Department of Neurology, University Medical Centre, Rostock, Germany.
DZNE site Rostock, German Centre for Neurodegenerative Diseases (DZNE), Rostock, Germany.
Amyotroph Lateral Scler Frontotemporal Degener. 2024 May;25(3-4):308-316. doi: 10.1080/21678421.2024.2307512. Epub 2024 Feb 2.
Language dysfunction is one of the most common cognitive impairments in amyotrophic lateral sclerosis (ALS). Although discourse capacities are essential for daily functioning, verbal expressive language has not been widely investigated in ALS. The existing research available suggests that discourse impairments are prevalent. This study investigates verbal expressive language in people living with ALS (plwALS) in contrast to healthy controls (HC). 64 plwALS and 49 age, gender and education-matched healthy controls were ask to describe the Cookie Theft Picture Task. The recordings were analyzed for discourse productivity, discourse content, syntactic complexity, speech fluency and verb processing. We applied the Bayesian hypothesis-testing framework, incorporating the effects of dysarthria, cognitive impairment status (CIS), and premorbid crystalline verbal IQ. Compared to HC, plwALS only showed a single impairment: speech dysfluency. Discourse productivity, discourse content, syntactic complexity and verb processing were not impaired. Cognition and dysarthria exceeded the influence of verbal IQ for total words spoken and content density. Cognition alone seemed to explain dysfluency. Body-agent verbs were produced at even higher rates than other verb types. For the remaining outcomes, verbal IQ was the most decisive factor. In contrast to existing research, our data demonstrates no discernible impairment in verbal expressive language in ALS. What our findings show to be decisive is accounting for the influence of dysarthria, cognitive impairment status, and verbal IQ as variables on spontaneous verbal expressive language. Minor impairments in verbal expressive language appear to be influenced to a greater degree by executive dysfunctioning and dysarthria than by language impairment.
语言障碍是肌萎缩侧索硬化症（ALS）最常见的认知障碍之一。虽然话语能力对于日常功能至关重要，但言语表达语言在 ALS 中尚未得到广泛研究。现有的研究表明，话语障碍普遍存在。本研究对比了肌萎缩侧索硬化症患者（plwALS）和健康对照组（HC）的言语表达语言。64 名 plwALS 和 49 名年龄、性别和教育程度匹配的健康对照组被要求描述饼干盗窃图片任务。对录音进行了话语产出、话语内容、句法复杂性、言语流畅性和动词处理分析。我们应用了贝叶斯假设检验框架，结合了构音障碍、认知障碍状态（CIS）和预患病理性言语智商的影响。与 HC 相比，plwALS 仅表现出单一的障碍：言语不流畅。话语产出、话语内容、句法复杂性和动词处理均未受损。认知和构音障碍对总词汇量和内容密度的影响超过了言语智商。认知似乎单独解释了不流畅。身体-代理动词的产生率甚至高于其他动词类型。对于其余结果，言语智商是最关键的因素。与现有研究相比，我们的数据表明 ALS 患者的言语表达语言没有明显的障碍。我们的研究结果表明，将构音障碍、认知障碍状态和言语智商作为变量纳入对自发性言语表达语言的影响是决定性的。言语表达语言的轻微障碍似乎更多地受到执行功能障碍和构音障碍的影响，而不是语言障碍。
