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Relationship between word properties of fluency tasks at baseline and treatment outcomes in Primary Progressive Aphasia

Adrià Rofes1, 2*, Vânia De Aguiar3, Bronte Ficek3, Kimberly T. Webster3, Haley Wendt3, Brenda Rapp2 and Kyrana Tsapkini3
  • 1 Global Brain Health Institute, Trinity College, Ireland
  • 2 Johns Hopkins University, Cognitive Science, United States
  • 3 Johns Hopkins University, Neurology, United States

Background: Fluency tasks are frequently used to investigate how language components break down in neurological populations (Marczinski & Kertesz, 2006; Rofes et al., 2017). In one minute, participants say as many words as possible starting with a specific letter or from a semantic category. Recent work examines the mean word properties of the words that are produced, including imageability, length, and others. This work has shown promising results in using these properties to identify variants of Primary Progressive Aphasia (PPA, Rofes et al., 2018; Vita et al., 2014), raising the question of whether properties of words retrieved during fluency tasks and obtained before naming/spelling therapy may relate to treatment outcomes. This information could open a window to using fluency tasks as a rapid method to recognize which individuals are more likely to benefit from therapy. Methods: Twenty-nine English-native speakers with PPA and a mild to moderate language impairment underwent 3 weeks of naming/spelling therapy, where they received either anodal tDCS stimulation over the left IFG or sham (randomized) – the left IFG has been repeatedly implicated in fluency tasks (Costafreda et al., 2006). Before therapy, participants were assessed with three letter fluency tasks (F, A, S) and three category fluency tasks (animals, vegetables, fruits). To evaluate the relationship between pre-treatment fluency data and responsiveness to therapy, we carried linear models using Change in spelling accuracy (post minus pre letter accuracy scores for treated or untreated words) as the dependent variable; main effects for Word Property (mean values for frequency, imageability, familiarity, age-of-acquisition, semantic association, length, orthographic or phonological neighborhood, concreteness) and Stimulation Type (tDCS/sham); and an interaction Stimulation Type (tDCS/sham) and Word Property. We evaluated separate models for each Word Property as produced in letter or category fluency. Also, we evaluated separate models for treated and untreated words, allowing for assessment of generalization effects. Results: For treated words, people with lower mean concreteness and lower mean imageability scores in letter fluency who received tDCS, changed more than those who received sham. For untreated words, people with lower mean concreteness and lower mean imageability scores in category fluency who received tDCS, changed more than those who received sham. Conclusions: The properties of words produced in fluency tasks at baseline were associated with treatment (language therapy +/- tDCS) outcomes. The same word properties (i.e., concreteness, imageability), in different fluency tasks, were associated with change for treated and untreated words, possibly reflecting different learning mechanisms. Finally, letter fluency and category fluency may be used independently to identify which individuals may benefit the most from specific types of therapy.

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References

Costafreda, S. G., Fu, C. H., Lee, L., Everitt, B., Brammer, M. J., & David, A. S. (2006). A systematic review and quantitative appraisal of fMRI studies of verbal fluency: role of the left inferior frontal gyrus. Human brain mapping, 27, 799-810.
Marczinski, C. A., & Kertesz, A. (2006). Category and letter fluency in semantic dementia, primary progressive aphasia, and Alzheimer’s disease. Brain and language, 97, 258-265.

Rofes, A., De Aguiar, V., Ficek, B., Webster, K., Wendt, H., Rapp, B., & Tsapkini, K. (2018). Word properties of fluency tasks in three variants of Primary Progressive Aphasia. Alzheimer's Association Satellite Symposium, Apr. 17-18, Buenos Aires, Argentina.

Rofes, A., Mandonnet, E., Godden, J., Baron, M. H., Colle, H., Darlix, A., …, Wager, M. (2017). Survey on current practices within the European Low Grade Glioma Network: language and cognitive assessment part. Acta Neurochirurgica, 159, 1167-1178.
Vita, M. G., Marra, C., Spinelli, P., Caprara, A., Scaricamazza, E., Castelli, D., ... & Quaranta, D. (2014). Typicality of words produced on a semantic fluency task in amnesic mild cognitive impairment: linguistic analysis and risk of conversion to dementia. Journal of Alzheimer's Disease, 42, 1171-1178.

Keywords: Imageability, concreteness, fluency, treatment outcome, PPA

Conference: Academy of Aphasia 56th Annual Meeting, Montreal, Canada, 21 Oct - 23 Oct, 2018.

Presentation Type: oral presentation

Topic: Eligible for a student award

Citation: Rofes A, De Aguiar V, Ficek B, Webster KT, Wendt H, Rapp B and Tsapkini K (2019). Relationship between word properties of fluency tasks at baseline and treatment outcomes in Primary Progressive Aphasia. Conference Abstract: Academy of Aphasia 56th Annual Meeting. doi: 10.3389/conf.fnhum.2018.228.00006

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Received: 30 Apr 2018; Published Online: 22 Jan 2019.

* Correspondence: Dr. Adrià Rofes, Global Brain Health Institute, Trinity College, Dublin, Ireland, a.rofes@rug.nl