Octogone-Lordat Interdisciplinary Research Unit (EA 4156), University of Toulouse II-Jean Jaurès, Toulouse, France.
Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France.
Int J Lang Commun Disord. 2019 May;54(3):390-400. doi: 10.1111/1460-6984.12444. Epub 2018 Nov 15.
Alzheimer's disease is characterized by macrolinguistic changes. This decline is often analyzed with quantitative scales.
To analyze discourse production in early Alzheimer's disease (AD) and to identify qualitative markers of macrolinguistic decline.
METHODS & PROCEDURES: We analyzed macrolinguistic features of a clinical narrative task along with patients' cognitive changes. To do so, 17 early AD participants and 17 healthy controls were recruited and given a full neuropsychological and language assessment. Narrative discourses produced during the language assessment were transcribed and macrolinguistic features were qualitatively analyzed (i.e., local and global coherence marks and discourse informativeness). Inter-group comparison was complemented by intra-group correlation. As some inter-group comparisons revealed the existence of subgroups of patients, permutation tests were used to investigate how these subgroups differed vis-à-vis cognitive measures.
OUTCOMES & RESULTS: Overall, the results indicate that AD participants presented declines in informativeness and global coherence, correlated with declines in memory and executive functions. Permutation tests showed that participants with AD producing referential errors or misinterpretations had a deeper lexical-executive decline and a lower Mini-Mental State Evaluation (MMSE).
CONCLUSIONS & IMPLICATIONS: This study shows that two clinically relevant, qualitative signs differ in discourse production between typical ageing and early AD, namely information units and modalizing discourse. It also shows that macrolinguistic assessment is a useful tool for revealing impaired communication and cognition in early AD. Although lexical processing decline probably contributes to patients' macrolinguistic impairment, implications of extralinguistic functioning should be further investigated.
阿尔茨海默病的特点是宏观语言变化。这种下降通常通过定量量表进行分析。
分析早期阿尔茨海默病（AD）的话语产生，并确定宏观语言下降的定性标志物。
我们分析了临床叙事任务中的宏观语言特征以及患者的认知变化。为此，招募了 17 名早期 AD 参与者和 17 名健康对照者，并进行了全面的神经心理学和语言评估。在语言评估期间产生的叙事话语被转录，并对宏观语言特征进行了定性分析（即局部和整体连贯性标记和话语信息量）。组间比较辅以组内相关性。由于一些组间比较显示出患者存在亚组，因此使用置换检验来研究这些亚组在认知测量方面的差异。
总的来说，结果表明 AD 参与者在信息量和整体连贯性方面表现出下降，这与记忆和执行功能的下降相关。置换检验表明，产生指代错误或误解的 AD 参与者在词汇执行方面的下降更深，且迷你精神状态评估（MMSE）得分更低。
本研究表明，在典型老化和早期 AD 之间的话语产生中，有两个临床相关的、定性的标志存在差异，即信息单位和模态化话语。它还表明，宏观语言评估是一种有用的工具，可以揭示早期 AD 中受损的沟通和认知。虽然词汇处理下降可能导致患者的宏观语言障碍，但应该进一步研究语言外功能的影响。
