Neuroplasticity across the lifespan and aging effects in bilinguals and monolinguals

Second language learning in older adults modulates Stroop task performance and brain activation

Introduction

Numerous studies have highlighted cognitive benefits in lifelong bilinguals during aging, manifesting as superior performance on cognitive tasks compared to monolingual counterparts. Yet, the cognitive impacts of acquiring a new language in older adulthood remain unexplored. In this study, we assessed both behavioral and fMRI responses during a Stroop task in older adults, pre- and post language-learning intervention.

Methods

A group of 41 participants (age:60-80) from a predominantly monolingual environment underwent a four-month online language course, selecting a new language of their preference. This intervention mandated engagement for 90 minutes a day, five days a week. Daily tracking was employed to monitor progress and retention. All participants completed a color-word Stroop task inside the scanner before and after the language instruction period.

Results

We found that performance on the Stroop task, as evidenced by accuracy and reaction time, improved following the language learning intervention. With the neuroimaging data, we observed significant differences in activity between congruent and incongruent trials in key regions in the prefrontal and parietal cortex. These results are consistent with previous reports using the Stroop paradigm. We also found that the amount of time participants spent with the language learning program was related to differential activity in these brain areas. Specifically, we found that people who spent more time with the language learning program showed a greater increase in differential activity between congruent and incongruent trials after the intervention relative to before.

Discussion

Future research is needed to determine the optimal parameters for language learning as an effective cognitive intervention for aging populations. We propose that with sufficient engagement, language learning can enhance specific domains of cognition such as the executive functions. These results extend the understanding of cognitive reserve and its augmentation through targeted interventions, setting a foundation for future investigations.

Brain gray matter morphometry relates to onset age of bilingualism and theory of mind in young and older adults

Lifelong bilingualism may result in neural reserve against decline not only in the general cognitive domain, but also in social cognitive functioning. In this study, we show the brain structural correlates that are associated with second language age of acquisition (L2AoA) and theory of mind (the ability to reason about mental states) in normal aging. Participants were bilingual adults (46 young, 50 older) who completed a theory-of-mind task battery, a language background questionnaire, and an anatomical MRI scan to obtain cortical morphometric features (i.e., gray matter volume, thickness, and surface area). Findings indicated a theory-of-mind decline in older adults compared to young adults, controlling for education and general cognition. Importantly, earlier L2AoA and better theory-of-mind performance were associated with larger volume, higher thickness, and larger surface area in the bilateral temporal, medial temporal, superior parietal, and prefrontal brain regions. These regions are likely to be involved in mental representations, language, and cognitive control. The morphometric association with L2AoA in young and older adults were comparable, but its association with theory of mind was stronger in older adults than young adults. The results demonstrate that early bilingual acquisition may provide protective benefits to intact theory-of-mind abilities against normal age-related declines.

Dynamic effects of bilingualism on brain structure map onto general principles of experience-based neuroplasticity

Bilingualism has been linked to structural adaptations of subcortical brain regions that are important for controlling multiple languages. However, research on the location and extent of these adaptations has yielded variable patterns, especially as far as the subcortical regions are concerned. Existing literature on bilingualism-induced brain restructuring has so far largely overseen evidence from other domains showing that experience-based structural neuroplasticity often triggers non-linear adaptations which follow expansion-renormalisation trajectories. Here we use generalised additive mixed models to investigate the non-linear effects of quantified bilingual experiences on the basal ganglia and the thalamus in a sample of bilinguals with a wide range of bilingual experiences. Our results revealed that volumes of the bilateral caudate nucleus and nucleus accumbens were significantly related to bilingual experiences. Importantly, these followed a non-linear pattern, with increases followed by plateauing in the most experienced bilinguals, suggesting that experience-based volumetric increases are only necessary up to a certain level of bilingual experience. Moreover, the volumes of putamen and thalamus were positively predicted by bilingual experiences. The results offer the first direct evidence that bilingualism, similarly to other cognitively demanding skills, leads to dynamic subcortical structural adaptations which can be nonlinear, in line with expansion-renormalisation models of experience-dependent neuroplasticity.

Can Speaking More Than One Language Help Prevent Alzheimer's Disease?

Alzheimer's disease (AD) is an age-related neurocognitive disorder that is epidemic in the elderly population. Currently, there are limited pharmacological interventions, and this has heightened the urgency to identify potential preventable or modifiable risk factors that promote resilience to the neuropathological effects of AD. The regular use of two or more languages is one such factor that may increases cognitive reserve through the long-standing executive control involved in managing multiple languages in the brain. There is also evidence that bilingualism is associated with increased brain reserve or maintenance, particularly in frontal-executive structures and networks. This review examines the current, sometimes conflicting literature on bi/multilingualism and AD. These studies have confounding variations in the assessment of age of second language onset, language proficiency, language usage, and whether determining incidence of AD or age of symptom onset. Despite these limitations, most publications support the presence of increased frontal-executive reserve that compensates for the development of AD neuropathology and, thereby, delays the emergence of clinical symptoms of dementia by about 4-5 years. Although regularly speaking more than one language does not protect against AD neuropathology, the delay in its clinical expression has a potentially significant impact on the lifelong morbidity from this age-related disease. Learning other languages may be an important modifiable factor for delaying the clinical expression of AD in later life.

Brain age predicts long-term recovery in post-stroke aphasia

The association between age and language recovery in stroke remains unclear. Here, we used neuroimaging data to estimate brain age, a measure of structural integrity, and examined the extent to which brain age at stroke onset is associated with (i) cross-sectional language performance, and (ii) longitudinal recovery of language function, beyond chronological age alone. A total of 49 participants (age: 65.2 ± 12.2 years, 25 female) underwent routine clinical neuroimaging (T1) and a bedside evaluation of language performance (Bedside Evaluation Screening Test-2) at onset of left hemisphere stroke. Brain age was estimated from enantiomorphically reconstructed brain scans using a machine learning algorithm trained on a large sample of healthy adults. A subsample of 30 participants returned for follow-up language assessments at least 2 years after stroke onset. To account for variability in age at stroke, we calculated proportional brain age difference, i.e. the proportional difference between brain age and chronological age. Multiple regression models were constructed to test the effects of proportional brain age difference on language outcomes. Lesion volume and chronological age were included as covariates in all models. Accelerated brain age compared with age was associated with worse overall aphasia severity (F(1, 48) = 5.65, P = 0.022), naming (F(1, 48) = 5.13, P = 0.028), and speech repetition (F(1, 48) = 8.49, P = 0.006) at stroke onset. Follow-up assessments were carried out ≥2 years after onset; decelerated brain age relative to age was significantly associated with reduced overall aphasia severity (F(1, 26) = 5.45, P = 0.028) and marginally failed to reach statistical significance for auditory comprehension (F(1, 26) = 2.87, P = 0.103). Proportional brain age difference was not found to be associated with changes in naming (F(1, 26) = 0.23, P = 0.880) and speech repetition (F(1, 26) = 0.00, P = 0.978). Chronological age was only associated with naming performance at stroke onset (F(1, 48) = 4.18, P = 0.047). These results indicate that brain age as estimated based on routine clinical brain scans may be a strong biomarker for language function and recovery after stroke.

Short- and long-term effects of chronic toluene exposure on recognition memory in adolescent and adult male Wistar rats

Abuse of toluene-containing volatile inhalants, particularly among youth, is of significant medical and social concern worldwide. Teenagers constitute the most abundant users of toluene and the majority of adult abusers of toluene started as teenagers. Although the euphoric and neurotoxic effects of acute toluene have been widely studied, lasting effects of chronic toluene exposure, especially in various age groups, have not been well investigated. In this study, we used adolescent and adult male Wistar rats to evaluate the short- and long-term effects of chronic toluene on various behaviors including cognitive function. Daily exposure to toluene (2000 ppm) for 40 days (5min/day) resulted in age-dependent behavioral impairments. Specifically, adolescent animals showed recognition memory impairment the day after the last exposure, which had normalized by day 90 post- exposure, whereas such impairment in adult animals was still evident at day 90 post-exposure. Our data suggest that age-dependent responses should be taken into consideration in interventional attempts to overcome specific detrimental consequences of chronic toluene exposure.

Multifactorial approaches to study bilingualism in the aging population: Past, present, future

A better understanding and more reliable classification of bilinguals has been progressively achieved through the fine-tuning methodology and simultaneously optimizing the measurement tools. However, the current understanding is far from generalization to a larger population varying in different measures of bilingualism-L2 Age of acquisition (L2 AOA), L2 usage and exposure, and L2 proficiency. More recent studies have highlighted the importance of modeling bilingualism as a continuous variable. An in-depth look at the role of bilingualism, comparing groups, may be considered a reductionist approach, i.e., grouping based on one measure of bilingualism (e.g., L2 AOA) may not account for variability in other measures of bilingualism (L2 exposure, L2 use or L2 proficiency, amongst others) within and between groups. Similarly, a multifactorial dimension is associated with cognitive performance, where not all domains of cognition and subcomponents are equally influenced by bilingualism. In addition, socio-cultural and demographical factors may add another dimension to the impact of bilingualism on cognitive performance, especially in older adults. Nevertheless, not many studies have controlled or used the multiple socio-cultural and demographical factors as a covariate to understand the role of different aspects of bilingualism that may influence cognitive performance differently. Such an approach would fail to generalize the research findings to a larger group of bilinguals. In the present review paper, we illustrate that considering a multifactorial approach to different dimensions of bilingual study may lead to a better understanding of the role of bilingualism on cognitive performance. With the evolution of various fine-tuned methodological approaches, there is a greater need to study variability in bilingual profiles that can help generalize the result universally.

Cognitive Advantage of Bilingualism Over Monolingualism in Older Adults: A Meta-Analysis

OBJECTIVES

This study aimed to explore whether bilingual older adults had a cognitive advantage over their monolingual counterparts, and validate the influence of cognition-related (participants' cognitive condition, the cognitive domain assessed), and bilingualism-related factors (second language proficiency, frequency of use, acquisition time, and immigration status of participants)on the cognitive advantage of bilingualism.

METHODS

Through a systematic search of nine databases (Web of Science, PubMed, Elsevier Science Direct, Cochrane Library, Embase, PsycINFO, CNKI, VIP and Wanfang) from the inception to April 2021, observational studies with bilingual and monolingual older adults as participants and cognitive function scores as outcome measures were included. Two reviewers independently completed the selection and methodological quality assessment of studies using the JBI cross-sectional study quality evaluation tool and used a pre-designed table for data extraction and sorting.

RESULTS

Fourteen studies with 51 tasks were included, involving 3737 participants (bilingual group: 1695, monolingual group: 2042). The overall results of the meta-analysis showed that bilingualism had a small cognitive advantage over monolingualism in older adults [SMD=0.23, 95%CI (0.07, 0.38), P=0.004]. In addition, the subgroup analyses indicated that factors such as participants' cognitive condition, the cognitive domain assessed, second language proficiency, acquisition time, and immigration status of participants impacted the cognitive advantage of bilingualism in older adults.

CONCLUSION

Bilingualism had a mild cognitive advantage over monolingualism in older adults, which was more prominent in older adults with mild cognitive impairment than in cognitively healthy ones, more evident in global cognitive function and inhibitory control than in other individual cognitive domains, and might be influenced by the proficiency and acquisition time of second language as well as the immigration status of older adults.

The Contribution of Bilingualism to Cognitive Functioning and Regional Brain Volume in Normal and Abnormal Aging

We examined the association between bilingualism, executive function (EF), and brain volume in older monolinguals and bilinguals who spoke English, Spanish, or both, and were cognitively normal (CN) or diagnosed with Mild Cognitive Impairment (MCI) or dementia. Gray matter volume (GMV) was higher in language and EF brain regions among bilinguals, but no differences were found in memory regions. Neuropsychological performance did not vary across language groups over time; however, bilinguals exhibited reduced Stroop interference and lower scores on Digit Span Backwards and category fluency. Higher scores on Digit Span Backwards were associated with a younger age of English acquisition, and a greater degree of balanced bilingualism was associated with lower scores in category fluency. The initial age of cognitive decline did not differ between language groups. The influence of bilingualism appears to be reflected in increased GMV in language and EF regions, and to a lesser degree, in EF.

Bilingualism and Aging: Implications for (Delaying) Neurocognitive Decline

As a result of advances in healthcare, the worldwide average life expectancy is steadily increasing. However, this positive trend has societal and individual costs, not least because greater life expectancy is linked to higher incidence of age-related diseases, such as dementia. Over the past few decades, research has isolated various protective "healthy lifestyle" factors argued to contribute positively to cognitive aging, e.g., healthy diet, physical exercise and occupational attainment. The present article critically reviews neuroscientific evidence for another such factor, i.e., speaking multiple languages. Moreover, with multiple societal stakeholders in mind, we contextualize and stress the importance of the research program that seeks to uncover and understand potential connections between bilingual language experience and cognitive aging trajectories, inclusive of the socio-economic impact it can have. If on the right track, this is an important line of research because bilingualism has the potential to cross-over socio-economic divides to a degree other healthy lifestyle factors currently do not and likely cannot.

Add Bilingualism to the Mix: L2 Proficiency Modulates the Effect of Cognitive Reserve Proxies on Executive Performance in Healthy Aging

We investigated the contribution of bilingual experience to the development of cognitive reserve (CR) when compared with other, traditionally more researched, CR proxies, in a sample of cognitively healthy senior (60 +) bilingual speakers. Participants performed in an online study where, in addition to a wide inventory of factors known to promote CR, we assessed several factors related to their second language (L2) use. In addition, participants’ inhibitory executive control was measured via the Flanker Task. We used Structural Equation Modeling to derive a latent composite measure of CR informed by traditional CR proxies (i.e., occupational complexity, marital status, current and retrospective socio-economic status, physical exercise, perceived positive support, maximal educational attainment, frequency of leisure activities and extent of social network). We examined whether bilingualism may act as a mediator of the effects of such proxies on cognitive performance therefore assessing the unique contribution of dual language use to CR. First, our analyses revealed facilitatory effects of both L2 age of acquisition and L2 proficiency on the executive performance. Second, our analyses confirmed the moderating role of bilingual experience on the relationship between other factors known to promote CR and cognitive integrity, revealing a strong contribution by bilingualism to CR development. Our findings provide further support to the notion that bilingualism plays an important role in mitigating cognitive decline and promoting successful aging.

Do Bilinguals Outperform Monolinguals in Switching Tasks? Contrary Evidence for Nonlinguistic and Linguistic Switching Tasks

The benefits of bilingualism in executive functions are highly debated. Even so, in switching tasks, these effects seem robust, although smaller than initially thought (Gunnerud et al., 2020; Ware et al., 2020). By handling two languages throughout their lifespan, bilinguals appear to train their executive functions and show benefits in nonlinguistic switching tasks compared to monolinguals. Nevertheless, because bilinguals need to control for the interference of another language, they may show a disadvantage when dealing with task-switching paradigms requiring language control, particularly when those are performed in their less dominant language. The present work explored this issue by studying bilingualism's effects on task switching within the visual and language domains. On the one hand, our results show that bilinguals were overall faster and presented reduced switch costs compared to monolinguals when performing perceptual geometric judgments with no time for task preparation. On the other hand, no bilingual advantage was found when a new sample of comparable bilinguals and monolinguals completed a within-language switching task. Our results provide clear evidence favoring the bilingual advantage, yet only when the task imposes greater executive demands and does not involve language control.

Does Second Language Learning Promote Neuroplasticity in Aging? A Systematic Review of Cognitive and Neuroimaging Studies

As the population ages, understanding how to maintain older adults' cognitive abilities is essential. Bilingualism has been linked to higher cognitive reserve, better performance in executive control, changes in brain structure and function relative to monolinguals, and delay in dementia onset. Learning a second language thus seems a promising avenue for cognitive enhancement in older adults. Our review aims to determine whether learning a foreign language in later life improves cognition and promotes neuroplasticity. We screened articles from the Pubmed, Scopus, and Science Direct databases to identify interventional studies using second language training in senior participants, including either cognition or neuroimaging as outcome measures. A total of nine articles were found, with only one neuroimaging study. Results from these studies are inconsistent, but tend to suggest that second language learning is associated with improvement in attentional switching, inhibition, working memory, and increased functional connectivity. We discuss the implications of these results, and suggest new directions and methodological recommendations for future research.

Structural brain changes with second language learning: A longitudinal voxel-based morphometry study

The underlying mechanisms that adapt with L2 learning are still poorly understood. The present longitudinal study examined the effects of L2 learning on grey matter structure of Chinese college freshmen majoring in English. Participants were scanned twice, one year apart. Our voxel-based morphometry analyses revealed that gray matter volume (GMV) decreased in the left anterior cingulate cortex (ACC) and right inferior frontal gyrus (IFG) after L2 learning for one year. Critically, these structural adaptations correlated with changes in participants' language control ability across L2 learning. Moreover, age of acquisition of L2 was a significant predictor of volumetric change in the left ACC and L2 proficiency was a significant predictor of volumetric change in the right IFG. Overall, these findings enrich our understanding of the dynamic nature of structural brain adaptations, and the mechanisms these adaptations index, as a function of classroom L2 learning.

Comparison of Activation in the Prefrontal Cortex of Native Speakers of Mandarin by Ability of Japanese as a Second Language Using a Novel Speaking Task

Evidence shows that second language (L2) learning affects cognitive function. Here in this work, we compared brain activation in native speakers of Mandarin (L1) who speak Japanese (L2) between and within two groups (high and low L2 ability) to determine the effect of L2 ability in L1 and L2 speaking tasks, and to map brain regions involved in both tasks. The brain activation during task performance was determined using prefrontal cortex blood flow as a proxy, measured by functional near-infrared spectroscopy (fNIRS). People with low L2 ability showed much more brain activation when speaking L2 than when speaking L1. People with high L2 ability showed high-level brain activation when speaking either L2 or L1. Almost the same high-level brain activation was observed in both ability groups when speaking L2. The high level of activation in people with high L2 ability when speaking either L2 or L1 suggested strong inhibition of the non-spoken language. A wider area of brain activation in people with low compared with high L2 ability when speaking L2 is considered to be attributed to the cognitive load involved in code-switching L1 to L2 with strong inhibition of L1 and the cognitive load involved in using L2.

Bilingualism: Pathway to Cognitive Reserve

Cognitive reserve is characterized by a dissociation between cognitive level and brain structure, thereby reducing the impact of deteriorating brain structure on cognitive function. Cognitive reserve is therefore a promising approach to maintaining cognitive function and protecting against symptoms of dementia. The present paper evaluates evidence supporting the claim that bilingualism contributes to cognitive reserve. Four types of evidence are presented: (i) brain and cognitive function in healthy aging, (ii) age of onset of symptoms of dementia, (iii) relation between clinical level and neuropathology for patients, and (iv) rate of cognitive decline in later stages of dementia. In all cases, bilinguals revealed patterns that were consistent with the interpretation of protection from cognitive reserve when compared with monolinguals.

Bilingualism and domain-general cognitive functions from a neural perspective: A systematic review

A large body of research has indicated that bilingualism - through continual practice in language control - may impact cognitive functions, as well as relevant aspects of brain function and structure. The present review aimed to bring together findings on the relationship between bilingualism and domain-general cognitive functions from a neural perspective. The final sample included 210 studies, covering findings regarding neural responses to bilingual language control and/or domain-general cognitive tasks, as well as findings regarding effects of bilingualism on non-task-related brain function and brain structure. The evidence indicates that a) bilingual language control likely entails neural mechanisms responsible for domain-general cognitive functions; b) bilingual experiences impact neural responses to domain-general cognitive functions; and c) bilingual experiences impact non-task-related brain function (both resting-state and metabolic function) as well as aspects of brain structure (both macrostructure and microstructure), each of which may in turn impact mental processes, including domain-general cognitive functions. Such functional and structural neuroplasticity associated with bilingualism may contribute to both cognitive and neural reserves, producing benefits across the lifespan.

Learning a Second Language in Adulthood Changes Subcortical Neural Encoding

Second language learning has been shown to impact and reshape the central nervous system, anatomically and functionally. Most of the studies on second language learning and neuroplasticity have been focused on cortical areas, whereas the subcortical neural encoding mechanism and its relationship with L2 learning have not been examined extensively. The purpose of this study was to utilize frequency-following response (FFR) to examine if and how learning a tonal language in adulthood changes the subcortical neural encoding in hearing adults. Three groups of subjects were recruited: native speakers of Mandarin Chinese (native speakers (NS)), learners of the language (L2 learners), and those with no experience (native speakers of foreign languages (NSFL)). It is hypothesized that differences would exist in FFRs obtained from the three language experience groups. Results revealed that FFRs obtained from L2 learners were found to be more robust than the NSFL group, yet not on a par with the NS group. Such results may suggest that in human adulthood, subcortical neural encoding ability may be trainable with the acquisition of a new language and that neuroplasticity at the brainstem level can indeed be influenced by L2 learning.

Beyond Alzheimer's disease: Can bilingualism be a more generalized protective factor in neurodegeneration?

Bilingualism has been argued to have an impact on cognition and brain structure. Effects have been reported across the lifespan: from healthy children to ageing adults, including clinical (ageing) populations. It has been argued that active bilingualism may significantly contribute to the delaying of the expression of Alzheimer's disease symptoms. If bilingualism plays an ameliorative role against the expression of neurodegeneration in dementia, it is possible that it could have similar effects for other neurodegenerative disorders, including Multiple Sclerosis, Parkinson's and Huntington's Diseases. To date, however, direct relevant evidence remains limited, not least because the necessary scientific motivations for investigating this with greater depth have not yet been fully articulated. Herein, we provide a roadmap that reviews the relevant literatures, highlighting potential links across neurodegenerative disorders and bilingualism more generally.

Effect of Picture-Book Reading With Additive Audio on Bilingual Preschoolers' Prefrontal Activation: A Naturalistic Functional Near-Infrared Spectroscopy Study

Acquiring a second language (L2) has the power to shape cognition and even the function and structure of the brain. Picture-book reading with additive audio (PRA) is a popular and convenient means of providing L2 exposure for non-balanced bilingual children; however, its contribution to bilingual children’s brain activity is unclear. This study conducted a rigorous bilingual word comprehension experiment and a naturalistic PRA task to explore the effect of L2 processing on brain activation among English as a foreign language (EFL) preschoolers, using functional near-infrared spectroscopy (fNIRS). We found that the two contexts of comprehending English words and bilingual switching (BS), which impose more cognitive control demands, activated the prefrontal cortex (PFC) more than did the condition of comprehending Chinese words. Furthermore, the effect of PFC activity in the condition of picture-book reading with additive English audio (English PRA) was also found to be greater than in the condition of picture-book reading with additive Chinese audio (Chinese PRA); moreover, the effect was modulated by story difficulty. Finally, a positive correlation was shown between EFL children’s English competence and PFC activation through English PRA. This study indicates that the experiences of hearing L2 auditory stories in a picture-book reading activity yielded significant changes to early bilinguals’ PFC functional for cognitive control and language processing.

Active bilingualism delays the onset of mild cognitive impairment

Lifelong bilingualism may contribute to cognitive reserve (CR) in neurodegenerative diseases as shown by a delay of the age at symptom onset in bilinguals with Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). However, some studies have failed to show this bilingual advantage, suggesting that it might depend on the type and degree of bilingualism. In the present study, we tested the hypothesis that active bilingualism, defined as the continuous use of the two languages as opposed to second language exposition only, may protect against cognitive decline. Moreover, we investigated whether bilingualism as a CR factor may be explained by an advantage within the executive control (EC) system. To do so, we collected clinical measures (age at onset of cognitive symptoms, age at the first medical visit for cognitive impairments, and age at diagnosis) in patients with MCI and patients with AD with different degrees of language experience and usage of Catalan and Spanish. Additionally, all participants were tested on four EC tasks and one long-term memory recognition task. First, results from multiple regression analyses showed that active bilingualism was a significant predictor of delay in the age at onset for all the clinical measures in MCI, but not AD patients. Second, the effect of active bilingualism was independent of occupation, educational level and job attainment across the individuals' lifespan. Finally, although we did not find an effect of active bilingualism across all EC tasks, we did find an effect for conflict resolution. These results are discussed in the context of CR hypotheses, suggesting that compensatory mechanisms may play a role in protecting against cognitive decline.

Theory of Mind Performance Predicts tDCS-Mediated Effects on the Medial Prefrontal Cortex: A Pilot Study to Investigate the Role of Sex and Age

Transcranial Direct Current Stimulation (tDCS) has become an increasingly promising tool for understanding the relationship between brain and behavior. The purpose of this study was to investigate whether the magnitude of sex- and age-related tDCS effects previously found in the medial prefrontal cortex (mPFC) during a Theory of Mind (ToM) task correlates with social cognition performance; in particular, we explored whether different patterns of activity would be detected in high- and low-performing participants. For this, young and elderly, male and female participants were categorized as a low- or high-performer according to their score on the Reading the Mind in the Eyes task. Furthermore, we explored whether sex- and age-related effects associated with active tDCS on the mPFC were related to cognitive functioning. We observed the following results: (i) elderly participants experience a significant decline in ToM performance compared to young participants; (ii) low-performing elderly females report slowing of reaction time when anodal tDCS is applied over the mPFC during a ToM task; and (iii) low-performing elderly females are characterized by lower scores in executive control functions, verbal fluency and verbal short-term memory. The relationship between tDCS results and cognitive functioning is discussed in light of the neuroscientific literature on sex- and age-related differences.

A Meta-Analysis of Gray Matter Differences Between Bilinguals and Monolinguals

Bilingualism is of great interest to the neuroscience of language, and understanding the anatomical changes associated with second language learning help inform theories of bilingual advantage across the lifespan. While the literature on structural differences between bilinguals and monolinguals is robust, relatively few studies of gray matter (GM) have directly compared bilinguals with monolinguals in a whole-brain analysis. Overall, this and heterogeneity of study samples and methodology have led to a lack of clear anatomical support for major theories. Here, we engage in an activation likelihood estimate (ALE) meta-analysis of voxel-based morphometry (VBM) studies of GM for cases that directly compare bilingual and monolingual subjects in a whole-brain analysis. The analysis (sixteen foci, from ten contrasts across eight studies) resulted in one cluster located primarily within the anterior lobe of the right cerebellum. However, when the one pediatric study was removed, the analysis revealed no consistent results across the studies included in this meta-analysis. This suggests that for VBM studies of bilingual and monolingual adults there is considerable heterogeneity of results that complicate the understanding of the bilingual brain. Future studies will need to include larger, more well-defined samples and interrogate more fine-grained anatomical features such as cortical thickness and surface area in order to more fully examine the anatomical changes associated with bilingualism across the lifespan.

The relationship between bilingual experience and gyrification in adulthood: A cross-sectional surface-based morphometry study

Neuroimaging evidence suggests that bilingualism may act as a source of neural plasticity. However, prior work has mostly focused on bilingualism-induced alterations in gray matter volume and white matter tract microstructure, with additional effects related to other neurostructural indices that might have remained undetected. The degree of cortical folding or gyrification is a morphometric parameter which provides information about changes on the brain's surface during development, aging and disease. We used Surface-based Morphometry (SBM) to investigate the contribution of bilingual experience to gyrification from early adulthood to old age in a sample of bilinguals and monolingual controls. Despite widespread cortical folding reductions for all participants with increasing age, preserved gyrification exclusive to bilinguals was detected in the right cingulate and entorhinal cortices, regions vulnerable with normal and pathological brain aging. Our results provide novel insights on experience-related cortical reshaping and bilingualism-induced cortical plasticity in adulthood.

Clinical and neurophysiological characteristics of heterozygous NPC1 carriers

Niemann-Pick disease type C (NPC) is an uncommon lysosomal storage disorder, which is characterized neuropathologically by cholinergic dysfunction and presents clinically with a broad series of neurological signs and symptoms. NPC is inherited as an autosomal recessive trait, caused by mutations in the NPC1 or NPC2 genes. However, recent reports have raised concerns on heterozygous NPC1 gene mutation carriers, which historically have been considered as clinically unaffected, occasionally presenting with clinical parkinsonian syndromes or dementia. In the present study, we aimed at comprehensively assessing clinical, biochemical, and neurophysiological features in heterozygous NPC1 gene mutation carriers. We assessed cholinergic intracortical circuits with transcranial magnetic stimulation, executive functions and plasma oxysterol levels in two families comprising two monozygotic twins with a homozygous NPC1 p.P888S mutation, four patients with a compound heterozygous p.E451K and p.G992W mutation, 10 heterozygous NPC1 p.P888S carriers, 1 heterozygous NPC1 p.E451K carrier, and 11 noncarrier family members. We observed a significant impairment in cholinergic circuits, evaluated with short-latency afferent inhibition (SAI), and executive abilities in homozygous/compound heterozygous patients and heterozygous asymptomatic NPC1 carriers, compared to noncarriers. Moreover, we reported a significant correlation between executive functions performances and both plasma oxysterol levels and neurophysiological parameters. These data suggest that heterozygous NPC1 carriers show subclinical deficits in cognition, possibly mediated by an impairment of cholinergic circuits, which in turn may mediate the onset of neurological disorders in a subset of patients.