Phonemic processing is below expectations and linked to word-finding difficulty in multiple sclerosis.

BACKGROUND

Word-finding difficulty is prevalent but poorly understood in persons with relapsing-remitting multiple sclerosis (RRMS).

OBJECTIVE

The objective was to investigate our hypothesis that phonological processing ability is below expectations and related to word-finding difficulty in patients with RRMS.

METHOD

Data were analyzed from patients with RRMS ( = 50) on patient-reported word-finding difficulty (PR-WFD) and objective performance on Wechsler Individual Achievement Test, Fourth Edition (WIAT-4) Phonemic Proficiency (PP; analysis of phonemes within words), Word Reading (WR; proxy of premorbid literacy and verbal ability), and Sentence Repetition (SR; auditory processing of word-level information).

RESULTS

Performance (mean (95% confidence interval)) was reliably lower than normative expectations for PP (-0.41 (-0.69, -0.13)) but not for WR (0.02 (-0.21, 0.25)) or SR (0.08 (-0.15, 0.31). Within-subjects performance was worse on PP than on both WR ((49) = 4.00, < 0.001, = 0.47) and SR ((49) =3.76, < 0.001, = 0.54). Worse PR-WFD was specifically related to lower PP ( = 6.24, = 0.004, η = 0.21); worse PP performance at PR-WFD Often ( = 13; -1.16 (-1.49, -0.83)) than Sometimes ( = 17; -0.14 (-0.68, 0.41)) or Rarely ( = 20; -0.16 (-0.58, 0.27). PR-WFD was unrelated to WR or SR (s > 0.25).

CONCLUSION

Phonological processing was below expectations and specifically linked to word-finding difficulty in RRMS. Findings are consistent with early disease-related cortical changes within the posterior superior temporal/supramarginal region. Results inform our developing model of multiple sclerosis-related word-finding difficulty.