Premorbid expertise produces category-specific impairment in a domain-general semantic disorder

Premorbid de novo artistic creativity in frontotemporal dementia (FTD) syndromes

The emergence of new artistic activities or shifts in artistic style in patients with frontotemporal dementia (FTD) syndromes is well documented at or after disease onset. However, a closer look in the literature reveals emerging artistic creativity also before FTD onset, although the significance and underlying pathology of such creative endeavors remain elusive. Here, we systematically review relevant studies and report an additional FTD case to elaborate on artistic activities that developed years before disease manifestation by paying particular attention to the sequence of events in individual patients' biography and clinical history. We further discuss the FTD patient's creative activities in the context of their life events, other initial or "premorbid" dementia symptoms or risk factors described in the literature such as mental illness and mild behavioral impairment (MBI), as well as changes in neuronal systems (i.e., neuroimaging and neuropathology). In addition to our FTD patient, we identified five published cases with an FTD syndrome, including three with FTD, one with primary progressive aphasia (PPA), and one with the behavioral variant of PPA (bvPPA). Premorbid novel creativity emerged across different domains (visual, musical, writing), with the FTD diagnosis ensuing artistic productivity by a median of 8 years. Data on late-life and pre-dementia life events were available in four cases. The late creative phase in our case was accompanied by personality changes, accentuation of personality traits, and cessation of painting activities occurred with the onset of memory complaints. Thus, premorbid personality changes in FTD patients can be associated with de novo creative activity. Stressful life events may also contribute to the burgeoning of creativity. Moreover, primary neocortical areas that are largely spared by pathology at early FTD stages may facilitate the engagement in artistic activities, offering a window of opportunity for art therapy and other therapeutic interventions during the MBI stage or even earlier.

Of logos and men: semantic memory impairment for unique entities in a case of semantic variant of primary progressive aphasia

In this study, an individual (NG) with the semantic varient of primary progressive aphasis (svPPA) was assessed with tasks designed to investigate the recognition and activation of semantic knowledge about unique entities. NG had significant difficulties in the recognition of brand names and famous names but was largely unimpaired in the recognition of logos and famous faces. However, she was impaired in tasks requiring the activation of semantic representations of logos, brand names, famous faces, and famous names. These results suggest that the recognition of unique entities results from the interaction of perceptual and conceptual processes and, that the ability to activate semantic information about these entities can be affected in svPPA.

On Simulating Neural Damage in Connectionist Networks

A key strength of connectionist modelling is its ability to simulate both intact cognition and the behavioural effects of neural damage. We survey the literature, showing that models have been damaged in a variety of ways, e.g. by removing connections, by adding noise to connection weights, by scaling weights, by removing units and by adding noise to unit activations. While these different implementations of damage have often been assumed to be behaviourally equivalent, some theorists have made aetiological claims that rest on nonequivalence. They suggest that related deficits with different aetiologies might be accounted for by different forms of damage within a single model. We present two case studies that explore the effects of different forms of damage in two influential connectionist models, each of which has been applied to explain neuropsychological deficits. Our results indicate that the effect of simulated damage can indeed be sensitive to the way in which damage is implemented, particularly when the environment comprises subsets of items that differ in their statistical properties, but such effects are sensitive to relatively subtle aspects of the model's training environment. We argue that, as a consequence, substantial methodological care is required if aetiological claims about simulated neural damage are to be justified, and conclude more generally that implementation assumptions, including those concerning simulated damage, must be fully explored when evaluating models of neurological deficits, both to avoid over-extending the explanatory power of specific implementations and to ensure that reported results are replicable.

ELECTRONIC SUPPLEMENTARY MATERIAL

The online version of this article (10.1007/s42113-020-00081-z) contains supplementary material, which is available to authorized users.

The neurocognitive basis of knowledge about object identity and events: dissociations reflect opposing effects of semantic coherence and control

Semantic memory encompasses knowledge of specific objects and their diverse associations, but the mechanisms that allow us to retrieve aspects of knowledge required for a given task are poorly understood. The dual hub theory suggests that separate semantic stores represent knowledge of (i) taxonomic categories (in the anterior temporal lobes, ATL) and (ii) thematic associations (in angular gyrus, AG or posterior middle temporal gyrus, pMTG). Alternatively, the controlled semantic cognition (CSC) framework suggests that semantic processing emerges from the flexible interaction of heteromodal semantic representations in ATL with a semantic control network, which includes pMTG as well as prefrontal regions. According to this view, ATL supports patterns of coherent auto-associative retrieval, while semantic control sites respond when ongoing conceptual activation needs to be altered to suit the task or context. These theories make different predictions about the nature of functional dissociations within the semantic network. We review evidence for these claims across multiple methods. First, we show ATL is sensitive to the strength of thematic associations as well as taxonomic relations. Next, we document functional dissociations between AG and pMTG: rather than these regions acting as comparable thematic hubs, AG is allied to the default mode network and supports more 'automatic' retrieval, while pMTG responds when control demands are high. However, the semantic control network, including pMTG, also shows a greater response to events/actions and verbs, supporting the claims of both theories. We propose that tasks tapping event semantics often require greater shaping of conceptual retrieval than comparison tasks, because these elements of our knowledge are inherently flexible, with relevant features depending on the context. In this way, the CSC account might be able to account for findings that suggest both a process and a content distinction within the semantic network. This article is part of the theme issue 'Towards mechanistic models of meaning composition'.

Avian agnosia: A window into auditory semantics

The functional and neural organisation of auditory knowledge is relatively poorly understood. The breakdown of conceptual knowledge in semantic dementia has revealed that pre-morbid expertise influences the extent to which knowledge is differentiated. Whether this principle applies to a similar extent in the auditory domain is not yet known. Previous reports of patients with impaired auditory vs. intact visual expert knowledge suggest that expertise may have differential effects upon the organisation of auditory and visual knowledge. An equally plausible alternative, however, is that auditory knowledge is simply more vulnerable to deterioration. Thus, expertise effects in the auditory domain may not yet have been observed because knowledge of auditory expert vs. non-expert knowledge has yet to be compared. We had the opportunity to address this issue by studying SA, a patient with semantic dementia and extensive pre-morbid knowledge of birds. We undertook a systematic investigation of SA's auditory vs. visual knowledge from matched expert vs. non-expert categories. Relative to a group of 10 age, education and IQ matched bird experts, SA showed impaired auditory vs. intact visual avian knowledge, despite intact basic auditory perceptual abilities. This was explained by independent effects of modality and expertise. Thus, he was also disproportionately impaired for auditory vs. visual knowledge of items from non-expert categories. In both auditory and visual modalities, his performance was relatively more impaired on tests of non-expert vs. expert knowledge. These findings suggest that, while auditory knowledge may be more vulnerable to deterioration, expertise modulates visual and auditory knowledge to a similar extent.

Agnosia for bird calls

The cognitive organisation of nonverbal auditory knowledge remains poorly defined. Deficits of environmental sound as well as word and visual object knowledge are well-recognised in semantic dementia. However, it is unclear how auditory cognition breaks down in this disorder and how this relates to deficits in other knowledge modalities. We had the opportunity to study a patient with a typical syndrome of semantic dementia who had extensive premorbid knowledge of birds, allowing us to assess the impact of the disease on the processing of auditory in relation to visual and verbal attributes of this specific knowledge category. We designed a novel neuropsychological test to probe knowledge of particular avian characteristics (size, behaviour [migratory or nonmigratory], habitat [whether or not primarily water-dwelling]) in the nonverbal auditory, visual and verbal modalities, based on a uniform two-alternative-forced-choice procedure. The patient's performance was compared to healthy older individuals of similar birding experience. We further compared his performance on this test of bird knowledge with his knowledge of familiar human voices and faces. Relative to healthy birder controls, the patient showed marked deficits of bird call and bird name knowledge but relatively preserved knowledge of avian visual attributes and retained knowledge of human voices and faces. In both the auditory and visual modalities, his knowledge of the avian characteristics of size and behaviour was intact whereas his knowledge of the associated characteristic of habitat was deficient. This case provides further evidence that nonverbal auditory knowledge has a fractionated organisation that can be differentially targeted in semantic dementia.

•

The cognitive organisation of auditory semantics is poorly understood.

•

We assessed multimodal avian knowledge in a birder with semantic dementia.

•

The patient had auditory (but not visual) agnosia for birds versus healthy birders.

•

Auditory knowledge of avian attributes and human voices were differentially affected.

•

This case illuminates the fractionated organisation of nonverbal auditory knowledge.

The contribution of executive control to semantic cognition: Convergent evidence from semantic aphasia and executive dysfunction

Semantic cognition, as described by the controlled semantic cognition (CSC) framework (Rogers et al., 2015, Neuropsychologia, 76, 220), involves two key components: activation of coherent, generalizable concepts within a heteromodal ‘hub’ in combination with modality‐specific features (spokes), and a constraining mechanism that manipulates and gates this knowledge to generate time‐ and task‐appropriate behaviour. Executive–semantic goal representations, largely supported by executive regions such as frontal and parietal cortex, are thought to allow the generation of non‐dominant aspects of knowledge when these are appropriate for the task or context. Semantic aphasia (SA) patients have executive–semantic deficits, and these are correlated with general executive impairment. If the CSC proposal is correct, patients with executive impairment should not only exhibit impaired semantic cognition, but should also show characteristics that align with those observed in SA. This possibility remains largely untested, as patients selected on the basis that they show executive impairment (i.e., with ‘dysexecutive syndrome’) have not been extensively tested on tasks tapping semantic control and have not been previously compared with SA cases. We explored conceptual processing in 12 patients showing symptoms consistent with dysexecutive syndrome (DYS) and 24 SA patients, using a range of multimodal semantic assessments which manipulated control demands. Patients with executive impairments, despite not being selected to show semantic impairments, nevertheless showed parallel patterns to SA cases. They showed strong effects of distractor strength, cues and miscues, and probe–target distance, plus minimal effects of word frequency on comprehension (unlike semantic dementia patients with degradation of conceptual knowledge). This supports a component process account of semantic cognition in which retrieval is shaped by control processes, and confirms that deficits in SA patients reflect difficulty controlling semantic retrieval.

Using neurostimulation to understand the impact of pre-morbid individual differences on post-lesion outcomes

Data from patients with brain damage have provided unique insights into the neural bases of cognitive function. Yet interpretation of patient data is complicated by the possible influence of pre-morbid individual differences on performance. We addressed this issue by considering the impact of transcranial magnetic stimulation (TMS)-induced “virtual lesions” of the left anterior temporal lobe upon reading performance in healthy individuals who vary in their degree of semantic reliance during reading. TMS only disrupted performance in higher semantic reliance readers. These results establish a direct link between pre-morbid individual differences and post-damage outcomes. Our virtual lesion approach provides a methodology through which the impact of pre-morbid individual differences can be examined and their theoretical implications understood.

Neuropsychological data have proven invaluable in advancing our understanding of higher cognition. The interpretation of such data is, however, complicated by the fact that post-lesion behavioral abnormalities could reflect pre-morbid individual differences in the cognitive domain of interest. Here we exploited the virtual lesion methodology offered by transcranial magnetic stimulation (TMS) to explore the impact of pre-morbid individual differences on post-lesion performance. We applied this approach to the domain of reading, a crucial ability in which there are known to be considerable individual differences in the normal population. As predicted by neuropsychological studies of surface dyslexia in semantic dementia and the connectionist triangle model of reading, previous empirical work has shown that healthy participants vary in their reliance on meaning for reading words with atypical correspondences between spelling and sound. We therefore selected participants who varied along this dimension and applied a virtual lesion to the left anterior temporal lobe. As expected, we observed a significant three-way interaction between “pre-morbid” reading status, stimulation, and word type, such that TMS increased the disadvantage for spelling–sound atypical words more for the individuals with stronger semantic reliance. This successful test-case study provides an approach to understanding the impact of pre-morbid individual variation on post-lesion outcomes that could be fruitfully applied to a variety of cognitive domains.

Do You Read How I Read? Systematic Individual Differences in Semantic Reliance amongst Normal Readers

The extent to which meaning is involved in reading aloud has proven an area of longstanding debate, and current computational models differ on this dimension. The connectionist triangle model proposes that normal individuals rely on semantic information for correct reading of words with atypical spelling-sound relationships, but to varying degrees. This proposed individual difference would account for the varying stage of decline at which patients with semantic dementia first show the reading impairment known as surface dyslexia. Recent neuroimaging data has provided validation of this view, showing that individual differences in degree of semantic reliance during exception word reading predict the amount of activation in left anterior temporal regions associated with semantic processing. This study aimed to establish the cognitive correlates of individual differences in semantic reliance during exception word reading. Experiment 1 used a subgrouping approach with 32 participants and found larger imageability and semantic priming effects specifically for exception word reading amongst high relative to low semantic reliance readers. High semantic reliance readers also tended to read nonwords more slowly than low semantic reliance readers. A second experiment used a regression approach with 129 readers and confirmed the relationship of degree of semantic reliance both to imageability effects in exception word reading and speed of nonword reading. Further, while the performance of the higher semantic readers revealed no significant association with semantic processing tasks, there was a negative relationship with rhyme processing tasks. We therefore speculate that differences in phonological abilities may be responsible for varying degrees of semantic reliance in reading aloud. This proposal accords with the results of functional imaging showing that higher semantic reliance during exception word reading corresponds to lower activation in left pre-central gyrus, an area associated with direct spelling sound mapping and phonological processing. Our results therefore establish the nature of systematic individual differences in degree of semantic involvement amongst normal readers, and suggest directions for future neuroimaging and computational modeling research to uncover their origins.

Cognitive world: Neuropsychology of individual differences

It is proposed that depending upon the specific pattern of cognitive abilities, each individual lives in an idiosyncratic "cognitive world." Brain pathology can be associated with some disturbed abilities, and frequently experiential changes (i.e., how the world is understood) are observed. Because these patients often are aware of their intellectual changes, they may represent excellent models to illustrate the diversity of cognitive interpretations an individual can have about the surrounding environmental conditions. Four neuropsychology cases are presented to illustrate this point: (a) prosopagnosia associated with spatial agnosia; (b) Gerstmann's syndrome; (c) dysexecutive syndrome due to a head injury; and, (d) patient with Capgras' syndrome associated with a left temporal cyst. It is further emphasized that non-brain damaged people present an enormous-but usually overlooked-dispersion in different cognitive domains, resulting in specific and idiosyncratic patterns of cognitive abilities. It is concluded that the concept of "cognitive world" in neuropsychology can parallel the concept of "perceptual world" introduced by von Uexküll in biology, which assumes that different animal species live in idiosyncratic perceptual worlds, available and knowable by the differences in their sensory system abilities. That is, different individuals live in idiosyncratic cognitive worlds, owing to their differences in cognitive abilities.

A Model of Emergent Category-specific Activation in the Posterior Fusiform Gyrus of Sighted and Congenitally Blind Populations

Theories about the neural bases of semantic knowledge tend between two poles, one proposing that distinct brain regions are innately dedicated to different conceptual domains and the other suggesting that all concepts are encoded within a single network. Category-sensitive functional activations in the fusiform cortex of the congenitally blind have been taken to support the former view but also raise several puzzles. We use neural network models to assess a hypothesis that spans the two poles: The interesting functional activation patterns reflect the base connectivity of a domain-general semantic network. Both similarities and differences between sighted and congenitally blind groups can emerge through learning in a neural network, but only in architectures adopting real anatomical constraints. Surprisingly, the same constraints suggest a novel account of a quite different phenomenon: the dyspraxia observed in patients with semantic impairments from anterior temporal pathology. From this work, we suggest that the cortical semantic network is wired not to encode knowledge of distinct conceptual domains but to promote learning about both conceptual and affordance structure in the environment.

When concepts lose their color: a case of object-color knowledge impairment

Color is important in our daily interactions with objects, and plays a role in both low- and high-level visual processing. Previous neuropsychological studies have shown that color perception and object-color knowledge can doubly dissociate, and that both can dissociate from processing of object form. We present a case study of an individual who displayed an impairment for knowledge of the typical colors of objects, with preserved color perception and color naming. Our case also presented with a pattern of, if anything, worse performance for naming living items compared to non-living things. The findings of the experimental investigation are evaluated in light of two theories of conceptual organization in the brain: the Sensory/Functional Theory and the Domain-Specific Hypothesis. The dissociations observed in this case compel a model in which sensory/motor modality and semantic domain jointly constrain the organization of object knowledge.

Revisiting domain-general accounts of category specificity in mind and brain

Theories about the neural basis of semantic knowledge have been strongly influenced by reports that particular semantic categories can be differentially impaired by neuropathology and can differentially activate particular regions of cortex in brain imaging studies. One well-known interpretation of these data is that the brain has evolved distinct functional and anatomical modules for storing and retrieving knowledge about different kinds of things. We review the evidence supporting an alternative view: that category specificity arises from many heterogeneous factors and so tells us little directly about the cognitive and neural architecture of semantic memory. We consider four general hypotheses about domain-general causes of category-specific patterns, their roots in early work, and their reemergence in contemporary research. We argue that there is compelling evidence supporting each hypothesis, and that the different hypotheses together can explain most of the interesting data. We further suggest that such a multifactor domain-general approach to category specificity is appealing partly because it explains the important findings with reference to theoretical claims that are already widely accepted, and partly because it resolves several puzzles that arise under the alternative view. For further resources related to this article, please visit the WIREs website.

CONFLICT OF INTEREST

The authors have declared no conflicts of interest for this article.

The degraded concept representation system in semantic dementia: damage to pan-modal hub, then visual spoke

The core clinical feature of semantic dementia is a progressive yet selective degradation of conceptual knowledge. Understanding the cognitive and neuroanatomical basis for this deficit is a key challenge for both clinical and basic science. Some researchers attribute the deficit to damage to pan-modal conceptual representations that are independent of any particular sensory-motor modality and are represented in the ventrolateral anterior temporal lobes. Others claim that damage to modality-specific visual feature representations in the occipitotemporal 'ventral stream' is responsible. In the present study, we tested the hypothesis that concept degradation in semantic dementia involves a combination of these pan-modal and modality-specific elements. We investigated factors influencing knowledge of object concepts by analysing 43 sets of picture-naming data from patients with semantic dementia. We found a strong influence of two pan-modal factors: highly familiar and typical items were named more accurately than less familiar/atypical items at all stages of the disorder. Items associated with rich sensory-motor information were also named more successfully at all stages, and this effect was present for sound/motion knowledge and tactile/action knowledge when these modalities were studied separately. However, there was no advantage for items rich in visual colour/form characteristics; instead, this factor had an increasingly negative impact in the later stages of the disorder. We propose that these results are best explained by a combination of (i) degradation of modality-independent conceptual representations, which is present throughout the disorder and is a consequence of atrophy focused on the ventrolateral anterior temporal lobes; and (ii) a later additional deficit for concepts that depend heavily on visual colour/form information, caused by the spreading of atrophy to posterior ventral temporal regions specialized for representing this information. This explanation is consistent with a graded hub-and-spoke model of conceptual knowledge, in which there is a gradual convergence of information along the temporal lobes, with visual attributes represented in the posterior cortex giving way to pan-modal representations in the anterior areas.

Neuroanatomical correlates of visual car expertise

Expertise in non-visual domains such as musical performance is associated with differences in gray matter volume of particular regions of the human brain. Whether this is also the case for expertise in visual object recognition is unknown. Here we tested whether individual variability in the ability to recognize car models, from novice performance to high level of expertise, is associated with specific structural changes in gray matter volume. We found that inter-individual variability in expertise with cars was significantly and selectively correlated with gray matter volume in prefrontal cortex. Inter-individual differences in the recognition of airplanes, that none of the participants had expertise with, were correlated with structural variability of regions bordering the visual cortex. These results highlight the role of prefrontal regions outside the visual cortex in accessing and processing visual knowledge about objects from the domain of expertise and suggest that expertise in visual object recognition may entail structural changes in regions associated with semantic knowledge.