The purpose of this study was to investigate the presence and nature of spoken language deficits in Huntington's (HD) and Parkinson's (PD) diseases. Specifically, the study examined whether (a) the spoken language abilities of patients with HD or PD differ from those of age-matched control participants with no brain damage, (b) HD and PD are associated with similar spoken language profiles, and (c) the spoken language abilities of patients with HD or PD are related to the severity of their motor speech deficits, cognitive impairments, or both. All participants completed picture description tasks and a battery of cognitive and motor speech tests. Syntactic, quantitative, and informativeness measures of spoken language were analyzed. In terms of syntax, patients with HD produced shorter utterances, a smaller proportion of grammatical utterances, a larger proportion of simple sentences, and fewer embeddings per utterance than their non-brain-damaged peers. The HD group also produced utterances that were shorter and syntactically simpler than those of the PD group, despite similar performances on the cognitive and motor speech tests. The only syntactic difference between the PD group and their control group was that patients with PD produced a smaller proportion of grammatical sentences. Although the patient and control participants tended to produce similar amounts of verbal output, less of what the patients said was considered informative. Correlations between language measures and test battery results suggested that the spoken language abilities of patients with HD or PD are related to a variety of neuropsychological and motor speech changes. The implications of these findings for the clinical management of HD and PD are discussed.

References

  • Abudi, S., Bar-Tal, Y., Ziv, L., & Fish, M. (1997). Parkinson's disease symptoms: Patients' perceptions.Journal of Advanced Nursing, 25, 54–59.
  • Ackermann, H., Hertrich, I., Daum, I., Scharf, G., & Spieker, S. (1997). Kinematic analysis of articulatory movements in central motor disorders.Movement Disorders, 12, 1019–1027.
  • Adams, R. D., & Victor, M. (1993). Principles of neurology (5th ed.). New York: McGraw-Hill.
  • Agliotti, S. (1997). The role of the thalamus and basal ganglia in human cognition.Journal of Neurolinguistics, 10, 255–265.
  • Albin, R. L., Young, A. B., & Penney, J. B. (1995). The functional anatomy of disorders of the basal ganglia.Trends in Neuroscience, 18, 63–64.
  • Alexander, G. E., DeLong, M. R., & Strick, P. L. (1986). Parallel organization of functionally segregated circuits linking basal ganglia and cortex.Annual Review of Neurosciences, 9, 357–381.
  • Aylward, E. H., Anderson, N. B., Bylsma, F. W., Wagster, M. V., Barta, P. E., Sherr, M., Feeney, J., Davis, A., Rosenblatt, A., Pearlson, G. D., & Ross, C. A. (1998). Frontal lobe volume in patients with Huntington's disease.Neurology, 50, 252–258.
  • Backman, L., Robins-Wahlin, T. B., Lundin, A., Ginovart, N., & Farde, L. (1997). Cognitive deficits in Huntington's disease are predicted by dopaminergic PET markers and brain volumes.Brain, 120, 2207–2217.
  • Bamford, K. A., Caine, E. D., Kido, D. K., Cox, C., & Shoulson, I. (1995). A prospective evaluation of cognitive decline in early Huntington's disease: Functional and radiographic correlates.Neurology, 45, 1867–1873.
  • Barch, D. M., & Berenbaum, H. (1997). Language generation in schizophrenia and mania: The relationships among verbosity, syntactic complexity, and pausing.Journal of Psycholinguistic Research, 26, 401–412.
  • Barona, A., Reynolds, C., & Chastain, R. (1984). A demographically based index of pre-morbid intelligence for the WAIS-R.Journal of Clinical and Consulting Psychology, 52, 885–887.
  • Bayles, K. A. (1990). Language and Parkinson disease.Alzheimer Disease and Associated Disorders, 4, 171–180.
  • Bayles, K. A., & Tomoeda, C. K. (1991). Arizona Battery for Communication Disorders of Dementia. Tucson, AZ: Canyonlands Publishing.
  • Berardelli, A., Noth, J., Thompson, P. D., Bollen, E. L. E. M., Curra, A., Deuschl, G., van Dijk, J. G., Topper, R., Schwarz, M., & Roos, R. A. C. (1999). Pathophysiology of chorea and bradykinesia in Huntington's disease.Movement Disorders, 14, 398–403.
  • Brooks, D. J. (1997). PET and SPECT studies in Parkinson's disease.Bailliere's Clinical Neurology, 6, 69–87.
  • Bruyn, G. W. (1968). Huntington's chorea. Historical, clinical, and laboratory synopsis.In P. J. Vinken, & G. W. Bruyn (Eds.), Diseases of the basal ganglia: Handbook of clinical neurology Vol. 6, pp. 298–378). Amsterdam: Elsevier.
  • Caine, E. D., Bamford, K. A., Schiffer, R. B., Shoulson, I., & Levy, S. (1986). A controlled neuropsychological comparison of Huntington's disease and multiple sclerosis.Archives of Neurology, 43, 249–254.
  • Calne, D. B., Snow, B. J., & Lee, C. (1992). Criteria for diagnosing Parkinson's disease.Annals of Neurology, 32 (Suppl.), S125–S127.
  • Campodonico, J. R., Aylward, E., Codori, A., Young, C., Krafft, L., Magdalinksi, M., Ranen, N., Slavney, P. R., & Brandt, J. (1998). When does Huntington's disease begin.Journal of the International Neuropsychological Society, 4, 467–473.
  • Claus, J. J., & Mohr, E. (1996). Attentional deficits in Alzheimer's, Parkinson's, and Huntington's diseases.Acta Neurologica Scandinavica, 93, 346–351.
  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum.
  • Cohen, J., & Cohen, P. (1983). Applied regression/correlation analysis for the behavioral sciences (2nd ed.). New York: Wiley.
  • Cooper, J. A., Sagar, H. J., & Sullivan, E. V. (1993). Short-term memory and temporal ordering in early Parkinson's disease: Effects of disease chronicity and medication.Neuropsychologia, 31, 933–949.
  • Cowan, N. (1998). Short-term memory, working memory, and their importance in language processing.In R. B. Gillam (Ed.) , Memory and language impairment in children and adults (pp. 3–27). Gaithersburg, MD: Aspen.
  • Cummings, J. L., Darkins, A., Mendez, M., Hill, M. A., & Benson, D. F. (1988). Alzheimer's disease and Parkinson's disease: Comparison of speech and language alterations.Neurology, 38, 680–684.
  • Dubois, B., & Pillon, B. (1997). Cognitive deficits in Parkinson's disease.Journal of Neurology, 244, 2–8.
  • Filoteo, J. V., Delis, D. C., Roman, M. J., Demadura, T., Ford, E., Butters, N., Salmon, D. P., Paulsen, J., Shults, C. W., Swenson, M., & Swerdlow, N. (1995). Visual attention and perception in patients with Huntington's disease: Comparisons with other subcortical and cortical dementias.Journal of Clinical and Experimental Neuropsychology, 17, 654–667.
  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-Mental State": A practical method for grading the cognitive state of patients for the clinician.Journal of Psychiatric Research, 12, 189–198.
  • Frank, E. M., McDade, H. L., & Scott, W. K. (1996). Naming in dementia secondary to Parkinson's, Huntington's, and Alzheimer's diseases.Journal of Communication Disorders, 29, 183–197.
  • Glosser, G., Wiener, M., & Kaplan, E. (1988). Variations in aphasic language behaviors.Journal of Speech and Hearing Research, 53, 115–124.
  • Goldman, W. P., Baty, J., Buckles, V. D., Sahrmann, S., & Morris, J. C. (1998). Cognitive and motor functioning in Parkinson disease: Subjects with and without questionable dementia.Archives of Neurology, 55, 674–680.
  • Gordon, W. P., & Illes, J. (1987). Neurolinguistic characteristics of language production in Huntington's disease: A preliminary report.Brain and Language, 31, 1–10.
  • Goodglass, H., & Kaplan, E. (1983). Boston Diagnostic Examination for Aphasia. Philadelphia: Lea and Febiger.
  • Goodwin, L. D. (1983). The use of power estimation in nursing research.Nursing Research, 33, 118–120.
  • Grossman, M. (1999). Sentence processing in Parkinson's disease.Brain and Cognition, 40, 387–413.
  • Hamilton, M. (1960). A rating scale for depression.Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62.
  • Hanes, K. R., Andrewes, D. G., & Pantelis, C. (1995). Cognitive flexibility and complex integration in Parkinson's disease, Huntington's disease, and schizophrenia.Journal of the International Neuropsychological Society, 1, 545–553.
  • Helm-Estabrooks, N. (1992). Aphasia Diagnostic Profiles. Chicago, IL: Riverside.
  • Heaton, R. K., Grant, I., & Matthews, C. G. (1992). Comprehensive norms for an expanded Halstead-Reitan battery: Demographic corrections, research findings and clinical applications with a supplement for the Wechsler Adult Intelligence Scale-Revised. Odessa, FL: Psychological Assessment Resources.
  • Hoehn, M. M., & Yahr, M. D. (1967). Parkinsonism: Onset, progression and mortality.Neurology, 17, 427–442.
  • Illes, J. (1989). Neurolinguistic features of spontaneous language production dissociate three forms of neuro-degenerative disease: Alzheimer's Huntington's, and Parkinson's.Brain and Language, 37, 628–642.
  • Illes, J., Metter, E. J., Hanson, W. R., & Iritani, S. (1988). Language production in Parkinson's disease: Acoustic and linguistic considerations.Brain and Language, 33, 146–160.
  • Kaczmarek, B. L. J. (1984). Neurolinguistic analysis of verbal utterances in patients with focal lesions of frontal lobes.Brain and Language, 21, 52–58.
  • Kegl, J., Cohen, H., & Poizner, H. (1999). Articulatory consequences of Parkinson's disease: Perspectives from two modalities.Brain and Cognition, 40, 355–386.
  • Kemper, S. (1988). Geriatric psycholinguistics: Syntactic limitations of oral and written language.In L. L. Light & D. M. Burke (Eds.), Language, memory and aging (pp. 5876). New York: Cambridge University Press.
  • Kennedy, J., Fisher, J., Shoulson, I., & Caine, E. (1981). Language impairment in Huntington's disease.Neurology, 31, 81–82.
  • Kent, R. D. (1997). The perceptual sensorimotor examination for motor speech.In M. R. McNeil (Ed.) , Clinical management of sensorimotor speech disorders (pp. 27–47). New York: Thieme.
  • Keppel, G. (1991). Design and analysis: A researcher's handbook. Englewood Cliffs, NJ: Prentice Hall.
  • Kirkwood, S. C., Siemers, E., Stout, J., Hodes, M. E., Conneally, P. M., Christian, J. C., & Foroud, T. (1999). Longitudinal cognitive and motor changes among pre-symptomatic Huntington disease gene carriers.Archives of Neurology, 56, 563–568.
  • Lauterbach, E. C., Cummings, J. L., Duffy, J., Coffey, C. E., Kaufer, D., Lovell, M., Malloy, P., Reeve, A., Royall, D. R., Rummans, T. A., & Salloway, S. P. (1998). Neuropsychiatric correlates and treatment of lenticulostriatal diseases: A review of the literature and overview of research opportunities in Huntington's, Wilson's, and Fahr's diseases.Journal of Neuropsychiatry, 10, 249–266.
  • Le Dorze, G., & Bedard, C. (1998). Effects of age and education on the lexico-semantic content of connected speech in adults.Journal of Communication Disorders, 31, 53–71.
  • Levin, B. E., & Katzen, H. L. (1995). Early cognitive changes and nondementing behavioral abnormalities in Parkinson's disease.In W. J. Weiner & A. E. Lang (Eds.), Advances in neurology: Behavioral neurology of movement disorders (Vol. 65, pp. 85–95). New York: Raven Press.
  • Lewis, F. M., LaPointe, L. L., Murdoch, B. E., & Chenery, H. J. (1998). Language impairment in Parkinson's disease.Aphasiology, 12, 193–206.
  • Litvan, I., Paulsen, J. S., Mega, M. S., & Cummings, J. L. (1998). Neuropsychiatric assessment of patients with hyperkinetic and hypokinetic movement disorders.Archives of Neurology, 55, 1313–1319.
  • Luscombe, G., Brodaty, H., & Freeth, S. (1998). Younger people with dementia: Diagnostic issues, effects on careers and use of services.International Journal of Geriatric Psychiatry, 13, 323–330.
  • MacWhinney, B. (1995). The CHILDESproject: Tools for analyzing talk. Hillsdale, NJ: Lawrence Erlbaum.
  • Mahieux, F., Fenelon, G., Flahault, A., Manifacier, M., Michelet, D., & Boller, F. (1999). Neuropsychological prediction of dementia in Parkinson's disease..ournal of Neurology, Neurosurgery, and Psychiatry, 64, 178–183.
  • Malapani, C., Pillon, B., Dubois, B., & Agid, Y. (1994). Impaired simultaneous cognitive task performance in Parkinson's disease: A dopamine-related dysfunction.Neurology, 44, 319–326.
  • Marr, J. A. (1991). The experience of living with Parkinson's disease.Journal of Neuroscience Nursing, 23, 325–329.
  • Mattis, S. (1988). Dementia Rating Scale (DRS). Odessa, FL: Psychological Assessment Resources.
  • McCall, B. (1998). Understanding the language of Parkinson's disease.Nursing Standard, 12, 32–33.
  • McNamara, P., Krueger, M., O'Quin, K., Clark, J., & Durso, R. (1996). Grammaticality judgments and sentence comprehension in Parkinson's disease: A comparison with Broca's aphasia.International Journal of Neuroscience, 86, 151–166.
  • Middleton, F. A., & Strick, P. L. (1996). Basal ganglia and cerebellar output influences non-motor function.Molecular Psychiatry, 1, 429–433.
  • Monsch, A. U., Bondi, M. W., Butters, N., Paulsen, J. S., Salmon, D. P., Brugger, P., & Swenson, M. R. (1994). A comparison of category and letter fluency in Alzheimer's disease and Huntington's disease.Neuropsychology, 8, 25–30.
  • Morris, J., Glosser, G., Kalmanson, J., Hurtig, H., Stern, M., & Grossman, M. (1998). Dopamine supports sentence comprehension in Parkinson's disease.Brain and Language, 65, 16–19.
  • Murray, L. L., & Stout, J. C. (1999). Discourse comprehension in Huntington's and Parkinson's diseases.American Journal of Speech-Language Pathology, 8, 137–148.
  • Nadeau, S. E., & Crosson, B. (1997). Subcortical aphasia.Brain and Language, 58, 355–402.
  • Naidoo, S., Goodglass, H., Alexander, M. P., & Christiansen, J. A. (1995). An investigation of the syntactic abilities of patients with lesions to the dominant dorsolateral prefrontal cortex and its subcortical connections.Brain and Language, 51, 91–93.
  • National Institute of Neurological Disorders and Stroke. (1999). Huntington's disease: Hope through research. Available: http://www.ninds.nih.gov/patients/Disorder/HUNTINGT/hdhtr.htm
  • Nicholas, L. D., & Brookshire, R. H. (1993). A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia.Journal of Speech and Hearing Research, 36, 338–350.
  • Novoa, O. P., & Ardila, A. (1987). Linguistic abilities in patients with prefrontal damage.Brain and Language, 30, 206–225.
  • Peng, F. C. C., Huang, S., Cheng, T., & Chia, L. (1992). Parkinson's disease and degenerative language disorders.Journal of Neurolinguistics, 7, 439–450.
  • Pillon, B., Deweer, B., Agid, Y., & Dubois, B. (1993). Explicit memory in Alzheimer's, Huntington's, and Parkinson's diseases.Archives of Neurology, 50, 374–379.
  • Podoll, K., Caspary, P., Lange, H. W., & Noth, J. (1988). Language functions in Huntington's disease.Brain, 111, 1475–1503.
  • Rajkowska, G., Selemon, L. D., & Goldman-Rakic, P. S. (1998). Neuronal and glial somal size in the prefrontal cortex: A postmortem morphometric study of schizophrenia and Huntington's disease.Archives of General Psychiatry, 55, 215–224.
  • Rauch, S. L., & Savage, C. R. (1997). Neuroimaging and neuropsychology of the striatum: Bridging basic science and clinical practice.The Psychiatric Clinics of North America, 20, 741–768.
  • Rinne, J. O., Portin, R., Ruottinen, H., Nurmi, I., Bergman, J., Haaparanta, M., & Solin, O. (2000). Cognitive impairment and the brain dopaminergic system in Parkinson's disease.Archives of Neurology, 57, 470–475.
  • Robertson, I. H., Ward, T., Ridgeway, V., & Nimmo-Smith, I. (1994). The Test of Everyday Attention. Gaylord, MI: Northern Speech Services.
  • Robertson, I. H., Ward, T., Ridgeway, V., & Nimmo-Smith, I. (1996). The structure of normal human attention: The Test of Everyday Attention.Journal of the International Neuropsychological Society, 2, 525–534.
  • Saffran, E. M., Berndt, R. S., & Schwartz, M. F. (1989). The quantitative analysis of agrammatic production: Procedure and data.Brain and Language, 37, 440–479.
  • Savage, C. R. (1997). Neuropsychology of subcortical dementias.The Psychiatric Clinics of North America, 20, 911–931.
  • Scott, S., Caird, F. I., & Williams, B. O. (1985). Communication in Parkinson's disease. London: Croom Helm.
  • Shay, K. A., Duke, L. W., Conboy, T., Harrell, L. E., Callaway, R., & Folks, D. G. (1991). The clinical validity of the Mattis Dementia Rating Scale in staging Alzheimer's disease.Journal of Geriatric Psychiatry and Neurology, 4, 18–25.
  • Shoulson, I., & Fahn, S. (1979). Huntington's disease: Clinical care and evaluation.Neurology, 29, 1–3.
  • Small, J. A., Lyons, K., & Kemper, S. (1997). Grammatical abilities in Parkinson's disease: Evidence from written sentences.Neuropsychologia, 35, 1571–1576.
  • Starkstein, S. E., Sabe, L., Petracca, G., Chemerinski, E., Kuzis, G., Merello, M., & Leiguarda, R. (1996). Neuropsychological and psychiatric differences between Alzheimer's disease and Parkinson's disease with dementia.Journal of Neurology, Neurosurgery, and Psychiatry, 61, 381–387.
  • Stern, Y., Tang, M., Jacobs, D. M., Sano, M., Marder, K., Bell, K., Dooneief, G., Schofield, P., & Côté, L. (1998). Prospective comparative study of the evolution of probable Alzheimer's disease and Parkinson's disease dementia.Journal of the International Neuropsychological Society, 4, 279–284.
  • Stuss, D. T., Benson, D. F., Clermont, R., Della Malva, C. L., Kaplan, E. F., & Weir, W. S. (1986). Language functioning after bilateral prefrontal leukotomy.Brain and Language, 28, 66–70.
  • Suhr, J. A., & Jones, R. D. (1998). Letter and semantic fluency in Alzheimer's, Huntington's, and Parkinson's dementias.Archives of Clinical Neuropsychology, 13, 447–454.
  • Tamaru, F. (1997). Disturbances in higher function in Parkinson's disease.European Neurology, 38, 33–36.
  • Thompson, C. K., Shapiro, L. P., Tait, M. E., Jacobs, B. J., Schneider, S. L., & Ballard, K. J. (1995). A system for the linguistic analysis of agrammatic language production.Brain and Language, 51, 124–129.
  • Tompkins, P., & Herman, L. (1998). How many people in the U.S. have Parkinson's disease? [On-line]. Available: http://www.parkinsonalliance.net/news/pdstat7.htm
  • Ulatowska, H. K., & Chapman, S. B. (1995). Discourse studies. In R. Lubinski (Ed.), Dementia and communication (pp. 115-132). San Diego, CA: Singular.
  • Ullman, M. T., Corkin, S., Coppola, M., Hickok, G., Growdon, J. H., Koroshetz, W. J., & Pinker, S. (1997). A neural dissociation within language: Evidence that the mental dictionary is part of declarative memory, and that grammatical rules are processed by the procedural system.Journal of Cognitive Neuroscience, 9, 266–276.
  • Van Vugt, J. P. P., & Roos, R. A. C. (1999). Huntington's disease: Options for controlling symptoms.CNS Drugs, 11, 105–123.
  • Verran, J. A., & Ferketich, S. L. (1987). Testing linear model assumptions: Residual analysis.Nursing Research, 36, 127–130.
  • Wallesch, C. W., & Fehrenbach, R. A. (1988). On the neurolinguistic nature of language abnormalities in Huntington's disease.Journal of Neurology, Neurosurgery, and Psychiatry, 51, 367–373.
  • Webster Ross, G., Cummings, J. L., & Benson, D. F. (1990). Speech and language alterations in dementia syndromes: Characteristics and treatment.Aphasiology, 4, 339–352.
  • Wechsler, D. (1987). Wechsler Adult Intelligence Scales-Revised Manual. New York: The Psychological Corporation.
  • Wilkinson, L., Hill, M., & Vang, E. (1992). SYSTAT: Statistics (Version 5.2 Ed.). Evanston, IL: SYSTAT.
  • Whitworth, A., Lesser, R., & McKeith, I. (1999). Profiling conversation in Parkinson's disease with cognitive impairment.Aphasiology, 13, 407–425.
  • World Health Organization. (1998). Towards a common language for functioning and disablement: ICIDH-2 the international classification of impairments, activities, and participation. Geneva, Switzerland: Author.
  • Yorkston, K. M., & Beukelman, D. R. (1981). Assessment ofIntelligibility of Dysarthric Speech. Austin, TX: Pro-Ed.
  • Yorkston, K. M., Beukelman, D. R., Strand, E. A., & Bell, K. R. (1999). Management of motor speech disorders in children and adults. Austin, TX: Pro-Ed.

Additional Resources