评估帕金森病患者的找词困难和认知的语言标志物。
Evaluation of Linguistic Markers of Word-Finding Difficulty and Cognition in Parkinson's Disease.
机构信息
Parkinson Disease and Movement Disorders Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Department of Neurology, University of Massachusetts Memorial Medical Center/UMass Medical School, Worcester.
出版信息
J Speech Lang Hear Res. 2018 Jul 13;61(7):1691-1699. doi: 10.1044/2018_JSLHR-L-17-0304.
PURPOSE
Early cognitive symptoms such as word-finding difficulty (WFD) in daily conversation are common in Parkinson's disease (PD), but studies have been limited by a lack of feasible, quantitative measures. Linguistic analysis, focused on pauses in speech, may yield markers of impairment of cognition and communication in PD. The objective of this study was to evaluate the relationship of linguistic markers in semistructured speech to WFD symptoms and cognitive function in PD.
METHOD
Speech recordings of description of the Cookie Theft picture in 53 patients with PD without dementia and 23 elderly controls were analyzed with Praat software. Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005), category naming fluency, and confrontation naming tests were administered. Questionnaires rating WFD symptoms and cognitive instrumental activities of daily living were completed. We determined the relationships between (a) pause length and location, (b) MoCA score, and (c) WFD symptoms, using Pearson's correlations and multivariate regression models.
RESULTS
Compared with controls, patients with PD had more pauses within utterances as well as fewer words per minute and a lower percentage of well-formed sentences. Pauses within utterances differed significantly between PD-mild cognitive impairment and normal cognition (p < .001). Words per minute and percentage of well-formed sentences were predictive of MoCA in multivariate regression models. Pauses before verbs were associated with patient-reported severity of WFD symptoms (p = .006).
CONCLUSIONS
Linguistic markers including pauses within utterances distinguish patients with PD with mild cognitive symptoms from elderly controls. These markers are associated with global cognitive function before the onset of dementia. Pauses before verbs and grammatical markers may index early cognitive symptoms such as WFD that may interfere with functional communication.
SUPPLEMENTAL MATERIAL
目的
在帕金森病（PD）中，日常会话中出现的早期认知症状，如找词困难（WFD）较为常见，但由于缺乏可行的定量测量方法，此类研究受到了限制。言语分析，侧重于言语停顿，可能为 PD 患者认知和交流受损提供标志物。本研究旨在评估半结构化言语中的语言标记与 PD 患者的 WFD 症状和认知功能的关系。
方法
使用 Praat 软件分析了 53 名无痴呆 PD 患者和 23 名老年对照者描述“Cookie Theft”图片的言语录音。进行蒙特利尔认知评估（MoCA；Nasreddine 等人，2005 年）、类别命名流畅性和命名测试。完成了评估 WFD 症状和认知日常工具活动能力的问卷。我们使用 Pearson 相关和多元回归模型确定了（a）停顿时长和位置、（b）MoCA 评分和（c）WFD 症状之间的关系。
结果
与对照组相比，PD 患者的言语停顿更多，每分钟单词数更少，完整句子的百分比更低。PD 轻度认知障碍与正常认知患者之间的言语停顿差异显著（p<0.001）。每分钟单词数和完整句子的百分比是多元回归模型中 MoCA 的预测指标。动词前的停顿与患者报告的 WFD 严重程度相关（p=0.006）。
结论
包括言语停顿在内的语言标记可将有轻度认知症状的 PD 患者与老年对照者区分开来。这些标记与痴呆前的整体认知功能相关。动词前的停顿和语法标记可能会影响到与功能交流相关的早期认知症状，如 WFD。
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