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区分轻度认知障碍和健康衰老的话语措施

Discourse Measures to Differentiate Between Mild Cognitive Impairment and Healthy Aging.

作者信息

Kim Bo Seon, Kim Yong Bum, Kim HyangHee

机构信息

Graduate Program in Speech-Language Pathology, Yonsei University, Seoul, South Korea.

Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Front Aging Neurosci. 2019 Aug 21;11:221. doi: 10.3389/fnagi.2019.00221. eCollection 2019.

Abstract

Although subtle discourse declines in people with mild cognitive impairment (MCI) have been reported, heterogeneous measures and tasks among the MCI discourse studies have yielded widely varying outcomes. The present study aimed to first, identify discourse measures that aid the differentiation among people with amnestic MCI (aMCI), people with non-amnestic MCI (naMCI), and cognitively healthy control (HC) participants, and second, delineate the cognitive functions related to such discourse measures. Three discourse tasks (an episodic narrative, a planning task, and a picture description) were performed by 30 aMCI, 22 naMCI, and 21 HC participants. Samples were analyzed using six categories of 15 measures, namely coherence, cohesion, proposition, grammaticality, lexicality, and fluency. The statistical analyses included (1) a multivariate analysis of variance for group comparison; (2) binary simple logistic regression and receiver operating characteristic curve analysis for differentiation between two groups; (3) binary multiple logistic regression for being diagnosed with naMCI or aMCI with the minimum number of predictors; and (4) Pearson correlation analysis for identifying the cognitive functions associated with the discourse measures. The proportion of cohesive words and propositional density in aMCI participants were worse than those in naMCI participants. Global coherence, the proportion of cohesive words, and the proportion of dysfluencies and pauses in naMCI participants were lower than those in the HC participants. Global and local coherence and the proportion of cohesive words, cohesive ties per utterances, propositional density, and dysfluencies and pauses in aMCI participants were worse than those in the HC participants. The aforementioned measures were demonstrated to be effective predictors for classifying groups by receiver operating characteristic curve analysis. In addition, the proportions of cohesive words and pauses were common discourse measures for differentiation between naMCI and HC participants or between aMCI and HC participants using binary multiple logistic regression. According to the correlation analysis, memory and executive functions are needed for coherent, cohesive, and efficient discourse productions in MCI. The detailed description of discourse performances in this study will aid the characterization of the declined language abilities of MCI participants and also the understanding of the cognitive functions involved in discourse performance in MCI.

摘要

尽管已有报道称轻度认知障碍(MCI)患者存在细微的话语能力下降,但MCI话语研究中使用的测量方法和任务各不相同,导致研究结果差异很大。本研究旨在:第一,确定有助于区分遗忘型MCI(aMCI)患者、非遗忘型MCI(naMCI)患者和认知健康对照(HC)参与者的话语测量方法;第二,描述与这些话语测量方法相关的认知功能。30名aMCI患者、22名naMCI患者和21名HC参与者完成了三项话语任务(一个情节叙述、一个计划任务和一个图片描述)。样本使用15项测量方法的六个类别进行分析,即连贯性、衔接性、命题、语法性、词汇性和流畅性。统计分析包括:(1)用于组间比较的多变量方差分析;(2)用于两组间区分的二元简单逻辑回归和受试者工作特征曲线分析;(3)使用最少预测变量诊断为naMCI或aMCI的二元多元逻辑回归;(4)用于确定与话语测量方法相关的认知功能的Pearson相关分析。aMCI参与者中衔接词的比例和命题密度低于naMCI参与者。naMCI参与者的全局连贯性、衔接词的比例以及不流畅和停顿的比例低于HC参与者。aMCI参与者的全局和局部连贯性、衔接词的比例、每句话的衔接关系、命题密度以及不流畅和停顿情况比HC参与者更差。通过受试者工作特征曲线分析,上述测量方法被证明是区分不同组别的有效预测指标。此外,使用二元多元逻辑回归时,衔接词和停顿的比例是区分naMCI与HC参与者或aMCI与HC参与者的常用话语测量方法。根据相关分析,MCI患者进行连贯、衔接和高效的话语表达需要记忆和执行功能。本研究中对话语表现的详细描述将有助于刻画MCI参与者语言能力下降的特征,也有助于理解MCI话语表现中涉及的认知功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfbb/6714864/fdaeaaf547d8/fnagi-11-00221-g001.jpg

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