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Connected Speech Deficit as an Early Hallmark of CSF-defined Alzheimer’s Disease and Correlation with Cerebral Hypoperfusion Pattern

[ Vol. 16 , Issue. 6 ]

Author(s):

Giulia Mazzon*, Miloš Ajčević, Tatiana Cattaruzza, Alina Menichelli, Michele Guerriero, Selene Capitanio, Valentina Pesavento, Franca Dore, Sandro Sorbi, Paolo Manganotti and Andrea Marini   Pages 483 - 494 ( 12 )

Abstract:


Background: Diagnosis of prodromal Alzheimer's disease (AD) still represents a hot topic and there is a growing interest for the detection of early and non-invasive biomarkers. Although progressive episodic memory impairment is the typical predominant feature of AD, communicative difficulties can be already present at the early stages of the disease.

Objective: This study investigated the narrative discourse production deficit as a hallmark of CSFdefined prodromal AD and its correlation with cerebral hypoperfusion pattern.

Methods: Narrative assessment with a multilevel procedure for discourse analysis was conducted on 28 subjects with Mild Cognitive Impairment (15 MCI due to AD; 13 MCI non-AD) and 28 healthy controls. The diagnostic workup included CSF AD biomarkers. Cerebral hypoperfusion pattern was identified by SPECT image processing.

Results: The results showed that the discourse analysis of global coherence and lexical informativeness indexes allowed to identify MCI due to AD from MCI non-AD and healthy subjects. These findings allow to hypothesize that the loss of narrative efficacy could be a possible early clinical hallmark of Alzheimer’s disease. Furthermore, a significant correlation of global coherence and lexical informativeness reduction with the SPECT hypoperfusion was found in the dorsal aspect of the anterior part of the left inferior frontal gyrus, supporting the hypothesis that this area has a significant role in communicative efficacy, and in particular, in semantic selection executive control.

Conclusion: This study contributes to the understanding of the neural networks for language processing and their involvement in prodromal Alzheimer's disease. It also suggests an easy and sensitive tool for clinical practice that can help identifying individuals with prodromal Alzheimer’s disease.

Keywords:

Mild cognitive impairment, Alzheimer’s disease, connected speech, language disorders, functional neuroimaging, lexical impairments.

Affiliation:

Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Department of Rehabilitation Medicine, Neuropsychology Unit, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Department of Rehabilitation Medicine, Neuropsychology Unit, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Unit of Nuclear Medicine, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Department of Rehabilitation Medicine, Neuropsychology Unit, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Unit of Nuclear Medicine, University Hospital and Health Services of Trieste, University of Trieste, Trieste, NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Department of Language and Literatures, Communication, Education and Society, University of Udine, Udine



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