Global Brain Health Institute, University of California, San Francisco, CA 94143, USA.
Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires B1644BID, Argentina.
Brain. 2023 Dec 1;146(12):4870-4879. doi: 10.1093/brain/awad253.
In the field of neurodegeneration, speech and language assessments are useful for diagnosing aphasic syndromes and for characterizing other disorders. As a complement to classic tests, scalable and low-cost digital tools can capture relevant anomalies automatically, potentially supporting the quest for globally equitable markers of brain health. However, this promise remains unfulfilled due to limited linguistic diversity in scientific works and clinical instruments. Here we argue for cross-linguistic research as a core strategy to counter this problem. First, we survey the contributions of linguistic assessments in the study of primary progressive aphasia and the three most prevalent neurodegenerative disorders worldwide-Alzheimer's disease, Parkinson's disease, and behavioural variant frontotemporal dementia. Second, we address two forms of linguistic unfairness in the literature: the neglect of most of the world's 7000 languages and the preponderance of English-speaking cohorts. Third, we review studies showing that linguistic dysfunctions in a given disorder may vary depending on the patient's language and that English speakers offer a suboptimal benchmark for other language groups. Finally, we highlight different approaches, tools and initiatives for cross-linguistic research, identifying core challenges for their deployment. Overall, we seek to inspire timely actions to counter a looming source of inequity in behavioural neurology.
在神经退行性疾病领域,言语和语言评估可用于诊断失语症综合征,并用于描述其他障碍。作为经典测试的补充,可扩展且低成本的数字工具可以自动捕捉相关异常,这可能有助于寻找全球范围内大脑健康的公平标志物。然而,由于科学著作和临床仪器中语言多样性有限,这一承诺仍未兑现。在这里,我们主张开展跨语言研究,将其作为解决这一问题的核心策略。首先,我们调查了语言评估在原发性进行性失语症研究以及全球最常见的三种神经退行性疾病(阿尔茨海默病、帕金森病和行为变异额颞叶痴呆)中的作用。其次,我们解决了文献中存在的两种语言不公平现象:忽视了世界上 7000 种语言中的大多数,以及以英语为母语的队列占主导地位。第三,我们回顾了一些研究,这些研究表明,在某种特定障碍中,语言功能障碍可能因患者的语言而异,且以英语为母语者为其他语言群体提供的基准并不理想。最后,我们强调了跨语言研究的不同方法、工具和举措,并确定了其部署的核心挑战。总的来说,我们希望激发及时的行动,以应对行为神经学中日益严重的不公平现象。
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