Reading fluency in Spanish patients with Parkinson's disease: A reading prosody examination.

BACKGROUND: The expressiveness during reading is essential for a fluent reading. Reading prosody has been scarcely studied in an experimental manner, owing to the difficulties in taking objective and direct measures of this reading skill. However, new technologies development has made it possible to analyse reading prosody in an experimental way. Prosodic patterns may vary, not being the same at the beginning of the reading learning process as in adulthood. They may also be altered in disorders such as dyslexia, but little is known about the prosodic characteristics and reading fluency of people with neurodegenerative diseases that cause language impairment, such as Parkinson's disease (PD). AIMS: The aim of this work was to study reading fluency in PD considering the prosodic characteristics of its reading. METHODS & PROCEDURES: The participants were 31 Spanish adults with PD and 31 healthy controls, aged 59-88 years. Two experimental texts were designed that included declarative, interrogative, and exclamatory sentences and experimental verbs and nouns. The manipulability level of the nouns and the motor content of the verbs were considered. The reading of the participants was recorded and analysed with Praat software. OUTCOMES & RESULTS: A longer reading duration and a greater number of pauses, especially in verbs, were found in the PD group, which also showed less pitch variation than the control group in the experimental sentences. The control group showed a big initial rise in declarative and interrogative sentences, as well as a stronger final declination in declarative and exclamatory ones, when compared to the PD group. CONCLUSIONS & IMPLICATIONS: The use of experimental methodologies for the analysis of reading fluency allows learning more about the prosodic characteristics of people with different pathologies, such as PD. Scarce pitch variability found in the analysis, together with the great number of pauses and the longer reading duration, leads to poorly expressive reading, which compromises fluency in PD. The exhaustive evaluation of the reading fluency of PD patients will make it possible to design more complete assessment methods that will favour the diagnosis and early detection of this pathology. WHAT THIS STUDY ADDS: What is already known on this subject • The speech of people with Parkinson's disease (PD) is often impaired by the appearance of hypokinetic dysarthria. The language of people with PD is usually affected with the progression of the disease, with lexico-semantic impairment which mainly affects verbs. Previous literature on reading fluency in PD usually considers reading speed and accuracy, neglecting prosody. Other neurodegenerative diseases with language impairment, such as Alzheimer's disease, commonly cause reading fluency problems. What this paper adds to existing knowledge • This study provides direct and objective measures of the reading fluency (speed, accuracy and prosody) in patients with PD, by the design of experimental texts. Reading fluency characteristics were found to be altered in these patients, especially in pitch variations and reading duration. The reading of Parkinson's patients showed a more flattened pitch. In addition, a greater number of pauses and longer reading durations were also found in the reading of verbs compared to the control group. What are the potential or actual clinical implications of this work? • The use of experimentally created texts makes it possible to analyse the influence of different psycholinguistic variables (frequency, length, motor content, manipulability) on reading fluency, and how the processing of these stimuli could be affected in PD. The objective analysis of the reading fluency characteristics in PD allows the design of more specific evaluation and diagnostic tasks. More complete assessment methods may allow the early detection of the disease. In the same way, it may favour a differential diagnosis with other neurodegenerative diseases.

Spelling problems after early oral language difficulties.

Recent research has stated that early oral language acquisition difficulties are related to reading and writing difficulties. Children with developmental language disorder (DLD) experience difficulties with several dimensions of language. In this study we focus on the specific difficulties of children with DLD in spelling. We examine the impact of lexicality and length in written production of Spanish-speaking children with DLD. A total of 18 children with language difficulties (Mage = 8;4) were compared with age-matched children (Mage = 8;2). Participants completed a spelling-to-dictation task of words and pseudo-words, where length was manipulated. A digital tablet was used to collect data and obtain measures of accuracy, latencies and total writing durations. Results showed that children with DLD produced more errors, longer latencies and longer writing durations than age-matched children. Regarding accuracy, analysis of the errors shows that children in the control group produce few errors, most being substitutions, while children with DLD made more errors and of more varied categories. Moreover, they were more affected by length on writing accuracy than the control group. WHAT THIS PAPER ADDS: What is already known on this subject Children with language difficulties are more likely to present reading difficulties. There are fewer studies analysing the impact of oral language difficulties in writing skills. What this paper adds to existing knowledge The study suggests that children with oral language difficulties also have impairments in spelling, impacting on accuracy, duration and reaction time, possibly related to poor phonological working memory. What are the potential or actual clinical implications of this work? This study highlights the need to emphasize early oral intervention and language-related processing skills to help prevent written language difficulties.

SpaVerb-WN-A megastudy of naming times for 4562 Spanish verbs: Effects of psycholinguistic and motor content variables.

Several studies have been carried out in various languages to explore the role of the main psycholinguistic variables in word naming, mainly in nouns. However, reading of verbs has not been explored to the same extent, despite the differences that have been found between the processing of nouns and verbs. To reduce this research gap, we present here SpaVerb-WN, a megastudy of word naming in Spanish, with response times (RT) for 4562 verbs. RT were obtained from at least 20 healthy adult participants in a reading-aloud task. Several research questions on the role of syllable frequency, word length, neighbourhood, frequency, age of acquisition (AoA), and the novel variable 'motor content' in verb naming were also examined. Linear mixed-effects model analyses indicated that (1) RT increase in with increasing word length and with decreasing neighbourhood size, (2) syllable frequency does not show a significant effect on RT, (3) AoA mediates the effect of motor content, with a positive slope of motor content at low AoA scores and a negative slope at high AoA scores, and (4) there is an interaction between word frequency and AoA, in which the AoA effect for low-frequency verbs gradually decreases as frequency increases. The results are discussed in relation to existing evidence and in the context of the consistency of the spelling-sound mappings in Spanish.

A new and short protocol to achieve the early diagnosis of mild cognitive impairment.

PURPOSE: The mild cognitive impairment (MCI) is a neurocognitive disorder which involves cognitive impairments beyond those expected for the age and education of the subject but are not significant enough to interfere with instrumental activities of daily living. The identification of individuals with MCI is particularly important for those who might benefit from new therapies. The aim of this work is to propose a comprehensive neuropsychological protocol to achieve early diagnosis of MCI. METHODS: A neuropsychological battery was created and administered to a sample of patients with MCI (n = 25) and healthy matched controls (n = 25). RESULTS: Although memory decline is often the first sign preceding the appearance of MCI, significant differences in visuospatial tasks, naming abilities, and executive function can be demonstrated as well between MCI and controls. CONCLUSIONS: A proper selection of cognitive measures within those included in the already-available neuropsychological batteries may provide a thorough assessment of MCI and allow its timely diagnosis.

Rapid acquisition of novel written word-forms: ERP evidence.

BACKGROUND: Novel word acquisition is generally believed to be a rapid process, essential for ensuring a flexible and efficient communication system; at least in spoken language, learners are able to construct memory traces for new linguistic stimuli after just a few exposures. However, such rapid word learning has not been systematically found in visual domain, with different confounding factors obscuring the orthographic learning of novel words. This study explored the changes in human brain activity occurring online, during a brief training with novel written word-forms using a silent reading task RESULTS: Single-trial, cluster-based random permutation analysis revealed that training caused an extremely fast (after just one repetition) and stable facilitation in novel word processing, reflected in the modulation of P200 and N400 components, possibly indicating rapid dynamics at early and late stages of the lexical processing. Furthermore, neural source estimation of these effects revealed the recruitment of brain areas involved in orthographic and lexico-semantic processing, respectively. CONCLUSIONS: These results suggest the formation of neural memory traces for novel written word-forms after a minimal exposure to them even in the absence of a semantic reference, resembling the rapid learning processes known to occur in spoken language.

Independence of syntactic and phonological deficits in dyslexia: A study using the attraction error paradigm.

This paper addresses the question of whether dyslexic children suffer from syntactic deficits that are independent of limitations with phonological processing. We looked at subject-verb agreement errors after sentence subjects containing a second noun (the attractor) known to be able to attract incorrect agreement (e.g., "the owner(s) of the house(s) is/are away"). In the general population, attraction errors are not straightforwardly dependent on the presence or absence of morphophonological plural markers but on their syntactic configuration. The same would be expected for dyslexic children if their syntactic problems are not phonological in nature. We also looked at the possible effect of system overload on syntactic processing by comparing auditory and written presentation of stimuli and stimuli with high and low frequency attractors. Dyslexic children produced more agreement errors than age-matched controls, but their errors were distributed in the expected manner and did not align with the presence of morphophonological number markers in the subject overall. Furthermore, there was no effect of either presentation mode or attractor frequency on the number of agreement errors. Our results confirm the existence of syntactic difficulties in dyslexia and suggest that they are not due to a phonological deficit or to verbal working memory limitations.

The role of sublexical variables in reading fluency development among Spanish children.

Several studies have found that, after repeated exposure to new words, children form orthographic representations that allow them to read those words faster and more fluently. However, these studies did not take into account variables related to the words. The aim of this study was to investigate the influence of sublexical variables on the formation of orthographic representations of words by Spanish children. The first experiment used pseudo-words of varying syllabic structure and syllabic frequency. The stimuli for the second experiment were formed with or without context-dependent graphemes. We found that formation of orthographic representations was influenced by syllabic structure (easier for words with simple syllabic structure) and the context-dependency of graphemes (easier in the absence of context-dependent graphemes), but not syllabic frequency. These results indicate that the easier it is to read a word, the easier it is to form an orthographic representation of it.

Formation of Orthographic Representations in Spanish Dyslexic Children: The Role of Syllable Complexity and Frequency.

Recent studies have suggested that Spanish children with dyslexia have difficulty storing orthographic representations of new words. But given that the syllable plays an important role in word recognition in Spanish, it is possible that the formation of orthographic representations is influenced by the characteristics of the syllables that make up the words. The objective of this study was to determine whether syllabic frequency and syllabic complexity influence orthographic learning in children with dyslexia. We compared the performance of a group of dyslexic children with that of a group of typical readers on a task that involved reading short and long pseudowords six times; we manipulated the frequency and complexity of the syllables from which the pseudowords were constructed. The results showed that dyslexic children do not benefit from syllabic simplicity or frequency when it comes to storing orthographic representations as the length effect in the dyslexic group remained was unchanged after repeated readings, regardless of stimulus characteristics. Copyright © 2017 John Wiley & Sons, Ltd.

Phonological, lexical, and semantic errors produced by impairment at the output buffer in a Spanish aphasic patient.

We present a single case of a right-handed female patient, RH, who was categorized as suffering from conduction aphasia. She presented no articulatory problems during spontaneous speech but made a significant number of phonological paraphasias in naming and repetition tasks. The number of errors increased for long words and pseudowords. This pattern of results points to damage in the "Phonological Output Buffer" (POB) as the basis of this disorder. However, this patient did not make mistakes when reading words and pseudowords aloud, even when we introduced a delay between the presentation of the word and its production to test the working memory resources of the phonological buffer. Furthermore, the patient's ability to name objects, repeat words, and write to dictation improved with her degree of familiarity with the items. The damage could be situated at the point where phonemes are selected and ordered to produce words. We posit that the deficits observed in this patient, and the differences encountered between her performance and that of others described in the literature, in particular in reading tasks, can be explained by considering POB damage to be gradual in nature. According to this explanation, the performance of patients with damage to the POB will depend on the amount of information provided by the stimulus (word/nonword), the language particularities (regular/irregular), and the nature of the task demands (repetition, writing, naming, or reading).

Repeated Exposure to "meaningless" Pseudowords Modulates LPC, but Not N(FN)400.

Training readers to recognize pseudowords could decrease the processing differences between them and real words while clarifying the lexical acquisition processes. We analyze the effect of pseudoword repetition through the recording of EEG during a lexical decision task. Results showed a functional dissociation between two well-known ERP components: FN400 (Frontal N400, traditionally related to semantic processes) and LPC (Late Positive Complex, related to memory processes). On the one hand, FN400 was unaffected by pseudoword repetition and showed the typical lexicality effect. On the other hand, topographic and neural source analyses showed that LPC amplitude increased across repetitions, causing the lexicality effect to disappear, with the left inferior frontal, left superior temporal and right superior frontal gyri identified as the most likely neural sources. The lack of repetition effect on FN400 suggests that this component is unrelated to familiarity processes and is only influenced by semantic differences between stimuli. The LPC observations, however, reflect the construction and strengthening of visual memory traces for repeated pseudowords, facilitating their processing over the course of the task.

Effects of the psycholinguistic variables on the lexical decision task in Spanish: a study with 2,765 words.

In order to explore the role of the main psycholinguistic variables on visual word recognition, several mega-studies have been conducted in English in recent years. Nevertheless, because the effects of these variables depend on the regularity of the orthographic system, studies must also be done in other languages with different characteristics. The goal of this work was to conduct a lexical decision study in Spanish, a language with a shallow orthography and a high number of words. The influence of psycholinguistic variables on latencies corresponding to 2,765 words was assessed by means of linear mixed-effects modeling. The results show that some variables, such as frequency or age of acquisition, have significant effects on reaction times regardless of the type of words used. Other variables, such as orthographic neighborhood or imageability, were significant only in specific groups of words. Our results highlight the importance of taking into account the peculiarities of each spelling system in the development of reading models.

Lexical and semantic age-of-acquisition effects on word naming in Spanish.

We report a study of the factors that affect reading in Spanish, a language with a transparent orthography. Our focus was on the influence of lexical semantic knowledge in phonological coding. This effect would be predicted to be minimal in Spanish, according to some accounts of semantic effects in reading. We asked 25 healthy adults to name 2,764 mono- and multisyllabic words. As is typical for psycholinguistics, variables capturing critical word attributes were highly intercorrelated. Therefore, we used principal components analysis (PCA) to derive orthogonalized predictors from raw variables. The PCA distinguished components relating to (1) word frequency, age of acquisition (AoA), and familiarity; (2) word AoA, imageability, and familiarity; (3) word length and orthographic neighborhood size; and (4) bigram type and token frequency. Linear mixed-effects analyses indicated significant effects on reading due to each PCA component. Our observations confirm that oral reading in Spanish proceeds through spelling-sound mappings involving lexical and sublexical units. Importantly, our observations distinguish between the effect of lexical frequency (the impact of the component relating to frequency, AoA, and familiarity) and the effect of semantic knowledge (the impact of the component relating to AoA, imageability, and familiarity). Semantic knowledge influences word naming even when all the words being read have regular spelling-sound mappings.

Struggling with L2 alphabet: The role of proficiency in orthographic learning.

The present study examined the process of L2 orthographic learning in bilinguals with distant L1-L2 orthographies. Chinese-English bilinguals with various English proficiency levels were trained with novel L2 words during a reading task. In contrast to higher proficient learners, those with lower L2 proficiency exhibited increased effects of length, frequency, and lexicality across exposures and at-chance recognition of trained words. Importantly, an additional post-training task assessing the lexical integration of trained words evidenced the engagement in different L1-L2 reading strategies across different levels of L2 proficiency, hence suggesting the L1 holistic processing at the base of the effortful establishment of L2 orthographic representations shown by lower-proficient learners. Overall, these findings indicate the role of L2 proficiency in the influence that cross-linguistic variation exerts on L2 orthographic learning and highlight the need for English education programmes to tackle specific grapheme-to-phoneme skills in non-alphabetic target communities.

Identification of the main components of spontaneous speech in primary progressive aphasia and their neural underpinnings using multimodal MRI and FDG-PET imaging.

BACKGROUND: Primary progressive aphasia (PPA) is a clinical syndrome characterized by gradual loss of language skills. This study aimed to evaluate the diagnostic capacity of a connected speech task for the diagnosis of PPA and its variants, to determine the main components of spontaneous speech, and to examine their neural correlates. METHODS: A total of 118 participants (31 patients with nfvPPA, 11 with svPPA, 45 with lvPPA, and 31 healthy controls) were evaluated with the Cookie Theft picture description task and a comprehensive language assessment protocol. Patients also underwent 18F-fluorodeoxyglucose positron emission tomography and magnetic resonance imaging studies. Principal component analysis and machine learning were used to evaluate the main components of connected speech and the accuracy of connected speech parameters for diagnosing PPA. Voxel-based analyses were conducted to evaluate the correlation between spontaneous speech components and brain metabolism, brain volumes, and white matter microstructure. RESULTS: Discrimination between patients with PPA and controls was 91.67%, with 77.78% discrimination between PPA variants. Parameters related to speech rate and lexical variables were the most discriminative for classification. Three main components were identified: lexical features, fluency, and syntax. The lexical component was associated with ventrolateral frontal regions, while the fluency component was associated with the medial superior prefrontal cortex. Number of pauses was more related with the left parietotemporal region, while pauses duration with the bilateral frontal lobe. The lexical component was correlated with several tracts in the language network (left frontal aslant tract, left superior longitudinal fasciculus I, II, and III, left arcuate fasciculus, and left uncinate fasciculus), and fluency was linked to the frontal aslant tract. CONCLUSION: Spontaneous speech assessment is a useful, brief approach for the diagnosis of PPA and its variants. Neuroimaging correlates suggested a subspecialization within the left frontal lobe, with ventrolateral regions being more associated with lexical production and the medial superior prefrontal cortex with speech rate.

Neural correlates of abstract verb processing.

The present study investigated the neural correlates of the processing of abstract (low imageability) verbs. An extensive body of literature has investigated concrete versus abstract nouns but little is known about how abstract verbs are processed. Spanish abstract verbs including emotion verbs (e.g., amar, "to love"; molestar, "to annoy") were compared to concrete verbs (e.g., llevar, "to carry"; arrastrar, "to drag"). Results indicated that abstract verbs elicited stronger activity in regions previously associated with semantic retrieval such as inferior frontal, anterior temporal, and posterior temporal regions, and that concrete and abstract activation networks (compared to that of pseudoverbs) were partially distinct, with concrete verbs eliciting more posterior activity in these regions. In contrast to previous studies investigating nouns, verbs strongly engage both left and right inferior frontal gyri, suggesting, as previously found, that right prefrontal cortex aids difficult semantic retrieval. Together with previous evidence demonstrating nonverbal conceptual roles for the active regions as well as experiential content for abstract word meanings, our results suggest that abstract verbs impose greater demands on semantic retrieval or property integration, and are less consistent with the view that abstract words recruit left-lateralized regions because they activate verbal codes or context, as claimed by proponents of the dual-code theory. Moreover, our results are consistent with distributed accounts of semantic memory because distributed networks may coexist with varying retrieval demands.

Famous faces naming test predicts conversion from mild cognitive impairment to Alzheimer's disease.

The presence of semantic memory dysfunction in Alzheimer's disease (AD) has been widely investigated. Several studies have showed a higher degree of impairment in naming persons and objects, compared to general semantic knowledge in early stages of AD. The aim of this study was to investigate if the Famous Faces Naming Test can help to differentiate patients with mild cognitive impairment (MCI) who will progress to AD and those who will not. A Famous Faces Naming Test was administered to 17 patients with MCI who did not convert to AD and eight patients with MCI who converted to AD 2 years later. MCI patients who converted to AD 2 years later performed significantly worse on Famous Faces Naming Test compared to MCI patients who did not convert over that time period. A neuropsychological task of semantic knowledge of famous people may be useful in the early diagnosis of Alzheimer's disease.

Reading Fluency in Spanish Patients with Alzheimer's Disease.

BACKGROUND: Reading fluency is essential for our functioning in the literate society in which we live. Reading expressiveness or prosody, along with speed and accuracy, are considered key aspects of fluent reading. Prosodic patterns may vary, not being the same in children learning to read as in adulthood. But little is known about the prosodic characteristics and reading fluency of people with neurodegenerative diseases that causes language impairment and reading difficulties, such as Alzheimer's disease (AD). OBJECTIVE: The aim of this work was to study reading fluency in AD, considering reading speed, accuracy and reading prosody. METHODS: The participants were 20 healthy elderly Spanish adults, and 20 AD patients, aged 64-88 years. An experimental text was designed, that included declarative, exclamatory, and interrogative sentences, words with different stresses and low-frequency words. The reading of the participants was recorded and analyzed using Praat software. RESULTS: The AD group showed significantly longer reading duration, both at the syllable level and at the word and sentence level. These patients also committed more pauses between words, which were also longer, and more reading errors. The control group showed a variation of the syllabic F0 in the three types of sentences, while these variations only appeared in declarative ones in the AD group. CONCLUSION: The pauses, along with the slight pitch variations and the longer reading times and errors committed, compromise the reading fluency of people with AD. Assessment of this reading feature could be interesting as a possible diagnostic marker for the disease.

Spanish Version of the Mini-Linguistic State Examination for the Diagnosis of Primary Progressive Aphasia.

BACKGROUND: Primary progressive aphasia (PPA) is a neurodegenerative syndrome with three main clinical variants: non-fluent, semantic, and logopenic. Clinical diagnosis and accurate classification are challenging and often time-consuming. The Mini-Linguistic State Examination (MLSE) has been recently developed as a short language test to specifically assess language in neurodegenerative disorders. OBJECTIVE: Our aim was to adapt and validate the Spanish version of MLSE for PPA diagnosis. METHODS: Cross-sectional study involving 70 patients with PPA and 42 healthy controls evaluated with the MLSE. Patients were independently diagnosed and classified according to comprehensive cognitive evaluation and advanced neuroimaging. RESULTS: Internal consistency was 0.758. The influence of age and education was very low. The area under the curve for discriminating PPA patients and healthy controls was 0.99. Effect sizes were moderate-large for the discrimination between PPA and healthy controls. Motor speech, phonology, and semantic subscores discriminated between the three clinical variants. A random forest classification model obtained an F1-score of 81%for the three PPA variants. CONCLUSION: Our study provides a brief and useful language test for PPA diagnosis, with excellent properties for both clinical routine assessment and research purposes.

Unfolded p53 as a Marker of Oxidative Stress in Mild Cognitive Impairment, Alzheimer's and Parkinson's Disease.

AIMS: There are several candidate biomarkers for AD and PD which differ in sensitivity, specificity, cost-effectiveness, invasiveness, logistical and technical demands. This study is aimed to test whether plasma concentration of unfolded p53 may help to discriminate among the neurodegenerative processes occurring in Mild Cognitive Impairment, Alzheimer's disease and Parkinson's disease. METHODS: An electrochemical immunosensor was used to measure unfolded p53 in plasma samples of 20 Mild Cognitive Impairment (13 males/7 females; mean age 74.95±5.31), 20 Alzheimer's (11 males/9 females; mean age: 77.25±7.79), 15 Parkinson's disease patients (12 males/3 females; mean age: 68.60 ± 7.36) and its respective age/sex/studies-matched controls. RESULTS: We observed a significantly higher concentration of unfolded p53 in the plasma of patients of each of the three pathologies with respect to their control groups (p=0.000). Furthermore, the plasma concentration of unfolded p53 was significantly higher in Alzheimer's disease patients in comparison with Mild Cognitive Impairment patients (p=0.000) and Parkinson's disease patients (p=0.006). No significant difference between Mild Cognitive Impairment and Parkinson's disease patients was observed (p=0.524). CONCLUSION: Our results suggest that unfolded p53 concentration in the plasma may be a useful biomarker for an undergoing neuropathological process that may be common, albeit with different intensity, to different diseases.

Cognitive impairment in Parkinson's disease without dementia.

Some degree of cognitive impairment appears frequently in Parkinson's disease (PD) patients, even at the onset of the disease. However, due to the heterogeneity of the patients and the lack of standardized assessment batteries, it remains unclear which capacities are primarily affected by this disease. Fifty PD patients were assessed with 15 tests including executive functions, attention, temporal and spatial orientation, memory, and language tasks. Their results were compared with those of 42 age- and education-matched healthy seniors. Semantic fluency, along with visual search appeared to be the most discriminant tasks, followed by temporal orientation and face naming, as well as action naming and immediate recall. PD patients studied showed an impairment of frontal- to posterior-dependent capacities. Executive functions, attention, and recall tasks appeared to be significantly impaired in the patients. Nevertheless, significantly poor scores in tasks like action and face naming, as well as semantic fluency, also reveal a mainly semantic deficit.