Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder frequently associated with dysphagia, leading to malnutrition, dehydration, and aspiration pneumonia. The Eating Assessment Tool-10 (EAT-10) is widely used for dysphagia screening; however, its reliability in advanced AD, where cognitive impairments hinder self-reporting, remains uncertain. Objective: This study aimed to evaluate the diagnostic accuracy of EAT-10 in detecting dysphagia and aspiration across different AD stages. Methods: The study included 30 AD patients classified into mild, moderate, and advanced stages based on Clinical Dementia Rating (CDR) scores. Dysphagia was assessed using EAT-10 and validated through Videofluoroscopic Swallowing Study (VFSS) and the Penetration-Aspiration Scale (PAS). Statistical analyses included the Mann-Whitney U test, Spearman correlation, and receiver operating characteristic (ROC) curve analysis (p < 0.05). Results: EAT-10 scores significantly differed across AD stages (p = 0.001), with mean scores of 3.11 ± 1.17 (mild), 11.70 ± 4.64 (moderate), and 18.00 ± 6.90 (advanced). Unsafe swallowing and aspiration were observed in 43.3% and 23.3% of patients, respectively, with higher prevalence in advanced AD. ROC analysis determined an EAT-10 cut-off score of 15 for unsafe swallowing (AUC: 0.96, sensitivity: 88%, specificity: 77%) and 18 for aspiration (AUC: 0.81, sensitivity: 81.2%, specificity: 75%). Strong correlations were found between EAT-10 and PAS scores (r = 0.812, p < 0.001). Conclusions: EAT-10 is an effective screening tool for dysphagia and aspiration risk in early and moderate AD stages. However, in advanced AD, objective assessments like VFSS remain essential to complement EAT-10 results. Integrating EAT-10 into routine evaluations may enhance early detection, enabling timely interventions and improved clinical outcomes.

Introduction: The electrical status epilepticus in sleep (ESES) accompanies a wide spectrum of focal and generalized epilepsies, which manifest with cognitive-linguistic regression. Both ESES and language impairment can be seen in self-limited focal epileptic syndromes of childhood (SFEC). The association between the presence of ESES pattern on the EEG and the severity of the language impairment has not been adequately clarified. Methods: Twenty-eight SFEC cases without intellectual and motor disabilities and 32 healthy children were recruited. Cases with active ESES (A-ESES, n=6) and without ESES pattern on EEG (non-ESES, n=22) were compared in terms of clinical features and linguistic parameters by both standard and descriptive assessment tools. Results: The only significantly different clinical feature in the A-ESES group was the increased prevalence of polytherapy. While most of the linguistic parameters were impaired in A-ESES and non-ESES groups compared to healthy controls, A-ESES patients differed from non-ESES patients only in terms of decreased complex sentence production, which was assessed by narrative analysis. A-ESES patients also showed trends toward producing lower numbers of words, nouns, verbs, and adverbs during narrative analysis. There were no differences among patients under polytherapy and monotherapy in terms of these language parameters. Conclusion: Our results show that ESES increases the negative effect of chronic epilepsy on complex sentence and word production. Linguistic distortions that are not reflected in objective tests can be detected by narrative tools. Complex syntactic production obtained by narrative analysis is an important parameter that extensively characterizes language skills in school-age children with epilepsy.

Bilingualism may lead to differences in narrative micro- and macrostructural features. Creating a normative data set on the narrative characteristics of healthy Turkish-Kurdish bilinguals may allow for a more effective assessment of language disorders that may occur in bilinguals with acquired brain injury. This study aims to determine how narrative micro- and macrostructural features differ in Turkish-Kurdish bilinguals in single picture and story narratives. A total of 23 bilingual (Turkish-Kurdish) and 23 monolingual (Turkish) healthy individuals were included in the study. Narrative samples were obtained using single pictures and a story. Micro- and macrostructural features were compared between bilinguals and monolinguals matched for age, education, and gender. Mean length utterance-morpheme and clausal density variables, considered as indicators of grammatical complexity, were higher in monolinguals in both single picture and story narratives. Morphemic errors were higher for bilinguals. Effort behaviors, which can interrupt verbal efficiency, were higher in bilinguals in single picture narratives. While there was no difference between the groups in verbal fluency (phonemic and categorical), the lexical diversty in storytelling was higher in monolinguals. In terms of macrostructural features, cognitive inferences in the story context and emotional discourse in the single picture context were higher in monolinguals, while enrichment expressions in the single picture narrative were higher in bilinguals. In both groups, macrostructural features such as cognitive inferences and expressions of uncertainty in discourse were negatively correlated with grammatical complexity variables. Turkish-Kurdish bilinguals’ single picture and story narratives in Turkish may show semantic, morphosyntactic and pragmatic differences compared to Turkish-speaking monolinguals.

Aims: This study aimed to investigate the impact of the presence or absence of verbal communication skills in pediatric intensive care unit (PICU) patients who are unable to eat orally and are fed via enteral or parenteral methods, on the stress levels perceived by their parents. Methods: The study included 49 children hospitalized in the PICU with dysphagia and feeding difficulties. The participants’ information regarding tracheostomy, intubation, ability/inability to engage in verbal communication, and type of enteral feeding was recorded. Patients were retrospectively assessed using PRISM (pediatric risk of mortality) scores, and the Turkish version of the Parental Stress Scale was administered to one parent per patient. The participants were grouped based on their child’s verbal communication ability and feeding method (enteral vs. parenteral), and statistical comparisons were made using the Mann-Whitney U test. ROC (receiver operating characteristic) analysis was conducted to identify which of the recorded clinical variables had the most significant effect on parental stress. Results: The mean age of the children was 7.69 years, with 59.2% being male. Of the 49 children included, 31 (63.3%) were classified as non-verbal and 18 (36.7%) as verbal, according to their ability to communicate. While 81.6% were non-intubated, 42.9% had tracheostomies. Feeding methods included nasogastric tube (46.9%), total parenteral nutrition (38.8%), and percutaneous endoscopic gastrostomy (10.2%). The mean PRISM score was 4.0, and the average parental stress score was 69.1. Parents of non-verbal children reported significantly higher stress levels than those of verbal children (p=0.002). Although parental stress appeared higher in the parenteral nutrition group, the difference was not statistically significant (p=0.077). PRISM scores showed no significant differences between groups based on communication or feeding method. According to the ROC analysis [area under the curve (AUC)=0.728], the most significant indicator of parenteral stress was found to be the inability to engage in verbal communication. Conclusion: The findings demonstrate that the inability of children in PICU to verbally communicate significantly increases parental stress levels, independent of illness severity. Although feeding method did not significantly impact parental stress, a trend toward higher stress in parents of parenterally fed children was observed. These results emphasize the importance of preserving or supporting communication abilities in PICU patients. Implementing augmentative and alternative communication strategies (e.g., speaking valves, communication boards) and integrating psychosocial support for caregivers may contribute to improved family-centered care in pediatric critical care settings.

Amaç: Posterior kortikal atrofi (PKA), parieto-oksipital alanlarda volüm kaybı ve görsel-mekansal bozulmaların gözlendiği nadir görülen bir demans sendromudur. Balint Sendromu, Gerstmann Sendromu gibi tabloların eşlik edebilmesi nedeniyle heterojen bir klinik görünüme sahiptir. Bu araştırmada PKA olduğu düşünülen bir olguda dil ve bilişsel tutulumun incelenmesi ve anlatı özelliklerinin betimlenmesi amaçlanmıştır. PKA’nın başlangıç döneminde giyinme apraksisi gibi vizyospasyal tutulumların daha belirgin olduğu ve dil fonksiyonlarının görece olarak korunduğu bildirilmektedir. Gerstmann (agrafi, akalkuli, sağ-sol dezoryantasyonu, parmak agnozisi) ve Balint sendromu (simultanagnozi, optik ataksi, oküler apraksi) bileşenlerinin eşlik etmesi klinik tabloyu şiddetlendirebilmektedir. Yöntem: 54 yaşında, anadili Türkçe ve lise mezunu olan olgunun kranyal görüntülemesinde sağ parietooksipital sulkus komşuluğunda hacim kaybı görülmüştür. Afazi dil değerlendirme testi (ADD), aritmetiksel hesaplama (4 temel işlem), ev resmi kopyalama, çizgi bölme testi, resim betimleme, WMS I kişisel ve aktüel bilgiler testi, WMS II oryantasyon, WMS III mental kontrol, WMS IV mantıksal bellek – anlık hatırlama, WMS IV mantıksal bellek- uzun süreli hatırlama, WMS VI görsel bellek – anlık hatırlama, WMS VI görsel bellek – uzun süreli serbest hatırlama, WMS R sayı menzili, soyut düşünme testi, konstrüksiyonel praksi, saat çizme testi, sözel akıcılık testi, kontrollü kelime çağrışım testi, kategori çağrışım testi uygulandı. Bulgular: ADD puanı; konuşma akıcılığı (11 puan), işitsel anlama (48 puan), tekrarlama (9 puan), adlandırma (5 puan), dilbilgisi (7 puan), söz eylem (4 puan), okuma (0 puan) ve yazma (0 puan) alt testleri kullanılarak 84 puan olarak hesaplandı. Gerstmann ve Balint sendromlarının semptomlarına ek olarak ekstremite apraksisi, konstrüksiyonel apraksi, disdiadokokinezi, disfaji ve dizartri gözlendi. Anlık ve gecikmeli hatırlama, dikkat, inhibisyon, set değiştirme, kognitif esneklik ve soyutlama performansı oldukça düşüktü. Sözel üretimleri çoğu zaman perseverasyonlar ve parafaziler içermekteydi ve belirgin anomi görüldü. Anlatı örneklerinde karmaşık cümle üretimi gözlenmedi. Konuşma örneklerinde toplam sözcük üretimi sınırlıydı. Sonuç: PKA olgusunda ağır görsel uzaysal bozukluklarla birlikte şiddetli dil bozukluğu görülmüştür. PKA’nın çoğu zaman primer progresif afazi ve Alzheimer demansında görülen dil bozuklukları ile prezente olmadığı bilinse de hastalığın evresinden bağımsız olarak dil ve iletişim fonksiyonlarının çeşitli seviyelerde etkilenmiş olabileceği göz önünde bulundurulmalı ve dil ve konuşma terapistleri tarafından değerlendirilmelidir.