Connected speech in progressive supranuclear palsy: a possible role in differential diagnosis
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ORIGINAL ARTICLE
Connected speech in progressive supranuclear palsy: a possible role in differential diagnosis Eleonora Del Prete 1 & Luca Tommasini 1 & Sonia Mazzucchi 1 & Daniela Frosini 2 & Giovanni Palermo 1 & Riccardo Morganti 3 & Cristina Pagni 1 & Gloria Tognoni 2 & Ubaldo Bonuccelli 1 & Roberto Ceravolo 1 Received: 16 May 2020 / Accepted: 30 July 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Progressive supranuclear palsy (PSP) is an atypical Parkinsonism characterized by motor and neuropsycological disorders. Language could be impaired in PSP patients, also in Richardson variant (PSP-RS). The analysis of connected speech is used in neurodegenerative disorder to investigate different levels of language organization, including phonetic, phonological, lexico-semantic, morpho-syntactic, and pragmatic processing. Objective In our study, we aimed to investigate the language profile, especially connected speech, in early-stage PSP-RS and Parkinson’s disease (PD) patients without predominant speech or language disorders. Methods Language was assessed using the Screening for Aphasia in NeuroDegeneration (SAND); connected speech analysis was conducted from the picture description subtest. Results We enrolled 48 patients, 22 PD and 26 PSP (18 PSP-RS and 8 non-RS). PSP-RS patients presented an impairment in language domain, particularly regarding connected speech. PSP-RS patients presented worse performances than PD in different scores. The output of PSP-RS patients was characterized by a reduction in number of sentences and subordinates with respect to PD; PSP presented also more repaired sequences and phonological and lexico-semantic errors than PD. Number of sentences and number of subordinates of the picture description task were identified as predictors of PSP diagnosis. Conclusion In summary, the SAND scale is able to identify language impairment in PSP patients. The analysis of connected speech could highlight some important aspects of language impairment in PSP-RS patients, and it could be helpful in the differential diagnosis with PD. Keywords Connected speech . Progressive supranuclear palsy . Language . SAND
Introduction Cognitive impairment is a well-known condition in progressive supranuclear palsy (PSP) patients [1], and according to current diagnostic criteria for PSP (Movement Disorder Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04635-8) contains supplementary material, which is available to authorized users. * Roberto Ceravolo [email protected] 1
Clinical and Experimental Medicine Department, Neurology Unit, University of Pisa, Via Roma 67, Pisa, Italy
2
Neurology Unit, Department of Medical Specialties, AOUP, Pisa, Italy
3
Section of Statistics, University Hospital of Pisa, Pisa, Italy
Society-MDS-PSP criteria), cognitive dysfunction is included as one of the four core features for diagnosis [2]. PSP is considered a prototype of “subcortical dementia” characterized by cognitive slowing, executive
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