Word-finding difficulty is a prevalent disease-related deficit in early multiple sclerosis

Abstract

Background: Persons with multiple sclerosis (MS) commonly report word-finding difficulty clinically, yet this language deficit remains underexplored. Objective: To investigate the prevalence and nature of word-finding difficulty in persons with early MS on three levels: patient report, cognitive substrates, and neuroimaging. Methods: Two samples of early MS patients ( n = 185 and n = 55; ⩽5 years diagnosed) and healthy controls ( n = 50) reported frequency/severity of cognitive deficits and underwent objective assessment with tasks of rapid automatized naming (RAN), measuring lexical access speed, memory, word generation, and cognitive efficiency. High-resolution brain magnetic resonance imaging (MRI) derived measurements of regional cortical thickness, global and deep gray matter volume, and T2 lesion volume. Relationships among patient-reported word-finding difficulty, cognitive performance, and neural correlates were examined. Results: Word-finding difficulty was the most common cognitive complaint of MS patients and the only complaint reported more by patients than healthy controls. Only RAN performance discriminated MS patients with subjective word-finding deficits from those without subjective complaints and from healthy controls. Thinner left parietal cortical gray matter independently predicted impaired RAN performance, driven primarily by the left precuneus. Conclusion: Three levels of evidence (patient-report, objective behavior, regional gray matter) support word-finding difficulty as a prevalent, measurable, disease-related deficit in early MS linked to left parietal cortical thinning.

Cognitive Processes Underlying Verbal Fluency in Multiple Sclerosis

“…This test shares some cognitive processes with fluency tasks, such as search, selection, and word retrieval, but with a lower degree of time restriction. Although language was usually considered to be largely preserved in MS, recent studies using novel tests evaluating the speed to lexical access have shown frequent impairment even in early stages ( 24 ).…”

Classifying multiple sclerosis patients on the basis of SDMT performance using machine learning

“…A total of 185 MS patients were included in this study (The Reserve against Disability in Early MS (RADIEMS) Cohort). 22 Patients were aged 20–50 years and diagnosed with relapsing-remitting MS (RRMS) ( N = 163) or clinically isolated syndrome (CIS with ⩾1 brain lesion, N = 20) 23 for ⩽5.0 years were enrolled from Corinne Goldsmith Dickinson Center for MS at Mount Sinai Hospital and Columbia University Irving Medical Center. Exclusion criteria included pregnancy, clinical relapse within 6 weeks, non-proficient in English, history of other neurologic condition, neurodevelopmental disorder, diagnosed learning disability, schizophrenia, bipolar disorder, substance abuse disorder, or current major depressive disorder (please see Table 1 for detailed sample demographics).…”

“…A comprehensive battery of cognitive tests across multiple domains and comprising the minimal neuropsychological assessment of MS (MACFIMS) was administered. 22 Raw SDMT (oral version) scores from this battery were regression corrected to control for age, sex, education, and intelligence quotient (IQ). Z -scores were calculated using 50 age, sex, and education-matched healthy controls.…”

Impaired Verb-Related Morphosyntactic Production in Multiple Sclerosis: Evidence From Greek

“…Importantly, these persons experienced a reduced quality of life than did those without language impairment ( El-Wahsh et al, 2020 ). Several studies reported evidence that word (verb and noun) finding problems are common in MS (e.g., Sepulcre et al, 2011 ; Kambanaros et al, 2017 ; Brandstadter et al, 2019 ). Brandstadter et al (2019) found that word-finding difficulties attested in MS are linked to left parietal cortical thinning.…”

“…Several studies reported evidence that word (verb and noun) finding problems are common in MS (e.g., Sepulcre et al, 2011 ; Kambanaros et al, 2017 ; Brandstadter et al, 2019 ). Brandstadter et al (2019) found that word-finding difficulties attested in MS are linked to left parietal cortical thinning. It should be noted, however, that there are still gaps in our knowledge regarding both the neural substrate of language impairment in MS and the aspects of language affected by MS. Morphosyntactic production, for example, has not been explored adequately thus far.…”