Clinical use of SAND battery to evaluate language in patients with Progressive Supranuclear Palsy

Abstract

BackgroundProgressive Supranuclear Palsy (PSP) patients present language disturbances in tasks like naming, repetition, reading, word comprehension and semantic association compared to Parkinson’s disease (PD) and healthy controls (HC).ObjectiveIn the present study we sought to validate a Screening for Aphasia in NeuroDegeneration (SAND) battery version specifically tailored on PSP patients and to describe language impairment in relation to PSP disease phenotype and cognitive status.Methods and resultsFifty-one PSP [23 with Richardson’s syndrome (PSP-RS), 10 with predominant parkinsonism (PSP-P) and 18 with the other variant syndromes of PSP (vPSP)], 28 PD and 30 HC were enrolled in the present study. By excluding the tasks with poor acceptability (i.e., writing and picture description tasks) and increasing the items related to the remaining tasks, we showed that the PSP-tailored SAND Global Score is an acceptable, consistent and reliable tool to screen language disturbances in PSP. However, we failed to detect major differences in language involvement according to disease phenotype. Differently, we showed that patients with dementia present worse language performances.ConclusionsTaking into account specific disease features, the combination of the SAND subscores included in the PSP-tailored SAND better represents language abilities in PSP. Furthermore, we showed that language disturbances feature PSP patients irrespective of disease phenotype, but parallels the deterioration of the global cognitive function.

The language profile in multiple system atrophy: an exploratory study

“…We found that the MSA-tailored SAND Global Score, composed of 17 tasks, is an acceptable, reliable and easily applicable tool to explore language profile in MSA patients. By removing sub-scores with high proportion of missing values, we obtained a significant improvement in consistency and acceptability comparable with the original SAND Global Score and PSP-tailored SAND (Battista et al 2005 ; Picillo et al 2019 ).…”

“…In this study, we evaluated an often overlooked aspect of cognitive dysfunction in movement disorders, namely language impairment. Indeed, a growing number of studies, especially regarding idiopathic PD, reported significant difficulties with language tasks, including understanding of sentences, verbal fluency and naming (Picillo et al 2019;Catricalà et al 2013Catricalà et al , 2019. Generally, language alterations have also been reported in patients with lesions of the basal ganglia following stroke (Auclair-Ouellet et al 2017).…”

“…Specifically, a global score was used for the identification of the psychometric properties of the battery. In PPA, the psychometric properties of SAND were calculated on a 23-task battery (Battista et al 2005 ), while a tailored 19-task battery was validated in PSP (Picillo et al 2019 ).…”

Best Practices in the Clinical Management of Progressive Supranuclear Palsy and Corticobasal Syndrome: A Consensus Statement of the CurePSP Centers of Care

“…Specific deficits comprising non-fluent aphasia in PSP/CBS include simplified or agrammatic speech produced in an effortful manner, with impaired grammatical comprehension and preserved lexical comprehension; and often accompanied by Apraxia of Speech. A version of the Screening for Aphasia in Neurodegeneration battery has been used for PSP patients and proposed as a reliable tool to screen for these characteristic language disturbances (180). For treatment of speech apraxia in PSP, one recent study (181) provides Class III evidence that transcranial direct current stimulation over the dorsolateral prefrontal cortex improves performance in some language tasks, but more study is required.…”

Language Disorder in Progressive Supranuclear Palsy and Corticobasal Syndrome: Neural Correlates and Detection by the MLSE Screening Tool

“…Such tasks might disadvantage PSP patients due to their oculomotor abnormalities or disadvantage both PSP and CBS patients due to motor deficits. This complicates interpretation of results from investigations of language in these disorders because scoring is often binary, the reasons for task failures can be unclear and can differ across disorders (Peterson et al, 2019 ; Picillo et al, 2019 ). The MLSE addresses this longstanding issue by incorporating an error-based scoring system to capture language-specific contributions to impaired test performance, enabling one to tease apart linguistic deficits from one another and from other impairments.…”