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Conversational turn-taking in frontotemporal dementia and related disorders
  1. Peter S Pressman1,
  2. Maxime Montembeault2,3,
  3. Gordon Matthewson1,
  4. Eric Lemieux4,
  5. Jane Brusilovsky1,
  6. Bruce L Miller5,
  7. Maria Luisa Gorno-Tempini2,
  8. Katherine Rankin2,
  9. Robert W Levenson6
  1. 1 Neurology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
  2. 2 Neurology, University of California Memory and Aging Center, San Francisco, California, USA
  3. 3 Department of Psychology, McGill University, Montreal, Quebec, Canada
  4. 4 Medicine, Baylor University Medical Center, Dallas, Texas, USA
  5. 5 Memory and Aging Center, University of California Memory and Aging Center, San Francisco, California, USA
  6. 6 Psychology, University of California, Berkeley, California, USA
  1. Correspondence to Dr Peter S Pressman, Neurology, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA; peter.pressman{at}ucdenver.edu

https://doi.org/10.1136/jnnp-2023-331389

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    Introduction

    There is an urgent need to efficiently screen for neurocognitive disorders (NCDs). Early detection can significantly influence therapeutic approaches, patient management and overall quality of life. Spontaneous speech may offer rapid, easy and cost-effective screening measures for NCDs. While prior research has primarily focused on picture description tasks, social interaction is especially cognitively demanding and may offer measures unique to interpersonal conversation. Smooth turn-taking requires high temporal coordination between participants despite the complexity of language and paralanguage during turns, and may serve as a marker of disrupted executive functioning, linguistic ability or social motivation. The behavioural variant of frontotemporal dementia (bvFTD) involves diminished executive function, non-verbal interpretation and social drive. We also investigated other FTLD (Frontotemporal lobar degeneration) -related disorders, including semantic, non-fluent and logopenic variants of primary progressive aphasia (svPPA, nfvPPA, lvPPA), corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), the right temporal variant of FTD and atypical Alzheimer’s disease (AD). We hypothesised that conversational turn-taking would differ between healthy controls (HCs) and neurocognitive disorders (NCDs), and that turn-taking measures would correlate with established neuropsychological and neuroimaging measures.

    Methods

    Participant population

    We investigated dyadic interactions between people with an NCD (N=157) and HC (N=14) and a study partner. HC and participants with AD (N=24), CBS (N=15), PSP (N=18), bvFTD (N=46), lvPPA (N=10), nfvPPA (N=21), rtFTD (N=8) and svPPA (N=14) were recruited at the Memory and Aging Center of the University of California, San Francisco (UCSF). All dyads were studied at the University of California Berkeley Psychophysiology Laboratory. Participants were diagnosed by a panel of behavioural neurologists, neuropsychologists and speech language pathologists using consensus criteria whenever available.

    Measures

    In this cross-sectional observational research, conversational turns could take three forms: (a) prolonged silence between speakers …

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    Footnotes

    • Contributors PSP designed and performed analyses and is primarily responsible for the writing of the manuscript. MM performed neuroimaging correlation. GM assisted in design of associated computer scripts used for analysis as well as providing input on the manuscript. EL assisted in design of associated computer scripts used for analysis as well as providing input on the manuscript. JB provided input on study design and assisted with writing the manuscript, BLM provided input on study design and assisted with writing the manuscript. MLGT provided input on study design and assisted with writing the manuscript. KPR provided input on study design and assisted with writing the manuscript. RWL provided input on study design and assisted with writing the manuscript.

    • Funding This study was funded by American Brain Foundation (N/A), Colorado Clinical and Translational Sciences Institute (N/A), NIA (K23 AG063900-01A1)

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.