The Dutch Mini-Linguistic State Examination (MLSE-NL): findings in Primary Progressive Aphasia (PPA).

Coppieters, Rosie; Janssen, Nikki; Garrard, Peter; Hiemstra, Fenna; Duits, Annelien; De Coninck, Mattias; De Keulenaer, Stéphanie; Storey, Ian; Piai, Vitória; Renssen, Johan; Ruis, Carla; Seelaar, Harro; van den Berg, Esther; Van Mossevelde, Sara; Bruffaerts, Rose; Jiskoot, Lize
journal of neurology 2026 Vol. 273
1
rosie2026the

Abstract

Changes in speech and language occur as the first symptoms of Primary Progressive Aphasia (PPA). The Mini-Linguistic State Examination (MLSE) is a short speech and language screening test used in the diagnostic process of PPA in English-speaking patients. We adapted the MLSE into Dutch (MLSE-NL) and validated this new version as a diagnostic screening tool in Dutch-speaking patients. We assessed the MLSE-NL in 90 Dutch-speaking patients with PPA (nonfluent variant PPA (nfvPPA) n = 23, logopenic variant PPA (lvPPA) n = 24, semantic variant PPA (svPPA) n = 32, PPA Not Otherwise Specified (PPA-NOS) n = 11) (mean age: 68.3, 47.8% male) and 276 healthy volunteers (mean age: 56.3, 38.8% male). The MLSE-NL includes subscores in motor speech, phonological structure, semantic knowledge, syntax, and working memory. Group differences were assessed using Kruskal-Wallis tests, with linear models controlling for covariates as confirmatory analyses. The MLSE-NL shows significantly lower scores for all PPA variants for total score, ranging from 30 to 96/100 in patients and 83 to 100/100 in controls. The AUC for total score was 0.99 (subdomain AUCs ranged from 0.80 to 0.92). nfvPPA had more motor speech errors than controls, svPPA had more semantic errors, while lvPPA had the most working memory deficits. Syntax errors were frequent in all variants, while phonological deficits were greater in lvPPA and nfvPPA. PPA-NOS had deficits in all domains aside from motor speech. The MLSE-NL can successfully discriminate the three canonical variants of PPA and PPA-NOS from controls and captures domain-specific neurolinguistic profiles.

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