Systematic Review and Meta-Analyses of Word Production Abilities in Dysfunction of the Basal Ganglia: Stroke, Small Vessel Disease, Parkinson’s Disease, and Huntington’s Disease

Abstract

Clinical populations with basal ganglia pathologies may present with language production impairments, which are often described in combination with comprehension measures or attributed to motor, memory, or processing-speed problems. In this systematic review and meta-analysis, we studied word production in four (vascular and non-vascular) pathologies of the basal ganglia: stroke affecting the basal ganglia, small vessel disease, Parkinson’s disease, and Huntington’s disease. We compared scores of these clinical populations with those of matched cognitively unimpaired adults on four well-established production tasks, namely picture naming, category fluency, letter fluency, and past-tense verb inflection. We conducted a systematic search in PubMed and PsycINFO with terms for basal ganglia structures, basal ganglia disorders and language production tasks. A total of 114 studies were included, containing results for one or more of the tasks of interest. For each pathology and task combination, effect sizes (Hedges’ g) were extracted comparing patient versus control groups. For all four populations, performance was consistently worse than that of cognitively unimpaired adults across the four language production tasks (p-values < 0.010). Given that performance in picture naming and verb inflection across all pathologies was quantified in terms of accuracy, our results suggest that production impairments cannot be fully explained by motor or processing-speed deficits. Our review shows that while language production difficulties in these clinical populations are not negligible, more evidence is necessary to determine the exact mechanism that leads to these deficits and whether this mechanism is the same across different pathologies.

Appendix

Mesh terms used in PubMed: ((“Stroke” [Mesh] OR “Infarction” [Mesh] OR “Basal Ganglia Diseases” [Mesh] OR Brain Infarction [Mesh] OR “Brain Diseases“[Mesh] OR “Cerebrovascular Disorders“[Mesh] OR “Lacunar“[Mesh] OR “Basal ganglia Hemorrhage“[Mesh] OR “Leukoaraiosis“[Mesh] OR “Basal Ganglia Cerebrovascular Disease“[Mesh] OR “Brain Damage [Mesh], Chronic“[Mesh] OR “Cerebral Small Vessel Diseases“[Mesh] OR “Brain Small Vessel Disease with Hemorrhage“[Mesh] OR “Intracranial Hemorrhages“[Mesh]) NOT “Cerebellum“[Mesh]) AND ((“Basal Ganglia“[Mesh] OR “Subcortical“[Mesh] OR “Putamen“[Mesh] OR “Caudate Nucleus“[Mesh] OR “Ventral striatum“[Mesh] OR “Striatal“[Mesh] OR “Globus pallidus“[Mesh] OR “Corpus striatum“[Mesh] OR “Neostriatum“[Mesh] OR “Substantia Nigra” [Mesh]) NOT “Cerebellum“[Mesh]) AND (“Language“[Mesh] OR “Language Test“[Mesh] OR “Linguistics“[Mesh] OR “Language Disorder“[Mesh] OR “Semantics“[Mesh] OR “Speech disorders“[Mesh] OR “Speech“[Mesh] OR “Speech Production Measurement“[Mesh] OR “Speech Articulation Tests“[Mesh] OR “Language Tests“[Mesh] OR “Communication“[Mesh] OR “Linguistics“[Mesh] OR Anomia[Mesh]). These Mesh terms were adapted and used to search in PsycINFO.

Terms used in PsycINFO: basal-ganglia.mp. or exp Basal Ganglia/ OR striatum.mp. or exp Striatum/ OR neostriatum.mp. or exp Striatum/ OR subcortical.mp. OR exp Subthalamic Nucleus/ or subthalamic.mp. OR subcortex.mp. NOT cerebellum.mp. or exp Cerebellum/ AND language.mp. or exp Language/ OR. speech.mp. or exp Oral Communication/ OR naming.mp. or exp Naming/ OR procedural.mp. OR oral communication.mp. or exp Oral Communication/ OR aphasia.mp. or exp Aphasia/ OR AND damag*.mp. OR lesion*.mp. or exp Lesions/ OR disease*.mp. OR stroke*.mp OR exp Cerebrovascular Accidents/ or cerebrovascular accident*.mp. OR vascular lesion*.mp. OR basal ganglia disease*.mp.