Speech characteristics of parkinson disease

Objective: Parkinson Disease (PD) is known the second most frequent neurodegenerative age-related disorder after Alzheimer’s disease. Although over the six million people worldwide suffer from PD, the main cause of the disease remains are unknown. Speech and language impairments have emerged in most patients with PD during the course of the disease. However, clinical profiles or characteristics that might differentiate individuals with PD who are predisposed to speech and language deficits are generally overlooked. Moreover, factors that expedite language disability have still been remained elusive. It is thought that the awareness of speech and language impairments in PD can significantly help to maintain language abilities as the disease progresses and also may contribute to improving communication skills with patients. For this reason, the present study aims to constitute a comprehensive frame for the speech and language characteristics of individuals with PD

“Hard to Say, Hard to Understand, Hard to Live”: Possible Associations between Neurologic Language Impairments and Suicide Risk

In clinical practice, patients with language impairments often exhibit suicidal ideation (SI) and suicidal behavior (SB, covering the entire range from suicide attempts, SA, to completed suicides). However, only few studies exist regarding this subject. We conducted a mini-review on the possible associations between neurologic language impairment (on the motor, comprehension, and semantic sides) and SI/SB. Based on the literature review, we hypothesized that language impairments exacerbate psychiatric comorbidities, which, in turn, aggravate language impairments. Patients trapped in this vicious cycle can develop SI/SB. The so-called “affective prosody” provides some relevant insights concerning the interaction between the different language levels and the world of emotions. This hypothesis is illustrated in a clinical case that we reported, consisting of the case of a 74-year old woman who was admitted to a psychiatric emergency department (ED) after a failed SA. Having suffered an ischemic stroke two years earlier, she suffered from incomplete Broca’s aphasia and dysprosody. She also presented with generalized anxiety and depressive symptoms. We observed that her language impairments were both aggravated by the exacerbations of her anxiety and depressive symptoms. In this patient, who had deficits on the motor side, these exacerbations were triggered by her inability to express herself, her emotional status, and suffering. SI was fluctuant, and—one year after the SA—she completed suicide. Further studies are needed to ascertain possible reciprocal and interacting associations between language impairments, psychiatric comorbidities, and SI/SB. They could enable clinicians to better understand their patient’s specific suffering, as brought on by language impairment, and contribute to the refining of suicide risk detection in this sub-group of affected patients.

Therapeutic effect of soluble factors of M2 phenotype macrophages in children with language impairments

The aim of the present study was to assess safety and clinical efficacy of inhalation immunotherapy based on intranasal administration of bioactive factors produced by the M2 phenotype macrophages in children with language impairments, as well as to study the effect of inhalation immunotherapy on the cytokine profile in the patients' blood serum. The study was carried out according to the NCT04689282 protocol (www.ClinicalTrials.gov) and included 14 children (9 boys / 5 girls), aged 3 to 8 years, with language impairments associated with perinatal or postnatal CNS lesions of various origin. The children recruited into the study were assessed by a neurologist and speech therapist before the therapy, at the end of the course (1 month), and 6 months later. Serum samples for cytokine analysis were obtained before and 1 month after therapy. The course of intranasal inhalations by the conditioned M2 media (2 ml one time per day for 28-30 days) was safe and well tolerated. None of the 14 treated children had significant adverse reactions and severe undesirable events. Intranasal immunotherapy led to a decrease in the severity of language problems, which manifested by improved speech understanding by 45%; the sensorimotor level of speech, by 51%; word formation skills, by 72%, as well as a twofold increase in general and fine motor skills. In children with signs of autism spectrum disorders, along with a language improvement, a decrease in the severity of autistic symptoms was registered, as evidenced by statistically significant decrease in the CARS score from 42.5 to 38.5 after 1 month, and to 33 points after 6 months (p < 0.05). The clinical effect was revealed rather soon, i.e., within a month after the first procedure, being maintained or intensified during a follow-up for 6 months. At the same time, two-thirds of the children showed a clear clinical improvement, with insignificant effect in the rest of patients. Comparative analysis of the serum cytokine levels in these subgroups showed that children with a pronounced positive response to inhaled immunotherapy differed in the following parameters: (1) initially higher level of VEGF and IGF-1, and (2) decrease the level of TNFα in response to intranasal immunotherapy. In summary, we first tested a fundamentally new approach based on the use of soluble factors from M2-type macrophages and intranasal route of their administration in order to treat the children with severe language impairments, demonstrating safety and obtained preliminary data on effectiveness of such approach.

Lexical and acoustic speech features relating to Alzheimer’s disease pathology

INTRODUCTIONIn this study, we compared digital speech features of AD and lvPPA patients in a biologically confirmed cohort and related them to specific neuropsychiatric test scores and CSF proteins.METHODSWe extracted language variables with automated lexical and acoustic pipelines from oral picture descriptions of 44 AD and 21 lvPPA patients with autopsy or CSF confirmation of AD pathology. We correlated distinct speech features with MMSE and BNT test scores and CSF p-tau levels.RESULTSLvPPA patients produced fewer verbs, adjectives, and more fillers with lower lexical diversity and higher pause rate than AD. Both groups showed some shared language impairments compared with normal speakers.DISCUSSIONOur speech measures captured differences in speech between the two phenotypes. Also, shared speech markers were linked to the common underlying pathology. This work demonstrates the potential of natural speech analysis in detecting underlying AD pathology.

Language Skills of Students With Emotional and Behavioral Disorders

This column highlights the importance of language and communication skills in students with emotional and behavioral disorders (EBD). Evidence continues to point to language impairments as a co-occurring area of concern in students with EBD. This complex association is described along with recommendations for supporting students with EBD who may have documented or undocumented language impairments. The goal of this column is to promote discussion and collaborative efforts to develop solutions for best supporting outcomes of students with EBD.