Agrammatic comprehension caused by a glioma in the left frontal cortex

The Neurofunctional Correlates of Morphosyntactic and Thematic Impairments in Aphasia: A Systematic Review and Meta-analysis

Lesion-symptom studies in persons with aphasia showed that left temporoparietal damage, but surprisingly not prefrontal damage, correlates with impaired ability to process thematic roles in the comprehension of semantically reversible sentences (The child is hugged by the mother). This result has led to challenge the time-honored view that left prefrontal regions are critical for sentence comprehension. However, most studies focused on thematic role assignment and failed to consider morphosyntactic processes that are also critical for sentence processing. We reviewed and meta-analyzed lesion-symptom studies on the neurofunctional correlates of thematic role assignment and morphosyntactic processing in comprehension and production in persons with aphasia. Following the PRISMA checklist, we selected 43 papers for the review and 27 for the meta-analysis, identifying a set of potential bias risks. Both the review and the meta-analysis confirmed the correlation between thematic role processing and temporoparietal regions but also clearly showed the involvement of prefrontal regions in sentence processing. Exploratory meta-analyses suggested that both thematic role and morphosyntactic processing correlate with left prefrontal and temporoparietal regions, that morphosyntactic processing correlates with prefrontal structures more than with temporoparietal regions, and that thematic role assignment displays the opposite trend. We discuss current limitations in the literature and propose a set of recommendations for clarifying unresolved issues.

Enhanced activations in the dorsal inferior frontal gyrus specifying the who, when, and what for successful building of sentence structures in a new language

It has been argued that the principles constraining first language acquisition also constrain second language acquisition; however, neuroscientific evidence for this is scant, and even less for third and subsequent languages. We conducted fMRI experiments to evaluate this claim by focusing on the building of complex sentence structures in Kazakh, a new language for participants having acquired at least two languages. The participants performed grammaticality judgment and subject-verb matching tasks with spoken sentences. We divided the participants into two groups based on the performance levels attained in one of the experimental tasks: High in Group I and Low in Group II. A direct comparison of the two groups, which examined those participants who parsed the structures, indicated significantly stronger activations for Group I in the dorsal left inferior frontal gyrus (L. IFG). Focusing on Group I, we tested the contrast between the initial and final phases in our testing, which examined when the structures were parsed, as well as the contrast which examined what structures were parsed. These analyses further demonstrated focal activations in the dorsal L. IFG alone. Among the individual participants, stronger activation in the dorsal L. IFG, measured during the sentence presentations, predicted higher accuracy rates and shorter response times for executing the tasks that followed. These results cannot be explained by task difficulty or memory loads, and they, instead, indicate a critical and consistent role of the dorsal L. IFG during the initial to intermediate stages of grammar acquisition in a new target language. Such functional specificity of the dorsal L. IFG provides neuroscientific evidence consistent with the claims made by the Cumulative-Enhancement model in investigating language acquisition beyond target second and third languages.

Syntactic Impairment Associated with Hypoperfusion in the Left Middle and Inferior Frontal Gyri after Right Cerebellar Hemorrhage

Cerebellar injuries can cause syntax impairments. Cortical dysfunction due to cerebello-cerebral diaschisis is assumed to play a role in this phenomenon. Functional magnetic resonance imaging studies have repeatedly shown the activation of Broca's area in response to syntactic tasks. However, there have been no reports of selective syntax impairment and hypoperfusion restricted to this area after cerebellar injury. We herein report a patient with right cerebellar hemorrhage that led to marked syntax impairment along with severe hypoperfusion confined to the Brodmann area (BA) 45 (anterior part of Broca's area) and BA46.

Diffuse glioma-induced structural reorganization in close association with preexisting syntax-related networks

Glioma in the left frontal cortex has been reported to cause agrammatic comprehension and induce global functional connectivity alterations within the syntax-related networks. However, it remains unclear to what extent the structural reorganization is affected by preexisting syntax-related networks. We examined 28 patients with a diffuse glioma in the left hemisphere and 23 healthy participants. Syntactic abilities were assessed by a picture-sentence matching task with various sentence types. The lesion responsible for agrammatic comprehension was identified by region-of-interest-based lesion-symptom mapping (RLSM). Cortical structural alterations were examined by surface-based morphometry (SBM), in which the cortical thickness and fractal dimension were measured with three-dimensional magnetic resonance imaging (MRI). Fiber tracking on the human population-averaged diffusion MRI template was performed to examine whether the cortical structural alterations were associated with the syntax-related networks. The RLSM revealed associations between agrammatic comprehension and a glioma in the posterior limb of the left internal capsule. The SBM demonstrated that decreased cortical thickness and/or increased complexity of the right posterior insula were associated not only with agrammatic comprehension of the patients but also with the syntactic abilities of healthy participants. The fiber tracking revealed that the route between these two regions was anatomically integrated into the preexisting syntax-related networks previously identified. These results suggest a potential association between agrammatic comprehension in patients with diffuse glioma and structural variations in specific tracts and cortical regions, which may be closely related to the syntax-related networks.

Canonical Sentence Processing and the Inferior Frontal Cortex: Is There a Connection?

The role of left inferior frontal cortex (LIFC) in canonical sentence comprehension is controversial. Many studies have found involvement of LIFC in sentence production or complex sentence comprehension, but negative or mixed results are often found in comprehension of simple or canonical sentences. We used voxel-, region-, and connectivity-based lesion symptom mapping (VLSM, RLSM, CLSM) in left-hemisphere chronic stroke survivors to investigate canonical sentence comprehension while controlling for lexical-semantic, executive, and phonological processes. We investigated how damage and disrupted white matter connectivity of LIFC and two other language-related regions, the left anterior temporal lobe (LATL) and posterior temporal-inferior parietal area (LpT-iP), affected sentence comprehension. VLSM and RLSM revealed that LIFC damage was not associated with canonical sentence comprehension measured by a sensibility judgment task. LIFC damage was associated instead with impairments in a lexical semantic similarity judgment task with high semantic/executive demands. Damage to the LpT-iP, specifically posterior middle temporal gyrus (pMTG), predicted worse sentence comprehension after controlling for visual lexical access, semantic knowledge, and auditory-verbal short-term memory (STM), but not auditory single-word comprehension, suggesting pMTG is vital for auditory language comprehension. CLSM revealed that disruption of left-lateralized white-matter connections from LIFC to LATL and LpT-iP was associated with worse sentence comprehension, controlling for performance in tasks related to lexical access, auditory word comprehension, and auditory-verbal STM. However, the LIFC connections were accounted for by the lexical semantic similarity judgment task, which had high semantic/executive demands. This suggests that LIFC connectivity is relevant to canonical sentence comprehension when task-related semantic/executive demands are high.

Task-Induced Functional Connectivity of the Syntax-Related Networks for Patients with a Cortical Glioma

Analysis of the functional connectivity has enabled understanding of the cortical networks. In the present study, we used a picture-sentence matching task to introduce syntactically harder conditions, and clarified 3 major points. First, patients with a glioma in the lateral premotor cortex/inferior frontal gyrus or in other cortical regions showed much weaker activations than controls, especially in the left inferior frontal gyrus. Moreover, the error rates under the harder conditions were much higher for these patients. Secondly, syntactic loads induced selective connectivity with enhancement and suppression, consistently for both patients and controls. More specifically, the local connectivity was enhanced among the 3 syntax-related networks within the left frontal cortex, while the global connectivity of both dorsal and ventral pathways was suppressed. In addition, the exact reproducibility of r-values across the control and patient groups was remarkable, since under easier conditions alone, connectivity patterns for the patients were completely unmatched with those for the controls. Thirdly, we found an additional syntax-related network, further confirming the intergroup similarity of task-induced functional connectivity. These results indicate that functional connectivity of agrammatic patients is mostly preserved regardless of a glioma, and that the connectivity can change dynamically and systematically according to syntactic loads.

Merge-Generability as the Key Concept of Human Language: Evidence From Neuroscience

Ever since the inception of generative linguistics, various dependency patterns have been widely discussed in the literature, particularly as they pertain to the hierarchy based on “weak generation” – the so-called Chomsky Hierarchy. However, humans can make any possible dependency patterns by using artificial means on a sequence of symbols (e.g., computer programing). The differences between sentences in human language and general symbol sequences have been routinely observed, but the question as to why such differences exist has barely been raised. Here, we address this problem and propose a theoretical explanation in terms of a new concept of “Merge-generability,” that is, whether the structural basis for a given dependency is provided by the fundamental operation Merge. In our functional magnetic resonance imaging (fMRI) study, we tested the judgments of noun phrase (NP)-predicate (Pred) pairings in sentences of Japanese, an SOV language that allows natural, unbounded nesting configurations. We further introduced two pseudo-adverbs, which artificially force dependencies that do not conform to structures generated by Merge, i.e., non-Merge-generable; these adverbs enable us to manipulate Merge-generability (Natural or Artificial). By employing this novel paradigm, we obtained the following results. Firstly, the behavioral data clearly showed that an NP-Pred matching task became more demanding under the Artificial conditions than under the Natural conditions, reflecting cognitive loads that could be covaried with the increased number of words. Secondly, localized activation in the left frontal cortex, as well as in the left middle temporal gyrus and angular gyrus, was observed for the [Natural – Artificial] contrast, indicating specialization of these left regions in syntactic processing. Any activation due to task difficulty was completely excluded from activations in these regions, because the Natural conditions were always easier than the Artificial ones. And finally, the [Artificial – Natural] contrast resulted in the dorsal portion of the left frontal cortex, together with wide-spread regions required for general cognitive demands. These results indicate that Merge-generable sentences are processed in these specific regions in contrast to non-Merge-generable sentences, demonstrating that Merge is indeed a fundamental operation, which comes into play especially under the Natural conditions.

Perturbation of left posterior prefrontal cortex modulates top-down processing in sentence comprehension

Communication is an inferential process. In particular, language comprehension constantly requires top-down efforts, as often multiple interpretations are compatible with a given sentence. To assess top-down processing in the language domain, our experiment employed ambiguous sentences that allow for multiple interpretations (e.g., The client sued the murderer with the corrupt lawyer., where the corrupt lawyer could either belong to The client or the murderer). Interpretation thus depended on whether participants chunk the words of the sentence into short or long syntactic phrases. In principle, bottom-up acoustic information (i.e., the presence or absence of an intonational phrase boundary at the offset of the murderer) indicates one of the two possible interpretations. Yet, acoustic information often indicates interpretations that require words to be chunked into overly long phrases that would overburden working memory. Processing is biased against these demands, reflected in a top-down preference to chunk words into short rather than long phrases. It is often proposed, but also hotly debated, that the ability to chunk words into short phrases is subserved by the left inferior frontal gyrus (IFG). Here, we employed focal repetitive transcranial magnetic stimulation to perturb the left IFG, which resulted in a further decrease of the aptitude to tolerate long phrases, indicating the inability of the left IFG to assist the chunking of words into phrases. In contrast, the processing of auditory information was not affected. Our findings support a causal top-down role of the left inferior frontal gyrus in the chunking of words into phrases.

Strategy of Surgical Resection for Glioma Based on Intraoperative Functional Mapping and Monitoring

A growing number of papers have pointed out the relationship between aggressive resection of gliomas and survival prognosis. For maximum resection, the current concept of surgical decision-making is in “information-guided surgery” using multimodal intraoperative information. With this, anatomical information from intraoperative magnetic resonance imaging (MRI) and navigation, functional information from brain mapping and monitoring, and histopathological information must all be taken into account in the new perspective for innovative minimally invasive surgical treatment of glioma. Intraoperative neurofunctional information such as neurophysiological functional monitoring takes the most important part in the process to acquire objective visual data during tumor removal and to integrate these findings as digitized data for intraoperative surgical decision-making. Moreover, the analysis of qualitative data and threshold-setting for quantitative data raise difficult issues in the interpretation and processing of each data type, such as determination of motor evoked potential (MEP) decline, underestimation in tractography, and judgments of patient response for neurofunctional mapping and monitoring during awake craniotomy. Neurofunctional diagnosis of false-positives in these situations may affect the extent of resection, while false-negatives influence intra- and postoperative complication rates. Additionally, even though the various intraoperative visualized data from multiple sources contribute significantly to the reliability of surgical decisions when the information is integrated and provided, it is not uncommon for individual pieces of information to convey opposing suggestions. Such conflicting pieces of information facilitate higher-order decision-making that is dependent on the policies of the facility and the priorities of the patient, as well as the availability of the histopathological characteristics from resected tissue.

The Influence of Frontal Lobe Tumors and Surgical Treatment on Advanced Cognitive Functions

Brain cognitive functions affect patient quality of life. The frontal lobe plays a crucial role in advanced cognitive functions, including executive function, meta-cognition, decision-making, memory, emotion, and language. Therefore, frontal tumors can lead to serious cognitive impairments. Currently, neurosurgical treatment is the primary method to treat brain tumors; however, the effects of the surgical treatments are difficult to predict or control. The treatment may both resolve the effects of the tumor to improve cognitive function or cause permanent disabilities resulting from damage to healthy functional brain tissue. Previous studies have focused on the influence of frontal lesions and surgical treatments on patient cognitive function. Here, we review cognitive impairment caused by frontal lobe brain tumors.

Frontal-posterior theta oscillations reflect memory retrieval during sentence comprehension

Successful working-memory retrieval requires that items be retained as distinct units. At the neural level, it has been shown that theta-band oscillatory power increases with the number of to-be-distinguished items during working-memory retrieval. Here we hypothesized that during sentence comprehension, verbal-working-memory retrieval demands lead to increased theta power over frontal cortex, supposedly supporting the distinction amongst stored items during verbal-working-memory retrieval. Also, synchronicity may increase between the frontal cortex and the posterior cortex, with the latter supposedly supporting item retention. We operationalized retrieval by using pronouns, which refer to and trigger the retrieval of antecedent nouns from a preceding sentence part. Retrieval demand was systematically varied by changing the pronoun antecedent: Either, it was non-embedded in the preceding main clause, and thus easy-to-retrieve across a single clause boundary, or embedded in the preceding subordinate clause, and thus hard-to-retrieve across a double clause boundary. We combined electroencephalography (EEG), scalp-level time-frequency analysis, source localization, and source-level coherence analysis, observing a frontal-midline and broad left-hemispheric theta-power increase for embedded-antecedent compared to non-embedded-antecedent retrieval. Sources were localized to left-frontal, left-parietal, and bilateral-inferior-temporal cortices. Coherence analyses suggested synchronicity between left-frontal and left-parietal and between left-frontal and right-inferior-temporal cortices. Activity of an array of left-frontal, left-parietal, and bilateral-inferior-temporal cortices may thus assist retrieval during sentence comprehension, potentially indexing the orchestration of item distinction, verbal working memory, and long-term memory. Our results extend prior findings by mapping prior knowledge on the functional role of theta oscillations onto processes genuine to human sentence comprehension.

Left frontal glioma induces functional connectivity changes in syntax-related networks

BACKGROUND

A glioma leads to a global loss of functional connectivity among multiple regions. However, the relationships between performance/activation changes and functional connectivity remain unclear. Our previous studies (Brain 137:1193-1212; Brain Lang 110:71-80) have shown that a glioma in the left lateral premotor cortex or the opercular/triangular parts of the left inferior frontal gyrus causes agrammatic comprehension accompanied by abnormal activations in 14 syntax-related regions. We have also confirmed that a glioma in the other left frontal regions does not affect task performances and activation patterns.

RESULTS

By a partial correlation method for the time-series functional magnetic resonance imaging data, we analyzed the functional connectivity in 21 patients with a left frontal glioma. We observed that almost all of the functional connectivity exhibited chaotic changes in the agrammatic patients. In contrast, some functional connectivity was preserved in an orderly manner in the patients who showed normal performances and activation patterns. More specifically, these latter patients showed normal connectivity between the left fronto-parietal regions, as well as normal connectivity between the left triangular and orbital parts of the left inferior frontal gyrus.

CONCLUSIONS

Our results indicate that these pathways are most crucial among the syntax-related networks. Both data from the activation patterns and functional connectivity, which are different in temporal domains, should thus be combined to assess any behavioral deficits associated with brain abnormalities.

Intraoperative functional mapping and monitoring during glioma surgery

Glioma surgery represents a significant advance with respect to improving resection rates using new surgical techniques, including intraoperative functional mapping, monitoring, and imaging. Functional mapping under awake craniotomy can be used to detect individual eloquent tissues of speech and/or motor functions in order to prevent unexpected deficits and promote extensive resection. In addition, monitoring the patient’s neurological findings during resection is also very useful for maximizing the removal rate and minimizing deficits by alarming that the touched area is close to eloquent regions and fibers. Assessing several types of evoked potentials, including motor evoked potentials (MEPs), sensory evoked potentials (SEPs) and visual evoked potentials (VEPs), is also helpful for performing surgical monitoring in patients under general anesthesia (GA). We herein review the utility of intraoperative mapping and monitoring the assessment of neurological findings, with a particular focus on speech and the motor function, in patients undergoing glioma surgery.

How (not) to draw philosophical implications from the cognitive nature of concepts: the case of intentionality

Philosophers have often appealed to intuitive judgments in various thought experiments to support or reject particular theses. Experimental philosophy is an emerging discipline that examines the cognitive nature of such intuitive judgments. In this paper, we assess the methodological and epistemological status of experimental philosophy. We focus on the Knobe effect, in which our intuitive judgment of the intentionality of an action seems to depend on the perceived moral status of that action. The debate on the philosophical implications of the Knobe effect has been framed in terms of the distinction between the competence and performance of the concept of intentionality. Some scholars seem to suggest that the Knobe effect reflects the competence (or otherwise, the performance error) of the concept of intentionality. However, we argue that these notions are purely functional and thus do not have philosophical implications, without assuming normativism, which we see as problematic in a psychological methodology. Finally, focusing on the gap between competence and rationality, we suggest future directions for experimental philosophy.

Differential reorganization of three syntax-related networks induced by a left frontal glioma

The opercular/triangular parts of the left inferior frontal gyrus and the left lateral premotor cortex are critical in syntactic processing. We have recently indicated that a glioma in one of these regions is sufficient to cause agrammatic comprehension. In the present study, we aimed to show how normally existing syntax-related networks are functionally reorganized by a lesion. Twenty-one patients with a left frontal glioma preoperatively performed a picture-sentence matching task, and underwent functional magnetic resonance imaging scans in an event-related design. We established two qualitatively different types of agrammatic comprehension, depending on glioma location. Patients with a glioma in the left lateral premotor cortex had a more profound deficit in the comprehension of scrambled sentences than that of active and passive sentences. In contrast, patients with a glioma in the opercular/triangular parts of the left inferior frontal gyrus had a more profound deficit in the comprehension of passive and scrambled sentences than that of active sentences. Moreover, we found dramatic changes in the activation patterns in these two patient groups, which accompanied abnormal overactivity and/or underactivity in the syntax-related regions. Furthermore, by examining functional connectivity in the normal brain, we identified three syntax-related networks among those regions, and anatomically visualized connections within individual networks by using diffusion tensor imaging. The first network consists of the opercular/triangular parts of the left inferior frontal gyrus, left intraparietal sulcus, right frontal regions, presupplementary motor area, and right temporal regions. These regions were overactivated in the patients with a glioma in the left lateral premotor cortex only for correct responses, indicating a cognitive change. The second network consists of the left lateral premotor cortex, left angular gyrus, lingual gyrus, and cerebellar nuclei. These regions were overactivated in the patients with a glioma in the opercular/triangular parts of the left inferior frontal gyrus for both correct and incorrect responses, indicating a neuronal change. The third network consists of the left ventral frontal and posterior temporal regions. These regions were underactivated in the patients with a glioma in the opercular/triangular parts of the left inferior frontal gyrus, indicating another neuronal change. These results demonstrate that agrammatic comprehension is associated with the global reorganization of functionally distinct networks, which indeed reflects a differential change in the relative contribution of these three networks to normal syntax-related functions.

Functional and anatomical correlates of word-, sentence-, and discourse-level integration in sign language

In both vocal and sign languages, we can distinguish word-, sentence-, and discourse-level integration in terms of hierarchical processes, which integrate various elements into another higher level of constructs. In the present study, we used magnetic resonance imaging and voxel-based morphometry (VBM) to test three language tasks in Japanese Sign Language (JSL): word-level (Word), sentence-level (Sent), and discourse-level (Disc) decision tasks. We analyzed cortical activity and gray matter (GM) volumes of Deaf signers, and clarified three major points. First, we found that the activated regions in the frontal language areas gradually expanded in the dorso-ventral axis, corresponding to a difference in linguistic units for the three tasks. Moreover, the activations in each region of the frontal language areas were incrementally modulated with the level of linguistic integration. These dual mechanisms of the frontal language areas may reflect a basic organization principle of hierarchically integrating linguistic information. Secondly, activations in the lateral premotor cortex and inferior frontal gyrus were left-lateralized. Direct comparisons among the language tasks exhibited more focal activation in these regions, suggesting their functional localization. Thirdly, we found significantly positive correlations between individual task performances and GM volumes in localized regions, even when the ages of acquisition (AOAs) of JSL and Japanese were factored out. More specifically, correlations with the performances of the Word and Sent tasks were found in the left precentral/postcentral gyrus and insula, respectively, while correlations with those of the Disc task were found in the left ventral inferior frontal gyrus and precuneus. The unification of functional and anatomical studies would thus be fruitful for understanding human language systems from the aspects of both universality and individuality.

Left inferior frontal activations depending on the canonicity determined by the argument structures of ditransitive sentences: an MEG study

To elucidate the relationships between syntactic and semantic processes, one interesting question is how syntactic structures are constructed by the argument structure of a verb, where each argument corresponds to a semantic role of each noun phrase (NP). Here we examined the effects of possessivity [sentences with or without a possessor] and canonicity [canonical or noncanonical word orders] using Japanese ditransitive sentences. During a syntactic decision task, the syntactic structure of each sentence would be constructed in an incremental manner based on the predicted argument structure of the ditransitive verb in a verb-final construction. Using magnetoencephalography, we found a significant canonicity effect on the current density in the left inferior frontal gyrus (IFG) at 530-550 ms after the verb onset. This effect was selective to canonical sentences, and significant even when the precedent NP was physically identical. We suggest that the predictive effects associated with syntactic processing became larger for canonical sentences, where the NPs and verb were merged with a minimum structural distance, leading to the left IFG activations. For monotransitive and intransitive verbs, in which structural computation of the sentences was simpler than that of ditransitive sentences, we observed a significant effect selective to noncanonical sentences in the temporoparietal regions during 480-670 ms. This effect probably reflects difficulty in semantic processing of noncanonical sentences. These results demonstrate that the left IFG plays a predictive role in syntactic processing, which depends on the canonicity determined by argument structures, whereas other temporoparietal regions would subserve more semantic aspects of sentence processing.

Neural aspects of sentence comprehension: syntactic complexity, reversibility, and reanalysis

Broca's area is preferentially activated by reversible sentences with complex syntax, but various linguistic factors may be responsible for this finding, including syntactic movement, working-memory demands, and post hoc reanalysis. To distinguish between these, we tested the interaction of syntactic complexity and semantic reversibility in a functional magnetic resonance imaging study of sentence–picture matching. During auditory comprehension, semantic reversibility induced selective activation throughout the left perisylvian language network. In contrast, syntactic complexity (object-embedded vs. subject-embedded relative clauses) within reversible sentences engaged only the left inferior frontal gyrus (LIFG) and left precentral gyrus. Within irreversible sentences, only the LIFG was sensitive to syntactic complexity, confirming a unique role for this region in syntactic processing. Nonetheless, larger effects of reversibility itself occurred in the same regions, suggesting that full syntactic parsing may be a nonautomatic process applied as needed. Complex reversible sentences also induced enhanced signals in LIFG and left precentral regions on subsequent picture selection, but with additional recruitment of the right hemisphere homolog area (right inferior frontal gyrus) as well, suggesting that post hoc reanalysis of sentence structure, compared with initial comprehension, engages an overlapping but larger network of brain regions. These dissociable effects may offer a basis for studying the reorganization of receptive language function after brain damage.