The effect of lexical deficits on narrative disturbances in fluent aphasia

Abstract

Aims: This study aims at investigating micro- and macrolinguistic skills in persons with fluent aphasia. The label “fluent aphasia” applies to different aphasic syndromes characterized by fluent speech with difficulties in lexical retrieval and/or grammatical processing. We hypothesized that their lexical and syntactic (i.e., microlinguistic) difficulties would affect also their narrative (i.e., macrolinguistic) skills. \ud Methods & Procedures: Growing evidence shows that traditional tests may not be sensitive enough to capture the patterns of the linguistic impairments observed in these persons. Therefore, we used a narrative task to elicit linguistic samples. Spontaneous speech was elicited through a picture description task. The narrative samples were analyzed with a multi-level approach that allows clinicians to quantify their productivity levels as well as their lexical, grammatical, and narrative skills. The spontaneous speech produced by a group of 20 persons with fluent aphasia was compared to that of a group of 20 healthy participants. All participants with aphasia were in the phase of neurological stability. The two groups were matched for age and level of formal education.\ud Outcomes & Results: Results showed that the lexical impairment observed in the group of participants with fluent aphasia were related to difficulties also in the grammatical construction of the utterances and in the macrolinguistic organization of their speech samples. \ud Conclusions: These findings support the possibility that in these patients microlinguistic difficulties might affect macrolinguistic processing. Furthermore, these results stress the importance of a multi-level approach to assess linguistic skills in patients with fluent aphasia, as it assesses both micro- and macrolinguistic dimensions in parallel. Therefore, it allows linguists, psychologists and clinicians to observe how the linguistic levels interact during natural language processing

Microlinguistic processes that contribute to the ability to relay main events: influence of age

“…Andreeta and Marini (2015) assessed micro- and macrostructural aspects of discourse in adults with fluent aphasia and age-matched controls. They reported reduced levels of cohesion and coherence were associated with poor sentence formation and reduced levels of informativeness, respectively (Andreetta & Marini, 2015). Alternatively, other factors, such as psychosocial factors not measured here may have contributed to the ability to relay the temporal and causal relationships depicted in picture stimuli for older adults.…”

The relationship between co-speech gesture production and macrolinguistic discourse abilities in people with focal brain injury

“…The results are more complicated regarding their macro-linguistic abilities (see Andreetta, Cantagallo, & Marini, 2012). For instance, individuals with fluent aphasia might exhibit problems of cohesion and thematic informativeness (Andreetta, 2014) or discourse organization (Kaczmarek, 1984). However, others report that people with LHD maintain macro-linguistic abilities similar to neurotypical individuals (see Pritchard et al, 2015).…”

Investigating the origin of nonfluency in aphasia: A path modeling approach to neuropsychology

“…For example, Bastiaanse and Jonkers (1998) found no difference between agrammatic and anomic PWA in their production of either object or action names in isolation. A possible relationship also exists between problems of phonological encoding and fluency: Andreetta and Marini (2015) found that the production of phonological errors (mainly false starts) was negatively correlated the proportion of complete sentences. As noted before, grammatical completeness is one criterion used to differentiate nonfluent from fluent aphasia (Goodglass & Kaplan, 1983; Kertesz, 1982).…”