Natural Reading in Parkinson’s Disease With and Without Mild Cognitive Impairment

Abstract

Background: Patients with Parkinson's disease (PD) show eye movement abnormalities and frequently complain about difficulties in reading. So far, it is unclear whether basal ganglia dysfunction or cognitive impairment has a greater impact on eye movements during reading.Objective: To analyze eye movement behavior during a natural reading task with respect to cognitive state and dopaminergic therapy in PD and healthy controls. Methods: Eye movements of 59 PD patients and 29 age-and education-matched healthy controls were recorded during mute, self-paced reading of a text. 25 cognitively normal PD patients performed the task additionally in off medication state. Clinical assessment included a comprehensive neuropsychological test battery and the motor section of MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS).Results: PD-mild cognitive impairment (MCI) was diagnosed in 21 patients. Reading speed was significantly reduced in PD-MCI compared to healthy controls and PD patients without MCI due to higher numbers of progressive saccades. Cognitively intact PD patients showed no significant alterations of reading speed or eye movement pattern during reading. The fixation duration tended to be prolonged in PD compared to healthy controls and decreased significantly after levodopa intake. Scores for executive functions, attention, and language correlated with reading speed in the PD group. Conclusion:The present study is the first to reveal (1) reduced reading speed with altered reading pattern in PD with MCI and (2) a relevant impact of levodopa on fixation duration during reading in PD. Further research is needed to determine whether therapeutic interventions, e.g., levodopa or neuropsychological training, improve the subjective reading experience for patients with PD.

The Potential of Naturalistic Eye Movement Tasks in the Diagnosis of Alzheimer’s Disease: A Review

“…For example, a somewhat recent meta-analysis concluded that individuals with depression show reduced maintenance of gaze towards positive stimuli, and anxious individuals showed difficulty disengaging from threatening stimuli during visual search tasks [ 61 ]. Moreover, Stock et al [ 62 ] observed that individuals with PD fixate on words for a greater duration and make a greater number of regressions when reading. As these morbidities and alternative neurological disorders can independently influence naturalistic eye movement behaviours, if one were to analyse naturalistic eye movement behaviours in individuals with AD with these comorbidities, it would be difficult to parse apart the influence of AD from the influence of the comorbidity.…”

Guidelines for Speech Recording and Acoustic Analyses in Dysarthrias of Movement Disorders

“…[13][14][15][16][17][18][19][20] The challenge in measuring speech and voice parameters is that one needs to account for the added instability of the speech signal because of movement disorders such as tremors, dyskinesias, dystonic postures, possible attention/cognitive problems, and fatigue. Reading abilities may be compromised by visual or reading difficulties 21 ; the emotional burden can affect speech. 22 As external cues for loudness can alter the volume, speech should be recorded by an independent person in a room not associated with speech therapy and consistent, clear instructions should be provided.…”

Clinical outcomes of PD Check‐In, a model for supported self‐managed maintenance of speech in Parkinson's disease: A Phase 1 study

“…Wight and Miller (2015) reported a significant increase in SPL reading pre‐ to 12 months but not 24 months post‐treatment. Neurological and cognitive–linguistic factors which may have impacted SPL for reading in the current study include impaired comprehension of written material (Murray & Rutledge, 2014); slowness in psychomotor tasks (Broeders et al., 2013), and changes in eye movement in PD leading to reduced speed in reading and altered reading pattern (Stock et al., 2020). The significant decrease in SPL reading from 6 months post‐treatment highlights the importance of supporting PWPD to continue to read salient, functional material that is visually and cognitively appropriate for their changing abilities, from post‐LSVT LOUD onwards.…”