J Clin Neurol.  2018 Oct;14(4):513-522. 10.3988/jcn.2018.14.4.513.

Association between Frontal-Executive Dysfunction and Speech-in-Noise Perception Deficits in Mild Cognitive Impairment

• Lee SJ
• Park KW
• Kim LS
• Kim H

• KMID: 2424180
• DOI: http://doi.org/10.3988/jcn.2018.14.4.513

Abstract

BACKGROUND AND PURPOSE
Speech-in-noise perception deficits have been demonstrated in patients with mild cognitive impairment (MCI). However, it remains unclear whether the impairment of speech perception varies between MCI subtypes. The purpose of this study was twofold: 1) to compare speech perception performance among MCI subgroups, and 2) to identify the cognitive domains specifically related to speech-in-noise perception.
METHODS
We studied 46 patients with MCI and 39 hearing-threshold-matched cognitively normal elderly (CNE) subjects. Two different patient classifications were used: 1) patients with amnestic mild cognitive impairment (aMCI) (n=21) or nonamnestic mild cognitive impairment (naMCI) (n=25), and 2) patients with frontal-executive dysfunction (FED) (n=16) or without FED (n=30). All of the subjects underwent audiometric, neuropsychological, and speech perception assessments. Speech-in-noise perception was measured using sentence recognition tests in the presence of two types of background noise at four levels.
RESULTS
First, as the level of background noise increased, the MCI with FED group scored lower than both the MCI without FED and CNE groups under both types of noise. Second, both the naMCI and aMCI groups scored lower than the CNE group, but there were no differences between the naMCI and aMCI groups in sentence recognition under any noise conditions. Third, significant correlations were found between sentence recognition and executive function scores both in the MCI groups and in the CNE group.
CONCLUSIONS
Our findings suggest that frontal-executive function is strongly related to speech-in-noise perception and that MCI patients with FED have greater deficits in speech-in-noise perception compared to other subgroups of MCI.

Keyword

mild cognitive impairment; frontal-executive dysfunction; speech-in-noise perception; central auditory processing

MeSH Terms

Aged
Classification
Executive Function
Humans
Mild Cognitive Impairment*
Noise
Speech Perception

Figure

• 

  Fig. 1 Percentage of keywords correctly recognized according to SNR for speech-spectrum noise (A) and multitalker-babble noise (B) in the MCI with FED, MCI without FED, and CNE groups. *p<0.05, †p<0.01, ‡p<0.001. CNE: cognitively normal elderly, FED: frontal-executive dysfunction, MCI: mild cognitive impairment, SNR: signal to noise ratio.

• 

  Fig. 2 Percentage of keywords correctly recognized according to SNR for speech-spectrum noise (A) and multitalker-babble noise (B) in the naMCI, aMCI, and CNE groups. *p<0.05, †p<0.01, ‡p<0.001. aMCI: amnestic mild cognitive impairment, CNE: cognitively normal elderly, MCI: mild cognitive impairment, naMCI: nonamnestic mild cognitive impairment, SNR: signal to noise ratio.

• 

  Fig. 3 Differences between groups in the rates of functional decline in speech perception performance across noise levels. Difference in slope: *p<0.05 vs. CNE, †p<0.01 vs. CNE, ‡p<0.001 vs. CNE, §p<0.05 vs. MCI without FED. aMCI: amnestic mild cognitive impairment, CNE: cognitively normal elderly, FED: frontal-executive dysfunction, MCI: mild cognitive impairment, naMCI: nonamnestic mild cognitive impairment.

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