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The association between performance on a test of motorsequencing and language abilities in neurodegenerativedisorders.

Citation for published version:Repetto, L, Bak, T, Connick, P, Colville, S & Pal, S 2016, 'The association between performance on a test ofmotor sequencing and language abilities in neurodegenerative disorders.', 10th International Conference onFrontotemporal Dementias (ICFTD), Munich, Germany, 31/08/16 - 2/09/16.

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Download date: 13. Sep. 2020

The association between performance on a test of motor sequencing and language abilities in neurodegenerative disorders

Linda Repetto1, Peter Connick2, Shuna Colville3, Suvankar Pal2, Thomas H. Bak1,2,3 1School for Medicine and Veterinary Science, University of Edinburgh; 2Centre for Clinical Brain Sciences, University of Edinburgh;

3Anne Rowling Regenerative Neurology Clinic, University of Edinburgh.

i 223 demen a pa ents (99 females) of the Anne Rowling Regenera ve Neurology Clinic. i Complex motor func ons assessment: Luria three-step test score (0 -3) from first EMAS i Language func ons assessment (obtained at the same me of pa ents’ first EMAS): -Clinical le ers: presence and type of language impairment (word finding difficul es, fre-quent spelling mistakes, motor speech problem). -ACE-III and ECAS subdomains i Diagnosis obtained from clinical files.

I. Analysis of clinical le ers shows a par cular rela on between the Luria three-step test and lan-guage func ons. -Luria three-step examina on is mainly related to higher-level motor sequencing rather than pe-ripheral motor dysfunc on.

II. The Language subdomains of ACE-III and ECAS seem to be measuring different aspects of lan-guage than those reported in clinical le ers.

III. This could be due to the difference between word finding difficul es occurring in spontaneous speech (clinical le ers) and confronta on naming (main part of ACE-III and ECAS Language subdo-mains).

Future direc ons: x� Inves gate the rela onship between language and other types of complex motor func ons x� Compare the Luria three=step test to Boston Cookie Descrip on (free speech)

2. Methods

3 . C l in ical Let ters

¹Bak T, Benne G, Symonds A, Parra M, Elamin M, Connick P, Holloway G, Pal S. Motor symptoms in healthy ageing and demen a: frequency, pa erns and the rela on between motor and cogni ve func ons. European Journal of Neurology 2015 Jun 1 (Vol. 22, pp. 94-94). 1

²Weiner M, Hynan L, Rosse H, Falkowski J. Luria's three-step test: what is it and what does it tell us?. Int Psychogeriatr. 2011;23(10):1602-1606.

³Mesulam M. Primary progressive aphasia: a demen a of the language network. Demen a & neuropsychologia. 2013 Jan 1;7(1):2.

⁴Braak H, Braak E. Neuropathological stageing of Alzheimer-related changes. Acta neuropathologica. 1991 Sep 1;82(4):239-59.

Figure 1: Analysis on the presence of a language impairment (n=223): Lan-guage problems are more o en present when performance on the Luria three-step test is abnormal (χ²=18.01, p<0.001, Cramer’s V=0.284).

Figure 2: Analysis on the type of

language impairment (n=223): A significant associa on was found between word finding difficul es and performance on the Luria test (χ²=12.17, p=0.007, Cramer’s V=0.234). There was no significant rela onship between Luria score and the other two types of language impairment.

4. ACE- I I I and ECAS

ACE-III Subdomain Kruskal-Wallis H(3) p-value

Language 2.735 0.434

Fluency 9.970 0.019

Visuospa al 20.449 <0.001

A en on 18.564 <0.001

Memory 10.255 0.017

Table 1: Results from the ACE-III subdomains analysis (n=92): ACE-III Language was the only not significantly different ACE-III subdomain across the four categories of Luria per-formance.

Table 2: Results from the ECAS subdomains analysis (n=92): All ECAS subdomains correlated with language reports, but interes ngly the correla on with language subtest was the weakest.

5. C l in ical le t ters vs . cogni t ive tes ts

6. Conclus ions

7 . References

ECAS Subdomain Mann-Whitney U p-value

Language 593 0.001

Fluency 539 <0.001

Visuospa al 619 0.001

Execu ve 468.5 <0.001

Memory 822 0.135

ACE-III Subdomain Mann-Whitney U p-value

Language 623 0.002

Fluency 534 <0.001

Visuospa al 515 <0.001

A en on 496.5 <0.001

Memory 787 0.077

Table 3: Analysis on data from cogni ve le ers and ACE-III (n=92): Pa-ents performed worse on four ACE-III subdomains when language prob-

lems were reported in clinical le ers, with the excep on of Memory.

Table 4: Analysis on data from cogni ve le ers and ECAS (n=92): Lan-guage problems are related to all ECAS subdomains, except in the case of ECAS Memory.

The Edinburgh Motor Assessment Scale (EMAS) is a brief motor screening test, composed of 33 items in 4 domains: Extrapyramidal, Amyotrophic, Cerebellar, Complex¹. Luria three-step examina on is a well-established test to assess motor sequencing and has been incorporated in the Complex domain. The Luria three-step test can dis nguish FTD from other disorders, as it reflects damage to the frontal area of the brain². Evidence from different direc ons (evolu on of language, language development in infants and language disorders) indicate the presence of a rela onship between language and complex motor func ons. The focus of this study was to explore this interac on.

1. In t roduct ion

ECAS Subdomain Kruskal-Wallis H(3) p-value

Language 8.936 0.030

Fluency 14.335 0.002

Visuospa al 18.011 <0.001

Execu ve 31.632 <0.001

Memory 14.797 0.002