Presentation

Jessica Gallegos¹, Alexandros Afthinos^1,3, Olivia Herrmann¹, Kyrana Tsapkini^1,2; ¹Johns Hopkins School of Medicine, ²Johns Hopkins University, ³Cooper Medical School of Rowan University

Introduction: Primary progressive aphasia (PPA) is a disease hallmarked by a progressive impairment of language functioning. In the early onset of PPA, one of the first detected symptoms is word-finding difficulties (Gorno-Tempini et. al, 2011). It has been claimed that word-finding difficulties depend on a sequence of executive and language processes which reflect a breakdown at one or more of the stages involved in word retrieval (Schwartz et. al, 2006). Behavioral studies have revealed three executive functions that are shifting, monitoring, and selection among competing alternatives that could possibly mediate naming performance (Themistocleous C. et . al, 2020). The goal of the study is to determine whether selection, monitoring, and shifting contribute to oral naming and spelling tasks. Methods: Forty-seven individuals diagnosed with PPA (mean age 66.96 ± 7.49 years) had comprehensive cognitive and linguistic evaluations. The oral language tasks included noun naming (Boston Naming Test) and verb naming (Hopkins Action Naming Assessment). As written spelling tasks, we included spelling of low probability words to test the contribution of the ventral language stream and spelling of nonwords as a proxy for the dorsal language stream (Hopkins Dysgraphia Battery). For selection amongst alternatives, we used the semantic fluency task (Fruits, Animals, Vegetables). For monitoring of information, we used Digit Span Forwards and Backwards and Trail-Making Task A. Finally, for shifting we used Trail-Making Task B. Scoring for the spelling of real words and nonwords was computed using an algorithm that computes the average orthographic distance between the subject’s written response and the target response 3. We performed Pearson’s correlations to determine the degree of correlation between executive functions and oral naming/spelling tasks. Results: Performance on oral noun and verb naming was significantly correlated with the semantic fluency task (noun naming, r(47) = 0.69, p<0.0001; verb naming r(47) = 0.74, p< 0.0001). Performance on spelling of low probability words was also significantly correlated with semantic fluency (r(47)=0.56, p<0.0001). Spelling of nonwords, however, was significantly correlated only with Digit Span Forward (r(47)= -0.64, p<0.0001) and Trail-Making Test A (r(47)= -0.008, p<0.0001). Trail-Making Task B did not correlate with any naming or spelling tasks. Conclusions: The preliminary results of this study suggest that oral noun naming, verb naming, and spelling of low probability words, which are all lexical access tasks, are associated with the process of selection amongst competing alternatives, as represented by the semantic fluency task. Spelling of nonwords, however, a task which is preferably associated with the dorsal language stream, was significantly associated with the process of monitoring of short-term memory, as demonstrated by Digit Span and Trail A. Therefore, we conclude that naming and spelling are indeed associated with executive functions: naming and spelling of real words are associated with selection and spelling of nonwords is associated with monitoring and updating. Regression analyses are also to be performed to determine the exact contribution of each executive function to language tasks as well as their common or different neural substrates.

Topic Areas: Language Production, Control, Selection, and Executive Processes