Dokument: Sprachstörungen als nicht-motorisches Symptom bei Morbus Parkinson

Titel:Sprachstörungen als nicht-motorisches Symptom bei Morbus Parkinson
Weiterer Titel:Speech impairment as a non-motor symptom in Parkinson's Disease
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=54872
URN (NBN):urn:nbn:de:hbz:061-20201130-112400-8
Kollektion:Dissertationen
Sprache:Deutsch
Dokumententyp:Wissenschaftliche Abschlussarbeiten » Dissertation
Medientyp:Text
Autor: Henkel, Julia [Autor]
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Dateien vom 26.11.2020 / geändert 26.11.2020
Beitragende:PD Dr. Biermann-Ruben, Katja [Gutachter]
Prof. Dr. van de Vijver, Ruben [Gutachter]
Stichwörter:Morbus Parkinson, Sprachstörungen, Basalganglien
Dewey Dezimal-Klassifikation:600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit
Beschreibungen:Das idiopathische Parkinson-Syndrom (IPS) ist für seine prominente motorische Symptomatik als Folge einer basalganglionären Degeneration bekannt. Das heterogene Spektrum der nicht-motorischen Symptome umfasst jedoch auch kognitive Dysfunktionen, darunter Sprachstörungen. Als solche wurden bislang vorrangig Beeinträchtigungen semantischer Funktionen, wie die Prozessierung aktionsbezogener Verben, untersucht (Piatt et al., 1999, Boulenger et al., 2008, Herrera et al., 2012).
Ziel: Die vorliegende Studie erforscht die Beeinträchtigung von syntaktischer Subordination, i.e. die Einbettung eines Nebensatzes in einen Hauptsatz, in der Spontansprache von IPS-Patienten. Ich erweitere damit die Perspektive von Wortebene auf Satzebene und ergänze zudem den in der Literatur beschriebenen semantischen Ansatz um eine syntaktische Analyse. Der Fokus liegt dabei auf der Sprachproduktion.
Methoden: Nach einem neuropsychologischen Assessment erzählen 15 IPS-Patienten im ON-Levodopa-Status sowie eine gesunde Kontrollgruppe eine kurze, allgemein bekannte Märchengeschichte anhand von Bildern. 13 der IPS-Probanden standen auch für eine Datenerhebung im OFF-Levodopa-Status zur Verfügung. Die Sprachproben wurden digitalisiert und im Anschluss gemäß der CHAT-Leitlinien des CHILDES-talkbank-Projekts (MacWhinney, 2000) ausgewertet. Hierdurch wurde eine systematische quantitative Analyse der Sprachdaten gewährleistet.
Ergebnisse: Meine Daten zeigen eine signifikante Reduktion subordinierender Satzstrukturen für die Gruppe der IPS-Probanden gegenüber der Kontrollgruppe (p = 0,021) bei vergleichbarer Anzahl nicht-subordinierender Strukturen. Es zeigt sich kein signifikanter Unterschied zwischen ON-Levodopa- und OFF-Levodopa-Status.
Fazit: Motorische Sprechstörungen im Sinne einer hypokinetischen Dysarthrie können die selektive Reduktion subordinierender Strukturen nicht erklären, kognitiv-kortikale Defizite erscheinen vor dem Hintergrund einer ausgeschlossenen dementiellen sowie depressiven Symptomatik, sowie guter Resultate in den durchgeführten kognitiven Leistungstests wenig plausibel. Meine Ergebnisse legen daher die Beteiligung subkortikaler Strukturen an sprachlicher Prozessierung, wie der syntaktischen Komposition gesprochener Sprache, nahe.

Parkinson’s disease (PD) is characterized as a basal ganglia movement disorder. Recently, non-motor symptoms (NMS) became part of the discussion. Within the heterogenous NMS, language impairment plays a particular role involving cognitive functions. In this regard, studies have primarily shown that PD has a negative impact on semantic tasks such as action word processing (Piatt et al., 1999, Boulenger et al., 2008, Herrera et al., 2012).
Aims: This study examines the impairment of syntactic subordination in PD patients’ spontaneous speech. Hereby, our study extends the perspective from word level to sentence level, supplementing the semantic approach by a syntactical analysis, focusing on speech production.
Methods: After a neuropsychological assessment, 15 PD patients in ON-Levodopa status and a healthy matched control group narrated a short story guided by a set of pictures. 13 PD patients were also available for data acquisition in OFF-levodopa status. Narrations were digitally recorded and subsequently transcribed and annotated following the CHAT guidelines of the CHILDES talkbank project (MacWhinney, 2000), making the produced speech accessible to systematical quantitative analysis.
Results: My data show a significant reduction of subordinating structures in PD patients during their ON-levodopa status compared with the healthy control group while the number of non-embedding sentences remains unaffected (p = .021). No significant effect regarding the comparison of data acquired in ON-levodopa versus OFF-levodopa status emerged.
Conclusion: Motor speech impairments such as hypokinetic dysarthria can’t explain the selective reduction of subordinating structures. Cognitive-cortical deficits appear improbable considering that dementia, severe depressive symptoms and functional deficiency such as working memory impairment and verbal executive function deficits were previously ruled out. Therefore, my results provide further insights into the role that subcortical structures might play in language processing, such as syntactic composition.
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Bezug:2015 - 2020
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:30.11.2020
Dateien geändert am:30.11.2020
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