Narrative Speech is Impaired in Multiple Sclerosis

Arrondo G, Sepulcre J, Duque B, Toledo J, Villoslada P.  Narrative Speech is Impaired in Multiple Sclerosis.  European Neurological Journal, June 2010; 2(1):  11-18

ORIGINAL ARTICLE


Gonzalo Arrondo ¹, Jorge Sepulcre 1, Beatriz Duque ¹, Jon Toledo ¹ and Pablo Villoslada ^{1 2}
Affiliations: ¹ Department of Neuroscience, Center for Applied Medical Research, University of Navarra and ² Department of Neurology, Hospital Clinic—IDIBAPS

ABSTRACT
Background
Language is frequently impaired in multiple sclerosis (MS) in which, in addition to dysarthria and loss of fluency, other language deficits might affect patients and impinge on their quality of life.

Aims
The aim of this study was to examine spontaneous language production in MS and to assess its relationship with cognitive deterioration.

Methods
Sixteen MS patients and 10 healthy control subjects matched by age and education were studied. Participants were instructed to talk about their life for half an hour. After the transcription of the texts, several parameters were measured, including the number of words, mean and maximum sentence length, lexical density, and number of words produced by the evaluator to maintain conversation. The cognitive impairment of the patients was classified using the Brief Repeatable Battery—Neuropsychology (BRB‐N).

Results
A decrease in the number of words and in sentence length was detected, as well as an increase in the interventions by the neuropsychologist in patients with MS. Patients with cognitive impairment performed worse in most parameters than control subjects and patients with no cognitive impairment. In addition, the number of words spoken by patients and the interventions by the evaluator were correlated with performance in the Paced Auditory Serial Addition Task and phonetic fluency tests of the BRB‐N. Moreover, lexical density was correlated with all cognitive domains.

Conclusions
MS patients have structural problems in language production, and flexibility when constructing a complex discourse is also impaired, with both difficulties being related to cognitive impairment, particularly with executive dysfunction. Cognitive impairment is also related to impoverished lexical access.

Keywords: multiple sclerosis, language, narrative speech, lexical access, cognitive impairment, Brief Repeatable Battery—Neuropsychology
Correspondence: Pablo Villoslada, Department of Neurology, Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain. Tel: (+34‐93)4031102; e‐mail: pvilloslada@clinic.ub.es