Validation of the Dutch version of the Mini-Linguistic State Examination (MLSE-NL) for  the diagnosis of Primary Progressive Aphasia

Primary progressive aphasia (PPA) is a form of early-onset dementia, characterised by a gradual decline in language abilities. PPA comprises three different subtypes with each subtype presenting unique linguistic impairments: nonfluent/agrammatic (nfvPPA), semantic (svPPA), and logopenic (lvPPA) PPA. However, diagnosing PPA in general, and specifically these variants, currently remains clinically challenging. To address this, the Mini Linguistic State Examination was adapted to the Dutch language (MLSE-NL). The MLSE-NL is a screening tool to evaluate language deficits related to PPA, measuring five different domains: motor speech, phonology, semantics, syntax, and working memory. This study aimed to validate and determine the effectiveness of MLSE-NL in distinguishing between PPA variants. A cross-sectional study was conducted with 99 participants, including 21 patients diagnosed with PPA and 78 cognitively healthy controls. A psychometric evaluation of the MLSE-NL was performed to...Show morePrimary progressive aphasia (PPA) is a form of early-onset dementia, characterised by a gradual decline in language abilities. PPA comprises three different subtypes with each subtype presenting unique linguistic impairments: nonfluent/agrammatic (nfvPPA), semantic (svPPA), and logopenic (lvPPA) PPA. However, diagnosing PPA in general, and specifically these variants, currently remains clinically challenging. To address this, the Mini Linguistic State Examination was adapted to the Dutch language (MLSE-NL). The MLSE-NL is a screening tool to evaluate language deficits related to PPA, measuring five different domains: motor speech, phonology, semantics, syntax, and working memory. This study aimed to validate and determine the effectiveness of MLSE-NL in distinguishing between PPA variants. A cross-sectional study was conducted with 99 participants, including 21 patients diagnosed with PPA and 78 cognitively healthy controls. A psychometric evaluation of the MLSE-NL was performed to evaluate the reliability and validity of the test. Furthermore, differences in performance on the MLSE-NL across PPA variants and the control group were analysed. Results showed that the MLSE-NL demonstrated robust psychometric properties, exhibiting high inter-rater reliability and strong convergent validity compared to other validated language tests. Significant differences were observed in the MLSE-NL total and subdomains scores between patients with PPA and control groups. Patients with PPA exhibited lower total scores and domain-specific scores on the MLSE-NL compared to cognitively healthy controls. Notably, within the motor speech and working memory domains, significant differences were observed within the PPA subtypes; nfvPPA, svPPA and lvPPA. No significant differences were found in the other domains. The findings of the current study are in line with outcomes from the original English version of the MLSE. Results showed that the MLSE is robust for use in another language and cultural context. When interpreting the results of the current study, the small sample size should be taken into account. In conclusion, the MLSE-NL emerges as a reliable and valid instrument for diagnosing and distinguishing PPA variants within the Dutch-speaking population. Future research with larger samples is necessary to validate these findings and expand the normative data.Show less

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Validation of the Dutch version of the Mini-Linguistic State Examination (MLSE-NL) for the diagnosis of Primary Progressive Aphasia