Prosody impairment and associated affective and behavioral disturbances in Alzheimer's disease

Abstract

We examined the ability to produce, repeat, and comprehend emotional prosody in 20 patients with Alzheimer's disease (AD) and in 11 elderly normal control subjects. In addition, caregivers of AD patients completed affective and behavioral measures with reference to the patient. Relative to control subjects, comprehension of emotional prosody was marginally impaired in mildly demented AD patients, whereas production, comprehension, and repetition of emotional prosody were significantly impaired in moderately demented AD patients. The moderately demented patients performed significantly poorer than the mildly demented patients on the production and repetition tasks. In contrast, there was no significance difference between the two groups on the prosody comprehension task. Additional analyses revealed an inverse relationship between the ability to correctly produce and repeat emotional prosody and the frequency of agitated behaviors and depressive symptomatology in moderately demented patients. This latter findings suggests that the inability to communicate emotional message is associated with disturbances in mood and behavior in AD patients. Implications for the management of disruptive behavior in agitated and aprosodic AD patients include the development of caregiver sensitivity to unexpressed emotion and caregiver assistance with emotional expression.

Impaired affective prosody in AD

“…Previous work 6 compared emotional processing ability in a group of mildly (MMSE 22 to 25) and moderately (MMSE 17 to 21) demented patients with AD to normal elderly control subjects (MMSE 26 to 30). Consistent with previous findings, 6 the current study found that patients with AD had deficits in repetition and compre-hension of affective prosody. Consistent with previous findings, 6 the current study found that patients with AD had deficits in repetition and compre-hension of affective prosody.…”

“…1 In addition to these cognitive deficits, some patients with AD experience disturbances in their ability to comprehend and express emotional information through facial expression and affective prosody, [2][3][4][5][6] which worsen as dementia severity increases. 1 In addition to these cognitive deficits, some patients with AD experience disturbances in their ability to comprehend and express emotional information through facial expression and affective prosody, [2][3][4][5][6] which worsen as dementia severity increases.…”

“…1 In addition to these cognitive deficits, some patients with AD experience disturbances in their ability to comprehend and express emotional information through facial expression and affective prosody, [2][3][4][5][6] which worsen as dementia severity increases. 6 Results of investigations of normal control subjects and patients with unilateral brain damage suggest that the integrity of the right hemisphere is important for the expression and comprehension of affective prosody. 6 Results of investigations of normal control subjects and patients with unilateral brain damage suggest that the integrity of the right hemisphere is important for the expression and comprehension of affective prosody.…”

Emotional Perception Deficits in Amyotrophic Lateral Sclerosis

“…It has been associated with vascular as well as neurodegenerative pathophysiology affecting prefrontal and right posterior cortical regions as well as frontal-subcortical circuits. [7][8][9][10][11][12][13][14][15][16] Importantly, emotional processing deficits can occur independent of depression and dementia, such as in Parkinson's disease. 17 Disturbances in emotional recognition may reduce patients' involvement in diverse relationships and activities, decrease their quality of life, increase caregiver burden, and aggravate mood and behavioral disturbance.…”

Altered Emotional Perception in Alcoholics: Deficits in Affective Prosody Comprehension

“…Another "nontraditional" skill found to be altered by alcohol abuse is interpersonal problemsolving (Nixon et al, 1992). Because affective prosodic functioning, an essential element of social interaction, is localized to the right hemisphere (Heilman and Gilmore, 1998;Roberts, 1996;Ross, 2000;Ross and Mesulam, 1979;Ross et al, 1997), we thought that this cognitive skill also might be affected by alcohol abuse.…”