Toolkit to Examine Lifelike Language v.2.0: Optimizing Speech Biomarkers of Neurodegeneration.

INTRODUCTION: The Toolkit to Examine Lifelike Language (TELL) is a web-based application providing speech biomarkers of neurodegeneration. After deployment of TELL v.1.0 in over 20 sites, we now introduce TELL v.2.0. METHODS: First, we describe the app's usability features, including functions for collecting and processing data onsite, offline, and via videoconference. Second, we summarize its clinical survey, tapping on relevant habits (e.g., smoking, sleep) alongside linguistic predictors of performance (language history, use, proficiency, and difficulties). Third, we detail TELL's speech-based assessments, each combining strategic tasks and features capturing diagnostically relevant domains (motor function, semantic memory, episodic memory, and emotional processing). Fourth, we specify the app's new data analysis, visualization, and download options. Finally, we list core challenges and opportunities for development. RESULTS: Overall, TELL v.2.0 offers scalable, objective, and multidimensional insights for the field. CONCLUSION: Through its technical and scientific breakthroughs, this tool can enhance disease detection, phenotyping, and monitoring.

Multivariate word properties in fluency tasks reveal markers of Alzheimer's dementia.

INTRODUCTION: Verbal fluency tasks are common in Alzheimer's disease (AD) assessments. Yet, standard valid response counts fail to reveal disease-specific semantic memory patterns. Here, we leveraged automated word-property analysis to capture neurocognitive markers of AD vis-à-vis behavioral variant frontotemporal dementia (bvFTD). METHODS: Patients and healthy controls completed two fluency tasks. We counted valid responses and computed each word's frequency, granularity, neighborhood, length, familiarity, and imageability. These features were used for group-level discrimination, patient-level identification, and correlations with executive and neural (magnetic resonanance imaging [MRI], functional MRI [fMRI], electroencephalography [EEG]) patterns. RESULTS: Valid responses revealed deficits in both disorders. Conversely, frequency, granularity, and neighborhood yielded robust group- and subject-level discrimination only in AD, also predicting executive outcomes. Disease-specific cortical thickness patterns were predicted by frequency in both disorders. Default-mode and salience network hypoconnectivity, and EEG beta hypoconnectivity, were predicted by frequency and granularity only in AD. DISCUSSION: Word-property analysis of fluency can boost AD characterization and diagnosis. HIGHLIGHTS: We report novel word-property analyses of verbal fluency in AD and bvFTD. Standard valid response counts captured deficits and brain patterns in both groups. Specific word properties (e.g., frequency, granularity) were altered only in AD. Such properties predicted cognitive and neural (MRI, fMRI, EEG) patterns in AD. Word-property analysis of fluency can boost AD characterization and diagnosis.

Semantic memory navigation in HIV: Conceptual associations and word selection patterns.

Objective: This proof-of-concept study aimed to characterize semantic memory profiles in individuals with human immunodeficiency virus (HIV) and mild neurocognitive impairment. Method: Using a semantic relatedness task, we explored conceptual association and word selection patterns in people living with HIV (PLWH; n = 50) relative to people living without HIV (n = 46). We also studied whether word selection patterns in the PLWH group were associated with working memory capacity, cognitive flexibility and inhibitory control. Results: While accuracy did not differ between groups, PLWH produced significantly longer responses than controls (r = .32), with fewer hypernyms (d = .47), more troponyms (r = .37), and words that were more frequent (r = .39) and had more phonological neighbors (r = .22). These patterns survived covariation with participants' cognitive status. None of these patterns correlated with measures of working memory, cognitive flexibility, inhibitory control or viral load (all correlation coefficients < .36). Conclusions: Together, these results suggest that PLWH might use alternative word finding strategies during semantic memory navigation, irrespective of the severity of other cognitive symptoms. Such findings contribute to the characterization of cognitive deficits in HIV and to the search for novel markers of the condition.