Linguistic, visuospatial, and kinematic writing characteristics in cognitively impaired patients with beta-amyloid deposition

Seo Kyung An; Hyemin Jang; Hee Jin Kim; Duk L Na; Ji Hye Yoon

doi:10.3389/fnagi.2023.1217746

Linguistic, visuospatial, and kinematic writing characteristics in cognitively impaired patients with beta-amyloid deposition

Front Aging Neurosci. 2023 Sep 11:15:1217746. doi: 10.3389/fnagi.2023.1217746. eCollection 2023.

Authors

Seo Kyung An¹, Hyemin Jang², Hee Jin Kim², Duk L Na², Ji Hye Yoon³

Affiliations

¹ Department of Speech-Language Pathology and Audiology, Hallym University, Chuncheon, Republic of Korea.
² Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
³ Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, Hallym University, Chuncheon, Republic of Korea.

Abstract

Introduction: Beta-amyloid (Aβ) deposition, a hallmark of Alzheimer's disease (AD), begins before dementia and is an important factor in mild cognitive impairment (MCI). Aβ deposition is a recognized risk factor for various cognitive impairments and has been reported to affect motor performance as well. This study aimed to identify the linguistic, visuospatial, and kinematic characteristics evident in the writing performance of patients with cognitive impairment (CI) who exhibit Aβ deposition.

Methods: A total of 31 patients diagnosed with amnestic mild cognitive impairment (aMCI) with Aβ deposition, 26 patients with Alzheimer's-type dementia, and 33 healthy control (HC) participants without deposition were administered tasks involving dictation of 60 regular words, irregular words, and non-words consisting of 1-4 syllables. Responses from all participants were collected and analyzed through digitized writing tests and analysis tools.

Results: In terms of linguistic aspects, as cognitive decline progressed, performance in the dictation of irregular words decreased, with errors observed in substituting the target grapheme with other graphemes. The aMCI group frequently exhibited corrective aspects involving letter rewriting during the task. In terms of visuospatial aspects, the AD group displayed more errors in grapheme combination compared to the HC group. Lastly, in the kinematic aspects, both the aMCI group and the AD group exhibited slower writing speeds compared to the HC group.

Discussion: The findings suggest that individuals in the CI group exhibited lower performance in word dictation tasks than those in the HC group, and these results possibly indicate complex cognitive-language-motor deficits resulting from temporal-parietal lobe damage, particularly affecting spelling processing. These results provide valuable clinical insights into understanding linguistic-visuospatial-kinematic aspects that contribute to the early diagnosis of CI with Aβ deposition.

Keywords: beta amyloid; cognitive impairment; speed; word dictation; writing.

Grants and funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (No. 2021R1I1A2044504).