Anomia: A doubly typical signature of semantic dementia

Establishing and evaluating the gradient of item naming difficulty in post-stroke aphasia and semantic dementia

Anomia is a common consequence following brain damage and a central symptom in semantic dementia (SD) and post-stroke aphasia (PSA), for instance. Picture naming tests are often used in clinical assessments and experience suggests that items vary systematically in their difficulty. Despite clinical intuitions and theoretical accounts, however, the existence and determinants of such a naming difficulty gradient remain to be empirically established and evaluated. Seizing the unique opportunity of two large-scale datasets of semantic dementia and post-stroke aphasia patients assessed with the same picture naming test, we applied an Item Response Theory (IRT) approach and we (a) established that an item naming difficulty gradient exists, which (b) partly differs between patient groups, and is (c) related in part to a limited number of psycholinguistic properties - frequency and familiarity for SD, frequency and word length for PSA. Our findings offer exciting future avenues for new, adaptive, time-efficient, and patient-tailored approaches to naming assessment and therapy.

Drawing from name in semantic dementia reveals graded object knowledge representations in anterior temporal lobe

Semantic dementia (SD) is characterized by progressive impairment in conceptual knowledge due to anterior temporal lobe (ATL) neurodegeneration. Extended neuropsychological assessments can quantitatively demonstrate the semantic impairment, but this graded loss of knowledge can also be readily observed in the qualitative observation of patients' recall of single concepts. Here, we present the results of a simple task of object drawing-from-name, by patients with SD (N = 19), who have isolated atrophy of the ATL bilaterally. Both cross-sectionally and longitudinally, patient drawings demonstrated a pattern of degradation in which rare and distinctive features (such as the hump on a camel) were lost earliest in disease course, and there was an increase in the intrusion of prototypical features (such as the typical small ears of most mammals on an elephant) with more advanced disease. Crucially, patient drawings showed a continuum of conceptual knowledge loss rather than a binary 'present' or 'absent' state. Overall, we demonstrate that qualitative evaluation of line drawings of animals and objects provides fascinating insights into the transmodal semantic deficit in SD. Our results are consistent with a distributed-plus-hub model of semantic memory. The graded nature of the deficit in semantic performance observed in our subset of longitudinally observed patients suggests that the temporal lobe binds feature-based semantic attributes in its central convergence zone.

Why is a flamingo named as pelican and asparagus as celery? Understanding the relationship between targets and errors in a speeded picture naming task

Speakers sometimes make word production errors, such as mistakenly saying pelican instead of flamingo. This study explored which properties of an error influence the likelihood of its selection over the target word. Analysing real-word errors in speeded picture naming, we investigated whether, relative to the target, naming errors were more typical representatives of the semantic category, were associated with more semantic features, and/or were semantically more closely related to the target than its near semantic neighbours were on average. Results indicated that naming errors tended to be more typical category representatives and possess more semantic features than the targets. Moreover, while not being the closest semantic neighbours, errors were largely near semantic neighbours of the targets. These findings suggest that typicality, number of semantic features, and semantic similarity govern activation levels in the production system, and we discuss possible mechanisms underlying these effects in the context of word production theories.

Disruption of Anterior Temporal Lobe Reduces Distortions in Memory From Category Knowledge

Memory retrieval does not provide a perfect recapitulation of past events, but instead an imperfect reconstruction of event-specific details and general knowledge. However, it remains unclear whether this reconstruction relies on mixtures of signals from different memory systems, including one supporting general knowledge. Here, we investigate whether the anterior temporal lobe (ATL) distorts new memories because of prior category knowledge. In this preregistered experiment (n = 36), participants encoded and retrieved image-location associations. Most images' locations were clustered according to their category, but some were in random locations. With this protocol, we previously demonstrated that randomly located images were retrieved closer to their category cluster relative to their encoded locations, suggesting an influence of category knowledge. We combined this procedure with TMS delivered to the left ATL before retrieval. We separately examined event-specific details (error) and category knowledge (bias) to identify distinct signals attributable to different memory systems. We found that TMS to ATL attenuated bias in location memory, but this effect was limited to exploratory analyses of atypical category members of animal categories. The magnitude of error was not impacted, suggesting that a memory's fidelity can be decoupled from its distortion by category knowledge. This raises the intriguing possibility that retrieval is jointly supported by separable memory systems.

Semantic dementia in Arabic: An assessment of Arabic word reading within sentences

INTRODUCTION

Language impairments have not yet been fully explored in native Arabic speakers with semantic dementia (SD). The aim of this paper is to describe the impairments in language in two Saudi Arabians with SD and to determine if their word reading within a sentence context would result in incorrect responses.

METHODS

Two patients with semantic dementia (one with right > left and the other with left > right temporal involvement) underwent a reading assessment in Arabic. Patients were asked to read a series of words within a sentence context in which the correct reading of the word was dependent on the context of the sentence. Thirty-four sentences were designed in which 17 Arabic homographs were used. The same homograph would occur in two separate sentences, in which the pronunciation and meaning would differ between sentences. Patients were also assessed using five other sentences that contained irregular pronouns of high frequency. Eighteen healthy controls were used as reference.

RESULTS

Both patients made errors in reading the target Arabic homographs; this was more pronounced in the patient with left > right variant of SD. The patient with right > left variant of SD also suffered from prosopagnosia.

CONCLUSION

Correct reading of Arabic words within the sentence context may be impaired from semantic language impairments in semantic dementia. The role of comprehension in the correct reading of words in Arabic sentences is important.

Comparing two picture naming tasks in primary progressive aphasia: Insights from behavioural and neural results

Picture naming tests are widely used to evaluate language impairments in neurodegenerative diseases, especially in Primary Progressive Aphasia (PPA). The available tests differ for many factors affecting the performance, e.g. format of stimuli and their psycholinguistic properties. We aim to identify the most appropriate naming test to be used on PPA according to the clinical and research demands. We investigated the behavioural characteristics, i.e. proportion of correct responses and error type, and their neural correlates in two Italian naming tests, CaGi naming (CaGi) and naming subtest of the Screening for Aphasia in NeuroDegeneration battery (SAND), administered to 52 PPA patients who underwent an FDG-PET scan. We analysed the effectiveness of the tests in distinguishing PPA versus controls and among PPA variants, considering the psycholinguistic variables affecting performance. We explored the brain metabolic correlates of behavioural performance in the tests. SAND, differently from CaGi, has time limits for the response and its items are less frequent and acquired later. SAND and CaGi differed in terms of number of correct responses and error profile, suggesting a higher difficulty to name SAND items compared to CaGi. Semantic errors predominated in CaGi, while anomic and semantic errors were equally frequent in SAND. Both tests distinguished PPA from controls, but SAND outperformed CaGi in discriminating among PPA variants. FDG-PET imaging revealed a shared metabolic involvement of temporal areas associated with lexico-semantic processing, encompassing anterior fusiform, temporal pole, and extending to posterior fusiform in sv-PPA. Concluding, a picture naming test with response time limit and items which are less frequent and acquired later in life, as SAND, may be effective at highlighting subtle distinctions between PPA variants, improving the diagnosis. Conversely, a naming test without time limit for the response, as CaGi, may be useful for a better characterization of the nature of the naming impairment at the behavioural level, eliciting more naming errors than anomia, possibly helping in the development of rehabilitation protocols.

Semantic cognition in healthy ageing: Neural signatures of representation and control mechanisms in naming typical and atypical objects

Effective use of conceptual knowledge engages semantic representation and control processes to access information in a goal-driven manner. Neuropsychological findings of patients presenting either degraded knowledge (e.g., semantic dementia) or disrupted control (e.g., semantic aphasia) converge with neuroimaging evidence from young adults, and delineate the neural segregation of representation and control mechanisms. However, there is still scarce research on the neurofunctional underpinnings of such mechanisms in healthy ageing. To address this, we conducted an fMRI study, wherein young and older adults performed a covert naming task of typical and atypical objects. Three main age-related differences were found. As shown by age group and typicality interactions, older adults exhibited overactivation during naming of atypical (e.g., avocado) relative to typical concepts in brain regions associated to semantic representation, including anterior and medial portions of left temporal lobe (respectively, ATL and MTG). This provides evidence for the reorganization of neural activity in these brain regions contingent to the enrichment of semantic repositories in older ages. The medial orbitofrontal gyrus was also overactivated, indicating that the processing of atypical concepts (relative to typical items) taxes additional control resources in the elderly. Increased activation in the inferior frontal gyrus (IFG) was observed in naming typical items (relative to atypical ones), but only for young adults. This suggests that naming typical items (e.g., strawberry) taxes more on control processes in younger ages, presumably due to the semantic competition set by other items that share multiple features with the target (e.g., raspberry, blackberry, cherry). Together, these results reveal the dynamic nature of semantic control interplaying with conceptual representations as people grow older, by indicating that distinct neural bases uphold semantic performance from young to older ages. These findings may be explained by neural compensation mechanisms coming into play to support neurocognitive changes in healthy ageing.

The eyes speak when the mouth cannot: Using eye movements to interpret omissions in primary progressive aphasia

Though it may seem simple, object naming is a complex multistage process that can be impaired by lesions at various sites of the language network. Individuals with neurodegenerative disorders of language, known as primary progressive aphasias (PPA), have difficulty with naming objects, and instead frequently say "I don't know" or fail to give a vocal response at all, known as an omission. Whereas other types of naming errors (paraphasias) give clues as to which aspects of the language network have been compromised, the mechanisms underlying omissions remain largely unknown. In this study, we used a novel eye tracking approach to probe the cognitive mechanisms of omissions in the logopenic and semantic variants of PPA (PPA-L and PPA-S). For each participant, we identified pictures of common objects (e.g., animals, tools) that they could name aloud correctly, as well as pictures that elicited an omission. In a separate word-to-picture matching task, those pictures appeared as targets embedded among an array with 15 foils. Participants were given a verbal cue and tasked with pointing to the target, while eye movements were monitored. On trials with correctly-named targets, controls and both PPA groups ceased visual search soon after foveating the target. On omission trials, however, the PPA-S group failed to stop searching, and went on to view many foils "post-target". As further indication of impaired word knowledge, gaze of the PPA-S group was subject to excessive "taxonomic capture", such that they spent less time viewing the target and more time viewing related foils on omission trials. In contrast, viewing behavior of the PPA-L group was similar to controls on both correctly-named and omission trials. These results indicate that the mechanisms of omission in PPA differ by variant. In PPA-S, anterior temporal lobe degeneration causes taxonomic blurring, such that words from the same category can no longer be reliably distinguished. In PPA-L, word knowledge remains relatively intact, and omissions instead appear to be caused by downstream factors (e.g., lexical access, phonological encoding). These findings demonstrate that when words fail, eye movements can be particularly informative.

Typicality in the brain during semantic and episodic memory decisions

Concept typicality is a key semantic dimension supporting the categorical organization of items based on their features, such that typical items share more features with other members of their category than atypical items, which are more distinctive. Typicality effects manifest in better accuracy and faster response times during categorization tasks, but higher performance for atypical items in episodic memory tasks, due to their distinctiveness. At a neural level, typicality has been linked to the anterior temporal lobe (ATL) and the inferior frontal gyrus (IFG) in semantic decision tasks, but patterns of brain activity during episodic memory tasks remain to be understood. We investigated the neural correlates of typicality in semantic and episodic memory to determine the brain regions associated with semantic typicality and uncover effects arising when items are reinstated during retrieval. In an fMRI study, 26 healthy young subjects first performed a category verification task on words representing typical and atypical concepts (encoding), and then completed a recognition memory task (retrieval). In line with previous literature, we observed higher accuracy and faster response times for typical items in the category verification task, while atypical items were better recognized in the episodic memory task. During category verification, univariate analyses revealed a greater involvement of the angular gyrus for typical items and the inferior frontal gyrus for atypical items. During the correct recognition of old items, regions belonging to the core recollection network were activated. We then compared the similarity of the representations from encoding to retrieval (ERS) using Representation Similarity Analyses. Results showed that typical items were reinstated more than atypical ones in several regions including the left precuneus and left anterior temporal lobe (ATL). This suggests that the correct retrieval of typical items requires finer-grained processing, evidenced by greater item-specific reinstatement, which is needed to resolve their confusability with other members of the category due to their higher feature similarity. Our findings confirm the centrality of the ATL in the processing of typicality while extending it to memory retrieval.

Temporopolar regions of the human brain

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.

Verb Frequency and Density Drive Naming Performance in Primary Progressive Aphasia

Background

Recent work has highlighted the utility of the Boston Naming Test and Hopkins Action Naming Assessment (HANA) for distinguishing between semantic (svPPA), logopenic (lvPPA) and non-fluent agrammatic (nfavPPA) variants of primary progressive aphasia (PPA).

Aims

To determine whether item level differences between variants on when naming verbs on the HANA were able to be accounted for using common variables of lexical interest: word frequency, semantic density, concreteness, or valency. We also examined three specific hypotheses: (1) svPPA and lvPPA may result in increased difficulty with decreased semantic density compared to nfavPPA; (2) svPPA may result in increased difficulty with decreased concreteness; and (3) nfavPPA may result in increased difficulty with high syntactic valency.

Methods & Procedures

268 patients with PPA were evaluated using the HANA. A hierarchical Bayesian regression approach was adopted to account for effects of repeated measurement within participants and items.

Outcomes & Results

The main effects of variant and verb trait were significant in all models, as was the interaction for frequency, semantic density, and valency. Increasing frequency, semantic density, and concreteness led to better performance, while increasing valency led to poorer performance. Low semantic density contributed to greater difficulty in svPPA and lvPPA, but low concreteness did not uniquely impact verb naming in svPPA. Those with nfavPPA had no particular difficulty as a result of valency.

Conclusions

Prior studies have identified the independent effects of frequency and semantic density on verb naming in PPA, which were confirmed by our analyses, and the best predictions of the data were achieved by combining these dimensions. This investigation complements our previous work highlighting the value of the HANA for efficiently demonstrating verb performance in PPA.

Investigating the influence of semantic factors on word retrieval: Reservations, results and recommendations

There is consensus that word retrieval starts with activation of semantic representations. However, in adults without language impairment, relatively little attention has been paid to the effects of the semantic attributes of to-be-retrieved words. This paper, therefore, addresses the question of which item-inherent semantic factors influence word retrieval. Specifically, it reviews the literature on a selection of these factors: imageability, concreteness, number of semantic features, typicality, intercorrelational density, featural distinctiveness, concept distinctiveness, animacy, semantic neighbourhood density, semantic similarity, operativity, valence, and arousal. It highlights several methodological challenges in this field, and has a focus on the insights from studies with people with aphasia where the effects of these variables are more prevalent. The paper concludes that further research simultaneously examining the effects of different semantic factors that are likely to affect lexical co-activation, and the interaction of these variables, would be fruitful, as would suitably scaled computational modelling of these effects in unimpaired language processing and in language impairment. Such research would enable the refinement of theories of semantic processing and word production, and potentially have implications for diagnosis and treatment of semantic and lexical impairments.

No negative impact of word retraining on vocabulary use or clarity of communication in semantic dementia

Word retraining techniques can improve picture naming of treated items in people with semantic dementia (SD). The utility of this, however, has been questioned given the propensity for under- and overgeneralization errors in naming in SD. Few studies have investigated the occurrence of such errors. This study examined whether, following tailored word retraining: (1) misuse of words increases, (2) the type of naming errors changes, and/or (3) clarity of communication is reduced. Performance on trained and untrained word naming from nine participants with SD who completed a word retraining programme were analysed. Responses from baseline and post-intervention assessments were coded for misuse (i.e., trained word produced for another target item), error type, and communication clarity. All participants showed significant improvement for trained vocabulary. There was no significant increase in misuse of words, with such errors occurring rarely. At a group level, there was an increased tendency toward omission errors for untrained items, and a reduction in semantically related responses. However, this did not impact on clarity scores with no consistent change across participants. In sum, we found no negative impacts following tailored word retraining, providing further evidence of the benefit of these programmes for individuals with SD.

A category-selective semantic memory deficit for animate objects in semantic variant primary progressive aphasia

Data are mixed on whether patients with semantic variant primary progressive aphasia exhibit a category-selective semantic deficit for animate objects. Moreover, there is little consensus regarding the neural substrates of this category-selective semantic deficit, though prior literature has suggested that the perirhinal cortex and the lateral posterior fusiform gyrus may support semantic memory functions important for processing animate objects. In this study, we investigated whether patients with semantic variant primary progressive aphasia exhibited a category-selective semantic deficit for animate objects in a word-picture matching task, controlling for psycholinguistic features of the stimuli, including frequency, familiarity, typicality and age of acquisition. We investigated the neural bases of this category selectivity by examining its relationship with cortical atrophy in two primary regions of interest: bilateral perirhinal cortex and lateral posterior fusiform gyri. We analysed data from 20 patients with semantic variant primary progressive aphasia (mean age = 64 years, S.D. = 6.94). For each participant, we calculated an animacy index score to denote the magnitude of the category-selective semantic deficit for animate objects. Multivariate regression analysis revealed a main effect of animacy (β = 0.52, t = 4.03, P < 0.001) even after including all psycholinguistic variables in the model, such that animate objects were less likely to be identified correctly relative to inanimate objects. Inspection of each individual patient's data indicated the presence of a disproportionate impairment in animate objects in most patients. A linear regression analysis revealed a relationship between the right perirhinal cortex thickness and animacy index scores (β = -0.57, t = -2.74, P = 0.015) such that patients who were more disproportionally impaired for animate relative to inanimate objects exhibited thinner right perirhinal cortex. A vertex-wise general linear model analysis restricted to the temporal lobes revealed additional associations between positive animacy index scores (i.e. a disproportionately poorer performance on animate objects) and cortical atrophy in the right perirhinal and entorhinal cortex, superior, middle, and inferior temporal gyri, and the anterior fusiform gyrus, as well as the left anterior fusiform gyrus. Taken together, our results indicate that a category-selective semantic deficit for animate objects is a characteristic feature of semantic variant primary progressive aphasia that is detectable in most individuals. Our imaging findings provide further support for the role of the right perirhinal cortex and other temporal lobe regions in the semantic processing of animate objects.

Functional Activation and Connectivity of the Left Inferior Frontal Gyrus during Lexical and Phonological Retrieval

Being language a paradigm of structural and functional asymmetry in cognitive processing, the left Inferior Frontal Gyrus has been consistently related to speech production. In fact, it has been considered a key node in cortical networks responsible for different components of naming. However, isolating these components (e.g., lexical, syntactic, and phonological retrieval) in neuroimaging studies is difficult due to the use of different baselines and tasks. In the present study, functional activation and connectivity of the left inferior frontal gyrus was explored using functional magnetic resonance imaging. Participants performed a covert naming task (pressing a button based on a phonological characteristic). Two conditions were compared: drawings of objects and single letters (baseline condition). Differences in activation and functional connectivity were obtained for objects and letters in different areas of the left Inferior Frontal Gyrus. The pars triangularis was involved in the retrieval of lexical-phonological information, showing a pattern of connectivity with temporal areas in the search for the name of objects and with perisylvanian areas for letters. Selection of phonological information seems to involve the pars opercularis both to letters and objects but recruiting supramarginal and superior temporal areas to letters, probably related to orthographic-phonological conversion. The results support the notion of the left Inferior Frontal Gyrus as a buffer forwarding neural information across cortical networks responsible for different components of speech production.

Contribution of the Cognitive Approach to Language Assessment to the Differential Diagnosis of Primary Progressive Aphasia

Diagnosis of primary progressive aphasia (PPA) is essentially based on the identification of progressive impairment of language abilities while other cognitive functions are preserved. The three variants of PPA are characterized by core and supportive clinical features related to the presence or absence of language impairment in different linguistic domains. In this article, we review the cognitive neuropsychological approach to the assessment of PPA and its contribution to the differential diagnosis of the three variants. The main advantage of this assessment approach is that it goes beyond the mere description and classification of clinical syndromes and identifies impaired and preserved cognitive and linguistic components and processes. The article is structured according to the main language domains: spoken production, language comprehension, and written language. Each section includes a brief description of the cognitive processes involved in the assessment tasks, followed by a discussion of typical characteristics for each PPA variant and common pitfalls in the interpretation of the results. In addition, the clinical benefit of the cognitive neuropsychological approach for the behavioral management of PPA is briefly sketched out in the conclusion.

Using concept typicality to explore semantic representation and control in healthy ageing

Successful use of conceptual knowledge entails the assembling of semantic representations and control processes to access the subsets of knowledge relevant in each situation. Research has suggested that representation and control mechanisms interact to support categorization. Notably, depleted representations in semantic dementia and disrupted control processes in semantic aphasia impair categorization of atypical concepts. Yet, it remains unclear how knowledge accumulation and control decay in healthy ageing impact categorization. To address this question, we compared young and older adults' performance in a categorization task of items varying in concept typicality. Critically, older adults were more accurate in categorizing atypical concepts than the younger counterparts, as indicated by the interaction between group and typicality. Moreover, the elderly outperformed the younger in categorizing atypical concepts that were also less familiar. Thus, the decay in semantic control observed along ageing did not significantly hinder the categorization of atypical items. Our data suggest that, relative to young adults, older adults possess enriched conceptual knowledge, which supports retrieval of the category-related features needed for categorizing atypical and less familiar exemplars.

Effects of semantic variables on word production in aphasia

Words differ in the complexity of their semantic representations and their relationships to other words and these differences can be operationalised as a variety of semantic variables. The research presented here investigates how word production in aphasia is influenced by six feature-based semantic variables (number of near semantic neighbours, semantic similarity, number of semantic features, typicality, intercorrelational density, and distinctiveness). Previous research has reported inconsistent findings for some of the semantic variables, while others have not been previously studied in aphasia. Spoken picture naming data from a large group of individuals with aphasia with mixed spoken word production impairments (n = 175) and a sub-group who produced few phonological errors (n = 60) was analysed. We examined effects of the semantic variables on overall naming accuracy and on the occurrence of different error types (semantic errors overall, coordinate errors, omissions), while controlling for other psycholinguistic variables using generalised linear mixed effects models and Bayesian correlations. Across analyses, number of semantic features was the most important predictor with a facilitatory main effect on naming accuracy in the sub-group analysis. Number of semantic features, along with typicality and semantic similarity, also predicted error types and in some analyses these effects depended on the integrity of semantic processing. Effects of the semantic variables and their theoretical explanations and implications are discussed in light of previous research and models of word production.

Evaluating the distinction between semantic knowledge and semantic access: Evidence from semantic dementia and comprehension-impaired stroke aphasia

Theories of semantic memory based on neuropsychological findings have posited a distinction between stored semantic representations and the mechanisms used to access and manipulate them (e.g., Lambon Ralph, Jefferies, Patterson, & Rogers, 2017; Warrington & Cipolotti, 1996). The most recent instantiation of this view, the controlled semantic cognition theory (Lambon Ralph et al., 2017), is supported by findings suggesting that multimodal (i.e., both verbal and nonverbal) semantic deficits may result from qualitatively different impairments: on the one hand, damage to a semantic access mechanism related to executive control, which is observed in semantic aphasia (SA), and on the other, damage to semantic representations, which is observed in semantic dementia (SD) (Jefferies & Lambon Ralph, 2006). In this study we compared SA and SD patients on several phenomena previously used to support these distinctions. Contrary to the prior results, we found that (1) overall, cross-task consistency was equivalent for the two groups; (2) neither patient group showed consistency driven by item identity across different semantic tasks; (3) correlations among task performance were not obviously driven by the semantic control demands of different tasks; (4) both groups showed executive function deficits; and (5) both groups showed strong effects of distractor interference in a synonym judgment task. Furthermore, we investigated the components of executive ability that could underlie semantic control deficits by correlating performance on updating, shifting, and inhibition tasks with performance on tasks testing semantic abilities. We found that updating was related to semantic processing generally, whereas shifting and inhibition were not. These results also suggest that complex executive function tasks relate to semantic tasks through their shared relationship with language abilities. Overall, evidence from SA and SD patients does not differentiate representations and access mechanisms in the semantic system, as has previously been suggested. Implications for the storage-access distinction are discussed.

A Brief Drawing Task for the Differential Diagnosis of Semantic Dementia

BACKGROUND

Semantic dementia (SD) is a subtype of frontotemporal lobe degeneration characterized by semantic loss, with other cognitive functions initially preserved. SD requires differential diagnosis with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Semantic knowledge can be evaluated through different tests; however, most of them depend on language.

OBJECTIVE

We describe the development of a brief drawing task that may be helpful for the differential diagnosis of SD.

METHODS

Seventy-two patients, including 32 AD, 19 bvFTD, and 21 SD were asked to draw 12 items with different age of acquisition and familiarity, belonging to four different semantic categories. We employed the drawings of healthy volunteers to build a scoring scheme.

RESULTS

Turtle, strawberry, train, and envelope were the items of each category that best discriminated between groups and were selected for the Brief drawing task. The discriminatory power of the Brief drawing task between SD versus AD and bvFTD patients, estimated through the area under the curve was 0.84 (95% CI = 0.72-0.96, p = 0.000007). In a logistic model, the Brief drawing task (p = 0.003) and VOSP "number location" subtest (p = 0.016) were significant predictors of the diagnosis of SD versus AD and bvFTD after adjustment by the main covariates. The Brief drawing task provided clinically useful qualitative information. SD drawings were characterized by loss of the distinctive features, intrusions, tendency to prototype, and answers like "I don't know what this is".

CONCLUSION

The Brief drawing task appears to reveal deficits in semantic knowledge among patients with SD that may assist in the differential diagnosis with other neurodegenerative diseases.

Eyetracking during picture naming predicts future vocabulary dropout in progressive anomia

The dynamic and unpredictable nature of expressive vocabulary dropout in progressive anomia presents a challenge for language intervention. We evaluated whether eye gaze patterns during naming could predict anomia for the same items in the near future. We tracked naming accuracy and gaze patterns as patients with semantic (n = 7) or logopenic (n = 2) variants of Primary Progressive Aphasia or amnestic Alzheimer's Disease (n = 1), named photographs of people and objects. Patients were tested three or more times spaced roughly evenly over an average duration of 19.1 months. Target words named accurately at baseline were retrospectively coded as either known (i.e., consistently named) or vulnerable (i.e., inaccurately or inconsistently named) based on naming accuracy over the study interval. We extracted gaze data corresponding to successful naming attempts and implemented logistic mixed effects models to determine whether common gaze measures could predict each word's naming status as known or vulnerable. More visual fixations and greater visual fixation dispersion predicted later anomia. These findings suggest that eye tracking may yield a biomarker of the robustness of particular target words to future expressive vocabulary dropout. We discuss the potential utility of this finding for optimizing treatment for progressive anomia.

The Role of Word Properties in Performance on Fluency Tasks in People with Primary Progressive Aphasia

People with primary progressive aphasia (PPA) present language difficulties that require lengthy assessments and follow-ups. Despite individual differences, people with PPA are often classified into three variants that present some distinctive language difficulties. We analyzed the data of 6 fluency tasks (i.e., "F", "A", "S", "Fruits", "Animals", "Vegetables"). We used random forests to pinpoint relevant word properties and error types in the classification of the three PPA variants, conditional inference trees to indicate how relevant variables may interact with one another and ANOVAs to cross-validate the results. Results indicate that total word count helps distinguish healthy individuals (N = 10) from people with PPA (N = 29). Furthermore, mean familiarity differentiates people with svPPA (N = 8) from people with lvPPA (N = 10) and nfvPPA (N = 11). No other word property or error type was relevant in the classification. These results relate to previous literature, as familiarity effects have been reported in people with svPPA in naming and spontaneous speech. Also, they strengthen the relevance of using familiarity to identify a specific group of people with PPA. This paper enhances our understanding of what determines word retrieval in people with PPA, complementing and extending data from naming studies.

A unified neurocognitive model of semantics language social behaviour and face recognition in semantic dementia

The anterior temporal lobes (ATL) have become a key brain region of interest in cognitive neuroscience founded upon neuropsychological investigations of semantic dementia (SD). The purposes of this investigation are to generate a single unified model that captures the known cognitive-behavioural variations in SD and map these to the patients' distribution of frontotemporal atrophy. Here we show that the degree of generalised semantic impairment is related to the patients' total, bilateral ATL atrophy. Verbal production ability is related to total ATL atrophy as well as to the balance of left > right ATL atrophy. Apathy is found to relate positively to the degree of orbitofrontal atrophy. Disinhibition is related to right ATL and orbitofrontal atrophy, and face recognition to right ATL volumes. Rather than positing mutually-exclusive sub-categories, the data-driven model repositions semantics, language, social behaviour and face recognition into a continuous frontotemporal neurocognitive space.

Representional and connectivity-based accounts of the cognitive consequences of atrophy of the right and left anterior temporal lobes

According to the original "hub-and-spoke" model of conceptual representations, the neural network for semantic memory requires a single convergence zone located in the anterior temporal lobes (ATLs). However, a more recent version of this model acknowledges that a graded specialization of the left and right ATLs might emerge as a consequence of their differential connectivity with language and sensory-motor regions. A recent influential paper maintained that both the format of semantic representations (representational account) and their differential connectivity (connectivity account) could contribute to the cognitive consequences of atrophy to the left versus the right ATL atrophy. That paper, however, also raised questions as to whether the distinction between representational and connectivity accounts is a meaningful question. I argue that an important theoretical difference exists between the representational and the connectivity-based models and that investigations, based on this difference, should allow to choose between these alternative accounts.

Neural Population Dynamics and Cognitive Function

Representations in the brain are encoded as patterns of activity of large populations of neurons. The science of population encoded representations, also known as parallel distributed processing (PDP), achieves neurological verisimilitude and has been able to account for a large number of cognitive phenomena in normal people, including reaction times (and reading latencies), stimulus recognition, the effect of stimulus salience on attention, perceptual invariance, simultaneous egocentric and allocentric visual processing, top-down/bottom-up processing, language errors, the effect of statistical regularities of experience, frequency, and age of acquisition, instantiation of rules and symbols, content addressable memory and the capacity for pattern completion, preservation of function in the face of noisy or distorted input, inference, parallel constraint satisfaction, the binding problem and gamma coherence, principles of hippocampal function, the location of knowledge in the brain, limitations in the scope and depth of knowledge acquired through experience, and Piagetian stages of cognitive development. PDP studies have been able to provide a coherent account for impairment in a variety of language functions resulting from stroke or dementia in a large number of languages and the phenomenon of graceful degradation observed in such studies. They have also made important contributions to our understanding of attention (including hemispatial neglect), emotional function, executive function, motor planning, visual processing, decision making, and neuroeconomics. The relationship of neural network population dynamics to electroencephalographic rhythms is starting to emerge. Nevertheless, PDP approaches have scarcely penetrated major areas of study of cognition, including neuropsychology and cognitive neuropsychology, as well as much of cognitive psychology. This article attempts to provide an overview of PDP principles and applications that addresses a broader audience.

Evaluating Semantic Knowledge Through a Semantic Association Task in Individuals With Dementia

Conceptual knowledge is supported by multiple semantic systems that are specialized for the analysis of different properties associated with object concepts. Various types of semantic association between concrete concepts-categorical (CA), encyclopedic (EA), functional (FA), and visual-encyclopedic (VEA) associations-were tested through a new picture-to-picture matching task (semantic association task, SAT). Forty individuals with Alzheimer's disease (AD), 13 with behavioral variant of frontotemporal dementia (bv-FTD), 6 with primary progressive aphasia (PPA), and 37 healthy participants were tested with the SAT. Within-group comparisons highlighted a global impairment of all types of semantic association in bv-FTD individuals but a disproportionate impairment of EA and FA, with relative sparing of CA and VEA, in AD individuals. Single-case analyses detected dissociations in all dementia groups. Conceptual knowledge can be selectively impaired in various types of neurodegenerative disease on the basis of the specific cognitive process that is disrupted.

Multivariate analysis reveals anatomical correlates of naming errors in primary progressive aphasia

Primary progressive aphasia (PPA) is an overarching term for a heterogeneous group of neurodegenerative diseases which affect language processing. Impaired picture naming has been linked to atrophy of the anterior temporal lobe in the semantic variant of PPA. Although atrophy of the anterior temporal lobe proposedly impairs picture naming by undermining access to semantic knowledge, picture naming also entails object recognition and lexical retrieval. Using multivariate analysis, we investigated whether cortical atrophy relates to different types of naming errors generated during picture naming in 43 PPA patients (13 semantic, 9 logopenic, 11 nonfluent, and 10 mixed variant). Omissions were associated with atrophy of the anterior temporal lobes. Semantic errors, for example, mistaking a rhinoceros for a hippopotamus, were associated with atrophy of the left mid and posterior fusiform cortex and the posterior middle and inferior temporal gyrus. Semantic errors and atrophy in these regions occurred in each PPA subtype, without major between-subtype differences. We propose that pathological changes to neural mechanisms associated with semantic errors occur across the PPA spectrum.

Striking loss of second language in bilingual patients with semantic dementia

BACKGROUND

Studies of bilingual or multilingual patients with neurodegenerative diseases that disrupt language like the primary progressive aphasias (PPA) may contribute valuable information on language organization in the bilingual brain and on the factors affecting language decline. There is limited literature on bilingual PPA and in particular on semantic dementia, a type of PPA with selective loss of semantic memory. We studied the nature and severity of naming and comprehension deficits across languages in bilingual patients with semantic dementia (SD).

METHODS

Sixteen bilingual patients with SD and 34 bilingual age-matched controls were administered the modified Boston Naming Test and components of Cambridge Semantic Battery. The patients' performance on picture naming and word comprehension was compared across languages and with controls. The most proficient language on self-rating was labelled as L1 and less proficient as L2.

RESULTS

We observed striking loss of second language (L2) in SD for both receptive and expressive language, even in patients who were premorbidly fluent in their L2. Naming and comprehension in every patient's L2 were impaired relative to both their own first-language (L1) scores and controls' L2 scores. Furthermore, item-specific correct responses in each patient's L2 were a subset of their successes in L1.

DISCUSSION

A striking contrast in performance between two languages in bilingual patients with SD indicates that a bilingual's L2 or less proficient language is more vulnerable to neurodegeneration. Our findings also support a common semantic network in the brain for the different languages of bilinguals.

Divergent effects of healthy ageing on semantic knowledge and control: Evidence from novel comparisons with semantically impaired patients

Effective use of semantic knowledge requires a set of conceptual representations and control processes which ensure that currently relevant aspects of this knowledge are retrieved and selected. It is well-established that levels of semantic knowledge increase across the lifespan. However, the effects of ageing on semantic control processes have not been assessed. I addressed this issue by comparing the performance profiles of young and older people on a verbal comprehension test. Two sets of variables were used to predict accuracy and RT in each group: (1) the psycholinguistic properties of words probed in each trial and (2) the performance on each trial by two groups of semantically impaired neuropsychological patients. Young people demonstrated poor performance for low-frequency and abstract words, suggesting that they had difficulty processing words with intrinsically weak semantic representations. Indeed, performance in this group was strongly predicted by the performance of patients with semantic dementia, who suffer from degradation of semantic knowledge. In contrast, older adults performed poorly on trials where the target semantic relationship was weak and distractor relationships strong - conditions which require high levels of controlled processing. Their performance was not predicted by the performance of semantic dementia patients, but was predicted by the performance of patients with semantic control deficits. These findings indicate that the effects of ageing on semantic cognition are more complex than has previously been assumed. While older people have larger stores of knowledge than young people, they appear to be less skilled at exercising control over the activation of this knowledge.

Morphometric correlates of anomia in patients with small left temporopolar lesions

Visual object naming is a complex cognitive process that engages an interconnected network of cortical regions moving from occipitotemporal to anterior-inferior temporal cortices, and extending into the inferior frontal cortex. Naming can fail for diverse reasons, and different stages of the naming multi-step process appear to be reliant upon the integrity of different neuroanatomical locations. While the neural correlates of semantic errors have been extensively studied, the neural basis of omission errors remains relatively unspecified. Although a strong line of evidence supports an association between anterior temporal lobe damage and semantic errors, there are some studies suggesting that the anterior temporal lobe could be also associated with omissions. However, support for this hypothesis comes from studies with patients in whom damage affected extensive brain regions, sometimes bilaterally. Here, we availed of a group of 12 patients with epilepsy associated with a small lesion at the tip of the left temporal pole. Using an unbiased surface-based morphometry methodology, we correlated two morphological features with errors observed during visual naming. Analyses revealed a correlation between omission errors and reduced local gyrification index in three cortical clusters: one in the left anteromedial temporal lobe region (AMTL) and two in the left anterior cingulate cortex (ACC). Our findings support the view that regions in ACC and AMTL are critical structures within a network engaged in word selection from semantics.

Cognitive consequences of the left-right asymmetry of atrophy in semantic dementia

Semantic dementia (SD) is a condition in which atrophy to the anterior temporal lobes (ATL) produces a selective deterioration of conceptual knowledge. As this atrophy is always bilateral but usually asymmetrical, differences in performance of the two SD subgroups-with left > right (L > R) versus right > left (R > L) atrophy-constitute a major source of evidence regarding the roles of the left and right sides of this region. We explored this issue using large scale case-series methodology, with a pool of 216 observations of neuropsychological data from 72 patients with SD. Anomia was significantly more severe in the L > R subgroup, even when cases from the two subgroups were matched on severity of comprehension deficits. For subgroups matched on the degree of anomia, we show that asymmetry of atrophy also affected both the nature of the naming errors produced, and the degree of a semantic category effect (living things vs artefacts). A comparison across tasks varying in their loading on verbal and visual processing revealed a greater deficit in object naming for L > R cases and in a picture-based semantic association test for R > L cases; this held true whether severity across subgroups was controlled using pairwise matching or statistically via principal components analysis. Importantly, the size of our sample allowed us to demonstrate considerable individual variation within each of the L > R and R > L subgroups, with consequent overlap between them. Our results paint a clear picture of how asymmetry of atrophy affects cognitive performance in SD, and we discuss the results in terms of two mechanisms that could contribute to these differences: variation in the information involved in semantic representations in the left and right ATL, and preferential connectivity between each ATL and other more modality specific intra-hemispheric regions.

Triangulation of language-cognitive impairments, naming errors and their neural bases post-stroke

In order to gain a better understanding of aphasia one must consider the complex combinations of language impairments along with the pattern of paraphasias. Despite the fact that both deficits and paraphasias feature in diagnostic criteria, most research has focused only on the lesion correlates of language deficits, with minimal attention on the pattern of patients' paraphasias. In this study, we used a data-driven approach (principal component analysis - PCA) to fuse patient impairments and their pattern of errors into one unified model of chronic post-stroke aphasia. This model was subsequently mapped onto the patients' lesion profiles to generate the triangulation of language-cognitive impairments, naming errors and their neural correlates. Specifically, we established the pattern of co-occurrence between fifteen error types, which avoids focussing on a subset of errors or the use of experimenter-derived methods to combine across error types. We obtained five principal components underlying the patients' errors: omission errors; semantically-related responses; phonologically-related responses; dysfluent responses; and a combination of circumlocutions with mixed errors. In the second step, we aligned these paraphasia-related principal components with the patients' performance on a detailed language and cognitive assessment battery, utilising an additional PCA. This omnibus PCA revealed seven unique fused impairment-paraphasia factors: output phonology; semantics; phonological working memory; speech quanta; executive-cognitive skill; phonological (input) discrimination; and the production of circumlocution errors. In doing so we were able to resolve the complex relationships between error types and impairments. Some are relatively straightforward: circumlocution errors formed their own independent factor; there was a one-to-one mapping for phonological errors with expressive phonological abilities and for dysfluent errors with speech fluency. In contrast, omission-type errors loaded across both semantic and phonological working memory factors, whilst semantically-related errors had the most complex relationship by loading across four factors (phonological ability, speech quanta, executive-cognitive skills and circumlocution-type errors). Three components had unique lesion correlates: phonological working memory with the primary auditory region; semantics with the anterior temporal region; and fluency with the pre-central gyrus, converging with existing literature. In conclusion, the data-driven approach allowed derivation of the triangulation of deficits, error types and lesion correlates in post-stroke aphasia.

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Using principal component analysis to identify structure in naming errors.

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Determining the relationship between language impairments and naming errors.

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Identifying neural correlates of behavioural deficits in performance and errors.

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Seven independent factors identified to describe performance and error pattern.

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Phonological working memory, semantic skill and speech quanta had lesion correlates.

Lexical access in semantic variant PPA: Evidence for a post-semantic contribution to naming deficits

The most salient clinical symptom of semantic variant primary progressive aphasia (PPA) is a profound and pervasive anomia. These patients' naming impairments have been shown to reflect in large part a domain-general deterioration of conceptual knowledge that impacts both linguistic and non-linguistic processing. However, it is possible that post-semantic stages of lexical access may also contribute to naming deficits. To clarify the stages at which lexical access breaks down in semantic variant PPA, eleven French-speaking patients were asked to name objects, and were then queried for semantic, lexical-syntactic, and word form information pertaining to the items they could not name. Specifically, our goal was to determine whether patients can access intermediate representations known as lemmas, which mediate the arbitrary mapping between semantic representations and word forms (phonological and orthographic forms). The French language was chosen for this study because nouns in French are marked for grammatical gender, a prototypical type of lexical-syntactic information, represented at the level of the lemma. Access to word form information is also dependent on lemma access under some theoretical views. We found that six of the eleven patients showed partial access to either lexical-syntactic properties of unnamed items (grammatical gender), word form information (initial letter), or both. Access to these types of information suggests that a lemma has been retrieved, implying a breakdown at the post-semantic stage of word form retrieval. Our results suggest that although degraded conceptual knowledge is the main cause of naming deficits in semantic variant PPA, in some patients, a post-semantic component also contributes to the impairment.

Semantic word category processing in semantic dementia and posterior cortical atrophy

There is general agreement that perisylvian language cortex plays a major role in lexical and semantic processing; but the contribution of additional, more widespread, brain areas in the processing of different semantic word categories remains controversial. We investigated word processing in two groups of patients whose neurodegenerative diseases preferentially affect specific parts of the brain, to determine whether their performance would vary as a function of semantic categories proposed to recruit those brain regions. Cohorts with (i) Semantic Dementia (SD), who have anterior temporal-lobe atrophy, and (ii) Posterior Cortical Atrophy (PCA), who have predominantly parieto-occipital atrophy, performed a lexical decision test on words from five different lexico-semantic categories: colour (e.g., yellow), form (oval), number (seven), spatial prepositions (under) and function words (also). Sets of pseudo-word foils matched the target words in length and bi-/tri-gram frequency. Word-frequency was matched between the two visual word categories (colour and form) and across the three other categories (number, prepositions, and function words). Age-matched healthy individuals served as controls. Although broad word processing deficits were apparent in both patient groups, the deficit was strongest for colour words in SD and for spatial prepositions in PCA. The patterns of performance on the lexical decision task demonstrate (a) general lexicosemantic processing deficits in both groups, though more prominent in SD than in PCA, and (b) differential involvement of anterior-temporal and posterior-parietal cortex in the processing of specific semantic categories of words.

White Matter Disruption and Connected Speech in Non-Fluent and Semantic Variants of Primary Progressive Aphasia

Differential patterns of white matter disruption have recently been reported in the non-fluent (nfvPPA) and semantic (svPPA) variants of primary progressive aphasia (PPA). No single measure is sufficient to distinguish between the PPA variants, but connected speech allows for the quantification of multiple measures. The aim of the present study was to further investigate the white matter correlates associated with connected speech features in PPA. We examined the relationship between white matter metrics and connected speech deficits using an automated analysis of transcriptions of connected speech and diffusion tensor imaging in language-related tracts. Syntactic, lexical, and semantic features were automatically extracted from transcriptions of topic-directed interviews conducted with groups of individuals with nfvPPA or svPPA as well as with a group of healthy controls. A principal component analysis was performed in order to reduce the number of language measures and yielded a five-factor solution. The results indicated that nfvPPA patients differed from healthy controls on a syntactic factor, and svPPA patients differed from controls on two semantic factors. However, the patient groups did not differ on any factor. Moreover, a correlational analysis revealed that the lexical richness factor was significantly correlated with radial diffusivity in the left inferior longitudinal fasciculus, which suggests that semantic deficits in connected speech reflect a disruption of this ventral pathway, and which is largely consistent with the results of previous studies. Using an automated approach for the analysis of connected speech combined with probabilistic tractography, the present findings demonstrate that nfvPPA patients are impaired relative to healthy controls on syntactic measures and have increased radial diffusivity in the left superior longitudinal fasciculus, whereas the svPPA group was impaired on lexico-semantic measures relative to controls and showed increased radial diffusivity in the uncinate and inferior longitudinal fasciculus bilaterally.

A boy named Sue

One major lesson learned in the cognitive sciences is that even basic human cognitive capacities are extraordinarily complicated and elusive to mechanistic explanations. This is definitely the case for naming and identity. Nothing seems simpler than using a proper name to refer to a unique individual object in the world. But psychological research has shown that the criteria and mechanisms by which humans establish and use names are unclear and seemingly contradictory. Children only develop the necessary knowledge and skills after years of development and naming degenerates in unusual selective ways with strokes, schizophrenia, or Alzheimer disease. Here we present an operational model of social interaction patterns and cognitive functions to explain how naming can be achieved and acquired. We study the Grounded Naming Game as a particular example of a symbolic interaction that requires naming and present mechanisms that build up and use the semiotic networks necessary for performance in the game. We demonstrate in experiments with autonomous physical robots that the proposed dynamical systems indeed lead to the formation of an effective naming system and that the model hence explains how naming and identity can get socially constructed and shared by a population of embodied agents.

Concept typicality responses in the semantic memory network

For decades concept typicality has been recognized as critical to structuring conceptual knowledge, but only recently has typicality been applied in better understanding the processes engaged by the neurological network underlying semantic memory. This previous work has focused on one region within the network - the Anterior Temporal Lobe (ATL). The ATL responds negatively to concept typicality (i.e., the more atypical the item, the greater the activation in the ATL). To better understand the role of typicality in the entire network, we ran an fMRI study using a category verification task in which concept typicality was manipulated parametrically. We argue that typicality is relevant to both amodal feature integration centers as well as category-specific regions. Both the Inferior Frontal Gyrus (IFG) and ATL demonstrated a negative correlation with typicality, whereas inferior parietal regions showed positive effects. We interpret this in light of functional theories of these regions. Interactions between category and typicality were not observed in regions classically recognized as category-specific, thus, providing an argument against category specific regions, at least with fMRI.

The meaning of 'life' and other abstract words: Insights from neuropsychology

There are a number of long-standing theories on how the cognitive processing of abstract words, like 'life', differs from that of concrete words, like 'knife'. This review considers current perspectives on this debate, focusing particularly on insights obtained from patients with language disorders and integrating these with evidence from functional neuroimaging studies. The evidence supports three distinct and mutually compatible hypotheses. (1) Concrete and abstract words differ in their representational substrates, with concrete words depending particularly on sensory experiences and abstract words on linguistic, emotional, and magnitude-based information. Differential dependence on visual versus verbal experience is supported by the evidence for graded specialization in the anterior temporal lobes for concrete versus abstract words. In addition, concrete words have richer representations, in line with better processing of these words in most aphasic patients and, in particular, patients with semantic dementia. (2) Abstract words place greater demands on executive regulation processes because they have variable meanings that change with context. This theory explains abstract word impairments in patients with semantic-executive deficits and is supported by neuroimaging studies showing greater response to abstract words in inferior prefrontal cortex. (3) The relationships between concrete words are governed primarily by conceptual similarity, while those of abstract words depend on association to a greater degree. This theory, based primarily on interference and priming effects in aphasic patients, is the most recent to emerge and the least well understood. I present analyses indicating that patterns of lexical co-occurrence may be important in understanding these effects.

A Neuropsychological Perspective on Abstract Word Representation: From Theory to Treatment of Acquired Language Disorders

Natural languages are rife with words that describe feelings, introspective states, and social constructs (e.g., liberty, persuasion) that cannot be directly observed through the senses. Effective communication demands linguistic competence with such abstract words. In clinical neurological settings, abstract words are especially vulnerable to the effects of stroke and neurodegenerative conditions such as Alzheimer's disease. A parallel literature in cognitive neuroscience suggests that abstract and concrete words are at least partially neuroanatomically dissociable. Much remains to be learned about the nature of lexical-semantic deficits of abstract words and how best to promote their recovery. Here, we review contemporary theoretical approaches to abstract-concrete word representation with an aim toward contextualizing patient-based dissociations for abstract words. We then describe a burgeoning treatment approach for targeting abstract words and suggest a number of potential strategies for future interventions. We argue that a deeper understanding of is essential for informing language rehabilitation.

Persistent sparing of action conceptual processing in spite of increasing disorders of action production: A case against motor embodiment of action concepts

In this study, we addressed the issue of whether the brain sensorimotor circuitry that controls action production is causally involved in representing and processing action-related concepts. We examined the three-year pattern of evolution of brain atrophy, action production disorders, and action-related concept processing in a patient (J.R.) diagnosed with corticobasal degeneration. During the period of investigation, J.R. presented with increasing action production disorders resulting from increasing bilateral atrophy in cortical and subcortical regions involved in the sensorimotor control of actions (notably, the superior parietal cortex, the primary motor and premotor cortex, the inferior frontal gyrus, and the basal ganglia). In contrast, the patient's performance in processing action-related concepts remained intact during the same period. This finding indicated that action concept processing hinges on cognitive and neural resources that are mostly distinct from those underlying the sensorimotor control of actions.

Study of visuospatial skill in patients with dementia

OBJECTIVES

To assess the visuospatial function in different types of dementia with the visual object and space perception (VOSP) battery and to relate the degree of visuospatial dysfunction with different types and stages of dementia.

MATERIALS AND METHODS

A sample of 53 participants with dementia and equal number of age-, sex-, and education-matched controls were recruited for the study. Participants were evaluated for visuospatial skill using VOSP test battery. The scores of dementia patients were compared with controls and within dementia cohort scores were compared based on stage of dementia.

RESULTS

The dementia group scored low in all of the subtests of the VOSP battery in comparison to controls. Alzheimer's disease (AD), dementia of Lewy bodies (DLB), and vascular dementia (VaD) patients performed more poorly than controls in all subtests examining object perception and space perception. The three semantic variants of frontotemporal dementia (FTD) patients scored low in all four subtests of object perception, whereas behavioral variant FTD (bvFTD) patients performed normally. The scores deteriorated with the advancement of dementia in all patients from the dementia groups.

CONCLUSIONS

Visuospatial function is significantly impaired in dementia patients particularly in AD, DLB, and VaD patients from the beginning, and the impairment is severe in advanced disease stages.

Disorders of representation and control in semantic cognition: Effects of familiarity, typicality, and specificity

We present a case-series comparison of patients with cross-modal semantic impairments consequent on either (a) bilateral anterior temporal lobe atrophy in semantic dementia (SD) or (b) left-hemisphere fronto-parietal and/or posterior temporal stroke in semantic aphasia (SA). Both groups were assessed on a new test battery designed to measure how performance is influenced by concept familiarity, typicality and specificity. In line with previous findings, performance in SD was strongly modulated by all of these factors, with better performance for more familiar items (regardless of typicality), for more typical items (regardless of familiarity) and for tasks that did not require very specific classification, consistent with the gradual degradation of conceptual knowledge in SD. The SA group showed significant impairments on all tasks but their sensitivity to familiarity, typicality and specificity was more variable and governed by task-specific effects of these factors on controlled semantic processing. The results are discussed with reference to theories about the complementary roles of representation and manipulation of semantic knowledge.

Time-varying effective connectivity during visual object naming as a function of semantic demands

Accumulating evidence suggests that visual object understanding involves a rapid feedforward sweep, after which subsequent recurrent interactions are necessary. The extent to which recurrence plays a critical role in object processing remains to be determined. Recent studies have demonstrated that recurrent processing is modulated by increasing semantic demands. Differentially from previous studies, we used dynamic causal modeling to model neural activity recorded with magnetoencephalography while 14 healthy humans named two sets of visual objects that differed in the degree of semantic accessing demands, operationalized in terms of the values of basic psycholinguistic variables associated with the presented objects (age of acquisition, frequency, and familiarity). This approach allowed us to estimate the directionality of the causal interactions among brain regions and their associated connectivity strengths. Furthermore, to understand the dynamic nature of connectivity (i.e., the chronnectome; Calhoun et al., 2014) we explored the time-dependent changes of effective connectivity during a period (200-400 ms) where adding semantic-feature information improves modeling and classifying visual objects, at 50 ms increments. First, we observed a graded involvement of backward connections, that became active beyond 200 ms. Second, we found that semantic demands caused a suppressive effect in the backward connection from inferior frontal cortex (IFC) to occipitotemporal cortex over time. These results complement those from previous studies underscoring the role of IFC as a common source of top-down modulation, which drives recurrent interactions with more posterior regions during visual object recognition. Crucially, our study revealed the inhibitory modulation of this interaction in situations that place greater demands on the conceptual system.

Subjective age-of-acquisition norms for 7,039 Spanish words

Subjective estimations of age of acquisition (AoA) for a large pool of Spanish words were collected from college students in Spain. The average score for each word (based on 50 individual responses, on a scale from 1 to 11) was taken as an AoA indicator, and normative values for a total of 7,039 single words are provided as supplemental materials. Beyond its intrinsic value as a standalone corpus, the largest of its kind for Spanish, the value of the database is enhanced by the fact that it contains most of the words that are currently included in other normative studies, allowing for a more complete characterization of the lexical stimuli that are usually employed in studies with Spanish-speaking participants. The norms are available for downloading as supplemental materials with this article.