SAND: a Screening for Aphasia in NeuroDegeneration. Development and normative data

Abstract

Language assessment has a critical role in the clinical diagnosis of neurodegenerative diseases, in particular, in the case of Primary Progressive Aphasia (PPA). The current diagnostic criteria (Gorno-Tempini et al., 2011) identify three main variants on the basis of clinical features and patterns of brain atrophy. Widely accepted tools to diagnose, clinically classify, and follow up the heterogeneous language profiles of PPA are still lacking. In this study, we develop a screening battery, composed of nine tests (picture naming, word and sentence comprehension, word and sentence repetition, reading, semantic association, writing and picture description), following the recommendations of current diagnostic guidelines and taking into account recent research on the topic. All tasks were developed with consideration of the psycholinguistic factors that can affect performance, with the aim of achieving sensitivity to the language deficit to which each task was relevant, and to allow identification of the selective characteristic impairments of each PPA variant. Normative data on 134 Italian subjects pooled across homogeneous subgroups for age, sex, and education are reported. Although further work is still needed, this battery represents a first step towards a concise multilingual standard language examination, a fast and simple tool to help clinicians and researchers in the diagnosis of PPA.

Regression-based normative data and equivalent scores for Trail Making Test (TMT): an updated Italian normative study

“…However, to verify whether the present sample size could make our inter-form parallelism analysis unreliable, we run a power analysis on an unconstrained measurement model (all loadings and error variances free to vary, according to Muthén and Muthén,[40]). The results of this analysis (Supplementary [42][43][44]). We conformed to this practice, also for the sake of consistency among Italian normative data.…”

Screening for Aphasia in NeuroDegeneration for the Diagnosis of Patients with Primary Progressive Aphasia: Clinical Validity and Psychometric Properties

“…Recently, a systematic review identified the few neuropsychological tests available for the assessment of speech and language disorders in PPA and discussed their limitations [7]. This is the main reason that led to the development of the SAND battery [8]. In this study, we explored its clinical validity and psychometric characteristics.…”

“…All participants were given the SAND battery, whose normative values have already been published [8]. The entire battery takes < 20 min to administer and yields scores for each of the nine subtests.…”

“…Most language tests in common use, such as the Aachen Aphasia Test [4] and the Boston Diagnostic Aphasia Examination [5], have been developed for the evaluation of aphasia due to stroke, which, besides having a different prognosis, is characterized by language profiles that can be very different from those of PPA [6]. Given the dearth of specific tools aimed at assessing language impairments in neurodegenerative diseases [7], we developed the Screening for Aphasia in NeuroDegeneration (SAND) battery [8], based on the Mini Standard Language Examination proposed by Garrard and Ahmed [9]. The SAND battery aims at the detection of language disorders through the assessment of different components of language.…”

Clinical, Anatomical, and Pathological Features in the Three Variants of Primary Progressive Aphasia: A Review

“…Furthermore, there is likely a high heterogeneity in tests and cutoffs used in the diagnosis of PPA across different clinical and research sites. There is a need for a use of sensitive and specific tests, and some authors have recently published assessment batteries specifically designed for the assessment of PPAs ( 157 , 158 ). Most importantly, apparently similar symptoms might be due to distinct underlying causes between PPA variants, and this should be considered in tests selection and interpretation.…”