Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
Department of Clinical and Experimental Linguistics, Vrije Universiteit Brussel, Brussels, Belgium.
Clin Linguist Phon. 2022 Nov 2;36(11):929-953. doi: 10.1080/02699206.2021.1992797. Epub 2022 Jul 28.
Brain tumour patients with mild language disturbances are typically underdiagnosed due to lack of sensitive tests leading to negative effects in daily communicative and social life. We aim to develop a Dutch standardised test-battery, the Diagnostic Instrument for Mild Aphasia (DIMA) to detect characteristics of mild aphasia at the main linguistic levels phonology, semantics and (morpho-)syntax in production and comprehension. We designed 4 DIMA subtests: 1) repetition (words, non-words, compounds and sentences), 2) semantic odd-picture-out (objects and actions), 3) sentence completion and 4) sentence judgment (accuracy and reaction time). A normative study was carried out in a healthy Dutch-speaking population (N = 211) divided into groups of gender, age and education. Clinical application of DIMA was demonstrated in two brain tumour patients (glioma and meningioma). Standard language tests were also administered: object naming, verbal fluency (category and letter), and Token Test. Performance was at ceiling on all sub-tests, except semantic odd-picture-out actions, with an effect of age and education on most subtests. Clinical application DIMA: repetition was impaired in both cases. Reaction time in the sentence judgment test (phonology and syntax) was impaired (not accuracy) in one patient. Standard language tests: category fluency was impaired in both cases and object naming in one patient. The Token Test was not able to detect language disturbances in both cases. DIMA seems to be sensitive to capture mild aphasic deficits. DIMA is expected to be of great potential for standard assessment of language functions in patients with also other neurological diseases than brain tumours.
由于缺乏敏感的测试，轻度语言障碍的脑肿瘤患者通常被漏诊，从而导致日常交流和社交生活受到负面影响。我们旨在开发一种荷兰标准化的测试组合，即诊断轻度失语症的工具（Diagnostic Instrument for Mild Aphasia，DIMA），以在语音、语义和（形态）句法等主要语言水平上检测轻度失语症的特征，包括在产出和理解方面。我们设计了 4 个 DIMA 子测试：1）重复（单词、非单词、复合词和句子），2）语义奇怪图片排除（物体和动作），3）句子完成，4）句子判断（准确性和反应时间）。在一个健康的荷兰语人群（N=211）中进行了一项规范研究，该人群分为性别、年龄和教育组。在 2 例脑肿瘤患者（胶质瘤和脑膜瘤）中展示了 DIMA 的临床应用。还进行了标准语言测试：物体命名、词汇流畅性（类别和字母）和代币测试。除语义奇怪图片排除的动作外，所有子测试的表现均接近满分，且年龄和教育对大多数子测试都有影响。DIMA 的临床应用：2 例患者的重复能力都受到损害。句子判断测试（语音和语法）的反应时间受损（但准确性未受损），在 1 例患者中。在 2 例患者中，类别流畅性受损，在 1 例患者中物体命名受损，而在 2 例患者中，代币测试都未能检测到语言障碍。DIMA 似乎能敏感地捕捉到轻度失语症的缺陷。DIMA 有望成为评估脑肿瘤等其他神经疾病患者语言功能的重要工具。
