Connected speech in progressive supranuclear palsy: a possible role in differential diagnosis

Neurol Sci. 2021 Apr;42(4):1483-1490. doi: 10.1007/s10072-020-04635-8. Epub 2020 Aug 27.

Abstract

Background: Progressive supranuclear palsy (PSP) is an atypical Parkinsonism characterized by motor and neuropsycological disorders. Language could be impaired in PSP patients, also in Richardson variant (PSP-RS). The analysis of connected speech is used in neurodegenerative disorder to investigate different levels of language organization, including phonetic, phonological, lexico-semantic, morpho-syntactic, and pragmatic processing.

Objective: In our study, we aimed to investigate the language profile, especially connected speech, in early-stage PSP-RS and Parkinson's disease (PD) patients without predominant speech or language disorders.

Methods: Language was assessed using the Screening for Aphasia in NeuroDegeneration (SAND); connected speech analysis was conducted from the picture description subtest.

Results: We enrolled 48 patients, 22 PD and 26 PSP (18 PSP-RS and 8 non-RS). PSP-RS patients presented an impairment in language domain, particularly regarding connected speech. PSP-RS patients presented worse performances than PD in different scores. The output of PSP-RS patients was characterized by a reduction in number of sentences and subordinates with respect to PD; PSP presented also more repaired sequences and phonological and lexico-semantic errors than PD. Number of sentences and number of subordinates of the picture description task were identified as predictors of PSP diagnosis.

Conclusion: In summary, the SAND scale is able to identify language impairment in PSP patients. The analysis of connected speech could highlight some important aspects of language impairment in PSP-RS patients, and it could be helpful in the differential diagnosis with PD.

Keywords: Connected speech; Language; Progressive supranuclear palsy; SAND.

MeSH terms

  • Diagnosis, Differential
  • Humans
  • Parkinson Disease* / complications
  • Parkinson Disease* / diagnosis
  • Parkinsonian Disorders*
  • Speech*
  • Supranuclear Palsy, Progressive* / complications
  • Supranuclear Palsy, Progressive* / diagnosis