Lexical access in aphasic and nonaphasic speakers

Quantifying the Interplay of Semantics and Phonology During Failures of Word Retrieval by People With Aphasia Using a Multiplex Lexical Network

Investigating instances where lexical selection fails can lead to deeper insights into the cognitive machinery and architecture supporting successful word retrieval and speech production. In this paper, we used a multiplex lexical network approach that combines semantic and phonological similarities among words to model the structure of the mental lexicon. Network measures at different levels of analysis (degree, network distance, and closeness centrality) were used to investigate the influence of network structure on picture naming accuracy and errors by people with Anomic, Broca's, Conduction, and Wernicke's aphasia. Our results reveal that word retrieval is influenced by the multiplex lexical network structure in at least two ways-(a) the accuracy of production and error type on incorrect productions were influenced by the degree and closeness centrality of the target word, and (b) error type also varied in terms of network distance between the target word and produced error word. Taken together, the analyses demonstrate that network science techniques, particularly the use of the multiplex lexical network to simultaneously represent semantic and phonological relationships among words, reveal how the structure of the mental lexicon influences language processes beyond traditionally examined psycholinguistic variables. We propose a framework for how the multiplex lexical network approach allows for understanding the influence of mental lexicon structure on word retrieval processes, with an eye toward a better understanding of the nature of clinical impairments, like aphasia.

Towards a New Model of Verbal Monitoring

As all human activities, verbal communication is fraught with errors. It is estimated that humans produce around 16,000 words per day, but the word that is selected for production is not always correct and neither is the articulation always flawless. However, to facilitate communication, it is important to limit the number of errors. This is accomplished via the verbal monitoring mechanism. A body of research over the last century has uncovered a number of properties of the mechanisms at work during verbal monitoring. Over a dozen routes for verbal monitoring have been postulated. However, to date a complete account of verbal monitoring does not exist. In the current paper we first outline the properties of verbal monitoring that have been empirically demonstrated. This is followed by a discussion of current verbal monitoring models: the perceptual loop theory, conflict monitoring, the hierarchical state feedback control model, and the forward model theory. Each of these models is evaluated given empirical findings and theoretical considerations. We then outline lacunae of current theories, which we address with a proposal for a new model of verbal monitoring for production and perception, based on conflict monitoring models. Additionally, this novel model suggests a mechanism of how a detected error leads to a correction. The error resolution mechanism proposed in our new model is then tested in a computational model. Finally, we outline the advances and predictions of the model.

A psycholinguistic method for measuring coarticulation in child and adult speech

A perceiver's ability to accurately predict target sounds in a forward-gated AV speech task indexes the strength and scope of anticipatory coarticulation in adult speech (Redford et al., JASA, 144, 2447-2461, 2018). This suggests a perception-based method for studying coarticulation in populations who may poorly tolerate the more invasive or restrictive techniques used to measure speech movements directly. But the use of perception to measure production begs the question of confounding influences on perceiver performance and thus on the reliability and generalizability of the proposed method. The present study was therefore designed to test whether a gated AV speech method for measuring coarticulation provides reliable results across different study populations (child versus adult), different task environments (in-lab versus online), and different coarticulatory directions (forward/anticipatory versus backward/carryover). The results indicated excellent measurement reliability across age groups in the forward/anticipatory measurement direction, though more perceivers are needed to achieve the same levels of agreement and consistency when the task is completed online. Accuracy was lower in the backward/carryover direction, and although agreement and consistency were still reasonably high across perceivers, the effect of age group differed between the laboratory and online environments, suggesting measurement error in one or both environments. Overall, the results support using in-lab or online perceptual judgments to measure anticipatory coarticulation in developmental studies of speech production. Further validation study is needed before the method can be extended to measure carryover coarticulation.

A Comprehension- or a Production-Based Monitor? Response to Roelofs (2020)

Roelofs (2020) has put forth a rebuttal of the criticisms raised against comprehension-based monitoring and has also raised a number of objections against production-based monitors. In this response, I clarify that the model defended by Roelofs is not a comprehension-based monitor, but belongs to a class of monitoring models which I refer to as production-perception models. I review comprehension-based and production-perception models, highlight the strength of each, and point out the differences between them. I then discuss the limitations of both for monitoring production at higher levels, which has been the motivation for production-based monitors. Next, I address the specific criticisms raised by Roelofs (2020) in light of the current evidence. I end by presenting several lines of arguments that preclude a single monitoring mechanism as meeting all the demands of monitoring in a task as complex as communication. A more fruitful avenue is perhaps to focus on what theories are compatible with the nature of representations at specific levels of the production system and with specific aims of monitoring in language production.

The dual origin of lexical perseverations in aphasia: Residual activation and incremental learning

Lexical perseveration, the inappropriate repetition of a previous response, is common in aphasia. Two underlying mechanisms have been proposed: residual activation and incremental learning. Previous attempts to differentiate the two have relied on experimental paradigms that encourage semantically related errors and analysis techniques designed to detect perseverations over short distances, resulting in a bias towards detecting short-lag, semantically related perseverations that both mechanisms can account for. Two key predictions that differentiate these accounts remain untested: only residual activation can explain short-lag, semantically unrelated perseverations, whereas only incremental learning can explain long-lag, semantically related perseverations. In this paper, we used a large set of picture naming trials and a novel analysis technique to test these key predictions in a multi-session study involving six individuals with aphasia. We found clear evidence for both mechanisms in different individuals, demonstrating that either one is sufficient to cause perseveration. Importantly, perseverations due to residual activation were associated with more severely impaired systems than those due to incremental learning, suggesting that a certain degree of structural and functional integrity was necessary for incremental learning. Finally, the results supported a key prediction of the incremental learning account by showing perseverations over longer lags than have previously been reported.

Moving beyond the dual stream account of language

This scientific commentary refers to ‘Structural white matter connectometry of word production in aphasia: an observational study’, by Hula etal. (doi:10.1093/brain/awaa193).

Modeling the Mental Lexicon as Part of Long-Term and Working Memory and Simulating Lexical Access in a Naming Task Including Semantic and Phonological Cues

BACKGROUND

To produce and understand words, humans access the mental lexicon. From a functional perspective, the long-term memory component of the mental lexicon is comprised of three levels: the concept level, the lemma level, and the phonological level. At each level, different kinds of word information are stored. Semantic as well as phonological cues can help to facilitate word access during a naming task, especially when neural dysfunctions are present. The processing corresponding to word access occurs in specific parts of working memory. Neural models for simulating speech processing help to uncover the complex relationships that exist between neural dysfunctions and corresponding behavioral patterns.

METHODS

The Neural Engineering Framework (NEF) and the Semantic Pointer Architecture (SPA) are used to develop a quantitative neural model of the mental lexicon and its access during speech processing. By simulating a picture-naming task (WWT 6-10), the influence of cues is investigated by introducing neural dysfunctions within the neural model at different levels of the mental lexicon.

RESULTS

First, the neural model is able to simulate the test behavior for normal children that exhibit no lexical dysfunction. Second, the model shows worse results in test performance as larger degrees of dysfunction are introduced. Third, if the severity of dysfunction is not too high, phonological and semantic cues are observed to lead to an increase in the number of correctly named words. Phonological cues are observed to be more effective than semantic cues.

CONCLUSION

Our simulation results are in line with human experimental data. Specifically, phonological cues seem not only to activate phonologically similar items within the phonological level. Moreover, phonological cues support higher-level processing during access of the mental lexicon. Thus, the neural model introduced in this paper offers a promising approach to modeling the mental lexicon, and to incorporating the mental lexicon into a complex model of language processing.

Primed to cue

The behavioral effects of lexical priming are well studied in the cognitive sciences. Clinical use of the term and widespread implementation of priming based behavioral interventions has remained limited. This is despite the fact that response-contingent cueing, a behavioral intervention technique used during many cognitive-linguistic interventions, is grounded in theories of priming research. The aim of this manuscript is to connect behavioral performance changes observed following priming with those noted following cueing, providing a theoretical rationale for the therapeutic use of both priming and cueing in language and cognitive interventions. In this review, we establish a conceptual basis for how both primes and cues serve to pre-engage the neural system by triggering the retrieval of linked conceptual knowledge, resulting in faster and more accurate responses. Differences between the two (primes and cues) have been linked to timing and conscious intentional engagement, though these distinctions are often task dependent. Additionally, this paper will provide evidence of the clinical utility of priming. Studies of priming in adults with acquired brain injuries are discussed and clinical interventions based on theories of priming are examined. Furthermore, the present work will briefly detail the inhibitory effects of priming to aid clinicians and researchers in deciding how to pair primes and cues with intended retrieval targets. In summation, the present work is intended to bridge two related fields providing both theoretical and clinical insight with respect to the use of primes and cues.

On Simulating Neural Damage in Connectionist Networks

A key strength of connectionist modelling is its ability to simulate both intact cognition and the behavioural effects of neural damage. We survey the literature, showing that models have been damaged in a variety of ways, e.g. by removing connections, by adding noise to connection weights, by scaling weights, by removing units and by adding noise to unit activations. While these different implementations of damage have often been assumed to be behaviourally equivalent, some theorists have made aetiological claims that rest on nonequivalence. They suggest that related deficits with different aetiologies might be accounted for by different forms of damage within a single model. We present two case studies that explore the effects of different forms of damage in two influential connectionist models, each of which has been applied to explain neuropsychological deficits. Our results indicate that the effect of simulated damage can indeed be sensitive to the way in which damage is implemented, particularly when the environment comprises subsets of items that differ in their statistical properties, but such effects are sensitive to relatively subtle aspects of the model's training environment. We argue that, as a consequence, substantial methodological care is required if aetiological claims about simulated neural damage are to be justified, and conclude more generally that implementation assumptions, including those concerning simulated damage, must be fully explored when evaluating models of neurological deficits, both to avoid over-extending the explanatory power of specific implementations and to ensure that reported results are replicable.

ELECTRONIC SUPPLEMENTARY MATERIAL

The online version of this article (10.1007/s42113-020-00081-z) contains supplementary material, which is available to authorized users.

Professional or Amateur? The Phonological Output Buffer as a Working Memory Operator

The Phonological Output Buffer (POB) is thought to be the stage in language production where phonemes are held in working memory and assembled into words. The neural implementation of the POB remains unclear despite a wealth of phenomenological data. Individuals with POB impairment make phonological errors when they produce words and non-words, including phoneme omissions, insertions, transpositions, substitutions and perseverations. Errors can apply to different kinds and sizes of units, such as phonemes, number words, morphological affixes, and function words, and evidence from POB impairments suggests that units tend to substituted with units of the same kind—e.g., numbers with numbers and whole morphological affixes with other affixes. This suggests that different units are processed and stored in the POB in the same stage, but perhaps separately in different mini-stores. Further, similar impairments can affect the buffer used to produce Sign Language, which raises the question of whether it is instantiated in a distinct device with the same design. However, what appear as separate buffers may be distinct regions in the activity space of a single extended POB network, connected with a lexicon network. The self-consistency of this idea can be assessed by studying an autoassociative Potts network, as a model of memory storage distributed over several cortical areas, and testing whether the network can represent both units of word and signs, reflecting the types and patterns of errors made by individuals with POB impairment.

Typicality-based semantic treatment for anomia results in multiple levels of generalisation

This study investigated the effects of typicality-based semantic feature analysis (SFA) treatment on generalisation across three levels: untrained related items, semantic/phonological processing tasks, and measures of global language function. Using a single-subject design with group-level analyses, 27 persons with aphasia (PWA) received typicality-based SFA to improve their naming of atypical and/or typical exemplars. Progress on trained, untrained, and monitored items was measured weekly. Pre- and post-treatment assessments were administered to evaluate semantic/phonological processing and overall language ability. Ten PWA served as controls. For the treatment participants, the likelihood of naming trained items accurately was significantly higher than for monitored items over time. When features of atypical items were trained, the likelihood of naming untrained typical items accurately was significantly higher than for untrained atypical items over time. Significant gains were observed on semantic/phonological processing tasks and standardised assessments after therapy. Different patterns of near and far transfer were seen across treatment response groups. Performance was also compared between responders and controls. Responders demonstrated significantly more improvement on a semantic processing task than controls, but no other significant change score differences were found between groups. In addition to positive treatment effects, typicality-based SFA naming therapy resulted in generalisation across multiple levels.

Contributions of modern network science to the cognitive sciences: revisiting research spirals of representation and process

Modelling the structure of cognitive systems is a central goal of the cognitive sciences-a goal that has greatly benefitted from the application of network science approaches. This paper provides an overview of how network science has been applied to the cognitive sciences, with a specific focus on the two research 'spirals' of cognitive sciences related to the representation and processes of the human mind. For each spiral, we first review classic papers in the psychological sciences that have drawn on graph-theoretic ideas or frameworks before the advent of modern network science approaches. We then discuss how current research in these areas has been shaped by modern network science, which provides the mathematical framework and methodological tools for psychologists to (i) represent cognitive network structure and (ii) investigate and model the psychological processes that occur in these cognitive networks. Finally, we briefly comment on the future of, and the challenges facing, cognitive network science.

Using narratives in differential diagnosis of neurodegenerative syndromes

PURPOSE

Language decline has been associated with healthy aging and with various neurodegenerative conditions, making it challenging to differentiate among these conditions. This study examined the utility of linguistic measures derived from a short narrative language sample for 1) identifying language characteristics and cut-off scores to differentiate between healthy aging, Primary Progressive Aphasia (PPA), Mild Cognitive Impairment (MCI), and Alzheimer's dementia (AD); and 2) differentiating among PPA variants in which language is the primary impairment.

METHOD

Participants were 25 neurologically healthy English speakers, 20 individuals with MCI, 20 with AD, and 26 with PPA (non-fluent/agrammatic N = 10, logopenic N = 9, semantic N = 7). Narrative language samples of the Cookie Theft Picture of persons with healthy aging, MCI and AD were retrospectively obtained from the DementiaBank database (https://talkbank.org/DementiaBank/) and PPA samples were obtained from an ongoing research study. The language samples were analyzed for fluency, word retrieval success, grammatical accuracy, and errors using automated and manual analysis methods. The sensitivity and specificity of various language measures was computed.

RESULTS

Participants with PPA scored lower than neurologically healthy and MCI groups on fluency (words per minute and disfluencies), word retrieval (Correct Information Units and number of errors), and sentence grammaticality. PPA and AD groups did not differ on language measures. Agrammatic PPA participants scored lower than logopenic and semantic PPA groups on several measures, while logopenic and semantic PPA did not differ on any measures.

CONCLUSION

Measures derived from brief language samples and analyzed using mostly automated methods are clinically useful in differentiating PPA from healthy aging and MCI, and agrammatic PPA from other variants. The sensitivity and specificity of these measures is modest and can be improved when coupled with clinical presentation.

Effects of distributed practice and criterion level on word retrieval in aphasia

This study examined how the distribution and amount of practice affect word retrieval in aphasia as well as how such factors relate to the efficiency of learning. The central hypothesis was that factors that enhance the learning of new knowledge also enhance persistent access to existing, but inconsistently available, word representations. The study evaluated the impact of learning principles on word retrieval by manipulating the timing and amount of retrievals for items presented for naming. Nine people with chronic aphasia with naming impairment completed the experiment. Training materials involved proper noun entities assigned to six conditions formed by crossing a 2-level factor of spacing of sessions, i.e., intersession interval (1 day versus 7 days between sessions) with a 3-level factor of number of correct retrievals per item per session, i.e., criterion level (Criterion-1, Criterion-2, and Criterion-4). Each intersession interval condition comprised three training sessions and a one-month retention test. Increasing the criterion level enhanced naming performance after short (1 day, 7 days) and long (one month) retention intervals, but these advantages came at the cost of many additional training trials. In most cases, later naming success was superior when the same number of correct retrievals of an item was distributed across multiple sessions rather than administered within one session. The substantial advantages for across-session spacing were gained at little cost in terms of additional training trials. At one-month retention, naming accuracy was numerically but not significantly higher in the 7-day versus 1-day intersession interval condition. Implications for theories of lexical access and naming treatment in aphasia are discussed.

"Did I Say Cherry?" Error Patterns on a Blocked Cyclic Naming Task for Bilingual Children With and Without Developmental Language Disorder

Purpose Using a blocked cyclic picture-naming task, we compared accuracy and error patterns across languages for Spanish-English bilingual children with and without developmental language disorder (DLD). Method Pictured stimuli were manipulated for semantic similarity across two (Same and Mixed) category contexts. Children's productions were scored off-line for accuracy, error frequency, and error type. Results Typically developing children were more accurate and produced fewer errors than their peers with DLD; however, this was moderated by task language and semantic context. Children were generally more accurate when naming pictures in English compared to Spanish and in the Mixed-category context compared to the Same-category context. Analyses of error types further showed that children with less English language exposure specifically produced more nonresponses in English than in Spanish. Children with DLD produced more of each error type than their typically developing peers, particularly in Spanish. Conclusions Regardless of language ability, bilingual children demonstrated greater difficulty with lexical retrieval for pictured items in the semantically related context than in the unrelated context. However, bilingual children with DLD produced more errors of all types than is typical for children developing more than one language. Their greater error rates are not secondary to limited second language exposure but instead reflect deficits inherent to the nature of language impairment. Results from this study are discussed using a framework of semantic constraint, where we propose that because bilingual children with DLD have impoverished semantic networks, and this knowledge insufficiently constrains activation for lexical selection, thereby increasing error production.

High electronic name agreement of 70 pictures in normative study of 5,290 Czechs for easy multicultural replication

The aim of this normative study was to verify recognition and name agreement of 70 black and white line pictures on a large Czech population sample using an electronic form. The set of pictures was selected based on previous research showing preliminary evidence of high name agreement with one word only. The pictures were arrayed into an electronic form that was distributed via the internet and filled in by 6,055 participants across the whole country. The group for final evaluation comprised of 5,290 respondents (age range 11-90 years, average ± SD: 53 ± 15 years, 77% of women, years of completed education: range 8-28 years, 15 ± 3 years) from all regions. The average name agreement for all pictures was 98%. Name agreement in the majority of pictures was not influenced by gender, age, and education. The most useful 14 pictures are entirely independent of all sociodemographic factors and include table, scissors, bell, ski, crown, chimney, glasses, steering wheel, heart, chain, ladder, horseshoe, bone, and alarm clock. The presented set of pictures named by one word only can be used for diagnostic or therapeutic purposes. The pictures and the electronic form are freely available for replication in other languages at our website www.abadeco.cz.

Taxonomic Interference Associated with Phonemic Paraphasias in Agrammatic Primary Progressive Aphasia

Phonemic paraphasias are thought to reflect phonological (post-semantic) deficits in language production. Here we present evidence that phonemic paraphasias in non-semantic primary progressive aphasia (PPA) may be associated with taxonomic interference. Agrammatic and logopenic PPA patients and control participants performed a word-to-picture visual search task where they matched a stimulus noun to 1 of 16 object pictures as their eye movements were recorded. Participants were subsequently asked to name the same items. We measured taxonomic interference (ratio of time spent viewing related vs. unrelated foils) during the search task for each item. Target items that elicited a phonemic paraphasia during object naming elicited increased taxonomic interference during the search task in agrammatic but not logopenic PPA patients. These results could reflect either very subtle sub-clinical semantic distortions of word representations or partial degradation of specific phonological word forms in agrammatic PPA during both word-to-picture matching (input stage) and picture naming (output stage). The mechanism for phonemic paraphasias in logopenic patients seems to be different and to be operative at the pre-articulatory stage of phonological retrieval. Glucose metabolic imaging suggests that degeneration in the left posterior frontal lobe and left temporo-parietal junction, respectively, might underlie these different patterns of phonemic paraphasia.

Verbal Working Memory as Emergent from Language Comprehension and Production

This article reviews current models of verbal working memory and considers the role of language comprehension and long-term memory in the ability to maintain and order verbal information for short periods of time. While all models of verbal working memory posit some interaction with long-term memory, few have considered the character of these long-term representations or how they might affect performance on verbal working memory tasks. Similarly, few models have considered how comprehension processes and production processes might affect performance in verbal working memory tasks. Modern theories of comprehension emphasize that people learn a vast web of correlated information about the language and the world and must activate that information from long-term memory to cope with the demands of language input. To date, there has been little consideration in theories of verbal working memory for how this rich input from comprehension would affect the nature of temporary memory. There has also been relatively little attention to the degree to which language production processes naturally manage serial order of verbal information. The authors argue for an emergent model of verbal working memory supported by a rich, distributed long-term memory for language. On this view, comprehension processes provide encoding in verbal working memory tasks, and production processes maintenance, serial ordering, and recall. Moreover, the computational capacity to maintain and order information varies with language experience. Implications for theories of working memory, comprehension, and production are considered.

Inner Speech in Aphasia: Current Evidence, Clinical Implications, and Future Directions

Purpose Typical language users can engage in a lively internal monologue for introspection and task performance, but what is the nature of inner speech among individuals with aphasia? Studying the phenomenon of inner speech in this population has the potential to further our understanding of inner speech more generally, help clarify the subjective experience of those with aphasia, and inform clinical practice. In this scoping review, we describe and synthesize the existing literature on inner speech in aphasia. Method Studies examining inner speech in aphasia were located through electronic databases and citation searches. Across the various studies, methods include both subjective approaches (i.e., asking individuals with aphasia about the integrity of their inner speech) and objective approaches (i.e., administering objective language tests as proxy measures for inner speech ability). The findings of relevant studies are summarized. Results Although definitions of inner speech vary across research groups, studies using both subjective and objective methods have established findings showing that inner speech can be preserved relative to spoken language in individuals with aphasia, particularly among those with relatively intact word retrieval and difficulty primarily at the level of speech output processing. Approaches that combine self-report with objective measures have demonstrated that individuals with aphasia are, on the whole, reliably able to report the integrity of their inner speech. Conclusions The examination of inner speech in individuals with aphasia has potential implications for clinical practice, in that differences in the preservation of inner speech across individuals may help guide clinical decision making around aphasia treatment. Although there are many questions that remain open to further investigation, studying inner speech in this specific population has also contributed to a broader understanding of the mechanisms of inner speech more generally.

Convergence of distinct functional networks supporting naming and semantic recognition in the left inferior frontal gyrus

Naming individual objects is accompanied with semantic recognition. Previous studies examined brain‐networks responsible for these operations individually. However, it remains unclear how these brain‐networks are related. To address this problem, we examined the brain‐networks during a novel object‐naming task, requiring participants to name animals in photographs at a specific‐level (e.g., “pigeon”). When the participants could not remember specific names, they answered basic names (e.g., “bird”). After fMRI scanning during the object‐naming task, the participants rated familiarity of the animals based on their sense of knowing. Since participants tend to remember specific names for familiar objects compared with unfamiliar objects, a typical issue in an object‐naming task is an internal covariance between the naming and familiarity levels. We removed this confounding factor by adjusting the familiarity/naming level of stimuli, and demonstrated distinct brain regions related to the two operations. Among them, the left inferior frontal gyrus triangularis (IFGtri) contained object‐naming and semantic‐recognition related areas in its anterior‐ventral and posterior‐dorsal parts, respectively. Psychophysiological interaction analyses suggested that both parts show connectivity with the brain regions related to object‐naming. By examining the connectivity under control tasks requiring nonlexical semantic retrieval (e.g., animal's body color), we found that both IFGtri parts altered their targeting brain areas according to the required memory attributes, while only the posterior‐dorsal part connected the brain regions related to semantic recognition. Together, the semantic recognition may be processed by distinct brain network from those for voluntary semantic retrievals including object‐naming although all these networks are mediated by the posterior‐dorsal IFGtri.

Clinician Perspectives on the Assessment of Short-Term Memory in Aphasia

BACKGROUND

Verbal short-term memory (STM) and the related ability, working memory (WM), are widely understood to be integral components of language production and comprehension. However, assessment of these abilities in people with aphasia is hampered by a lack of valid, standardized measures that are clinically appropriate. Focusing primarily on verbal STM, we held a series of five focus groups with speech-language pathologists (SLPs) to understand better their current clinical practices and their beliefs and attitudes regarding assessment of verbal STM in aphasia.

AIMS

The purpose of this study was to explore the attitudes, beliefs and preferences of clinical SLPs to determine: (1) current practices related to verbal STM assessment; (2) the extent to which practices reflect current theories of aphasia and the role of verbal STM in language processing; and (3) practical considerations regarding aphasia assessment in clinical practice.

METHODS & PROCEDURES

Five focus groups were conducted using a semi-structured interview protocol with a total of 44 SLPs. Grounded theory methodology was used to collect, code and analyse the data. Codes were reviewed to identify emerging themes. Themes were compared to explore meta-themes, connections and potential theoretical frameworks.

OUTCOMES & RESULTS

Five main themes were identified: (1) The theoretical understanding that clinical SLPs have regarding the role of verbal STM in aphasia is not always consistent with clinical practice; (2) Clinical SLPs highly value functionally relevant assessments; (3) The intense time constraints in clinical practice affect all aspects of assessment; (4) Clinical SLPs feel that there is a lack of appropriate tests for assessment of STM in aphasia; and (5) Clinical SLPs prefer tests that are comprehensive, easy to administer and psychometrically sound.

CONCLUSIONS

Clinical SLPs report a lack of standardized measures to assess STM in individuals with aphasia. Researchers are met with several challenges in the development of these tests including effective communication with clinicians regarding the benefit of verbal STM assessments, especially as it relates to functional skills, and the creation of a test that is comprehensive yet simple, quick and easy to administer.

Mapping eloquent cortex: A voxel-based lesion-symptom mapping study of core speech production capacities in brain tumour patients

This study used voxel-based lesion-symptom mapping to examine the cortical and white matter regions associated with language production impairments in a sample of 63 preoperative tumour patients. We identified four cognitive functions considered crucial for spoken language production: semantic-to-lexical mapping (selecting the appropriate lexical label for the intended concept); phonological encoding (retrieving the word's phonological form); articulatory-motor planning (programming the articulatory motor movements); and goal-driven language selection (exerting top-down control over the words selected for production). Each participant received a score estimating their competence on each function. We then mapped the region(s) where pathology was significantly associated with low scores. For semantic-to-lexical mapping, the critical map encompassed portions of the left posterior middle and inferior temporal gyri, extending into posterior fusiform gyrus, overlapping substantially with the territory of the inferior longitudinal fasciculus. For phonological encoding, the map encompassed the left inferior parietal lobe and posterior middle temporal gyrus, overlapping with the territory of the inferior longitudinal and posterior arcuate fasciculi. For articulatory-motor planning, the map encompassed parts of the left frontal pole, frontal operculum, and inferior frontal gyrus, and overlapped with the territory of the frontal aslant tract. Finally, the map for goal-driven language selection encompassed the left frontal pole and the anterior cingulate cortex. We compare our findings with those from other neuropsychological samples, and conclude that the study of tumour patients offers evidence that complements that available from other populations.

The time course of priming in aphasia: An exploration of learning along a continuum of linguistic processing demands

This study investigates learning in aphasia as manifested through automatic priming effects. There is growing evidence that people with aphasia have impairments beyond language processing that could affect their response to treatment. Therefore, better understanding these mechanisms would be beneficial for improving methods of rehabilitation. This study assesses semantic and repetition priming effects at varied interstimulus intervals, using stimuli that are both non-linguistic and linguistic in tasks that range from requiring nearly no linguistic processing to requiring both lexical and semantic processing. Results indicate that people with aphasia maintain typical patterns of learning across both linguistic and non-linguistic tasks as long as the implicit prime-target relationship does not depend on deep levels of linguistic processing. As linguistic processing demands increase, those with agrammatic aphasia may require more time to take advantage of learning through implicit prime-target relationships, and people with both agrammatic and non-agrammatic aphasia are more susceptible to breakdown of the semantic networks as processing demands on that system increase.

WORD LEARNING IN APHASIA: TREATMENT IMPLICATIONS AND STRUCTURAL CONNECTIVITY ANALYSES

OBJECTIVE

Of current interest in aphasia research is the relevance of what we can learn from studying word learning ability in aphasia. In a preliminary study, we addressed two issues related to the novel word learning ability of individuals with aphasia. First, as word learning engages large-scale cognitive-linguistic systems (language skills, verbal short-term memory (STM), other memory and executive functions), we probed whether novel word learning practice in three people with aphasia could stimulate these language-related systems. Second, as lesion correlates affecting word learning in aphasia remain unclear, we examined whether the structural integrity of the left arcuate fasciculus (AF) in the same three individuals is related to outcomes of novel word learning practice.

METHOD

To stimulate word learning systems, our three participants practiced for 4 weeks with an explicit novel word - novel referent word learning task, adopted from the Ancient Farming Equipment learning paradigm (Laine & Salmelin, 2010). The participants' progress on receptive and expressive novel word learning was followed up, and their language and verbal STM abilities as well as single-session novel word learning (Learning to Name Aliens by Gupta, Martin, Abbs, Schwartz & Lipinski, 2006) were tested before and after the practice period. To address the second question, we analyzed the participants' structural MRI scans with respect to the integrity of the left AF and its overlap with the lesion areas.

RESULTS

All participants showed some receptive word learning in the trained task, as well as improvements in verbal STM span at posttest. Two of the three participants also showed improved performance on some of the language outcome measures. One participant with partially spared left AF, especially temporo-parietal connections, exhibited better word learning performance than the other two who had larger damage and disconnection of the AF.

CONCLUSIONS

While the present results are preliminary, they open the possibility that novel word learning practice in aphasia may stimulate remaining word learning mechanisms in aphasia, and thereby influence language and verbal STM abilities. These results also suggest that preservation of novel word learning ability in aphasia in part depends on the integrity of the left arcuate track.

A Review of the Application of Distributed Practice Principles to Naming Treatment in Aphasia

It is uncontroversial in psychological research that different schedules of practice, which govern the distribution of practice over time, can promote radically different outcomes in terms of gains in performance and the durability of learning. In contrast, in speech-language treatment research, there is a critical need for well-controlled studies examining the impact of the distribution of treatment on efficacy (for reviews, see Cherney, 2012; Warren, Fey, & Yoder, 2007). In this paper, we enumerate key findings from psychological research on learning and memory regarding how different schedules of practice differentially confer durable learning. We review existing studies of aphasia treatment with a focus on naming impairment that have examined how the distribution of practice affects treatment efficacy. We close by discussing potential productive lines of research to elaborate the clinical applicability of distributed practice principles to language treatment.

The multiplex structure of the mental lexicon influences picture naming in people with aphasia

An emerging area of research in cognitive science is the utilization of networks to model the structure and processes of the mental lexicon in healthy and clinical populations, like aphasia. Previous research has focused on only one type of word similarity at a time (e.g., semantic relationships), even though words are multi-faceted. Here, we investigate lexical retrieval in a picture naming task from people with Broca's and Wernicke's aphasia and healthy controls by utilizing a multiplex network structure that accounts for the interplay between multiple semantic and phonological relationships among words in the mental lexicon. Extending upon previous work, we focused on the global network measure of closeness centrality which is known to capture spreading activation, an important process supporting lexical retrieval. We conducted a series of logistic regression models predicting the probability of correct picture naming. We tested whether multiplex closeness centrality was a better predictor of picture naming performance than single-layer closeness centralities, other network measures assessing local and meso-scale structure, psycholinguistic variables and group differences. We also examined production gaps, or the difference between the likelihood of producing a word with the lowest and highest closeness centralities. Our results indicated that multiplex closeness centrality was a significant predictor of picture naming performance, where words with high closeness centrality were more likely to be produced than words with low closeness centrality. Additionally, multiplex closeness centrality outperformed single-layer closeness centralities and other multiplex network measures, and remained a significant predictor after controlling for psycholinguistic variables and group differences. Furthermore, we found that the facilitative effect of closeness centrality was similar for both types of aphasia. Our results underline the importance of integrating multiple measures of word similarities in cognitive language networks for better understanding lexical retrieval in aphasia, with an eye towards future clinical applications.

Maintenance Versus Transmission Deficits: The Effect of Delay on Naming Performance in Aphasia

We propose that deficits in lexical retrieval can involve difficulty in transmission of activation between processing levels, or difficulty in maintaining activation. In support, we present an investigation of picture naming by persons with aphasia in which the naming response is generated after a 1 s (sec) cue to respond in one condition or a 5 s cue to respond in another. Some individuals did better after 5 s, some did worse after 5 s, and some were not impacted by the delay. It is suggested that better performance after 5 s indicates a transmission deficit and that worse performance after 5 s indicates a maintenance deficit. To support this hypothesis, we adapted the two-step semantic-phonological model of lexical retrieval (Schwartz et al., 2006) so that it can simulate the passage of time and can simulate lesions in transmission (its semantic and phonological connection strength parameters) and/or maintenance (its decay parameter). The naming error patterns after 1 and 5 s for each participant were successfully fit to the model. Persons who did better after 5 s were found to have low connection strength parameters, persons who did worse after 5 s were simulated with an increased decay rate, and persons whose performance did not differ with delay were found to have lesions of both types. Some potential theoretical and clinical implications are discussed.

The Influence of Phonomotor Treatment on Word Retrieval: Insights From Naming Errors

Purpose An increasing number of anomia treatment studies have coupled traditional word retrieval accuracy outcome measures with more fine-grained analysis of word retrieval errors to allow for more comprehensive measurement of treatment-induced changes in word retrieval. The aim of this study was to examine changes in picture naming errors after phonomotor treatment. Method Twenty-eight individuals with aphasia received 60 hr of phonomotor treatment, an intensive, phoneme-based therapy for anomia. Confrontation naming was assessed pretreatment, immediately posttreatment, and 3 months posttreatment for trained and untrained nouns. Responses were scored for accuracy and coded for error type, and error proportions of each error type (e.g., semantic, phonological, omission) were compared: pre- versus posttreatment and pretreatment versus 3 months posttreatment. Results The group of treatment participants improved in whole-word naming accuracy on trained items and maintained their improvement. Treatment effects also generalized to untrained nouns at the maintenance testing phase. Additionally, participants demonstrated a decrease in proportions of omission and description errors on trained items immediately posttreatment. Conclusions Along with generalized improved whole-word naming accuracy, results of the error analysis suggest that a global (i.e., both lexical-semantic and phonological) change in lexical knowledge underlies the observed changes in confrontation naming accuracy following phonomotor treatment.

The Role of Cortico-Thalamo-Cortical Circuits in Language: Recurrent Circuits Revisited

Based on a review of recent literature, a recurrent circuit model describes how cortico-thalamo-cortical and cortico-cortical circuitry supports word retrieval, auditory-verbal comprehension, and other language functions. Supporting data include cellular and layer-specific cortico-thalamic, thalamo-cortical, and cortico-cortical neuroanatomy and electrophysiology. The model posits that during word retrieval, higher order cortico-thalamo-cortical relays maintain stable representations of semantic information in feedforward processes at the semantic-lexical interface. These stable semantic representations are compared to emerging lexical solutions to represent the semantic construct to determine how well constructs are associated with each other. The resultant error signal allows cortico-cortical sculpting of activity between the semantic and lexical mechanisms until there is a good match between these two levels, at which time the lexical solution will be passed along to the cortical processor necessary for the next stage of word retrieval. Evidence is cited that high gamma activity is the neural signature for processing in the cortico-thalamo-cortical and cortico-cortical circuitry. Methods for testing hypotheses generated from this recurrent circuit model are discussed. Mathematical modeling may be a useful tool in exploring underlying properties of these circuits.

Investigating the effects of phonological neighbors on word retrieval and phonetic variation in word naming and picture naming paradigms

Phonological neighbors have been shown to affect word processing. Prior work has shown that when a word with an initial voiceless stop has a contrasting initial voiced stop neighbor, Voice Onset Times (VOTs) are longer. Higher phonological neighborhood density (PND) has also been shown to facilitate word retrieval latency, and be associated with longer VOTs. However, these effects have rarely been investigated with picture naming, which is thought to be a more semantically driven task. The current study examined the effects of phonological neighbors on word retrieval times and phonetic variation, and how these effects differed in word naming and picture naming paradigms. Results showed that PND was positively correlated with longer VOT in both paradigms. Furthermore, the effect of initial stop neighbors on VOTs was only significant in word naming. These results highlight the influence of phonological neighbors on word production in different paradigms, support interactive models of word production, and suggest that hyper-articulation in speech does not solely depend on communicative context.

Neuroanatomical structures supporting lexical diversity, sophistication, and phonological word features during discourse

Deficits in lexical retrieval are commonly observed in individuals with post-stroke aphasia. Successful lexical retrieval is related to lexical diversity, lexical sophistication, and phonological word properties; however, the crucial brain regions supporting these different features are not fully understood. We performed MRI-based lesion symptom mapping in 58 individuals with a chronic left hemisphere stroke to assess how regional damage relates to spoken discourse-extracted measures of lexical diversity, lexical sophistication, and phonological word properties. For discourse transcription and word feature analysis, we used the Computerized Language Analysis (CLAN) program, Stanford Core Natural Language Processing, Irvine Phonotactic Online Dictionary, Lexical Complexity Analyzer, and Gramulator. Lesions involving the left posterior insula and supramarginal gyri and inferior fronto-occipital fasciculus were significant predictors of utterances with, on average, lower lexical diversity. Low lexical sophistication was associated with damage to the left pole of the superior temporal gyrus. Production of words with lower phonological complexity (fewer phonemes, higher phonological similarity) was associated with damage to the left supramarginal gyrus. Our findings indicate that discourse-extracted features of lexical retrieval depend on the integrity of specific brain regions involving insular and peri-Sylvian areas. The identified regions provide insight into potentially underlying mechanisms of lexically diverse, sophisticated and phonologically complex words produced during discourse.

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Word production in connected speech of individuals with post-stroke aphasia depends on lesion locations

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Low lexical diversity is linked to lesions to the left insula, supramarginal gyrus and inferior fronto-occipital fasciculus

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Lexical sophistication is linked to lesions to the left pole of the temporal gyrus

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Phonological word features are linked to lesions to the left supramarginal gyrus

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Features of lexical retrieval in connected speech depend on the integrity of ventral and dorsal language processing streams

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

Natural Language Processing in Large-Scale Neural Models for Medical Screenings

Many medical screenings used for the diagnosis of neurological, psychological or language and speech disorders access the language and speech processing system. Specifically, patients are asked to fulfill a task (perception) and then requested to give answers verbally or by writing (production). To analyze cognitive or higher-level linguistic impairments or disorders it is thus expected that specific parts of the language and speech processing system of patients are working correctly or that verbal instructions are replaced by pictures (avoiding auditory perception) or oral answers by pointing (avoiding speech articulation). The first goal of this paper is to propose a large-scale neural model which comprises cognitive and lexical levels of the human neural system, and which is able to simulate the human behavior occurring in medical screenings. The second goal of this paper is to relate (microscopic) neural deficits introduced into the model to corresponding (macroscopic) behavioral deficits resulting from the model simulations. The Neural Engineering Framework and the Semantic Pointer Architecture are used to develop the large-scale neural model. Parts of two medical screenings are simulated: (1) a screening of word naming for the detection of developmental problems in lexical storage and lexical retrieval; and (2) a screening of cognitive abilities for the detection of mild cognitive impairment and early dementia. Both screenings include cognitive, language, and speech processing, and for both screenings the same model is simulated with and without neural deficits (physiological case vs. pathological case). While the simulation of both screenings results in the expected normal behavior in the physiological case, the simulations clearly show a deviation of behavior, e.g., an increase in errors in the pathological case. Moreover, specific types of neural dysfunctions resulting from different types of neural defects lead to differences in the type and strength of the observed behavioral deficits.

Effects of semantic neighbourhood density on spoken word production

When producing words, it is generally agreed that semantically related words are activated along with the target. However, relatively little is known about the extent to which the number of such semantically related words affects the production of spoken words. The research presented here explores, in detail, the influence of semantic neighbourhood density—the number of words of similar meaning in the lexicon—on picture naming performance in both unimpaired speakers and a large group of individuals with aphasia. In Experiment 1, six different semantic neighbourhood density measures were compared using principal component analysis. Four different semantic neighbourhood density components were identified: feature-based, context-based, association-based, and distant. In Experiment 2, these new measures were used as predictors in an analysis of picture naming data from unimpaired English speakers: no significant effects of semantic neighbourhood factors were observed on either latency or accuracy. Finally, Experiment 3 reports an analysis of picture naming responses of a large group of individuals with aphasia ( n = 193), examining the influence of the semantic neighbourhood density measures. Effects of the feature-based semantic neighbourhood measure on accuracy varied across participants with no overall main effect. This same measure increased the probability of a coordinate error compared with a correct response but also compared with an omission. Results are best accommodated by theories of word production that incorporate mechanisms by which semantically related concepts can both facilitate and inhibit target production.

Tone slips in Cantonese: Evidence for early phonological encoding

This article examines speech errors in Cantonese with the aim of fleshing out a larger speech production architecture for encoding phonological tone. A corpus was created by extracting 2462 speech errors, including 668 tone errors, from audio recordings of natural conversations. The structure of these errors was then investigated in order to distinguish two contemporary approaches to tone in speech production. In the tonal frames account, tone is encoded like metrical stress, represented in abstract structural frames for a word. Because tone cannot be mis-selected in tonal frames, tone errors are expected to be rare and non-contextual, as observed with stress. An alternative is that tone is actively selected in phonological encoding like phonological segments. This approach predicts that tone errors will be relatively common and exhibit the contextual patterns observed with segments, like perseveration and anticipation. In our corpus, tone errors are the second most common type of error, and the majority of errors exhibit contextual patterns that parallel segmental errors. Building on prior research, a two-stage model of phonological tone encoding is proposed, following the patterns seen in tone errors: Tone is phonologically selected concurrently with segments, but then sequentially assigned after segments to a syllable.

Dynamic Brain Interactions during Picture Naming

Brain computations involve multiple processes by which sensory information is encoded and transformed to drive behavior. These computations are thought to be mediated by dynamic interactions between populations of neurons. Here, we demonstrate that human brains exhibit a reliable sequence of neural interactions during speech production. We use an autoregressive Hidden Markov Model (ARHMM) to identify dynamical network states exhibited by electrocorticographic signals recorded from human neurosurgical patients. Our method resolves dynamic latent network states on a trial-by-trial basis. We characterize individual network states according to the patterns of directional information flow between cortical regions of interest. These network states occur consistently and in a specific, interpretable sequence across trials and subjects: the data support the hypothesis of a fixed-length visual processing state, followed by a variable-length language state, and then by a terminal articulation state. This empirical evidence validates classical psycholinguistic theories that have posited such intermediate states during speaking. It further reveals these state dynamics are not localized to one brain area or one sequence of areas, but are instead a network phenomenon.