"It's on the tip of my tongue!" exploring confrontation naming difficulties in patients with multiple sclerosis

Tiffany Grezmak; John W Lace; Kunio Nakamura; Daniel Ontaneda; Rachel Galioto

doi:10.1016/j.msard.2023.104579

"It's on the tip of my tongue!" exploring confrontation naming difficulties in patients with multiple sclerosis

Mult Scler Relat Disord. 2023 Mar:71:104579. doi: 10.1016/j.msard.2023.104579. Epub 2023 Feb 14.

Authors

Tiffany Grezmak¹, John W Lace¹, Kunio Nakamura², Daniel Ontaneda³, Rachel Galioto⁴

Affiliations

¹ Neurological Institute, Section of Neuropsychology, Cleveland Clinic, Cleveland, OH USA.
² Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, OH, USA.
³ Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH USA.
⁴ Neurological Institute, Section of Neuropsychology, Cleveland Clinic, Cleveland, OH USA; Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH USA. Electronic address: GALIOTR@ccf.org.

PMID: 36805174
DOI: 10.1016/j.msard.2023.104579

Abstract

Background: Naming difficulty is commonly reported by patients with multiple sclerosis (pwMS). Though many cognitive batteries recommended for pwMS include fluency tasks, they do not include naming tasks. The aim of this study was to examine the prevalence of naming impairment in pwMS by using a measure of confrontation naming and to identify correlates with neuroimaging.

Methods: One-hundred-eighty-five pwMS (M_age = 48.75 ± 11.23) completed neuropsychological testing and fifty had brain MRI scans within one year of neuropsychological testing. Controlling for demographic variables, partial correlations and hierarchical regressions with language tests as the outcome variables and neuroimaging variables as predictors were performed.

Results: Performance on language tasks ranged within low average to average, with impairment most frequently found on a measure of confrontation naming (Boston Naming Test [BNT];27.6%), followed by a measure of phonemic fluency (Controlled Oral Word Association Test [COWAT]; 24.3%) and semantic fluency (animals [AF]; 18.3%). In the subset of patients with neuroimaging, thalamic volume had the strongest relationship with language variables, followed by white matter volume and T2 lesion volume. Language variables had no association with fractional gray matter volume. Of the language measures, BNT demonstrated the strongest relationship with MRI variables, followed by AF. There were no significant associations between neuroimaging variables and COWAT. Regression results revealed that fractional thalamic volume significantly contributed to BNT scores after adjusting for demographics, while T2 lesion volume predicted AF and no neuroimaging variables emerged as predictors for COWAT after controlling for demographics.

Conclusions: Objective naming impairment is common in pwMS and are more strongly associated with neuroimaging of MS brain pathology than verbal fluency tasks that are commonly used in cognitive batteries for pwMS. Continued research on language (especially naming) deficits and neuroimaging correlates (particularly thalamic involvement) in pwMS is needed.

Keywords: Language; Multiple sclerosis; Naming; Neuropsychological assessment; Word finding.

MeSH terms

Brain / diagnostic imaging
Brain / pathology
Humans
Magnetic Resonance Imaging
Multiple Sclerosis* / complications
Multiple Sclerosis* / diagnostic imaging
Multiple Sclerosis* / pathology
Neuropsychological Tests
Tongue