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Chang YN, Welbourne S, Furber S, Lambon Ralph MA. Simultaneous simulations of pure, surface and phonological acquired dyslexia within a full computational model of the primary systems hypothesis. Cortex 2024; 179:112-125. [PMID: 39167917 DOI: 10.1016/j.cortex.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/06/2023] [Accepted: 07/05/2024] [Indexed: 08/23/2024]
Abstract
According to the primary systems hypothesis, reading requires interactions of visual-orthographic, phonological and semantic systems. Damage to each primary system generates very different types of acquired dyslexia. Variants of the connectionist 'triangle' models of reading have been developed to investigate individual acquired dyslexia. However, only a few studies have investigated multiple acquired alexia within one framework. Importantly, there are no studies that simultaneously simulate both central dyslexia (e.g. surface and phonological dyslexia) and peripheral dyslexia (e.g. pure alexia). That is largely due to the lack of a visual component in the traditional reading models. To verify the predictions made by the primary systems hypothesis, we developed a connectionist 'deep' multi-layer triangle model of reading including visual, orthographic, phonological and semantic processing layers. We investigated whether damage to the model could produce the general behavioural patterns of impaired performance observed in patients with the corresponding reading deficits. Crucially, damage to the visual-orthographic, phonological or semantic components of the model resulted in the expected reading impairments associated with pure alexia, phonological dyslexia and surface dyslexia, respectively. The simulation results demonstrated for the first time that neurologically-impaired reading including both central and peripheral dyslexia could be addressed within a single triangle model of reading. The findings are consistent with the predictions made by the primary systems hypothesis.
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Affiliation(s)
- Ya-Ning Chang
- Miin Wu School of Computing, National Cheng Kung University, Taiwan; MRC Cognition and Brain Sciences Unit, University of Cambridge, UK.
| | - Stephen Welbourne
- Neuroscience and Aphasia Research Unit (NARU), University of Manchester, UK
| | - Steve Furber
- School of Computer Science, University of Manchester, UK
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Barbieri E, Salvo JJ, Anderson NL, Simon S, Ables-Torres L, Los MA, Behn J, Bonakdarpour B, Holubecki AM, Braga RM, Mesulam MM. Progressive verbal apraxia of reading. Cortex 2024; 178:223-234. [PMID: 39024940 PMCID: PMC11375791 DOI: 10.1016/j.cortex.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/04/2024] [Accepted: 06/05/2024] [Indexed: 07/20/2024]
Abstract
We identified a syndrome characterized by a relatively isolated progressive impairment of reading words that the patient was able to understand and repeat but without other components of speech apraxia. This cluster of symptoms fits a new syndrome designated Progressive Verbal Apraxia of Reading. A right-handed man (AB) came with a 2.5-year history of increasing difficulties in reading aloud. He was evaluated twice, 2 years apart, using multimodal neuroimaging techniques and quantitative neurolinguistic assessment. In the laboratory, reading difficulties arose in the context of intact visual and auditory word recognition as well as intact ability to understand and repeat words he was unable to read aloud. The unique feature was the absence of dysarthria or speech apraxia in tasks other than reading. Initial imaging did not reveal statistically significant atrophy. Structural magnetic resonance and FDG-PET imaging at the second assessment revealed atrophy and hypometabolism in the right posterior cerebellum, in areas shown to be part of his language network by task-based functional neuroimaging at initial assessment. This syndromic cluster can be designated Progressive Verbal Apraxia of Reading, an entity that has not been reported previously to the best of our knowledge. We hypothesize a selective disconnection of the visual word recognition system from the otherwise intact articulatory apparatus, a disconnection that appears to reflect the disruption of multisynaptic cerebello-cortical circuits.
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Affiliation(s)
- Elena Barbieri
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, USA.
| | - Joseph J Salvo
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
| | - Nathan L Anderson
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
| | - Sarah Simon
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, USA
| | - Lauren Ables-Torres
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, USA
| | - Michelle A Los
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, USA
| | - Jordan Behn
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, USA
| | - Borna Bonakdarpour
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, USA; Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
| | - Ania M Holubecki
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
| | - Rodrigo M Braga
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
| | - Marek-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, USA; Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
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Swamy A, Goswami SP. Appraising Linguistic and Reading Impairments in Kannada-Speaking Persons With Central Alexia. Cureus 2024; 16:e63437. [PMID: 39077278 PMCID: PMC11284617 DOI: 10.7759/cureus.63437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/31/2024] Open
Abstract
INTRODUCTION Alexia is an acquired condition resulting in impaired abilities to comprehend and/or read aloud written scripts secondary to lesions in the brain involved in reading processes. Just as how linguistic aspects are multi-faceted in persons with aphasia (PWAs), the reading impairments also vary extensively across each PWA depending on the type and nature of the language deficits. Each language has its unique linguistic properties. Whether the impairment is in the spoken form or written form, the dissociations in both aspects across the linguistic distinctions are paramount. Given the diverse orthographic features of Kannada, alongside inquiries into the impairment in oral language skills among individuals with acquired reading difficulties, the study emphasizes distinguishing the concurrent language processes associated with reading impairment. AIM The study aimed to explore the relationship between spoken language and reading abilities in Kannada-speaking post-stroke survivors with acquired alexia. METHOD The study recruited 15 Kannada-speaking adults with complaints of reading impairment post-ictus through convenient sampling. The enrolled participants included both males and females with a mean age of 42.2 years (SD=15.58; range=20-68) with 16 years of formal education. The study performed three primary investigations; a) linguistic, b) oral reading, and c) reading comprehension. Linguistic tasks entailed semantics, syntax, and phonological tasks. Oral reading entailed real word and non-word reading tasks. Reading comprehension tasks entailed single-word level, sentence-level, and paragraph-level tasks. RESULTS Results of overall domain performance across linguistics, oral reading, and reading comprehension revealed superior performance in linguistics (M=71.77, SD=19.18) followed by reading comprehension (M=70.55, SD=24.10) and oral reading (M=41.55, SD=24.66), which was significant (p<0.05). Performance in phonology was weakest (M=58.06, SD=12.44) compared to syntax (M=71.13) and semantics (M=85.33) on comparing PWAs' abilities within the linguistic domain. Reading abilities were compared across oral reading and reading comprehension, which significantly varied (p<0.05), and reading comprehension abilities were superior (M=72.65, SD=24.10). Task-specific variabilities were significant (p<0.05) in both oral reading and reading comprehension, wherein, real word reading (M=58.22) and comprehension at a single level (M=80.22) were better performed. Results of correlation analysis revealed semantics (r=0.494, p<0.05) and phonology (r=0.428, p>0.05) were highly positively correlated to oral reading abilities. Syntax (r=0.412, p>0.05), and semantics (r=0.377, p>0.05) were strongly positively correlated to reading comprehension abilities. CONCLUSION The study has convincingly shown that performance on reading-related tasks reflects the functionality of central semantic, phonological, and syntactic processing elements. The literate adults routinely interact with both spoken and written language and a comprehensive assessment framework of language processing must encompass both modalities (linguistic and reading) for individuals with alexia, specific to Indian languages. Owing to the transparent writing system of the Kannada language, a multimodal phonological and lexical-based reading treatment may prove to be beneficial in remediating reading impairments among adult post-stroke survivors.
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Affiliation(s)
- Akshaya Swamy
- Department of Speech and Hearing, Father Muller College, Mangalore, IND
| | - Sathyapal Puri Goswami
- Deaprtment of Speech Language Pathology, All India Institute of Speech and Hearing, Mysuru, IND
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Madden EB, Bush EJ. Insights on Literacy From Stroke Survivors With Aphasia: A Mixed-Methods Inquiry. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-17. [PMID: 38820595 DOI: 10.1044/2024_ajslp-23-00360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
PURPOSE Individuals with aphasia commonly experience reading and writing difficulties, negatively impacting everyday communication and life participation. Using mixed methods, this study aimed to understand literacy experiences described by individuals with aphasia and explore how their perspectives are related to test performance and other demographic factors. METHOD Twenty-one stroke survivors with aphasia completed reading and writing testing and shared their perspectives through a close-ended survey and an open-ended interview about literacy abilities and experiences. Quantitative methods were used to compare pre- and poststroke self-ratings and explore associations between self-ratings and demographic factors. Qualitative methods were used to identify themes in the interviews. The data sets were merged to derive mixed-methods results for a more in-depth view of participants' perspectives. RESULTS Significant decreases in perceived literacy abilities were found; however, there were no differences in literacy importance or enjoyment pre- to poststroke. Reading and writing test scores were correlated with self-rated abilities but not with importance, enjoyment, or frequency of reading and writing. The thematic analysis process identified four main themes: Feelings about literacy, Literacy challenges, Literacy supports, and Literacy goals. CONCLUSIONS The data indicate that individuals with aphasia highly value reading and writing and are heavily invested, despite recognized challenges, in using and improving these skills. Therefore, assessments and treatments addressing literacy in aphasia are critical, and individuals with aphasia should be invited to share their literacy experiences and goals, allowing for more person-centered clinical resources to be collaboratively constructed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25893049.
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Affiliation(s)
- Elizabeth B Madden
- School of Communication Science & Disorders, Florida State University, Tallahassee
| | - Erin J Bush
- School of Communication Science & Disorders, Florida State University, Tallahassee
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Bartha-Doering L, Roberts D, Baumgartner B, Yildirim MS, Giordano V, Spagna A, Pal-Handl K, Javorszky SM, Kasprian G, Seidl R. Developmental surface dyslexia and dysgraphia in a child with corpus callosum agenesis: an approach to diagnosis and treatment. Cogn Neuropsychol 2024; 41:148-170. [PMID: 38942485 DOI: 10.1080/02643294.2024.2368876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/30/2024]
Abstract
We present a case study detailing cognitive performance, functional neuroimaging, and effects of a hypothesis-driven treatment in a 10-year-old girl diagnosed with complete, isolated corpus callosum agenesis. Despite having average overall intellectual abilities, the girl exhibited profound surface dyslexia and dysgraphia. Spelling treatment significantly and persistently improved her spelling of trained irregular words, and this improvement generalized to reading accuracy and speed of trained words. Diffusion weighted imaging revealed strengthened intrahemispheric white matter connectivity of the left temporal cortex after treatment and identified interhemispheric connectivity between the occipital lobes, likely facilitated by a pathway crossing the midline via the posterior commissure. This case underlines the corpus callosum's critical role in lexical reading and writing. It demonstrates that spelling treatment may enhance interhemispheric connectivity in corpus callosum agenesis through alternative pathways, boosting the development of a more efficient functional organization of the visual word form area within the left temporo-occipital cortex.
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Affiliation(s)
- Lisa Bartha-Doering
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Daniel Roberts
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Bettina Baumgartner
- Department of Logopedics, Phoniatrics, and Audiology, University of Applied Sciences, Vienna, Austria
| | - Mehmet Salih Yildirim
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Vito Giordano
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Alfredo Spagna
- Department of Psychology, Columbia University, New York, NY, USA
| | - Katharina Pal-Handl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Susanne Maria Javorszky
- Department of Logopedics, Phoniatrics, and Audiology, University of Applied Sciences, Vienna, Austria
| | - Gregor Kasprian
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Rainer Seidl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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Jebahi F, Nickels KV, Kielar A. Patterns of performance on the animal fluency task in logopenic variant of primary progressive aphasia: A reflection of phonological and semantic skills. JOURNAL OF COMMUNICATION DISORDERS 2024; 108:106405. [PMID: 38324949 DOI: 10.1016/j.jcomdis.2024.106405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE This study aimed to characterize the quantitative (total number of correct words generated) and qualitative (psycholinguistic properties of correct words generated) performance patterns on the animal fluency task in individuals with the logopenic variant of primary progressive aphasia and to investigate the influence of phonological and semantic abilities to these patterns. METHODS Fifteen participants with lvPPA and twenty neurotypical adults completed the animal fluency task and an assessment battery to characterize their phonological and semantic abilities. We recorded the total number of correct words produced and their psycholinguistic properties. Group differences were analyzed using independent samples t-tests and analysis of covariance. Stepwise and multiple linear regression analyses were implemented to investigate the contribution of psycholinguistic properties on word generation as well as the role of phonological and semantic abilities on performance. We also investigated the mediating role of phonological and semantic abilities on the relationship between relevant psycholinguistic properties and word generation output. RESULTS Compared to neurotypical controls, participants with lvPPA produced fewer correct responses and more words with lower age of acquisition. The total number of correct words generated was predicted by the age of word acquisition, such that individuals who generated more responses, produced words acquired later in life. Phonology and semantics influenced the number of correct words generated and their frequency, age of acquisition, and semantic neighborhood density. Familiarity and arousal were driven by semantic abilities. Phonological abilities partially mediated the relationship between age of acquisition and word generation output. CONCLUSIONS This study provides valuable insights into the performance patterns of the animal fluency task in lvPPA. Individuals with lvPPA with more intact phonological and semantic abilities generated greater number of words with more complex psycholinguistic properties. Our findings contribute to the understanding of language processes underlying word retrieval in lvPPA.
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Affiliation(s)
- Fatima Jebahi
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA.
| | - Katlyn V Nickels
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
| | - Aneta Kielar
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA
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van der Molen MW, Snellings P, Aravena S, Fraga González G, Zeguers MHT, Verwimp C, Tijms J. Dyslexia, the Amsterdam Way. Behav Sci (Basel) 2024; 14:72. [PMID: 38275355 PMCID: PMC10813111 DOI: 10.3390/bs14010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
The current aim is to illustrate our research on dyslexia conducted at the Developmental Psychology section of the Department of Psychology, University of Amsterdam, in collaboration with the nationwide IWAL institute for learning disabilities (now RID). The collaborative efforts are institutionalized in the Rudolf Berlin Center. The first series of studies aimed at furthering the understanding of dyslexia using a gamified tool based on an artificial script. Behavioral measures were augmented with diffusion modeling in one study, and indices derived from the electroencephalogram were used in others. Next, we illustrated a series of studies aiming to assess individuals who struggle with reading and spelling using similar research strategies. In one study, we used methodology derived from the machine learning literature. The third series of studies involved intervention targeting the phonics of language. These studies included a network analysis that is now rapidly gaining prominence in the psychopathology literature. Collectively, the studies demonstrate the importance of letter-speech sound mapping and word decoding in the acquisition of reading. It was demonstrated that focusing on these abilities may inform the prediction, classification, and intervention of reading difficulties and their neural underpinnings. A final section examined dyslexia, conceived as a neurobiological disorder. This analysis converged on the conclusion that recent developments in the psychopathology literature inspired by the focus on research domain criteria and network analysis might further the field by staying away from longstanding debates in the dyslexia literature (single vs. a multiple deficit, category vs. dimension, disorder vs. lack of skill).
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Affiliation(s)
- Maurits W. van der Molen
- Developmental Psychology, Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Rudolf Berlin Center for Learning Disabilities, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
| | - Patrick Snellings
- Developmental Psychology, Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Rudolf Berlin Center for Learning Disabilities, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
| | | | | | - Maaike H. T. Zeguers
- Samenwerkingsverband VO Amsterdam-Diemen, Bijlmermeerdreef 1289, 1103 TV Amsterdam, The Netherlands
| | - Cara Verwimp
- Developmental Psychology, Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Rudolf Berlin Center for Learning Disabilities, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
| | - Jurgen Tijms
- Developmental Psychology, Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Rudolf Berlin Center for Learning Disabilities, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
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G S A, Ponniah RJ. The Modularity of Dysgraphia. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2023; 52:2903-2917. [PMID: 37930468 DOI: 10.1007/s10936-023-10029-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
Research regarding dysgraphia, an impairment in writing, is attaining more attention in recent times. The existing studies on dysgraphia draw insights from cognitive, behavioural, neurological, and genetic fields of knowledge. However, these multiple studies on dysgraphia fail to illustrate how these cognitive, behavioural, neurological, and genetic systems interact and intersect in dysgraphia. Therefore, the studies could not offer a comprehensive understanding of dysgraphia. In order to fill this gap, the review attempts to study dysgraphia using the notion of modularity by accommodating insights from cognitive, behavioural, neurological, and genetic aspects of dysgraphia. Such a profound understanding could facilitate an early diagnosis and holistic intervention towards dysgraphia.
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Affiliation(s)
- Aiswarya G S
- Department of Humanities and Social Sciences, National Institute of Technology, Tiruchirappalli, 620015, Tamil Nadu, India
| | - R Joseph Ponniah
- Department of Humanities and Social Sciences, National Institute of Technology, Tiruchirappalli, 620015, Tamil Nadu, India.
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Panahi R, Akbari M, Jarollahi F, Haghani H, Kazemnezhad Leyli E, Zia M. Atypical function of auditory sensory gating in children with developmental dyslexia: Investigating its relationship with cognitive abilities. DYSLEXIA (CHICHESTER, ENGLAND) 2023; 29:426-440. [PMID: 37779260 DOI: 10.1002/dys.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 06/24/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023]
Abstract
Impairments of auditory processing are among frequent findings in dyslexia. However, it is unclear how auditory signals are gated from brainstem to higher central processing stages in these individuals. The present study was done to investigate auditory sensory gating in children with developmental dyslexia (DD), and to determine whether sensory gating correlates with performance on behavioural tasks. Auditory sensory gating at P50, N1 and P2 waves was evaluated in two groups including 20 children with DD and 19 children with typical reading development (TRD). Behavioural tests were used to evaluate phonological working memory (PWM) and selective attention abilities. Sensory gating in children with DD was significantly less efficient than their peers at P50, N1 and P2 waves. Lower auditory evoked potential (AEP) amplitudes were found in the DD group. The children with TRD scored better in all the behavioural tests. Relationships were reported between sensory gating at P50, N1, P2 and behavioural performance in the two groups. Children with dyslexia had deficient sensory gating in comparison with controls. In addition, children with dyslexia experienced problems with PWM and selective attention tasks. The function of sensory gating was associated with attentional and PWM performances in this group.
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Affiliation(s)
- Rasool Panahi
- Otorhinolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Akbari
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farnoush Jarollahi
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Haghani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Kazemnezhad Leyli
- Department of Biostatistics, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Zia
- Otorhinolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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An SK, Jang H, Kim HJ, Na DL, Yoon JH. Linguistic, visuospatial, and kinematic writing characteristics in cognitively impaired patients with beta-amyloid deposition. Front Aging Neurosci 2023; 15:1217746. [PMID: 37753065 PMCID: PMC10518411 DOI: 10.3389/fnagi.2023.1217746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/26/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction Beta-amyloid (Aβ) deposition, a hallmark of Alzheimer's disease (AD), begins before dementia and is an important factor in mild cognitive impairment (MCI). Aβ deposition is a recognized risk factor for various cognitive impairments and has been reported to affect motor performance as well. This study aimed to identify the linguistic, visuospatial, and kinematic characteristics evident in the writing performance of patients with cognitive impairment (CI) who exhibit Aβ deposition. Methods A total of 31 patients diagnosed with amnestic mild cognitive impairment (aMCI) with Aβ deposition, 26 patients with Alzheimer's-type dementia, and 33 healthy control (HC) participants without deposition were administered tasks involving dictation of 60 regular words, irregular words, and non-words consisting of 1-4 syllables. Responses from all participants were collected and analyzed through digitized writing tests and analysis tools. Results In terms of linguistic aspects, as cognitive decline progressed, performance in the dictation of irregular words decreased, with errors observed in substituting the target grapheme with other graphemes. The aMCI group frequently exhibited corrective aspects involving letter rewriting during the task. In terms of visuospatial aspects, the AD group displayed more errors in grapheme combination compared to the HC group. Lastly, in the kinematic aspects, both the aMCI group and the AD group exhibited slower writing speeds compared to the HC group. Discussion The findings suggest that individuals in the CI group exhibited lower performance in word dictation tasks than those in the HC group, and these results possibly indicate complex cognitive-language-motor deficits resulting from temporal-parietal lobe damage, particularly affecting spelling processing. These results provide valuable clinical insights into understanding linguistic-visuospatial-kinematic aspects that contribute to the early diagnosis of CI with Aβ deposition.
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Affiliation(s)
- Seo Kyung An
- Department of Speech-Language Pathology and Audiology, Hallym University, Chuncheon, Republic of Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Yoon
- Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, Hallym University, Chuncheon, Republic of Korea
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de Carvalho Rodrigues J, Pioli Dos Santos D, de Bitencourt Fél D, de Salles JF. Word Reading and Spelling Processing and Acquired Dyslexia post Unilateral Stroke. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2023; 52:1017-1035. [PMID: 37022628 DOI: 10.1007/s10936-023-09951-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
This study investigates the performance of adults with cerebrovascular lesion in the right hemisphere (RHL) or left hemisphere (LHL) in word reading (TLPP) and spelling (TEPP) tasks based on the dual-route models. A total of 85 adults were assessed, divided into three groups: 10 with RHL, 15 with LHL, and 60 neurologically healthy ones. The performance of the three groups was compared in terms of the characteristics of the words (regularity, frequency, and length) and pseudowords (length), error types, and psycholinguistic effects. A cluster analysis was performed to investigate the profiles of the reading. The LHL group showed lower scores in reading and spelling tasks of words and pseudowords, as well as a higher frequency of errors. Four LHL cases were found to have an acquired dyslexia profile. This study highlights that the tasks developed in Brazil are in accordance with theoretical models of written language, and the results point to the heterogeneous performance of the cases with acquired dyslexia.
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Affiliation(s)
- Jaqueline de Carvalho Rodrigues
- MSc and PhD in Psychology, Professora do Departamento de Psicologia da Pontifícia Universidade Católica do Rio de Janeiro - PUCRio, Rua Marquês de São Vicente, 225, Gávea, Rio de Janeiro, Brazil.
| | - Daniele Pioli Dos Santos
- Psychologist, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Débora de Bitencourt Fél
- Psychologist, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Jerusa Fumagalli de Salles
- MSc and PhD in Psychology, Professora Associada na Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
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Levy DF, Silva AB, Scott TL, Liu JR, Harper S, Zhao L, Hullett PW, Kurteff G, Wilson SM, Leonard MK, Chang EF. Apraxia of speech with phonological alexia and agraphia following resection of the left middle precentral gyrus: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 5:CASE22504. [PMID: 37014023 PMCID: PMC10550577 DOI: 10.3171/case22504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/23/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Apraxia of speech is a disorder of speech-motor planning in which articulation is effortful and error-prone despite normal strength of the articulators. Phonological alexia and agraphia are disorders of reading and writing disproportionately affecting unfamiliar words. These disorders are almost always accompanied by aphasia. OBSERVATIONS A 36-year-old woman underwent resection of a grade IV astrocytoma based in the left middle precentral gyrus, including a cortical site associated with speech arrest during electrocortical stimulation mapping. Following surgery, she exhibited moderate apraxia of speech and difficulty with reading and spelling, both of which improved but persisted 6 months after surgery. A battery of speech and language assessments was administered, revealing preserved comprehension, naming, cognition, and orofacial praxis, with largely isolated deficits in speech-motor planning and the spelling and reading of nonwords. LESSONS This case describes a specific constellation of speech-motor and written language symptoms-apraxia of speech, phonological agraphia, and phonological alexia in the absence of aphasia-which the authors theorize may be attributable to disruption of a single process of "motor-phonological sequencing." The middle precentral gyrus may play an important role in the planning of motorically complex phonological sequences for production, independent of output modality.
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Affiliation(s)
- Deborah F. Levy
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Alexander B. Silva
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
- University of California Berkeley - University of California San Francisco Graduate Program in Bioengineering, Berkeley, California
- Medical Scientist Training Program, University of California, San Francisco, California
| | - Terri L. Scott
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Jessie R. Liu
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
- University of California Berkeley - University of California San Francisco Graduate Program in Bioengineering, Berkeley, California
| | - Sarah Harper
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Lingyun Zhao
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Patrick W. Hullett
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Garret Kurteff
- Department of Speech, Language, and Hearing Sciences, University of Texas Austin, Austin, Texas; and
| | - Stephen M. Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, Tennessee
| | - Matthew K. Leonard
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Edward F. Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
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Biddau F, Brisotto C, Innocenti T, Ranaldi S, Meneghello F, D'Imperio D, Nordio S. Speech and Language Therapy for Acquired Central Dysgraphia in Neurological Patients: A Systematic Review to Describe and Identify Trainings for Clinical Practice. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:762-785. [PMID: 36857041 DOI: 10.1044/2022_ajslp-22-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Acquired central dysgraphia is a heterogeneous neurological disorder that usually co-occurs with other language disorders. Written language training is relevant to improve everyday skills and as a compensatory strategy to support limited oral communication. A systematic evaluation of existing writing treatments is thus needed. METHOD We performed a systematic review of speech and language therapies for acquired dysgraphia in studies of neurological diseases (PROSPERO: CRD42018084221), following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist with a search on several databases for articles written in English and published until August 31, 2021. Only methodological well-designed studies were included. Further assessment of methodological quality was conducted by means of a modified version of the Downs and Black checklist. RESULTS Eleven studies of 43 patients in total were included. For each study, we collected data on type of population, type of impairment, experimental design, type of treatment, and measured outcomes. The studies had a medium level of assessed methodological quality. An informative description of treatments and linkages to deficits is reported. CONCLUSIONS Although there is a need for further experimental evidence, most treatments showed good applicability and improvement of written skills in patients with dysgraphia. Lexical treatments appear to be more frequently adopted and more flexible in improving dysgraphia and communication, especially when a multimodal approach is used. Finally, the reported description of treatment modalities for dysgraphia in relation to patients' deficits may be important for providing tailored therapies in clinical management.
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Affiliation(s)
| | | | - Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, the Netherlands
- GIMBE Foundation, Bologna, Italy
| | - Sara Ranaldi
- UOIAF (Unità Operativa Infanzia Adolescenza Famiglia), Ulss 3 Serenissima, Venice, Italy
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Piazzalunga C, Dui LG, Termine C, Bortolozzo M, Matteucci M, Ferrante S. Investigating Visual Perception Impairments through Serious Games and Eye Tracking to Anticipate Handwriting Difficulties. SENSORS (BASEL, SWITZERLAND) 2023; 23:1765. [PMID: 36850364 PMCID: PMC9958538 DOI: 10.3390/s23041765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/23/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Dysgraphia is a learning disability that causes handwritten production below expectations. Its diagnosis is delayed until the completion of handwriting development. To allow a preventive training program, abilities not directly related to handwriting should be evaluated, and one of them is visual perception. To investigate the role of visual perception in handwriting skills, we gamified standard clinical visual perception tests to be played while wearing an eye tracker at three difficulty levels. Then, we identified children at risk of dysgraphia through the means of a handwriting speed test. Five machine learning models were constructed to predict if the child was at risk, using the CatBoost algorithm with Nested Cross-Validation, with combinations of game performance, eye-tracking, and drawing data as predictors. A total of 53 children participated in the study. The machine learning models obtained good results, particularly with game performances as predictors (F1 score: 0.77 train, 0.71 test). SHAP explainer was used to identify the most impactful features. The game reached an excellent usability score (89.4 ± 9.6). These results are promising to suggest a new tool for dysgraphia early screening based on visual perception skills.
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Affiliation(s)
- Chiara Piazzalunga
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Linda Greta Dui
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Cristiano Termine
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | - Marisa Bortolozzo
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | - Matteo Matteucci
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Simona Ferrante
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
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Nickels K, Beeson PM, Rising K, Jebahi F, Kielar A. Positive changes to written language following phonological treatment in logopenic variant primary progressive aphasia: Case report. Front Hum Neurosci 2023; 16:1006350. [PMID: 36760227 PMCID: PMC9905434 DOI: 10.3389/fnhum.2022.1006350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/31/2022] [Indexed: 01/26/2023] Open
Abstract
Phonological impairment contributes to deficits in repetition and spoken naming in logopenic variant Primary Progressive Aphasia (lvPPA), but weakened phonology can also affect written language skills. In this experimental case report, we demonstrate phonological text agraphia in a 71-year-old woman in the early stages of lvPPA that undermined her ability to write meaningful, grammatical sentences. We investigated the therapeutic value of a rigorous treatment protocol to strengthen phonological manipulation skills coupled with transcranial direct current stimulation (tDCS). Intervention took place 5 days a week for 2 weeks with active tDCS, followed by a 2-month rest period, and then a second period of phonological treatment with sham tDCS. Over the course of treatment, our participant demonstrated improved phonological transcoding and manipulation skills as well as marked improvement in the proportion of grammatically well-formed, meaningful written narratives. Improvements in spelling and letter selection were also observed. Treatment gains were documented during phonological intervention in both active tDCS and sham treatment phases and were maintained 2 months after the conclusion of intervention. Importantly, improvements were observed in the context of a progressive disorder. These data present compelling evidence regarding the impairment-based approach that targets compromised phonological skills, presenting opportunity for improving functional written communication skills relevant to the everyday lives of individuals with lvPPA.
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Affiliation(s)
- Katlyn Nickels
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
| | - Pélagie M. Beeson
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
- Department of Neurology, The University of Arizona, Tucson, AZ, United States
| | - Kindle Rising
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
| | - Fatima Jebahi
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
| | - Aneta Kielar
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
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Ohdake R, Watanabe H, Kawabata K, Ogura A, Sato M, Tanaka Y, Imai K, Masuda M, Kato T, Yokoi T, Hara K, Nakamura R, Atsuta N, Nakagawa M, Katsuno M, Sobue G. Convenient Auditory-Based Language and Executive Function Test for Patients With Amyotrophic Lateral Sclerosis: A Pilot Study. Arch Clin Neuropsychol 2023; 38:57-71. [PMID: 36003060 DOI: 10.1093/arclin/acac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE About 30%-50% of patients with amyotrophic lateral sclerosis (ALS) show cognitive impairment ranging from mild dysexecutive syndrome to frontotemporal dementia. We aimed to develop a brief cognitive test, convenient auditory-based language and executive function test (CABLET), for rapid detection of cognitive impairment in ALS, with reduced load on motor function. METHOD The CABLET comprises two tests using auditory verbal stimuli: Test 1, assessing word repetition and lexical judgment, and Test 2, evaluating verbal short-term memory and semantics knowledge. The administration time of Test 1 and Test 2 was 1 and 3-5 min, respectively. Overall, 61 patients with ALS and 46 age-, sex-, and education-matched healthy controls participated in this study. All participants underwent existing neuropsychological tests and the CABLET. We investigated the applicability of the CABLET to detect ALS with cognitive impairment (ALSci) from normal cognition. RESULTS Receiver operating characteristic analyses showed that both the CABLET total and Test 2 had good diagnostic accuracy (area under the curve [AUC]: total = 0.894, Test 2 = 0.893). Test 2 had the highest sensitivity (100% sensitivity and 71.4% specificity). No significant difference existed in the AUC between the analyses with and without age, education, and disease severity as covariates. Correlations were observed between the CABLET and established neuropsychological tests, supporting its good convergent validity. CONCLUSIONS Our findings indicated that the CABLET could be useful in identifying ALSci quickly without adjusting for confounding factors. Further validation is required to evaluate it in larger groups and compare with ALS-specific cognitive screen.
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Affiliation(s)
- Reiko Ohdake
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan
- Department of Neurology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hirohisa Watanabe
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan
- Department of Neurology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuya Kawabata
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Aya Ogura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Maki Sato
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Tanaka
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazunori Imai
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michihito Masuda
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiyasu Kato
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takamasa Yokoi
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhiro Hara
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryoichi Nakamura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Gen Sobue
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan
- Aichi Medical University, Nagakute, Japan
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Beeson PM, Rising K, Sachs A, Rapcsak SZ. Common predictors of spoken and written language performance in aphasia, alexia, and agraphia. Front Hum Neurosci 2022; 16:1025468. [PMID: 36419644 PMCID: PMC9677348 DOI: 10.3389/fnhum.2022.1025468] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/28/2022] [Indexed: 09/01/2024] Open
Abstract
Language performance requires support from central cognitive/linguistic abilities as well as the more peripheral sensorimotor skills to plan and implement spoken and written communication. Both output modalities are vulnerable to impairment following damage to the language-dominant hemisphere, but much of the research to date has focused exclusively on spoken language. In this study we aimed to examine an integrated model of language processing that includes the common cognitive processes that support spoken and written language, as well as modality-specific skills. To do so, we evaluated spoken and written language performance from 87 individuals with acquired language impairment resulting from damage to left perisylvian cortical regions that collectively constitute the dorsal language pathway. Comprehensive behavioral assessment served to characterize the status of central and peripheral components of language processing in relation to neurotypical controls (n = 38). Performance data entered into principal components analyses (with or without control scores) consistently yielded a strong five-factor solution. In line with a primary systems framework, three central cognitive factors emerged: semantics, phonology, and orthography that were distinguished from peripheral processes supporting speech production and allographic skill for handwriting. The central phonology construct reflected performance on phonological awareness and manipulation tasks and showed the greatest deficit of all the derived factors. Importantly, this phonological construct was orthogonal to the speech production factor that reflected repetition of words/non-words. When entered into regression analyses, semantics and phonological skill were common predictors of language performance across spoken and written modalities. The speech production factor was also a strong, distinct predictor of spoken naming and oral reading, in contrast to allographic skills which only predicted written output. As expected, visual orthographic processing contributed more to written than spoken language tasks and reading/spelling performance was strongly reliant on phonological and semantic abilities. Despite the heterogeneity of this cohort regarding aphasia type and severity, the marked impairment of phonological skill was a unifying feature. These findings prompt greater attention to clinical assessment and potential treatment of underlying phonological skill in individuals with left perisylvian damage.
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Affiliation(s)
- Pélagie M. Beeson
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
- Department of Neurology, The University of Arizona, Tucson, AZ, United States
| | - Kindle Rising
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
| | - Alyssa Sachs
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
| | - Steven Z. Rapcsak
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, AZ, United States
- Department of Neurology, The University of Arizona, Tucson, AZ, United States
- Banner Alzheimer’s Institute, Tucson, AZ, United States
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18
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Pillay SB, Gross WL, Heffernan J, Book DS, Binder JR. Semantic network activation facilitates oral word reading in chronic aphasia. BRAIN AND LANGUAGE 2022; 233:105164. [PMID: 35933744 PMCID: PMC9948519 DOI: 10.1016/j.bandl.2022.105164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 03/22/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
People with aphasia often show partial impairments on a given task. This trial-to-trial variability offers a potential window into understanding how damaged language networks function. We test the hypothesis that successful word reading in participants with phonological system damage reflects semantic system recruitment. Residual semantic and phonological networks were defined with fMRI in 21 stroke participants with phonological damage using semantic- and rhyme-matching tasks. Participants performed an oral word reading task, and activation was compared between correct and incorrect trials within the semantic and phonological networks. The results showed a significant interaction between hemisphere, network activation, and reading success. Activation in the left hemisphere semantic network was higher when participants successfully read words. Residual phonological regions showed no difference in activation between correct and incorrect trials on the word reading task. The results provide evidence that semantic processing supports successful phonological retrieval in participants with phonological impairment.
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Affiliation(s)
- Sara B Pillay
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States.
| | - William L Gross
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States; Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Joseph Heffernan
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Diane S Book
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Jeffrey R Binder
- Department of Neurology and the Center for Imaging Research, Medical College of Wisconsin, Milwaukee, WI 53226, United States
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Woolnough O, Donos C, Curtis A, Rollo PS, Roccaforte ZJ, Dehaene S, Fischer-Baum S, Tandon N. A Spatiotemporal Map of Reading Aloud. J Neurosci 2022; 42:5438-5450. [PMID: 35641189 PMCID: PMC9270918 DOI: 10.1523/jneurosci.2324-21.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/01/2022] [Accepted: 05/07/2022] [Indexed: 01/09/2023] Open
Abstract
Reading words aloud is a fundamental aspect of literacy. The rapid rate at which multiple distributed neural substrates are engaged in this process can only be probed via techniques with high spatiotemporal resolution. We probed this with direct intracranial recordings covering most of the left hemisphere in 46 humans (26 male, 20 female) as they read aloud regular, exception and pseudo-words. We used this to create a spatiotemporal map of word processing and to derive how broadband γ activity varies with multiple word attributes critical to reading speed: lexicality, word frequency, and orthographic neighborhood. We found that lexicality is encoded earliest in mid-fusiform (mFus) cortex, and precentral sulcus, and is represented reliably enough to allow single-trial lexicality decoding. Word frequency is first represented in mFus and later in the inferior frontal gyrus (IFG) and inferior parietal sulcus (IPS), while orthographic neighborhood sensitivity resides solely in IPS. We thus isolate the neural correlates of the distributed reading network involving mFus, IFG, IPS, precentral sulcus, and motor cortex and provide direct evidence for parallel processes via the lexical route from mFus to IFG, and the sublexical route from IPS and precentral sulcus to anterior IFG.SIGNIFICANCE STATEMENT Reading aloud depends on multiple complex cerebral computations: mapping from a written letter string on a page to a sequence of spoken sound representations. Here, we used direct intracranial recordings in a large cohort while they read aloud known and novel words, to track, across space and time, the progression of neural representations of behaviorally relevant factors that govern reading speed. We find, concordant with cognitive models of reading, that known and novel words are differentially processed through a lexical route, sensitive to frequency of occurrence of known words in natural language, and a sublexical route, performing letter-by-letter construction of novel words.
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Affiliation(s)
- Oscar Woolnough
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas 77030
- Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas 77030
| | - Cristian Donos
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas 77030
- Faculty of Physics, University of Bucharest, Bucharest, 050663, Romania
| | - Aidan Curtis
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas 77030
| | - Patrick S Rollo
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas 77030
- Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas 77030
| | - Zachary J Roccaforte
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas 77030
- Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas 77030
| | - Stanislas Dehaene
- Cognitive Neuroimaging Unit CEA, Institut National de la Santé et de la Recherche Médicale, NeuroSpin Center, Université Paris-Sud and Université Paris-Saclay, Gif-sur-Yvette, 91191, France
- Collège de France, Paris, 75005, France
| | - Simon Fischer-Baum
- Department of Psychological Sciences, Rice University, Houston, Texas 77005
| | - Nitin Tandon
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas 77030
- Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas 77030
- Memorial Hermann Hospital, Texas Medical Center, Houston, Texas 77030
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Sullivan AW, Bowren MD, Bruss J, Tranel D, Demir-Lira ÖE. Academic skills after brain injury: A lifespan perspective. Neuropsychology 2022; 36:419-432. [PMID: 35420857 PMCID: PMC9631230 DOI: 10.1037/neu0000806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study investigated academic skills outcomes after brain injury and identified the influence of age and injury factors across the lifespan. METHOD Our sample included 651 participants with focal brain lesions. Math, reading, and spelling data from the Wide Range Achievement Test (WRAT) were used as the academic skills outcomes. Age of lesion onset ranged from 0 to 85 years old. Linear regressions were conducted to identify the relation between age and injury factors and academic skills outcomes. Lesion-symptom mapping was conducted to identify the brain areas that, when lesioned, were associated with deficits in academic skills. RESULTS A quadratic model of age of lesion onset significantly predicted math (R² = .28, p < .001), reading (R² = .29, p < .001), and spelling outcomes (R² = .32, p < .001), while accounting for various covariates. Education, sex, lesion size and laterality, etiology, and seizure history were additional reliable predictors of academic skills outcomes across the lifespan. Academic skill deficits were associated with damage to various brain areas across the left-hemisphere frontal, temporal, and parietal lobes, the insular area, and left- and right-hemisphere white matter. CONCLUSIONS This study supports age of lesion onset as a relevant predictor of academic skills after brain injury in a lifespan sample. Several other variables (e.g., education, sex, lesion characteristics, and seizure history) are notable in the prediction of outcomes across the lifespan. Future work could investigate more diverse samples and emphasize recruitment of early onset injuries to examine generalizability and potential critical periods for academic skills. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Asci F, Scardapane S, Zampogna A, D’Onofrio V, Testa L, Patera M, Falletti M, Marsili L, Suppa A. Handwriting Declines With Human Aging: A Machine Learning Study. Front Aging Neurosci 2022; 14:889930. [PMID: 35601625 PMCID: PMC9120912 DOI: 10.3389/fnagi.2022.889930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundHandwriting is an acquired complex cognitive and motor skill resulting from the activation of a widespread brain network. Handwriting therefore may provide biologically relevant information on health status. Also, handwriting can be collected easily in an ecological scenario, through safe, cheap, and largely available tools. Hence, objective handwriting analysis through artificial intelligence would represent an innovative strategy for telemedicine purposes in healthy subjects and people affected by neurological disorders.Materials and MethodsOne-hundred and fifty-six healthy subjects (61 males; 49.6 ± 20.4 years) were enrolled and divided according to age into three subgroups: Younger adults (YA), middle-aged adults (MA), and older adults (OA). Participants performed an ecological handwriting task that was digitalized through smartphones. Data underwent the DBNet algorithm for measuring and comparing the average stroke sizes in the three groups. A convolutional neural network (CNN) was also used to classify handwriting samples. Lastly, receiver operating characteristic (ROC) curves and sensitivity, specificity, positive, negative predictive values (PPV, NPV), accuracy and area under the curve (AUC) were calculated to report the performance of the algorithm.ResultsStroke sizes were significantly smaller in OA than in MA and YA. The CNN classifier objectively discriminated YA vs. OA (sensitivity = 82%, specificity = 80%, PPV = 78%, NPV = 79%, accuracy = 77%, and AUC = 0.84), MA vs. OA (sensitivity = 84%, specificity = 56%, PPV = 78%, NPV = 73%, accuracy = 74%, and AUC = 0.7), and YA vs. MA (sensitivity = 75%, specificity = 82%, PPV = 79%, NPV = 83%, accuracy = 79%, and AUC = 0.83).DiscussionHandwriting progressively declines with human aging. The effect of physiological aging on handwriting abilities can be detected remotely and objectively by using machine learning algorithms.
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Affiliation(s)
| | - Simone Scardapane
- Department of Information, Electronic and Communication Engineering (DIET), Sapienza University of Rome, Rome, Italy
| | | | | | - Lucia Testa
- Department of Informatic, Automatic and Gestional Engineering (DIAG), Sapienza University of Rome, Rome, Italy
| | - Martina Patera
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Marco Falletti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Luca Marsili
- Department of Neurology, Gardner Family Center for Parkinson’s Disease and Movement Disorders, University of Cincinnati, Cincinnati, OH, United States
| | - Antonio Suppa
- IRCCS Neuromed Institute, Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- *Correspondence: Antonio Suppa,
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Evidence of Altered Functional Connectivity at Rest in the Writing Network of Children with Dyslexia. Brain Sci 2022; 12:brainsci12020243. [PMID: 35204006 PMCID: PMC8869855 DOI: 10.3390/brainsci12020243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 02/04/2023] Open
Abstract
Aim. Handwriting abilities in children with dyslexia (DYS) are not well documented in the current literature, and the presence of graphomotor impairment in addition to spelling impairment in dyslexia is controversial. Using resting-state functional connectivity (RSFC), the present study aims to answer the following question: are there markers of graphomotor impairment at rest in DYS children? Method. The participants were children with DYS and typically developing (TD) children (n = 32) from French-speaking primary schools (Mage = 9.3 years). The behavioural evaluation consisted of spelling and handwriting measures. Participants underwent a resting-state fMRI scan. Results. Analyses of RSFC focused on a brain region responsible for graphomotor processes—the graphemic/motor frontal area (GMFA). The RSFC between the GMFA and all other voxels of the brain was measured. Whole-brain ANOVAs were run to compare RSFC in DYS and TD children. The results demonstrated reduced RSFC in DYS compared to TD between the GMFA and brain areas involved in both spelling processes and motor-related processes. Conclusions. For the first time, this study highlighted a disruption of the writing network in DYS. By identifying functional markers of both spelling and handwriting deficits at rest in young DYS participants, this study supports the presence of graphomotor impairment in dyslexia.
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23
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Cohen L. Acquired dyslexias following temporal lesions. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:277-285. [PMID: 35964977 DOI: 10.1016/b978-0-12-823493-8.00003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The acquisition of reading by children is supported by deep changes in the brain systems devoted to vision and language. The left temporal lobe contributes critically to both systems, and lesions affecting it may therefore cause both peripheral vision-related and central language-related reading impairments. The diversity of peripheral dyslexias reflects the anatomical and functional division of the visual cortex into early visual regions, whose lesions have a limited impact on reading; ventral regions, whose lesions are mostly associated to Pure Alexia; and dorsal regions, whose lesions may yield spatial, neglect-related, and attentional dyslexias. Similarly, central alexias reflect the broad distinction, within language processes, between phonological and lexico-semantic components. Phonological and surface dyslexias roughly result from impairment of the former and the latter processes, respectively, while deep dyslexia may be seen as the association of both. In this chapter, we review such types of acquired dyslexias, their clinical features, pathophysiology, and anatomical correlates.
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Affiliation(s)
- Laurent Cohen
- Paris Brain Institute, Hôpital de la Pitié-Salpêtrière, Paris, France.
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24
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Ng S, Moritz-Gasser S, Lemaitre AL, Duffau H, Herbet G. White matter disconnectivity fingerprints causally linked to dissociated forms of alexia. Commun Biol 2021; 4:1413. [PMID: 34931059 PMCID: PMC8688436 DOI: 10.1038/s42003-021-02943-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
For over 150 years, the study of patients with acquired alexia has fueled research aimed at disentangling the neural system critical for reading. An unreached goal, however, relates to the determination of the fiber pathways that root the different visual and linguistic processes needed for accurate word reading. In a unique series of neurosurgical patients with a tumor close to the visual word form area, we combine direct electrostimulation and population-based streamline tractography to map the disconnectivity fingerprints characterizing dissociated forms of alexia. Comprehensive analyses of disconnectivity matrices establish similarities and dissimilarities in the disconnection patterns associated with pure, phonological and lexical-semantic alexia. While disconnections of the inferior longitudinal and posterior arcuate fasciculi are common to all alexia subtypes, disconnections of the long arcuate and vertical occipital fasciculi are specific to phonological and pure alexia, respectively. These findings provide a strong anatomical background for cognitive and neurocomputational models of reading.
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Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France. .,Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.
| | - Sylvie Moritz-Gasser
- grid.414130.30000 0001 2151 3479Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France ,grid.461890.20000 0004 0383 2080Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France ,grid.121334.60000 0001 2097 0141Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
| | - Anne-Laure Lemaitre
- grid.414130.30000 0001 2151 3479Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France ,grid.461890.20000 0004 0383 2080Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Hugues Duffau
- grid.414130.30000 0001 2151 3479Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France ,grid.461890.20000 0004 0383 2080Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Guillaume Herbet
- grid.414130.30000 0001 2151 3479Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France ,grid.461890.20000 0004 0383 2080Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France ,grid.121334.60000 0001 2097 0141Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
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25
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Difalcis M, Morello García F, Abusamra V, Ferreres A. Types of acquired dyslexia in Spanish-speaking patients with aphasia. Cogn Neuropsychol 2021; 38:283-301. [PMID: 34668460 DOI: 10.1080/02643294.2021.1989394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The different types of acquired dyslexia described by cognitive neuropsychology have been observed in single-case and case series studies in different languages. However, no multipatient study of Spanish-speaking individuals has been reported that uses the same criteria and tasks to identify each participant's acquired dyslexia pattern. In this study, we analyzed participants' performance in three tasks (oral reading of words and nonwords, visual lexical decision with pseudohomophones, and written homophone comprehension) among 16 Spanish-speaking patients with aphasia. We identified 9 patients with acquired phonological dyslexia, 3 with acquired surface dyslexia, and 4 with acquired mixed dyslexia. The results of this research provide more information about the relative frequency of each type of acquired dyslexia in Spanish, which could be used to help design more appropriate treatments for rehabilitation. Identifying which processes have been impaired and which have been preserved will allow professionals to plan more specific interventions.
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Affiliation(s)
- Micaela Difalcis
- Instituto de Investigaciones, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Facultad de Filosofía y Letras, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Florentina Morello García
- Instituto de Investigaciones, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Valeria Abusamra
- Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental (CIIPME-CONICET), Buenos Aires, Argentina.,Facultad de Filosofía y Letras, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Aldo Ferreres
- Instituto de Investigaciones, Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina.,Unidad de Neuropsicología, Hospital Interzonal General de Agudos "Eva Perón", Buenos Aires, Argentina
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26
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Dickens JV, DeMarco AT, van der Stelt CM, Snider SF, Lacey EH, Medaglia JD, Friedman RB, Turkeltaub PE. Two types of phonological reading impairment in stroke aphasia. Brain Commun 2021; 3:fcab194. [PMID: 34522884 PMCID: PMC8432944 DOI: 10.1093/braincomms/fcab194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 07/18/2021] [Accepted: 07/26/2021] [Indexed: 11/12/2022] Open
Abstract
Alexia is common in the context of aphasia. It is widely agreed that damage to phonological and semantic systems not specific to reading causes co-morbid alexia and aphasia. Studies of alexia to date have only examined phonology and semantics as singular processes or axes of impairment, typically in the context of stereotyped alexia syndromes. However, phonology, in particular, is known to rely on subprocesses, including sensory-phonological processing, motor-phonological processing, and sensory-motor integration. Moreover, many people with stroke aphasia demonstrate mild or mixed patterns of reading impairment that do not fit neatly with one syndrome. This cross-sectional study tested whether the hallmark symptom of phonological reading impairment, the lexicality effect, emerges from damage to a specific subprocess of phonology in stroke patients not selected for alexia syndromes. Participants were 30 subjects with left-hemispheric stroke and 37 age- and education-matched controls. A logistic mixed-effects model tested whether post-stroke impairments in sensory phonology, motor phonology, or sensory-motor integration modulated the effect of item lexicality on patient accuracy in reading aloud. Support vector regression voxel-based lesion-symptom mapping localized brain regions necessary for reading and non-orthographic phonological processing. Additionally, a novel support vector regression structural connectome-symptom mapping method identified the contribution of both lesioned and spared but disconnected, brain regions to reading accuracy and non-orthographic phonological processing. Specifically, we derived whole-brain structural connectomes using constrained spherical deconvolution-based probabilistic tractography and identified lesioned connections based on comparisons between patients and controls. Logistic mixed-effects regression revealed that only greater motor-phonological impairment related to lower accuracy reading aloud pseudowords versus words. Impaired sensory-motor integration was related to lower overall accuracy in reading aloud. No relationship was identified between sensory-phonological impairment and reading accuracy. Voxel-based and structural connectome lesion-symptom mapping revealed that lesioned and disconnected left ventral precentral gyrus related to both greater motor-phonological impairment and lower sublexical reading accuracy. In contrast, lesioned and disconnected left temporoparietal cortex is related to both impaired sensory-motor integration and reduced overall reading accuracy. These results clarify that at least two dissociable phonological processes contribute to the pattern of reading impairment in aphasia. First, impaired sensory-motor integration, caused by lesions disrupting the left temporoparietal cortex and its structural connections, non-selectively reduces accuracy in reading aloud. Second, impaired motor-phonological processing, caused at least partially by lesions disrupting left ventral premotor cortex and structural connections, selectively reduces sublexical reading accuracy. These results motivate a revised cognitive model of reading aloud that incorporates a sensory-motor phonological circuit.
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Affiliation(s)
- Jonathan Vivian Dickens
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Andrew T DeMarco
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA.,Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Candace M van der Stelt
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Sarah F Snider
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Elizabeth H Lacey
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA
| | - John D Medaglia
- Drexel University, Philadelphia, PA 19104, USA.,University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rhonda B Friedman
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Peter E Turkeltaub
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA.,Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.,Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20001, USA
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27
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Li J, Hong L, Bi HY, Yang Y. Functional brain networks underlying automatic and controlled handwriting in Chinese. BRAIN AND LANGUAGE 2021; 219:104962. [PMID: 33984629 DOI: 10.1016/j.bandl.2021.104962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 06/12/2023]
Abstract
This study aimed to identify the functional brain networks underlying the distinctions between automatic and controlled handwriting in Chinese. Network-based analysis was applied to functional magnetic resonance imaging data collected while adult participants performed a copying task under automatic and speed-controlled conditions. We found significant differences between automatic and speed-controlled handwriting in functional connectivity within and between the frontoparietal network, default mode network, dorsal attention network, somatomotor network and visual network; these differences reflect the variations in general attentional control and task-relevant visuomotor operations. However, no differences in brain activation were detected between the two handwriting conditions, suggesting that the reorganization of functional networks, rather than the modulation of local brain activation, underlies the dissociations between automatic and controlled handwriting in Chinese. Our findings illustrate the brain basis of handwriting automaticity, shedding new light on how handwriting automaticity may be disrupted in individuals with neurological disorders.
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Affiliation(s)
- Junjun Li
- CAS Key Laboratory of Behavioral Science, Center for Brain Science and Learning Difficulties, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lei Hong
- Department of Foreign Languages, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hong-Yan Bi
- CAS Key Laboratory of Behavioral Science, Center for Brain Science and Learning Difficulties, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yang Yang
- CAS Key Laboratory of Behavioral Science, Center for Brain Science and Learning Difficulties, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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28
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Pre-Surgery Cognitive Performance and Voxel-Based Lesion-Symptom Mapping in Patients with Left High-Grade Glioma. Cancers (Basel) 2021; 13:cancers13061467. [PMID: 33806837 PMCID: PMC8004913 DOI: 10.3390/cancers13061467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: The literature on the effects of high-grade glioma (HGG) growth on cognition is still scarce. (2) Method: A consecutive series of 85 patients with HGG involving the left hemisphere underwent an extended neuropsychological evaluation prior to surgery. Voxel-based lesion-symptom mapping (VLSM) was used to identify regions related to cognitive performance. (3) Results: The patients' mean level of pre-surgery accuracy was overall high. They showed the greatest difficulties in language with tasks such as naming (42.1% of patients impaired on nouns and 61.4% on verbs), reading (36.3% on words and 32.7% on pseudo-words), auditory lexical decisions (43.9%) and writing (41.3%) being most frequently impaired. VLSM analysis revealed anatomically separated areas along the temporal cortex and the white matter related to impairments on the different tasks, with voxels commonly shared by all tasks restricted to a small region in the ventral superior and middle temporal gyrus. (4) Conclusions: High-grade glioma affects cognition; nonetheless, lesions do not cause diffuse deficits but selectively impact the different language sub-domains along the ventral stream and the dorsal stream for language processing.
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29
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Sharma S, Kim H, Harris H, Haberstroh A, Wright HH, Rothermich K. Eye Tracking Measures for Studying Language Comprehension Deficits in Aphasia: A Systematic Search and Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1008-1022. [PMID: 33606952 DOI: 10.1044/2020_jslhr-20-00287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Aim The aim of this scoping review is to identify the eye tracking paradigms and eye movement measures used to investigate auditory and reading comprehension deficits in persons with aphasia (PWA). Method MEDLINE via PubMed, Cochrane, CINAHL, Embase, PsycINFO, OTseeker, Scopus, Google Scholar, Grey Literature Database, and ProQuest Search (Dissertations & Theses) were searched for relevant studies. The Covidence software was used to manage the initial and full-text screening process for the search. Results and Discussion From a total of 1,803 studies, 68 studies were included for full-text screening. In addition, 418 records from gray literature were also screened. After full-text screening, 16 studies were included for this review-12 studies for auditory comprehension in PWA and four studies for reading comprehension in PWA. The review highlights the use of common eye tracking paradigms used to study language comprehension in PWA. We also discusse eye movement measures and how they help in assessing auditory and reading comprehension. Methodological challenges of using eye tracking are discussed. Conclusion The studies summarized in this scoping review provide evidence that the eye tracking methods are beneficial for studying auditory and reading comprehension in PWA.
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Affiliation(s)
- Saryu Sharma
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Hana Kim
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Havan Harris
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | | | - Heather Harris Wright
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
| | - Kathrin Rothermich
- Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC
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30
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Johansson‐Malmeling C, Wengelin Å, Henriksson I. Aphasia and spelling to dictation: Analysis of spelling errors and editing. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:145-160. [PMID: 33368870 PMCID: PMC7898650 DOI: 10.1111/1460-6984.12591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Spelling difficulty is a common symptom of aphasia and can entail editing difficulties. Previous research has shown that extensive editing is related to a lower production rate in text writing for persons with aphasia, yet editing difficulty is not commonly examined. It is not known if editing difficulty is related to reading and writing skills or to aspects of the word. AIMS To analyse spelling and editing processes as well as errors in a dictation task performed by Swedish-speaking adults with post-stroke aphasia. Furthermore, the study aimed to identify any relationships between spelling and editing difficulties and characteristics of individual words. Finally, relationships between successful edits and reading and phonological ability were investigated and specific editing strategies or behaviours identified. Correlation analyses were performed between measures of spelling and editing and word frequency and length as well as participants' scores on tests of reading, phonological spelling and phonological decoding. METHODS & PROCEDURES A total of 16 Swedish speaking participants with post-stroke aphasia wrote a word-dictation task in a keystroke logging program and were tested for phonological spelling, phonological decoding and reading ability. Spelling errors were categorized and analysed. OUTCOMES & RESULTS The most common error type was omission of letter(s) and there was evidence of aphasia-specific writing errors. Both spelling and editing difficulty were related to word frequency and word length. Successful editing was related to participants' scores on the phonological spelling task, but not to phonological decoding or reading ability. Specific editing strategies could be identified, and some strategies were individual, while others were more commonly used. CONCLUSIONS & IMPLICATIONS Word length and word frequency should be taken into consideration in spelling tests for persons with aphasia, and the presence of editing difficulty should be taken into account when assessing spelling difficulties. Treatment for writing difficulties in aphasia should include training in successful editing strategies and individual fitting of digital writing aids. What this paper adds What is already known on the subject Post-stroke aphasia often causes writing and spelling difficulties. Spelling difficulties may entail editing difficulties, in turn causing extensive and/or unsuccessful editing. Extensive editing is known to impede productivity in text writing. Still, editing behaviour, abilities relating to editing or what features of a word that causes editing difficulty has not been investigated for persons with aphasia. What this paper adds to existing knowledge This study adds an in-depth analysis of spelling ability, spelling errors and editing behaviour for persons with aphasia, using keystroke logging and a single-word dictation task. Results showed that both features of the target word (frequency and word length) and the individual abilities of the person with aphasia (score on a phonological spelling task) related to spelling and editing difficulty, editing behaviour and successful editing. Specific editing strategies were analysed and described. What are the potential or actual clinical implications of this work? Word length and word frequency should be taken into consideration when testing single-word spelling for persons with aphasia. When assessing spelling difficulties, both correctness of spelling as well as the presence and nature of any editing difficulties should be taken into account and treatment for writing difficulties in should include training in successful editing strategies. The fitting of digital writing aids for persons with aphasia should be individual, since many of the editing strategies used were individual.
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Affiliation(s)
- Charlotte Johansson‐Malmeling
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Åsa Wengelin
- Department of SwedishUniversity of GothenburgGothenburgSweden
| | - Ingrid Henriksson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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31
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Morshed RA, Young JS, Lee AT, Berger MS, Hervey-Jumper SL. Clinical Pearls and Methods for Intraoperative Awake Language Mapping. Neurosurgery 2020; 89:143-153. [PMID: 33289505 DOI: 10.1093/neuros/nyaa440] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/12/2020] [Indexed: 12/12/2022] Open
Abstract
Intraoperative language mapping of tumor and peritumor tissue is a well-established technique for avoiding permanent neurological deficits and maximizing extent of resection. Although there are several components of language that may be tested intraoperatively (eg, naming, writing, reading, and repetition), there is a lack of consistency in how patients are tested intraoperatively as well as the techniques involved to ensure safety during an awake procedure. Here, we review appropriate patient selection, neuroanesthetic techniques, cortical and subcortical language mapping stimulation paradigms, and selection of intraoperative language tasks used during awake craniotomies. We also expand on existing language mapping reviews by considering how intensity and timing of electrical stimulation may impact interpretation of mapping results.
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32
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Tomasino B, Ius T, Skrap M, Luzzatti C. Phonological and surface dyslexia in individuals with brain tumors: Performance pre-, intra-, immediately post-surgery and at follow-up. Hum Brain Mapp 2020; 41:5015-5031. [PMID: 32857483 PMCID: PMC7643394 DOI: 10.1002/hbm.25176] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 11/29/2022] Open
Abstract
We address existing controversies regarding neuroanatomical substrates of reading-aloud processes according to the dual-route processing models, in this particular instance in a series of 49 individuals with brain tumors who performed several reading tasks of real-time neuropsychological testing during surgery (low- to high-grade cerebral neoplasms involving the left hemisphere). We explored how reading abilities in individuals with brain tumors evolve during and after surgery for a brain tumor, and we studied the reading performance in a sample of 33 individuals in a 4-month follow-up after surgery. Impaired reading performance was seen pre-surgery in 7 individuals with brain tumors, intra-surgery in 18 individuals, at immediate post-surgery testing in 26 individuals, and at follow-up in 5 individuals. We classified their reading disorders according to operational criteria for either phonological or surface dyslexia. Neuroimaging results are discussed within the theoretical framework of the dual-route model of reading. Lesion-mask subtraction analyses revealed that areas selectively related with phonological dyslexia were located-along with the left hemisphere dorsal stream-in the Rolandic operculum, the inferior frontal gyrus, the precentral gyrus, the supramarginal gyrus, the insula (and/or the underlying external capsule), and parts of the superior longitudinal fasciculus, whereas lesions related to surface dyslexia involved the ventral stream, that is, the left middle and inferior temporal gyrus and parts of the left inferior longitudinal fasciculus.
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Affiliation(s)
- Barbara Tomasino
- Scientific Institute, IRCCS "E. Medea,"San Vito al TagliamentoPordenoneItaly
| | - Tamara Ius
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Integrata S. Maria della MisericordiaUdineItaly
| | - Miran Skrap
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Integrata S. Maria della MisericordiaUdineItaly
| | - Claudio Luzzatti
- Dipartimento di PsicologiaUniversità di Milano‐Bicocca and Milan Centre for NeuroscienceMilanItaly
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Europa E, Iaccarino L, Perry DC, Weis E, Welch AE, Rabinovici GD, Miller BL, Gorno-Tempini ML, Henry ML. Diagnostic Assessment in Primary Progressive Aphasia: An Illustrative Case Example. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1833-1849. [PMID: 32910678 PMCID: PMC8740567 DOI: 10.1044/2020_ajslp-20-00007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/15/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Purpose Diagnosis and classification of primary progressive aphasia (PPA) requires confirmation of specific speech and language symptoms, highlighting the important role of speech-language pathologists in the evaluation process. The purpose of this case report is to inform speech-language pathologists regarding current practices for diagnostic assessment in PPA, describing standard approaches as well as complementary, state-of-the-art procedures that may improve diagnostic precision. Method We describe the diagnostic evaluation of a 49-year-old woman with complaints of progressive word-finding difficulty. She completed standard neurological, neuropsychological, and speech-language evaluations, as well as magnetic resonance and positron emission tomography imaging of her brain. In addition, a history of developmental speech, language, and learning abilities was obtained, as well as genetic testing and assessment of cerebrospinal fluid biomarkers. We discuss the evaluation results in the context of the most current research related to PPA diagnosis. Conclusion Detailed behavioral assessment, thorough intake of symptom history and neurodevelopmental differences, multimodal neuroimaging, and comprehensive examination of genes and biomarkers are of paramount importance for detecting and characterizing PPA, with ramifications for early behavioral and/or pharmacological intervention. Supplemental Material https://doi.org/10.23641/asha.12771113.
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Affiliation(s)
- Eduardo Europa
- Memory and Aging Center, University of California, San Francisco
| | | | - David C. Perry
- Memory and Aging Center, University of California, San Francisco
| | - Elizabeth Weis
- Memory and Aging Center, University of California, San Francisco
| | - Ariane E. Welch
- Memory and Aging Center, University of California, San Francisco
| | | | - Bruce L. Miller
- Memory and Aging Center, University of California, San Francisco
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, University of California, San Francisco
- Dyslexia Center, University of California, San Francisco
| | - Maya L. Henry
- Department of Communication Sciences and Disorders, The University of Texas at Austin
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Shea J, Wiley R, Moss N, Rapp B. Pseudoword spelling ability predicts response to word spelling treatment in acquired dysgraphia. Neuropsychol Rehabil 2020; 32:231-267. [PMID: 33047661 DOI: 10.1080/09602011.2020.1813596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although rehabilitation of acquired dysgraphia can be quite effective, identifying predictors of responsiveness to treatment is useful for prognosis and individualization of treatment protocols. This study examined whether various features of treatment response were predicted by the integrity of one or more of the central cognitive components of spelling: orthographic long-term memory, orthographic working memory, and phoneme-grapheme conversion. Twenty dysgraphic individuals received 12 weeks of bi-weekly, individualized, lexically-based spelling rehabilitation using a spell-study-spell paradigm. Linear multiple regression modelling examined whether the type and severity of the dysgraphic deficit, assessed before rehabilitation, predicted the magnitude and rate of improvement, generalization to untrained items and maintenance of treatment gains. The results revealed that pseudoword spelling accuracy - indexing the integrity of the phoneme-grapheme conversion system - was the only factor examined that significantly predicted the rate of accuracy gains for trained words as well as the extent of generalization to untrained words. Pre-treatment pseudoword spelling accuracy also predicted retention of gains for trained and untrained words at 3-month follow-up. These findings reveal that the integrity of the phoneme-grapheme conversion system prior to dysgraphia rehabilitation may play a key role in rehabilitation-driven recovery, even when the treatment approach targets lexical rather than pseudoword spelling processes.
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Affiliation(s)
- Jennifer Shea
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | - Robert Wiley
- Department of Psychology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Natalie Moss
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | - Brenda Rapp
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
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Cilibrasi L, Tsimpli I. Categorical and Dimensional Diagnoses of Dyslexia: Are They Compatible? Front Psychol 2020; 11:2171. [PMID: 32982884 PMCID: PMC7489143 DOI: 10.3389/fpsyg.2020.02171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
Dyslexia is often assessed using categorical diagnoses, and subtypes of dyslexia are also recognized in a categorical fashion. Children may meet the criteria for dyslexia, and they may more specifically meet the criteria for a subtype of it, and thus get a diagnosis. This approach to diagnosis clashes with the actual distribution of reading performance in children (which is normal and continuous), and it has received criticism. This article offers a conceptual framework for conciliating these two positions. In short, the proposal is to use a set of multicomponent continuous assessments of reading, rather than thresholds. The proposal is explained using original data obtained from a sample of 30 children (age 7 to 11), tested in the United Kingdom. Using an assessment based on categorical-thresholds, only five children in our sample qualify for extra assistance, and only one may get a diagnosis of dyslexia, while with the mixed system proposed, a few additional children in the gray area would receive attention. This approach would not discard previous categorical approaches such as those distinguishing between surface and phonological dyslexia, but it would rather see these subtypes of dyslexia as the instance of a lower score on the continuum obtained on a single component of the multicomponent assessment.
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Affiliation(s)
- Luca Cilibrasi
- Faculty of Arts, Charles University, Prague, Czechia.,Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, United Kingdom
| | - Ianthi Tsimpli
- Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, United Kingdom
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36
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Chung PJ, Patel DR, Nizami I. Disorder of written expression and dysgraphia: definition, diagnosis, and management. Transl Pediatr 2020; 9:S46-S54. [PMID: 32206583 PMCID: PMC7082241 DOI: 10.21037/tp.2019.11.01] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Writing is a complex task that is vital to learning and is usually acquired in the early years of life. 'Dysgraphia' and 'specific learning disorder in written expression' are terms used to describe those individuals who, despite exposure to adequate instruction, demonstrate writing ability discordant with their cognitive level and age. Dysgraphia can present with different symptoms at different ages. Different theories have been proposed regarding the mechanisms of dysgraphia. Dysgraphia is poorly understood and is often undiagnosed. It has a high rate of co-morbidity with other learning and psychiatric disorders. The diagnosis and treatment of dysgraphia and specific learning disorders typically centers around the educational system; however, the pediatrician can play an important role in surveillance and evaluation of co-morbidity as well as provision of guidance and support.
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Affiliation(s)
- Peter J Chung
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Iman Nizami
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
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37
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de Aguiar V, Zhao Y, Faria A, Ficek B, Webster KT, Wendt H, Wang Z, Hillis AE, Onyike CU, Frangakis C, Caffo B, Tsapkini K. Brain volumes as predictors of tDCS effects in primary progressive aphasia. BRAIN AND LANGUAGE 2020; 200:104707. [PMID: 31704518 PMCID: PMC7709910 DOI: 10.1016/j.bandl.2019.104707] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 05/28/2023]
Abstract
The current study aims to determine the brain areas critical for response to anodal transcranial direct current stimulation (tDCS) in PPA. Anodal tDCS and sham were administered over the left inferior frontal gyrus (IFG), combined with written naming/spelling therapy. Thirty people with PPA were included in this study, and assessed immediately, 2 weeks, and 2 months post-therapy. We identified anatomical areas whose volumes significantly predicted the additional tDCS effects. For trained words, the volumes of the left Angular Gyrus and left Posterior Cingulate Cortex predicted the additional tDCS gain. For untrained words, the volumes of the left Middle Frontal Gyrus, left Supramarginal Gyrus, and right Posterior Cingulate Cortex predicted the additional tDCS gain. These findings show that areas involved in language, attention and working memory contribute to the maintenance and generalization of stimulation effects. The findings highlight that tDCS possibly affects areas anatomically or functionally connected to stimulation targets.
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Affiliation(s)
- Vânia de Aguiar
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States; Center for Language and Cognition Groningen (CLCG), University of Groningen, Netherlands.
| | - Yi Zhao
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Andreia Faria
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kimberly T Webster
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Haley Wendt
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Zeyi Wang
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States; Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Constantine Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, United States; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
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38
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de Aguiar V, Zhao Y, Ficek BN, Webster K, Rofes A, Wendt H, Frangakis C, Caffo B, Hillis AE, Rapp B, Tsapkini K. Cognitive and language performance predicts effects of spelling intervention and tDCS in Primary Progressive Aphasia. Cortex 2019; 124:66-84. [PMID: 31838450 DOI: 10.1016/j.cortex.2019.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/16/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
Abstract
Predictors of treatment effects allow individual tailoring of treatment characteristics, thereby saving resources and optimizing outcomes. Electrical stimulation coupled with language intervention has shown promising results in improving language performance in individuals with Primary Progressive Aphasia (PPA). The current study aimed to identify language and cognitive variables associated with response to therapy consisting of language intervention combined with transcranial direct current stimulation (tDCS). Forty individuals with PPA received written naming/spelling intervention combined with anodal tDCS or Sham, using a between-subjects, randomized design, with intervention delivered over a period of 3 weeks. Participants were assessed using a battery of neuropsychological tests before and after each phase. We measured letter accuracy during spelling of trained and untrained words, before, immediately after, 2 weeks, and 2 months after therapy. We used step-wise regression methods to identify variables amongst the neuropsychological measures and experimental factors that were significantly associated with therapy outcomes at each time-point. For trained words, improvement was related to pre-therapy scores, in RAVLT (5 trials sum), pseudoword spelling, object naming, digit span backward, spatial span backward and years post symptom onset. Regarding generalization to untrained words, improvement in spelling was associated with pseudoword spelling, RAVLT proactive interference, RAVLT immediate recall. Generalization effects were larger under tDCS compared to Sham at the 2-month post training measurement. We conclude that, for trained words, patients who improve the most are those who retain for longer language skills such as sublexical spelling processes (phoneme-to-grapheme correspondences) and word retrieval, and other cognitive functions such as executive functions and working memory, and those who have a better learning capacity. Generalization to untrained words occurs through improvement in knowledge of phoneme-to-grapheme correspondences. Furthermore, tDCS enhances the generalizability and duration of therapy effects.
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Affiliation(s)
- Vânia de Aguiar
- Department of Neurology, Johns Hopkins Medicine; Centre for Language and Cognition Groningen (CLCG), University of Groningen.
| | - Yi Zhao
- Department of Biostatistics, Johns Hopkins School of Public Health
| | | | - Kimberly Webster
- Department of Neurology, Johns Hopkins Medicine; Department of Otolaryngology, Johns Hopkins Medicine
| | - Adrià Rofes
- Centre for Language and Cognition Groningen (CLCG), University of Groningen; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Department of Cognitive Science, Johns Hopkins University
| | - Haley Wendt
- Department of Neurology, Johns Hopkins Medicine
| | | | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins Medicine; Department of Cognitive Science, Johns Hopkins University; Department of Physical Medicine & Rehabilitation, Johns Hopkins University
| | - Brenda Rapp
- Department of Cognitive Science, Johns Hopkins University
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins Medicine; Department of Cognitive Science, Johns Hopkins University
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39
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Neglect dyslexia as a word-centred impairment: A single case study. Cortex 2019; 119:543-554. [DOI: 10.1016/j.cortex.2018.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/30/2018] [Accepted: 10/28/2018] [Indexed: 12/18/2022]
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40
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Beeson PM, Bayley C, Shultz C, Rising K. Maximising recovery from aphasia with central and peripheral agraphia: The benefit of sequential treatments. Neuropsychol Rehabil 2019; 29:1399-1425. [PMID: 29298550 DOI: 10.1080/09602011.2017.1417873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Maximal recovery from acquired language impairment may require progression from one behavioural treatment protocol to the next in order to build upon residual and relearned cognitive-linguistic and sensory-motor processes. We present a five-stage treatment sequence that was initiated at one year post stroke in a woman with acquired impairments of spoken and written language. As is typical of individuals with left perisylvian damage, she demonstrated marked impairment of phonological retrieval and sublexical phonology, but she also faced additional challenges due to impaired letter shape knowledge and visual attention. The treatment sequence included (1) written spelling of targeted words, (2) retraining sublexical sound-to-letter correspondences and phonological manipulation skills, (3) training strategic approaches to maximise interactive use of lexical, phonological, and orthographic knowledge, (4) lexical retrieval of spoken words, and finally (5) sentence-level stimulation to improve grammatical form of written narratives. This Phase II clinical study documented positive direct treatment outcomes along with evidence of a significant reduction in the underlying deficits and generalisation to untrained items and language tasks. Improvements on a comprehensive assessment battery were realised as functional gains in everyday written and spoken communication, including improved lexical retrieval and grammatical complexity of written narratives. This case provides a valuable example of the cumulative therapeutic benefit of sequential application of theoretically motivated treatment protocols.
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Affiliation(s)
- Pélagie M Beeson
- Department of Speech, Language, and Hearing Sciences, The University of Arizona , Tucson , AZ , USA.,Department of Neurology, The University of Arizona , Tucson , AZ , USA
| | - Chelsea Bayley
- Department of Speech, Language, and Hearing Sciences, The University of Arizona , Tucson , AZ , USA
| | - Christine Shultz
- Department of Speech, Language, and Hearing Sciences, The University of Arizona , Tucson , AZ , USA
| | - Kindle Rising
- Department of Speech, Language, and Hearing Sciences, The University of Arizona , Tucson , AZ , USA
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41
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Boukrina O, Barrett AM, Graves WW. Cerebral perfusion of the left reading network predicts recovery of reading in subacute to chronic stroke. Hum Brain Mapp 2019; 40:5301-5314. [PMID: 31452284 PMCID: PMC6864894 DOI: 10.1002/hbm.24773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 07/25/2019] [Accepted: 07/31/2019] [Indexed: 01/13/2023] Open
Abstract
Better understanding of cerebral blood flow (CBF) perfusion in stroke recovery can help inform decisions about optimal timing and targets of restorative treatments. In this study, we examined the relationship between cerebral perfusion and recovery from stroke‐induced reading deficits. Left stroke patients were tested with a noninvasive CBF measure (arterial spin labeling) <5 weeks post‐stroke, and a subset had follow up testing >3 months post‐stroke. We measured blood flow perfusion within the left and right sides of the brain, in areas surrounding the lesion, and areas belonging to the reading network. Two hypotheses were tested. The first was that recovery of reading function depends on increased perfusion around the stroke lesion. This hypothesis was not supported by our findings. The second hypothesis was that increased perfusion of intact areas within the reading circuit is tightly coupled with recovery. Our findings are consistent with this hypothesis. Specifically, higher perfusion in the left reading network measured during the subacute stroke period predicted better reading ability and phonology competence in the chronic period. In contrast, higher perfusion of the right homologous regions was associated with decreased reading accuracy and phonology competence in the subacute and chronic periods. These findings suggest that recovery of reading and language competence may rely on improved blood flow in the reading network of the language‐dominant hemisphere.
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Affiliation(s)
- Olga Boukrina
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, New Jersey.,Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, New Jersey
| | - A M Barrett
- Center for Stroke Rehabilitation Research, Kessler Foundation, West Orange, New Jersey.,Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, New Jersey.,Kessler Institute for Rehabilitation, West Orange, New Jersey
| | - William W Graves
- Department of Psychology, Rutgers, The State University of New Jersey, Newark, New Jersey
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42
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Mayes SD, Breaux RP, Calhoun SL, Frye SS. High Prevalence of Dysgraphia in Elementary Through High School Students With ADHD and Autism. J Atten Disord 2019; 23:787-796. [PMID: 28741400 DOI: 10.1177/1087054717720721] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Prevalence of dysgraphia by age across all grade levels was determined in students with ADHD or autism. METHOD Referred children with normal intelligence and ADHD-Combined, ADHD-Inattentive, or autism ( N = 1,034) were administered the Developmental Test of Visual-Motor Integration (VMI) and Wechsler Intelligence Scale for Children (WISC). RESULTS VMI and WISC Coding scores were significantly lower than IQ and the normal mean of 100 for all diagnoses. More than half (59%) had dysgraphia, and 92% had a weakness in graphomotor ability relative to other abilities. Dysgraphia prevalence did not differ between diagnostic or age groups (6-7 years, 56%; 8-10 years, 60%; and 11-16 years, 61%). CONCLUSION Dysgraphia is common at all ages in children and adolescents with ADHD and autism. Accommodations and strategies for addressing this problem are discussed.
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Affiliation(s)
| | | | | | - Sara S Frye
- 1 Penn State College of Medicine, Hershey, USA
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43
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Localization of Phonological and Semantic Contributions to Reading. J Neurosci 2019; 39:5361-5368. [PMID: 31061085 DOI: 10.1523/jneurosci.2707-18.2019] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 04/08/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022] Open
Abstract
Reading involves the rapid extraction of sound and meaning from print through a cooperative division of labor between phonological and lexical-semantic processes. Whereas lesion studies of patients with stereotyped acquired reading deficits contributed to the notion of a dissociation between phonological and lexical-semantic reading, the neuroanatomical basis for effects of lexicality (word vs pseudoword), orthographic regularity (regular vs irregular spelling-sound correspondences), and concreteness (concrete vs abstract meaning) on reading is underspecified, particularly outside the context of strong behavioral dissociations. Support vector regression lesion-symptom mapping (LSM) of 73 left hemisphere stroke survivors (male and female human subjects) not preselected for stereotyped dissociations revealed the differential contributions of specific cortical regions to reading pseudowords (ventral precentral gyrus), regular words (planum temporale, supramarginal gyrus, ventral precentral and postcentral gyrus, and insula), and concrete words (pars orbitalis and pars triangularis). Consistent with the primary systems view of reading being parasitic on language-general circuitry, our multivariate LSM analyses revealed that phonological decoding depends on perisylvian areas subserving sound-motor integration and that semantic effects on reading depend on frontal cortex subserving control over concrete semantic representations that aid phonological access from print. As the first study to localize the differential cortical contributions to reading pseudowords, regular words, and concrete words in stroke survivors with variable reading abilities, our results provide important information on the neurobiological basis of reading and highlight the insights attainable through multivariate, process-based approaches to alexia.SIGNIFICANCE STATEMENT Whereas fMRI evidence for neuroanatomical dissociations between phonological and lexical-semantic reading is abundant, evidence from modern lesion studies establishing the differential contributions of specific brain regions to specific reading processes is lacking. Our application of multivariate lesion-symptom mapping revealed that effects of lexicality, orthographic regularity, and concreteness on reading differentially depend on areas subserving auditory-motor integration and semantic control. Phonological decoding of print relies on a dorsal perisylvian network supporting auditory and articulatory representations, with unfamiliar words relying especially on articulatory mapping. In tandem with this dorsal decoding system, anterior inferior frontal gyrus may coordinate control over concrete semantic representations that support mapping of print to sound, which is a novel potential mechanism for semantic influences on reading.
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44
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Battistella G, Henry M, Gesierich B, Wilson SM, Borghesani V, Shwe W, Miller Z, Deleon J, Miller BL, Jovicich J, Papinutto N, Dronkers NF, Seeley WW, Mandelli ML, Gorno-Tempini ML. Differential intrinsic functional connectivity changes in semantic variant primary progressive aphasia. NEUROIMAGE-CLINICAL 2019; 22:101797. [PMID: 31146321 PMCID: PMC6465769 DOI: 10.1016/j.nicl.2019.101797] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/26/2019] [Indexed: 12/25/2022]
Abstract
The semantic variant of primary progressive aphasia (svPPA) is a clinical syndrome characterized by semantic memory deficits with relatively preserved motor speech, syntax, and phonology. There is consistent evidence linking focal neurodegeneration of the anterior temporal lobes (ATL) to the semantic deficits observed in svPPA. Less is known about large-scale functional connectivity changes in this syndrome, particularly regarding the interplay between affected and spared language networks that leads to the unique cognitive dissociations typical of svPPA. Using whole-brain, seed-based connectivity on task-free Magnetic Resonance Imaging (MRI) data, we studied connectivity of networks anchored to three left-hemisphere regions crucially involved in svPPA symptomatology: ATL just posterior to the main atrophic area, opercular inferior frontal gyrus, and posterior inferior temporal lobe. First, in 32 healthy controls, these seeds isolated three networks: a ventral semantic network involving anterior middle temporal and angular gyri, a dorsal articulatory-phonological system involving inferior frontal and supramarginal regions, and a third functional connection between posterior inferior temporal and intraparietal regions likely involved in linking visual and linguistic processes. We then compared connectivity strength of these three networks between 16 svPPA patients and the 32 controls. In svPPA, decreased functional connectivity in the ventral semantic network correlated with weak semantic skills, while connectivity of the network seeded from the posterior inferior temporal lobe, though not significantly different between the two groups, correlated with pseudoword reading skills. Increased connectivity between the inferior frontal gyrus and the superior portion of the angular gyrus suggested possible adaptive changes. Our findings have two main implications. First, they support a functional subdivision of the left IPL based on its connectivity to specific language-related regions. Second, the unique neuroanatomical and linguistic profile observed in svPPA provides a compelling model for the functional interplay of these networks, being either up- or down- regulated in response to disease.
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Affiliation(s)
- Giovanni Battistella
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA.
| | - Maya Henry
- Department of Communication Sciences and Disorders, University of Texas, Austin, USA
| | - Benno Gesierich
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Stephen M Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Valentina Borghesani
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Wendy Shwe
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Zachary Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA; Department of Neurology, Dyslexia Center, University of California, San Francisco, CA 94158, USA
| | - Jessica Deleon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Jorge Jovicich
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - Nico Papinutto
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Nina F Dronkers
- Department of Psychology, University of California, Berkeley, CA 94720, USA; Department of Neurology, University of California, Davis, CA 95616, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA; Department of Neurology, Dyslexia Center, University of California, San Francisco, CA 94158, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94158, USA; Department of Neurology, Dyslexia Center, University of California, San Francisco, CA 94158, USA
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45
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Madden EB, Conway T, Henry ML, Spencer KA, Yorkston KM, Kendall DL. The Relationship Between Non-Orthographic Language Abilities and Reading Performance in Chronic Aphasia: An Exploration of the Primary Systems Hypothesis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:3038-3054. [PMID: 30515520 PMCID: PMC6440304 DOI: 10.1044/2018_jslhr-l-18-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/20/2018] [Accepted: 07/20/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE This study investigated the relationship between non-orthographic language abilities and reading in order to examine assumptions of the primary systems hypothesis and further our understanding of language processing poststroke. METHOD Performance on non-orthographic semantic, phonologic, and syntactic tasks, as well as oral reading and reading comprehension tasks, was assessed in 43 individuals with aphasia. Correlation and regression analyses were conducted to determine the relationship between these measures. In addition, analyses of variance examined differences within and between reading groups (within normal limits, phonological, deep, or global alexia). RESULTS Results showed that non-orthographic language abilities were significantly related to reading abilities. Semantics was most predictive of regular and irregular word reading, whereas phonology was most predictive of pseudohomophone and nonword reading. Written word and paragraph comprehension were primarily supported by semantics, whereas written sentence comprehension was related to semantic, phonologic, and syntactic performance. Finally, severity of alexia was found to reflect severity of semantic and phonologic impairment. CONCLUSIONS Findings support the primary systems view of language by showing that non-orthographic language abilities and reading abilities are closely linked. This preliminary work requires replication and extension; however, current results highlight the importance of routine, integrated assessment and treatment of spoken and written language in aphasia. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.7403963.
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Affiliation(s)
| | | | - Maya L. Henry
- Department of Communication Sciences and Disorders, University of Texas at Austin
| | - Kristie A. Spencer
- Department of Speech & Hearing Sciences, University of Washington, Seattle
| | | | - Diane L. Kendall
- Department of Speech & Hearing Sciences, University of Washington, Seattle
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
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46
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Martin N, Minkina I, Kohen FP, Kalinyak-Fliszar M. Assessment of linguistic and verbal short-term memory components of language abilities in aphasia. JOURNAL OF NEUROLINGUISTICS 2018; 48:199-225. [PMID: 30220790 PMCID: PMC6135249 DOI: 10.1016/j.jneuroling.2018.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Some current models of aphasia emphasize a role of short-term memory in the processing of language and propose that the language impairment in aphasia involves impairment to cognitive processes that activate and maintain representations of words over the time-period needed to support single word and multiple word tasks, including verbal span tasks. This paper reports normative data from 39 people with aphasia and 16 age-matched neurotypical controls on a test battery for aphasia that assesses effects of increased short-term/working memory load on word and sentence processing as well as effects of linguistic variations on verbal short-term memory abilities Two concepts are discussed that capture the unique potential of this test battery for research and clinical practice: specificity of diagnosis and sensitivity to all degrees of aphasia severity, including mild aphasia. An analysis is included that shows how the performance of individuals with mild aphasia who achieve normal level of performance on the Western Aphasia Battery (Kertesz, 2006) show a decline in a temporal delay condition that is greater than performance of control participants. We also report preliminary data showing differential effects of adding a time interval before a response or between items to be compared: reduced accuracy for some individuals with aphasia and improved accuracy for others. The theoretical and clinical importance of this finding is discussed, as well as the overall potential for this test battery to be used in research and as a clinical tool. Finally, we discuss the relevance of this test battery to investigate functional communication abilities in aphasia.
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Affiliation(s)
- Nadine Martin
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, USA
| | - Irene Minkina
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, USA
| | - Francine P Kohen
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, USA
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Mapping the intersection of language and reading: the neural bases of the primary systems hypothesis. Brain Struct Funct 2018; 223:3769-3786. [PMID: 30073420 DOI: 10.1007/s00429-018-1716-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
Abstract
The primary systems framework has been used to relate behavioural performance across many different language activities to the status of core underpinning domain-general cognitive systems. This study provided the first quantitative investigation of this account at both behavioural and neural levels in a group of patients with chronic post-stroke aphasia. Principal components analysis was used to distil orthogonal measures of phonological and semantic processing, which were then related to reading performance and the underlying lesion distributions using voxel-based correlational methodology. Concrete word reading involved both a ventral semantic pathway, and inferior and anterior aspects of the dorsal phonological pathway. Abstract word reading overlapped with the ventral semantic pathway but also drew more extensively on the superior and posterior aspects of the dorsal phonological pathway. Nonword reading was related to phonological processing along the dorsal pathway and was also supported by a more superior set of regions previously associated with speech motor output. The use of continuous measures of behavioural performance and neural integrity allowed us to elucidate for the first time both the lesion and behavioural correlates for the semantic and phonological components of the primary systems hypothesis and to extend these by identifying the importance of an additional dorsal speech motor output system. These results provide a target for future neuroanatomically constrained computational models of reading.
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48
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DeMarco AT, Turkeltaub PE. A multivariate lesion symptom mapping toolbox and examination of lesion-volume biases and correction methods in lesion-symptom mapping. Hum Brain Mapp 2018; 39:4169-4182. [PMID: 29972618 DOI: 10.1002/hbm.24289] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 05/17/2018] [Accepted: 06/19/2018] [Indexed: 11/09/2022] Open
Abstract
Lesion-symptom mapping has become a cornerstone of neuroscience research seeking to localize cognitive function in the brain by examining the sequelae of brain lesions. Recently, multivariate lesion-symptom mapping methods have emerged, such as support vector regression, which simultaneously consider many voxels at once when determining whether damaged regions contribute to behavioral deficits (Zhang, Kimberg, Coslett, Schwartz, & Wang, ). Such multivariate approaches are capable of identifying complex dependences that traditional mass-univariate approach cannot. Here, we provide a new toolbox for support vector regression lesion-symptom mapping (SVR-LSM) that provides a graphical interface and enhances the flexibility and rigor of analyses that can be conducted using this method. Specifically, the toolbox provides cluster-level family-wise error correction via permutation testing, the capacity to incorporate arbitrary nuisance models for behavioral data and lesion data and makes available a range of lesion volume correction methods including a new approach that regresses lesion volume out of each voxel in the lesion maps. We demonstrate these new tools in a cohort of chronic left-hemisphere stroke survivors and examine the difference between results achieved with various lesion volume control methods. A strong bias was found toward brain wide lesion-deficit associations in both SVR-LSM and traditional mass-univariate voxel-based lesion symptom mapping when lesion volume was not adequately controlled. This bias was corrected using three different regression approaches; among these, regressing lesion volume out of both the behavioral score and the lesion maps provided the greatest sensitivity in analyses.
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Affiliation(s)
- Andrew T DeMarco
- Department of Neurology, Georgetown University, Washington, District of Columbia
| | - Peter E Turkeltaub
- Department of Neurology, Georgetown University, Washington, District of Columbia.,Research Division, MedStar National Rehabilitation Hospital, Washington, District of Columbia
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Henry ML, Grasso SM. Assessment of Individuals with Primary Progressive Aphasia. Semin Speech Lang 2018; 39:231-241. [PMID: 29933490 DOI: 10.1055/s-0038-1660782] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Speech-language pathologists play a crucial role in the assessment and treatment of individuals with primary progressive aphasia (PPA). The speech-language evaluation is a critical aspect of the diagnostic and rehabilitative process, informing differential diagnosis as well as intervention planning and monitoring of cognitive-linguistic status over time. The evaluation should include a thorough case history and interview and a detailed assessment of speech-language and cognitive functions, with tasks designed to detect core and associated deficits outlined in current diagnostic criteria. In this paper, we review assessments that can be utilized to examine communication and cognition in PPA, including general aphasia batteries designed for stroke and/or progressive aphasia as well as tests of specific cognitive-linguistic functions, including naming, object/person knowledge, single-word and sentence comprehension, repetition, spontaneous speech/language production, motor speech, written language, and nonlinguistic cognitive domains. The comprehensive evaluation can inform diagnostic decision making and facilitate planning of interventions that are tailored to the patient's current status and likely progression of deficits. As such, the speech-language evaluation allows the medical team to provide individuals with PPA and their families with appropriate recommendations for the present and the future.
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Affiliation(s)
- Maya L Henry
- Department of Communication Sciences and Disorders, University of Texas, Austin, Texas
| | - Stephanie M Grasso
- Department of Communication Sciences and Disorders, University of Texas, Austin, Texas
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Pillay SB, Gross WL, Graves WW, Humphries C, Book DS, Binder JR. The Neural Basis of Successful Word Reading in Aphasia. J Cogn Neurosci 2018; 30:514-525. [PMID: 29211656 PMCID: PMC9926535 DOI: 10.1162/jocn_a_01214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Understanding the neural basis of recovery from stroke is a major research goal. Many functional neuroimaging studies have identified changes in brain activity in people with aphasia, but it is unclear whether these changes truly support successful performance or merely reflect increased task difficulty. We addressed this problem by examining differences in brain activity associated with correct and incorrect responses on an overt reading task. On the basis of previous proposals that semantic retrieval can assist pronunciation of written words, we hypothesized that recruitment of semantic areas would be greater on successful trials. Participants were 21 patients with left-hemisphere stroke with phonologic retrieval deficits. They read words aloud during an event-related fMRI paradigm. BOLD signals obtained during correct and incorrect trials were contrasted to highlight brain activity specific to successful trials. Successful word reading was associated with higher BOLD signal in the left angular gyrus. In contrast, BOLD signal in bilateral posterior inferior frontal cortex, SMA, and anterior cingulate cortex was greater on incorrect trials. These data show for the first time the brain regions where neural activity is correlated specifically with successful performance in people with aphasia. The angular gyrus is a key node in the semantic network, consistent with the hypothesis that additional recruitment of the semantic system contributes to successful word production when phonologic retrieval is impaired. Higher activity in other brain regions during incorrect trials likely reflects secondary engagement of attention, working memory, and error monitoring processes when phonologic retrieval is unsuccessful.
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