Role of the anterior temporal lobes in semantic representations: Paradoxical results of a cTBS study

Overlapping neural correlates underpin theory of mind and semantic cognition: Evidence from a meta-analysis of 344 functional neuroimaging studies

Key unanswered questions for cognitive neuroscience include whether social cognition is underpinned by specialised brain regions and to what extent it simultaneously depends on more domain-general systems. Until we glean a better understanding of the full set of contributions made by various systems, theories of social cognition will remain fundamentally limited. In the present study, we evaluate a recent proposal that semantic cognition plays a crucial role in supporting social cognition. While previous brain-based investigations have focused on dissociating these two systems, our primary aim was to assess the degree to which the neural correlates are overlapping, particularly within two key regions, the anterior temporal lobe (ATL) and the temporoparietal junction (TPJ). We focus on activation associated with theory of mind (ToM) and adopt a meta-analytic activation likelihood approach to synthesise a large set of functional neuroimaging studies and compare their results with studies of semantic cognition. As a key consideration, we sought to account for methodological differences across the two sets of studies, including the fact that ToM studies tend to use nonverbal stimuli while the semantics literature is dominated by language-based tasks. Overall, we observed consistent overlap between the two sets of brain regions, especially in the ATL and TPJ. This supports the claim that tasks involving ToM draw upon more general semantic retrieval processes. We also identified activation specific to ToM in the right TPJ, bilateral anterior mPFC, and right precuneus. This is consistent with the view that, nested amongst more domain-general systems, there is specialised circuitry that is tuned to social processes.

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.

Transcranial Direct Current Stimulation Effects on the Neural Substrate of Conceptual Representations

The aim of this study was to shed light on the neural substrate of conceptual representations starting from the construct of higher-order convergence zones and trying to evaluate the unitary or non-unitary nature of this construct. We used the 'Thematic and Taxonomic Semantic (TTS) task' to investigate (a) the neural substrate of stimuli belonging to biological and artifact categories, (b) the format of stimuli presentation, i.e., verbal or pictorial, and (c) the relation between stimuli, i.e., categorial or contextual. We administered anodal transcranial direct current stimulation (tDCS) to different brain structures during the execution of the TTS task. Twenty healthy participants were enrolled and divided into two groups, one investigating the role of the anterior temporal lobes (ATL) and the other the temporo-parietal junctions (TPJ). Each participant underwent three sessions of stimulation to facilitate a control condition and to investigate the role of both hemispheres. Results showed that ATL stimulation influenced all conceptual representations in relation to the format of presentation (i.e., left-verbal and right-pictorial). Moreover, ATL stimulation modulated living categories and taxonomic relations specifically, whereas TPJ stimulation did not influence semantic task performances.

A Semantic Cognition Contribution to Mood and Anxiety Disorder Pathophysiology

Over the last two decades, the functional role of the bilateral anterior temporal lobes (bATLs) has been receiving more attention. They have been associated with semantics and social concept processing, and are regarded as a core region for depression. In the past, the role of the ATL has often been overlooked in semantic models based on functional magnetic resonance imaging (fMRI) due to geometric distortions in the BOLD signal. However, previous work has unequivocally associated the bATLs with these higher-order cognitive functions following advances in neuroimaging techniques to overcome the geometric distortions. At the same time, the importance of the neural basis of conceptual knowledge in understanding mood disorders became apparent. Theoretical models of the neural basis of mood and anxiety disorders have been classically studied from the emotion perspective, without concentrating on conceptual processing. However, recent work suggests that the ATL, a brain region underlying conceptual knowledge, plays an essential role in mood and anxiety disorders. Patients with anxiety and depression often cope with self-blaming biases and guilt. The theory is that in order to experience guilt, the brain needs to access the related conceptual information via the ATL. This narrative review describes how aberrant interactions of the ATL with the fronto–limbic emotional system could underlie mood and anxiety disorders.

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

Background

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

Methods

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

Results

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

Discussion

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

Systematic review registration

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

Neurochemical profiles of the anterior temporal lobe predict response of repetitive transcranial magnetic stimulation on semantic processing

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique used to modulate cortical excitability in the human brain. However, one major challenge with rTMS is that the responses to stimulation are highly variable across individuals. The underlying reasons why responses to rTMS are highly variable between individuals still remain unclear. Here, we investigated whether the response to continuous theta-burst stimulation (cTBS) - an effective rTMS protocol for decreasing cortical excitability - is related to individual differences in glutamate and GABA neurotransmission. We acquired resting-state magnetic resonance spectroscopy (MRS) and functional magnetic resonance imaging (fMRI) during semantic processing. Then, we applied cTBS over the anterior temporal lobe (ATL), a hub for semantic representation, to explore the relationship between the baseline neurochemical profiles in this region and the response to cTBS. We found that the baseline excitation-inhibition balance (glutamate + glutamine/GABA ratio) in the ATL was associated with individual cTBS responsiveness during semantic processing. Specifically, individuals with lower excitation-inhibition balance showed stronger inhibitory effect - poorer semantic performance. Our results revealed that non-responders (subjects who did not show an inhibitory effect of cTBS on subsequent semantic performance) had higher excitatory-inhibitory balance in the ATL, which led to up-regulated task-induced regional activity as well as increased ATL-connectivity with other semantic regions compared to responders. These results disclose that the baseline neurochemical state of a cortical region can be a significant factor in predicting responses to cTBS.

A Reproducible Deep-Learning-Based Computer-Aided Diagnosis Tool for Frontotemporal Dementia Using MONAI and Clinica Frameworks

Despite Artificial Intelligence (AI) being a leading technology in biomedical research, real-life implementation of AI-based Computer-Aided Diagnosis (CAD) tools into the clinical setting is still remote due to unstandardized practices during development. However, few or no attempts have been made to propose a reproducible CAD development workflow for 3D MRI data. In this paper, we present the development of an easily reproducible and reliable CAD tool using the Clinica and MONAI frameworks that were developed to introduce standardized practices in medical imaging. A Deep Learning (DL) algorithm was trained to detect frontotemporal dementia (FTD) on data from the NIFD database to ensure reproducibility. The DL model yielded 0.80 accuracy (95% confidence intervals: 0.64, 0.91), 1 sensitivity, 0.6 specificity, 0.83 F1-score, and 0.86 AUC, achieving a comparable performance with other FTD classification approaches. Explainable AI methods were applied to understand AI behavior and to identify regions of the images where the DL model misbehaves. Attention maps highlighted that its decision was driven by hallmarking brain areas for FTD and helped us to understand how to improve FTD detection. The proposed standardized methodology could be useful for benchmark comparison in FTD classification. AI-based CAD tools should be developed with the goal of standardizing pipelines, as varying pre-processing and training methods, along with the absence of model behavior explanations, negatively impact regulators' attitudes towards CAD. The adoption of common best practices for neuroimaging data analysis is a step toward fast evaluation of efficacy and safety of CAD and may accelerate the adoption of AI products in the healthcare system.

Inhibition of the occipital face area modulates the electrophysiological signals of face familiarity: A combined cTBS-EEG study

The occipital face area (OFA) is hierarchically one of the first stages of the face processing network. It has originally been thought to be involved in early, structural processing steps, but currently more and more studies challenge this view and propose that it also takes part in higher level face processing, such as identification and recognition. Here we tested whether the OFA is involved in the initial steps of recognition memory and plays a causal role in the differential processing of familiar and unfamiliar faces. We used an offline, inhibitory continuous theta-burst stimulation (cTBS) protocol over the right OFA and the vertex as control site. Electroencephalographic (EEG) recording of event-related potentials (ERPs), elicited by visually presented familiar (famous) and unfamiliar faces was performed before and after stimulation. We observed a difference in ERPs for famous and unfamiliar faces in a time-window corresponding to the N250 component. Importantly, this difference was significantly increased by cTBS of the right OFA, suggesting its causal role in the differential processing of familiar and unfamiliar faces. The enhancement occurred focally, at electrodes close to the right hemispheric cTBS site, as well as over similar occipito-temporal sites of the contralateral hemisphere. To the best of our knowledge, this is the first study showing the causal role of the rOFA in the differential processing of familiar and unfamiliar faces, using combined cTBS and EEG recording methods. These results are discussed with respect to the nature of familiar face representations, supported by an extensive, bilateral network.

Enhancing vs. inhibiting semantic performance with transcranial magnetic stimulation over the anterior temporal lobe: Frequency- and task-specific effects

Accumulating, converging evidence indicates that the anterior temporal lobe (ATL) appears to be the transmodal hub for semantic representation. A series of repetitive transcranial magnetic stimulation (rTMS) investigations utilizing the ‘virtual lesion’ approach have established the brain-behavioural relationship between the ATL and semantic processing by demonstrating that inhibitory rTMS over the ATL induced impairments in semantic performance in healthy individuals. However, a growing body of rTMS studies suggest that rTMS might also be a tool for cognitive enhancement and rehabilitation, though there has been no previous exploration in semantic cognition. Here, we explored a potential role of rTMS in enhancing and inhibiting semantic performance with contrastive rTMS protocols (1 Hz vs. 20 Hz) by controlling practice effects. Twenty-one healthy participants were recruited and performed an object category judgement task and a pattern matching task serving as a control task before and after the stimulation over the ATL (1 Hz, 20 Hz, and sham). A task familiarization procedure was performed prior to the experiment in order to establish a ‘stable baseline’ prior to stimulation and thus minimize practice effect. Our results demonstrated that it is possible to modulate semantic performance positively or negatively depending on the ATL stimulation frequency: 20 Hz rTMS was optimal for facilitating cortical processing (faster RT in a semantic task) contrasting with diminished semantic performance after 1 Hz rTMS. In addition to cementing the importance of the ATL to semantic representation, our findings suggest that 20 Hz rTMS leads to semantic enhancement in healthy individuals and potentially could be used for patients with semantic impairments as a therapeutic tool.

Boosting the effect of reward on cognitive control using TMS over the left IFJ

Although an enhancing effect of reward on cognitive performance has been observed consistently, its neural underpinnings remain elusive. Recent evidence suggests that the inferior frontal junction (IFJ) may be a key player underlying such an enhancement by integrating motivational processes and cognitive control. However, its exact role and in particular a potential causality of IFJ activation is still unclear. In the present study, we therefore investigated the causal contributions of the left IFJ in motivated task switching by temporarily disrupting its activity using continuous theta burst stimulation (cTBS, Exp.1) or 1 Hz repetitive transcranial magnetic stimulation (rTMS, Exp.2). After TMS application over the left IFJ or a control site (vertex), participants performed a switch task in which numbers had to be judged by magnitude or parity. Different amounts of monetary rewards (high vs low) were used to manipulate the participants' motivational states. We measured reaction times and error rates. Irrespective of TMS stimulation, participants exhibited slower responses following task switches compared to task repeats. This effect was reduced in high reward trials. Importantly, we found that disrupting the IFJ improved participants' behavioral performance in the high reward condition. For high reward trials exclusively, error rates decreased when the IFJ was modulated with cTBS or 1 Hz rTMS but not after vertex stimulation. Our results suggest that the left IFJ is causally related to the increase in cognitive performance through reward.

Does TMS Disruption of the Left Primary Motor Cortex Affect Verb Retrieval Following Exposure to Pantomimed Gestures?

Previous research suggests that meaning-laden gestures, even when produced in the absence of language (i.e., pantomimed gestures), influence lexical retrieval. Yet, little is known about the neural mechanisms that underlie this process. Based on embodied cognition theories, many studies have demonstrated motor cortex involvement in the representation of action verbs and in the understanding of actions. The present study aimed to investigate whether the motor system plays a critical role in the behavioral influence of pantomimed gestures on action naming. Continuous theta burst stimulation (cTBS) was applied over the hand area of the left primary motor cortex and to a control site (occipital cortex). An action-picture naming task followed cTBS. In the naming task, participants named action pictures that were preceded by videos of congruent pantomimed gestures, unrelated pantomimed gestures or a control video with no movement (as a neutral, non-gestural condition). In addition to behavioral measures of performance, cTBS-induced changes in corticospinal activity were assessed. We replicated previous finding that exposure to congruent pantomimed gestures facilitates word production, compared to unrelated or neutral primes. However, we found no evidence that the left primary motor area is crucially involved in the mechanism underlying behavioral facilitation effects of gesture on verb production. Although, at the group level, cTBS induced motor cortex suppression, at the individual level we found remarkable variability of cTBS effects on the motor cortex. We found cTBS induction of both inhibition of corticospinal activity (with slower behavioral of responses) and enhancement (with faster behavioral responses). Our findings cast doubt on assumptions that the motor cortex is causally involved in the impact of gestures on action-word processing. Our results also highlight the importance of careful consideration of interindividual variability for the interpretation of cTBS effects.

As Time Goes by: A rTMS Study on Age-Related Changes in Sentence Comprehension

It is well established that off-line sentence judgment tasks (oSJTs) typically rely on phonological working memory (WM), beyond specific linguistic processing. Nevertheless, empirical findings suggest that a juvenile level of performance in an oSJT could be associated with the recruitment of age-specific additional supportive neural network in healthy aging. In particular, in one of our previous study, healthy elderlies showed the additional activation of associative visual cortices when compared with young controls. We suggested that age-related hyperactivations, during an auditory sentence judgment task, might represent the neurofunctional correlate of the recruitment of compensatory strategies that are necessary to maintain a juvenile level of performance. To explicitly test this hypothesis we adopted repetitive transcranial magnetic stimulation (rTMS). Twelve healthy elderlies and 12 young participants were engaged in an off-line semantic plausibility judgment task while rTMS was delivered over: (1) the left inferior frontal gyrus (LIFG; i.e., a core region of the WM network); (2) the precuneus; and (3) a Control Site (vertex). Results showed a significant main effect of Stimulation Site and a significant Group-by-Stimulation Site interaction effect. In particular, the rTMS stimulation of the LIFG slowed down reaction times (RTs) both in young and healthy elderly participants, while only healthy elderlies showed an increment of RTs during the stimulation of the precuneus. Taken together our results further support the idea that the maintenance of a juvenile level of performance in graceful aging may be associated with task-specific compensatory processes that would manifest them-selves, from the neurofunctional point of view, by the recruitment of additional neural supportive regions.

Laterality of anterior temporal lobe repetitive transcranial magnetic stimulation determines the degree of disruption in picture naming

The bilateral anterior temporal lobes play a key role in semantic representation. This is clearly demonstrated by the performance of patients with semantic dementia, a disorder characterised by a progressive and selective decline in semantic memory over all modalities as a result of anterior temporal atrophy. Although all patients exhibit a progressive decline in both single-word production and comprehension, those with greater atrophy to the left anterior temporal lobe show a stronger decline in word production than comprehension. This asymmetry has been attributed to the greater connectivity of the left anterior temporal lobe with left-lateralised speech production mechanisms. Virtual lesioning of the left ATL using offline repetitive transcranial magnetic stimulation (rTMS) has been shown to disrupt picture naming, but, the impact of right ATL rTMS is yet to be explored. We tested the prediction that disruption of picture naming in normal participants by rTMS should be greater for the left than the right ATL. We found a significant increase in picture naming latencies specifically for stimulation of the left ATL only. Neither left nor right ATL TMS slowed performance in a number naming control task. These results support the hypothesis that although both temporal lobes are part of a widespread semantic network in the human brain, the left anterior temporal lobe possesses a stronger connection to left-lateralised speech production areas than the right temporal lobe.

Safety and Efficacy of Adjunctive Θ Burst Repetitive Transcranial Magnetic Stimulation to Right Inferior Parietal Lobule in Schizophrenia Patients With First-Rank Symptoms: A Pilot, Exploratory Study

BACKGROUND

First-rank symptoms (FRS) in schizophrenia have been found to be associated with various cognitive and biological markers. Repetitive transcranial magnetic stimulation (rTMS) has been shown to modulate such factors. We hypothesized that rTMS adjunctive to antipsychotics will be safe and effective in treatment of FRS in schizophrenia.

METHODS

Schizophrenia patients with FRS randomly received either active or sham-magnetic resonance imaging navigated continuous Θ burst stimulation (cTBS)-rTMS to right inferior parietal lobule for 2 weeks; assessments were repeated. While primary outcome variables were safety profile, FRS and overall psychopathology; secondary outcomes were γ oscillatory activity, brain-derived neurotrophic factor levels, and self-monitoring function.

RESULTS

No significant adverse events were reported in either group. None of the outcome measures showed sufficient power on the time by group analysis.

CONCLUSIONS

This study fails to demonstrate whether or not adjunctive cTBS to right inferior parietal lobule could significantly alleviate FRS. We also fail to provide evidence for whether this protocol has any effect on brain-derived neurotrophic factor levels, self-monitoring function, and right hemispheric γ oscillations.

Hemispheric lateralization of semantic feature distinctiveness

Recent models of semantic memory propose that the semantic representation of concepts is based, in part, on a network of features. In this view, a feature that is distinctive for an object (a zebra has stripes) is processed differently from a feature that is shared across many objects (a zebra has four legs). The goal of this paper is to determine whether there are hemispheric differences in such processing. In a feature verification task, participants responded 'yes' or 'no' following concepts which were presented to a single visual field (left or right) paired with a shared or distinctive feature. Both hemispheres showed faster reaction times to shared features than to distinctive features, although right hemisphere responses were significantly slower overall and particularly in the processing of distinctive features. These findings support models of semantic processing in which the dominant left hemisphere more efficiently performs highly discriminating 'fine' encoding, in contrast to the right hemisphere which performs less discriminating 'coarse' encoding.