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Walker GM, Fridriksson J, Hickok G. Assessing Relative Linguistic Impairment With Model-Based Item Selection. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-20. [PMID: 38995869 DOI: 10.1044/2024_jslhr-23-00439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
PURPOSE A picture naming test is presented that reveals impairment to specific mechanisms involved in the naming process, using accuracy scores on curated item sets. A series of psychometric validation experiments are reported. METHOD Using a computational model that enables estimation of item difficulty at the lexical and sublexical stages of word retrieval, two complimentary sets of items were constructed that challenge the respective psycholinguistic levels of representation. The difference in accuracy between these item sets yields the relative linguistic impairment (RLI) score. In a cohort of 91 people with chronic left-hemisphere stroke who enrolled in a clinical trial for anomia, we assessed psychometric properties of the RLI score and then used the new scale to make predictions about other language behaviors, lesion distributions, and functional activation during naming. RESULTS RLI scores had adequate psychometric properties for clinical significance. RLI scores contained predictive information about spontaneous speech fluency, over and above accuracy. A dissociation was observed between performance on the RLI item sets and performance on the subtests of an independent language battery. Sublexical RLI was significantly associated with apraxia of speech and with lesions encompassing perisylvian regions, while lexical RLI was associated with lesions to deep white matter. The RLI construct was reflected in functional brain activity during naming, independent of overall accuracy, with a respective shift of activation between dorsal and ventral networks responsible for different aspects of word retrieval. CONCLUSION The RLI assessment satisfies the psychometric requirements to serve as a useful clinical measure.
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Affiliation(s)
- Grant M Walker
- Department of Cognitive Sciences, University of California, Irvine
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine
- Department of Language Science, University of California, Irvine
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Ulanov M, Kopytin G, Bermúdez-Margaretto B, Ntoumanis I, Gorin A, Moiseenko O, Blagovechtchenski E, Moiseeva V, Shestakova A, Jääskeläinen I, Shtyrov Y. Regionally specific cortical lateralization of abstract and concrete verb processing: Magnetic mismatch negativity study. Neuropsychologia 2024; 195:108800. [PMID: 38246413 DOI: 10.1016/j.neuropsychologia.2024.108800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/03/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
The neural underpinnings of processing concrete and abstract semantics remain poorly understood. Previous fMRI studies have shown that multimodal and amodal neural networks respond differentially to different semantic types; importantly, abstract semantics activates more left-lateralized networks, as opposed to more bilateral activity for concrete words. Due to the lack of temporal resolution, these fMRI results do not allow to easily separate language- and task-specific brain responses and to disentangle early processing stages from later post-comprehension phenomena. To tackle this, we used magnetoencephalography (MEG), a time-resolved neuroimaging technique, in combination with a task-free oddball mismatch negativity (MMN) paradigm, an established approach to tracking early automatic activation of word-specific memory traces in the brain. We recorded the magnetic MMN responses in 30 healthy adults to auditorily presented abstract and concrete action verbs to assess lateralization of word-specific lexico-semantic processing in a set of neocortical areas. We found that MMN responses to these stimuli showed different lateralization patterns of activity in the upper limb motor area (BA4) and parts of Broca's area (BA45/BA47) within ∼100-350 ms after the word disambiguation point. Importantly, the greater leftward response lateralization for abstract semantics was due to the lesser involvement of the right-hemispheric homologues, not increased left-hemispheric activity. These findings suggest differential region-specific involvement of bilateral sensorimotor systems already in the early automatic stages of processing abstract and concrete action semantics.
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Affiliation(s)
- Maxim Ulanov
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia.
| | - Grigory Kopytin
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia
| | - Beatriz Bermúdez-Margaretto
- Universidad de Salamanca, Facultad de Psicología, Departamento de Psicología Básica, Psicobiología y Metodología de Las Ciencias Del Comportamiento, Salamanca, Spain; Instituto de Integración en La Comunidad - INICO, Salamanca, Spain
| | - Ioannis Ntoumanis
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia
| | - Aleksei Gorin
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia
| | - Olesya Moiseenko
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia
| | | | - Victoria Moiseeva
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia
| | - Anna Shestakova
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia
| | - Iiro Jääskeläinen
- HSE University, Institute for Cognitive Neuroscience, Moscow, Russia
| | - Yury Shtyrov
- Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus, Denmark
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Raman A, Hillis AE, Stockbridge MD. Shave, shear, shred, or cut: PPA variant differentially impacts erroneous responses produced in a confrontation naming test of verbs. APHASIOLOGY 2024; 38:1428-1440. [PMID: 39056000 PMCID: PMC11268835 DOI: 10.1080/02687038.2024.2311963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/14/2023] [Indexed: 07/28/2024]
Abstract
Background All common variants of primary progressive aphasia (PPA) exhibit naming deficits. Variants are distinguished by relative deficits in repetition (logopenic; lvPPA), object knowledge (semantic; svPPA), and agrammatism or articulation (non-fluent/agrammatic; nfavPPA; Gorno-Tempini et al., 2011). The Hopkins Action Naming Assessment (HANA) is a 30-item verb naming task that can distinguish between variants (Stockbridge et al., 2021). Item-level accuracy is driven by target verb frequency, semantic information density, and conceptual concreteness of the target word (Stockbridge, Venezia, et al., 2022). Aims In this investigation, we examined whether word frequency, semantic density, concreteness, and age of acquisition (AoA) also shaped the incorrect responses patients provided. We hypothesised that error responses would vary in these dimensions as a function of PPA variant. Methods & Procedures The HANA was administered to 271 participants with PPA, resulting in 443 total administrations and 4,529 analysable error responses. Standardised differences between error and target responses for frequency, density, concreteness, and AoA were calculated and averaged for each patient. Analysis of variance (ANOVA) for correlated samples was used to compare variants and planned post-hoc analyses examined the effect of variant on each response quality. Outcomes & Results Participants were similar in age, sex, handedness, and education. There was a significant interaction between PPA variant and the standardised mean differences in lexical qualities (Pillai's Trace=0.11, F(9, 747)=3.19, p<0.001). Univariate ANOVAs revealed significant differences in the semantic density of error responses relative to the target (F(3)=7.91, p<0.001, ηP 2=0.09), as individuals with lvPPA tended to produce error responses with greater semantic density than the target when compared to the words produced by individuals with nfavPPA (mean difference=1.45, 95%CI=[0.60,2.29], p<0.001; Figure 1). PPA variants also differed in the concreteness of their error responses relative to the target (F(3)=5.99, p<0.001, ηP 2=0.07), as error responses produced by individuals with nfavPPA were significantly more concrete than those with lvPPA (mean difference=0.08, 95%CI=[0.02,0.13], p=0.003) or svPPA (mean difference=0.08, 95%CI=[0.02,0.14], p=0.007). Variants did not differ significantly in AoA or frequency of responses relative to their targets. All variants tended to produce more frequent words with a lower AoA than the target verb. Conclusions Error responses tended to be more semantically dense, more concrete, higher frequency, and younger AoA than the target verb. However, PPA variants differed significantly in the extent to which these broader trends held true. These distinct patterns may be included as part of a larger diagnostic picture that to distinguish among PPA variants.
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Affiliation(s)
- Ashley Raman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218
| | - Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
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Walenski M, Sostarics T, Mesulam MM, Thompson CK. The production of adjectives in narratives by individuals with primary progressive aphasia. JOURNAL OF NEUROLINGUISTICS 2024; 69:101179. [PMID: 37994312 PMCID: PMC10662918 DOI: 10.1016/j.jneuroling.2023.101179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Adjectives (e.g., hungry) are an important part of language, but have been little studied in individuals with impaired language. Adjectives are used in two different ways in English: attributively, to modify a noun (the hungry dog); or predicatively, after a verb (the dog is hungry). Attributive adjectives have a more complex grammatical structure than predicative adjectives, and may therefore be particularly prone to disruption in individuals with grammatical impairments. We investigated adjective production in three subtypes of primary progressive aphasia (PPA: agrammatic, semantic, logopenic), as well as in agrammatic stroke aphasia and a group of healthy control participants. Participants produced narratives based on picture books, and we coded every adjective they produced for its syntactic structure. Compared to healthy controls, the two agrammatic groups, but not the other two patient groups, produced significantly fewer attributive adjectives per sentence. All four patient groups were similar to controls for their rate of predicative adjective production. In addition, we found a significant correlation in the agrammatic PPA participants between their rate of producing attributive adjective and impaired production of sentences with complex syntactic structure (subject cleft sentences like It was the boy that chased the girl); no such correlation was found for predicative adjectives. Irrespective of structure, we examined the lexical characteristics of the adjectives that were produced, including length, frequency, semantic diversity and neighborhood density. Overall, the lexical characteristics of the produced adjectives were largely consistent with the language profile of each group. In sum, the results suggest that attributive adjectives present a particular challenge for individuals with agrammatic language production, and add a new dimension to the description of agrammatism. Our results further suggest that attributive adjectives may be a fruitful target for improved treatment and recovery of agrammatic language.
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Affiliation(s)
- Matthew Walenski
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Thomas Sostarics
- Department of Linguistics, Northwestern University, Evanston, IL, USA
| | - M. Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, USA
| | - Cynthia K. Thompson
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL, USA
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Rezaii N, Quimby M, Wong B, Hochberg D, Brickhouse M, Touroutoglou A, Dickerson BC, Wolff P. Using Generative Artificial Intelligence to Classify Primary Progressive Aphasia from Connected Speech. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.22.23300470. [PMID: 38234853 PMCID: PMC10793520 DOI: 10.1101/2023.12.22.23300470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Neurodegenerative dementia syndromes, such as Primary Progressive Aphasias (PPA), have traditionally been diagnosed based in part on verbal and nonverbal cognitive profiles. Debate continues about whether PPA is best subdivided into three variants and also regarding the most distinctive linguistic features for classifying PPA variants. In this study, we harnessed the capabilities of artificial intelligence (AI) and natural language processing (NLP) to first perform unsupervised classification of concise, connected speech samples from 78 PPA patients. Large Language Models discerned three distinct PPA clusters, with 88.5% agreement with independent clinical diagnoses. Patterns of cortical atrophy of three data-driven clusters corresponded to the localization in the clinical diagnostic criteria. We then used NLP to identify linguistic features that best dissociate the three PPA variants. Seventeen features emerged as most valuable for this purpose, including the observation that separating verbs into high and low-frequency types significantly improves classification accuracy. Using these linguistic features derived from the analysis of brief connected speech samples, we developed a classifier that achieved 97.9% accuracy in predicting PPA subtypes and healthy controls. Our findings provide pivotal insights for refining early-stage dementia diagnosis, deepening our understanding of the characteristics of these neurodegenerative phenotypes and the neurobiology of language processing, and enhancing diagnostic evaluation accuracy.
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Affiliation(s)
- Neguine Rezaii
- Frontotemporal Disorders Unit, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
| | - Megan Quimby
- Frontotemporal Disorders Unit, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
| | - Bonnie Wong
- Frontotemporal Disorders Unit, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
| | - Daisy Hochberg
- Frontotemporal Disorders Unit, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
| | - Michael Brickhouse
- Frontotemporal Disorders Unit, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
| | - Alexandra Touroutoglou
- Frontotemporal Disorders Unit, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Massachusetts Alzheimer’s Disease Research Center, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
| | - Bradford C. Dickerson
- Frontotemporal Disorders Unit, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
- Massachusetts Alzheimer’s Disease Research Center, Massachusetts General Hospital & Harvard Medical School, Boston MA, USA
| | - Phillip Wolff
- Department of Psychology, Emory University, Atlanta, GA, USA
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Akhmadullina DR, Konovalov RN, Shpilyukova YA, Fedotova EY, Illarioshkin SN. Anomia: Deciphering Functional Neuroanatomy in Primary Progressive Aphasia Variants. Brain Sci 2023; 13:1703. [PMID: 38137151 PMCID: PMC10741652 DOI: 10.3390/brainsci13121703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/12/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Naming decline is one of the most common symptoms of primary progressive aphasia (PPA). Most studies on anomia in PPA are performed without taking into account PPA variants, especially for action naming. Only limited data are available for the neuroanatomical basis of anomia considering differences in the pathogenesis of PPAs. The aim of our study is to investigate the associations between anomia severity for both noun and verb naming and gray matter (GM) atrophy, as well as accompanying functional connectivity (FC) changes in three PPA variants. A total of 17 patients with non-fluent (nfvPPA), 11 with semantic (svPPA), and 9 with logopenic (lvPPA) PPA variants were included in the study and underwent cognitive/naming assessments and brain MRIs. Voxel-based morphometry was performed to evaluate GM volume. A resting-state functional MRI was applied to investigate FC changes in the identified GM areas. The study shows that different brain regions are involved in naming decline in each PPA variant with a predominantly temporal lobe involvement in svPPA, parietal lobe involvement in lvPPA, and frontal lobe involvement in nfvPPA. Separate data for object and action naming in PPA variants are provided. The obtained results mainly correspond to the current understanding of language processing and indicate that the evaluation of language impairments is preferable for each PPA variant separately. A further analysis of larger cohorts of patients is necessary to confirm these preliminary results.
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Shtyrov Y, Efremov A, Kuptsova A, Wennekers T, Gutkin B, Garagnani M. Breakdown of category-specific word representations in a brain-constrained neurocomputational model of semantic dementia. Sci Rep 2023; 13:19572. [PMID: 37949997 PMCID: PMC10638411 DOI: 10.1038/s41598-023-41922-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/04/2023] [Indexed: 11/12/2023] Open
Abstract
The neurobiological nature of semantic knowledge, i.e., the encoding and storage of conceptual information in the human brain, remains a poorly understood and hotly debated subject. Clinical data on semantic deficits and neuroimaging evidence from healthy individuals have suggested multiple cortical regions to be involved in the processing of meaning. These include semantic hubs (most notably, anterior temporal lobe, ATL) that take part in semantic processing in general as well as sensorimotor areas that process specific aspects/categories according to their modality. Biologically inspired neurocomputational models can help elucidate the exact roles of these regions in the functioning of the semantic system and, importantly, in its breakdown in neurological deficits. We used a neuroanatomically constrained computational model of frontotemporal cortices implicated in word acquisition and processing, and adapted it to simulate and explain the effects of semantic dementia (SD) on word processing abilities. SD is a devastating, yet insufficiently understood progressive neurodegenerative disease, characterised by semantic knowledge deterioration that is hypothesised to be specifically related to neural damage in the ATL. The behaviour of our brain-based model is in full accordance with clinical data-namely, word comprehension performance decreases as SD lesions in ATL progress, whereas word repetition abilities remain less affected. Furthermore, our model makes predictions about lesion- and category-specific effects of SD: our simulation results indicate that word processing should be more impaired for object- than for action-related words, and that degradation of white matter should produce more severe consequences than the same proportion of grey matter decay. In sum, the present results provide a neuromechanistic explanatory account of cortical-level language impairments observed during the onset and progress of semantic dementia.
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Affiliation(s)
- Yury Shtyrov
- Center of Functionally Integrative Neuroscience (CFIN), Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Aleksei Efremov
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, Moscow, Russia
- Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
| | - Anastasia Kuptsova
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, Moscow, Russia
| | - Thomas Wennekers
- School of Engineering, Computing and Mathematics, University of Plymouth, Plymouth, UK
| | - Boris Gutkin
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, Moscow, Russia
- Département d'Etudes Cognitives, École Normale Supérieure, Paris, France
| | - Max Garagnani
- Department of Computing, Goldsmiths - University of London, London, UK.
- Brain Language Laboratory, Department of Philosophy and Humanities, Freie Universität Berlin, Berlin, Germany.
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Meyer AM, Snider SF, Tippett DC, Saloma R, Turkeltaub PE, Hillis AE, Friedman RB. Baseline Conceptual-Semantic Impairment Predicts Longitudinal Treatment Effects for Anomia in Primary Progressive Aphasia and Alzheimer's Disease. APHASIOLOGY 2023; 38:205-236. [PMID: 38283767 PMCID: PMC10809875 DOI: 10.1080/02687038.2023.2183075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 02/16/2023] [Indexed: 01/30/2024]
Abstract
Background An individual's diagnostic subtype may fail to predict the efficacy of a given type of treatment for anomia. Classification by conceptual-semantic impairment may be more informative. Aims This study examined the effects of conceptual-semantic impairment and diagnostic subtype on anomia treatment effects in primary progressive aphasia (PPA) and Alzheimer's disease (AD). Methods & Procedures At baseline, the picture and word versions of the Pyramids and Palm Trees and Kissing and Dancing tests were used to measure conceptual-semantic processing. Based on norming that was conducted with unimpaired older adults, participants were classified as being impaired on both the picture and word versions (i.e., modality-general conceptual-semantic impairment), the picture version (Objects or Actions) only (i.e., visual-conceptual impairment), the word version (Nouns or Verbs) only (i.e., lexical-semantic impairment), or neither the picture nor the word version (i.e., no impairment). Following baseline testing, a lexical treatment and a semantic treatment were administered to all participants. The treatment stimuli consisted of nouns and verbs that were consistently named correctly at baseline (Prophylaxis items) and/or nouns and verbs that were consistently named incorrectly at baseline (Remediation items). Naming accuracy was measured at baseline, and it was measured at three, seven, eleven, fourteen, eighteen, and twenty-one months. Outcomes & Results Compared to baseline naming performance, lexical and semantic treatments both improved naming accuracy for treated Remediation nouns and verbs. For Prophylaxis items, lexical treatment was effective for both nouns and verbs, and semantic treatment was effective for verbs, but the pattern of results was different for nouns -- the effect of semantic treatment was initially nonsignificant or marginally significant, but it was significant beginning at 11 Months, suggesting that the effects of prophylactic semantic treatment may become more apparent as the disorder progresses. Furthermore, the interaction between baseline Conceptual-Semantic Impairment and the Treatment Condition (Lexical vs. Semantic) was significant for verb Prophylaxis items at 3 and 18 Months, and it was significant for noun Prophylaxis items at 14 and 18 Months. Conclusions The pattern of results suggested that individuals who have modality-general conceptual-semantic impairment at baseline are more likely to benefit from lexical treatment, while individuals who have unimpaired conceptual-semantic processing at baseline are more likely to benefit from semantic treatment as the disorder progresses. In contrast to conceptual-semantic impairment, diagnostic subtype did not typically predict the treatment effects.
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Affiliation(s)
- Aaron M. Meyer
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Sarah F. Snider
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Ryan Saloma
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Peter E. Turkeltaub
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Rhonda B. Friedman
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
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Macoir J, Routhier S, Auclair-Ouellet N, Wilson MA, Hudon C. Validation of and Normative Data of the DVAQ-30, a New Video-Naming Test for Assessing Verb Anomia. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2023; 38:80-90. [PMID: 35901465 DOI: 10.1093/arclin/acac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Anomia is usually assessed using picture-naming tests. While many tests evaluate anomia for nouns, very few tests have been specifically designed for verb anomia. This article presents the DVAQ-30, a new naming test for detecting verb anomia in adults and elderly people. METHOD The article describes three studies. Study 1 focused on the DVAQ-30 development phase. In Study 2, healthy participants and individuals with post-stroke aphasia, mild cognitive impairment, Alzheimer's disease, or primary progressive aphasia were assessed using the DVAQ-30 to establish its convergent and discriminant validity, test-retest reliability, and internal consistency. In Study 3, a group of adults and elderly Quebec French-speaking adults were assessed to obtain normative data. RESULTS The DVAQ-30 had good convergent validity and distinguished the performance of healthy participants from that of participants with pathological conditions. The test also had good internal consistency, and the test-retest analysis showed that the scores had good temporal stability. Furthermore, normative data were collected on the performance of 244 participants aged 50 years old and over. CONCLUSIONS The DVAQ-30 fills an important gap and has the potential to help clinicians and researchers better detect verb anomia associated with pathological aging and post-stroke aphasia.
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Affiliation(s)
- J Macoir
- Faculté de médecine, Département de réadaptation, Université Laval, Québec, Canada.,Centre de recherche CERVO - Brain Research Centre, Québec, Canada
| | - S Routhier
- Centre de recherche sur le vieillissement, CSSS-IUGS, Sherbrooke, Canada
| | | | - M A Wilson
- Faculté de médecine, Département de réadaptation, Université Laval, Québec, Canada.,Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, Canada
| | - C Hudon
- Centre de recherche CERVO - Brain Research Centre, Québec, Canada.,Faculté des sciences sociales, École de psychologie, Université Laval, Québec, Canada.,Centre de recherche VITAM, Québec, Canada
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10
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The Naming Assessment in Multicultural Europe (NAME): Development and Validation in a Multicultural Memory Clinic. J Int Neuropsychol Soc 2023; 29:92-104. [PMID: 35039100 DOI: 10.1017/s135561772100148x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Traditional naming tests are unsuitable to assess naming impairment in diverse populations, given the influence of culture, language, and education on naming performance. Our goal was therefore to develop and validate a new test to assess naming impairment in diverse populations: the Naming Assessment in Multicultural Europe (NAME). METHOD We carried out a multistage pilot study. First, we generated a list of 149 potentially suitable items - e.g. from published cross-linguistic word lists and other naming tests - and selected those with a homogeneous age of acquisition and word frequency across languages. We selected three to four colored photographs for each of the 73 remaining items; 194 controls selected the most suitable photographs. Thirteen items were removed after a pilot study in 15 diverse healthy controls. The final 60-item test was validated in 39 controls and 137 diverse memory clinic patients with subjective cognitive impairment, neurological/neurodegenerative disease or psychiatric disorders in the Netherlands and Turkey (mean age: 67, SD: 11). Patients were from 15 different countries; the majority completed primary education or less (53%). RESULTS The NAME showed excellent reliability (Spearman-Brown coefficient: 0.95; Kuder-Richardson coefficient: 0.94) and robust correlations with other language tests (ρ = .35-.73). Patients with AD/mixed dementia obtained lower scores on most (48/60) NAME items, with an area under the curve of 0.88. NAME scores were correlated with age and education, but not with acculturation or sex. CONCLUSIONS The NAME is a promising tool to assess naming impairment in culturally, educationally, and linguistically diverse individuals.
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Stockbridge MD, Venezia JH, Vitti E, Tippett DC, Hillis AE. Verb Frequency and Density Drive Naming Performance in Primary Progressive Aphasia. APHASIOLOGY 2022; 37:1964-1980. [PMID: 38155815 PMCID: PMC10752624 DOI: 10.1080/02687038.2022.2142036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Background Recent work has highlighted the utility of the Boston Naming Test and Hopkins Action Naming Assessment (HANA) for distinguishing between semantic (svPPA), logopenic (lvPPA) and non-fluent agrammatic (nfavPPA) variants of primary progressive aphasia (PPA). Aims To determine whether item level differences between variants on when naming verbs on the HANA were able to be accounted for using common variables of lexical interest: word frequency, semantic density, concreteness, or valency. We also examined three specific hypotheses: (1) svPPA and lvPPA may result in increased difficulty with decreased semantic density compared to nfavPPA; (2) svPPA may result in increased difficulty with decreased concreteness; and (3) nfavPPA may result in increased difficulty with high syntactic valency. Methods & Procedures 268 patients with PPA were evaluated using the HANA. A hierarchical Bayesian regression approach was adopted to account for effects of repeated measurement within participants and items. Outcomes & Results The main effects of variant and verb trait were significant in all models, as was the interaction for frequency, semantic density, and valency. Increasing frequency, semantic density, and concreteness led to better performance, while increasing valency led to poorer performance. Low semantic density contributed to greater difficulty in svPPA and lvPPA, but low concreteness did not uniquely impact verb naming in svPPA. Those with nfavPPA had no particular difficulty as a result of valency. Conclusions Prior studies have identified the independent effects of frequency and semantic density on verb naming in PPA, which were confirmed by our analyses, and the best predictions of the data were achieved by combining these dimensions. This investigation complements our previous work highlighting the value of the HANA for efficiently demonstrating verb performance in PPA.
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Affiliation(s)
- Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Jonathan H. Venezia
- VA Loma Linda Healthcare System, Loma Linda, CA 92357
- Department of Otolaryngology & Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, CA 92350
| | - Emilia Vitti
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218
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Kim M, Kim H, Seo P, Jung KY, Kim KH. Explainable Machine-Learning-Based Characterization of Abnormal Cortical Activities for Working Memory of Restless Legs Syndrome Patients. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22207792. [PMID: 36298144 PMCID: PMC9608870 DOI: 10.3390/s22207792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 05/31/2023]
Abstract
Restless legs syndrome (RLS) is a sensorimotor disorder accompanied by a strong urge to move the legs and an unpleasant sensation in the legs, and is known to accompany prefrontal dysfunction. Here, we aimed to clarify the neural mechanism of working memory deficits associated with RLS using machine-learning-based analysis of single-trial neural activities. A convolutional neural network classifier was developed to discriminate the cortical activities between RLS patients and normal controls. A layer-wise relevance propagation was applied to the trained classifier in order to determine the critical nodes in the input layer for the output decision, i.e., the time/location of cortical activities discriminating RLS patients and normal controls during working memory tasks. Our method provided high classification accuracy (~94%) from single-trial event-related potentials, which are known to suffer from high inter-trial/inter-subject variation and low signal-to-noise ratio, after strict separation of training/test/validation data according to leave-one-subject-out cross-validation. The determined critical areas overlapped with the cortical substrates of working memory, and the neural activities in these areas were correlated with some significant clinical scores of RLS.
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Affiliation(s)
- Minju Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 1, Yeonsedae-gil, Heungeop-myeon, Wonju-si 26493, Korea
| | - Hyun Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 1, Yeonsedae-gil, Heungeop-myeon, Wonju-si 26493, Korea
| | - Pukyeong Seo
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 1, Yeonsedae-gil, Heungeop-myeon, Wonju-si 26493, Korea
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - Kyung Hwan Kim
- Department of Biomedical Engineering, College of Health Science, Yonsei University, 1, Yeonsedae-gil, Heungeop-myeon, Wonju-si 26493, Korea
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Ward E, Brownsett S, McMahon K, Hartwigsen G, Mascelloni M, de Zubicaray G. Online transcranial magnetic stimulation reveals differential effects of transitivity in left inferior parietal cortex but not premotor cortex during action naming. Neuropsychologia 2022; 174:108339. [DOI: 10.1016/j.neuropsychologia.2022.108339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
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Stockbridge MD, Tippett DC, Breining BL, Hillis AE. When words first fail: Predicting the emergence of primary progressive aphasia variants from unclassifiable anomic performance in early disease. APHASIOLOGY 2022; 37:1173-1185. [PMID: 37377938 PMCID: PMC10292722 DOI: 10.1080/02687038.2022.2084706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Background The majority of patients with primary progressive aphasia (PPA) can be distinguished into one of three variants: semantic, non-fluent/agrammatic, or logopenic. However, many do not meet criteria for any one variant. Aim To identify aspects of cognitive-linguistic performance that yield an early unclassifiable PPA designation that predicted the later emergence of a given variant. Methods & Procedures Of 256 individuals with PPA evaluated, 19 initially were unclassifiable and later met criteria for a variant. Receiver operating characteristic curves were used to evaluate the binary ability of a given task to predict eventual classification as a given variant. Tasks with a high area under the curve were examined using regression analyses to determine their ability to predict variant. Outcomes & Results High mean predictive value was observed for multiple naming assessments targeting nouns and verbs. The Boston Naming Test (BNT) was the only test that, in isolation, resulted in a significant model and high classification accuracy. Conclusions Although naming impairment is common across PPA variants, very low initial BNT scores emerged as a uniquely accurate basis for predicting eventual semantic variant, and normal BNT scores predicted eventual nonfluent/agrammatic variant. High performance on picture-verb verification was useful in identifying future lvPPA.
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Affiliation(s)
- Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Bonnie L. Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218
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15
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Tippett DC, Keser Z. Clinical and neuroimaging characteristics of primary progressive aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:81-97. [PMID: 35078612 PMCID: PMC9951770 DOI: 10.1016/b978-0-12-823384-9.00016-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The chapter covers the clinical syndrome of a primary progressive aphasia (PPA), the demographics of this rare neurodegenerative disease, defining clinical and neuroanatomic characteristics of each PPA variant, disease progression, and behavioral features. The chapter begins with a brief introduction that includes references to seminal papers that defined this clinical syndrome and its three variants. The classic PPA subtypes discussed in the chapter are semantic variant PPA (svPPA), nonfluent/agrammatic PPA (nfaPPA), and logopenic variant PPA (lvPPA). The key language and cognitive characteristics, and language tasks that can elicit these language impairments, are detailed. Overlap in the clinical profiles of the PPA variants, which make differential diagnosis challenging, are explained. Disease progression is described, revealing that the PPA variants become more similar over time. Although PPA is language-predominant dementia, there are behavioral manifestations, particularly in svPPA. Changes in behavior in this variant are addressed as well as behavioral changes in nfaPPA and lvPPA that are less well recognized. The patterns of atrophy in the left temporal, parietal, and/or frontal cortices unique to each PPA variant are described. The underlying neuropathologies of the PPA variants are discussed, specifically tauopathies and non-tauopathies associated with svPPA and nfaPPA and Alzheimer's disease pathology in lvPPA.
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Affiliation(s)
- Donna C. Tippett
- Departments of Neurology, Otolaryngology—Head and Neck Surgery, and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Zafer Keser
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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16
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Pinto-Grau M, O'Connor S, Murphy L, Heverin M, Vajda A, Hardiman O, Pender N. Development and Psychometric Evaluation of Alternate Short Forms of the Action Naming Test. Arch Clin Neuropsychol 2021; 36:1473–1484. [PMID: 33822859 DOI: 10.1093/arclin/acab013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The action naming test (ANT) is a confrontation naming task used to assess the ability to name action words. This study aimed to create two short forms of the ANT and assess their equivalence, reliability, and comparability to the long form. METHODS In total, 100 healthy adults (31 females and 69 males), aged 34-89 years (M = 64 and SD = 10.4) were recruited. Short forms were developed using a split-half procedure. RESULTS No significant differences were observed between short forms on mean performance and distribution of scores for correct spontaneous responses, responses after semantic cue and total correct responses after cueing, but a higher number of accurate responses were prompted after phonemic cueing for Form A. Significant strong correlations between short forms and with the full form were encountered, although a weak correlation was found between short forms on performance after semantic cueing. IQ and age were significant predictors of action word retrieval. Whereas IQ also predicted post-cueing performance in all ANT forms, age predicted performance only for Form B. CONCLUSION The two ANT short forms are equivalent when considering total spontaneous responses and total correct responses after cueing, but semantic and phonemic cues evoked different responses on the two forms. The two short forms were also affected differently by demographics. When the psychometric equivalence of Forms A and B was examined, the strict conditions for parallel forms were not met for all performance indices. Therefore, these newly developed short versions should be considered as alternate forms.
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Affiliation(s)
- Marta Pinto-Grau
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Sarah O'Connor
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Lisa Murphy
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Alice Vajda
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Niall Pender
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
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17
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Lukic S, Borghesani V, Weis E, Welch A, Bogley R, Neuhaus J, Deleon J, Miller ZA, Kramer JH, Miller BL, Dronkers NF, Gorno-Tempini ML. Dissociating nouns and verbs in temporal and perisylvian networks: Evidence from neurodegenerative diseases. Cortex 2021; 142:47-61. [PMID: 34182153 PMCID: PMC8556704 DOI: 10.1016/j.cortex.2021.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/27/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022]
Abstract
Naming of nouns and verbs can be selectively impaired in neurological disorders, but the specificity of the neural and cognitive correlates of such dissociation remains unclear. Functional imaging and stroke research sought to identify cortical regions selectively recruited for nouns versus verbs, yet findings are inconsistent. The present study investigated this issue in neurodegenerative diseases known to selectively affect different brain networks, thus providing new critical evidence of network specificity. We examined naming performances on nouns and verbs in 146 patients with different neurodegenerative syndromes (Primary Progressive Aphasia - PPA, Alzheimer's disease - AD, and behavioral variant Frontotemporal Dementia - FTD) and 30 healthy adults. We then correlated naming scores with MRI-derived cortical thickness values as well as with performances in semantic and syntactic tasks, across all subjects. Results indicated that patients with the semantic variant PPA named significantly fewer nouns than verbs. Instead, nonfluent/agrammatic PPA patients named fewer verbs than nouns. Across all subjects, performance on nouns (adjusted for verbs) specifically correlated with cortical atrophy in left anterior temporal regions, and performance on verbs (adjusted for nouns) with atrophy in left inferior and middle frontal, inferior parietal and posterior temporal regions. Furthermore, lower lexical-semantic abilities correlated with deficits in naming both nouns and verbs, while lower syntactic abilities only correlated with naming verbs. Our results show that different neural and cognitive mechanisms underlie naming of specific grammatical categories in neurodegenerative diseases. Importantly, our findings showed that verb processing depends on a widespread perisylvian networks, suggesting that some regions might be involved in processing different types of action knowledge. These findings have important implications for early differential diagnosis of neurodegenerative disorders.
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Affiliation(s)
- Sladjana Lukic
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.
| | - Valentina Borghesani
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Elizabeth Weis
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Ariane Welch
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Rian Bogley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - John Neuhaus
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Jessica Deleon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Nina F Dronkers
- University of California, Berkeley, CA, USA; University of California, Davis, CA, USA
| | - Maria L Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
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Lavoie M, Black SE, Tang-Wai DF, Graham NL, Stewart S, Leonard C, Rochon E. Description of connected speech across different elicitation tasks in the logopenic variant of primary progressive aphasia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1074-1085. [PMID: 34383346 DOI: 10.1111/1460-6984.12660] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 05/06/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Despite its importance, in-depth analysis of connected speech is often neglected in the diagnosis of primary progressive aphasia (PPA) - especially for the logopenic variant (lvPPA) for which unreliable differential diagnosis has been documented. Only a few studies have been conducted on this topic in lvPPA. AIMS The aim of this study was to describe and compare lexico-semantic and morphosyntactic features of connected speech in participants with lvPPA, in comparison with healthy controls, using three different elicitation tasks (i.e., picture description, story narration and semi-structured interviews). In addition to a number of discourse features, we were particularly interested in the presence or absence of syntactic deficits in this PPA variant in line with recent findings. METHODS & PROCEDURES A prospective group study was conducted to compare lvPPA participants (n = 13) to age- and education-matched healthy controls (n = 13). For each individual, connected speech was obtained using three tasks: (1) The Cookie Theft picture description; (2) Cinderella Story; (3) Topic-directed interview. Production on each task was recorded, transcribed and analysed according to the Quantitative Production Analysis (QPA) protocol, a tool developed by Berndt et al. (2000) for the analysis of sentence production in aphasia. Differences between lvPPA and healthy controls and among elicitation tasks were analysed using repeated measures multilevel mixed-effects regression, separately for each outcome. OUTCOMES & RESULTS Four measures were significantly different between lvPPA participants and healthy controls across all elicitation tasks. Specifically, lvPPA participants produced a reduced proportion of open-class words, a higher proportion of verbs, a higher proportion of pronouns and fewer well-formed sentences. For these measures, the difference between lvPPA and healthy controls was consistent among elicitation tasks, except for the proportion of well-formed sentences, where the difference between the two groups was significantly greater in the story narration task than in the other tasks. CONCLUSIONS & IMPLICATIONS Across elicitation tasks that used the same analysis protocol (i.e., QPA), a similar pattern of deficits in connected speech emerged in lvPPA patients. Importantly, the findings replicate previous studies, which used different elicitation tasks and analysis protocols. Especially in relation to the documented syntactic deficits, these findings provide implications for differential diagnosis in PPA. WHAT THIS PAPER ADDS What is already known on the subject Connected speech analysis can provide an important contribution to the language assessment for the logopenic variant of primary progressive aphasia (lvPPA). However, only a few studies have been conducted with this population. What this paper adds to existing knowledge This study highlights differences between patients with lvPPA and healthy controls regarding the proportion of open-class words, nouns, verbs and well-formed sentences. What are the potential or actual clinical implications of this work? Importantly, our results highlight syntactic deficits in the same group of individuals with lvPPA, using the same analysis protocol and across various elicitation tasks, which has implications for differential diagnosis.
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Affiliation(s)
- Monica Lavoie
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehab, University Health Network, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - David F Tang-Wai
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada
- University Health Network Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Naida L Graham
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehab, University Health Network, Toronto, ON, Canada
| | - Steven Stewart
- KITE, Toronto Rehab, University Health Network, Toronto, ON, Canada
| | - Carol Leonard
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, ON, Canada
| | - Elizabeth Rochon
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehab, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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Pagnoni I, Gobbi E, Premi E, Borroni B, Binetti G, Cotelli M, Manenti R. Language training for oral and written naming impairment in primary progressive aphasia: a review. Transl Neurodegener 2021; 10:24. [PMID: 34266501 PMCID: PMC8282407 DOI: 10.1186/s40035-021-00248-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a gradual, insidious and progressive loss of language abilities, with naming difficulties being an early and persistent impairment common to all three variants. In the absence of effective pharmacological treatments and given the progressive nature of the disorder, in the past few decades, many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life. MAIN BODY We review language treatments most commonly used in clinical practice among patients with different variants of PPA, with a focus on the enhancement of spoken and written naming abilities. Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed. Forty-eight studies were included in this literature review, identifying four main types of language treatment: a) lexical retrieval treatment, b) phonological and/or orthographic treatment, c) semantic treatment, and d) a multimodality approach treatment. Overall, language training is able to induce immediate improvements of naming abilities in all variants of PPA. Moreover, despite the large variability among results, generalization and long-term effects can be recorded after the training. The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system. CONCLUSION The majority of studies have demonstrated improvements of naming abilities following language treatments. Given the progressive nature of PPA, it is essential to apply language treatment in the early stages of the disease.
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Affiliation(s)
- Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Enrico Premi
- Vascular Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Paek EJ, Murray LL, Newman SD. Effects of concurrent action and object naming treatment on naming skills and functional brain activation patterns in primary progressive aphasia: An fMRI study with a case-series design. BRAIN AND LANGUAGE 2021; 218:104950. [PMID: 33836414 DOI: 10.1016/j.bandl.2021.104950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 11/18/2020] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Abstract
Individuals with primary progressive aphasia (PPA) exhibit differential impairment patterns in noun and verb naming, but it remains unclear whether anomia treatment results in similar improvements in noun and verb naming. Therefore, we examined the immediate and long-term (3-months post-treatment) behavioral and neural effects of an anomia treatment on object and action naming skills in PPA. A case-series design was utilized involving two individuals with PPA. Object and action words were trained concurrently and probed regularly using word lists matched on a number of lexical characteristics. One participant showed improvements in all word categories with different effect sizes whereas the other participant demonstrated improved naming only on trained object words. Treatment-induced fMRI changes were found in both hemispheres, with distinct patterns observed across participants. Further research is needed to better understand the effects of residual language and cognitive skills on behavioral and neurophysiological outcomes following anomia treatment for PPA.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville, TN 37996, United States.
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario N6G 1H1, Canada.
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States; Department of Psychology, University of Alabama, Tuscaloosa, AL 35487, United States.
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21
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Breining BL, Faria AV, Caffo B, Meier EL, Sheppard SM, Sebastian R, Tippett DC, Hillis AE. Neural regions underlying object and action naming: Complementary evidence from acute stroke and primary progressive aphasia. APHASIOLOGY 2021; 36:732-760. [PMID: 35832655 PMCID: PMC9272983 DOI: 10.1080/02687038.2021.1907291] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Naming impairment is commonly noted in individuals with aphasia. However, object naming receives more attention than action naming. Furthermore, most studies include participants with aphasia due to only one aetiology, commonly stroke. We developed a new assessment, the Hopkins Action Naming Assessment (HANA), to evaluate action naming impairments. AIMS Our aims were to show that the HANA is a useful tool that can (1) identify action naming impairments and (2) be used to investigate the neural substrates underlying naming. We paired the HANA with the Boston Naming Test (BNT) to compare action and object naming. We considered participants with aphasia due to primary progressive aphasia (PPA) or acute left hemisphere stroke to provide a more comprehensive picture of brain-behaviour relationships critical for naming. Behaviourally, we hypothesised that there would be a double dissociation between object and action naming performance. Neuroanatomically, we hypothesised that different neural substrates would be implicated in object vs. action naming and that different lesion-deficit associations would be identified in participants with PPA vs. acute stroke. METHODS & PROCEDURES Participants (N=138 with PPA, N=37 with acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N=31 with PPA, N=37 with acute stroke) provided neuroimaging data. The whole brain was automatically segmented into regions of interest (ROIs). For participants with PPA, the image variables were the ROI volumes, normalised by the brain volume. For participants with acute stroke, the image variables were the percentage of each ROI affected by the lesion. The relationship between ROIs likely to be involved in naming performance was modelled with LASSO regression. OUTCOMES & RESULTS Behavioural results showed a double dissociation in performance: in each group, some participants displayed intact performance relative to healthy controls on actions but not objects and/or significantly better performance on actions than objects, while others showed the opposite pattern. These results support the need to assess both objects and actions when evaluating naming deficits. Neuroimaging results identified different regions associated with object vs. action naming, implicating overlapping but distinct networks of regions. Furthermore, results differed for participants with PPA vs. acute stroke, indicating that critical information may be missed when only one aetiology is considered. CONCLUSIONS Overall, the study provides a more comprehensive picture of the neural bases of naming, underscoring the importance of assessing both objects and actions and considering different aetiologies of damage. It demonstrates the utility of the HANA.
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Affiliation(s)
- Bonnie L. Breining
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Andreia V. Faria
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Erin L. Meier
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Communication Sciences & Disorders, Chapman University, Irvine, CA 92618, USA
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
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22
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Cho S, Nevler N, Ash S, Shellikeri S, Irwin DJ, Massimo L, Rascovsky K, Olm C, Grossman M, Liberman M. Automated analysis of lexical features in frontotemporal degeneration. Cortex 2021; 137:215-231. [PMID: 33640853 PMCID: PMC8044033 DOI: 10.1016/j.cortex.2021.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/26/2020] [Accepted: 01/22/2021] [Indexed: 12/14/2022]
Abstract
We implemented an automated analysis of lexical aspects of semi-structured speech produced by healthy elderly controls (n = 37) and three patient groups with frontotemporal degeneration (FTD): behavioral variant FTD (n = 74), semantic variant primary progressive aphasia (svPPA, n = 42), and nonfluent/agrammatic PPA (naPPA, n = 22). Based on previous findings, we hypothesized that the three patient groups and controls would differ in the counts of part-of-speech (POS) categories and several lexical measures. With a natural language processing program, we automatically tagged POS categories of all words produced during a picture description task. We further counted the number of wh-words, and we rated nouns for abstractness, ambiguity, frequency, familiarity, and age of acquisition. We also computed the cross-entropy estimation, where low cross-entropy indicates high predictability, and lexical diversity for each description. We validated a subset of the POS data that were automatically tagged with the Google Universal POS scheme using gold-standard POS data tagged by a linguist, and we found that the POS categories from our automated methods were more than 90% accurate. For svPPA patients, we found fewer unique nouns than in naPPA and more pronouns and wh-words than in the other groups. We also found high abstractness, ambiguity, frequency, and familiarity for nouns and the lowest cross-entropy estimation among all groups. These measures were associated with cortical thinning in the left temporal lobe. In naPPA patients, we found increased speech errors and partial words compared to controls, and these impairments were associated with cortical thinning in the left middle frontal gyrus. bvFTD patients' adjective production was decreased compared to controls and was correlated with their apathy scores. Their adjective production was associated with cortical thinning in the dorsolateral frontal and orbitofrontal gyri. Our results demonstrate distinct language profiles in subgroups of FTD patients and validate our automated method of analyzing FTD patients' speech.
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Affiliation(s)
- Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA.
| | - Naomi Nevler
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon Ash
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjana Shellikeri
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren Massimo
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Katya Rascovsky
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Olm
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA; Department of Radiology and Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
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Themistocleous C, Webster K, Afthinos A, Tsapkini K. Part of Speech Production in Patients With Primary Progressive Aphasia: An Analysis Based on Natural Language Processing. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:466-480. [PMID: 32697669 PMCID: PMC8702871 DOI: 10.1044/2020_ajslp-19-00114] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/14/2020] [Accepted: 05/13/2020] [Indexed: 06/11/2023]
Abstract
Background Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a progressive decline of language functions. Its symptoms are grouped into three PPA variants: nonfluent PPA, logopenic PPA, and semantic PPA. Grammatical deficiencies differ depending on the PPA variant. Aims This study aims to determine the differences between PPA variants with respect to part of speech (POS) production and to identify morphological markers that classify PPA variants using machine learning. By fulfilling these aims, the overarching goal is to provide objective measures that can facilitate clinical diagnosis, evaluation, and prognosis. Method and Procedure Connected speech productions from PPA patients produced in a picture description task were transcribed, and the POS class of each word was estimated using natural language processing, namely, POS tagging. We then implemented a twofold analysis: (a) linear regression to determine how patients with nonfluent PPA, semantic PPA, and logopenic PPA variants differ in their POS productions and (b) a supervised classification analysis based on POS using machine learning models (i.e., random forests, decision trees, and support vector machines) to subtype PPA variants and generate feature importance (FI). Outcome and Results Using an automated analysis of a short picture description task, this study showed that content versus function words can distinguish patients with nonfluent PPA, semantic PPA, and logopenic PPA variants. Verbs were less important as distinguishing features of patients with different PPA variants than earlier thought. Finally, the study showed that among the most important distinguishing features of PPA variants were elaborative speech elements, such as adjectives and adverbs.
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Affiliation(s)
| | - Kimberly Webster
- Department of Otolaryngology, Johns Hopkins Medicine, Baltimore MD
| | | | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Cognitive Science, Johns Hopkins University, Baltimore MD
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Zhang M, Geng L, Yang Y, Ding H. Cohesion in the discourse of people with post-stroke aphasia. CLINICAL LINGUISTICS & PHONETICS 2021; 35:2-18. [PMID: 32200658 DOI: 10.1080/02699206.2020.1734864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/18/2020] [Accepted: 02/22/2020] [Indexed: 06/10/2023]
Abstract
Aphasic discourse has been investigated through two major approaches: a micro-linguistic approach and a macro one, but the separate analysis of the micro and macro aspects of aphasic discourse has led to a noticeable gap between them. Cohesion analysis is one of the possible ways that can directly connect these two aspects. However, few studies have investigated cohesion in aphasic discourse in an integrated manner. The present study employs a mixed-methods approach to examine whether and how patients with fluent and non-fluent stroke-induced aphasia differ from normal individuals in the cohesion of their discourse, aiming to provide a more comprehensive understanding of this issue. We compared the use of cohesive devices in the discourse of 7 non-fluent aphasics (4 males, mean age = 70.9) and 9 fluent aphasics (4 males, mean age = 70.7) against 16 non-aphasic controls (NACs) (8 males, mean age = 71.0). Transcripts were analysed and conclusions were drawn based on the combination of quantitative and qualitative observations. As predicted, discourse by aphasic participants is less cohesive than that by non-aphasic participants and the three groups' discourse differs from each other in the distribution of cohesion categories, with non-fluent aphasics having more trouble in using grammatical cohesive devices while fluent aphasics more severely affected in constructing lexical cohesion. Results suggest that cohesion in post-stroke aphasic discourse may vary between different aphasia types and thus can be rather complicated. Additional work involving more aphasia types and more dimensions of discourse cohesion is needed to provide further insight into this question.
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Affiliation(s)
- Minyue Zhang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University , Shanghai, China
| | - Luyuan Geng
- Department of English, School of Foreign Languages, East China Normal University , Shanghai, China
| | - Yanning Yang
- Department of English, School of Foreign Languages, East China Normal University , Shanghai, China
| | - Hongwei Ding
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University , Shanghai, China
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25
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Ghosh A. Language Breakdown in Primary Progressive Aphasias. Ann Indian Acad Neurol 2020; 23:S67-S72. [PMID: 33343129 PMCID: PMC7731691 DOI: 10.4103/aian.aian_715_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 11/30/2022] Open
Abstract
Dementias with predominant language involvement, called primary progressive aphasias provide us with unique insight into systematic breakdown of language in neurodegenerative diseases and the structures and networks involved. Clinical and neuroimaging models quite distinct from those seen in stroke aphasias have evolved. In this short overview, we will discuss the cognitive processes involved in expressive and receptive verbal communication and how these processes are affected in the different variants of primary progressive aphasia producing distinctive clinical patterns. We will also discuss the brain's language network and how different components of the network break down in each of the primary progressive aphasia variants.
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Affiliation(s)
- Amitabha Ghosh
- Department of Neurology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
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26
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Prell T, Witte OW, Gunkel A, Grosskreutz J. Cognitive deficits have only limited influence on health-related quality of life in amyotrophic lateral sclerosis. Aging Ment Health 2020; 24:1963-1967. [PMID: 31317778 DOI: 10.1080/13607863.2019.1642296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To explore the association between cognitive deficits and health-related quality of life in amyotrophic lateral sclerosis (ALS). METHODS The revised ALS Functional Rating Scale (ALSFRS-R for physical impairment), the ALS Assessment Questionnaire (ALSAQ-40 for health-related quality of life) and the Edinburgh Cognitive and Behavioral ALS Screen (ECAS for cognition) were assessed in 125 patients with ALS. Correlations between ALSAQ-40 domains and ECAS functions were tested using Spearman correlation. Linear regression was used to evaluate the relationship between dysphagia, depression, hopelessness, pain (all derived from corresponding items from the ALSFRS-R or ALSAQ-40), ALSFRS-R, ECAS and the ALSAQ-40. RESULTS Verbal fluency, language and executive function were disturbed in 69 (55%), 54 (43%) and 41 (33%) patients, respectively. In the ALS non-specific domains the memory and visuospatial function were impaired in 44 (35%) and 12 (10%) patients. In the non-demented group the five ECAS functions did not correlate with the ALSAQ-40 subdomains. The ALSFRS-R score, hopelessness, pain, and depression explained 65% of the ALSAQ-40 SI variance; the ECAS total score did not significantly predict ALSAQ-40 summary index. The ECAS visuospatial, executive function and fluency significantly predicted emotional well-being (adjusted R2 = 0.08). When the model was controlled for depression, hopelessness and pain none of the ECAS functions (visuospatial, executive function and fluency) were significant predictors of emotional well-being. CONCLUSION Deficits in visuospatial function, executive function and fluency constrain the ability to manage activities of daily living and this might cause decline in well-being.
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Affiliation(s)
- Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Anne Gunkel
- Department of Neurology, Jena University Hospital, Jena, Germany
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Stalpaert J, Cocquyt EM, Criel Y, Segers L, Miatton M, Van Langenhove T, van Mierlo P, De Letter M. Language and Speech Markers of Primary Progressive Aphasia: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2206-2225. [PMID: 32810414 DOI: 10.1044/2020_ajslp-20-00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This systematic review aimed to establish language and speech markers to support the clinical diagnosis of primary progressive aphasia (PPA) and its clinical phenotypes. Our first objective was to identify behavioral language and speech markers of early-stage PPA. Our second objective was to identify the electrophysiological correlates of the language and speech characteristics in PPA. Method The databases MEDLINE, Web of Science, and Embase were searched for relevant articles. To identify behavioral markers, the initial subjective complaints and the language and speech deficits detected during the initial diagnostic evaluation were summarized for PPA in general and each clinical variant according to the 2011 consensus diagnostic criteria (nonfluent variant [NFV], semantic variant, and logopenic variant [LV]). To identify electrophysiological markers, the studies in which event-related potentials (ERPs) were elicited by a language or speech paradigm in patients with PPA were included. Results In total, 114 relevant studies were identified, including 110 behavioral studies and only four electrophysiological studies. This review suggests that patients with the semantic variant could be accurately differentiated from the NFV and LV in the initial stages based on the consensus criteria. Nonetheless, the early differentiation between the NFV and LV is not straightforward. In the four electrophysiological studies, differences in the latency, amplitude, and topographical distribution of the semantic N400 component were found between patients with PPA and healthy controls. Conclusions To accurately differentiate the NFV from the LV, it could be important to assess the language and speech degeneration by more specific assessments and by more objective diagnostic methods that offer insights into the language-related processes. Electrophysiological markers of PPA were not identified in this review due to the low number of studies that investigated language-related ERPs. More controlled ERP studies in larger patient cohorts are needed to investigate the diagnostic applicability of language-related ERPs in PPA. Supplemental Material https://doi.org/10.23641/asha.12798080.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | - Yana Criel
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Lieselot Segers
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | | | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Belgium
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28
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Cho S, Nevler N, Ash S, Shellikeri S, Irwin DJ, Massimo L, Rascovsky K, Olm C, Grossman M, Liberman M. Automated analysis of lexical features in Frontotemporal Degeneration. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.09.10.20192054. [PMID: 33173922 PMCID: PMC7654918 DOI: 10.1101/2020.09.10.20192054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We implemented an automated analysis of lexical aspects of semi-structured speech produced by healthy elderly controls (n=37) and three patient groups with frontotemporal degeneration (FTD): behavioral variant FTD (n=74), semantic variant primary progressive aphasia (svPPA, n=42), and nonfluent/agrammatic PPA (naPPA, n=22). Based on previous findings, we hypothesized that the three patient groups and controls would differ in the counts of part-of-speech (POS) categories and several lexical measures. With a natural language processing program, we automatically tagged POS categories of all words produced during a picture description task. We further counted the number of wh -words, and we rated nouns for abstractness, ambiguity, frequency, familiarity, and age of acquisition. We also computed the cross-entropy estimation, which is a measure of word predictability, and lexical diversity for each description. We validated a subset of the POS data that were automatically tagged with the Google Universal POS scheme using gold-standard POS data tagged by a linguist, and we found that the POS categories from our automated methods were more than 90% accurate. For svPPA patients, we found fewer unique nouns than in naPPA and more pronouns and wh -words than in the other groups. We also found high abstractness, ambiguity, frequency, and familiarity for nouns and the lowest cross-entropy estimation among all groups. These measures were associated with cortical thinning in the left temporal lobe. In naPPA patients, we found increased speech errors and partial words compared to controls, and these impairments were associated with cortical thinning in the left middle frontal gyrus. bvFTD patients' adjective production was decreased compared to controls and was correlated with their apathy scores. Their adjective production was associated with cortical thinning in the dorsolateral frontal and orbitofrontal gyri. Our results demonstrate distinct language profiles in subgroups of FTD patients and validate our automated method of analyzing FTD patients' speech.
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Affiliation(s)
- Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
| | - Naomi Nevler
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon Ash
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjana Shellikeri
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - David J. Irwin
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren Massimo
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Katya Rascovsky
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Olm
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology and Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
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Auclair-Ouellet N, Fossard M, Macoir J, Laforce R. The Nonverbal Processing of Actions Is an Area of Relative Strength in the Semantic Variant of Primary Progressive Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:569-584. [PMID: 32013713 DOI: 10.1044/2019_jslhr-19-00271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Better performance for actions compared to objects has been reported in the semantic variant of primary progressive aphasia (svPPA). This study investigated the influence of the assessment task (naming, semantic picture matching) over the dissociation between objects and actions. Method Ten individuals with svPPA and 17 matched controls completed object and action naming tests, and object and action semantic picture matching tests. Performance was compared between the svPPA and control groups, within the svPPA group, and for each participant with svPPA versus the control group individually. Results Compared to controls, participants with svPPA were impaired on object and action naming, and object and action semantic picture matching. As a group, participants with svPPA had an advantage for actions over objects and for semantic picture matching tests over naming tests. Eight participants had a better performance for actions compared to objects in naming, with three showing a significant difference. Nine participants had a better performance for actions compared to objects in semantic picture matching, with six showing a significant difference. For objects, semantic picture matching was better than naming in nine participants, with five showing a significant difference. For actions, semantic picture matching was better than naming in all 10 participants, with nine showing a significant difference. Conclusion The nonverbal processing of actions, as assessed with a semantic picture matching test, is an area of relative strength in svPPA. Clinical implications for assessment planning and interpretation and theoretical implications for current models of semantic cognition are discussed.
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Affiliation(s)
- Noémie Auclair-Ouellet
- Faculty of Medicine, School of Communication Sciences and Disorders, McGill University, Montréal, Québec, Canada
- Centre for Research on Brain, Language and Music, Montréal, Québec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Québec, Canada
| | - Marion Fossard
- Faculté des lettres et sciences humaines, Institut des sciences logopédiques, Université de Neuchâtel, Neuchâtel, Switzerland
| | - Joël Macoir
- Faculté de Médecine, Département de Réadaptation, Université Laval, Quebec City, Québec, Canada
- Centre de Recherche CERVO, Québec City, Québec, Canada
| | - Robert Laforce
- Faculté de Médecine, Département de Médecine, Université Laval, Quebec City, Québec, Canada
- Clinique Interdisciplinaire de Mémoire, Centre Hospitalier Universitaire de Québec, Quebec City, Québec, Canada
- Chaire de recherche sur les aphasies primaires progressives-Fondation de la famille Lemaire, Quebec City, Québec, Canada
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30
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Farina E, Borgnis F, Pozzo T. Mirror neurons and their relationship with neurodegenerative disorders. J Neurosci Res 2020; 98:1070-1094. [DOI: 10.1002/jnr.24579] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Thierry Pozzo
- INSERM UMR1093‐CAPS, Université Bourgogne Franche‐Comté Dijon France
- IT@UniFe Center for Translational Neurophysiology Istituto Italiano di Tecnologia Ferrara Italy
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31
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Weekes BSH. Aphasia in Alzheimer's Disease and Other Dementias (ADOD): Evidence From Chinese. Am J Alzheimers Dis Other Demen 2020; 35:1533317520949708. [PMID: 33040568 PMCID: PMC10624002 DOI: 10.1177/1533317520949708] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Speech and language impairments (aphasia) are typical of patients with Alzheimer's Disease and other dementias (ADOD) and in some pathologies are diagnostic e.g. Primary Progressive Aphasia (PPA). One question concerns the reliability and validity of symptomatology across typologically different languages. A review of aphasia in ADOD across languages suggests a similar pattern of word comprehension, naming and word finding difficulties but also evidence of language specific features in symptomatology e.g. processing of tone in Chinese languages. Given differences in linguistic impairments across languages, it is recommended that screening for aphasia in community and epidemiological studies use a Short ScreeningTest (SST) that can be delivered across dialects and languages in indigenous languages and also multilingual populations.
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Affiliation(s)
- Brendan Stuart Hackett Weekes
- University of Cambridge, United Kingdom
- University of Hong Kong, Hong Kong
- University of Melbourne, Victoria, Australia
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32
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Cotelli M, Manenti R, Ferrari C, Gobbi E, Macis A, Cappa SF. Effectiveness of language training and non-invasive brain stimulation on oral and written naming performance in Primary Progressive Aphasia: A meta-analysis and systematic review. Neurosci Biobehav Rev 2020; 108:498-525. [DOI: 10.1016/j.neubiorev.2019.12.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 10/11/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022]
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Mack JE, Mesulam MM, Rogalski EJ, Thompson CK. Verb-argument integration in primary progressive aphasia: Real-time argument access and selection. Neuropsychologia 2019; 134:107192. [PMID: 31521633 DOI: 10.1016/j.neuropsychologia.2019.107192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Impaired sentence comprehension is observed in the three major subtypes of PPA, with distinct performance patterns relating to impairments in comprehending complex sentences in the agrammatic (PPA-G) and logopenic (PPA-L) variants and word comprehension in the semantic subtype (PPA-S). However, little is known about basic combinatory processes during sentence comprehension in PPA, such the integration of verbs with their subject and object(s) (verb-argument integration). METHODS The present study used visual-world eye-tracking to examine real-time verb-argument integration in individuals with PPA (12 with PPA-G, 10 with PPA-L, and 6 with PPA-S) and neurotypical older adults (15). Two baseline experiments probed eye movement control, using a non-linguistic task, and noun comprehension, respectively. Two verb-argument integration experiments examined the effects of verb meaning on (a) lexical access of the verb's direct object (argument access) and (b) selection of a semantically-appropriate direct object (argument selection), respectively. Eye movement analyses were conducted only for trials with correct behavioral responses, allowing us to distinguish accuracy and online processing. RESULTS The eye movement control experiment revealed no significant impairments in PPA, whereas the noun comprehension experiment revealed reduced accuracy and eye-movement latencies in PPA-S, and to a lesser extent PPA-G. In the argument access experiment, verb meaning facilitated argument access normally in PPA-G and PPA-L; in PPA-S, verb-meaning effects emerged on an atypical time course. In the argument selection experiment, significant impairments in accuracy were observed only in PPA-G, accompanied by markedly atypical eye movement patterns. CONCLUSION This study revealed two distinct patterns of impaired verb-argument integration in PPA. In PPA-S, impaired verb-argument integration was observed in the argument access experiment, indicating impairments in basic semantic combinatory processes which likely relate to damage in ventral language pathways. In contrast, listeners with PPA-G showed marked impairments of argument selection, likely relating to damage to left inferior frontal regions.
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Affiliation(s)
- Jennifer E Mack
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA.
| | - M-Marsel Mesulam
- Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
| | - Emily J Rogalski
- Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, USA
| | - Cynthia K Thompson
- Roxelyn & Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, USA; Mesulam Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA; Ken & Ruth Davee Department of Neurology, Northwestern University, USA
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Fenner AS, Webster KT, Ficek BN, Frangakis CE, Tsapkini K. Written Verb Naming Improves After tDCS Over the Left IFG in Primary Progressive Aphasia. Front Psychol 2019; 10:1396. [PMID: 31249546 PMCID: PMC6582664 DOI: 10.3389/fpsyg.2019.01396] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 05/29/2019] [Indexed: 11/15/2022] Open
Abstract
Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique, is an effective adjunct to naming treatments in post-stroke aphasia and primary progressive aphasia (PPA). Enhanced performance in oral and written naming and spelling of nouns with tDCS has been quantified in detail, but it is not known whether it is effective for verb treatment in PPA. We addressed the question of whether performance in naming and spelling of verbs can be augmented with anodal tDCS over the left inferior frontal gyrus (IFG). We compared tDCS coupled with oral and written verb naming/spelling treatment with oral and written verb naming/spelling treatment alone. In a double-blind, sham-controlled, crossover design, 11 participants with logopenic or non-fluent variant PPA received approximately 15 consecutive sessions of anodal tDCS and sham over the left IFG coupled with oral and written verb-naming + spelling treatment. Written verb-naming performance improved significantly more for trained verbs in the tDCS than the sham condition. Importantly, tDCS effects generalized to untrained items for written verb naming and were significant even at 2 months post-treatment. We conclude that tDCS over the left IFG can improve written verb naming and spelling in PPA.
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Affiliation(s)
- Amberlynn S. Fenner
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Kimberly T. Webster
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, United States
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Bronte N. Ficek
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Constantine E. Frangakis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine, Baltimore, MD, United States
- Department of Radiology, Johns Hopkins Medicine, Baltimore, MD, United States
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, United States
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
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Preferential Disruption of Auditory Word Representations in Primary Progressive Aphasia With the Neuropathology of FTLD-TDP Type A. Cogn Behav Neurol 2019; 32:46-53. [PMID: 30896577 DOI: 10.1097/wnn.0000000000000180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Four patients with primary progressive aphasia displayed a greater deficit in understanding words they heard than words they read, and a further deficiency in naming objects orally rather than in writing. All four had frontotemporal lobar degeneration-transactive response DNA binding protein Type A neuropathology, three determined postmortem and one surmised on the basis of granulin gene (GRN) mutation. These features of language impairment are not characteristic of any currently recognized primary progressive aphasia variant. They can be operationalized as manifestations of dysfunction centered on a putative auditory word-form area located in the superior temporal gyrus of the left hemisphere. The small size of our sample makes the conclusions related to underlying pathology and auditory word-form area dysfunction tentative. Nonetheless, a deeper assessment of such patients may clarify the nature of pathways that link modality-specific word-form information to the associations that mediate their recognition as concepts. From a practical point of view, the identification of these features in patients with primary progressive aphasia should help in the design of therapeutic interventions where written communication modalities are promoted to circumvent some of the oral communication deficits.
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Odolil A, Wright AE, Keator LM, Sheppard SM, Breining B, Tippett DC, Hillis AE. Leukoaraiosis Severity Predicts Rate of Decline in Primary Progressive Aphasia. APHASIOLOGY 2019; 34:365-375. [PMID: 32377026 PMCID: PMC7202552 DOI: 10.1080/02687038.2019.1594152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/07/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND The rate of decline in language in Primary Progressive Aphasia (PPA) is highly variable and difficult to predict at baseline. The severity of diffuse white matter disease (leukoaraiosis), a marker of overall brain health, may substantially influence the rate of decline. AIMS To test the hypothesis that leukoaraiosis is associated with a steeper decline in naming in PPA. METHODS AND PROCEDURES In this longitudinal, observational study, 29 individuals with PPA (all variants) were administered the Boston Naming Test (BNT) at baseline and 1 year later. Two raters evaluated leukoaraiosis on baseline MRI, using the Cardiovascular Health Study scale. We evaluated the effects of leukoaraiosis severity, age, education, and baseline BNT on decline measured by change in BNT accuracy with multivariable linear regression. We also evaluated the effects of these variables on the dichotomized outcome of faster decline in BNT (worst 50%) versus slower decline (best 50%) using logistic regression. RESULTS Together, leukoaraiosis, age, education, and baseline BNT score predicted change in BNT score (F(3, 25) = 8.12; p=0.0006). Change in BNT score was predicted by severity of leukoaraiosis (t =-3.81; p=0.001) and education (t= -2.45; p=0.022), independently of the other variables. When we dichotomized outcome into upper 50th percentile versus lower 50th percentile (faster decline), faster decline was predicted by all variables together (chi squared = 13.91; p = 0.008). However, only leukoaraiosis independently predicted outcome (OR=2.80; 95%CI: 1.11 to 7.03). For every 1 point increase on the CHS rating scale, there was 2.8 times higher chance of showing faster decline in naming. CONCLUSION Severity of leukoaraiosis is associated with steeper decline in naming in PPA. This imaging marker can aide in prognosis and planning by caregivers and stratification of participants in clinical trials.
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Affiliation(s)
- Adam Odolil
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Amy E. Wright
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Lynsey M. Keator
- Department of Neurology, Johns Hopkins University School of Medicine
| | | | - Bonnie Breining
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins University School of Medicine
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine
- Department of Otolaryngology & Head & Neck Surgery, Johns Hopkins University School of Medicine
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine
- Department of Cognitive Science, Johns Hopkins University
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Macoir J, Lafay A, Hudon C. Reduced Lexical Access to Verbs in Individuals With Subjective Cognitive Decline. Am J Alzheimers Dis Other Demen 2019; 34:5-15. [PMID: 30041538 PMCID: PMC10852429 DOI: 10.1177/1533317518790541] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
The detection of cognitive impairment in individuals with subjective cognitive decline (SCD) may improve detection of the emergence of Alzheimer's disease (AD) pathology. This detection is challenging, however, given the lack of sensitive assessment tools. The main objective of this study was to determine the potential contribution of word production tasks to the detection of cognitive impairment in SCD. The performances of 20 individuals with SCD, healthy controls (HCs), and individuals with mild cognitive impairment (MCI) were compared on object and action naming and free fluency tasks. Participants with SCD performed similarly to HCs, while both groups differed significantly from participants with MCI in object naming and object fluency. Results showed that participants with SCD were at the midpoint between HCs and participants with MCI in action naming. They also revealed a HCs > SCD = MCI pattern in action fluency. This study provides evidence that verb production is impaired in SCD and that SCD is a pre-MCI condition.
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Affiliation(s)
- Joël Macoir
- Département de réadaptation, Faculté de médecine, Université Laval, Quebec City, Quebec, Canada
- Centre de recherche CERVO, CERVO Brain Research Center, Quebec City, Quebec, Canada
| | - Anne Lafay
- Département de réadaptation, Faculté de médecine, Université Laval, Quebec City, Quebec, Canada
- Centre de recherche CERVO, CERVO Brain Research Center, Quebec City, Quebec, Canada
| | - Carol Hudon
- Département de réadaptation, Faculté de médecine, Université Laval, Quebec City, Quebec, Canada
- École de psychologie, Université Laval, Quebec City, Quebec, Canada
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Vinceti G, Olney N, Mandelli ML, Spina S, Hubbard HI, Santos-Santos MA, Watson C, Miller ZA, Lomen-Hoerth C, Nichelli P, Miller BL, Grinberg LT, Seeley WW, Gorno-Tempini ML. Primary progressive aphasia and the FTD-MND spectrum disorders: clinical, pathological, and neuroimaging correlates. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:146-158. [PMID: 30668155 DOI: 10.1080/21678421.2018.1556695] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: Behavioral variant frontotemporal dementia (bvFTD), is commonly considered the cognitive presentation of the frontotemporal dementia-motor neuron disease (FTD-MND) spectrum disorder. We evaluated the prevalence of primary progressive aphasia in a series of pathologically confirmed cases of FTD-MND spectrum. Methods: Pathologically confirmed cases of frontotemporal lobar degeneration-motor neuron disease (FTLD-MND) were obtained from the UCSF brain bank. Cases were analyzed for presence of language impairment via retrospective chart review of research visits that include neurologic exam, in-depth cognitive testing and magnetic resonance imaging (MRI) imaging. Forty one cases were included. Thirty two were diagnosed with FTD-MND, while nine cases were diagnosed as MND-only from clinical evaluation. Results: Ten FTLD-MND cases (31%) presented with prominent or isolated language involvement consistent with a diagnosis of primary progressive aphasia (PPA), which we called progressive aphasia with motor neuron disease (PA-MND). Of these, three cases that mirrored the non-fluent variant of PPA (nfvPPA) were named nfvPA-MND. The imaging pattern of these nfvPA-MND showed atrophy strictly confined to the frontal and anterior temporal language cortical areas. Another group of seven cases that resembled patients with the semantic variant PPA (svPPA) were named svPA-MND. The group of svPPA-MND on imaging analysis showed selective atrophy of the temporal lobe and orbitofrontal cortex. Conclusions: Language impairment was a frequent phenotype of FTD-MND associated with focal atrophy patterns within the language networks. This data suggest patients with FTD-MND can present quite often with language phenotype of nfvPPA and svPPA, as opposed to exclusive bvFTD symptoms.
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Affiliation(s)
- Giulia Vinceti
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,b Department of Biomedical, Metabolic and Neural Science , University of Modena and Reggio Emilia , Modena , Italy
| | - Nicholas Olney
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,d UCSF ALS Center , University of California , San Francisco , CA , USA
| | - Maria Luisa Mandelli
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Salvatore Spina
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - H Isabel Hubbard
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,c Department of Communication Sciences and Disorders , University of Texas , Austin , TX, USA
| | - Miguel A Santos-Santos
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Christa Watson
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Zachary A Miller
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | | | - Paolo Nichelli
- b Department of Biomedical, Metabolic and Neural Science , University of Modena and Reggio Emilia , Modena , Italy
| | - Bruce L Miller
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Lea T Grinberg
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,e Department of Pathology , University of California , San Francisco , CA , USA
| | - William W Seeley
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,e Department of Pathology , University of California , San Francisco , CA , USA
| | - Maria Luisa Gorno-Tempini
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
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Riello M, Faria AV, Ficek B, Webster K, Onyike CU, Desmond J, Frangakis C, Tsapkini K. The Role of Language Severity and Education in Explaining Performance on Object and Action Naming in Primary Progressive Aphasia. Front Aging Neurosci 2018; 10:346. [PMID: 30425638 PMCID: PMC6218435 DOI: 10.3389/fnagi.2018.00346] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 10/11/2018] [Indexed: 01/10/2023] Open
Abstract
Despite the common assumption that atrophy in a certain brain area would compromise the function that it subserves, this is not always the case, especially in complex clinical syndromes such as primary progressive aphasia (PPA). Clinical and demographic information may contribute to PPA phenotypes and explain the manifested impairments better than atrophy. In the present study, we asked how much variance of the object and action naming impairments observed in PPA may be attributed to atrophy in the language network alone vs. additional clinical and demographic factors including language severity and education. Thirty-nine participants with PPA underwent magnetic resonance imaging (MRI) for volumetric analysis and a complete neuropsychological examination, including standardized tests of object and action naming. We used stepwise regression models to compare atrophy (volumetric model) to clinical/demographic variables (clinical-demographic model) for naming objects and actions. The clinical-demographic model was the best-fit model that explained the largest amount of variance in both object and action naming. Brain volume measurements alone explained little variance in both object and action naming. Clinical factors, particularly language severity, and demographic factors, particularly education, need to be considered in conjunction with brain volumes in PPA. The present study emphasizes the complexity of PPA as a syndrome and provides an example of how volumetric, clinical and demographic factors may interact in determining naming performance/deterioration.
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Affiliation(s)
- Marianna Riello
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Andreia V Faria
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kimberly Webster
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Otolaryngology, Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - John Desmond
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Constantine Frangakis
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
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Montembeault M, Brambati SM, Gorno-Tempini ML, Migliaccio R. Clinical, Anatomical, and Pathological Features in the Three Variants of Primary Progressive Aphasia: A Review. Front Neurol 2018; 9:692. [PMID: 30186225 PMCID: PMC6110931 DOI: 10.3389/fneur.2018.00692] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022] Open
Abstract
Primary progressive aphasias (PPA) are neurodegenerative diseases clinically characterized by an early and relatively isolated language impairment. Three main clinical variants, namely the nonfluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA) have been described, each with specific linguistic/cognitive deficits, corresponding anatomical and most probable pathological features. Since the discovery and the development of diagnostic criteria for the PPA variants by the experts in the field, significant progress has been made in the understanding of these diseases. This review aims to provide an overview of the literature on each of the PPA variant in terms of their clinical, anatomical and pathological features, with a specific focus on recent findings. In terms of clinical advancements, recent studies have allowed a better characterization and differentiation of PPA patients based on both their linguistic and non-linguistic profiles. In terms of neuroimaging, techniques such as diffusion imaging and resting-state fMRI have allowed a deeper understanding of the impact of PPA on structural and functional connectivity alterations beyond the well-defined pattern of regional gray matter atrophy. Finally, in terms of pathology, despite significant advances, clinico-pathological correspondence in PPA remains far from absolute. Nonetheless, the improved characterization of PPA has the potential to have a positive impact on the management of patients. Improved reliability of diagnoses and the development of reliable in vivo biomarkers for underlying neuropathology will also be increasingly important in the future as trials for etiology-specific treatments become available.
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Affiliation(s)
- Maxime Montembeault
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Simona M Brambati
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, University of California at San Francisco, San Francisco, CA, United States
| | - Raffaella Migliaccio
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Paris, France
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41
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Sebastian R, Thompson CB, Wang NY, Wright A, Meyer A, Friedman RB, Hillis AE, Tippett DC. Patterns of Decline in Naming and Semantic Knowledge in Primary Progressive Aphasia. APHASIOLOGY 2018; 32:1010-1030. [PMID: 30613121 PMCID: PMC6317736 DOI: 10.1080/02687038.2018.1490388] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Individuals with primary progressive aphasia (PPA) and their caregivers want to know what to expect so that they can plan support appropriately. The ability to predict decline in naming and semantic knowledge, and advise individuals with PPA and their caregivers regarding future planning, would be invaluable clinically. AIMS The aims of this study were to investigate patterns of decline in naming and semantic knowledge in each of the clinical variants of PPA (logopenic variant PPA, lvPPA; nonfluent agrammatic PPA, nfaPPA; and semantic variant PPA, svPPA) and to examine the effects of other variables on rate of decline. We hypothesized that speech-language rehabilitation, higher education, and higher baseline test scores would be associated with slower decline, and older age with faster decline. METHODS AND PROCEDURES A total of ninety-four participants with PPA underwent language testing, including thirty six participants with lvPPA, thirty-one participants with nfaPPA, and twenty-seven participants with svPPA. All participant groups were similar in age and education. We focused on decline on three tests: the short form of the Boston Naming Test (BNT), the Hopkins Assessment of Naming Actions (HANA), and the short form of the Pyramids and Palm Trees Test (PPTT). OUTCOME AND RESULTS Across language tests, the most precipitous rates of decline (loss of points per month) occurred in nfaPPA, followed by svPPA, then lvPPA. Female sex, longer symptom duration, higher baseline test score, and speech-language rehabilitation were associated with slower decline. CONCLUSIONS PPA variants were distinguishable by rapidity of decline, with nfaPPA having the most precipitous decline. As hypothesized, higher baseline test scores and speech-language rehabilitation were associated with slower decline. Surprisingly, age and education were not important prognostically for individuals in this study. Further study of prognostically-relevant variables in PPA is indicated in this population.
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Affiliation(s)
- Rajani Sebastian
- Department of Neurology, Johns Hopkins University School of Medicine, Phipps 446, 600 N. Wolfe Street, Baltimore, Maryland 21287 USA; Telephone (410) 614-2381; , , ,
| | - Carol B Thompson
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E-3142, Baltimore, Maryland 21205-2179 USA; Telephone (410) 502-9142;
| | - Nae-Yuh Wang
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E-3142, Baltimore, Maryland 21205-2179 USA; Telephone (410) 502-9142;
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA 21287
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205-2179 USA
- Welch Center for Prevention, Epidemiology & Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Suite 2-500, Baltimore, Maryland 21205-2179 USA; Telephone (410) 614-3994;
| | - Amy Wright
- Department of Neurology, Johns Hopkins University School of Medicine, Phipps 446, 600 N. Wolfe Street, Baltimore, Maryland 21287 USA; Telephone (410) 614-2381; , , ,
| | - Aaron Meyer
- Cognitive Neuropsychology Lab, Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Building D, Suite 207, 4000 Reservoir Road, Washington, DC 20057 USA; Telephone (202) 687-4196; ,
| | - Rhonda B Friedman
- Cognitive Neuropsychology Lab, Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Building D, Suite 207, 4000 Reservoir Road, Washington, DC 20057 USA; Telephone (202) 687-4196; ,
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Phipps 446, 600 N. Wolfe Street, Baltimore, Maryland 21287 USA; Telephone (410) 614-2381; , , ,
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Donna C Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Phipps 446, 600 N. Wolfe Street, Baltimore, Maryland 21287 USA; Telephone (410) 614-2381; , , ,
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Martínez-Cuitiño M, Soriano F, Formoso J, Borovinsky G, Ferrari J, Pontello N, Barreyro JP, Manes F. Procesamiento semántico de conceptos concretos y abstractos en Afasia Progresiva Primaria-variante semántica. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2018. [DOI: 10.5209/rlog.59530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La Afasia Progresiva Primaria-variante semántica (APP-vs) se caracteriza por la afectación progresiva del conocimiento conceptual. Algunas investigaciones han reportado la mayor afectación de los conceptos abstractos en relación con los concretos, es decir, un efecto de concretud. No obstante, otros investigadores dan cuenta de un efecto de concretud inverso, es decir, un mejor desempeño con conceptos abstractos en relación con concretos. En esta investigación se compara el desempeño, por medio en una tarea de juicios de sinonimia, de un grupo de 8 pacientes diagnosticados con APP-vs y un grupo de 20 controles emparejados en edad y nivel educativo. Los resultados dan cuenta de un efecto de concretud, es decir, un mejor desempeño con conceptos concretos tanto con sustantivos como con verbos. Estos hallazgos se alinean con las investigaciones previas en las que se detecta un peor rendimiento de los pacientes con APP-vs con conceptos abstractos. El efecto de concretud encontrado apoyaría la hipótesis de un centro semántico amodal relevante para el procesamiento de conceptos concretos y abstractos. La menor afectación de los conceptos concretos observada podría explicarse por su mayor riqueza semántica.
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Meyer AM, Tippett DC, Turner RS, Friedman RB. Long-Term maintenance of anomia treatment effects in primary progressive aphasia. Neuropsychol Rehabil 2018; 29:1439-1463. [PMID: 29380657 DOI: 10.1080/09602011.2018.1425146] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined the maintenance of anomia treatment effects in primary progressive aphasia (PPA). Following baseline testing, a phonological treatment and an orthographic treatment were administered over the course of six months. The treatment stimuli consisted of nouns that were consistently named correctly at baseline (Prophylaxis items) and/or nouns that were consistently named incorrectly at baseline (Remediation items). Naming accuracy was measured at baseline, and it was measured at 1 month, 8 months, and 15 months post-treatment. The change in naming accuracy from baseline to each post-treatment evaluation was calculated within each treatment condition, and within a matched untrained condition. The change in naming accuracy was then compared between the three conditions. The results of these analyses indicate that phonological and orthographic treatments are both effective in the Prophylaxis and Remediation of anomia in all three variants of PPA. For Prophylaxis items, some of the effects of each treatment can persist for as long as 15 months post-treatment. These long-term treatment effects were more robust in the orthographic treatment condition and for participants with the semantic variant of PPA.
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Affiliation(s)
- Aaron M Meyer
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center , Washington , DC , USA
| | - Donna C Tippett
- Department of Neurology, Johns Hopkins University , Baltimore , MD , USA
| | - R Scott Turner
- Department of Neurology, Georgetown University Medical Center , Washington , DC , USA
| | - Rhonda B Friedman
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center , Washington , DC , USA
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Tippett DC, Thompson CB, Demsky C, Sebastian R, Wright A, Hillis AE. Differentiating between subtypes of primary progressive aphasia and mild cognitive impairment on a modified version of the Frontal Behavioral Inventory. PLoS One 2017; 12:e0183212. [PMID: 28813486 PMCID: PMC5559070 DOI: 10.1371/journal.pone.0183212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 08/01/2017] [Indexed: 11/19/2022] Open
Abstract
Behavioral assessment has been investigated in frontotemporal lobar degeneration and Alzheimer's disease, but has not been explored extensively in subtypes of primary progressive aphasia (PPA). We explored the ability of a modified version of the Frontal Behavioral Inventory (FBI-mod) to discriminate between patients with distinct subtypes of PPA and patients with mild cognitive impairment (MCI). We hypothesized that individuals with nonfluent agrammatic PPA (nfaPPA) would have higher negative behavior scores than other groups and that individuals with semantic variant PPA (svPPA) would have higher disinhibition scores than other groups. Family members and/or caregivers of 120 individuals with PPA and MCI (mean age 69.54+8.75 years; 65 (54%) female; education 16.06±2.68 years; disease duration 46.47±34.26 months) completed the FBI-mod [logopenic PPA (lvPPA) n = 40. nfaPPA n = 29, svPPA n = 27, MCI n = 24]. The groups were not significantly different in age, gender, education, or disease duration. There were no significant differences between the groups for negative behaviors (p = 0.72) and disinhibition scores (p = 0.14). When comparing negative and disinhibition scores (in percent), negative scores were significantly higher in all groups (p < 0.001). When comparing subtest items, there was a pairwise difference between lvPPA and svPPA for restlessness (lvPPA < svPPA, p = 0.02, after adjusting for multiple between-group comparisons). There was a significant difference in the proportion of severe neglect between the groups with lvPPA having a lower proportion than the other two variants (p = 0.05), and there was a significant difference in the proportion of severe poor judgment between the groups with lvPPA also having a lower proportion than nfaPPA (p = 0.04). This study reveals the greater negative behavioral disturbance than disinhibition in the PPA and MCI groups of similar age and duration since onset and identifies different profiles for some specific behaviors for the PPA groups. These findings may have clinical and practical implications.
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Affiliation(s)
- Donna C. Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
| | - Carol B. Thompson
- Johns Hopkins Biostatistics Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Cornelia Demsky
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Rajani Sebastian
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Amy Wright
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, Maryland, United States of America
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Silveri MC, Traficante D, Lo Monaco MR, Iori L, Sarchioni F, Burani C. Word selection processing in Parkinson's disease: When nouns are more difficult than verbs. Cortex 2017; 100:8-20. [PMID: 28669510 DOI: 10.1016/j.cortex.2017.05.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 03/21/2017] [Accepted: 05/28/2017] [Indexed: 10/19/2022]
Abstract
Patients with Parkinson's disease (PD) are impaired in verb production. Interpretations range from grammatical deficits to semantic-conceptual decay of action representation. The verb production deficit in PD can also be considered a dysexecutive disorder, specifically, a deficit of selection processing during word production, due to corticostriatal damage. Producing verbs is "more difficult" than producing nouns, because verb-forms must be selected from a large set of word-forms which share the verb-root, and the set of possible verb-forms is larger than the set of possible noun-forms when a noun has to be produced. However, if we devise a condition in which a noun must be selected from a set of alternatives larger than the set of alternative forms from which a verb must be selected, we expect an opposite pattern, with nouns becoming more difficult than verbs. We used morphological tasks varying in the number of alternative responses during word production. Fourteen PD patients and 14 healthy Controls participated in the study. Participants performed a noun-from-verb ('observation' from 'to observe') and a noun-from adjective derivation task ('kindness' from 'kind'), and a verb-from-noun ('to observe' from 'observation') and an adjective-from-noun generation task ('kind' from 'kindness'). Input-stimuli were presented singularly on a screen and participants produced the response as fast as possible. Response latencies were longer in derivation tasks (several alternative responses) than in generation tasks (one possible response), irrespective of the grammatical class of the target word, with no difference between groups. PD patients were significantly less accurate than Controls only in the noun-from-verb derivation task, that is, in the task with the highest number of alternative responses (PD: 60%; Controls: 81%). Results suggest that the verb production disorder in PD patients may reflect disturbed selection processes among competitors: the higher the number of alternative responses the more severe the impairment.
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Affiliation(s)
- Maria C Silveri
- Catholic University, Department of Psychology, Milan, Italy.
| | - Daniela Traficante
- Catholic University, Department of Psychology, Milan, Italy; NeuroMi, Milan Center for Neuroscience, Italy
| | - Maria R Lo Monaco
- Catholic University, Centre for the Medicine of the Ageing, Rome, Italy
| | - Laura Iori
- Catholic University, Centre for the Medicine of the Ageing, Rome, Italy
| | | | - Cristina Burani
- National Research Council, Institute of Cognitive Sciences and Technologies, Rome, Italy; University of Trieste, Department of Life Sciences, Italy
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Marcotte K, Graham NL, Fraser KC, Meltzer JA, Tang-Wai DF, Chow TW, Freedman M, Leonard C, Black SE, Rochon E. White Matter Disruption and Connected Speech in Non-Fluent and Semantic Variants of Primary Progressive Aphasia. Dement Geriatr Cogn Dis Extra 2017; 7:52-73. [PMID: 28611820 PMCID: PMC5465709 DOI: 10.1159/000456710] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/06/2017] [Indexed: 02/04/2023] Open
Abstract
Differential patterns of white matter disruption have recently been reported in the non-fluent (nfvPPA) and semantic (svPPA) variants of primary progressive aphasia (PPA). No single measure is sufficient to distinguish between the PPA variants, but connected speech allows for the quantification of multiple measures. The aim of the present study was to further investigate the white matter correlates associated with connected speech features in PPA. We examined the relationship between white matter metrics and connected speech deficits using an automated analysis of transcriptions of connected speech and diffusion tensor imaging in language-related tracts. Syntactic, lexical, and semantic features were automatically extracted from transcriptions of topic-directed interviews conducted with groups of individuals with nfvPPA or svPPA as well as with a group of healthy controls. A principal component analysis was performed in order to reduce the number of language measures and yielded a five-factor solution. The results indicated that nfvPPA patients differed from healthy controls on a syntactic factor, and svPPA patients differed from controls on two semantic factors. However, the patient groups did not differ on any factor. Moreover, a correlational analysis revealed that the lexical richness factor was significantly correlated with radial diffusivity in the left inferior longitudinal fasciculus, which suggests that semantic deficits in connected speech reflect a disruption of this ventral pathway, and which is largely consistent with the results of previous studies. Using an automated approach for the analysis of connected speech combined with probabilistic tractography, the present findings demonstrate that nfvPPA patients are impaired relative to healthy controls on syntactic measures and have increased radial diffusivity in the left superior longitudinal fasciculus, whereas the svPPA group was impaired on lexico-semantic measures relative to controls and showed increased radial diffusivity in the uncinate and inferior longitudinal fasciculus bilaterally.
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Affiliation(s)
- Karine Marcotte
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,bÉcole d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada.,cCentre de recherche de l'Hôpital du Sacré-Cœur de Montréal, Montreal, Québec, Canada
| | - Naida L Graham
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kathleen C Fraser
- eDepartment of Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Jed A Meltzer
- dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,gDepartment of Psychology, University of Toronto, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada
| | - David F Tang-Wai
- iDepartment of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,jUniversity Health Network Memory Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Tiffany W Chow
- fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,iDepartment of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,kDepartment of Clinical Neurology, University of Southern California, Los Angeles, California, USA
| | - Morris Freedman
- fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,lDepartment of Medicine, Division of Neurology, Baycrest Health Sciences, University of Toronto, and Mt. Sinai Hospital, Toronto, Ontario, Canada.,mSam and Ida Ross Memory Clinic, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Carol Leonard
- dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada.,nSchool of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sandra E Black
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada.,iDepartment of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,oInstitute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,pL.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,qBrain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Elizabeth Rochon
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada.,rRehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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Teichmann M, Lesoil C, Godard J, Vernet M, Bertrand A, Levy R, Dubois B, Lemoine L, Truong DQ, Bikson M, Kas A, Valero-Cabré A. Direct current stimulation over the anterior temporal areas boosts semantic processing in primary progressive aphasia. Ann Neurol 2016; 80:693-707. [PMID: 27553723 DOI: 10.1002/ana.24766] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 08/19/2016] [Accepted: 08/19/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Noninvasive brain stimulation in primary progressive aphasia (PPA) is a promising approach. Yet, applied to single cases or insufficiently controlled small-cohort studies, it has not clarified its therapeutic value. We here address the effectiveness of transcranial direct current stimulation (tDCS) on the semantic PPA variant (sv-PPA), applying a rigorous study design to a large, homogeneous sv-PPA cohort. METHODS Using a double-blind, sham-controlled counterbalanced cross-over design, we applied three tDCS conditions targeting the temporal poles of 12 sv-PPA patients. Efficiency was assessed by a semantic matching task orthogonally manipulating "living"/"nonliving" categories and verbal/visual modalities. Conforming to predominantly left-lateralized damage in sv-PPA and accounts of interhemispheric inhibition, we applied left hemisphere anodal-excitatory and right hemisphere cathodal-inhibitory tDCS, compared to sham stimulation. RESULTS Prestimulation data, compared to 15 healthy controls, showed that patients had semantic disorders predominating with living categories in the verbal modality. Stimulation selectively impacted these most impaired domains: Left-excitatory and right-inhibitory tDCS improved semantic accuracy in verbal modality, and right-inhibitory tDCS improved processing speed with living categories and accuracy and processing speed in the combined verbal × living condition. INTERPRETATION Our findings demonstrate the efficiency of tDCS in sv-PPA by generating highly specific intrasemantic effects. They provide "proof of concept" for future applications of tDCS in therapeutic multiday regimes, potentially driving sustained improvement of semantic processing. Our data also support the hotly debated existence of a left temporal-pole network for verbal semantics selectively modulated through both left-excitatory and right-inhibitory brain stimulation. Ann Neurol 2016;80:693-707.
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Affiliation(s)
- Marc Teichmann
- Department of Neurology, National Reference Center for "PPA and rare dementias", Pitié Salpêtrière Hospital, AP-HP, Paris, France.,Brain & Spine Institute, ICM-UMR INSERM-CNRS-UPMC 1127, Frontlab team, Paris, France
| | - Constance Lesoil
- Department of Neurology, National Reference Center for "PPA and rare dementias", Pitié Salpêtrière Hospital, AP-HP, Paris, France.,Brain & Spine Institute, ICM-UMR INSERM-CNRS-UPMC 1127, Frontlab team, Paris, France
| | - Juliette Godard
- Brain & Spine Institute, ICM-UMR INSERM-CNRS-UPMC 1127, Frontlab team, Paris, France.,Brain & Spine Institute, UMR INSERM-CNRS-UPMC 1127, Team of Cerebral Dynamics Plasticity & Rehabilitation, Paris, France.,Laboratory for Cerebral Dynamics Plasticity & Rehabilitation, Boston University School of Medicine, Boston, MA
| | - Marine Vernet
- Brain & Spine Institute, ICM-UMR INSERM-CNRS-UPMC 1127, Frontlab team, Paris, France.,Brain & Spine Institute, UMR INSERM-CNRS-UPMC 1127, Team of Cerebral Dynamics Plasticity & Rehabilitation, Paris, France
| | - Anne Bertrand
- Department of diagnostic and functional neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Richard Levy
- Brain & Spine Institute, ICM-UMR INSERM-CNRS-UPMC 1127, Frontlab team, Paris, France.,Department of Neurology, Saint Antoine Hospital, AP-HP, Paris, France
| | - Bruno Dubois
- Department of Neurology, National Reference Center for "PPA and rare dementias", Pitié Salpêtrière Hospital, AP-HP, Paris, France.,Brain & Spine Institute, ICM-UMR INSERM-CNRS-UPMC 1127, Frontlab team, Paris, France
| | - Laurie Lemoine
- Department of Neurology, Henri Mondor Hospital, AP-HP & Mondor Institute of biomedical research, INSERM U955 - Team 1, Créteil, France
| | - Dennis Q Truong
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of New York, City University of New York, New York, NY
| | - Marom Bikson
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of New York, City University of New York, New York, NY
| | - Aurélie Kas
- Nuclear Medicine Department, Pitié-Salpêtrière Hospital, AP-HP & Pierre et Marie Curie University, LIB-INSERM UMR 678, Paris, France
| | - Antoni Valero-Cabré
- Brain & Spine Institute, ICM-UMR INSERM-CNRS-UPMC 1127, Frontlab team, Paris, France.,Brain & Spine Institute, UMR INSERM-CNRS-UPMC 1127, Team of Cerebral Dynamics Plasticity & Rehabilitation, Paris, France.,Laboratory for Cerebral Dynamics Plasticity & Rehabilitation, Boston University School of Medicine, Boston, MA.,Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia (UOC), Barcelona, Spain
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Vannuscorps G, Dricot L, Pillon A. Persistent sparing of action conceptual processing in spite of increasing disorders of action production: A case against motor embodiment of action concepts. Cogn Neuropsychol 2016; 33:191-219. [PMID: 27414396 DOI: 10.1080/02643294.2016.1186615] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this study, we addressed the issue of whether the brain sensorimotor circuitry that controls action production is causally involved in representing and processing action-related concepts. We examined the three-year pattern of evolution of brain atrophy, action production disorders, and action-related concept processing in a patient (J.R.) diagnosed with corticobasal degeneration. During the period of investigation, J.R. presented with increasing action production disorders resulting from increasing bilateral atrophy in cortical and subcortical regions involved in the sensorimotor control of actions (notably, the superior parietal cortex, the primary motor and premotor cortex, the inferior frontal gyrus, and the basal ganglia). In contrast, the patient's performance in processing action-related concepts remained intact during the same period. This finding indicated that action concept processing hinges on cognitive and neural resources that are mostly distinct from those underlying the sensorimotor control of actions.
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Affiliation(s)
- Gilles Vannuscorps
- a Institute of Psychological Sciences , Université catholique de Louvain , Louvain-la-Neuve , Belgium.,b Institute of Neuroscience , Université catholique de Louvain , Bruxelles , Belgium.,c Fonds de la Recherche Scientifique-FNRS , Bruxelles , Belgium
| | - Laurence Dricot
- b Institute of Neuroscience , Université catholique de Louvain , Bruxelles , Belgium
| | - Agnesa Pillon
- a Institute of Psychological Sciences , Université catholique de Louvain , Louvain-la-Neuve , Belgium.,b Institute of Neuroscience , Université catholique de Louvain , Bruxelles , Belgium.,c Fonds de la Recherche Scientifique-FNRS , Bruxelles , Belgium
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Grey Matter Density Predicts the Improvement of Naming Abilities After tDCS Intervention in Agrammatic Variant of Primary Progressive Aphasia. Brain Topogr 2016; 29:738-51. [DOI: 10.1007/s10548-016-0494-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 05/07/2016] [Indexed: 12/22/2022]
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50
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Migliaccio R, Boutet C, Valabregue R, Ferrieux S, Nogues M, Lehéricy S, Dormont D, Levy R, Dubois B, Teichmann M. The Brain Network of Naming: A Lesson from Primary Progressive Aphasia. PLoS One 2016; 11:e0148707. [PMID: 26901052 PMCID: PMC4764674 DOI: 10.1371/journal.pone.0148707] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/20/2016] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Word finding depends on the processing of semantic and lexical information, and it involves an intermediate level for mapping semantic-to-lexical information which also subserves lexical-to-semantic mapping during word comprehension. However, the brain regions implementing these components are still controversial and have not been clarified via a comprehensive lesion model encompassing the whole range of language-related cortices. Primary progressive aphasia (PPA), for which anomia is thought to be the most common sign, provides such a model, but the exploration of cortical areas impacting naming in its three main variants and the underlying processing mechanisms is still lacking. METHODS We addressed this double issue, related to language structure and PPA, with thirty patients (11 semantic, 12 logopenic, 7 agrammatic variant) using a picture-naming task and voxel-based morphometry for anatomo-functional correlation. First, we analyzed correlations for each of the three variants to identify the regions impacting naming in PPA and to disentangle the core regions of word finding. We then combined the three variants and correlation analyses for naming (semantic-to-lexical mapping) and single-word comprehension (lexical-to-semantic mapping), predicting an overlap zone corresponding to a bidirectional lexical-semantic hub. RESULTS AND CONCLUSIONS Our results showed that superior portions of the left temporal pole and left posterior temporal cortices impact semantic and lexical naming mechanisms in semantic and logopenic PPA, respectively. In agrammatic PPA naming deficits were rare, and did not correlate with any cortical region. Combined analyses revealed a cortical overlap zone in superior/middle mid-temporal cortices, distinct from the two former regions, impacting bidirectional binding of lexical and semantic information. Altogether, our findings indicate that lexical/semantic word processing depends on an anterior-posterior axis within lateral-temporal cortices, including an anatomically intermediate hub dedicated to lexical-semantic integration. Within this axis our data reveal the underpinnings of anomia in the PPA variants, which is of relevance for both diagnosis and future therapy strategies.
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Affiliation(s)
- Raffaella Migliaccio
- Institut du Cerveau et de la Moelle Epinière, UMR INSERM-CNRS-UPMC 1127, Frontlab, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Claire Boutet
- Institut du Cerveau et de la Moelle Epinière, UMR INSERM-CNRS-UPMC 1127, Frontlab, Paris, France
- Centre de Neuro-imagerie de Recherche (CENIR), Institut du Cerveau et de la Moëlle Epinière, Paris, France
| | - Romain Valabregue
- Institut du Cerveau et de la Moelle Epinière, UMR INSERM-CNRS-UPMC 1127, Frontlab, Paris, France
- Centre de Neuro-imagerie de Recherche (CENIR), Institut du Cerveau et de la Moëlle Epinière, Paris, France
| | - Sophie Ferrieux
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Marie Nogues
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Stéphane Lehéricy
- Institut du Cerveau et de la Moelle Epinière, UMR INSERM-CNRS-UPMC 1127, Frontlab, Paris, France
- Centre de Neuro-imagerie de Recherche (CENIR), Institut du Cerveau et de la Moëlle Epinière, Paris, France
| | - Didier Dormont
- Université Pierre et Marie Curie, INSERM, UMR-S 678, Paris, France
- Service de Neuroradiologie Diagnostique et Fonctionnelle, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | - Richard Levy
- Institut du Cerveau et de la Moelle Epinière, UMR INSERM-CNRS-UPMC 1127, Frontlab, Paris, France
- Department of Neurology, Hôpital Saint Antoine, AP-HP, Paris, France
| | - Bruno Dubois
- Institut du Cerveau et de la Moelle Epinière, UMR INSERM-CNRS-UPMC 1127, Frontlab, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Marc Teichmann
- Institut du Cerveau et de la Moelle Epinière, UMR INSERM-CNRS-UPMC 1127, Frontlab, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
- * E-mail:
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