Anomia in people with Relapsing-Remitting Multiple Sclerosis

Abstract

Multiple Sclerosis (MS) is a neurodegenerative disease that produces plaques and inflammation throughout the central nervous system (CNS). MS can present in four different clinical courses, of which Relapsing-Remitting Multiple Sclerosis (RRMS) is the main clinical course, especially at early stages of the disease. The age of onset is typically between 20-40 years. MS can have a devastating impact in the personal, social and professional life of the sufferer. MS affects the grey and white matter and the subcortical pathways that connect these areas. This leads to impairment in both physical and cognitive skills. The majority of research about cognition in MS focuses on memory and processing speed deficits. Speech and communication deficits in MS have been relatively neglected in the current literature.A systematic review of speech/language disorders in MS confirmed that there is a gap in the understanding of anomic deficits in people with MS. The research regarding speech and communication deficits in MS has been mainly focused on deficits such as verbal fluency. Anomic deficits have not been properly addressed in the MS literature, possibly reflecting difficulty in detecting milder presentations. Moreover, previous studies have failed to delineate the nature and extent of anomia. This study aimed to examine communication deficits in people with MS, with specific focus on anomic symptoms, as well as potential interaction with dysarthric symptoms. A communication screening assessment was conducted with participants (n=100) suffering from RRMS. The cognitive and linguistic skills of the participants were assessed with several behavioural assessments.The mean participant performance was at the neuro-typical control cut-off in all tasks, although there was a wide range of performance across each test. There was a clinical performance across the cohort for 42% in picture naming, 43% in the ACE-R, 11% in the NART, and 32% in the Pyramids and Palm trees. The anomic symptoms presented as both difficulty in retrieving words and reduced speed of word retrieval. There was evidence of mild dysarthria for 33% of participants, although speed of word retrieval was still on average slower without these participants. The majority of participants presented with cognitive impairment in more than one domain. Statistical testing using correlation and regression analyses showed numerous correlations between test scores but not between test scores and years with MS. Within the regression model, semantic deficits were most strongly related to anomic symptoms.Anomia in MS has been underestimated and requires further research across the MS range of presentations. Future research should aim to better understand the deficits that lead to anomic symptoms, develop sensitive and time-efficient assessments and evaluate treatment programmes through which people with MS can reduce the disabling consequences of anomia and related deficits.

Date of Award	1 Aug 2017
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Paul Conroy (Supervisor) & Lauren Cloutman (Supervisor)