ABSTRACT. The differential diagnosis of primary progressive aphasia (PPA) is challenging due to overlapping clinical manifestations of the different variants of the disease. This is particularly true for the logopenic variant of PPA (lvPPA), in which such overlap was reported with regard to impairments in repetition abilities. In this study, four individuals with lvPPA underwent standard neuropsychological and language assessments. The influence of psycholinguistic variables on their performance of in word, nonword and sentence repetition tasks was also specifically explored. Some level of heterogeneity was found in cognitive functions and in language. The four participants showed impairment in sentence repetition in which their performance was negatively affected by semantic reversibility and syntactic complexity. This study supports the heterogeneity of lvPPA with respect to the cognitive and linguistic status of participants. It also shows that sentence repetition is influenced not only by length, but also by semantic reversibility and syntactic complexity, two psycholinguistic variables known to place additional demands on phonological working memory.
Background:The term progressive apraxia of speech (PAOS) is used to describe speakers presenting with isolated or dominant apraxia of speech in the context of a neurodegenerative syndrome, including primary progressive apraxia of speech (PPAOS) and dominant progressive apraxia of speech (DAOS), respectively. Its motor speech profile has been increasingly explored in the last decade, but description remains vague and very English oriented, although the effect of speakers' language on motor speech phenotypes is increasingly recognized. Although some studies suggest that speakers presenting with isolated PAOS (PPAOS) versus dominant PAOS with concomitant aphasia (DAOS) should be differentiated, distinct characteristics of the two presentations are unclear. Furthermore, a careful description of their clinical presentation in languages other than English is required. Aims: To describe the motor speech characteristics of Quebec French-speaking participants with prominent PAOS and to explore the communication profile of those presenting more specifically with isolated PAOS (PPAOS), and with dominant PAOS and concomitant aphasia (DAOS). Methods & Procedures: A thorough effort to recruit all speakers presenting with PAOS in the larger population areas of the province of Quebec was conducted over a 3-year span. A total of nine participants with PAOS (pwPAOS; PPAOS = 5, DAOS = 4) underwent a comprehensive language and motor speech assessment, and a cognitive screening. Their performance was compared with 30 matched healthy controls.Outcomes & Results: As a group, pwPAOS differed from healthy speakers on all acoustic and perceptual measures. The PPAOS and PAOS subgroups were similar on several measures, but participants from the PPAOS subgroup tended to perform better on articulatory measures and maximum speech rate tasks. Conclusions & Implications:This study provides an in-depth analysis of motor speech characteristics of PAOS in Quebec French speakers and adds further evidence for the differentiation of PPAOS and DAOS. Combining simple perceptual and acoustic analyses represent a promising approach to distinguish the two variants and identify treatment targets.
Purpose: This study sought to determine whether clinically interpretable kinematic features extracted automatically from three-dimensional (3D) videos were correlated with corresponding perceptual clinical orofacial ratings in individuals with orofacial impairments due to neurological disorders. Method: 45 participants (19 diagnosed with motor neuron diseases [MNDs] and 26 poststroke) performed two nonspeech tasks (mouth opening and lip spreading) and one speech task (repetition of a sentence “Buy Bobby a Puppy”) while being video-recorded in a standardized lab setting. The color video recordings of participants were assessed by an expert clinician—a speech language pathologist—on the severity of three orofacial measures: symmetry, range of motion (ROM), and speed. Clinically interpretable 3D kinematic features, linked to symmetry, ROM, and speed, were automatically extracted from video recordings, using a deep facial landmark detection and tracking algorithm for each of the three tasks. Spearman correlations were used to identify features that were significantly correlated ( p value < .05) with their corresponding clinical scores. Clinically significant kinematic features were then used in the subsequent multivariate regression models to predict the overall orofacial impairment severity score. Results: Several kinematic features extracted from 3D video recordings were associated with their corresponding perceptual clinical scores, indicating clinical validity of these automatically derived measures. Different patterns of significant features were observed between MND and poststroke groups; these differences were aligned with clinical expectations in both cases. Conclusions: The results show that kinematic features extracted automatically from simple clinical tasks can capture characteristics used by clinicians during assessments. These findings support the clinical validity of video-based automatic extraction of kinematic features.
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