Clustering and switching on verbal fluency tests in Alzheimer's and Parkinson's disease

1998 ◽  
Vol 4 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Angela K. Troyer ◽  
Morris Moscovitch ◽  
Gordon Winocur ◽  
Larry Leach ◽  
and Morris Freedman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Verbal Fluency ◽  
Semantic Fluency ◽  
Alzheimer Type ◽  
Control Groups ◽  
Respective Control ◽  
Phonemic Fluency ◽  
Differential Pattern ◽  
Pattern Of Performance

Two components of verbal fluency performance—clustering (i.e., generating words within subcategories) and switching (i.e., shifting between subcategories)—were examined in patients with dementia of the Alzheimer type (DAT), patients with dementia with Parkinson's disease (DPD), nondemented patients with Parkinson's disease (NPD), and demographically matched controls. The DAT and DPD groups were impaired in the number of words generated on both phonemic and semantic fluency. The DAT group produced smaller clusters on both tasks and switched less often on semantic fluency than controls. The DPD group switched less often on both tasks and produced smaller clusters on phonemic fluency than controls. The NPD group was not impaired on any fluency variable. Thus, the total number of words generated on phonemic and semantic fluency did not discriminate the dementia groups from their respective control groups, but measures of clustering and switching did. This differential pattern of performance provides evidence for the potential usefulness of measures of switching and clustering in the assessment of dementia. (JINS, 1998, 4, 137–143.)

Verbal fluency in Parkinson's disease: results of a 2-min fluency test

2006 ◽  
Vol 18 (1) ◽  
pp. 38-41 ◽  
Author(s):  
B. Scholtissen ◽  
J. Dijkstra ◽  
J. Reithler ◽  
A. F. G. Leentjens
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Executive Functioning ◽  
Verbal Fluency ◽  
Healthy Controls ◽  
Impaired Performance ◽  
Phonemic Fluency ◽  
Retrieval Strategies ◽  
Fluency Task ◽  
Fluency Test

Background:Patients suffering from Parkinson's disease (PD) are often reported to have an impaired performance on tests measuring executive functioning, such as fluency tasks.Aim:To investigate whether verbal fluency is impaired in PD patients (n = 25) compared with healthy controls (n = 15) using a 2-min semantic and phonemic verbal fluency test. A 2-min version of the fluency task was used to allow for more switches between clusters to study retrieval strategies more adequately.Results:No differences in performance on both semantic and phonemic fluency tasks between the PD patients and the control persons were found. Moreover, both groups appeared to use the same retrieval strategies.Conclusion:Patients suffering from PD appear to use the same strategies for producing words as healthy controls do. Different pathways may be involved in switching clusters during the fluency task than in other types of switching that may be impaired in PD, such as motor switching and concept-shifting.

scholarly journals Verbal fluency deficits in Parkinson's disease: A meta-analysis

2004 ◽  
Vol 10 (4) ◽  
pp. 608-622 ◽  
Author(s):  
JULIE D. HENRY ◽  
JOHN R. CRAWFORD
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Semantic Memory ◽  
Verbal Fluency ◽  
Meta Analysis ◽  
Relative Magnitude ◽  
Semantic Fluency ◽  
Confrontation Naming ◽  
Cognitive Speed ◽  
Differential Deficit

A meta-analysis of 68 studies with a total of 4644 participants was conducted to investigate the sensitivity of tests of verbal fluency to the presence of Parkinson's disease (PD) relative to healthy controls. Both phonemic and semantic fluency were moderately impaired but neither deficit qualified as a differential deficit relative to verbal intelligence or psychomotor speed. However, PD patients were significantly more impaired on semantic relative to phonemic fluency (rs = .37vs..33, respectively), and confrontation naming, a test of semantic memory that imposes only minimal demands upon cognitive speed and effortful retrieval, was associated with a deficit that was of a comparable magnitude to the deficits upon each of these types of fluency. Thus, the disorder appears to be associated with particular problems with semantic memory. Tests that impose heavy demands upon switching may also be disproportionately affected. Demented and non-demented PD patients differ quantitatively but not qualitatively in terms of the relative prominence of deficits on tests of phonemic and semantic fluency. However, patients with dementia of the Alzheimer's type and demented PD patients can be differentiated from one another by the relative magnitude of deficits upon these two measures. (JINS, 2004,10, 608–622.)

scholarly journals Semantic and Phonemic Verbal Fluency in Parkinson’s Disease: Influence of Clinical and Demographic Variables

2012 ◽  
Vol 25 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Ignacio Obeso ◽  
Enrique Casabona ◽  
Maria Luisa Bringas ◽  
Lázaro Álvarez ◽  
Marjan Jahanshahi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Verbal Fluency ◽  
Executive Dysfunction ◽  
Demographic Variables ◽  
Semantic Verbal Fluency ◽  
Phonemic Fluency ◽  
Main Components ◽  
Depression Education ◽  
Deep Brain

Changes of cognitive function in PD have been extensively documented and defined as a ‘frontal’ type executive dysfunction. One of the main components of this executive dysfunction is the impairment of verbal fluency. The aim of the present study was to assess semantic and phonemic fluency in a large sample of PD patients and to investigate the effect of clinical and sociodemographic variables on verbal fluency in this patient group.Three hundred patients with idiopathic Parkinson's disease who were consecutive referrals to our clinic and 50 age and education matched healthy controls completed the phonemic and semantic verbal fluency tasks. Both phonemic and semantic verbal fluency were significantly impaired in PD patients relative to matched controls. Stage of illness, presence of depression, education and age influenced verbal fluency measures. Regression analyses established that global measures of cognitive ability (MMSE) and executive function (FAB) and side of onset of motor symptoms predicted 36–37% of variance of phonemic or semantic verbal fluency measures. Thus, future studies aimed at assessing cognitive functioning in PD patients treated by deep brain stimulation (DBS) should adequately take into account several factors (stage of illness, depression, executive functioning) which may potentially influence performance on verbal fluency tasks.

scholarly journals Semantic Fluency Deficits and Associated Brain Activity in Parkinson’s Disease Patients With Mild Cognitive Impairment

2021 ◽  
Author(s):  
Jihyun Yang ◽  
Katie L McMahon ◽  
David A Copland ◽  
Dana Pourzinal ◽  
Gerard J Byrne ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Verbal Fluency ◽  
Brain Activity ◽  
Angular Gyrus ◽  
Semantic Fluency ◽  
Compensatory Mechanisms ◽  
Increased Risk

Abstract Parkinson’s disease (PD) patients with poor verbal fluency have an increased risk of developing dementia. This study examines the neural mechanisms underpinning semantic fluency deficits in PD patients with mild cognitive impairment (PD-MCI) compared to patients without MCI (PD-NC) and healthy controls (HC). Thirty-seven (37) PD patients completed a cognitive assessment battery to identify MCI (13 PD-MCI). Gender- and age-matched 20 HC also participated. Participants were scanned (3T Siemens PRISMA) whilst performing semantic fluency, semantic switching, and automatic speech tasks. The number of responses, error rate, and fMRI data for semantic generation and semantic switching were analyzed. Participants also completed a series of verbal fluency tests outside the scanner, including letter fluency. Patients with PD-MCI performed significantly worse than PD-NC and HC during semantic fluency and semantic switching tasks. Patients with PD-MCI showed greater activity in the right angular gyrus compared to PD-NC and HC during semantic switching. Increased right angular activity correlated with worse verbal fluency performance outside the scanner. Our study showed that PD-MCI patients perform more poorly on semantic fluency than either PD-NC or HC groups. Increased right angular gyrus activity in patients with PD-MCI during semantic switching suggests early compensatory mechanisms predicting the risk of future dementia in PD.

Qualitative Deficits in Verbal Fluency in Parkinson’s Disease with Mild Cognitive Impairment: A Clinical and Neuroimaging Study

2021 ◽  
pp. 1-12
Author(s):  
Tomoya Hamada ◽  
Yuichi Higashiyama ◽  
Asami Saito ◽  
Keisuke Morihara ◽  
Ramon Landin-Romero ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Connectivity ◽  
Diagnostic Accuracy ◽  
Verbal Fluency ◽  
Salience Network ◽  
Semantic Fluency ◽  
Characteristic Analysis

Background: Mild cognitive impairment (MCI) in Parkinson’s disease (PD) is considered a risk factor for PD with dementia (PDD). Verbal fluency tasks are widely used to assess executive function in PDD. However, in cases of PD with MCI (PD-MCI), the relative diagnostic accuracy of different qualitative verbal fluency measures and their related neural mechanisms remain unknown. Objective: This study aimed to investigate the relative diagnostic accuracy of qualitative (clustering and switching) verbal fluency strategies and their correlates with functional imaging in PD-MCI. Methods: Forty-five patients with PD (26 with MCI and 19 without MCI) and 25 healthy controls underwent comprehensive neurocognitive testing and resting-state functional magnetic resonance imaging. MCI in patients with PD was diagnosed according to established clinical criteria. The diagnostic accuracy of verbal fluency measures was determined via receiver operating characteristic analysis. Changes in brain functional connectivity between groups and across clinical measures were assessed using seed-to-voxel analyses. Results: Patients with PD-MCI generated fewer words and switched less frequently in semantic and phonemic fluency tasks compared to other groups. Switching in semantic fluency showed high diagnostic accuracy for PD-MCI and was associated with reduced functional connectivity in the salience network. Conclusion: Our results indicate that reduced switching in semantic fluency tasks is a sensitive and specific marker for PD-MCI. Qualitative verbal fluency deficits and salience network dysfunction represent early clinical changes observed in PD-MCI.

scholarly journals Different outcomes of phonemic verbal fluency in Parkinson’s disease patients with subthalamic nucleus deep brain stimulation

2017 ◽  
Vol 75 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Aline Juliane Romann ◽  
Bárbara Costa Beber ◽  
Maira Rozenfeld Olchik ◽  
Carlos R M. Rieder
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Verbal Fluency ◽  
Phonemic Fluency ◽  
Phonemic Verbal Fluency ◽  
Stn Dbs ◽  
Deep Brain

ABSTRACT Subthalamic nucleus deep brain stimulation (STN-DBS) is a surgical technique to treat motor symptoms in patients with Parkinson’s disease (PD). Studies have shown that STN-DBS may cause a decline in verbal fluency performance. We aimed to verify the effects of STN-DBS on the performance of phonemic verbal fluency in Brazilian PD patients. Sixteen participants were evaluated on the Unified Parkinson’s Disease Rating Scale - Part III and for phonemic fluency (“FAS” version) in the conditions of on- and off-stimulation. We identified two different patterns of phonemic verbal fluency outcomes. The results indicate that there may be no expected pattern of effect of bilateral STN-DBS in the phonemic fluency, and patients may present with different outcomes for some reason not well understood.

scholarly journals Which Neuropsychological Tests? Predicting Cognitive Decline and Dementia in Parkinson’s Disease in the ICICLE-PD Cohort

2021 ◽  
pp. 1-12
Author(s):  
Rachael A. Lawson ◽  
Caroline H. Williams-Gray ◽  
Marta Camacho ◽  
Gordon W. Duncan ◽  
Tien K. Khoo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Verbal Fluency ◽  
Neuropsychological Tests ◽  
Visual Memory ◽  
Attention And Memory ◽  
Memory And Attention ◽  
Global Cognition

Background: Cognitive impairment is common in Parkinson’s disease (PD), with 80% cumulatively developing dementia (PDD). Objective: We sought to identify tests that are sensitive to change over time above normal ageing so as to refine the neuropsychological tests predictive of PDD. Methods: Participants with newly diagnosed PD (n = 211) and age-matched controls (n = 99) completed a range of clinical and neuropsychological tests as part of the ICICLE-PD study at 18-month intervals over 72 months. Impairments on tests were determined using control means (<1-2SD) and median scores. Mild cognitive impairment (PD-MCI) was classified using 1-2SD below normative values. Linear mixed effects modelling assessed cognitive decline, while Cox regression identified baseline predictors of PDD. Results: At 72 months, 46 (cumulative probability 33.9%) participants had developed PDD; these participants declined at a faster rate in tests of global cognition, verbal fluency, memory and attention (p <  0.05) compared to those who remained dementia-free. Impaired baseline global cognition, visual memory and attention using median cut-offs were the best predictors of early PDD (area under the curve [AUC] = 0.88, p <  0.001) compared to control-generated cut-offs (AUC = 0.76–0.84, p <  0.001) and PD-MCI (AUC] = 0.64–0.81, p <  0.001). Impaired global cognition and semantic fluency were the most useful brief tests employable in a clinical setting (AUC = 0.79, p <  0.001). Conclusion: Verbal fluency, attention and memory were sensitive to change in early PDD and may be suitable tests to measure therapeutic response in future interventions. Impaired global cognition, attention and visual memory were the most accurate predictors for developing a PDD. Future studies could consider adopting these tests for patient clinical trial stratification.

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