Pragmatic Language Skills in Patients with Parkinson’s Disease
Major collaborators on this project include Dr. Raymon Durso (Boston University, Boston, MA) and Dr. Thomas Holtgraves (Ball State University, Muncie, IN).
This research is funded by NIDCD Grant number 1R01DC007956-01.
Although Parkinson’s Disease (PD) is primarily associated with debilitating extrapyramidal motor dysfunction, PD also affects thinking, reasoning, planning and language functions. The language-related deficits of PD are clinically severe and significant, but, with the partial exception of the sentence processing deficit, they are largely understudied. In particular, the recently documented impairment in the domain of ‘pragmatics’ (McNamara & Durso, 2003; Bhat et al., 2001; Berg et al., 2003) has not yet been studied adequately. It is important to study pragmatic competence in PD because pragmatic dysfunction may be a key component of both the communication disorders associated with PD and the social-cognitive and behavioral disorders of PD.
We propose to expand the study of cognitive and language-related disorders of PD by examining “pragmatic” comprehension and production abilities of PD patients, as well as the relation of these abilities to progression of the disease, dopaminergic medication, and neuropsychologic function. Study of pragmatic language skills in PD will 1) give us a clearer picture of the nature of the pragmatic language-related deficits in PD as well as their cognitive and neuropsychologic correlates; 2) clarify the extent to which pragmatic deficits are related to the social and cognitive deficits of PD; 3) clarify the role of right vs. left frontal neural systems in mediation of pragmatic functions more generally (see below); and 4) establish benchmark data on neural, cognitive and affective correlates of fundamental pragmatic functions which could potentially be used to develop more effective clinical treatments for disorders of social communication.
In order to accurately characterize pragmatic communication skills and deficits of PD, as well as their underlying neurobiologic correlates, we propose a novel cross-disciplinary collaboration between specialists in the neurobiology/neuropharmacology of PD (co-investigator Durso); the study of cognitive and linguistic deficits of PD (PI – McNamara), the study of pragmatic constraints on language processing (co-investigator Holtgraves); and in the modeling and analysis of data derived from longitudinal assessments of neurobehavioral functions.
We propose the following specific aims and hypotheses:
- Aim 1. Describe the natural history of change in pragmatic production and comprehension skills (henceforth “pragmatic competence”) in PD patients.
- Aim 2. Quantify the relation of pragmatic competence to disease severity (motor function).
- Aim 3. Quantify the relation of change in pragmatic competence to change in mood function in PD.
- Aim 4. Quantify the relation of change in pragmatic competence to change in selected executive cognitive functions (ECF).
- Aim 5. Quantify the relation of change in pragmatic competence to change in medication dosage levels.
- Aim 6. Quantify the relation of change in pragmatic competence to change in social skills/behaviors.
- Aim 7. Quantify the relation of change in pragmatic competence to change in asymmetric disease profile.
