What Causes Word Retrieval Problems in MS?
While experts are still learning about the causes of word retrieval problems in MS, there doesn’t seem to be any single brain process that explains what’s happening.
“With word finding, multiple areas of the brain work together to produce the word you want to say,” says Laura Hancock, PhD, a neuropsychologist at the Mellen Center for Multiple Sclerosis at Cleveland Clinic in Ohio.
According to Dr. Hancock, finding a word involves cognitive processes as varied as visualizing objects or situations, retrieving stored information about words and sounds, initiating speech, and the motor (muscle movement) aspects of speech. When word finding is delayed, “It could be any one of those places where the breakdown is happening,” she says.
In a recent study, researchers looked at verbal fluency in 64 people with MS as well as 73 participants without MS. While people with MS scored the same as those without MS in many measures of verbal fluency, they demonstrated less efficiency and flexibility in their word networks — how words are connected by category and concept.
In many people with MS, word-finding challenges are related to processing speed in the brain. “A lot of times the words are there, but the brain isn’t pulling the information as quickly as it should,” says Meghan Beier, PhD, a rehabilitation neuropsychologist who specializes in MS at the Rowan Center for Behavioral Medicine in Towson, Maryland.
Often, Dr. Beier says, slowed processing speed leads to pauses in speech and the “tip of the tongue” phenomenon in which you feel close to finding a word but can’t find it.
Word finding and other cognitive challenges in MS can be worsened by certain factors, says Lyana Frantz, a speech-language pathologist at Johns Hopkins Medicine in Columbia, Maryland:
- Fatigue
- Sleep difficulties
- Medication side effects
- Depression or anxiety
Frantz says that once difficulties with word finding begin, “A lot of times, people say that they start communicating less to avoid those issues,” potentially making the problem worse by reducing the everyday practice in conversation that most people get.
In a study that looked at experiences with word retrieval among people with MS, researchers found that stressful situations, sensory overload, fatigue, emotions, and the behaviors of conversation partners all played a role in participants’ ability to find words.
Read the full article here
