H - 01 “¿Cómo qué, ¿Cómo qué? ¿Cómo qué?” Single-Language Echolalia in a Bilingual Female with Progressive Supranuclear Palsy: a Case Report

Abstract Objective Bilingualism has been associated during brain development with differences in cortical thickness and increased cortical connectivity in areas involved in language production and comprehension (Pilatsikas, et al., 2020). However, much less is known about the role of bilingualism and neurodegeneration. The following case illustrates a neuropsychological profile of a 78-year-old, Mexican American, bilingual female, who, at the 80th minute of her psychiatric interview, displays echolalia, but only in response to Spanish speech. To date, this is the only case report demonstrating single-language echolalia in a bilingual female with progressive non-fluent aphasia (PNFA) in progressive supranuclear palsy (PSP). Methods The Assessment follows a flexible battery approach. Results The patient is diagnosed with PSP with PNFA, as well as depression and anxiety. Conclusion Echolalia that manifests in a single language disproves theories suggesting that it is a purely auditory phenomenon and places the focus of the disorder at the phonological retrieval stage. Single-language echolalia in a bilingual individual suggests that either a) language control mechanisms can be selectively impaired, such that only one language is successfully monitored to avoid repeated productions or b) representation of each language in the bi/multilingual brain could be fully independent of each other. Last, there is a question as to what the exact step of neurodegeneration could lead to this phenomenon. In all, a detailed analysis of this and other cases could shed light on what patterns of language loss could be expected in multilingual individuals and what language background and neurodegenerative factors contribute to such pattern during aging.