Sentence comprehension in Parkinson's disease

Prieto, Fernanda; Radanovic, Márcia; Schmitt, Cristina; Barbosa, Egberto Reis; Mansur, Letícia Lessa

doi:10.1590/S1980-57642008DN10400010

Abstract

Parkinson's disease (PD) patients with dementia have impairment of syntactic comprehension. Non-demented PD patients also experience difficulties in sentence comprehension and can be particularly impaired in the processing of grammatical characteristics of syntactically complex sentences. Objective: The aim of this study was to verify the performance of PD patients without dementia in a syntactic comprehension task compared with normal elderly. Methods: We studied oral sentence comprehension in fourteen patients with idiopathic PD together with fourteen controls matched for age and education, using the Token Test and Schmitt's Syntactic Comprehension Test (developed in Brazilian Portuguese). Results: For the Token Test, there was no statistically significant difference between the PD group and the control group, whereas on the Syntactic Comprehension Test there was a slight statistically significant difference between the groups only for relatives in subject clauses (p=0.0407). Conclusions: PD patients differed from controls in the oral comprehension for relatives subject sentences alone. These results did not strictly reproduce those previously reported in the literature, and therefore point to the need for creating tests with diverse syntactic constructions in Portuguese able to produce consistent data regarding language behavior of Brazilian subjects with PD in comprehension tasks.

Key words:
Parkinson's disease; comprehension; language tests; cognition; working memory

Resumo

Pacientes com doença de Parkinson (DP) e demência apresentam prejuízo da compreensão sintática. Pacientes com DP sem demência também apresentam dificuldades na compreensão de sentenças e podem estar particularmente comprometidos na habilidade de processar as características gramaticais de sentenças sintaticamente complexas. Objetivo: O objetivo deste estudo foi verificar o desempenho de pacientes com DP sem demência em tarefas de compreensão sintática, comparados a idosos normais. Métodos: Foram estudados quatorze pacientes com DP idiopática e quatorze controles emparelhados por idade e escolaridade, usando o Teste Token e o Teste de Compreensão Sintática de Schmitt (desenvolvido em português do Brasil). Resultados: No Teste Token, não houve diferenças estatisticamente significantes entre os pacientes com DP e o grupo controle. No Teste de Compreensão Sintática, foi encontrada diferença estatisticamente significante entre os grupos apenas nas sentenças relativas de sujeito (p=0.0407). Conclusão: Os pacientes com DP diferenciam-se do grupo controle apenas na compreensão oral de sentenças relativas de sujeito. Tendo em vista estes resultados, que não reproduzem de forma estrita o que é descrito na literatura, torna-se evidente a necessidade da criação de testes de linguagem com diferentes construções sintáticas em português do Brasil, a fim de obtermos dados consistentes a respeito do comportamento de pacientes brasileiros com DP em tarefas de compreensão sintática.

Palavras-chave:
doença de Parkinson; compreensão; testes de linguagem; cognição; memória operacional

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References

¹
Colcher A, Simuni T. Clinical manifestations of Parkinson's disease. Med Clin North Am 1999;83:327-343.
²
Jacobs DM, Levy G, Marder K. Dementia in Parkinson's disease, Huntington's disease and related disorders. In: Feinberg TE, Farah MJ, Editors. Behavioral Neurology and Neuropsychology. 2nd ed. New York:McGraw-Hill; 2003:593-607.
³
Lieberman P, Friedman J, Feldman LS. Syntax comprehension deficits in Parkinson's disease. J Nerv Ment Dis 1990;178:360-365.
⁴
Kempler D. Language changes in dementia of the Alzheimer type. In: Lubinski R, Editors. Dementia and communication. San Diego: Singular Publishing Group, Inc.; 1995:98-114.
⁵
Lieberman P, Kako E, Friedman J, Tajchman G, Feldman LS, Jiminez EB. Speech production, syntax comprehension, and cognitive deficits in Parkinson's disease. Brain Lang 1992; 43:169-189.
⁶
Grossman M, Carvell S, Gollomp S, Stern MB, Vernon G, Hurtig H. Sentence comprehension and praxis deficits in Parkinson's disease. Neurology 1991;41:1620-1626.
⁷
Grossman M, Carvell S, Stern B, Gollomp S, Hurtig H. Sentence comprehension in Parkinson's disease: The role of attention and memory. Brain Lang 1992;42:347-384.
⁸
Natsopoulos D, Grouios G, Bostantzopoulou S, Mentanopoulos G, Katsarou Z, Logothetis J. Algorithmic and heuristic strategies in comprehension of complement clauses by patients with Parkinson's disease. Neuropsychologia 1993;31: 951-964.
⁹
Seidl A, Onishi K, White H, D'Esposito M, Grossman M. Resource limitations and grammatical complexity in the sentence comprehension of patients with Parkinson's disease. Brain Lang 1995;51:106-108.
¹⁰
Cohen H. Language impairment in Parkinson's Disease. In: Stemmer B, Whitaker HA, Editors. Handbook of Neurolinguistics. New York: Academic Press; 1998:475-483.
¹¹
Kemmerer D. Impaired comprehension of raising-to-subject constructions in Parkinson's disease. Brain Lang 1999;66:311-328.
¹²
Kemper S. Life-span changes in syntactic complexity. J Gerontol. 1987;42:323-328.
¹³
Kemper S, Kynette D, Rash S, O´Brien K, Sprott R. Life-span changes to adult´s languagem: effects of memory and gender. Appl Psycholing 1989;10:49-66.
¹⁴
Norman S, Kemper S, Kynette D, Cheung HT, Anagnopoulos C. Syntactic complexity and adults' running memory span. J Gerontol 1991;46:346-351.
¹⁵
Hoehn M, Yahr M. Parkinsonism: onset, progression, and mortality. Neurology 1967;17:427-442.
¹⁶
Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
¹⁷
Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Suggestions for utilization of the Mini Mental State Examination in Brazil Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arq Neuropsiquiatr 2003;61:777-81.
¹⁸
Smith GE, Ivnik RJ, Normative neuropsychology. In: Petersen RC, Edito. Mild Cognitive Impairment, New York: Oxford; 2003:63-88.
¹⁹
De Renzi E, Vignolo LA. The token test: a sensitive test to detect receptive disturbances in aphasics. Brain 1962;85:665-678.
²⁰
Rochon E, Waters GS, Caplan D. The relationship between measures of working memory and sentence comprehension with Alzheimer's disease. J Speech Lang Hear Res 2000;43:395-413.
²¹
Berndt R. Sentence processing in aphasia. In: Sarno M, Editor. Acquired Aphasia. 3ed. New York: Academic Press , Inc.;1998:229-267.
²²
Waters GS, Caplan D. Age, working memory, and on-line syntactic processing in sentence comprehension. Psychol Aging 2001;16:128-144.
²³
Grossman M, Zurif E, Lee C, et al. Information processing speed and sentence comprehension in Parkinson's disease. Neuropsychology 2002;16:174-181.
²⁴
Lee C, Grossman M, Morris J, Stern MB, Hurtig HI. Attentional resource and processing speed limitations during sentence processing in Parkinson's disease. Brain Lang 2003;85:347-356.
²⁵
Grossman M, Glosser G, Kalmanson J, Morris J, Stern MB, Hurtig HI. Dopamine supports sentence comprehension in Parkinson's disease. J Neurol Sci 2001;184:123-130.
²⁶
Hochstadt J, Nakano H, Lieberman P, Friedman J. The roles of sequencing and verbal working memory in sentence comprehension deficits in Parkinson's disease. Brain Lang 2006;97:243-257.
²⁷
Skeel RL, Crosson B, Nadeau SE, Algina J, Bauer RM, Fennell EB. Basal ganglia dysfunction, working memory, and sentence comprehension in patients with Parkinson's disease. Neuropsychologia 2001;39:962-971.
²⁸
Martin R, Feher E. The consequences of reduced memory span for the comprehension of semantic versus syntactic information. Brain Lang 1990;38:1-20.
²⁹
Martin RC, Romani C. Verbal working memory and sentence comprehension: a multiple-components view. Neuropsychology 1994;8:506-523.
³⁰
Miyake A, Just M, Carpenter PA. Capacity approach to syntactic comprehension disorders: making normal adults perform like aphasic patients. Cogn Neuropsychol 1994;11:671-717.
³¹
Angwin AJ, Chenery HJ, Copland DA, Murdoch BE, Silburn PA. Summation of semantic priming and complex sentence comprehension in Parkinson's disease. Brain Res Cogn Brain Res 2005;25:78-89.
³²
Angwin AJ, Chenery HJ, Copland DA, Murdoch BE, Silburn PA. The speed of lexical activation is altered in Parkinson's disease. J Clin Exp Neuropsychol 2007;29:73-85.
³³
Green J, McDonald WM, Vitek JL, et al. Cognitive impairments in advanced Parkinson's disease without dementia. Neurology 2002;59:1320-1324.
³⁴
Grossman M, Cooke A, DeVita C, et al. Grammatical and resource components of sentence processing in Parkinson's disease: an fMRI study. Neurology 2003;60:775-781.

Publication Dates

Publication in this collection
Oct-Dec 2007

History

Received
25 Oct 2007
Reviewed
04 Nov 2007
Accepted
25 Nov 2007

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Colcher A, Simuni T. Clinical manifestations of Parkinson's disease. Med Clin North Am 1999;83:327-343.

[2] ²
Jacobs DM, Levy G, Marder K. Dementia in Parkinson's disease, Huntington's disease and related disorders. In: Feinberg TE, Farah MJ, Editors. Behavioral Neurology and Neuropsychology. 2nd ed. New York:McGraw-Hill; 2003:593-607.

[3] ³
Lieberman P, Friedman J, Feldman LS. Syntax comprehension deficits in Parkinson's disease. J Nerv Ment Dis 1990;178:360-365.

[4] ⁴
Kempler D. Language changes in dementia of the Alzheimer type. In: Lubinski R, Editors. Dementia and communication. San Diego: Singular Publishing Group, Inc.; 1995:98-114.

[5] ⁵
Lieberman P, Kako E, Friedman J, Tajchman G, Feldman LS, Jiminez EB. Speech production, syntax comprehension, and cognitive deficits in Parkinson's disease. Brain Lang 1992; 43:169-189.

[6] ⁶
Grossman M, Carvell S, Gollomp S, Stern MB, Vernon G, Hurtig H. Sentence comprehension and praxis deficits in Parkinson's disease. Neurology 1991;41:1620-1626.

[7] ⁷
Grossman M, Carvell S, Stern B, Gollomp S, Hurtig H. Sentence comprehension in Parkinson's disease: The role of attention and memory. Brain Lang 1992;42:347-384.

[8] ⁸
Natsopoulos D, Grouios G, Bostantzopoulou S, Mentanopoulos G, Katsarou Z, Logothetis J. Algorithmic and heuristic strategies in comprehension of complement clauses by patients with Parkinson's disease. Neuropsychologia 1993;31: 951-964.

[9] ⁹
Seidl A, Onishi K, White H, D'Esposito M, Grossman M. Resource limitations and grammatical complexity in the sentence comprehension of patients with Parkinson's disease. Brain Lang 1995;51:106-108.

[10] ¹⁰
Cohen H. Language impairment in Parkinson's Disease. In: Stemmer B, Whitaker HA, Editors. Handbook of Neurolinguistics. New York: Academic Press; 1998:475-483.

[11] ¹¹
Kemmerer D. Impaired comprehension of raising-to-subject constructions in Parkinson's disease. Brain Lang 1999;66:311-328.

[12] ¹²
Kemper S. Life-span changes in syntactic complexity. J Gerontol. 1987;42:323-328.

[13] ¹³
Kemper S, Kynette D, Rash S, O´Brien K, Sprott R. Life-span changes to adult´s languagem: effects of memory and gender. Appl Psycholing 1989;10:49-66.

[14] ¹⁴
Norman S, Kemper S, Kynette D, Cheung HT, Anagnopoulos C. Syntactic complexity and adults' running memory span. J Gerontol 1991;46:346-351.

[15] ¹⁵
Hoehn M, Yahr M. Parkinsonism: onset, progression, and mortality. Neurology 1967;17:427-442.

[16] ¹⁶
Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.

[17] ¹⁷
Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Suggestions for utilization of the Mini Mental State Examination in Brazil Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arq Neuropsiquiatr 2003;61:777-81.

[18] ¹⁸
Smith GE, Ivnik RJ, Normative neuropsychology. In: Petersen RC, Edito. Mild Cognitive Impairment, New York: Oxford; 2003:63-88.

[19] ¹⁹
De Renzi E, Vignolo LA. The token test: a sensitive test to detect receptive disturbances in aphasics. Brain 1962;85:665-678.

[20] ²⁰
Rochon E, Waters GS, Caplan D. The relationship between measures of working memory and sentence comprehension with Alzheimer's disease. J Speech Lang Hear Res 2000;43:395-413.

[21] ²¹
Berndt R. Sentence processing in aphasia. In: Sarno M, Editor. Acquired Aphasia. 3ed. New York: Academic Press , Inc.;1998:229-267.

[22] ²²
Waters GS, Caplan D. Age, working memory, and on-line syntactic processing in sentence comprehension. Psychol Aging 2001;16:128-144.

[23] ²³
Grossman M, Zurif E, Lee C, et al. Information processing speed and sentence comprehension in Parkinson's disease. Neuropsychology 2002;16:174-181.

[24] ²⁴
Lee C, Grossman M, Morris J, Stern MB, Hurtig HI. Attentional resource and processing speed limitations during sentence processing in Parkinson's disease. Brain Lang 2003;85:347-356.

[25] ²⁵
Grossman M, Glosser G, Kalmanson J, Morris J, Stern MB, Hurtig HI. Dopamine supports sentence comprehension in Parkinson's disease. J Neurol Sci 2001;184:123-130.

[26] ²⁶
Hochstadt J, Nakano H, Lieberman P, Friedman J. The roles of sequencing and verbal working memory in sentence comprehension deficits in Parkinson's disease. Brain Lang 2006;97:243-257.

[27] ²⁷
Skeel RL, Crosson B, Nadeau SE, Algina J, Bauer RM, Fennell EB. Basal ganglia dysfunction, working memory, and sentence comprehension in patients with Parkinson's disease. Neuropsychologia 2001;39:962-971.

[28] ²⁸
Martin R, Feher E. The consequences of reduced memory span for the comprehension of semantic versus syntactic information. Brain Lang 1990;38:1-20.

[29] ²⁹
Martin RC, Romani C. Verbal working memory and sentence comprehension: a multiple-components view. Neuropsychology 1994;8:506-523.

[30] ³⁰
Miyake A, Just M, Carpenter PA. Capacity approach to syntactic comprehension disorders: making normal adults perform like aphasic patients. Cogn Neuropsychol 1994;11:671-717.

[31] ³¹
Angwin AJ, Chenery HJ, Copland DA, Murdoch BE, Silburn PA. Summation of semantic priming and complex sentence comprehension in Parkinson's disease. Brain Res Cogn Brain Res 2005;25:78-89.

[32] ³²
Angwin AJ, Chenery HJ, Copland DA, Murdoch BE, Silburn PA. The speed of lexical activation is altered in Parkinson's disease. J Clin Exp Neuropsychol 2007;29:73-85.

[33] ³³
Green J, McDonald WM, Vitek JL, et al. Cognitive impairments in advanced Parkinson's disease without dementia. Neurology 2002;59:1320-1324.

[34] ³⁴
Grossman M, Cooke A, DeVita C, et al. Grammatical and resource components of sentence processing in Parkinson's disease: an fMRI study. Neurology 2003;60:775-781.

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