Discussion Flashcards
This study demonstrates three key findings in relation to PPA, which extend established knowledge. Firstly ?
they show that not all test measures within a language domain are equally valuable or discriminating.
This study demonstrates three key findings in relation to PPA, which extend established knowledge. Secondly ?
they highlight features outside the language domain that contribute to the differentiation between subtypes of PPA. A PCA elicited(saada selville) three distinct factors that combined pure linguistic and extra linguistic features, which were useful in discriminating the groups.
This study demonstrates three key findings in relation to PPA, which extend established knowledge. Thirdly?
the findings show that despite high sensitivity of several measures to lvPPA they showed relatively poor specificity in discriminating lvPPA both from nfvPPA and from multidomain AD, highlighting the challenge for the diagnosis and classification of lvPPA.
SD patients showed severely impaired
Naming.
Yet, raw scores on naming tests ?
What was more useful marker?
Did not differentiate SD from the other patient groups.
A more useful marker was the relative magnitude of the naming impairment for nouns compared to that for verbs, which was significantly greater in SD compared to other groups.
The Manchester comprehension test (word-picture matching), involving high frequency words, was ?
highly discriminatory because SD patients alone showed reduced scores.
What is a limitation?
that the test is sufficiently easy that it elicited ceiling level scores in some SD patients, and so may be insensitive to mild comprehension impairments.
This finding highlights the importance of ?
including for diagnostic purposes a variety of tests that range in level of difficulty.
NfvPPA was the only group to perform ?
worse than controls and other patient groups on tests of grammar.
Interestingly, however, production of grammatical sentences in picture description, a conventional measure of grammaticality, as well as a sentence completion using the correct verb tense, were ?
less discriminating than the simple Manchester sentence ordering task involving the ordering of five words to form a grammatically correct sentence.
Different conditions of the Manchester sentence ordering task were
not equally discriminatory.
The core ‘order’ condition, in which patients have to order five words to make a sentence, was reasonably sensitive to nfvPPA (i.e., most patients with nfvPPA exhibited reduced scores on this test), yet it was not as specific as some of the other conditions (i.e., patients in other groups also had reduced scores in this domain).
The likely explanation is ?
that performance could be compromised for reasons other than agrammatism. For example, SD patients might have difficulty understanding the component words of a sentence, whereas lvPPA and AD patients might be overloaded by task demands due to reduced working memory capacity.
The ‘dictation’ condition, in which participants are dictated a full sentence and asked to order the words accordingly
increased specificity.
NfvPPA patients predictably performed ?
on tests of orofacial praxis relative to the other patient groups.
Poorly
Impaired production of repetitive and elongated speech sounds (orofacial praxis: sounds), that is, indicators of AOS, had ?
high sensitivity and specificity for nfvPPA.
Problems in orofacial praxis in nfvPPA
extended beyond the realm of AOS, with impairments being demonstrated also in production of emotional gesture and orofacial actions, highlighting the association between gestural and spoken communication.
patients in the nfvPPA group had the lowest factor scores
on the PCA, tests of orofacial actions, sentence processing and narrative production loaded heavily onto the same factor (speech production and grammaticality), on which
Behavioural changes, particularly changes in frequency of engagement in hobbies, increased preference for order and routines, repetitive behaviours, and hoarding, occurred more frequently in
SD than the other patient groups.
an increase in repetitive behaviours and increased enjoyment of quizzes occurred in the majority of
SD patients
Nevertheless, each core behavioural domain evaluated in this study was affected in some patients with
NfvPPA
Most of the behavioural changes we observed are characteristic of
BvFTD
Consistent with previous findings, it is apparent that overlapping characteristics exist in these
three syndromes predominantly (mainly/mostly) predicated on FTLD pathology, that is, SD, nfvPPA, and bvFTD.
In this study, there were no significant differences in the behavioural profile of
SD patients presenting with left and right predominant temporal lobe atrophy, and these behavioural features have been well documented
The ubiquitous (kaikkialla oleva) nature of behavioural changes in SD
underscores the fact that this disorder extends beyond the realm of semantic memory and calls into question whether it should be considered primarily a disorder of language.
Similarities between patients with left and right predominant temporal lobe atrophy also raises the question of ?
the usefulness of the contemporary distinction between syndromes associated, respectively, with left and right temporal lobe degeneration.
Individual test scores failed to show a
clear pattern of deficits in lvPPA relative to the nfvPPA group.
