1
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Nau M, Schmid AC, Kaplan SM, Baker CI, Kravitz DJ. Centering cognitive neuroscience on task demands and generalization. Nat Neurosci 2024:10.1038/s41593-024-01711-6. [PMID: 39075326 DOI: 10.1038/s41593-024-01711-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/17/2024] [Indexed: 07/31/2024]
Abstract
Cognitive neuroscience seeks generalizable theories explaining the relationship between behavioral, physiological and mental states. In pursuit of such theories, we propose a theoretical and empirical framework that centers on understanding task demands and the mutual constraints they impose on behavior and neural activity. Task demands emerge from the interaction between an agent's sensory impressions, goals and behavior, which jointly shape the activity and structure of the nervous system on multiple spatiotemporal scales. Understanding this interaction requires multitask studies that vary more than one experimental component (for example, stimuli and instructions) combined with dense behavioral and neural sampling and explicit testing for generalization across tasks and data modalities. By centering task demands rather than mental processes that tasks are assumed to engage, this framework paves the way for the discovery of new generalizable concepts unconstrained by existing taxonomies, and moves cognitive neuroscience toward an action-oriented, dynamic and integrated view of the brain.
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Affiliation(s)
- Matthias Nau
- Laboratory of Brain and Cognition, National Institutes of Health, Bethesda, MD, USA.
| | - Alexandra C Schmid
- Laboratory of Brain and Cognition, National Institutes of Health, Bethesda, MD, USA
| | - Simon M Kaplan
- Department of Psychological & Brain Sciences, The George Washington University, Washington, DC, USA
| | - Chris I Baker
- Laboratory of Brain and Cognition, National Institutes of Health, Bethesda, MD, USA.
| | - Dwight J Kravitz
- Department of Psychological & Brain Sciences, The George Washington University, Washington, DC, USA.
- Division of Behavioral and Cognitive Sciences, Directorate for Social, Behavioral, and Economic Sciences, US National Science Foundation, Arlington, VA, USA.
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2
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Zioga I, Zhou YJ, Weissbart H, Martin AE, Haegens S. Alpha and Beta Oscillations Differentially Support Word Production in a Rule-Switching Task. eNeuro 2024; 11:ENEURO.0312-23.2024. [PMID: 38490743 PMCID: PMC10988358 DOI: 10.1523/eneuro.0312-23.2024] [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: 08/23/2023] [Revised: 01/26/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
Research into the role of brain oscillations in basic perceptual and cognitive functions has suggested that the alpha rhythm reflects functional inhibition while the beta rhythm reflects neural ensemble (re)activation. However, little is known regarding the generalization of these proposed fundamental operations to linguistic processes, such as speech comprehension and production. Here, we recorded magnetoencephalography in participants performing a novel rule-switching paradigm. Specifically, Dutch native speakers had to produce an alternative exemplar from the same category or a feature of a given target word embedded in spoken sentences (e.g., for the word "tuna", an exemplar from the same category-"seafood"-would be "shrimp", and a feature would be "pink"). A cue indicated the task rule-exemplar or feature-either before (pre-cue) or after (retro-cue) listening to the sentence. Alpha power during the working memory delay was lower for retro-cue compared with that for pre-cue in the left hemispheric language-related regions. Critically, alpha power negatively correlated with reaction times, suggestive of alpha facilitating task performance by regulating inhibition in regions linked to lexical retrieval. Furthermore, we observed a different spatiotemporal pattern of beta activity for exemplars versus features in the right temporoparietal regions, in line with the proposed role of beta in recruiting neural networks for the encoding of distinct categories. Overall, our study provides evidence for the generalizability of the role of alpha and beta oscillations from perceptual to more "complex, linguistic processes" and offers a novel task to investigate links between rule-switching, working memory, and word production.
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Affiliation(s)
- Ioanna Zioga
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen 6525 EN, The Netherlands
- Max Planck Institute for Psycholinguistics, Nijmegen 6525 XD, The Netherlands
| | - Ying Joey Zhou
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen 6525 EN, The Netherlands
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Oxford, United Kingdom
| | - Hugo Weissbart
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen 6525 EN, The Netherlands
| | - Andrea E Martin
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen 6525 EN, The Netherlands
- Max Planck Institute for Psycholinguistics, Nijmegen 6525 XD, The Netherlands
| | - Saskia Haegens
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen 6525 EN, The Netherlands
- Department of Psychiatry, Columbia University, New York, New York 10032
- Division of Systems Neuroscience, New York State Psychiatric Institute, New York, New York 10032
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3
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Schwen Blackett D, Borod JC, Speer SR, Pan X, Harnish SM. The effects of emotional stimuli on Word retrieval in people with aphasia. Neuropsychologia 2024; 192:108734. [PMID: 37952713 PMCID: PMC10833091 DOI: 10.1016/j.neuropsychologia.2023.108734] [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: 02/24/2023] [Revised: 10/07/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE Prior studies have shown that people with aphasia (PWA) have demonstrated superior language performance for emotional compared to nonemotional stimuli on a range of tasks, including auditory comprehension, verbal pragmatics, repetition, reading, and writing. However, studies on word retrieval, specifically, have suggested a possible interference effect of emotion on naming. The purpose of this study was to examine the effect of the emotional valence of stimuli on word retrieval in a series of naming tasks in PWA. METHOD Thirteen PWA and 13 neurotypical controls participated in four single-word naming tasks, including 1) object picture naming, 2) action picture naming, 3) category-member generation, and 4) verb generation. Each task included three valence sets of positively-, negatively-, and neutrally-rated pictures or words, which were obtained from the standardized International Affective Picture System (Lang et al., 2008) and the Affective Norms for Emotional Words (Bradley and Lang, 1999) databases. Accuracy and reaction time (RT) were measured and compared across groups, tasks, and valence sets. RESULTS Emotional stimuli, especially negative stimuli, resulted in worse naming performance, as measured by accuracy and RT, compared to nonemotional stimuli in PWA and neurotypical controls. This effect was relatively robust across the four naming tasks. In most cases, negative stimuli resulted in lower accuracy and slower RT than positive stimuli. CONCLUSIONS These findings suggest that stimulus valence may interfere with word retrieval for PWA and neurotypical adults and that this effect is robust across different types of naming tasks that vary by word class (nouns versus verbs) and stimulus type (pictures versus words). Negative stimuli resulted in worse naming performance than positive stimuli. These results suggest that emotionality of stimuli is an important variable to consider in word retrieval research.
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Affiliation(s)
- Deena Schwen Blackett
- Department of Speech and Hearing Science, College of Arts & Sciences, The Ohio State University, 110 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.
| | - Joan C Borod
- Department of Psychology, Queens College of the City University of New York, 65-30 Kissena Blvd, Flushing, NY, 11367, USA.
| | - Shari R Speer
- Department of Linguistics, College of Arts & Sciences, The Ohio State University, Oxley Hall, 1712 Neil Ave, Columbus, OH, 43210, USA.
| | - Xueliang Pan
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, 310-H Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA.
| | - Stacy M Harnish
- Department of Speech and Hearing Science, College of Arts & Sciences, The Ohio State University, 110 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.
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4
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Mesulam MM. Temporopolar regions of the human brain. Brain 2023; 146:20-41. [PMID: 36331542 DOI: 10.1093/brain/awac339] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/26/2022] [Accepted: 08/29/2022] [Indexed: 11/06/2022] Open
Abstract
Following prolonged neglect during the formative decades of behavioural neurology, the temporopolar region has become a site of vibrant research on the neurobiology of cognition and conduct. This turnaround can be attributed to increasing recognition of neurodegenerative diseases that target temporopolar regions for peak destruction. The resultant syndromes include behavioural dementia, associative agnosia, semantic forms of primary progressive aphasia and semantic dementia. Clinicopathological correlations show that object naming and word comprehension are critically dependent on the language-dominant (usually left) temporopolar region, whereas behavioural control and non-verbal object recognition display a more bilateral representation with a rightward bias. Neuroanatomical experiments in macaques and neuroimaging in humans show that the temporoparietal region sits at the confluence of auditory, visual and limbic streams of processing at the downstream (deep) pole of the 'what' pathway. The functional neuroanatomy of this region revolves around three axes, an anterograde horizontal axis from unimodal to heteromodal and paralimbic cortex; a radial axis where visual (ventral), auditory (dorsal) and paralimbic (medial) territories encircle temporopolar cortex and display hemispheric asymmetry; and a vertical depth-of-processing axis for the associative elaboration of words, objects and interoceptive states. One function of this neural matrix is to support the transformation of object and word representations from unimodal percepts to multimodal concepts. The underlying process is likely to start at canonical gateways that successively lead to generic (superordinate), specific (basic) and unique levels of recognition. A first sign of left temporopolar dysfunction takes the form of taxonomic blurring where boundaries among categories are preserved but not boundaries among exemplars of a category. Semantic paraphasias and coordinate errors in word-picture verification tests are consequences of this phenomenon. Eventually, boundaries among categories are also blurred and comprehension impairments become more profound. The medial temporopolar region belongs to the amygdalocentric component of the limbic system and stands to integrate exteroceptive information with interoceptive states underlying social interactions. Review of the pertinent literature shows that word comprehension and conduct impairments caused by temporopolar strokes and temporal lobectomy are far less severe than those seen in temporopolar atrophies. One explanation for this unexpected discrepancy invokes the miswiring of residual temporopolar neurons during the many years of indolently progressive neurodegeneration. According to this hypothesis, the temporopolar regions become not only dysfunctional but also sources of aberrant outputs that interfere with the function of areas elsewhere in the language and paralimbic networks, a juxtaposition not seen in lobectomy or stroke.
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Affiliation(s)
- M Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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5
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Bulut T. Meta-analytic connectivity modeling of the left and right inferior frontal gyri. Cortex 2022; 155:107-131. [DOI: 10.1016/j.cortex.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/21/2022] [Accepted: 07/15/2022] [Indexed: 11/03/2022]
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6
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Li A, Yang R, Qu J, Dong J, Gu L, Mei L. Neural representation of phonological information during Chinese character reading. Hum Brain Mapp 2022; 43:4013-4029. [PMID: 35545935 PMCID: PMC9374885 DOI: 10.1002/hbm.25900] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/04/2022] [Accepted: 04/26/2022] [Indexed: 11/12/2022] Open
Abstract
Previous studies have revealed that phonological processing of Chinese characters elicited activation in the left prefrontal cortex, bilateral parietal cortex, and occipitotemporal regions. However, it is controversial what role the left middle frontal gyrus plays in Chinese character reading, and whether the core regions (e.g., the left superior temporal gyrus and supramarginal gyrus) for phonological processing of alphabetic languages are also involved in Chinese character reading. To address these questions, the present study used both univariate and multivariate analysis (i.e., representational similarity analysis, RSA) to explore neural representations of phonological information during Chinese character reading. Participants were scanned while performing a reading aloud task. Univariate activation analysis revealed a widely distributed network for word reading, including the bilateral inferior frontal gyrus, middle frontal gyrus, lateral temporal cortex, and occipitotemporal cortex. More importantly, RSA showed that the left prefrontal (i.e., the left middle frontal gyrus and left inferior frontal gyrus) and bilateral occipitotemporal areas (i.e., the left inferior and middle temporal gyrus and bilateral fusiform gyrus) represented phonological information of Chinese characters. These results confirmed the importance of the left middle frontal gyrus and regions in ventral pathway in representing phonological information of Chinese characters.
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Affiliation(s)
- Aqian Li
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Rui Yang
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jing Qu
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jie Dong
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Lala Gu
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Leilei Mei
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou, China
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7
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Li H, Yuan Q, Luo YJ, Tao W. A new perspective for understanding the contributions of the cerebellum to reading: The cerebro-cerebellar mapping hypothesis. Neuropsychologia 2022; 170:108231. [DOI: 10.1016/j.neuropsychologia.2022.108231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 02/07/2023]
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8
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Kaestner E, Wu X, Friedman D, Dugan P, Devinsky O, Carlson C, Doyle W, Thesen T, Halgren E. The Precentral Gyrus Contributions to the Early Time-Course of Grapheme-to-Phoneme Conversion. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2022; 3:18-45. [PMID: 37215328 PMCID: PMC10158576 DOI: 10.1162/nol_a_00047] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 06/16/2021] [Indexed: 05/24/2023]
Abstract
As part of silent reading models, visual orthographic information is transduced into an auditory phonological code in a process of grapheme-to-phoneme conversion (GPC). This process is often identified with lateral temporal-parietal regions associated with auditory phoneme encoding. However, the role of articulatory phonemic representations and the precentral gyrus in GPC is ambiguous. Though the precentral gyrus is implicated in many functional MRI studies of reading, it is not clear if the time course of activity in this region is consistent with the precentral gyrus being involved in GPC. We recorded cortical electrophysiology during a bimodal match/mismatch task from eight patients with perisylvian subdural electrodes to examine the time course of neural activity during a task that necessitated GPC. Patients made a match/mismatch decision between a 3-letter string and the following auditory bi-phoneme. We characterized the distribution and timing of evoked broadband high gamma (70-170 Hz) as well as phase-locking between electrodes. The precentral gyrus emerged with a high concentration of broadband high gamma responses to visual and auditory language as well as mismatch effects. The pars opercularis, supramarginal gyrus, and superior temporal gyrus were also involved. The precentral gyrus showed strong phase-locking with the caudal fusiform gyrus during letter-string presentation and with surrounding perisylvian cortex during the bimodal visual-auditory comparison period. These findings hint at a role for precentral cortex in transducing visual into auditory codes during silent reading.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, USA
| | - Xiaojing Wu
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Daniel Friedman
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Patricia Dugan
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Orrin Devinsky
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Chad Carlson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, USA
| | - Werner Doyle
- Department of Neurology, NYU Langone School of Medicine, New York, USA
- Department of Neurosurgery, NYU Langone School of Medicine, New York, USA
| | - Thomas Thesen
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Eric Halgren
- Department of Neurosciences, University of California at San Diego, La Jolla, USA
- Department of Radiology, University of California at San Diego, La Jolla, USA
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9
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Gajardo-Vidal A, Lorca-Puls DL, Team P, Warner H, Pshdary B, Crinion JT, Leff AP, Hope TMH, Geva S, Seghier ML, Green DW, Bowman H, Price CJ. Damage to Broca's area does not contribute to long-term speech production outcome after stroke. Brain 2021; 144:817-832. [PMID: 33517378 PMCID: PMC8041045 DOI: 10.1093/brain/awaa460] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/12/2020] [Accepted: 10/22/2020] [Indexed: 02/03/2023] Open
Abstract
Broca's area in the posterior half of the left inferior frontal gyrus has long been thought to be critical for speech production. The current view is that long-term speech production outcome in patients with Broca's area damage is best explained by the combination of damage to Broca's area and neighbouring regions including the underlying white matter, which was also damaged in Paul Broca's two historic cases. Here, we dissociate the effect of damage to Broca's area from the effect of damage to surrounding areas by studying long-term speech production outcome in 134 stroke survivors with relatively circumscribed left frontal lobe lesions that spared posterior speech production areas in lateral inferior parietal and superior temporal association cortices. Collectively, these patients had varying degrees of damage to one or more of nine atlas-based grey or white matter regions: Brodmann areas 44 and 45 (together known as Broca's area), ventral premotor cortex, primary motor cortex, insula, putamen, the anterior segment of the arcuate fasciculus, uncinate fasciculus and frontal aslant tract. Spoken picture description scores from the Comprehensive Aphasia Test were used as the outcome measure. Multiple regression analyses allowed us to tease apart the contribution of other variables influencing speech production abilities such as total lesion volume and time post-stroke. We found that, in our sample of patients with left frontal damage, long-term speech production impairments (lasting beyond 3 months post-stroke) were solely predicted by the degree of damage to white matter, directly above the insula, in the vicinity of the anterior part of the arcuate fasciculus, with no contribution from the degree of damage to Broca's area (as confirmed with Bayesian statistics). The effect of white matter damage cannot be explained by a disconnection of Broca's area, because speech production scores were worse after damage to the anterior arcuate fasciculus with relative sparing of Broca's area than after damage to Broca's area with relative sparing of the anterior arcuate fasciculus. Our findings provide evidence for three novel conclusions: (i) Broca's area damage does not contribute to long-term speech production outcome after left frontal lobe strokes; (ii) persistent speech production impairments after damage to the anterior arcuate fasciculus cannot be explained by a disconnection of Broca's area; and (iii) the prior association between persistent speech production impairments and Broca's area damage can be explained by co-occurring white matter damage, above the insula, in the vicinity of the anterior part of the arcuate fasciculus.
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Affiliation(s)
- Andrea Gajardo-Vidal
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Faculty of Health Sciences, Universidad del Desarrollo, Concepcion, Chile
| | - Diego L Lorca-Puls
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Department of Speech, Language and Hearing Sciences, Faculty of Medicine, Universidad de Concepcion, Concepcion, Chile
| | - Ploras Team
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Holly Warner
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Bawan Pshdary
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Jennifer T Crinion
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Alexander P Leff
- Institute of Cognitive Neuroscience, University College London, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Thomas M H Hope
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Sharon Geva
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Mohamed L Seghier
- Cognitive Neuroimaging Unit, Emirates College for Advanced Education, Abu Dhabi, UAE.,Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, UAE
| | - David W Green
- Department of Experimental Psychology, University College London, London, UK
| | - Howard Bowman
- Centre for Cognitive Neuroscience and Cognitive Systems and the School of Computing, University of Kent, Canterbury, UK.,School of Psychology, University of Birmingham, Birmingham, UK
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
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10
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Mesulam MM, Coventry CA, Rader BM, Kuang A, Sridhar J, Martersteck A, Zhang H, Thompson CK, Weintraub S, Rogalski EJ. Modularity and granularity across the language network-A primary progressive aphasia perspective. Cortex 2021; 141:482-496. [PMID: 34153680 PMCID: PMC8319115 DOI: 10.1016/j.cortex.2021.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/22/2021] [Accepted: 05/05/2021] [Indexed: 11/16/2022]
Abstract
Tests of grammar, repetition and semantics were administered to 62 prospectively enrolled right-handed participants with primary progressive aphasia (PPA). Structural brain images were obtained at the time of testing. Regression analyses uncovered 3 clearly delineated non-overlapping left hemisphere clusters where cortical thinning (atrophy) was significantly correlated with impaired performance. A morphosyntactic cluster associated with the grammaticality of sentence construction was located predominantly within the middle and inferior frontal gyri; a phonolexical cluster associated with language repetition was located in the temporoparietal junction; a lexicosemantic cluster associated with object naming and single word comprehension was located within the middle and anterior parts of the temporal lobe and extended into insular, orbitofrontal, and mediotemporal cortices. Commonality analyses were undertaken to explore whether these three clusters were as modular as indicated by the regression analyses or whether some underlying functional granularity could be uncovered. Modularity was defined as the exclusive association of an anatomical cluster with a single type of language task whereas granularity was defined as the association of a single anatomical cluster with more than one type of language task. The commonality analyses revealed a predominantly modular organization with quantitatively minor instances of inter-cluster granularity. The results also reconfirmed previous work on PPA which had shown that Wernicke's area is not essential for word comprehension, that naming impairments can be based either on deficits of lexical retrieval or word comprehension, and that the essential substrates of word comprehension encompass much wider areas of the temporal lobe than the temporal pole. The anatomy of the language network has traditionally been explored through patients with focal cerebrovascular accidents and experiments based on functional activation. Investigations on PPA are showing that focal neurodegenerations can add new perspectives to existing models of the language network.
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Affiliation(s)
- M-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Christina A Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Alan Kuang
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA
| | - Jaiashre Sridhar
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Adam Martersteck
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Hui Zhang
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA
| | - Cynthia K Thompson
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University School of Communication, Evanston, IL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA
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11
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Liu Y, Shi G, Li M, Xing H, Song Y, Xiao L, Guan Y, Han Z. Early Top-Down Modulation in Visual Word Form Processing: Evidence From an Intracranial SEEG Study. J Neurosci 2021; 41:6102-6115. [PMID: 34011525 PMCID: PMC8276739 DOI: 10.1523/jneurosci.2288-20.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 11/21/2022] Open
Abstract
Visual word recognition, at a minimum, involves the processing of word form and lexical information. Opinions diverge on the spatiotemporal distribution of and interaction between the two types of information. Feedforward theory argues that they are processed sequentially, whereas interactive theory advocates that lexical information is processed fast and modulates early word form processing. To distinguish between the two theories, we applied stereoelectroencephalography (SEEG) to 33 human adults with epilepsy (25 males and eight females) during visual lexical decisions. The stimuli included real words (RWs), pseudowords (PWs) with legal radical positions, nonwords (NWs) with illegal radical positions, and stroked-changed words (SWs) in Chinese. Word form and lexical processing were measured by the word form effect (PW versus NW) and lexical effect (RW versus PW), respectively. Gamma-band (60 ∼ 140 Hz) SEEG activity was treated as an electrophysiological measure. A word form effect was found in eight left brain regions (i.e., the inferior parietal lobe, insula, fusiform, inferior temporal, middle temporal, middle occipital, precentral and postcentral gyri) from 50 ms poststimulus onset, whereas a lexical effect was observed in five left brain regions (i.e., the calcarine, middle temporal, superior temporal, precentral, and postcentral gyri) from 100 ms poststimulus onset. The two effects overlapped in the precentral (300 ∼ 500 ms) and postcentral (100 ∼ 200 ms and 250 ∼ 600 ms) gyri. Moreover, high-level regions provide early feedback to word form regions. These results demonstrate that lexical processing occurs early and modulates word form recognition, providing vital supportive evidence for interactive theory.SIGNIFICANCE STATEMENT A pivotal unresolved dispute in the field of word processing is whether word form recognition is obligatorily modulated by high-level lexical top-down information. To address this issue, we applied intracranial SEEG to 33 adults with epilepsy to precisely delineate the spatiotemporal dynamics between processing word form and lexical information during visual word recognition. We observed that lexical processing occurred from 100 ms poststimulus presentation and even spatiotemporally overlapped with word form processing. Moreover, the high-order regions provided feedback to the word form regions in the early stage of word recognition. These results revealed the crucial role of high-level lexical information in word form recognition, deepening our understanding of the functional coupling among brain regions in word processing networks.
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Affiliation(s)
- Yi Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Gaofeng Shi
- Faculty of International Education of Chinese Language, Beijing Language and Culture University, Beijing 100083, China
| | - Mingyang Li
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Hongbing Xing
- Faculty of International Education of Chinese Language, Beijing Language and Culture University, Beijing 100083, China
| | - Yan Song
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Luchuan Xiao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Yuguang Guan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Zaizhu Han
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
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12
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Mesulam MM, Coventry C, Bigio EH, Geula C, Thompson C, Bonakdarpour B, Gefen T, Rogalski EJ, Weintraub S. Nosology of Primary Progressive Aphasia and the Neuropathology of Language. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1281:33-49. [PMID: 33433867 PMCID: PMC8103786 DOI: 10.1007/978-3-030-51140-1_3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Primary progressive aphasia (PPA) is a dementia syndrome associated with several neuropathologic entities, including Alzheimer's disease (AD) and all major forms of frontotemporal lobar degeneration (FTLD). It is classified into subtypes defined by the nature of the language domain that is most impaired. The asymmetric neurodegeneration of the hemisphere dominant for language (usually left) is one consistent feature of all PPA variants. This feature offers unique opportunities for exploring mechanisms of selective vulnerability in neurodegenerative diseases and the neuroanatomy of language. This chapter reviews some of the current trends in PPA research as well as the challenges that remain to be addressed on the nosology, clinicopathologic correlations, and therapy of this syndrome.
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Affiliation(s)
- M -Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease; Department of Neurology, Northwestern University, Chicago, IL, USA.
| | - Christina Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, USA
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease; Department of Pathology, Northwestern University, Chicago, IL, USA
| | - Changiz Geula
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, USA
| | - Cynthia Thompson
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease; Department of Communication Sciences and Disorders; Department of Neurology, Northwestern University, Evanston, IL, USA
| | - Borna Bonakdarpour
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease; Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Tamar Gefen
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease; Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease; Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, IL, USA
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13
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Deschamps I, Courson M, Dick AS, Tremblay P. The phonological loop: is speech special? Exp Brain Res 2020; 238:2307-2321. [PMID: 32734355 DOI: 10.1007/s00221-020-05886-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/16/2020] [Indexed: 12/13/2022]
Abstract
It has been proposed that the maintenance of phonological information in verbal working memory (vWM) is carried by a domain-specific short-term storage center-the phonological loop-which is composed of a phonological store and an articulatory rehearsal system. Several brain regions including the left posterior inferior frontal gyrus (pIFG) and anterior supramarginal gyri (aSMG) are thought to support these processes. However, recent behavioral evidence suggests that verbal and non-verbal auditory information may be processed as part of a unique domain general short-term storage center instead of through specialized subsystems such as the phonological loop. In the current study, we used a single-pulse transcranial magnetic stimulation (TMS)-delayed priming paradigm with speech (syllables) and acoustically complex non-speech sounds (bird songs) to examine whether the pIFG and aSMG are involved in the processing of verbal information or, alternatively, in the processing of any complex auditory information. Our results demonstrate that TMS delivered to both regions had an effect on performance for speech and non-speech stimuli, but the nature of the effect was different. That is, priming was reduced for the speech sounds because TMS facilitated the detection of different but not identical stimuli, and accuracy was decreased for non-speech sounds. Since TMS interfered with both speech and non-speech sounds, these findings support the existence of an auditory short-term storage center located within the dorsal auditory stream.
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Affiliation(s)
- Isabelle Deschamps
- Département de Réadaptation, Faculté de Médecine, Université Laval, 1050 Avenue de La Médecine, Office 4109, Quebec City, QC, G1V 0A6, Canada
- CERVO Brain Research Centre, Quebec City, QC, Canada
| | - Melody Courson
- Département de Réadaptation, Faculté de Médecine, Université Laval, 1050 Avenue de La Médecine, Office 4109, Quebec City, QC, G1V 0A6, Canada
- CERVO Brain Research Centre, Quebec City, QC, Canada
| | | | - Pascale Tremblay
- Département de Réadaptation, Faculté de Médecine, Université Laval, 1050 Avenue de La Médecine, Office 4109, Quebec City, QC, G1V 0A6, Canada.
- CERVO Brain Research Centre, Quebec City, QC, Canada.
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14
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Valderrama JT, Beach EF, Sharma M, Appaiah-Konganda S, Schmidt E. Design and evaluation of the effectiveness of a corpus of congruent and incongruent English sentences for the study of event related potentials. Int J Audiol 2020; 60:96-103. [PMID: 32720818 DOI: 10.1080/14992027.2020.1798518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To design and evaluate the effectiveness of a stimulus material in eliciting the N400 event related potential (ERP). DESIGN A set of 700 semantically congruent and incongruent sentences was developed in accordance with current linguistic norms, and validated with an electroencephalography (EEG) study, in which the influence of age and gender on the N400 ERP magnitude was analysed. STUDY SAMPLE Forty-five normal-hearing subjects (19-57 years, 21 females) participated in the EEG study. RESULTS The stimulus material used in the EEG study elicited a robust N400 ERP, with a morphology consistent with the literature. Results also showed no statistically significant effect of age or gender on the N400 magnitude. CONCLUSIONS The material presented in this paper constitutes the largest complete stimulus set suitable for both auditory and text-based N400 experiments. This material may help facilitate the efficient implementation of future N400 ERP studies, as well as promote standardisation and consistency across studies.
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Affiliation(s)
- Joaquin T Valderrama
- National Acoustic Laboratories, Macquarie University, Sydney, Australia.,Department of Linguistics, Macquarie University, Sydney Australia
| | - Elizabeth F Beach
- National Acoustic Laboratories, Macquarie University, Sydney, Australia
| | - Mridula Sharma
- Department of Linguistics, Macquarie University, Sydney Australia
| | | | - Elaine Schmidt
- Department of Linguistics, Macquarie University, Sydney Australia.,Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, UK
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15
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Marxreiter F, Utz K, Schlachetzki JCM, Seifert F, Schmidt M, Doerfler A, Schwab S, Schenk T. Transient naming deficits associated with insular lesions in a patient with encephalitis. Neurocase 2019; 25:243-250. [PMID: 31532322 DOI: 10.1080/13554794.2019.1668421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We describe a patient with acute herpes simplex encephalitis with left-hemispheric hippocampal, parahippocampal and insular lesions. Although prototypic language areas were unaffected, the patient suffered from an inability to name objects or animals displayed on pictures. This deficit was transient and gradually disappeared 8 weeks after the initial diagnosis. Our findings are in line with a previous report showing similar deficits in a patient with a comparable lesion pattern and support the hypothesis that left insular lesions can produce severe naming deficits. Using FDG-PET we ruled out that functional deactivation in classical language areas account for the observed naming deficits.
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Affiliation(s)
- Franz Marxreiter
- Department of Neurology, University Hospital Erlangen , Erlangen , Germany.,Department of Molecular Neurology, University Hospital Erlangen , Erlangen , Germany
| | - Kathrin Utz
- Department of Neurology, University Hospital Erlangen , Erlangen , Germany
| | | | - Frank Seifert
- Department of Neurology, University Hospital Erlangen , Erlangen , Germany
| | - Manuel Schmidt
- Department of Neuroradiology, University Hospital Erlangen , Erlangen , Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen , Erlangen , Germany
| | - Stefan Schwab
- Department of Neurology, University Hospital Erlangen , Erlangen , Germany
| | - Thomas Schenk
- Clinical Neuropsychology, Department Psychology, Ludwig-Maximilians University Munich , Munich , Germany
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16
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Del Maschio N, Fedeli D, Sulpizio S, Abutalebi J. The relationship between bilingual experience and gyrification in adulthood: A cross-sectional surface-based morphometry study. BRAIN AND LANGUAGE 2019; 198:104680. [PMID: 31465990 DOI: 10.1016/j.bandl.2019.104680] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 06/10/2023]
Abstract
Neuroimaging evidence suggests that bilingualism may act as a source of neural plasticity. However, prior work has mostly focused on bilingualism-induced alterations in gray matter volume and white matter tract microstructure, with additional effects related to other neurostructural indices that might have remained undetected. The degree of cortical folding or gyrification is a morphometric parameter which provides information about changes on the brain's surface during development, aging and disease. We used Surface-based Morphometry (SBM) to investigate the contribution of bilingual experience to gyrification from early adulthood to old age in a sample of bilinguals and monolingual controls. Despite widespread cortical folding reductions for all participants with increasing age, preserved gyrification exclusive to bilinguals was detected in the right cingulate and entorhinal cortices, regions vulnerable with normal and pathological brain aging. Our results provide novel insights on experience-related cortical reshaping and bilingualism-induced cortical plasticity in adulthood.
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Affiliation(s)
- Nicola Del Maschio
- Centre for Neurolinguistics and Psycholinguistics (CNPL), University Vita-Salute San Raffaele, Milano 20132, Italy
| | - Davide Fedeli
- Centre for Neurolinguistics and Psycholinguistics (CNPL), University Vita-Salute San Raffaele, Milano 20132, Italy
| | - Simone Sulpizio
- Centre for Neurolinguistics and Psycholinguistics (CNPL), University Vita-Salute San Raffaele, Milano 20132, Italy
| | - Jubin Abutalebi
- Centre for Neurolinguistics and Psycholinguistics (CNPL), University Vita-Salute San Raffaele, Milano 20132, Italy.
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17
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Bonakdarpour B, Hurley RS, Wang AR, Fereira HR, Basu A, Chatrathi A, Guillaume K, Rogalski EJ, Mesulam MM. Perturbations of language network connectivity in primary progressive aphasia. Cortex 2019; 121:468-480. [PMID: 31530376 DOI: 10.1016/j.cortex.2019.08.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/21/2019] [Accepted: 08/08/2019] [Indexed: 12/17/2022]
Abstract
Aphasias are caused by disruption in structural integrity and interconnectivity within a large-scale distributed language network. We investigated the distribution and behavioral consequences of altered functional connectivity in three variants of primary progressive aphasia (PPA). The goal was to clarify relationships among atrophy, resting connectivity, and the resulting behavioral changes in 73 PPA and 33 control participants. Three core regions of the left perisylvian language network: the inferior frontal gyrus (IFG), middle temporal gyrus (MTG), and anterior temporal lobe (ATL) were evaluated in agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S) PPA variants. All PPA groups showed decreased connectivity between IFG and MTG. The PPA-S group also showed additional loss of connectivity strength between ATL and the other language regions. Decreased connectivity between the IFG and MTG nodes in PPA-G remained significant even when controlled for the effect of atrophy. In the PPA group as a whole, IFG-MTG connectivity strength correlated with repetition and grammar scores, whereas MTG-ATL connectivity correlated with picture naming and single-word comprehension. There was no significant change in the connectivity of homologous regions in the right hemisphere. These results show that language impairments in PPA are associated with perturbations of functional connectivity within behaviorally concordant components of the language network. Altered connectivity in PPA may reflect not only the irreversible loss of cortical components indexed by atrophy, but also the dysfunction of remaining neurons.
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Affiliation(s)
- Borna Bonakdarpour
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Department of Neurology, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Robert S Hurley
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Department of Neurology, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Psychology, Cleveland State University, Cleveland, OH, USA
| | - Allan R Wang
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hernando R Fereira
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anisha Basu
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Arjuna Chatrathi
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kyla Guillaume
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M Marsel Mesulam
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Department of Neurology, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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18
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Ficek BN, Wang Z, Zhao Y, Webster KT, Desmond JE, Hillis AE, Frangakis C, Faria AV, Caffo B, Tsapkini K. "The effect of tDCS on functional connectivity in primary progressive aphasia" NeuroImage: Clinical, volume 19 (2018), pages 703-715. NEUROIMAGE-CLINICAL 2019; 22:101734. [PMID: 30878405 PMCID: PMC6543522 DOI: 10.1016/j.nicl.2019.101734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Transcranial direct current stimulation (tDCS) is an innovative technique recently shown to improve language outcomes even in neurodegenerative conditions such as primary progressive aphasia (PPA), but the underlying brain mechanisms are not known. The present study tested whether the additional language gains with repetitive tDCS (over sham) in PPA are caused by changes in functional connectivity between the stimulated area (the left inferior frontal gyrus (IFG)) and the rest of the language network. We scanned 24 PPA participants (11 female) before and after language intervention (written naming/spelling) with a resting-state fMRI sequence and compared changes before and after three weeks of tDCS or sham coupled with language therapy. We correlated changes in the language network as well as in the default mode network (DMN) with language therapy outcome measures (letter accuracy in written naming). Significant tDCS effects in functional connectivity were observed between the stimulated area and other language network areas and between the language network and the DMN. TDCS over the left IFG lowered the connectivity between the above pairs. Changes in functional connectivity correlated with improvement in language scores (letter accuracy as a proxy for written naming) evaluated before and after therapy. These results suggest that one mechanism for anodal tDCS over the left IFG in PPA is a decrease in functional connectivity (compared to sham) between the stimulated site and other posterior areas of the language network. These results are in line with similar decreases in connectivity observed after tDCS over the left IFG in aging and other neurodegenerative conditions.
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Affiliation(s)
- Bronte N Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Zeyi Wang
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Yi Zhao
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Kimberly T Webster
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - John E Desmond
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Constantine Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | | | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA.
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19
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Yen M, DeMarco AT, Wilson SM. Adaptive paradigms for mapping phonological regions in individual participants. Neuroimage 2019; 189:368-379. [PMID: 30665008 DOI: 10.1016/j.neuroimage.2019.01.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/03/2018] [Accepted: 01/15/2019] [Indexed: 11/19/2022] Open
Abstract
Phonological encoding depends on left-lateralized regions in the supramarginal gyrus and the ventral precentral gyrus. Localization of these phonological regions in individual participants-including individuals with language impairments-is important in several research and clinical contexts. To localize these regions, we developed two paradigms that load on phonological encoding: a rhyme judgment task and a syllable counting task. Both paradigms relied on an adaptive staircase design to ensure that each individual performed each task at a similarly challenging level. The goal of this study was to assess the validity and reliability of the two paradigms, in terms of their ability to consistently produce left-lateralized activations of the supramarginal gyrus and ventral precentral gyrus in neurologically normal individuals with presumptively normal language localization. Sixteen participants were scanned with fMRI as they performed the rhyme judgment paradigm, the syllable counting paradigm, and an adaptive semantic paradigm that we have described previously. We found that the rhyme and syllable paradigms both yielded left-lateralized supramarginal and ventral precentral activations in the majority of participants. The rhyme paradigm produced more lateralized and more reliable activations, and so should be favored in future applications. In contrast, the semantic paradigm did not reveal supramarginal or precentral activations in most participants, suggesting that the recruitment of these regions is indeed driven by phonological encoding, not language processing in general. In sum, the adaptive rhyme judgment paradigm was effective in localizing left-lateralized phonological encoding regions in individual participants, and, in conjunction with the adaptive semantic paradigm, can be used to map individual language networks.
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Affiliation(s)
- Melodie Yen
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Andrew T DeMarco
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
| | - Stephen M Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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20
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Mesulam MM, Rader BM, Sridhar J, Nelson MJ, Hyun J, Rademaker A, Geula C, Bigio EH, Thompson CK, Gefen TD, Weintraub S, Rogalski EJ. Word comprehension in temporal cortex and Wernicke area: A PPA perspective. Neurology 2018; 92:e224-e233. [PMID: 30578374 DOI: 10.1212/wnl.0000000000006788] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/19/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore atrophy-deficit correlations of word comprehension and repetition in temporoparietal cortices encompassing the Wernicke area, based on patients with primary progressive aphasia (PPA). METHODS Cortical thickness in regions within and outside the classical Wernicke area, measured by FreeSurfer, was correlated with repetition and single word comprehension scores in 73 right-handed patients at mild to moderate stages of PPA. RESULTS Atrophy in the Wernicke area was correlated with repetition (r = 0.42, p = 0.001) but not single word comprehension (r = -0.072, p = 0.553). Correlations with word comprehension were confined to more anterior parts of the temporal lobe, especially its anterior third (r = 0.60, p < 0.001). A single case with postmortem autopsy illustrated preservation of word comprehension but not repetition 6 months prior to death despite nearly 50% loss of cortical volume and severe neurofibrillary degeneration in core components of the Wernicke area. CONCLUSIONS Temporoparietal cortices containing the Wernicke area are critical for language repetition. Contrary to the formulations of classic aphasiology, their role in word and sentence comprehension is ancillary rather than critical. Thus, the Wernicke area is not sufficient to sustain word comprehension if the anterior temporal lobe is damaged. Traditional models of the role of the Wernicke area in comprehension are based almost entirely on patients with cerebrovascular lesions. Such lesions also cause deep white matter destruction and acute network diaschisis, whereas progressive neurodegenerative diseases associated with PPA do not. Conceptualizations of the Wernicke area that appear to conflict, therefore, can be reconciled by considering the hodologic and physiologic differences of the underlying lesions.
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Affiliation(s)
- M-Marsel Mesulam
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL.
| | - Benjamin M Rader
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Jaiashre Sridhar
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Matthew J Nelson
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Jungmoon Hyun
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Alfred Rademaker
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Changiz Geula
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Eileen H Bigio
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Cynthia K Thompson
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Tamar D Gefen
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Sandra Weintraub
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
| | - Emily J Rogalski
- From the Mesulam Center for Cognitive Neurology and Alzheimer's Disease (M.-M.M., B.M.R., J.S., M.J.N., J.H., A.R., C.G., E.H.B., T.D.G., S.W., E.J.R.) and Departments of Neurology (M.-M.M.), Preventive Medicine (A.R.), Pathology (E.H.B.), and Psychiatry and Behavioral Sciences (T.D.G., S.W., E.J.R.), Northwestern University Feinberg School of Medicine, Chicago; and School of Communication (C.K.T.), Northwestern University, Evanston, IL
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21
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Semantic composition of sentences word by word: MEG evidence for shared processing of conceptual and logical elements. Neuropsychologia 2018; 119:392-404. [DOI: 10.1016/j.neuropsychologia.2018.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/17/2018] [Accepted: 08/18/2018] [Indexed: 11/21/2022]
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22
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Wilson SM, Yen M, Eriksson DK. An adaptive semantic matching paradigm for reliable and valid language mapping in individuals with aphasia. Hum Brain Mapp 2018; 39:3285-3307. [PMID: 29665223 PMCID: PMC6045968 DOI: 10.1002/hbm.24077] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/26/2018] [Accepted: 03/30/2018] [Indexed: 11/08/2022] Open
Abstract
Research on neuroplasticity in recovery from aphasia depends on the ability to identify language areas of the brain in individuals with aphasia. However, tasks commonly used to engage language processing in people with aphasia, such as narrative comprehension and picture naming, are limited in terms of reliability (test-retest reproducibility) and validity (identification of language regions, and not other regions). On the other hand, paradigms such as semantic decision that are effective in identifying language regions in people without aphasia can be prohibitively challenging for people with aphasia. This paper describes a new semantic matching paradigm that uses an adaptive staircase procedure to present individuals with stimuli that are challenging yet within their competence, so that language processing can be fully engaged in people with and without language impairments. The feasibility, reliability and validity of the adaptive semantic matching paradigm were investigated in sixteen individuals with chronic post-stroke aphasia and fourteen neurologically normal participants, in comparison to narrative comprehension and picture naming paradigms. All participants succeeded in learning and performing the semantic paradigm. Test-retest reproducibility of the semantic paradigm in people with aphasia was good (Dice coefficient = 0.66), and was superior to the other two paradigms. The semantic paradigm revealed known features of typical language organization (lateralization; frontal and temporal regions) more consistently in neurologically normal individuals than the other two paradigms, constituting evidence for validity. In sum, the adaptive semantic matching paradigm is a feasible, reliable and valid method for mapping language regions in people with aphasia.
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Affiliation(s)
- Stephen M. Wilson
- Department of Hearing and Speech SciencesVanderbilt University Medical CenterNashvilleTennessee
| | - Melodie Yen
- Department of Hearing and Speech SciencesVanderbilt University Medical CenterNashvilleTennessee
| | - Dana K. Eriksson
- Department of SpeechLanguage, and Hearing Sciences, University of ArizonaTucsonArizona
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23
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Ficek BN, Wang Z, Zhao Y, Webster KT, Desmond JE, Hillis AE, Frangakis C, Vasconcellos Faria A, Caffo B, Tsapkini K. The effect of tDCS on functional connectivity in primary progressive aphasia. NEUROIMAGE-CLINICAL 2018; 19:703-715. [PMID: 30009127 PMCID: PMC6041563 DOI: 10.1016/j.nicl.2018.05.023] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/27/2018] [Accepted: 05/19/2018] [Indexed: 01/21/2023]
Abstract
Transcranial direct current stimulation (tDCS) is an innovative technique recently shown to improve language outcomes even in neurodegenerative conditions such as primary progressive aphasia (PPA), but the underlying brain mechanisms are not known. The present study tested whether the additional language gains with repetitive tDCS (over sham) in PPA are caused by changes in functional connectivity between the stimulated area (the left inferior frontal gyrus (IFG)) and the rest of the language network. We scanned 24 PPA participants (11 female) before and after language intervention (written naming/spelling) with a resting-state fMRI sequence and compared changes before and after three weeks of tDCS or sham coupled with language therapy. We correlated changes in the language network as well as in the default mode network (DMN) with language therapy outcome measures (letter accuracy in written naming). Significant tDCS effects in functional connectivity were observed between the stimulated area and other language network areas and between the language network and the DMN. TDCS over the left IFG lowered the connectivity between the above pairs. Changes in functional connectivity correlated with improvement in language scores (letter accuracy as a proxy for written naming) evaluated before and after therapy. These results suggest that one mechanism for anodal tDCS over the left IFG in PPA is a decrease in functional connectivity (compared to sham) between the stimulated site and other posterior areas of the language network. These results are in line with similar decreases in connectivity observed after tDCS over the left IFG in aging and other neurodegenerative conditions.
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Affiliation(s)
- Bronte N Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Zeyi Wang
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Yi Zhao
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Kimberly T Webster
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - John E Desmond
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Constantine Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | | | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA.
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24
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Ficek BN, Wang Z, Zhao Y, Webster KT, Desmond JE, Hillis AE, Frangakis C, Vasconcellos Faria A, Caffo B, Tsapkini K. The effect of tDCS on functional connectivity in primary progressive aphasia. Neuroimage Clin 2018; 19:703-715. [PMID: 30009127 PMCID: PMC6041563 DOI: 10.1016/j.nicl.2018.05.023 10.1016/j.nicl.2019.101734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/27/2018] [Accepted: 05/19/2018] [Indexed: 10/05/2023]
Abstract
Transcranial direct current stimulation (tDCS) is an innovative technique recently shown to improve language outcomes even in neurodegenerative conditions such as primary progressive aphasia (PPA), but the underlying brain mechanisms are not known. The present study tested whether the additional language gains with repetitive tDCS (over sham) in PPA are caused by changes in functional connectivity between the stimulated area (the left inferior frontal gyrus (IFG)) and the rest of the language network. We scanned 24 PPA participants (11 female) before and after language intervention (written naming/spelling) with a resting-state fMRI sequence and compared changes before and after three weeks of tDCS or sham coupled with language therapy. We correlated changes in the language network as well as in the default mode network (DMN) with language therapy outcome measures (letter accuracy in written naming). Significant tDCS effects in functional connectivity were observed between the stimulated area and other language network areas and between the language network and the DMN. TDCS over the left IFG lowered the connectivity between the above pairs. Changes in functional connectivity correlated with improvement in language scores (letter accuracy as a proxy for written naming) evaluated before and after therapy. These results suggest that one mechanism for anodal tDCS over the left IFG in PPA is a decrease in functional connectivity (compared to sham) between the stimulated site and other posterior areas of the language network. These results are in line with similar decreases in connectivity observed after tDCS over the left IFG in aging and other neurodegenerative conditions.
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Affiliation(s)
- Bronte N Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Zeyi Wang
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Yi Zhao
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Kimberly T Webster
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - John E Desmond
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Constantine Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | | | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA.
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25
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Alemi R, Batouli SAH, Behzad E, Ebrahimpoor M, Oghabian MA. Not single brain areas but a network is involved in language: Applications in presurgical planning. Clin Neurol Neurosurg 2018; 165:116-128. [PMID: 29334640 DOI: 10.1016/j.clineuro.2018.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/03/2018] [Accepted: 01/08/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Language is an important human function, and is a determinant of the quality of life. In conditions such as brain lesions, disruption of the language function may occur, and lesion resection is a solution for that. Presurgical planning to determine the language-related brain areas would enhance the chances of language preservation after the operation; however, availability of a normative language template is essential. PATIENTS AND METHODS In this study, using data from 60 young individuals who were meticulously checked for mental and physical health, and using fMRI and robust imaging and data analysis methods, functional brain maps for the language production, perception and semantic were produced. RESULTS The obtained templates showed that the language function should be considered as the product of the collaboration of a network of brain regions, instead of considering only few brain areas to be involved in that. CONCLUSION This study has important clinical applications, and extends our knowledge on the neuroanatomy of the language function.
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Affiliation(s)
- Razieh Alemi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Otorhinolaryngology, Faculty of Medicine, McGill University, Canada
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Neuroimaging and Analysis Group, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Behzad
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Ebrahimpoor
- Neuroimaging and Analysis Group, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis Group, Tehran University of Medical Sciences, Tehran, Iran; Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran.
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26
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Abstract
An extensive program of research in the past 2 decades has focused on the role of modal sensory, motor, and affective brain systems in storing and retrieving concept knowledge. This focus has led in some circles to an underestimation of the need for more abstract, supramodal conceptual representations in semantic cognition. Evidence for supramodal processing comes from neuroimaging work documenting a large, well-defined cortical network that responds to meaningful stimuli regardless of modal content. The nodes in this network correspond to high-level "convergence zones" that receive broadly crossmodal input and presumably process crossmodal conjunctions. It is proposed that highly conjunctive representations are needed for several critical functions, including capturing conceptual similarity structure, enabling thematic associative relationships independent of conceptual similarity, and providing efficient "chunking" of concept representations for a range of higher order tasks that require concepts to be configured as situations. These hypothesized functions account for a wide range of neuroimaging results showing modulation of the supramodal convergence zone network by associative strength, lexicality, familiarity, imageability, frequency, and semantic compositionality. The evidence supports a hierarchical model of knowledge representation in which modal systems provide a mechanism for concept acquisition and serve to ground individual concepts in external reality, whereas broadly conjunctive, supramodal representations play an equally important role in concept association and situation knowledge.
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27
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Lorca-Puls DL, Gajardo-Vidal A, Seghier ML, Leff AP, Sethi V, Prejawa S, Hope TMH, Devlin JT, Price CJ. Using transcranial magnetic stimulation of the undamaged brain to identify lesion sites that predict language outcome after stroke. Brain 2017; 140:1729-1742. [PMID: 28430974 PMCID: PMC5445259 DOI: 10.1093/brain/awx087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 02/21/2017] [Indexed: 12/03/2022] Open
Abstract
Transcranial magnetic stimulation focused on either the left anterior supramarginal gyrus or opercular part of the left inferior frontal gyrus has been reported to transiently impair the ability to perform phonological more than semantic tasks. Here we tested whether phonological processing abilities were also impaired following lesions to these regions in right-handed, English speaking adults, who were investigated at least 1 year after a left-hemisphere stroke. When our regions of interest were limited to 0.5 cm3 of grey matter centred around sites that had been identified with transcranial magnetic stimulation-based functional localization, phonological impairments were observed in 74% (40/54) of patients with damage to the regions and 21% (21/100) of patients sparing these regions. This classification accuracy was better than that observed when using regions of interest centred on activation sites in previous functional magnetic resonance imaging studies of phonological processing, or transcranial magnetic stimulation sites that did not use functional localization. New regions of interest were generated by redefining the borders of each of the transcranial magnetic stimulation sites to include areas that were consistently damaged in the patients with phonological impairments. This increased the incidence of phonological impairments in the presence of damage to 85% (46/54) and also reduced the incidence of phonological impairments in the absence of damage to 15% (15/100). The difference in phonological processing abilities between those with and without damage to these ‘transcranial magnetic stimulation-guided’ regions remained highly significant even after controlling for the effect of lesion size. The classification accuracy of the transcranial magnetic stimulation-guided regions was validated in a second sample of 108 patients and found to be better than that for (i) functional magnetic resonance imaging-guided regions; (ii) a region identified from an unguided lesion overlap map; and (iii) a region identified from voxel-based lesion-symptom mapping. Finally, consistent with prior findings from functional imaging and transcranial magnetic stimulation in healthy participants, we show how damage to our transcranial magnetic stimulation-guided regions affected performance on phonologically more than semantically demanding tasks. The observation that phonological processing abilities were impaired years after the stroke, suggests that other brain regions were not able to fully compensate for the contribution that the transcranial magnetic stimulation-guided regions make to language tasks. More generally, our novel transcranial magnetic stimulation-guided lesion-deficit mapping approach shows how non-invasive stimulation of the healthy brain can be used to guide the identification of regions where brain damage is likely to cause persistent behavioural effects.
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Affiliation(s)
- Diego L Lorca-Puls
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Andrea Gajardo-Vidal
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London WC1N 3BG, UK.,Department of Speech, Language and Hearing Sciences, Faculty of Health Sciences, Universidad del Desarrollo, 4070001 Concepcion, Chile
| | - Mohamed L Seghier
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London WC1N 3BG, UK.,Cognitive Neuroimaging Unit, Emirates College for Advanced Education, PO Box 126662 Abu Dhabi, United Arab Emirates
| | - Alexander P Leff
- Institute of Cognitive Neuroscience, Division of Psychology and Language Sciences, University College London, London WC1N 3AR, UK.,Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Varun Sethi
- Department of Neuroinflammation, Institute of Neurology, University College London, London WC1N 1PJ, UK
| | - Susan Prejawa
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London WC1N 3BG, UK.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.,Collaborative Research Centre 1052 'Obesity Mechanisms', Faculty of Medicine, University of Leipzig, 04103 Leipzig, Germany
| | - Thomas M H Hope
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Joseph T Devlin
- Department of Experimental Psychology, Division of Psychology and Language Sciences, University College London, London WC1H 0AP, UK
| | - Cathy J Price
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London WC1N 3BG, UK
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28
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Perrone-Bertolotti M, Kauffmann L, Pichat C, Vidal JR, Baciu M. Effective Connectivity between Ventral Occipito-Temporal and Ventral Inferior Frontal Cortex during Lexico-Semantic Processing. A Dynamic Causal Modeling Study. Front Hum Neurosci 2017; 11:325. [PMID: 28690506 PMCID: PMC5480016 DOI: 10.3389/fnhum.2017.00325] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 06/06/2017] [Indexed: 11/13/2022] Open
Abstract
It has been suggested that dorsal and ventral pathways support distinct aspects of language processing. Yet, the full extent of their involvement and their inter-regional connectivity in visual word recognition is still unknown. Studies suggest that they might reflect the dual-route model of reading, with the dorsal pathway more involved in grapho-phonological conversion during phonological tasks, and the ventral pathway performing lexico-semantic access during semantic tasks. Furthermore, this subdivision is also suggested at the level of the inferior frontal cortex, involving ventral and dorsal parts for lexico-semantic and phonological processing, respectively. In the present study, we assessed inter-regional brain connectivity and task-induced modulations of brain activity during a phoneme detection and semantic categorization tasks, using fMRI in healthy subject. We used a dynamic causal modeling approach to assess inter-regional connectivity and task demand modulation within the dorsal and ventral pathways, including the following network components: the ventral occipito-temporal cortex (vOTC; dorsal and ventral), the superior temporal gyrus (STG; dorsal), the dorsal inferior frontal gyrus (dIFG; dorsal), and the ventral IFG (vIFG; ventral). We report three distinct inter-regional interactions supporting orthographic information transfer from vOTC to other language regions (vOTC -> STG, vOTC -> vIFG and vOTC -> dIFG) regardless of task demands. Moreover, we found that (a) during semantic processing (direct ventral pathway) the vOTC -> vIFG connection strength specifically increased and (b) a lack of modulation of the vOTC -> dIFG connection strength by the task that could suggest a more general involvement of the dorsal pathway during visual word recognition. Results are discussed in terms of anatomo-functional connectivity of visual word recognition network.
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Affiliation(s)
| | - Louise Kauffmann
- Department of Psychology, Université Grenoble Alpes, CNRS, LPNC UMR 51055105Grenoble, France.,Neural Mechanisms of Human Communication Research group, Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
| | - Cédric Pichat
- Department of Psychology, Université Grenoble Alpes, CNRS, LPNC UMR 51055105Grenoble, France
| | - Juan R Vidal
- Department of Psychology, Université Grenoble Alpes, CNRS, LPNC UMR 51055105Grenoble, France
| | - Monica Baciu
- Department of Psychology, Université Grenoble Alpes, CNRS, LPNC UMR 51055105Grenoble, France
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29
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Pisoni A, Cerciello M, Cattaneo Z, Papagno C. Phonological facilitation in picture naming: When and where? A tDCS study. Neuroscience 2017; 352:106-121. [DOI: 10.1016/j.neuroscience.2017.03.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 03/24/2017] [Accepted: 03/25/2017] [Indexed: 11/29/2022]
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30
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Oberhuber M, Hope TMH, Seghier ML, Parker Jones O, Prejawa S, Green DW, Price CJ. Four Functionally Distinct Regions in the Left Supramarginal Gyrus Support Word Processing. Cereb Cortex 2016; 26:4212-4226. [PMID: 27600852 PMCID: PMC5066832 DOI: 10.1093/cercor/bhw251] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We used fMRI in 85 healthy participants to investigate whether different parts of the left supramarginal gyrus (SMG) are involved in processing phonological inputs and outputs. The experiment involved 2 tasks (speech production (SP) and one-back (OB) matching) on 8 different types of stimuli that systematically varied the demands on sensory processing (visual vs. auditory), sublexical phonological input (words and pseudowords vs. nonverbal stimuli), and semantic content (words and objects vs. pseudowords and meaningless baseline stimuli). In ventral SMG, we found an anterior subregion associated with articulatory sequencing (for SP > OB matching) and a posterior subregion associated with auditory short-term memory (for all auditory > visual stimuli and written words and pseudowords > objects). In dorsal SMG, a posterior subregion was most highly activated by words, indicating a role in the integration of sublexical and lexical cues. In anterior dorsal SMG, activation was higher for both pseudoword reading and object naming compared with word reading, which is more consistent with executive demands than phonological processing. The dissociation of these four “functionally-distinct” regions, all within left SMG, has implications for differentiating between different types of phonological processing, understanding the functional anatomy of language and predicting the effect of brain damage.
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Affiliation(s)
- M Oberhuber
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - T M H Hope
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - M L Seghier
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK.,Cognitive Neuroimaging Unit, Emirates College for Advanced Education (ECAE), P.O. Box 126662, Abu Dhabi, UAE
| | - O Parker Jones
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK.,FMRIB (Oxford Centre for Functional MRI of the Brain), University of Oxford, Oxford, UK.,Wolfson College, University of Oxford, Oxford, UK
| | - S Prejawa
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK.,Collaborative Research Centre 1052 "Obesity Mechanisms", Faculty of Medicine, University Leipzig, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - D W Green
- Experimental Psychology, Faculty of Brain Sciences, University College London, London, UK
| | - C J Price
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
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31
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Häberling IS, Corballis PM, Corballis MC. Language, gesture, and handedness: Evidence for independent lateralized networks. Cortex 2016; 82:72-85. [DOI: 10.1016/j.cortex.2016.06.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/25/2016] [Accepted: 06/06/2016] [Indexed: 12/16/2022]
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33
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Abstract
The primary motor cortex (M1) is traditionally implicated in voluntary movement control. In order to test the hypothesis that there is a functional topography of M1 activation in studies where it has been implicated in higher cognitive tasks we performed activation-likelihood-estimation (ALE) meta-analyses of functional neuroimaging experiments reporting M1 activation in relation to six cognitive functional categories for which there was a sufficient number of studies to include, namely motor imagery, working memory, mental rotation, social/emotion/empathy, language, and auditory processing. The six categories activated different sub-sectors of M1, either bilaterally or lateralized to one hemisphere. Notably, the activations found in the M1 of the left or right hemisphere detected in our study were unlikely due to button presses. In fact, all contrasts were selected in order to eliminate M1 activation due to activity related to the finger button press. In addition, we identified the M1 sub-region of Area 4a commonly activated by 4/6 categories, namely motor imagery and working memory, emotion/empathy, and language. Overall, our findings lend support to the idea that there is a functional topography of M1 activation in studies where it has been found activated in higher cognitive tasks and that the left Area 4a can be involved in a number of cognitive processes, likely as a product of implicit mental simulation processing.
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Coderre EL, Smith JF, van Heuven WJB, Horwitz B. The Functional Overlap of Executive Control and Language Processing in Bilinguals. BILINGUALISM (CAMBRIDGE, ENGLAND) 2016; 19:471-488. [PMID: 27695385 PMCID: PMC5042330 DOI: 10.1017/s1366728915000188] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The need to control multiple languages is thought to require domain-general executive control (EC) in bilinguals such that the EC and language systems become interdependent. However, there has been no systematic investigation into how and where EC and language processes overlap in the bilingual brain. If the concurrent recruitment of EC during bilingual language processing is domain-general and extends to non-linguistic EC, we hypothesize that regions commonly involvement in language processing, linguistic EC, and non-linguistic EC may be selectively altered in bilinguals compared to monolinguals. A conjunction of functional magnetic resonance imaging (fMRI) data from a flanker task with linguistic and nonlinguistic distractors and a semantic categorization task showed functional overlap in the left inferior frontal gyrus (LIFG) in bilinguals, whereas no overlap occurred in monolinguals. This research therefore identifies a neural locus of functional overlap of language and EC in the bilingual brain.
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Affiliation(s)
- Emily L Coderre
- School of Psychology, University of Nottingham, Nottingham, UK; Brain Imaging and Modeling Section, Voice, Speech and Language Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA; Cognitive Neurology/Neuropsychology, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jason F Smith
- Brain Imaging and Modeling Section, Voice, Speech and Language Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA; Affective and Translational Neuroscience Laboratory, Department of Psychology and Maryland Neuroimaging Center, University of Maryland, College Park, MD
| | | | - Barry Horwitz
- Brain Imaging and Modeling Section, Voice, Speech and Language Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
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Madec S, Le Goff K, Anton JL, Longcamp M, Velay JL, Nazarian B, Roth M, Courrieu P, Grainger J, Rey A. Brain correlates of phonological recoding of visual symbols. Neuroimage 2016; 132:359-372. [DOI: 10.1016/j.neuroimage.2016.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 01/26/2016] [Accepted: 02/07/2016] [Indexed: 10/22/2022] Open
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Ardila A, Bernal B, Rosselli M. How Localized are Language Brain Areas? A Review of Brodmann Areas Involvement in Oral Language. Arch Clin Neuropsychol 2015; 31:112-22. [PMID: 26663825 DOI: 10.1093/arclin/acv081] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 11/13/2022] Open
Abstract
The interest in understanding how language is "localized" in the brain has existed for centuries. Departing from seven meta-analytic studies of functional magnetic resonance imaging activity during the performance of different language activities, it is proposed here that there are two different language networks in the brain: first, a language reception/understanding system, including a "core Wernicke's area" involved in word recognition (BA21, BA22, BA41, and BA42), and a fringe or peripheral area ("extended Wernicke's area:" BA20, BA37, BA38, BA39, and BA40) involved in language associations (associating words with other information); second, a language production system ("Broca's complex:" BA44, BA45, and also BA46, BA47, partially BA6-mainly its mesial supplementary motor area-and extending toward the basal ganglia and the thalamus). This paper additionally proposes that the insula (BA13) plays a certain coordinating role in interconnecting these two brain language systems.
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Affiliation(s)
- Alfredo Ardila
- Department of Communication Sciences and Disorders, Florida International University, Miami, FL, USA
| | - Byron Bernal
- Radiology Department/Research Institute, Miami Children's Hospital, Miami, FL, USA
| | - Monica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
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Perrone-Bertolotti M, Girard C, Cousin E, Vidal JR, Pichat C, Kahane P, Baciu M. NEREC, an effective brain mapping protocol for combined language and long-term memory functions. Epilepsy Behav 2015; 53:140-8. [PMID: 26575255 DOI: 10.1016/j.yebeh.2015.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/26/2015] [Accepted: 09/14/2015] [Indexed: 11/16/2022]
Abstract
Temporal lobe epilepsy can induce functional plasticity in temporoparietal networks involved in language and long-term memory processing. Previous studies in healthy subjects have revealed the relative difficulty for this network to respond effectively across different experimental designs, as compared to more reactive regions such as frontal lobes. For a protocol to be optimal for clinical use, it has to first show robust effects in a healthy cohort. In this study, we developed a novel experimental paradigm entitled NEREC, which is able to reveal the robust participation of temporoparietal networks in a uniquely combined language and memory task, validated in an fMRI study with healthy subjects. Concretely, NEREC is composed of two runs: (a) an intermixed language-memory task (confrontation naming associated with encoding in nonverbal items, NE) to map language (i.e., word retrieval and lexico-semantic processes) combined with simultaneous long-term verbal memory encoding (NE items named but also explicitly memorized) and (b) a memory retrieval task of items encoded during NE (word recognition, REC) intermixed with new items. Word recognition is based on both perceptual-semantic familiarity (feeling of 'know') and accessing stored memory representations (remembering). In order to maximize the remembering and recruitment of medial temporal lobe structures, we increased REC difficulty by changing the modality of stimulus presentation (from nonverbal during NE to verbal during REC). We report that (a) temporoparietal activation during NE was attributable to both lexico-semantic (language) and memory (episodic encoding and semantic retrieval) processes; that (b) encoding activated the left hippocampus, bilateral fusiform, and bilateral inferior temporal gyri; and that (c) task recognition (recollection) activated the right hippocampus and bilateral but predominant left fusiform gyrus. The novelty of this protocol consists of (a) combining two tasks in one (language and long-term memory encoding/recall) instead of applying isolated tasks to map temporoparietal regions, (b) analyzing NE data based on performances recorded during REC, (c) double-mapping networks involved in naming and in long-term memory encoding and retrieval, (d) focusing on remembering with hippocampal activation and familiarity judgment with lateral temporal cortices activation, and (e) short duration of examination and feasibility. These aspects are of particular interest in patients with TLE, who frequently show impairment of these cognitive functions. Here, we show that the novel protocol is suited for this clinical evaluation.
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Affiliation(s)
| | - Cléa Girard
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France
| | - Emilie Cousin
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France; UMS IRMaGe, IRM 3T Recherche, CHU Grenoble, Univ. Grenoble Alpes, F-38043 Grenoble, France
| | - Juan Ricardo Vidal
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France
| | - Cédric Pichat
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France
| | - Philippe Kahane
- Neurology Department & Inserm U836-UJF-CEA, Grenoble University Hospital, France
| | - Monica Baciu
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France.
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Häberling IS, Corballis MC. Cerebellar asymmetry, cortical asymmetry and handedness: Two independent networks. Laterality 2015; 21:397-414. [PMID: 26582534 DOI: 10.1080/1357650x.2015.1110161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In 46 right-handers and 46 left-handers, we used functional magnetic resonance imaging to record activity in the frontal lobes while they generated words, the temporal lobe while they made synonym judgments, and the parietal lobe while they watched videos of manual actions. In each case we also recorded activity in the cerebellum. Laterality indices showed a significant left-hemispheric bias in each cortical lobe and a right-hemispheric bias in the cerebellum for the 2 language tasks, but not during action observation. Cerebellar asymmetry also correlated negatively with frontal and temporal asymmetry, reflecting contralateral connections, but not with parietal asymmetry. A factor analysis of the inter-correlations among laterality indices revealed 2 factors, implying independent lateralized networks, with cerebellar asymmetry strongly linked to a language network in frontal and temporal cortices, and handedness strongly linked to an action-observation network in the parietal lobe.
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Häberling IS, Steinemann A, Corballis MC. Cerebral asymmetry for language: Comparing production with comprehension. Neuropsychologia 2015; 80:17-23. [PMID: 26548403 DOI: 10.1016/j.neuropsychologia.2015.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 10/12/2015] [Accepted: 11/04/2015] [Indexed: 10/22/2022]
Abstract
Although left-hemispheric damage can impair both the production and comprehension of language, it has been claimed that comprehension is more bilaterally represented than is production. A variant of this theme is based on the theory that different aspects of language are processed by a dorsal stream, responsible for mapping words to articulation, and a ventral stream for processing input for meaning. Some have claimed that the dorsal stream is left-hemispheric, while the ventral stream is bilaterally organized. We used fMRI to record activation while left- and right-handed participants performed covert word-generation task and judged whether word pairs were synonyms. Regions of interest were Broca's area as part of the dorsal stream and the superior and middle temporal gyri as part of the ventral stream. Laterality indices showed equal left-hemispheric lateralization in Broca's area for word generation and both Broca's area and temporal lobe for the synonym judgments. Handedness influenced laterality equally in each area and task, with right-handers showing stronger left-hemispheric dominance than left-handers. Although our findings provide no evidence that asymmetry is more pronounced for production than for comprehension, correlations between the tasks and regions of interest support the view that lateralization in the temporal lobe depends on feedback influences from frontal regions.
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Affiliation(s)
- Isabelle S Häberling
- School of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Anita Steinemann
- School of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Michael C Corballis
- School of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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Mesulam MM, Thompson CK, Weintraub S, Rogalski EJ. The Wernicke conundrum and the anatomy of language comprehension in primary progressive aphasia. Brain 2015; 138:2423-37. [PMID: 26112340 DOI: 10.1093/brain/awv154] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 04/14/2015] [Indexed: 11/14/2022] Open
Abstract
Wernicke's aphasia is characterized by severe word and sentence comprehension impairments. The location of the underlying lesion site, known as Wernicke's area, remains controversial. Questions related to this controversy were addressed in 72 patients with primary progressive aphasia who collectively displayed a wide spectrum of cortical atrophy sites and language impairment patterns. Clinico-anatomical correlations were explored at the individual and group levels. These analyses showed that neuronal loss in temporoparietal areas, traditionally included within Wernicke's area, leave single word comprehension intact and cause inconsistent impairments of sentence comprehension. The most severe sentence comprehension impairments were associated with a heterogeneous set of cortical atrophy sites variably encompassing temporoparietal components of Wernicke's area, Broca's area, and dorsal premotor cortex. Severe comprehension impairments for single words, on the other hand, were invariably associated with peak atrophy sites in the left temporal pole and adjacent anterior temporal cortex, a pattern of atrophy that left sentence comprehension intact. These results show that the neural substrates of word and sentence comprehension are dissociable and that a circumscribed cortical area equally critical for word and sentence comprehension is unlikely to exist anywhere in the cerebral cortex. Reports of combined word and sentence comprehension impairments in Wernicke's aphasia come almost exclusively from patients with cerebrovascular accidents where brain damage extends into subcortical white matter. The syndrome of Wernicke's aphasia is thus likely to reflect damage not only to the cerebral cortex but also to underlying axonal pathways, leading to strategic cortico-cortical disconnections within the language network. The results of this investigation further reinforce the conclusion that the left anterior temporal lobe, a region ignored by classic aphasiology, needs to be inserted into the language network with a critical role in the multisynaptic hierarchy underlying word comprehension and object naming.
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Affiliation(s)
- M-Marsel Mesulam
- 1 Cognitive Neurology and Alzheimer's Disease Centre, Northwestern University, Chicago, Illinois 60611, USA 2 Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA 3 Department of Psychology, Northwestern University, Chicago, Illinois 60611, USA
| | - Cynthia K Thompson
- 1 Cognitive Neurology and Alzheimer's Disease Centre, Northwestern University, Chicago, Illinois 60611, USA 4 Department of Communication Sciences and Disorders, Northwestern University, Chicago, Illinois 60611, USA
| | - Sandra Weintraub
- 1 Cognitive Neurology and Alzheimer's Disease Centre, Northwestern University, Chicago, Illinois 60611, USA 5 Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA
| | - Emily J Rogalski
- 1 Cognitive Neurology and Alzheimer's Disease Centre, Northwestern University, Chicago, Illinois 60611, USA
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Sheldon S, Levine B. The medial temporal lobes distinguish between within-item and item-context relations during autobiographical memory retrieval. Hippocampus 2015; 25:1577-90. [DOI: 10.1002/hipo.22477] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Signy Sheldon
- Department of Psychology; McGill University; Montreal Quebec Canada
| | - Brian Levine
- Rotman Research Institute; Baycrest Centre for Geriatric Care; Toronto Ontario Canada
- Department of Psychology; University of Toronto; Toronto Ontario Canada
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Baratelli E, Laiacona M, Capitani E. Language disturbances associated to insular and entorhinal damage: study of a patient affected by herpetic encephalitis. Neurocase 2015; 21:299-308. [PMID: 24593839 DOI: 10.1080/13554794.2014.892623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The herpes simplex encephalitis (HSE) patient reported in this study presented a left hemisphere lesion limited to the left insula and to the left anterior parahippocampal region. The patient was followed longitudinally, focusing on the aphasia type, the language recovery, and the integrity of semantic representations. The language deficit was of fluent type, without phonological impairment, and showed a good but incomplete recovery after four months. A semantic impairment was possible at the onset, but recovered quickly and did not present a disproportionate impairment of living categories.
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Affiliation(s)
- Elena Baratelli
- a Health Sciences Department , Neurology Unit, Milan University , S.Paolo Hospital, Milan , Italy
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43
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Mesulam MM, Rogalski EJ, Wieneke C, Hurley RS, Geula C, Bigio EH, Thompson CK, Weintraub S. Primary progressive aphasia and the evolving neurology of the language network. Nat Rev Neurol 2014; 10:554-69. [PMID: 25179257 PMCID: PMC4201050 DOI: 10.1038/nrneurol.2014.159] [Citation(s) in RCA: 215] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary progressive aphasia (PPA) is caused by selective neurodegeneration of the language-dominant cerebral hemisphere; a language deficit initially arises as the only consequential impairment and remains predominant throughout most of the course of the disease. Agrammatic, logopenic and semantic subtypes, each reflecting a characteristic pattern of language impairment and corresponding anatomical distribution of cortical atrophy, represent the most frequent presentations of PPA. Such associations between clinical features and the sites of atrophy have provided new insights into the neurology of fluency, grammar, word retrieval, and word comprehension, and have necessitated modification of concepts related to the functions of the anterior temporal lobe and Wernicke's area. The underlying neuropathology of PPA is, most commonly, frontotemporal lobar degeneration in the agrammatic and semantic forms, and Alzheimer disease (AD) pathology in the logopenic form; the AD pathology often displays atypical and asymmetrical anatomical features consistent with the aphasic phenotype. The PPA syndrome reflects complex interactions between disease-specific neuropathological features and patient-specific vulnerability. A better understanding of these interactions might help us to elucidate the biology of the language network and the principles of selective vulnerability in neurodegenerative diseases. We review these aspects of PPA, focusing on advances in our understanding of the clinical features and neuropathology of PPA and what they have taught us about the neural substrates of the language network.
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Affiliation(s)
- M-Marsel Mesulam
- Cognitive Neurology and Alzheimer's Disease Centre, 320 East Superior Street, Searle Building, 11-450, Northwestern University, Chicago, IL 60611, USA
| | - Emily J Rogalski
- Cognitive Neurology and Alzheimer's Disease Centre, 320 East Superior Street, Searle Building, 11-450, Northwestern University, Chicago, IL 60611, USA
| | - Christina Wieneke
- Cognitive Neurology and Alzheimer's Disease Centre, 320 East Superior Street, Searle Building, 11-450, Northwestern University, Chicago, IL 60611, USA
| | - Robert S Hurley
- Cognitive Neurology and Alzheimer's Disease Centre, 320 East Superior Street, Searle Building, 11-450, Northwestern University, Chicago, IL 60611, USA
| | - Changiz Geula
- Cognitive Neurology and Alzheimer's Disease Centre, 320 East Superior Street, Searle Building, 11-450, Northwestern University, Chicago, IL 60611, USA
| | - Eileen H Bigio
- Department of Neuropathology, Northwestern University Feinberg School of Medicine, 710 North Fairbanks Court, Chicago, IL 60611, USA
| | - Cynthia K Thompson
- Department of Communication Sciences and Disorders, Northwestern University, 633 Clark Street, Evanston, IL 60208, USA
| | - Sandra Weintraub
- Cognitive Neurology and Alzheimer's Disease Centre, 320 East Superior Street, Searle Building, 11-450, Northwestern University, Chicago, IL 60611, USA
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44
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Hurley RS, Bonakdarpour B, Wang X, Mesulam MM. Asymmetric connectivity between the anterior temporal lobe and the language network. J Cogn Neurosci 2014; 27:464-73. [PMID: 25244113 DOI: 10.1162/jocn_a_00722] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The anterior temporal lobe (ATL) sits at the confluence of auditory, visual, olfactory, transmodal, and limbic processing hierarchies. In keeping with this anatomical heterogeneity, the ATL has been implicated in numerous functional domains, including language, semantic memory, social cognition, and facial identification. One question that has attracted considerable discussion is whether the ATL contains a mosaic of differentially specialized areas or whether it provides a domain-independent amodal hub. In the current study, based on task-free fMRI in right-handed neurologically intact participants, we found that the left lateral ATL is interconnected with hubs of the temporosylvian language network, including the inferior frontal gyrus and middle temporal gyrus of the ipsilateral hemisphere and, to a lesser extent, with homotopic areas of the contralateral hemisphere. In contrast, the right lateral ATL had much weaker functional connectivity with these regions in either hemisphere. Together with evidence that has been gathered in lesion-mapping and event-related neuroimaging studies, this asymmetry of functional connectivity supports the inclusion of the left ATL within the language network, a relationship that had been overlooked by classic aphasiology. The asymmetric domain selectivity for language of the left ATL, together with the absence of such an affiliation in the right ATL, is inconsistent with a strict definition of domain-independent amodal functionality in this region of the brain.
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Hirshorn EA, Dye MWG, Hauser PC, Supalla TR, Bavelier D. Neural networks mediating sentence reading in the deaf. Front Hum Neurosci 2014; 8:394. [PMID: 24959127 PMCID: PMC4050738 DOI: 10.3389/fnhum.2014.00394] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 05/17/2014] [Indexed: 11/13/2022] Open
Abstract
The present work addresses the neural bases of sentence reading in deaf populations. To better understand the relative role of deafness and spoken language knowledge in shaping the neural networks that mediate sentence reading, three populations with different degrees of English knowledge and depth of hearing loss were included—deaf signers, oral deaf and hearing individuals. The three groups were matched for reading comprehension and scanned while reading sentences. A similar neural network of left perisylvian areas was observed, supporting the view of a shared network of areas for reading despite differences in hearing and English knowledge. However, differences were observed, in particular in the auditory cortex, with deaf signers and oral deaf showing greatest bilateral superior temporal gyrus (STG) recruitment as compared to hearing individuals. Importantly, within deaf individuals, the same STG area in the left hemisphere showed greater recruitment as hearing loss increased. To further understand the functional role of such auditory cortex re-organization after deafness, connectivity analyses were performed from the STG regions identified above. Connectivity from the left STG toward areas typically associated with semantic processing (BA45 and thalami) was greater in deaf signers and in oral deaf as compared to hearing. In contrast, connectivity from left STG toward areas identified with speech-based processing was greater in hearing and in oral deaf as compared to deaf signers. These results support the growing literature indicating recruitment of auditory areas after congenital deafness for visually-mediated language functions, and establish that both auditory deprivation and language experience shape its functional reorganization. Implications for differential reliance on semantic vs. phonological pathways during reading in the three groups is discussed.
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Affiliation(s)
- Elizabeth A Hirshorn
- Department of Brain and Cognitive Sciences, University of Rochester , Rochester, NY, USA ; Learning Research and Development Center, University of Pittsburgh , Pittsburgh, PA, USA
| | - Matthew W G Dye
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign , Champaign, IL, USA ; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign , Urbana, IL, USA ; Department of Psychology, University of Illinois at Urbana-Champaign , Champaign, IL, USA
| | - Peter C Hauser
- National Technical Institute for the Deaf, Rochester Institute of Technology , Rochester, NY, USA
| | - Ted R Supalla
- Department of Brain and Cognitive Sciences, University of Rochester , Rochester, NY, USA
| | - Daphne Bavelier
- Department of Brain and Cognitive Sciences, University of Rochester , Rochester, NY, USA ; Faculté de Psychologie et des Sciences de l'éducation, Université de Genève Geneva, Switzerland
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Zhu L, Nie Y, Chang C, Gao JH, Niu Z. Different patterns and development characteristics of processing written logographic characters and alphabetic words: an ALE meta-analysis. Hum Brain Mapp 2013; 35:2607-18. [PMID: 24105858 DOI: 10.1002/hbm.22354] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 05/31/2013] [Accepted: 05/31/2013] [Indexed: 11/10/2022] Open
Abstract
The neural systems for phonological processing of written language have been well identified now, while models based on these neural systems are different for different language systems or age groups. Although each of such models is mostly concordant across different experiments, the results are sensitive to the experiment design and intersubject variability. Activation likelihood estimation (ALE) meta-analysis can quantitatively synthesize the data from multiple studies and minimize the interstudy or intersubject differences. In this study, we performed two ALE meta-analysis experiments: one was to examine the neural activation patterns of the phonological processing of two different types of written languages and the other was to examine the development characteristics of such neural activation patterns based on both alphabetic language and logographic language data. The results of our first meta-analysis experiment were consistent with the meta-analysis which was based on the studies published before 2005. And there were new findings in our second meta-analysis experiment, where both adults and children groups showed great activation in the left frontal lobe, the left superior/middle temporal gyrus, and the bilateral middle/superior occipital gyrus. However, the activation of the left middle/inferior frontal gyrus was found increase with the development, and the activation was found decrease in the following areas: the right claustrum and inferior frontal gyrus, the left inferior/medial frontal gyrus, the left middle/superior temporal gyrus, the right cerebellum, and the bilateral fusiform gyrus. It seems that adults involve more phonological areas, whereas children involve more orthographic areas and semantic areas.
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Affiliation(s)
- Linlin Zhu
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, China
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Janssen AL, Boster A, Patterson BA, Abduljalil A, Prakash RS. Resting-state functional connectivity in multiple sclerosis: an examination of group differences and individual differences. Neuropsychologia 2013; 51:2918-29. [PMID: 23973635 DOI: 10.1016/j.neuropsychologia.2013.08.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 01/12/2023]
Abstract
Multiple sclerosis (MS) is a neurodegenerative, inflammatory disease of the central nervous system, resulting in physical and cognitive disturbances. The goal of the current study was to examine the association between network integrity and composite measures of cognition and disease severity in individuals with relapsing-remitting MS (RRMS), relative to healthy controls. All participants underwent a neuropsychological and neuroimaging session, where resting-state data was collected. Independent component analysis and dual regression were employed to examine network integrity in individuals with MS, relative to healthy controls. The MS sample exhibited less connectivity in the motor and visual networks, relative to healthy controls, after controlling for group differences in gray matter volume. However, no alterations were observed in the frontoparietal, executive control, or default-mode networks, despite previous evidence of altered neuronal patterns during tasks of exogenous processing. Whole-brain, voxel-wise regression analyses with disease severity and processing speed composites were also performed to elucidate the brain-behavior relationship with neuronal network integrity. Individuals with higher levels of disease severity demonstrated reduced intra-network connectivity of the motor network, and the executive control network, while higher disease burden was associated with greater inter-network connectivity between the medial visual network and areas involved in visuomotor learning. Our findings underscore the importance of examining resting-state oscillations in this population, both as a biomarker of disease progression and a potential target for therapeutic intervention.
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Affiliation(s)
- Alisha L Janssen
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH 43210, United States
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Vogel AC, Church JA, Power JD, Miezin FM, Petersen SE, Schlaggar BL. Functional network architecture of reading-related regions across development. BRAIN AND LANGUAGE 2013; 125:231-43. [PMID: 23506969 PMCID: PMC3863779 DOI: 10.1016/j.bandl.2012.12.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 12/19/2012] [Accepted: 12/24/2012] [Indexed: 05/25/2023]
Abstract
Reading requires coordinated neural processing across a large number of brain regions. Studying relationships between reading-related regions informs the specificity of information processing performed in each region. Here, regions of interest were defined from a meta-analysis of reading studies, including a developmental study. Relationships between regions were defined as temporal correlations in spontaneous fMRI signal; i.e., resting state functional connectivity MRI (RSFC). Graph theory based network analysis defined the community structure of the "reading-related" regions. Regions sorted into previously defined communities, such as the fronto-parietal and cingulo-opercular control networks, and the default mode network. This structure was similar in children, and no apparent "reading" community was defined in any age group. These results argue against regions, or sets of regions, being specific or preferential for reading, instead indicating that regions used in reading are also used in a number of other tasks.
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Affiliation(s)
- Alecia C Vogel
- Dept. of Neurology, Washington University School of Medicine, St. Louis, MO, United States.
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Mesulam MM, Wieneke C, Hurley R, Rademaker A, Thompson CK, Weintraub S, Rogalski EJ. Words and objects at the tip of the left temporal lobe in primary progressive aphasia. ACTA ACUST UNITED AC 2013; 136:601-18. [PMID: 23361063 DOI: 10.1093/brain/aws336] [Citation(s) in RCA: 152] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Eleven of 69 prospectively enrolled primary progressive aphasics were selected for this study because of peak atrophy sites located predominantly or exclusively within the anterior left temporal lobe. Cortical volumes in these areas were reduced to less than half of control values, whereas average volume elsewhere in the left hemisphere deviated from control values by only 8%. Failure to name objects emerged as the most consistent and severe deficit. Naming errors were attributed to pure retrieval failure if the object could not be named even when the denoting word was understood, the object recognized and the two accurately matched. Surprisingly many of the naming errors reflected pure retrieval failures, without discernible semantic or associative component. The remaining set of errors had associative components. These errors reflected the inability to define the word denoting the object more often than the inability to define the nature of the pictured object. In a separate task where the same object had to be linked to verbal or non-verbal associations, performance was abnormal only in the verbal format. Excessive taxonomic interference was observed for picture-word, but not picture-picture, matching tasks. This excessive interference reflected a blurring of intra- rather than inter-category distinctions as if the acuity of word-object associations had been diminished so that correspondences were easier to recognize at generic than specific levels. These dissociations between verbal and non-verbal markers of object knowledge indicate that the reduced neural mass at peak atrophy sites of the left temporal tip, accounting for half or more of the presumed premorbid volume, was unlikely to have contained domain-independent semantic representations of the type that would be expected in a strictly amodal hub. A more likely arrangement entails two highly interactive routes--a strongly left lateralized temporosylvian language network for verbal concepts, and a presumably more bilateral or right-sided inferotemporal/fusiform object recognition network, which remained relatively spared because peak atrophy sites were concentrated on the left. The current results also suggest that the left anterior temporal neocortex should be inserted into the language network where it is likely to play a major role in selecting verbal labels for objects and mediating the progression of word comprehension from generic to specific levels of precision.
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Affiliation(s)
- M-Marsel Mesulam
- Cognitive Neurology and Alzheimer's Disease Centre, Northwestern University, 320 East Superior Street Feinberg School of Medicine, Chicago, IL 60611, USA.
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Mesulam M. Primary progressive aphasia: A dementia of the language network. Dement Neuropsychol 2013; 7:2-9. [PMID: 24707349 PMCID: PMC3975615 DOI: 10.1590/s1980-57642013dn70100002] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/08/2013] [Indexed: 12/11/2022] Open
Abstract
Primary progressive aphasia (PPA) is a clinical syndrome diagnosed when three core criteria are met. First, there should be a language impairment (i.e., aphasia) that interferes with the usage or comprehension of words. Second, the neurological work-up should determine that the disease is neurodegenerative, and therefore progressive. Third, the aphasia should arise in relative isolation, without equivalent deficits of comportment or episodic memory. The language impairment can be fluent or non-fluent and may or may not interfere with word comprehension. Memory for recent events is preserved although memory scores obtained in verbally mediated tests may be abnormal. Minor changes in personality and behavior may be present but are not the leading factors that bring the patient to medical attention or that limit daily living activities. This distinctive clinical pattern is most conspicuous in the initial stages of the disease, and reflects a relatively selective atrophy of the language network, usually located in the left hemisphere. There are different clinical variants of PPA, each with a characteristic pattern of atrophy. The underlying neuropathological diseases are heterogeneous and can include Alzheimer's disease as well as frontotemporal lobar degeneration. The clinician's task is to recognize PPA and differentiate it from other neurodegenerative phenotypes, use biomarkers to surmise the nature of the underlying neuropathology, and institute the most fitting multimodal interventions.
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Affiliation(s)
- Marsel Mesulam
- MD, Cognitive Neurology and Alzheimer's Disease Center, Northwestern
University Feinberg School of Medicine, Chicago, IL, USA
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