Using narratives in differential diagnosis of neurodegenerative syndromes
Open accessAbstract
Purpose Language decline has been associated with healthy aging and with various neurodegenerative conditions, making it challenging to differentiate among these conditions. This study examined the utility of linguistic measures derived from a short narrative language sample for 1) identifying language characteristics and cut-off scores to differentiate between healthy aging, Primary Progressive Aphasia (PPA), Mild Cognitive Impairment (MCI), and Alzheimer's dementia (AD); and 2) differentiating among PPA variants in which language is the primary impairment.Method Participants were 25 neurologically healthy English speakers, 20 individuals with MCI, 20 with AD, and 26 with PPA (non-fluent/agrammatic N = 10, logopenic N = 9, semantic N = 7). Narrative language samples of the Cookie Theft Picture of persons with healthy aging, MCI and AD were retrospectively obtained from the DementiaBank database (https://talkbank.org/DementiaBank/) and PPA samples were obtained from an ongoing research study. The language samples were analyzed for fluency, word retrieval success, grammatical accuracy, and errors using automated and manual analysis methods. The sensitivity and specificity of various language measures was computed.Results Participants with PPA scored lower than neurologically healthy and MCI groups on fluency (words per minute and disfluencies), word retrieval (Correct Information Units and number of errors), and sentence grammaticality. PPA and AD groups did not differ on language measures. Agrammatic PPA participants scored lower than logopenic and semantic PPA groups on several measures, while logopenic and semantic PPA did not differ on any measures.Conclusion Measures derived from brief language samples and analyzed using mostly automated methods are clinically useful in differentiating PPA from healthy aging and MCI, and agrammatic PPA from other variants. The sensitivity and specificity of these measures is modest and can be improved when coupled with clinical presentation.
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Across primary progressive aphasia variants, ASLA markers capture syndrome-specific patterns that predict underlying neuropathology years before death and correlate with variant-specific atrophy, even longitudinally.
“Across primary progressive aphasia variants, ASLA markers capture syndromespecific patterns 49-53 that predict underlying neuropathology years before death 7 and correlate with variant-specific atrophy, 53-56 even longitudinally. 57”
From Speech and language markers of neurodegeneration: a call for global equity (2023) · cites this paper as [51]
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References 83 · Cited by 32
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- Authors
- Faroqi-Shah, Y., Treanor, A., Ratner, N. B., Ficek, B., Webster, K., & Tsapkini, K.
- Affiliations
- Johns Hopkins University (US)
- Venue
- Journal of Communication Disorders
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 85
- Pages
- 105994
- ISSN
- 0021-9924 (ISSN-L)
- PMC
- PMC7304645
- OpenAlex
- W3021645609
- Cited by
- 32
- References
- 83
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 2 · 2021: 4 · 2020: 3
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Communication Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Deafness and Other Communication Disorders (R01 DC014475)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Keywords
- primary progressive aphasia, mild cognitive impairment, Alzheimer's dementia, healthy aging, differential diagnosis, narrative language, language loss, word retrieval, grammaticality, fluency, DementiaBank
- MeSH terms
- Aged, Alzheimer Disease, Diagnosis, Differential, Humans, Language, Middle Aged, Retrospective Studies, Aphasia, Primary Progressive, Neurodegenerative Diseases, Cognitive Dysfunction
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