening rather than prognosis tool. Relevant categories of language and neuropsychological tests can be extracted by ML that maximize the classification accuracy.ConclusionML applied on language and neuropsychological measures can automatically classify AD patients, even at an early stage of the disease. This brings several advantages, such as the development of more objective and efficient language and neuropsychological batteries for improving the early diagnosis of AD. Future studies should empirically test the combination of methodological features necessary to improve patients’ classification also at the preclinical stages.

Visually supported short-term auditory memory in children with developmental language disorder (DLD)

BackgroundDevelopmental language disorder (DLD) is an impairment that disturbs the ability to acquire and make use of native language. The exact cognitive and neuronal brain underpinnings of the disorder are still a matter of investigation.Material and methodsThe relationship between the audiovisual phonemic short-term memory and particular language abilities was examined among 7–9 year-old children with DLD as well as in a gender, age, and IQ-matched control group. Children were assessed with a standard language battery and the Stanford–Binet scale (SB5). Subsequently, they performed a short-term memory task requiring immediate recall of sequences composed of syllables presented audiovisually.ResultsThere were lower levels of audiovisual phonemic memory among children with DLD. They performed significantly worse than matched typically developing (TD) children in the experimental task and their performance was correlated with scores obtained in each language subtest. In contrast, we did not find between-group differences in visual short-term operational memory measured on the SB5 scale.ConclusionsThe present experiment replicated previous findings about short-term phonemic memory impairment in the DLD population. We found that memory impairment also occurs even if phoneme information is presented simultaneously in the auditory and visual domains. It appears that non-linguistic spatial cues accompanying phoneme stimuli do not overcome phonemic short-term memory impairment.

Dissociation of Broca's area from Broca's aphasia in patients undergoing neurosurgical resections.

Broca's aphasia is a syndrome of impaired fluency with retained comprehension. The authors used an unbiased algorithm to examine which neuroanatomical areas are most likely to result in Broca's aphasia following surgical lesions. Patients were prospectively evaluated with standardized language batteries before and after surgery. Broca's area was defined anatomically as the pars opercularis and triangularis of the inferior frontal gyrus. Broca's aphasia was defined by the Western Aphasia Battery language assessment. Resections were outlined from MRI scans to construct 3D volumes of interest. These were aligned using a nonlinear transformation to Montreal Neurological Institute brain space. A voxel-based lesion-symptom mapping (VLSM) algorithm was used to test for areas statistically associated with Broca's aphasia when incorporated into a resection, as well as areas associated with deficits in fluency independent of Western Aphasia Battery classification. Postoperative MRI scans were reviewed in blinded fashion to estimate the percentage resection of Broca's area compared to areas identified using the VLSM algorithm. A total of 289 patients had early language evaluations, of whom 19 had postoperative Broca's aphasia. VLSM analysis revealed an area that was highly correlated (p < 0.001) with Broca's aphasia, spanning ventral sensorimotor cortex and supramarginal gyri, as well as extending into subcortical white matter tracts. Reduced fluency scores were significantly associated with an overlapping region of interest. The fluency score was negatively correlated with fraction of resected precentral, postcentral, and supramarginal components of the VLSM area. Broca's aphasia does not typically arise from neurosurgical resections in Broca's area. When Broca's aphasia does occur after surgery, it is typically in the early postoperative period, improves by 1 month, and is associated with resections of ventral sensorimotor cortex and supramarginal gyri.

Image‐based primary age‐related tauopathy as a risk of dementia: a five‐year longitudinal study

AbstractBackgroundTo investigate cognitive and pathological (amyloid and tau) changes of image‐based primary age‐related tauopathy (PART) in a long‐term follow‐up cohort study.MethodIn this study, a total of 108 patients who were both negative in amyloid and tau PET images were enrolled. All participants completed the same two PET scans (18F‐flortaucipir for tau and 18F‐florbetaben for Aβ), and neuropsychological tests at least twice over 5 years. We defined PART+ as those who had a higher standardized uptake value ratio (SUVR) in the entorhinal cortex than the cutoff calculated by the Youden index. We investigated the cognitive and 18F‐florbetaben and 18F‐flortaucipir SUVR changes longitudinally between PART+ and PART‐ participants while adjusting for age, sex, education, and ApoE4.ResultCompared with PART‐, PART+ participants had more rapid worsening of MMSE (β=‐0.274, p&lt;0.001), CDR‐SB (β=0.081, p&lt;0.001), and memory function (β=‐0.140, p=0.008). No significant differences were observed in the language, visuospatial, frontal‐executive, attention domains, and total cognitive battery score. In PART+ participants, the annual Aβ accumulation rate from whole cortical SUVR was also increased (β=0.016, p=0.003), and a more rapid accumulation rate was observed in Alzheimer’s disease (AD) specific hot meta‐region‐of‐interest (meta‐ROI) SUVR, compared with PART‐ participants (β=0.019, p=0.001). The annual tau accumulation rate of PART+ was higher than PART‐ in the entorhinal cortex (β=0.010, p&lt;0.001), however, no differences were observed in whole cortical SUVR tau.ConclusionThe PART+ participants showed a rapid cognitive decline in memory function as well as MMSE, and CDR‐SB, than those of PART‐. In addition, amyloid was accumulated at a faster rate in PART+ participants and tau was accumulated more rapidly in the medial temporal area. In conclusion, our longitudinal study suggests that image‐based entorhinal tau defined as a PART+ could be an earlier stage than the preclinical stage of AD.

The Korean Version of the Right Hemisphere Language Battery: Adaptation and Reliability

Objectives: This study presents the Korean version of the Right Hemisphere Language Battery (K-RHLB), reports the preliminary results in healthy subjects, and evaluates inter- and intra-rater reliability. Methods: Fifty-two healthy patients underwent the RHLB, which was adapted to the Korean language. The rater reliability of the Emphatic Stress Test, which is a subtest of the battery, was examined. For inter-rater reliability, three raters evaluated the focus prosody of 35 randomly chosen subjects. For intra-rater reliability, one rater re-evaluated the prosody within 2-week and 3-month intervals. Results: The total mean score of the K-RHLB result was 110.75 ± 2.90 out of 116. The mean percentages of correct responses in the subtests were high and appeared in the following order: Discourse Analysis (99.9%), Written Metaphor Test (99.6%), Lexical Semantic Test (99.3%), Picture Metaphor Test (98.7%), Emphatic Stress Test (94.4%), Inference Test (83.5%), and Humor Test (76.5%). In addition, the inter-rater agreement was high (Gwet’s chance-corrected agreement coefficients AC1 of 0.83 ± 0.02, p &lt; 0.001), as was the intra-rater consistency (Gwet’s AC1 0.93 ± 0.01, p &lt; 0.001). However, some changes in evaluation criteria were confirmed for retest intervals longer than 2 months [Cochran’s Q (2) = 13.82, p &lt; 0.001]. Conclusion: The preliminary results of the K-RHLB in healthy subjects showed overall high scores. Both inter- and intra-rater reliabilities were acceptable. The K-RHLB can be a starting point for more detailed assessment and elaborate intervention in patients with right hemisphere damage. The battery can also be used to evaluate neurodevelopmental disorders with symptoms such as deficits in understanding non-literal languages, semantic integration, and perception and production of appropriate prosody.

The Validity and Reliability of the Language Battery in Comprehensive Aphasia Test-Turkish (CAT-TR)

Aphasia assessment is the initial step of a well-structured language therapy. Therefore, it is reasonable to underline that the assessment tools need to consider the typological and cultural characteristics of the language. A group of international researchers in the Collaboration of Aphasia Trialists have been adapting the Comprehensive Aphasia Test (CAT) into 14 languages spoken in Europe including Turkish. Thus, the aim of this study was to perform the validity and reliability analyses of the Language Battery section of CAT-TR to ensure the assessment of Turkish-speaking people with aphasia (PWA). The test included 21 sub-tests and yielded six modality scores (spoken language comprehension, written language comprehension, repetition, naming, reading, writing). Ninety PWA (Mean AGE = 61.07) and 200 controls (Mean AGE = 54.89) involved in the analyses. The participants were stratified into two education and three age groups. The analyses belonging to content, construct and criterion validity were performed, while the reliability analyses included internal consistency, test-retest and inter-rater reliability. Education influenced all the modality scores of the controls, while age-related differences were significant among all the modality scores except reading. It has to be underlined that Education did not hold any significant effects on the language performance of PWA, whereas those younger than 60 showed statistically better performance in the Spoken and Written Language Comprehension modality scores. The cut-off scores for each modality and Language Battery were presented with high sensitivity and specificity values. Compared to the psychometric characteristics of the adapted versions of CAT and aphasia tests utilized in Turkey, CAT-TR is an appropriate test for the language assessment of Turkish-speaking adults with aphasia.