What (more) can verbal fluency tell us about multiple sclerosis?

Area of Science:

• Neuroscience
• Cognitive Psychology
• Speech and Language Therapy

Background:

• Multiple sclerosis (MS) presents with varied symptoms, including cognitive impairment.
• The traditional verbal fluency test (VFT) assesses cognitive function but lacks functional relevance.
• Current VFT methods, based on word count, do not fully capture communication abilities.

Purpose of the Study:

• To identify novel parameters from real-time VFT word production for assessing cognitive and communication functions in persons with multiple sclerosis (PwMS).
• To compare these new parameters between PwMS and a healthy control group.
• To determine the impact of including speech errors in the VFT analysis.

Main Methods:

• Phonological (letter P) and semantic (animals) fluency tests were administered.
• Real-time word production was recorded and analyzed for parameters like word count, initial delay, inflection point, speed, and inter-word delay.
• Analysis considered the inclusion or exclusion of speech errors.

Main Results:

• PwMS demonstrated impaired VFT performance compared to controls.
• Key parameters for phonological fluency included total words, first word delay, speed before inflection, and maximum delay.
• For semantic fluency, total words, first word delay, speed before inflection, and inflection time were significant.
• The inclusion of errors only impacted the total word count, not other studied variables.

Conclusions:

• New VFT parameters derived from real-time word production offer a more functional assessment of communication in PwMS.
• Excluding errors does not significantly alter the interpretation of most VFT variables beyond total word count.
• These refined VFT metrics are recommended for quantitatively evaluating verbal fluency and communication in MS.