The Organization and Anatomy of Narrative Comprehension and Expression in Lewy Body Spectrum Disorders

被引:24
作者
Ash, Sharon [1 ]
Xie, Sharon X. [2 ]
Gross, Rachel Goldmann [1 ]
Dreyfuss, Michael [1 ]
Boller, Ashley [1 ]
Camp, Emily [1 ]
Morgan, Brianna [1 ]
O'Shea, Jessica [1 ]
Grossman, Murray [1 ]
机构
[1] Univ Penn, Perelman Sch Med, Dept Neurol, Philadelphia, PA 19104 USA
[2] Univ Penn, Perelman Sch Med, Dept Biostat, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
Parkinson's disease; speech; language; dementia with Lewy bodies; IDIOPATHIC PARKINSONS-DISEASE; WHITE-MATTER ALTERATIONS; TEMPORAL-LOBE ATROPHY; ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; PREFRONTAL CORTEX; BRAIN-INJURY; HIERARCHICAL ORGANIZATION; EXECUTIVE PROCESSES; VERBAL FLUENCY;
D O I
10.1037/a0027115
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Objective: Patients with Lewy body spectrum disorders (LBSD) such as Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies exhibit deficits in both narrative comprehension and narrative expression. The present research examines the hypothesis that these impairments are due to a material-neutral deficit in organizational executive resources rather than to impairments of language per se. We predicted that comprehension and expression of narrative would be similarly affected and that deficits in both expression and comprehension of narrative would be related to the same anatomic distribution of prefrontal disease. Method: We examined 29 LBSD patients and 26 healthy seniors on their comprehension and expression of narrative discourse. For comprehension, we measured accuracy and latency in judging events with high and low associativity from familiar scripts such as "going fishing." The expression task involved maintaining the connectedness of events while narrating a story from a wordless picture book. Results: LBSD patients were impaired on measures of narrative organization during both comprehension and expression relative to healthy seniors. Measures of organization during narrative expression and comprehension were significantly correlated with each other. These measures both correlated with executive measures but not with neuropsychological measures of lexical semantics or grammar. Voxel-based morphometry revealed overlapping regressions relating frontal atrophy to narrative comprehension, narrative expression, and measures of executive control. Conclusions: Difficulty with narrative discourse in LBSD stems in part from a deficit of organization common to comprehension and expression. This deficit is related to prefrontal cortical atrophy in LBSD.
引用
收藏
页码:368 / 384
页数:17
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