Striking loss of second language in bilingual patients with semantic dementia.

BACKGROUND: Studies of bilingual or multilingual patients with neurodegenerative diseases that disrupt language like the primary progressive aphasias (PPA) may contribute valuable information on language organization in the bilingual brain and on the factors affecting language decline. There is limited literature on bilingual PPA and in particular on semantic dementia, a type of PPA with selective loss of semantic memory. We studied the nature and severity of naming and comprehension deficits across languages in bilingual patients with semantic dementia (SD).

METHODS: Sixteen bilingual patients with SD and 34 bilingual age-matched controls were administered the modified Boston Naming Test and components of Cambridge Semantic Battery. The patients' performance on picture naming and word comprehension was compared across languages and with controls. The most proficient language on self-rating was labelled as L1 and less proficient as L2.

RESULTS: We observed striking loss of second language (L2) in SD for both receptive and expressive language, even in patients who were premorbidly fluent in their L2. Naming and comprehension in every patient's L2 were impaired relative to both their own first-language (L1) scores and controls' L2 scores. Furthermore, item-specific correct responses in each patient's L2 were a subset of their successes in L1.

DISCUSSION: A striking contrast in performance between two languages in bilingual patients with SD indicates that a bilingual's L2 or less proficient language is more vulnerable to neurodegeneration. Our findings also support a common semantic network in the brain for the different languages of bilinguals.