Document Type: Original Articles

Authors

1 Faculty member/speech therapy department, Faculty of rehabilitation sciences, Zahedan university of medical sciences, Zahedan, Iran,

2 Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran university of medical sciences, Tehran, Iran.

3 Department of Speech and Language Pathology, School of Rehabilitation Sciences, University Social Welfare and Rehabilitation Sciences, Tehran, Iran.

4 Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Recent studies have demonstrated that ALS patients suffer from cognitive and language impairments. One of the most striking and consistent cognitive dysfunctions in these patients is verbal fluency deficits. The aim of this study is the determination of verbal fluency performance of Persian speakers with ALS.
Methods: It was a cross-sectional, analytical-descriptive study. In this study, 30 individuals (15 patients with ALS, and 15 healthy people) were examined by verbal fluency test. Verbal fluency test is a cognitive-linguistic test that has two subtests: phonemic fluency and semantic fluency; in each of them, words normally fall in clusters. Finally, the total number of words, mean cluster sizes and number of switches between clusters are counted and the results are compared between patients with ALS and healthy control groups.
Results: Mean score of total naming, switching, and clustering in verbal fluency in the patient group was 39.80, 22.53, and 0.809. For the control group, it was 55.26, 31.86 and 1.00. Difference between the two groups in total naming (p≤ 0.05) and in switching (p≤ 0.05) was significant, but not in clusters (p≥0.05).
Conclusion: Result of this study shows that ALS patients have a deficit in total naming and switching parts of verbal fluency test, but they have no impairment in clustering part. Based on these results, it seems that these patients may have problems in searching in the lexicon, but no problem in accessing words in clusters.

Keywords

1.         Pagnini F, Simmons Z. Amyotrophic Lateral Sclerosis, understanding and optimizing quality of lifeand psychological well-being. United Kingdom: Oxford university press; 2018.

2.         Abrahams S, Leigh P, Harvey A, Vythelingum G, Grise D, Goldstein L. Verbal fluency and executive dysfunction in amyotrophic lateral sclerosis (ALS). Neuropsychologia. 2000;38(6):734-47.

3.         Abrahams S, Goldstein L, Simmons A, Brammer M, Williams S, Giampietro V, et al. Word retrieval in amyotrophic lateral sclerosis: a functional magnetic resonance imaging study. Brain. 2004;127(7):1507-17.

4.         Abe K, Takanashi M, Watanabe Y, Tanaka H, Fujita N, Hirabuki N, et al. Decrease in N-acetylaspartate/creatine ratio in the motor area and the frontal lobe in amyotrophic lateral sclerosis. Neuroradiology. 2001;43(7):537-41.

5.         Abrahams S, Goldstein L, Kew J, Brooks D, Lloyd C, Frith C, et al. Frontal lobe dysfunction in amyotrophic lateral sclerosis: a PET study. Brain. 1996;119(6):2105-20.

6.         Sergeant JA, Geurts H, Oosterlaan J. How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behavioural brain research. 2002;130(1-2):3-28.

7.         Troyer AK, Moscovitch M, Winocur G. Clustering and switching as two components of verbal fluency: evidence from younger and older healthy adults. neuropsychology. 1997;11(1):138.

8.         Troyer AK. Normative data for clustering and switching on verbal fluency tasks. Journal of clinical and experimental neuropsychology. 2000;22(3):370-8.

9.         Troyer AK, Moscovitch M, Winocur G, Leach L, Freedman M. Clustering and switching on verbal fluency tests in Alzheimer's and Parkinson's disease. Journal of the International Neuropsychological Society. 1998;4(2):137-43.

10.       Bousfield WA, Sedgewick CHW. An analysis of sequences of restricted associative responses. The Journal of General Psychology. 1944;30(2):149-65.

11.       Gruenewald PJ, Lockhead GR. The free recall of category examples. Journal of Experimental Psychology: Human Learning and Memory. 1980;6(3):225.

12.       Robert P, Migneco V, Marmod D, Chaix I, Thauby S, Benoit M, et al. Verbal fluency in schizophrenia: The role of semantic clustering in category instance generation. European Psychiatry. 1997;12(3):124-9.

13.       Kosmidis MH, Tsapkini K, Folia V, Vlahou CH, Kiosseoglou G. Semantic and phonological processing in illiteracy. Journal of the International Neuropsychological Society. 2004;10(6):818-27.

14.       Tröster AI, Fields JA, Testa JA, Paul RH, Blanco CR, Hames KA, et al. Cortical and subcortical influences on clustering and switching in the performance of verbal fluency tasks. Neuropsychologia. 1998;36(4):295-304.

15.       Mousavi SZ, Mehri A, Maroufizadeh S, Koochak SE. Comparing Verb Fluency With Verbal Fluency in Patients With Alzheimer's Disease. Middle East Journal of Rehabilitation and Health. 2014;1(2).

16.       Dadgar H, Khatoonabadi AR, Bakhtiyari J. Verbal fluency performance in patients with non-demented Parkinson's disease. Iranian journal of psychiatry. 2013;8(1):55.

17.       Dadgar H, Shahbeigi S, Nikbakht D, Malmir F, Akrami Z. Comparison of semantic and phonemic Clustering and switching in Parkinson's disease and normal subjects. Audiology. 2014;23(2).

18.       Ebrahimipour M, Weisi F, Rezaei M, Motamed MR, Ashayeri H, Modarresi Y, et al. Word finding difficulties in multiple sclerosis. Neurology Asia. 2017 1:22(2).

19.       Lepow L, Van Sweringen J, Strutt AM, Jawaid A, MacAdam C, Harati Y, et al. Frontal and temporal lobe involvement on verbal fluency measures in amyotrophic lateral sclerosis. Journal of clinical and experimental neuropsychology. 2010;32(9):913-22.

20.       Van Der Elst W, Van Boxtel MP, Van Breukelen GJ, Jolles J. Normative data for the Animal, Profession and Letter M Naming verbal fluency tests for Dutch speaking participants and the effects of age, education, and sex. Journal of the International Neuropsychological Society. 2006;12(1):80-9.

21.       Ebrahimipour M. Verbal fluency test. Iran, Tehran: Ghalame Elm; 2014.

22.       Abrahams S, Leigh P, Goldstein L. Cognitive change in ALS A prospective study. Neurology. 2005;64(7):1222-6.

23.       Evdokimidis I, Constantinidis T, Gourtzelidis P, Smyrnis N, Zalonis I, Zis P, et al. Frontal lobe dysfunction in amyotrophic lateral sclerosis. Journal of the neurological sciences. 2002;195(1):25-33.

24.       Murphy J, Henry R, Lomen-Hoerth C. Establishing subtypes of the continuum of frontal lobe impairment in amyotrophic lateral sclerosis. Archives of Neurology. 2007;64(3):330-4.

25.       Murphy JM, Henry RG, Langmore S, Kramer JH, Miller BL, Lomen-Hoerth C. Continuum of frontal lobe impairment in amyotrophic lateral sclerosis. Archives of Neurology. 2007;64(4):530-4.

26.       Pihlajamäki M, Tanila H, Hänninen T, Könönen M, Laakso M, Partanen K, et al. Verbal fluency activates the left medial temporal lobe: a functional magnetic resonance imaging study. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 2000;47(4):470-6.

27.       Mardani N, Rohani M H, Mahdipour R, K B. Comparison of Phonemic Fluency Test Results Using Different Letters among Persian Speakers. Journal of Rehabilitation Sciences and Research. 2018;4:109-13.

28.       Koren R, Kofman O, Berger A. Analysis of word clustering in verbal fluency of school-aged children. Archives of Clinical Neuropsychology. 2005;20(8):1087-104.

29.       Abwender DA, Swan JG, Bowerman JT, Connolly SW. Qualitative analysis of verbal fluency output: Review and comparison of several scoring methods. Assessment. 2001;8(3):323-38.