EAN 2023 | Importance of cross-linguistic assessments for primary progressive aphasia
Thomas Bak, MD, from the University of Edinburgh, Edinburgh, UK, introduces the importance of cross-linguistic assessment of primary progressive aphasia (PPA). As society becomes increasingly multicultural, it is more and more important to consider the impact of being a non-native speaker in the diagnosis of speech and language disorders. There is a great need for further study of aphasia in a broad range of languages, not just focusing on English-speaking patients. Dr Bak gives the example that in languages where words are given grammatical gender, patients with semantic variant PPA will often misgender words, an observation which is impossible in English-speaking patients where grammatical gender is not present. Additionally, agrammatism will show itself very differently in different languages and by focusing on English-speaking research, we may miss other manifestations of aphasia or its manifestation in non-native speakers. Recorded at the 9th Congress of the European Academy of Neurology (EAN) 2023 held in Budapest, Hungary.
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Transcript (edited for clarity)
Well indeed the session was suggested by EAN Dementia and Cognitive Disorders Panel, Sofia Toniolo and by young researchers and research fellows and the residents, because it’s a topic which is becoming more and more important. In all Europe, we have more and more people, immigrants, refugees, and so on, people who speak other languages, and therefore it becomes relevant to be able to diagnose aphasia also in different languages...
Well indeed the session was suggested by EAN Dementia and Cognitive Disorders Panel, Sofia Toniolo and by young researchers and research fellows and the residents, because it’s a topic which is becoming more and more important. In all Europe, we have more and more people, immigrants, refugees, and so on, people who speak other languages, and therefore it becomes relevant to be able to diagnose aphasia also in different languages. Now, the opening talk was by my colleague Stefano Cappa, and he was stressing that the different types of aphasia are not just something that we observe from observation of language, but also they have different pathological and anatomical correlates. So, from this point of view, there has been a lot of progress in the functional neuroanatomy and our understanding of aphasia. So, we distinguish three big groups in progressive aphasia, the non-fluent progressive aphasia, the semantic dementia and logopenic aphasia.
For instance, I mean, just to start with a very practical example, I mentioned there’s three types of aphasia, one of them being semantic dementia. Now, most work on semantic dementia has been in patients who spoke English as their first language. The problem is, in Europe, the majority of Indo-European languages have grammatical gender. From Portuguese to Russian we have male, female, neutral in some languages, and so on. This has implications for the way aphasia manifests itself. So, one of the examples I gave is that in Spanish, patients make errors, they use for instance “La” instead of “El”, they will make errors. This is something which we’ll never find out in English because English doesn’t have grammatical gender. There are many languages, particularly in Eastern Europe, which are morphologically very complex. In this case, if patient has, for instance, agrammatism, it will show itself very differently from what we will see in an English language speaking patient. So, from this point of view, if all our understanding of aphasia is based on observations in English, we are missing a lot of very relevant ways in which aphasia manifests itself in other languages.
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