The northwestern anagram test: measuring sentence production in primary progressive aphasia

Abstract

Primary progressive aphasia (PPA) is a clinical dementia syndrome with early symptoms of language dysfunction. Postmortem findings are varied and include Alzheimer disease and frontotemporal lobar degeneration (FTLD), both tauopathies and TAR DNA binding protein (TDP-43) proteinopathies. Clinical-pathological correlations in PPA are complex but the presence in the clinical profile of agrammatism has a high association with tauopathy. Grammatical competence is difficult to assess in the clinical setting with available methods. This article describes the Northwestern Anagram Test (NAT), a new clinical measure of sentence production. A total of 16 patients with PPA and their controls assembled single printed words to create sentences describing pictures. Northwestern Anagram Test performance was significantly correlated with a measure of sentence production and with aphasia severity but not with measures of naming, single word comprehension, object recognition, or motor speech. The NAT can be used to assess syntax competence when patients cannot be tested with measures that require intact speech production.

Conflict of interest statement

Disclosures: The authors have reported no conflicts of interest

Figures

Figure 1. Sample Item From The Northwestern Anagram Test (NAT)

The word cards beneath the picture must be arranged in the proper sequence to describe the picture, in this instance, “The girl is tickling the boy.” The subject is provided with the first two words in proper sequence and asked to construct the remainder of the sentence.

Figure 2. NAT and NAVS Percent Correct By Sentence Type

PPA patients’ performance on canonical [Active, Subject-Wh (Sub-Wh), and Subject-Cleft (Sub-Cleft)] and Non canonical[Passive, Object-Wh (Obj-Wh), and Object-Ceft (Obj-Cleft)] sentence structures on the NAT and the NAVS.