The right hemisphere contribution to semantic categorization: A TMS study

tDCS of right-hemispheric Wernicke's area homologue affects contextual learning of novel lexicon

Numerous studies have shown robust evidence of the right hemisphere's involvement in the language function, for instance in the processing of intonation, grammar, word meanings, metaphors, etc. However, its role in lexicon acquisition remains obscure. We applied transcranial direct current stimulation (tDCS) over the right-hemispheric homologue of Wernicke's area to assess its putative involvement in the processing of different types of novel semantics. After receiving 15 min of anodal, cathodal, or sham (placebo) tDCS, three groups of healthy participants learnt novel concrete and abstract words in the context of short stories. Learning outcomes were assessed using a battery of tests immediately after this contextual learning session and 24 h later. As a result, an inhibitory effect of cathodal tDCS and a facilitatory effect of anodal tDCS were found for abstract word acquisition only. We also found a significant drop in task performance on the second day of the assessment for both word types in all the stimulation groups, suggesting no significant influence of tDCS on the post-learning consolidation of new memory traces. The results suggest an involvement of Wernicke's right-hemispheric counterpart in initial encoding (but not consolidation) of abstract semantics, which may be explained either by the right hemispheres direct role in processing lexical semantics or by an indirect impact of tDCS on contralateral (left-hemispheric) cortical areas through cross-callosal connections.

Right hemisphere and metaphor comprehension: A connectionist perspective

Metaphor comprehension is a cognitively complex task, with evidence pointing to the engagement of multiple cerebral areas. In addition, the involvement of the right hemisphere appears to vary with cognitive effort. Therefore, the interconnecting pathways of such distributed cortical centers should be taken into account when studying this topic. Despite this, the potential contribution of white matter fasciculi has received very little attention in the literature to date and is not mentioned in most metaphor comprehension studies. To highlight the probable implications of the right inferior fronto-occipital fasciculus, right superior longitudinal system, and callosal radiations, we bring together findings from different research fields. The aim is to describe important insights enabled by the cross-fertilization of functional neuroimaging, clinical findings, and structural connectivity.

Visuo-spatial attention and semantic memory competition in the parietal cortex

Neuroimaging studies associate specific functional roles to distinct brain regions investigating separate cognitive processes using dedicated tasks. For example, using both correlative (i.e., fMRI) and causal (i.e., TMS) approaches it has been shown the involvement of intra-parietal sulcus (IPS), as part of the dorsal attention network, in spatial attentional tasks as well as the importance of the angular gyrus (AG), as part of the default mode network, during the selection of relevant information in semantic memory. Nonetheless, in our daily life attention and semantic memory are rarely needed in isolation. In the present TMS study we investigate how the brain combines attentional and semantic memory demands in a single task. Results showed that, compared to a pseudo-TMS, stimulation of IPS, but not AG, affects behavioral performance, thus suggesting its preponderant role in such a combined task. Moreover, the lack of difference between the effect of IPS and AG stimulations seems to suggest that the two regions may be coactivated or that a third-party source might indirectly mediate the interaction between the two networks.

Neuromodulatory effects of transcranial magnetic stimulation on language performance in healthy participants: Systematic review and meta-analysis

Background

The causal relationships between neural substrates and human language have been investigated by transcranial magnetic stimulation (TMS). However, the robustness of TMS neuromodulatory effects is still largely unspecified. This study aims to systematically examine the efficacy of TMS on healthy participants' language performance.

Methods

For this meta-analysis, we searched PubMed, Web of Science, PsycINFO, Scopus, and Google Scholar from database inception until October 15, 2022 for eligible TMS studies on language comprehension and production in healthy adults published in English. The quality of the included studies was assessed with the Cochrane risk of bias tool. Potential publication biases were assessed by funnel plots and the Egger Test. We conducted overall as well as moderator meta-analyses. Effect sizes were estimated using Hedges'g (g) and entered into a three-level random effects model.

Results

Thirty-seven studies (797 participants) with 77 effect sizes were included. The three-level random effects model revealed significant overall TMS effects on language performance in healthy participants (RT: g = 0.16, 95% CI: 0.04-0.29; ACC: g = 0.14, 95% CI: 0.04-0.24). Further moderator analyses indicated that (a) for language tasks, TMS induced significant neuromodulatory effects on semantic and phonological tasks, but didn't show significance for syntactic tasks; (b) for cortical targets, TMS effects were not significant in left frontal, temporal or parietal regions, but were marginally significant in the inferior frontal gyrus in a finer-scale analysis; (c) for stimulation parameters, stimulation sites extracted from previous studies, rTMS, and intensities calibrated to the individual resting motor threshold are more prone to induce robust TMS effects. As for stimulation frequencies and timing, both high and low frequencies, online and offline stimulation elicited significant effects; (d) for experimental designs, studies adopting sham TMS or no TMS as the control condition and within-subject design obtained more significant effects.

Discussion

Overall, the results show that TMS may robustly modulate healthy adults' language performance and scrutinize the brain-and-language relation in a profound fashion. However, due to limited sample size and constraints in the current meta-analysis approach, analyses at a more comprehensive level were not conducted and results need to be confirmed by future studies.

Systematic review registration

[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=366481], identifier [CRD42022366481].

rTMS affects EEG microstates dynamic during evoked activity

Electrophysiological (EEG) correlates both at time (i.e., event-related potentials, ERP) and frequency (i.e., event-related desynchronization, ERD) domains have been shown to be modulated by external magnetic interference. Parallel studies reported a similar interference also for the EEG microstate at rest and in the period that anticipates a task. Here we investigated whether such interference was prolonged during the evoked activity in the framework of the semantic decision task. To this aim, rTMS was delivered over a core region of both the Default mode network and the language network (i.e., left angular gyrus, AG), previously associated to the current task, and as active control we stimulated the left IPS. When subjects received a non-active stimulation (i.e., Sham), in the period that follows the target onset (i.e., 2 sec after the rTMS) we found an interesting alternation of two dominant microstates (MS1, MS3), previously associated to the phonological network and the Cingulo-Opercular Network (CON), respectively. This dynamic was not altered when TMS was delivered over the left IPS. On the contrary, rTMS over left AG selectively suppressed the phonological-related microstate. These findings provide the first causal evidence of region specificity of the EEG microstates topography during the evoked activity corroborating the idea of a crucial role of AG in the semantic memory. Moreover, the present results might provide insight for understanding the neurophysiological correlates of language disorders e.g., aphasia as well as for planning non-invasive brain stimulation protocols for the rehabilitation.

Effects of online repetitive transcranial magnetic stimulation (rTMS) on cognitive processing: A meta-analysis and recommendations for future studies

Online repetitive transcranial magnetic stimulation (rTMS), applied while subjects are performing a task, is widely used to disrupt brain regions underlying cognition. However, online rTMS has also induced "paradoxical enhancement". Given the rapid proliferation of this approach, it is crucial to develop a better understanding of how online stimulation influences cognition, and the optimal parameters to achieve desired effects. To accomplish this goal, a quantitative meta-analysis was performed with random-effects models fitted to reaction time (RT) and accuracy data. The final dataset included 126 studies published between 1998 and 2016, with 244 total effects for reaction times, and 202 for accuracy. Meta-analytically, rTMS at 10 Hz and 20 Hz disrupted accuracy for attention, executive, language, memory, motor, and perception domains, while no effects were found with 1 Hz or 5 Hz. Stimulation applied at and 10 and 20 Hz slowed down RTs in attention and perception tasks. No performance enhancement was found. Meta-regression analysis showed that fMRI-guided targeting and short inter-trial intervals are associated with increased disruptive effects with rTMS.

fMRI evidence of aberrant neural adaptation for objects in schizophrenia and bipolar disorder

Functional magnetic resonance imaging (fMRI) adaptation (also known as fMRI repetition suppression) has been widely used to characterize stimulus selectivity in vivo, a fundamental feature of neuronal processing in the brain. We investigated whether SZ patients and BD patients show aberrant fMRI adaptation for object perception. About 52 SZ patients, 55 BD patients, and 53 community controls completed an object discrimination task with three conditions: the same object presented twice, two exemplars from the same category, and two exemplars from different categories. We also administered two functional localizer tasks. A region of interest analysis was employed to evaluate a priori hypotheses about the lateral occipital complex (LOC) and early visual cortex (EVC). An exploratory whole brain analysis was also conducted. In the LOC and EVC, controls showed the expected reduced fMRI responses to repeated presentation of the same objects compared with different objects (i.e., fMRI adaptation for objects, p < .001). SZ patients showed an adaptation effect that was significantly smaller compared with controls. BD patients showed a lack of fMRI adaptation. The whole brain analyses showed enhanced fMRI responses to repeated presentation of the same objects only in BD patients in several brain regions including anterior cingulate cortex. This study was the first to employ fMRI adaptation for objects in SZ and BD. The current findings provide empirical evidence of aberrant fMRI adaptation in the visual cortex in SZ and BD, but in distinctly different ways.

Theta-burst stimulation causally affects side perception in the Deutsch's octave illusion

Deutsch’s octave illusion is produced by a sequence of two specular dichotic stimuli presented in alternation to the left and right ear causing an illusory segregation of pitch (frequency) and side (ear of origin). Previous studies have indicated that illusory perception of pitch takes place in temporo-frontal areas, whereas illusory perception of side is primarily associated to neural activity in parietal cortex and in particular in the inferior parietal lobule (IPL). Here we investigated the causal role of left IPL in the perception of side (ear of origin) during the octave illusion by following its inhibition through continuous theta-burst stimulation (cTBS), as compared to the left posterior intraparietal sulcus (pIPS), whose activity is thought to be unrelated to side perception during the illusion. We observed a prolonged modification in the side of the illusory perceived tone during the first 10 minutes following the stimulation. Specifically, while after cTBS over the left IPS subjects reported to perceive the last tone more often at the right compared to the left ear, cTBS over left IPL significantly reverted this distribution, as the number of last perceived tones at the right ear was smaller than at the left ear. Such alteration was not maintained in the successive 10 minutes. These results provide the first evidence of the causal involvement of the left IPL in the perception of side during the octave illusion.

Task and Regions Specific Top-Down Modulation of Alpha Rhythms in Parietal Cortex

Alpha (8-12 Hz) power desynchronization is strongly associated to visual perception but has been observed in a large variety of tasks, indicating a general role in task anticipation. We previously reported in human observers that interference by repetitive transcranial magnetic stimulation (rTMS) of core regions of the dorsal attention network (DAN) disrupts both anticipatory alpha desynchronization and performance during a visuospatial attention (VSA) task. Here, we test the hypothesis that alpha desynchronization is task specific, and can be selectively modulated by interfering with activity in different higher-order parietal regions. We contrast the effects of rTMS on alpha rhythms and behavior on 2 different tasks: a VSA and a semantic decision task, by targeting the posterior intraparietal sulcus (pIPS), a core region of the DAN, or the angular gyrus (AG), a core region of the default mode network (DMN). We found that both performance and anticipatory alpha desynchronization were affected by stimulation of IPS only during VSA, and of AG only during semantic decisions. These findings indicate the existence of multiple dedicated parietal channels for the modulation of anticipatory alpha rhythms, which in turn reflect task-specific modulation of excitability in human parieto-occipital cortex.

Offline stimulation of human parietal cortex differently affects resting EEG microstates

The interference effects of transcranial magnetic stimulation (TMS) on several electroencephalographic (EEG) measures in both temporal and frequency domains have been reported. We tested the hypothesis whether the offline external inhibitory interference, although focal, could result in a global reorganization of the functional brain state, as assessed by EEG microstates. In 16 healthy subjects, we inhibited five parietal areas and used a pseudo stimulation (Sham) at rest. The EEG microstates were extracted before and after each stimulation. The canonical A, B, C and D templates were found before and after all stimulation conditions. The Sham, as well as the stimulation of a ventral site did not modify any resting EEG microstates’ topography. On the contrary, interfering with parietal key-nodes of both dorsal attention (DAN) and default mode networks (DMN), we observed that the microstate C clearly changes, whereas the other three topographies are not affected. These results provide the first causal evidence of a microstates modification following magnetic interference. Since the microstate C has been associated to the activity in regions belonging to the cingulo-opercular network (CON), the regional specificity of such inhibition seems to support the theory of a link between CON and both DAN and DMN at rest.

Improving language mapping in clinical fMRI through assessment of grammar

Introduction

Brain surgery in the language dominant hemisphere remains challenging due to unintended post-surgical language deficits, despite using pre-surgical functional magnetic resonance (fMRI) and intraoperative cortical stimulation. Moreover, patients are often recommended not to undergo surgery if the accompanying risk to language appears to be too high. While standard fMRI language mapping protocols may have relatively good predictive value at the group level, they remain sub-optimal on an individual level. The standard tests used typically assess lexico-semantic aspects of language, and they do not accurately reflect the complexity of language either in comprehension or production at the sentence level. Among patients who had left hemisphere language dominance we assessed which tests are best at activating language areas in the brain.

Method

We compared grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking) with standard tests (object naming, auditory and visual responsive naming), using pre-operative fMRI. Twenty-five surgical candidates (13 females) participated in this study. Sixteen patients presented with a brain tumor, and nine with epilepsy. All participants underwent two pre-operative fMRI protocols: one including CYCLE-N grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking); and a second one with standard fMRI tests (object naming, auditory and visual responsive naming). fMRI activations during performance in both protocols were compared at the group level, as well as in individual candidates.

Results

The grammar tests generated more volume of activation in the left hemisphere (left/right angular gyrus, right anterior/posterior superior temporal gyrus) and identified additional language regions not shown by the standard tests (e.g., left anterior/posterior supramarginal gyrus). The standard tests produced more activation in left BA 47. Ten participants had more robust activations in the left hemisphere in the grammar tests and two in the standard tests. The grammar tests also elicited substantial activations in the right hemisphere and thus turned out to be superior at identifying both right and left hemisphere contribution to language processing.

Conclusion

The grammar tests may be an important addition to the standard pre-operative fMRI testing.

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We added comprehensive grammar tests to standard presurgical fMRI of language.

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The grammar tests generated more volume of activation bilaterally.

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The tests identified additional language regions not shown by the standard tests.

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The grammar tests may be an important addition to standard pre-operative fMRI.

Temporal dynamics of TMS interference over preparatory alpha activity during semantic decisions

The mean amplitude of the EEG alpha (8–12 Hz) power de-synchronization (ERD) is a robust electrophysiological correlate of task anticipation. Furthermore, in paradigms using a fixed period between warning and target stimuli, such alpha de-synchronization tends to increase and to peak just before target presentation. Previous studies from our group showed that the anticipatory alpha ERD can be modulated when magnetic stimulation is delivered over specific cortical regions during a variety of cognitive tasks. In this study we investigate the temporal dynamics of the anticipatory alpha ERD and test whether the magnetic stimulation produces either a general attenuation or an interruption of the typical development of alpha ERD. We report that, during a semantic decision task, rTMS over left AG, a region previously associated to semantic memory retrieval, shortened the peak latency and decreased the peak amplitude of the anticipatory alpha de-synchronization as compared to both active (left IPS) and non-active (Sham) TMS conditions. These results, while supporting the causal role of the left AG in the anticipation of a semantic decision task, suggest that magnetic interference not simply reduces the mean amplitude of anticipatory alpha ERD but also interrupts its typical temporal evolution in paradigms employing fixed cue-target intervals.

Children and adolescents' performance on a medium-length/nonsemantic word-list test

Word-list learning tasks are among the most important and frequently used tests for declarative memory evaluation. For example, the California Verbal Learning Test-Children's Version (CVLT-C) and Rey Auditory Verbal Learning Test provide important information about different cognitive-neuropsychological processes. However, the impact of test length (i.e., number of words) and semantic organization (i.e., type of words) on children's and adolescents' memory performance remains to be clarified, especially during this developmental stage. To explore whether a medium-length non-semantically organized test can produce the typical curvilinear performance that semantically organized tests produce, reflecting executive control, we studied and compared the cognitive performance of normal children and adolescents by utilizing mathematical modeling. The model is based on the first-order system transfer function and has been successfully applied to learning curves for the CVLT-C (15 words, semantically organized paradigm). Results indicate that learning nine semantically unrelated words produces typical curvilinear (executive function) performance in children and younger adolescents and that performance could be effectively analyzed with the mathematical model. This indicates that the exponential increase (curvilinear performance) of correctly learned words does not solely depend on semantic and/or length features. This type of test controls semantic and length effects and may represent complementary tools for executive function evaluation in clinical populations in which semantic and/or length processing are affected.