Functional connectivity of the left inferior frontal gyrus during semantic priming

Neuropsychological differential diagnosis of Alzheimer's disease and vascular dementia: a systematic review with meta-regressions

Introduction

Diagnostic classification systems and guidelines posit distinguishing patterns of impairment in Alzheimer's (AD) and vascular dementia (VaD). In our study, we aim to identify which diagnostic instruments distinguish them.

Methods

We searched PubMed and PsychInfo for empirical studies published until December 2020, which investigated differences in cognitive, behavioral, psychiatric, and functional measures in patients older than 64 years and reported information on VaD subtype, age, education, dementia severity, and proportion of women. We systematically reviewed these studies and conducted Bayesian hierarchical meta-regressions to quantify the evidence for differences using the Bayes factor (BF). The risk of bias was assessed using the Newcastle-Ottawa-Scale and funnel plots.

Results

We identified 122 studies with 17,850 AD and 5,247 VaD patients. Methodological limitations of the included studies are low comparability of patient groups and an untransparent patient selection process. In the digit span backward task, AD patients were nine times more probable (BF = 9.38) to outperform VaD patients (β g = 0.33, 95% ETI = 0.12, 0.52). In the phonemic fluency task, AD patients outperformed subcortical VaD (sVaD) patients (β g = 0.51, 95% ETI = 0.22, 0.77, BF = 42.36). VaD patients, in contrast, outperformed AD patients in verbal (β g = -0.61, 95% ETI = -0.97, -0.26, BF = 22.71) and visual (β g = -0.85, 95% ETI = -1.29, -0.32, BF = 13.67) delayed recall. We found the greatest difference in verbal memory, showing that sVaD patients outperform AD patients (β g = -0.64, 95% ETI = -0.88, -0.36, BF = 72.97). Finally, AD patients performed worse than sVaD patients in recognition memory tasks (β g = -0.76, 95% ETI = -1.26, -0.26, BF = 11.50).

Conclusion

Our findings show inferior performance of AD in episodic memory and superior performance in working memory. We found little support for other differences proposed by diagnostic systems and diagnostic guidelines. The utility of cognitive, behavioral, psychiatric, and functional measures in differential diagnosis is limited and should be complemented by other information. Finally, we identify research areas and avenues, which could significantly improve the diagnostic value of cognitive measures.

Second-language word recognition in noise: Interdependent neuromodulatory effects of semantic context and crosslinguistic interactions driven by word form similarity

Spoken language comprehension is a fundamental component of our cognitive skills. We are quite proficient at deciphering words from the auditory input despite the fact that the speech we hear is often masked by noise such as background babble originating from talkers other than the one we are attending to. To perceive spoken language as intended, we rely on prior linguistic knowledge and context. Prior knowledge includes all sounds and words that are familiar to a listener and depends on linguistic experience. For bilinguals, the phonetic and lexical repertoire encompasses two languages, and the degree of overlap between word forms across languages affects the degree to which they influence one another during auditory word recognition. To support spoken word recognition, listeners often rely on semantic information (i.e., the words we hear are usually related in a meaningful way). Although the number of multilinguals across the globe is increasing, little is known about how crosslinguistic effects (i.e., word overlap) interact with semantic context and affect the flexible neural systems that support accurate word recognition. The current multi-echo functional magnetic resonance imaging (fMRI) study addresses this question by examining how prime-target word pair semantic relationships interact with the target word's form similarity (cognate status) to the translation equivalent in the dominant language (L1) during accurate word recognition of a non-dominant (L2) language. We tested 26 early-proficient Spanish-Basque (L1-L2) bilinguals. When L2 targets matching L1 translation-equivalent phonological word forms were preceded by unrelated semantic contexts that drive lexical competition, a flexible language control (fronto-parietal-subcortical) network was upregulated, whereas when they were preceded by related semantic contexts that reduce lexical competition, it was downregulated. We conclude that an interplay between semantic and crosslinguistic effects regulates flexible control mechanisms of speech processing to facilitate L2 word recognition, in noise.