Sentence processing strategies in healthy seniors with poor comprehension: an fMRI study

Hemispheric dissociations in regions supporting auditory sentence comprehension in older adults

We investigated how the aging brain copes with acoustic and syntactic challenges during spoken language comprehension. Thirty-eight healthy adults aged 54 - 80 years (M = 66 years) participated in an fMRI experiment wherein listeners indicated the gender of an agent in short spoken sentences that varied in syntactic complexity (object-relative vs subject-relative center-embedded clause structures) and acoustic richness (high vs low spectral detail, but all intelligible). We found widespread activity throughout a bilateral frontotemporal network during successful sentence comprehension. Consistent with prior reports, bilateral inferior frontal gyrus and left posterior superior temporal gyrus were more active in response to object-relative sentences than to subject-relative sentences. Moreover, several regions were significantly correlated with individual differences in task performance: Activity in right frontoparietal cortex and left cerebellum (Crus I & II) showed a negative correlation with overall comprehension. By contrast, left frontotemporal areas and right cerebellum (Lobule VII) showed a negative correlation with accuracy specifically for syntactically complex sentences. In addition, laterality analyses confirmed a lack of hemispheric lateralization in activity evoked by sentence stimuli in older adults. Importantly, we found different hemispheric roles, with a left-lateralized core language network supporting syntactic operations, and right-hemisphere regions coming into play to aid in general cognitive demands during spoken sentence processing. Together our findings support the view that high levels of language comprehension in older adults are maintained by a close interplay between a core left hemisphere language network and additional neural resources in the contralateral hemisphere.

Prefrontal cortex alterations in major depressive disorder, generalized anxiety disorder and their comorbidity during a verbal fluency task assessed by multi-channel near-infrared spectroscopy

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are frequently comorbid with each other, and both associated with substantial cognitive impairments; however, it is still unclear whether their impairments are neurobiologically similar or distinct. This study aims to investigate the cognitive functions of the prefrontal cortex (PFC) in patients with MDD and GAD during the verbal fluency task (VFT) using functional near-infrared spectroscopy (fNIRS). Fifty-two patients with MDD, fifty-one patients with GAD, fifty-two patients with the comorbidity of MDD and GAD (CMG), and forty-seven healthy controls (HC) participated in the study. Significant hypoactivation in the left ventrolateral and the left dorsolateral PFC was common in all patient groups when compared to HCs, suggesting a shared etiology. Furthermore,  MDD patients showed significant hypoactivation at the right frontal pole cortex (FPoC) when compared to HCs and significant hypoactivation at the middle FPoC when compared to the CMG patients. Our work is the first fNIRS study to reveal the shared and unique neurobiological profiles of MDD, GAD and their comorbidity under the same standard experimentation condition, suggesting fNIRS holds promise as an adjutant to assist clinical diagnosis.

Linking the association between circRNAs and Alzheimer's disease progression by multi-tissue circular RNA characterization

Alzheimer's disease (AD) has devastating consequences for patients during its slow, progressive course. It is important to understand the pathology of AD onset. Recently, circular RNAs (circRNAs) have been found to participate in many human diseases including cancers and neurodegenerative conditions. In this study, we mined the published dataset on the AMP-AD Knowledge Portal from the Mount Sinai Brain Bank (MSBB) to describe the circRNA profiles at different AD stages in brain samples from four brain regions: anterior prefrontal cortex, superior temporal lobe, parahippocampal gyrus and inferior frontal gyrus. In total, we found 147 circRNAs to be differentially expressed (DE) for different AD severity levels in the four regions. We also characterized the mRNA-circRNA co-expression network and annotated the potential function of circRNAs based on the co-expressed modules. Based on our results, we found that the most circRNA-regulated region in AD patients with severe symptoms was the parahippocampal gyrus. The strongest negatively AD severity-correlated module in the parahippocampal gyrus was enriched in cognitive disability and pathological-associated pathways such as synapse organization and regulation of membrane potential. Finally, a regression model based on the expression pattern of DE circRNAs in the module could help to distinguish the disease severity of patients, further supporting a role for circRNAs in AD pathology. In conclusion, our findings indicate that circRNAs in parahippocampal gyrus are possible biomarkers and regulators of AD as well as potential therapeutic targets.

The association between prenatal endocrine-disrupting chemical exposure and altered resting-state brain fMRI in teenagers

Many studies have reported that prenatal exposure to endocrine-disrupting chemicals (EDCs) can cause adverse behavioral effects or cognitive dysfunction in children. This study aimed to investigate a relationship of the concentration of prenatal EDCs and brain function in teenagers. We recruited 59 mother-child pairs during the third trimester of pregnancy, and collected and examined the concentration of EDCs, such as heavy metals, phthalates and perfluoroalkyl substances (PFASs), in maternal urine and serum. Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected in teenagers 13-16 years of age, and fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) were performed to find the association between maternal EDC concentrations and the functional development of the teenage brain. We found a correlation between MBP concentration and activity in the superior frontal gyrus, middle frontal gyrus, middle temporal gyrus and inferior temporal gyrus in the combined group of boys and girls. We also observed a correlation between MBzP concentration and activity in the anterior cingulum gyrus and insula in girls. We found a correlation between lead concentration and activity in the cuneus in the combined group. We also observed a correlation between MeHg concentration and activity in the superior temporal gyrus, caudate nucleus and putamen in the combined group. The PFOS results revealed a negative relationship between activity in the right putamen in boys, girls and the combined group after phthalate or heavy metals were applied as covariates. The PFNA results showed a negative correlation between activity in the left/right putamen and left caudate nucleus in boys, girls and the combined group after phthalate, heavy metals or PFOS were applied as covariates. We examined the correlations between maternal EDC concentrations and brain development and found that the associations with resting-state teenage brains in some circumstances are sex-related.

Brain Metabolism but Not Gray Matter Volume Underlies the Presence of Language Function in the Minimally Conscious State (MCS): MCS+ Versus MCS- Neuroimaging Differences

Background. The minimally conscious state (MCS) is subcategorized into MCS- and MCS+, depending on the absence or presence, respectively, of high-level behavioral responses such as command-following. Objective. We aim to investigate the functional and structural neuroanatomy underlying the presence of these responses in MCS- and MCS+ patients. Methods. In this cross-sectional retrospective study, chronic MCS patients were diagnosed using repeated Coma Recovery Scale-Revised assessments. Fluorodeoxyglucose-positron emission tomography data were acquired on 57 patients (16 MCS-; 41 MCS+) and magnetic resonance imaging with voxel-based morphometry analysis was performed on 66 patients (17 MCS-; 49 MCS+). Brain glucose metabolism and gray matter integrity were compared between patient groups and control groups. A metabolic functional connectivity analysis testing the hypothesis of preserved language network in MCS+ compared with MCS- was also done. Results. Patients in MCS+ presented higher metabolism mainly in the left middle temporal cortex, known to be important for semantic processing, compared with the MCS- group. The left angular gyrus was also functionally disconnected from the left prefrontal cortex in MCS- compared with MCS+ group. No significant differences were found in gray matter volume between patient groups. Conclusions. The clinical subcategorization of MCS is supported by differences in brain metabolism but not in gray matter structure, suggesting that brain function in the language network is the main support for recovery of command-following, intelligible verbalization and/or intentional communication in the MCS. Better characterizing the neural correlates of residual cognitive abilities of MCS patients contributes to reduce their misdiagnosis and to adapt therapeutic approaches.

As Time Goes by: A rTMS Study on Age-Related Changes in Sentence Comprehension

It is well established that off-line sentence judgment tasks (oSJTs) typically rely on phonological working memory (WM), beyond specific linguistic processing. Nevertheless, empirical findings suggest that a juvenile level of performance in an oSJT could be associated with the recruitment of age-specific additional supportive neural network in healthy aging. In particular, in one of our previous study, healthy elderlies showed the additional activation of associative visual cortices when compared with young controls. We suggested that age-related hyperactivations, during an auditory sentence judgment task, might represent the neurofunctional correlate of the recruitment of compensatory strategies that are necessary to maintain a juvenile level of performance. To explicitly test this hypothesis we adopted repetitive transcranial magnetic stimulation (rTMS). Twelve healthy elderlies and 12 young participants were engaged in an off-line semantic plausibility judgment task while rTMS was delivered over: (1) the left inferior frontal gyrus (LIFG; i.e., a core region of the WM network); (2) the precuneus; and (3) a Control Site (vertex). Results showed a significant main effect of Stimulation Site and a significant Group-by-Stimulation Site interaction effect. In particular, the rTMS stimulation of the LIFG slowed down reaction times (RTs) both in young and healthy elderly participants, while only healthy elderlies showed an increment of RTs during the stimulation of the precuneus. Taken together our results further support the idea that the maintenance of a juvenile level of performance in graceful aging may be associated with task-specific compensatory processes that would manifest them-selves, from the neurofunctional point of view, by the recruitment of additional neural supportive regions.

Reduced Syntactic Processing Efficiency in Older Adults During Sentence Comprehension

Researchers have frequently reported an age-related decline in semantic processing during sentence comprehension. However, it remains unclear whether syntactic processing also declines or whether it remains constant as people age. In the present study, 26 younger adults and 20 older adults were recruited and matched in terms of working memory, general intelligence, verbal intelligence and fluency. They were then asked to make semantic acceptability judgments while completing a Chinese sentence reading task. The behavioral results revealed that the older adults had significantly lower accuracy on measures of semantic and syntactic processing compared to younger adults. Event-related potential (ERP) results showed that during semantic processing, older adults had a significantly reduced amplitude and delayed peak latency of the N400 compared to the younger adults. During syntactic processing, older adults also showed delayed peak latency of the P600 relative to younger adults. Moreover, while P600 amplitude was comparable between the two age groups, larger P600 amplitude was associated with worse performance only in the older adults. Together, the behavioral and ERP data suggest that there is an age-related decline in both semantic and syntactic processing, with a trend toward lower efficiency in syntactic ability.

Age-related reduction of adaptive brain response during semantic integration is associated with gray matter reduction

While aging is associated with increased knowledge, it is also associated with decreased semantic integration. To investigate brain activation changes during semantic integration, a sample of forty-eight 25–75 year-old adults read sentences with high cloze (HC) and low cloze (LC) probability while functional magnetic resonance imaging was conducted. Significant age-related reduction of cloze effect (LC vs. HC) was found in several regions, especially the left middle frontal gyrus (MFG) and right inferior frontal gyrus (IFG), which play an important role in semantic integration. Moreover, when accounting for global gray matter volume reduction, the age-cloze correlation in the left MFG and right IFG was absent. The results suggest that brain structural atrophy may disrupt brain response in aging brains, which then show less brain engagement in semantic integration.

The influences and neural correlates of past and present during gambling in humans

During financial decision-making tasks, humans often make "rational" decisions, where they maximize expected reward. However, this rationality may compete with a bias that reflects past outcomes. That is, if one just lost money or won money, this may impact future decisions. It is unclear how past outcomes influence future decisions in humans, and how neural circuits encode present and past information. In this study, six human subjects performed a financial decision-making task while we recorded local field potentials from multiple brain structures. We constructed a model for each subject characterizing bets on each trial as a function of present and past information. The models suggest that some patients are more influenced by previous trial outcomes (i.e., previous return and risk) than others who stick to more fixed decision strategies. In addition, past return and present risk modulated with the activity in the cuneus; while present return and past risk modulated with the activity in the superior temporal gyrus and the angular gyrus, respectively. Our findings suggest that these structures play a role in decision-making beyond their classical functions by incorporating predictions and risks in humans' decision strategy, and provide new insight into how humans link their internal biases to decisions.

Language Impairment in Adolescents With Sydenham Chorea

BACKGROUND

Neuropsychiatric comorbidities are frequent in Sydenham chorea. However, cognitive impairment in Sydenham chorea has not been sufficiently described. The objective of this study was to evaluate expressive and receptive language deficits in adolescents with Sydenham chorea.

METHODS

Twenty patients with Sydenham chorea were compared with 20 patients with rheumatic fever without chorea and 20 healthy controls. Participants were matched for age and gender. Participants were assessed with verbal fluency tasks (phonemic and semantic) and with verbal comprehension tasks (Token Test). Patients with Sydenham chorea were also assessed with the Universidade Federal de Minas Gerais Sydenham Chorea Rating Scale.

RESULTS

Performance in verbal fluency and in verbal comprehension tasks differed significantly (P < 0.01) among the three groups. Patients with Sydenham chorea performed significantly worse than healthy control group in phonemic and semantic verbal fluency tasks as well as in the Token Test. The group with rheumatic fever also performed worse than healthy controls in phonemic verbal fluency. Severity of motor signs in Sydenham chorea inversely correlated with performance in phonemic verbal fluency (words beginning with letter S, and total sum of words beginning with letters F, A, and S).

CONCLUSIONS

Adolescents with Sydenham chorea show difficulties in verbal fluency and in verbal comprehension. Patients with rheumatic fever also have some degree of language impairment. Future studies must investigate language impairment in difference stages of Sydenham chorea (acute, persistent, and remission) and putative biological markers.

What is Normal Cognitive Aging? Evidence from Task-Based Functional Neuroimaging

The idea that our cognitive abilities change with age has support from empirical research as well as from anecdotal reports. Cognition has many component processes, some of which are impaired by normal aging like attention and memory as a result of changes in perceptual systems or speed of processing. Other cognitive domains improve in functioning as aging continues such as wisdom and some kinds of decision making. Many years of research in the psychology of cognitive aging has described patterns of age-related changes in cognitive processes with older adults performing worse than younger adults on tests of attention, working memory and episodic memory and better on tests of general knowledge. More recent work in task-related functional neuroimaging has further elucidated the effects of aging on brain circuitry related to these cognitive processes. Generally, studies show that older adults activate regions of the frontal cortex more than younger adults while younger adults activate more posterior cortical areas. This paper describes normal patterns of cognitive change in healthy aging, describes how some of these processes can be explored with functional neuroimaging, and briefly describes the work attempting to describe differences between normal and pathological cognitive aging.

Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome

The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.

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Decrease in divided attention was related to fatigue in childhood and adolescence.

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Left frontal cortex of healthy students activated in verbal divided attention task

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Right MFG and ACG were additionally activated in CCFS patients.

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CCFS is characterized as an energy-inefficient process in frontal cortex.

Broca's area network in language function: a pooling-data connectivity study

Background and Objective: Modern neuroimaging developments have demonstrated that cognitive functions correlate with brain networks rather than specific areas. The purpose of this paper was to analyze the connectivity of Broca’s area based on language tasks.

Methods: A connectivity modeling study was performed by pooling data of Broca’s activation in language tasks. Fifty-seven papers that included 883 subjects in 84 experiments were analyzed. Analysis of Likelihood Estimates of pooled data was utilized to generate the map; thresholds at p < 0.01 were corrected for multiple comparisons and false discovery rate. Resulting images were co-registered into MNI standard space.

Results: A network consisting of 16 clusters of activation was obtained. Main clusters were located in the frontal operculum, left posterior temporal region, supplementary motor area, and the parietal lobe. Less common clusters were seen in the sub-cortical structures including the left thalamus, left putamen, secondary visual areas, and the right cerebellum.

Conclusion: Broca’s area-44-related networks involved in language processing were demonstrated utilizing a pooling-data connectivity study. Significance, interpretation, and limitations of the results are discussed.

The implications of age-related neurofunctional compensatory mechanisms in executive function and language processing including the new Temporal Hypothesis for Compensation

As the passage of time structurally alters one’s brain, cognition does not have to suffer the same faith, at least not to the same extent. Indeed, the existence of age-related compensatory mechanisms allow for some cognitive preservation. This paper attempts to coherently review the existing concepts of neurofunctional compensation when applied to two different cognitive domains, namely executive function and language processing. More precisely, we explore the Cognitive reserve (CR) model in healthy aging as well as its two underlying mechanisms: neural reserve and neural compensation. Furthermore, we review the Compensation-Related Utilization of Neural Circuits Hypothesis as well as the Growing Of Life Differences Explains Normal Aging model. Finally, we propose, based on some functional neuroimaging studies, the existence of another compensatory mechanism characterized by age-related delayed cerebral activation allowing for cognitive performance to be preserved at the expense of speed processing: the Temporal Hypothesis for Compensation.

Neurodevelopment for syntactic processing distinguishes childhood stuttering recovery versus persistence

BACKGROUND

Characterized by the presence of involuntary speech disfluencies, developmental stuttering is a neurodevelopmental disorder of atypical speech-motor coordination. Although the etiology of stuttering is multifactorial, language development during early childhood may influence both the onset of the disorder and the likelihood of recovery. The purpose of this study was to determine whether differences in neural indices mediating language processing are associated with persistence or recovery in school-age children who stutter.

METHODS

Event-related brain potentials (ERPs) were obtained from 31 6-7-year-olds, including nine children who do not stutter (CWNS), 11 children who had recovered from stuttering (CWS-Rec), and 11 children who persisted in stuttering (CWS-Per), matched for age, and all with similar socioeconomic status, nonverbal intelligence, and language ability. We examined ERPs elicited by semantic and syntactic (phrase structure) violations within an auditory narrative consisting of English and Jabberwocky sentences. In Jabberwocky sentences, content words were replaced with pseudowords to limit semantic context. A mixed effects repeated measures analysis of variance (ANOVA) was computed for ERP components with four within-subject factors, including condition, hemisphere, anterior/posterior distribution, and laterality.

RESULTS

During the comprehension of English sentences, ERP activity mediating semantic and syntactic (phrase structure) processing did not distinguish CWS-Per, CWS-Rec, and CWNS. Semantic violations elicited a qualitatively similar N400 component across groups. Phrase structure violations within English sentences also elicited a similar P600 component in all groups. However, identical phrase structure violations within Jabberwocky sentences elicited a P600 in CWNS and CWS-Rec, but an N400-like effect in CWS-Per.

CONCLUSIONS

The distinguishing neural patterns mediating syntactic, but not semantic, processing provide evidence that specific brain functions for some aspects of language processing may be associated with stuttering persistence. Unlike CWS-Rec and CWNS, the lack of semantic context in Jabberwocky sentences seemed to affect the syntactic processing strategies of CWS-Per, resulting in the elicitation of semantically based N400-like activity during syntactic (phrase structure) violations. This vulnerability suggests neural mechanisms associated with the processing of syntactic structure may be less mature in 6-7-year-old children whose stuttering persisted compared to their fluent or recovered peers.

Hearing loss and cognitive decline in older adults: questions and answers

The association between hearing impairment, the diagnosis of dementia, and the role of sensory therapy has been proposed for some time, but further research is needed. Current understanding of this association requires the commitment of those experts who can integrate experience and research from several fields to be able to understand the link from hearing to dementia. A workshop whose panelists included experts from many areas, ranging from ear, nose and throat (ENT) to dementia's specialists, was promoted and organized by the Giovanni Lorenzini Medical Science Foundation (Milan, Italy; Houston, TX, USA) to increase the awareness of the relationship between hearing loss and dementia, and included questions and comments following a presentation from the clinical researcher, Frank Lin, who has been evaluating the relationship between hearing loss and cognitive decline since 2009.

Differences between patterns of brain activity associated with semantics and those linked with phonological processing diminish with age

It is widely believed that language function tends to show little age-related performance decline. Indeed, some older individuals seem to use compensatory mechanisms to maintain a high level of performance when submitted to lexical tasks. However, how these mechanisms affect cortical and subcortical activity during semantic and phonological processing has not been extensively explored. The purpose of this study was to look at the effect of healthy aging on cortico-subcortical routes related to semantic and phonological processing using a lexical analogue of the Wisconsin Cart-Sorting Task. Our results indicate that while young adults tend to show increased activity in the ventrolateral prefrontal cortex, the dorsolateral prefrontal cortex, the fusiform gyrus, the ventral temporal lobe and the caudate nucleus during semantic decisions and in the posterior Broca's area (area 44), the temporal lobe (area 37), the temporoparietal junction (area 40) and the motor cortical regions during phonological decisions, older individuals showed increased activity in the dorsolateral prefrontal cortex and motor cortical regions during both semantic and phonological decisions. Furthermore, when semantic and phonological decisions were contrasted with each other, younger individuals showed significant brain activity differences in several regions while older individuals did not. Therefore, in older individuals, the semantic and phonological routes seem to merge into a single pathway. These findings represent most probably neural reserve/compensation mechanisms, characterized by a decrease in specificity, on which the elderly rely to maintain an adequate level of performance.

Age-related changes in functional network connectivity associated with high levels of verbal fluency performance

The relative preservation of receptive language abilities in older adults has been associated with adaptive changes in cerebral activation patterns, which have been suggested to be task-load dependent. However, the effects of aging and task demands on the functional integration of neural networks contributing to speech production abilities remain largely unexplored. In the present functional neuroimaging study, data-driven spatial independent component analysis and hierarchical measures of integration were used to explore age-related changes in functional connectivity among cortical areas contributing to semantic, orthographic, and automated word fluency tasks in healthy young and older adults, as well as to assess the effect of age and task demands on the functional integration of a verbal fluency network. The results showed that the functional integration of speech production networks decreases with age, while at the same time this has a marginal effect on behavioral outcomes in high-performing older adults. Moreover, a significant task demand/age interaction was found in functional connectivity within the anterior and posterior subnetworks of the verbal fluency network. These results suggest that local changes in functional integration among cortical areas supporting lexical speech production are modulated by age and task demands.

Electrophysiological correlates of object-repetition effects: sLORETA imaging with 64-channel EEG and individual MRI

BACKGROUND

We investigated the electrophysiological correlates of object-repetition effects using an object categorization task, standardized low-resolution electromagnetic tomography (sLORETA), and individual magnetic resonance imaging. Sixteen healthy adults participated, and a total of 396 line drawings of living and non-living objects were used as stimuli. Of these stimuli, 274 were presented only once, and 122 were repeated after one to five intervening pictures. Participants were asked to categorize the objects as living or non-living things by pressing one of two buttons.

RESULTS

The old/new effect (i.e., a faster response time and more positive potentials in response to repeated stimuli than to stimuli initially presented) was observed at 350-550 ms post-stimulus. The distributions of cortical sources for the old and new stimuli were very similar at 250-650 ms after stimulus-onset. Activation in the right middle occipital gyrus/cuneus, right fusiform gyrus, left superior temporal gyrus, and right inferior frontal gyrus was significantly reduced in response to old compared with new stimuli at 250-350, 350-450, 450-550, and 550-650 ms after stimulus-onset, respectively. Priming in response time was correlated with the electrophysiological priming at left parietal area and repetition suppression at left superior temporal gyrus in 450-550 ms.

CONCLUSIONS

These results suggest processing of repeated objects is facilitated by sharpening perceptual representation and by efficient detection or attentional control of repeated objects.

The neural substrates associated with attentional resources and difficulty of concurrent processing of the two verbal tasks

The kana pick-out test has been widely used in Japan to evaluate the ability to divide attention in both adult and pediatric patients. However, the neural substrates underlying the ability to divide attention using the kana pick-out test, which requires participants to pick out individual letters (vowels) in a story while also reading for comprehension, thus requiring simultaneous allocation of attention to both activities, are still unclear. Moreover, outside of the clinical area, neuroimaging studies focused on the mechanisms of divided attention during complex story comprehension are rare. Thus, the purpose of the present study, to clarify the neural substrates of kana pick-out test, improves our current understanding of the basic neural mechanisms of dual task performance in verbal memory function. We compared patterns of activation in the brain obtained during performance of the individual tasks of vowel identification and story comprehension, to levels of activation when participants performed the two tasks simultaneously during the kana pick-out test. We found that activations of the left dorsal inferior frontal gyrus and superior parietal lobule increase in functional connectivity to a greater extent during the dual task condition compared to the two single task conditions. In contrast, activations of the left fusiform gyrus and middle temporal gyrus, which are significantly involved in picking out letters and complex sentences during story comprehension, respectively, were reduced in the dual task condition compared to during the two single task conditions. These results suggest that increased activations of the dorsal inferior frontal gyrus and superior parietal lobule during dual task performance may be associated with the capacity for attentional resources, and reduced activations of the left fusiform gyrus and middle temporal gyrus may reflect the difficulty of concurrent processing of the two tasks. In addition, the increase in synchronization between the left dorsal inferior frontal gyrus and superior parietal lobule in the dual task condition may induce effective communication between these brain regions and contribute to more attentional processing than in the single task condition, due to greater and more complex demands on voluntary attentional resources.

Age-related and individual differences in the use of prediction during language comprehension

During sentence comprehension, older adults are less likely than younger adults to predict features of likely upcoming words. A pair of experiments assessed whether such differences would extend to tasks with reduced working memory demands and time pressures. In Experiment 1, event-related brain potentials were measured as younger and older adults read short phrases cuing antonyms or category exemplars, followed three seconds later by targets that were either congruent or incongruent and, for congruent category exemplars, of higher or lower typicality. When processing the less expected low typicality targets, younger - but not older - adults elicited a prefrontal positivity (500-900ms) that has been linked to processing consequences of having predictions disconfirmed. Thus, age-related changes in prediction during comprehension generalize across task circumstances. Analyses of individual differences revealed that older adults with higher category fluency were more likely to show the young-like pattern. Experiment 2 showed that these age-related differences were not due to simple slowing of language production mechanisms, as older adults generated overt responses to the cues as quickly as - and more accurately than - younger adults. However, older adults who were relatively faster to produce category exemplars in Experiment 2 were more likely to have shown predictive processing patterns in Experiment 1. Taken together, the results link prediction during language comprehension to language production mechanisms and suggest that although older adults can produce speeded language output on demand, they are less likely to automatically recruit these mechanisms during comprehension unless top-down circuitry is particularly strong.

Neuroanatomical characteristics and speech perception in noise in older adults

OBJECTIVES

Previous research has attributed older adults' difficulty with perceiving speech in noise to peripheral hearing loss. However, recent studies have suggested a more complex picture and implicate the central nervous system in sensation and sensory deficits. This study examines the relationship between the neuroanatomical structure of cognitive brain regions and the ability to perceive speech in noise in older adults. In particular, the neuroanatomical characteristics of the left ventral and dorsal prefrontal cortex (PFC) are considered relative to standard measures of hearing in noise.

DESIGN

The participants were 15 older and 14 younger right-handed native speakers of American English who had no neurologic deficits and scored better than normal on standardized cognitive tests. We measured the participants' peripheral hearing ability and their ability to perceive speech in noise using established tests. Anatomical magnetic resonance images were taken and analyzed to extract regional volumes and thicknesses of several key neuroanatomical structures.

RESULTS

Younger adults had better hearing sensitivity and better speech perception in noise ability than older adults. For the older adults only, the volume of the left pars triangularis and the cortical thickness of the left superior frontal gyrus were significant predictors of performance on the speech in noise test.

DISCUSSION

These findings suggest that, in addition to peripheral structures, the central nervous system also contributes to the ability to perceive speech in noise. In older adults, a decline in the relative volume and cortical thickness of the PFC during aging can therefore be a factor in a declining ability to perceive speech in a naturalistic environment. These findings are consistent with the decline-compensation hypothesis, which states that a decline in sensory processing caused by cognitive aging can be accompanied by an increase in the recruitment of more general cognitive areas as a means of compensation. We found that a larger PFC volume may compensate for declining peripheral hearing. Clinically, recognizing the contribution of the cerebral cortex expands treatment possibilities for hearing loss in older adults beyond peripheral hearing aids to include strategies for improving cognitive function. We conclude by considering several mechanisms by which the PFC may facilitate speech perception in noise, including inhibitory control, attention, cross-modal compensation, word prediction and phonological working memory, although no definitive conclusion can be drawn.

With time on our side? Task-dependent compensatory processes in graceful aging

Graceful aging has been associated with frontal hyperactivations in working- and episodic long-term memory tasks, a compensatory process, according to some, that allows the best normal elders to perform these tasks at a juvenile level, in spite of natural cortical impoverishment. In this study, 24 young and 24 healthy elderly participants were compared. Graceful aging was explored by investigating domains where most healthy elders perform like youngers (e.g. lexical-semantic knowledge) and tasks that are typically more challenging, like episodic long-term recognition memory tasks. With voxel-based morphometry, we also studied to what extent changes of fMRI activation were consistent with the pattern of brain atrophy. We found that hyperactivations and hypoactivations of the elders were not restricted to the frontal lobes, rather they presented with task-dependent patterns. Only hypoactivations and normal levels of activation systematically overlapped with regional atrophy. We conclude that compensatory processes associated with graceful aging may not necessarily be a sign of early saturation of executive resources, if this was to be represented by a systematic frontal hyperactivation, but rather they may represent the ability of recruiting new cognitive strategies. We discuss two possible approaches to further test this hypothesis.

The amount of retrieval support modulates age effects on episodic memory: evidence from event-related potentials

This experiment was designed to explore the impact of age and amount of retrieval support on episodic memory and its electrophysiological correlates. Event-related potentials (ERPs) were recorded while young and older participants performed a word-stem cued-recall task in a low-support condition (LSC) in which the stem was composed of three letters, and a high-support condition (HSC) in which the cue consisted of four letters. Behavioral analyses showed that recall in the older group was less accurate than in the young group in the LSC, but no age differences were observed in the HSC. In the LSC, old/new ERP effects at frontal and parietal sites were later and less sustained for the older adults. Furthermore, the parietal old/new effect was symmetrically distributed for older adults, whereas it was predominant over the left hemisphere for their younger counterparts. In addition, young participants demonstrated early and long-lasting frontal and parietal effects in the HSC but with predominance over the right hemisphere, whereas the older adults exhibited a frontal effect and an early and long-lasting parietal effect becoming predominant over the left hemisphere. No age differences in the time course of the parietal old/new effect were observed in this more supportive condition. In addition, in the last period, the left parietal effect was greater for the older group. This study suggests that episodic memory performance and ERP correlates of recall processes are more similar between young and older adults when increased support is provided at retrieval.

Changes in fMRI activation following rehabilitation of reading and visual processing deficits in subjects with traumatic brain injury

In this case series fMRI was used to examine activation patterns during presentation of a reading comprehension (RC) task in three adult subjects with a history of severe traumatic brain injury (TBI). These subjects received cognitive rehabilitation therapy (CRT) for visual processing and acquired reading deficits. fMRI and neuropsychological testing occurred pre- and post-rehabilitation. The study's objective was to evaluate the neurobiological changes using fMRI occurring with CRT and to compare these results to repeat fMRI in matched controlsubjects. While improvements in neuropsychologicaltesting occurred post-CRT, diffuse and variable activation patterns in the subjects with TBI were still demonstrated when compared to the control subjects repeat imaging. Multiple networks exist to accomplish the complex task of sentence reading and rehabilitation of the cognitive components of reading, such as visual processing; in subjects with TBI, can alter the activation pattern demonstrated during reading comprehension in subjects many years post-injury. This is the first demonstration of changes in network activation patterns post-CRT in patients with severe, chronic TBI on an fMRI task shown to have imaging stability in a normal control sample.

Aging effects on the activation of the auditory cortex during binaural speech listening in white noise: an fMRI study

The functional significance of age-related pathology of the auditory cortex is not well established. The purpose of this study was to elucidate the activation pattern of the auditory cortex in aged subjects in response to speech signals. Functional magnetic resonance imaging was performed on 12 elderly subjects with normal hearing acuity during selective listening with both ears to speech sounds in quiet and in white noise. Twelve young, normal-hearing subjects served as controls. Our results showed that activation of the auditory cortex during selective listening to speech decreased in elderly subjects compared to young subjects, especially in noise. Reduced activation occurred in the anterior and posterior regions of the bilateral superior temporal gyrus (STG), but mainly in the posterior part of the left STG. In addition, background noise had a greater masking effect on speech perception in the elderly subjects than in the young ones. These findings suggest that early functional changes associated with central presbycusis occur mainly in the posterior part of the left STG.

Location, location: using functional magnetic resonance imaging to pinpoint brain differences relevant to stimulant use

AIMS

The purpose of this review is to summarize the neural substrate dysfunctions and disrupted cognitive, affective and experiential processes observed in methamphetamine and cocaine-dependent individuals.

METHODS

We reviewed all publications in PubMed that conducted comparison studies between healthy volunteers and cocaine-, amphetamine- or methamphetamine-dependent individuals using functional magnetic resonance imaging.

RESULTS

Stimulant dependence is characterized by a distributed alteration of functional activation to a number of experimental paradigms. Attenuated anterior and posterior cingulate activation, reduced inferior frontal and dorsolateral prefrontal cortex activation and altered posterior parietal activation point towards an inadequate demand-specific processing of information. Processes reported most consistently to be deficient in these functional neuroimaging studies include inhibitory control, executive functioning and decision-making.

CONCLUSION

One emerging theme is that stimulant-dependent individuals show specific, rather than generic, brain activation differences, i.e. instead of showing more or less brain activation regardless of task, they exhibit process-related brain activation differences that are consistent with a shift from context-specific, effortful processing to more stereotyped, habitual response generation.

Cerebral perfusion changes in older delirious patients using 99mTc HMPAO SPECT

BACKGROUND

Prior studies describe variable cerebral blood flow changes in delirium. This study aims to investigate cerebral blood flow changes in older hospitalized patients with delirium, the population in which most cases of delirium occur.

METHODS

Participants included hospitalized general medical patients aged 65 years and older with documented delirium and no relevant medical conditions or preexisting abnormalities on neuroimaging prospectively studied using 99mTc HMPAO single photon emission computed tomography (SPECT) scans obtained during and after resolution of delirium. Twenty-two patients enrolled in the study, of whom six completed both scans. All participants underwent neuropsychological assessment immediately prior to SPECT scanning. SPECT images were compared across all participants during delirium; for patients completing paired scans, within-patient comparisons were made.

RESULTS

Visual assessment of SPECT scans revealed perfusion abnormalities in frontal (5 participants) or parietal regions (6 participants); scans were normal in 11 participants (50%). Region-of-interest analysis identified reduced blood flow (p <.01) in the left inferior frontal, right temporal, right occipital, and pontine regions. Analysis of paired scans revealed reversible abnormalities in three participants (p <.001), with decreased right parietal perfusion in two participants and increased left parietal perfusion in one participant.

CONCLUSIONS

The results of this study of a small group of general medical patients are suggestive that frontal or parietal cerebral perfusion abnormalities occur in delirium, and these findings need to be confirmed by future, larger studies. These results may help to improve basic understanding of delirium pathophysiology, to identify long-term changes, and to evaluate response to treatment over time.

Language and the aging brain: patterns of neural compensation revealed by functional brain imaging

Human aging brings with it declines in sensory function, both in vision and in hearing, as well as a general slowing in a variety of perceptual and cognitive operations. Yet in spite of these declines, language comprehension typically remains well preserved in normal aging. We review data from functional magnetic resonance imaging (fMRI) to describe a two-component model of sentence comprehension: a core sentence-processing area located in the perisylvian region of the left cerebral hemisphere and an associated network of brain regions that support the working memory and other resources needed for comprehension of long or syntactically complex sentences. We use this two-component model to describe the nature of compensatory recruitment of novel brain regions observed when healthy older adults show the same success at comprehending sentences as their younger adult counterparts. We suggest that this plasticity in neural recruitment contributes to the stability of language comprehension in the aging brain.

The effect of aging on event-related potentials and behavioral responses: Comparison of tonal, phonologic and semantic targets

OBJECTIVE

To investigate age-related changes in speech perception by measuring event-related potentials (ERPs) elicited by auditory stimuli varying in their linguistic characteristics from pure tones to words.

METHODS

ERPs were recorded from 64 subjects in three age groups (young, middle age and elderly) to auditory target stimuli, using an oddball paradigm. Three different tasks and stimuli were used: tonal, phonological and semantic.

RESULTS

N100 latency to tonal targets was significantly shorter than to both types of speech targets. P300 latency to tonal targets was significantly shorter than to phonological targets, which in turn was shorter than to semantic targets. P300 amplitude recorded to the speech targets was significantly larger over the left hemisphere than over the right hemisphere in the young subjects. However, the reverse pattern of asymmetry, favoring the right hemisphere was found in the elderly subjects. The pattern of the hemispheric distribution for the middle aged was somewhere in between the young and elderly.

CONCLUSIONS

The data indicate possible progressive changes in left-right asymmetry in language processing with aging.

SIGNIFICANCE

Findings may indicate an increased use of compensatory mechanisms for speech processing, or alternatively, an increased use of different generators as individuals age.

Music and language side by side in the brain: a PET study of the generation of melodies and sentences

Parallel generational tasks for music and language were compared using positron emission tomography. Amateur musicians vocally improvised melodic or linguistic phrases in response to unfamiliar, auditorily presented melodies or phrases. Core areas for generating melodic phrases appeared to be in left Brodmann area (BA) 45, right BA 44, bilateral temporal planum polare, lateral BA 6, and pre-SMA. Core areas for generating sentences seemed to be in bilateral posterior superior and middle temporal cortex (BA 22, 21), left BA 39, bilateral superior frontal (BA 8, 9), left inferior frontal (BA 44, 45), anterior cingulate, and pre-SMA. Direct comparisons of the two tasks revealed activations in nearly identical functional brain areas, including the primary motor cortex, supplementary motor area, Broca's area, anterior insula, primary and secondary auditory cortices, temporal pole, basal ganglia, ventral thalamus, and posterior cerebellum. Most of the differences between melodic and sentential generation were seen in lateralization tendencies, with the language task favouring the left hemisphere. However, many of the activations for each modality were bilateral, and so there was significant overlap. While clarification of this overlapping activity awaits higher-resolution measurements and interventional assessments, plausible accounts for it include component sharing, interleaved representations, and adaptive coding. With these and related findings, we outline a comparative model of shared, parallel, and distinctive features of the neural systems supporting music and language. The model assumes that music and language show parallel combinatoric generativity for complex sound structures (phonology) but distinctly different informational content (semantics).

Making memories: a cross-sectional investigation of episodic memory encoding in childhood using FMRI

In adults, the neural substrate associated with encoding memories connected to a specific time and place include the prefrontal cortex and medial temporal lobe (MTL). Using functional magnetic resonance imaging, this research studied the developmental trajectory of this frontal-MTL system by comparing 7- and 8-year-old children to those who were 10 or older in conditions that promoted episodic encoding. In 1 condition, participants generated verbs from nouns heard; in another, they listened to short stories for comprehension. Regions in which brain activation predicted subsequent recognition memory performance were identified. These included the left prefrontal cortex, but not MTL, in the verb generation condition for both age groups. In the story comprehension condition, activation in left posterior MTL predicted subsequent memory performance in both age groups, and activation in left anterior MTL (including the hippocampus proper) and left prefrontal cortex predicted subsequent memory only for the older children. These results illustrate both similarities and differences in how brain systems interact in development to mediate the formation of episodic memories.

A functional neuroimaging investigation of the roles of structural complexity and task-demand during auditory sentence processing

Using functional magnetic resonance imaging (fMRI), this study directly examined an issue that bridges the potential language processing and multi-modal views of the role of Broca's area: the effects of task-demands in language comprehension studies. We presented syntactically simple and complex sentences for auditory comprehension under three different (differentially complex) task-demand conditions: passive listening, probe verification, and theme judgment. Contrary to many language imaging findings, we found that both simple and complex syntactic structures activated left inferior frontal cortex (L-IFC). Critically, we found activation in these frontal regions increased together with increased task-demands. Specifically, tasks that required greater manipulation and comparison of linguistic material recruited L-IFC more strongly; independent of syntactic structure complexity. We argue that much of the presumed syntactic effects previously found in sentence imaging studies of L-IFC may, among other things, reflect the tasks employed in these studies and that L-IFC is a region underlying mnemonic and other integrative functions, on which much language processing may rely.

Searching for the trace: the influence of age, lexical activation and working memory on sentence processing

To investigate the stability of trace reactivation in healthy older adults, 22 older volunteers with no significant neurological history participated in a cross-modal priming task. Whilst both object relative center embedded (ORC) and object relative right branching (ORR) sentences were employed, working memory load was reduced by limiting the number of words separating the antecedent from the gap for both sentence types. Analysis of the results did not reveal any significant trace reactivation for the ORC or ORR sentences. The results did reveal, however, a positive correlation between age and semantic priming at the pre-gap position and a negative correlation between age and semantic priming at the gap position for ORC sentences. In contrast, there was no correlation between age and priming effects for the ORR sentences. These results indicated that trace reactivation may be sensitive to a variety of age related factors, including lexical activation and working memory. The implications of these results for sentence processing in the older population are discussed.

Superior temporal gyrus and insula provide response and outcome-dependent information during assessment and action selection in a decision-making situation

Decision-making is a complex process that comprises the assessment of a situation, the selection of an action, and the evaluation of an outcome. Distinct neural systems may contribute differentially during various stages within a decision-making situation. This study investigated whether neural activation during assessment or action selection is critically dependent on previous outcomes or actions. Twelve healthy, right-handed subjects (6 females) played a Rock Paper Scissors (RPS) computer game during functional magnetic resonance imaging. Bilateral insula and medial prefrontal cortex (including the anterior cingulate) were specifically engaged during the assessment and action selection stages of decision-making, whereas bilateral superior frontal gyrus and right inferior parietal lobule activated more during the outcome. Two regions of activation within the bilateral superior temporal gyrus activated only when the previous outcome was a win. Moreover, right insula and superior temporal gyrus were active more when the subject switched responses relative to staying with the same choice made on the previous trial. These findings support the hypothesis that distinct neural systems underlie different stages of the decision-making process. Furthermore, the superior temporal gyrus may play an important role in integrating previous actions and successful outcomes into one's decision-making strategy.

Age-related differences in the areas of Broca and Wernicke using functional magnetic resonance imaging

BACKGROUND

Previous studies have identified differences in the brain activation pattern between children and adults as well as between healthy subjects and patients using various imaging methods. Despite the increase of old people in the population, at present no study has applied a language task to investigate differences in adults.

OBJECTIVE

We used a simple paradigm to elicit activation in young and old adults to investigate differences in the activation of the classical Broca and Wernicke areas.

METHODS

Using functional magnetic resonance imaging, we applied a simple language paradigm to 10 right-handed subjects in each age group. Words and letter strings were presented separately with the instruction to decide for each pair if it represents a synonym (in case of words) or identical strings (in case of letters). The corresponding changes in the brain activation for words and letters were contrasted for each individual subject and compared by statistical parametric methods.

RESULTS

For all subjects, the paradigm resulted in the activation of Broca and Wernicke areas in the left hemisphere only. Group analysis demonstrated a higher level of activation in Broca as well as in Wernicke areas for the young adults in comparison with the old adults.

CONCLUSIONS

The applied, short paradigm provided consistent activation of the classical Broca and Wernicke areas in both age groups. These results demonstrate specific age-related differences in the processing of language stimuli during identical performance measures.

Reduced anterior and posterior cingulate gray matter in borderline personality disorder

BACKGROUND

Structural abnormalities in prefrontal and cingulate gyrus regions-important in affective processing, impulse control and cognition may contribute to the psychopathology of borderline personality disorder (BPD). Previous MRI studies examining volume have reported that compared with healthy controls, BPD patients have decreases in right anterior cingulate, no differences in dorsolateral prefrontal cortex, and mixed findings for prefrontal cortex. We extended this investigation by examining gray and white matter volume of frontal and cingulate gyrus Brodmann areas (BAs) in a large group of patients and healthy controls.

METHODS

MRI scans were acquired in 50 BPD patients (n = 13 with comorbid diagnosis of BPD and Schizotypal Personality Disorder (SPD) and n = 37 without SPD) and 50 healthy controls, and gray/white matter volume in cingulate gyrus and frontal lobe BAs were assessed. Normal BPD and BPD subgroup comparisons were conducted.

RESULTS

Compared with controls, BPD patients showed reduced gray matter volume in BA 24 and 31 of the cingulate. BPD patients without comorbid SPD had isolated gray matter volume loss in BA 24, but were spared for BA 31 in contrast to BPD patients with SPD. There were no group differences in whole cingulate or frontal lobe volume.

CONCLUSIONS

The finding of more pervasive cingulate shrinkage in the patients with BPD and SPD comorbidity resembles recent observations with the same methods in patients with schizophrenia. The pattern of reduced anterior and posterior cingulate gray matter volume in BPD patients, particularly those comorbid for SPD is consistent with the affective and attentional deficits observed in these personality disorders.

Volume of the cingulate and outcome in schizophrenia

BACKGROUND

Previous studies indicated that schizophrenia patients have reduced frontal volumes in comparison with normal, but among schizophrenics, reduced volumes of the posterior (temporal, parietal and occipital) cortex were associated with poor outcome. We examined whether this pattern is seen within the anteroposterior arch of the cingulate gyrus.

METHODS

MR images were acquired in 37 schizophrenia patients (Kraepelinian, n = 13; non-Kraepelinian, n = 24) and 37 controls, and CSF, gray and white matter volumes in individual Brodmann's areas (BA) of the cingulate arch (areas 25, 24, 23, 31, 30, 29) were assessed and examined in relation to outcome.

RESULTS

Schizophrenia patients had significant gray matter reductions in the absolute (mm(3)) volume of Brodmann's area 24 in anterior cingulate and, when corrected for brain size, in the whole cingulate and retrosplenial (areas 29-30) cortex. White matter volumes were increased in right posterior cingulate (area 31). Schizophrenia patients also showed abnormal lateralization of white matter volumes in retrosplenial cortex (area 30) and had lower correlations between frontal and anterior cingulate regions than controls. Poor-outcome subgroup exhibited significant bilateral gray matter deficits in posterior cingulate and retrosplenial cortices compared to good-outcome patients, while no white matter increases in these areas were seen.

CONCLUSIONS

Poor outcome was associated with gray matter deficits in posterior cingulate while compensatory white matter increases in dorsal posterior regions may be related to better outcome. Possible consequences of this may include thought disorder, disturbance of consciousness, treatment resistance, and cognitive decline indicative of a dementing process as a superimposed or inherent part of this schizophrenia subtype.

Effects of age and speed of processing on rCBF correlates of syntactic processing in sentence comprehension

Positron emission tomography (PET) was used to determine the effect of age on regional cerebral blood flow (rCBF) during syntactic processing in sentence comprehension. PET activity associated with making plausibility judgments about syntactically more complex subject object (SO) sentences (e.g., The juice that the child spilled stained the rug) was compared to that associated with making judgments about synonymous syntactically simpler object subject (OS) sentences (e.g., The child spilled the juice that stained the rug). In the first study, 13 elderly (70-80-year-old) subjects showed increased rCBF in the left inferior parietal lobe. This result contrasted with previous studies, which have shown activation in Broca's area in this task in young subjects. Elderly subjects were noted to have longer reaction times than young subjects previously tested. A second study found that young subjects whose reaction times were as long as those of the elderly subjects tested in Experiment 1 activated left superior parietal, and not left inferior frontal, structures. A third experiment found that elderly subjects with reaction times as fast as previously tested young subjects activated left inferior frontal structures. The results suggest that the speed of syntactic processing, but not age per se is related to the neural location where one aspect of syntactic processing is carried out.

Neural basis for sentence comprehension deficits in frontotemporal dementia

Many patients with frontotemporal dementia (FTD) have impaired sentence comprehension. However, the pattern of comprehension difficulty appears to vary depending on the clinical subgroup. The purpose of this study was to elucidate the neural basis for these deficits in FTD. We studied patients with two different presentations: Three patients with Progressive Non-Fluent Ahasia (PNFA), and five non-aphasic patients with a dysexecutive and social impairment (EXEC). The FTD patient subgroups were compared to a cohort of 11 healthy seniors with intact sentence comprehension. We monitored regional cerebral activity with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) while subjects read sentences featuring both a grammatically complex object-relative center-embedded clause and a long linkage between the head noun phrase (NP) and the gap where the NP is interpreted in the center-embedded clause. Subjects decided whether the agent of the action is a male or a female. Healthy seniors activated both ventral portions of inferior frontal cortex (vIFC) and dorsal portions of IFC (dIFC) in the left hemisphere, often associated with grammatical and working memory components of these sentences, respectively. PNFA patients differed from healthy controls since they have reduced activation of left vIFC, while EXEC patients have less recruitment of left dIFC. We conclude that FTD subgroups have distinct patterns of sentence comprehension difficulty in part because of selective interruptions of a large-scale neural network for sentence processing.