D'Ascanio Sara, Piras Fabrizio, Banaj Nerisa, Assogna Francesca, Pellicano Clelia, Bassi Andrea, Spalletta Gianfranco, Piras Federica
Neuropsychiatry Laboratory, Department of Clinical Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Heliyon. 2023 Jul 29;9(8):e18633. doi: 10.1016/j.heliyon.2023.e18633. eCollection 2023 Aug.
the interplay between neuropsychological and communicative abilities in Parkinson's disease (PD) has been relatively overlooked, and it is not entirely understood which difficulties are consequent to impaired motor control, and which have a linguistic/cognitive basis. Here, we examined narrative discourse in PD using a multi-level analysis procedure considering sentence-level (productivity, lexical-grammatical processing) and discourse-level processes (narrative organization, informativeness), and partialling out patients' motor speech impairments. The interaction between cognitive (i.e. linguistic and executive) and communication abilities was also investigated.
Twenty-nine PD subjects in the mild stage of the disease were compared to 29 matched healthy comparators (HC) on quantitative measures of narrative discourse derived from two picture description tasks. Multivariate (considering articulation rate and educational attainment as covariates) and univariate (with group membership as independent variable) analyses of variance were conducted on separate linguistic domains. The contribution of executive/linguistic abilities to PD's narrative performance was explored by multiple regression analyses on narrative measures significantly differentiating patients from HC.
significant reductions in patients were observed on measures of productivity (less well-formed words, shorter sentences) and informativeness (fewer conceptual units, less informative elements, lower number of details) and these alterations were explained by variations in linguistic abilities (action and object naming) rather than executive abilities. Articulation rate and educational attainment did not impact the observed reduced productivity and under-informativeness.
referential narrative discourse is altered in PD, regardless of motor impairments in speech production. The observed reductions in productivity/informativeness aspects of narratives were related to naming abilities and in particular to verbs processing, consistently with the neurocognitive model of motor language coupling. Since narratives are amenable to recurrent and automated analysis for the identification of linguistic patterns potentially anticipating the development of PD and the onset of cognitive deterioration, discourse abilities should be quantitatively and repeatedly profiled in the disorder.
帕金森病（PD）中神经心理能力与沟通能力之间的相互作用相对被忽视，目前尚不完全清楚哪些困难是由运动控制受损导致的，哪些具有语言/认知基础。在此，我们使用多层次分析程序研究了PD患者的叙事话语，该程序考虑了句子层面（生成能力、词汇语法加工）和语篇层面的过程（叙事组织、信息性），并排除了患者的运动性言语障碍。我们还研究了认知（即语言和执行）与沟通能力之间的相互作用。
将29名处于疾病轻度阶段的PD患者与29名匹配的健康对照者（HC）在两项图片描述任务得出的叙事话语定量指标上进行比较。对不同的语言领域进行多变量（将发音速度和教育程度作为协变量）和单变量（以组群归属为自变量）方差分析。通过对能显著区分患者与HC的叙事指标进行多元回归分析，探讨执行/语言能力对PD叙事表现的贡献。
在生成能力（构词能力较差、句子较短）和信息性（概念单元较少、信息元素较少、细节数量较少）指标上观察到患者有显著降低，这些改变是由语言能力（动作和物体命名）的变化而非执行能力所解释。发音速度和教育程度并未影响所观察到的生成能力降低和信息不足。
无论言语产生中的运动障碍如何，PD患者的指称性叙事话语都会发生改变。所观察到叙事在生成能力/信息性方面的降低与命名能力有关，特别是与动词加工有关，这与运动语言耦合的神经认知模型一致。由于叙事易于进行反复和自动分析以识别可能预示PD发展和认知衰退发作的语言模式，因此应在该疾病中对语篇能力进行定量和反复分析。
