Project

Development of a 'Mini Linguistic State Examination'

Goal: To validate a brief, clinic based instrument that will allow clinicians to accurately and reproducibly classify and monitor patients with primary progressive aphasia syndromes. Data will also be obtained from patients with post stroke aphasia to allow systematic comparisons between the classic aphasia syndromes and PPA. The initial phase of the project will involve parallel development of English and Italian versions of the instrument, but it is hoped that other language versions will be developed using equivalent methodology.

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Project log

Katie A Peterson
added a research item
Background: Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) affect speech and language as well as motor functions. Clinical and neuropathological data indicate a close relationship between these two disorders and the non-fluent variant of primary progressive aphasia (nfvPPA). We use the recently developed Mini Linguistic State Examination tool (MLSE) to study speech and language disorders in patients with PSP, CBS, and nfvPPA, in combination with structural magnetic resonance imaging (MRI). Methods: Fifty-one patients (PSP N = 13, CBS N = 19, nfvPPA N = 19) and 30 age-matched controls completed the MLSE, the short form of the Boston Diagnostic Aphasia Examination (BDAE), and the Addenbrooke's Cognitive Examination III. Thirty-eight patients and all controls underwent structural MRI at 3 Tesla, with T1 and T2-weighted images processed by surface-based and subcortical segmentation within FreeSurfer 6.0.0 to extract cortical thickness and subcortical volumes. Morphometric differences were compared between groups and correlated with the severity of speech and language impairment. Results: CBS and PSP patients showed impaired MLSE performance, compared to controls, with a similar language profile to nfvPPA, albeit less severe. All patient groups showed reduced cortical thickness in bilateral frontal regions and striatal volume. PSP and nfvPPA patients also showed reduced superior temporal cortical thickness, with additional thalamic and amygdalo-hippocampal volume reductions in nfvPPA. Multivariate analysis of brain-wide cortical thickness and subcortical volumes with MLSE domain scores revealed associations between performance on multiple speech and language domains with atrophy of left-lateralised fronto-temporal cortex, amygdala, hippocampus, putamen, and caudate. Conclusions: The effect of PSP and CBS on speech and language overlaps with nfvPPA. These three disorders cause a common anatomical pattern of atrophy in the left frontotemporal language network and striatum. The MLSE is a short clinical screening tool that can identify the language disorder of PSP and CBS, facilitating clinical management and patient access to future clinical trials.
Peter Garrard
added an update
Apologies to all those who have expressed interest for the long wait for the final version of the test plus scoring/administration instructions. Near final drafts of these documents are currently under review by the project PIs in UK and Italy. When the texts of these documents have been finally signed off by both groups we will place them on a password protected area of the website for downloading. Passwords will be made available on request.
 
Peter Garrard
added an update
More details on the MLSE project are available on the project website at www.mlsexam.com
Please take a look. All comments welcome.
 
Peter Garrard
added an update
There is now a new project, led by Leticia Vivas and Macarena Martínez-Cuitiño and Laura Manoiloff to develop an Argentinian Spanish version of the MLSE. Search for 'adaptaction argentina del MSLE'
 
Peter Garrard
added a project goal
To validate a brief, clinic based instrument that will allow clinicians to accurately and reproducibly classify and monitor patients with primary progressive aphasia syndromes. Data will also be obtained from patients with post stroke aphasia to allow systematic comparisons between the classic aphasia syndromes and PPA. The initial phase of the project will involve parallel development of English and Italian versions of the instrument, but it is hoped that other language versions will be developed using equivalent methodology.