臨床症状

There is a need for internationally applicable screening tests assessing language in neurodegenerative conditions, allowing for homogenized diagnosis/classification of primary progressive aphasias (PPA), monitoring language decline, and providing endpoints in clinical/therapy trials. The 'Mini-Linguistic State Examination' (MLSE) is currently developed within a worldwide network including 22 countries, and our Paris-Québec collaboration aimed at developing the French/Canadian MLSE (fc-MLSE), validating it with healthy controls and clinical populations.

The fc-MLSE was adapted from the English version using stimuli of similar linguistic complexity. As the English version, the fc-MLSE included 11 sub-tests assessing 5 linguistic domains (motor-speech, phonology, semantics, syntax, verbal working-memory), providing a total score (/100) and 5 sub-scores. The test was administered to 182 healthy controls to generate normative scores, and subsequently to 36 patients with PPA [(nonfluent/agrammatic variant (nfvPPA, n = 8), logopenic variant (lvPPA, n = 20), semantic PPA (svPPA, n = 8)], and 6 patients with Alzheimer's disease (AD).

Testing durations were approximately 8 and 12 minutes for controls and patients, respectively, and the inter-rater consistency was of 92%. In controls, no ceiling effects were observed. The total score and the 5 sub-scores were similar for women/men, and led to stratifications according to age-ranges and educational levels. In clinical populations, the fc-MLSE was able to distinguish AD and PPA patients from controls, and PPA had lower total MLSE scores than AD patients. Sub-scores also distinguished the three PPA variants, showing highest error-rates for motor speech in nfvPPA, verbal working-memory in lvPPA, and semantics in svPPA.

The fc-MLSE is a rapid and examiner-consistent language test, validated with a large population of healthy controls. It can be helpful for clinical classification of PPA variants, and might represent a valuable tool for follow-up trial monitoring in PPA, AD and other neurodegenerative diseases affecting language. More generally, the use of MLSE versions developed in 22 countries will improve the consistency/uniformity of language assessments at the international level.