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Shekari E, Seyfi M, Modarres Zadeh A, Batouli SA, Valinejad V, Goudarzi S, Joghataei MT. Mechanisms of brain activation following naming therapy in aphasia: A systematic review on task-based fMRI studies. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:780-801. [PMID: 35666667 DOI: 10.1080/23279095.2022.2074849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The pattern of brain neuroplasticity after naming therapies in patients with aphasia can be evaluated using task-based fMRI. This article aims to review studies investigating brain reorganization after semantic and phonological-based anomia therapy that used picture-naming fMRI tasks. We searched for those articles that compared the activation of brain areas before and after aphasia therapies in the PubMed and the EMBASE databases from 1993 up to April 2020. All studies (single-cases or group designs) on anomia treatment in individuals with acquired aphasia were reviewed. Data were synthesized descriptively through tables to allow the facilitated comparison of the studies. A total of 14 studies were selected and reviewed. The results of the reviewed studies demonstrated that the naming improvement is associated with changes in the activation of cortical and subcortical brain areas. This review highlights the need for a more systematic investigation of the association between decreased and increased activation of brain areas related to anomia therapy. Also, more detailed information about factors influencing brain reorganization is required to elucidate the neural mechanisms of anomia therapy. Overall, regarding the theoretical and clinical aspects, the number of studies that used intensive protocol is growing, and based on the positive potential of these treatments, they could be suitable for the rehabilitation of people with aphasia.
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Affiliation(s)
- Ehsan Shekari
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Seyfi
- Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Modarres Zadeh
- Department of Speech Therapy, Faculty of Rehabilitation, Tehran University of Medical science, Tehran, Iran
| | - Seyed Amirhossein Batouli
- Neuroimaging and Analysis Group, Tehran University of Medical Sciences, Tehran, Iran
- School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Valinejad
- Department of Speech Therapy, Faculty of Rehabilitation, Tehran University of Medical science, Tehran, Iran
| | - Sepideh Goudarzi
- Department of Pharmacology and Toxicology, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Taghi Joghataei
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
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Alonso-Sánchez MF, Limongi R, Gati J, Palaniyappan L. Language network self-inhibition and semantic similarity in first-episode schizophrenia: A computational-linguistic and effective connectivity approach. Schizophr Res 2023; 259:97-103. [PMID: 35568676 DOI: 10.1016/j.schres.2022.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION A central feature of schizophrenia is the disorganization and impoverishment of language. Recently, we observed higher semantic similarity in first-episode-schizophrenia (FES) patients. In this study, we investigate if this aberrant similarity relates to the 'causal' connectivity between two key nodes of the word production system: inferior frontal gyrus (IFG) and the semantic-hub at the ventral anterior temporal lobe (vATL). METHODS Resting-state fMRI scans were collected from 60 participants (30 untreated FES and 30 healthy controls). The semantic distance was measured with the CoVec semantic tool based on GloVe. A spectral dynamic causal model with Parametrical Empirical Bayes was constructed modelling the intrinsic self-inhibitory and extrinsic-excitatory connections within the brain regions. We estimated the parameters of a fully connected model with the semantic distance as a covariate. RESULTS FES patients chose words with higher semantic similarity when describing the pictures compared to the HC group. Among patients, an increased semantic similarity was related with an increase in intrinsic connections within both the vATL and IFG, suggesting that reduced 'synaptic gain' in these regions likely contribute to aberrant sampling of the semantic space during discourse in schizophrenia. CONCLUSIONS Lexical impoverishment relates to increased self-inhibition in both the IFG and vATL. The associated reduction in synaptic gain may relate to reduced precision of locally generated neural activity, forcing the choice of words that are already 'activated' in a lexical network. One approach to improve word sampling may be via promoting synaptic gain via supra-physiological stimulation within the Broca's-vATL network; this proposal needs verification.
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Affiliation(s)
- María Francisca Alonso-Sánchez
- CIDCL, Fonoaudiología, Facultad de Medicina, Universidad de Valparaíso, Chile; Robarts Research Institute, Western University, London, Ontario, Canada.
| | - Roberto Limongi
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Joseph Gati
- Robarts Research Institute, Western University, London, Ontario, Canada; Centre for Youth Mental Health Service Innovation, Research and Training, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Lena Palaniyappan
- Robarts Research Institute, Western University, London, Ontario, Canada; Centre for Youth Mental Health Service Innovation, Research and Training, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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3
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Xu L, Wei H, Sun Z, Chu T, Li M, Liu R, Jiang L, Liang Z. Dynamic alterations of spontaneous neural activity in post-stroke aphasia: a resting-state functional magnetic resonance imaging study. Front Neurosci 2023; 17:1177930. [PMID: 37250389 PMCID: PMC10213748 DOI: 10.3389/fnins.2023.1177930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/20/2023] [Indexed: 05/31/2023] Open
Abstract
Background and purpose The dynamic alterations in spontaneous neural activity of the brain during the acute phase of post-stroke aphasia (PSA) remain unclear. Therefore, in this study, dynamic amplitude of low-frequency fluctuation (dALFF) was applied to explore abnormal temporal variability in local functional activity of the brain during acute PSA. Materials and methods Resting-state functional magnetic resonance imaging (rs-fMRI) data from 26 patients with PSA and 25 healthy controls (HCs) were acquired. The sliding window method was used to assess dALFF, with the k-means clustering method used to identify dALFF states. The two-sample t-test was applied to compare differences in dALFF variability and state metrics between the PSA and HC groups. Results (1) In the PSA group, greater variance of dALFF in the cerebellar network (CBN) and left fronto-temporo-parietal network (FTPN) was observed. (2) Three dALFF states were identified among all subjects. States 1 and 2 were identified in the PSA patients, and the two dALFF states shared a similar proportion. Moreover, the number of transitions between the two dALFF states was higher in the patients compared with that in HCs. Conclusion The results of this study provide valuable insights into brain dysfunction that occurs during the acute phase (6.00 ± 3.52 days) of PSA. The observed increase in variability of local functional activities in CBN and left FTPN may be related to the spontaneous functional recovery of language during acute PSA, and it also suggests that cerebellum plays an important role in language.
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Affiliation(s)
- Luyao Xu
- Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
| | - Hongchun Wei
- Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
| | - Zhongwen Sun
- Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
| | - Tongpeng Chu
- Department of Radiology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
| | - Min Li
- Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
| | - Ruhui Liu
- Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
| | - Li Jiang
- Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
| | - Zhigang Liang
- Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong, China
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Stephan-Otto C, Núñez C, Lombardini F, Cambra-Martí MR, Ochoa S, Senior C, Brébion G. Neurocognitive bases of self-monitoring of inner speech in hallucination prone individuals. Sci Rep 2023; 13:6251. [PMID: 37069194 PMCID: PMC10110610 DOI: 10.1038/s41598-023-32042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/20/2023] [Indexed: 04/19/2023] Open
Abstract
Verbal hallucinations in schizophrenia patients might be seen as internal verbal productions mistaken for perceptions as a result of over-salient inner speech and/or defective self-monitoring processes. Similar cognitive mechanisms might underpin verbal hallucination proneness in the general population. We investigated, in a non-clinical sample, the cerebral activity associated with verbal hallucinatory predisposition during false recognition of familiar words -assumed to stem from poor monitoring of inner speech-vs. uncommon words. Thirty-seven healthy participants underwent a verbal recognition task. High- and low-frequency words were presented outside the scanner. In the scanner, the participants were then required to recognize the target words among equivalent distractors. Results showed that verbal hallucination proneness was associated with higher rates of false recognition of high-frequency words. It was further associated with activation of language and decisional brain areas during false recognitions of low-, but not high-, frequency words, and with activation of a recollective brain area during correct recognitions of low-, but not high-, frequency words. The increased tendency to report familiar words as targets, along with a lack of activation of the language, recollective, and decisional brain areas necessary for their judgement, suggests failure in the self-monitoring of inner speech in verbal hallucination-prone individuals.
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Affiliation(s)
- Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Christian Núñez
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | | | - Susana Ochoa
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Carl Senior
- School of Life & Health Sciences, Aston University, Birmingham, UK.
- University of Gibraltar, Gibraltar, UK.
| | - Gildas Brébion
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
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Xu G, Hao F, Zhao W, Qiu J, Zhao P, Zhang Q. The influential factors and non-pharmacological interventions of cognitive impairment in children with ischemic stroke. Front Neurol 2022; 13:1072388. [PMID: 36588886 PMCID: PMC9797836 DOI: 10.3389/fneur.2022.1072388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Background The prevalence of pediatric ischemic stroke rose by 35% between 1990 and 2013. Affected patients can experience the gradual onset of cognitive impairment in the form of impaired language, memory, intelligence, attention, and processing speed, which affect 20-50% of these patients. Only few evidence-based treatments are available due to significant heterogeneity in age, pathological characteristics, and the combined epilepsy status of the affected children. Methods We searched the literature published by Web of Science, Scopus, and PubMed, which researched non-pharmacological rehabilitation interventions for cognitive impairment following pediatric ischemic stroke. The search period is from the establishment of the database to January 2022. Results The incidence of such impairment is influenced by patient age, pathological characteristics, combined epilepsy status, and environmental factors. Non-pharmacological treatments for cognitive impairment that have been explored to date mainly include exercise training, psychological intervention, neuromodulation strategies, computer-assisted cognitive training, brain-computer interfaces (BCI), virtual reality, music therapy, and acupuncture. In childhood stroke, the only interventions that can be retrieved are psychological intervention and neuromodulation strategies. Conclusion However, evidence regarding the efficacy of these interventions is relatively weak. In future studies, the active application of a variety of interventions to improve pediatric cognitive function will be necessary, and neuroimaging and electrophysiological measurement techniques will be of great value in this context. Larger multi-center prospective longitudinal studies are also required to offer more accurate evidence-based guidance for the treatment of patients with pediatric stroke.
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Affiliation(s)
- Gang Xu
- Rehabilitation Branch, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China
| | - Fuchun Hao
- Medicine & Nursing Faculty, Tianjin Medical College, Tianjin, China
| | - Weiwei Zhao
- Chinese Teaching and Research Section, Tianjin Beichen Experimental Middle School, Tianjin, China
| | - Jiwen Qiu
- Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China,School of Medical Technology, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Peng Zhao
- Rehabilitation Branch, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China,*Correspondence: Peng Zhao
| | - Qian Zhang
- Child Health Care Department, Tianjin Beichen Women and Children Health Center, Tianjin, China,Qian Zhang
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Xue K, Chen J, Wei Y, Chen Y, Han S, Wang C, Zhang Y, Song X, Cheng J. Altered dynamic functional connectivity of auditory cortex and medial geniculate nucleus in first-episode, drug-naïve schizophrenia patients with and without auditory verbal hallucinations. Front Psychiatry 2022; 13:963634. [PMID: 36159925 PMCID: PMC9489854 DOI: 10.3389/fpsyt.2022.963634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE As a key feature of schizophrenia, auditory verbal hallucination (AVH) is causing concern. Altered dynamic functional connectivity (dFC) patterns involving in auditory related regions were rarely reported in schizophrenia patients with AVH. The goal of this research was to find out the dFC abnormalities of auditory related regions in first-episode, drug-naïve schizophrenia patients with and without AVH using resting state functional magnetic resonance imaging (rs-fMRI). METHODS A total of 107 schizophrenia patients with AVH, 85 schizophrenia patients without AVH (NAVH) underwent rs-fMRI examinations, and 104 healthy controls (HC) were matched. Seed-based dFC of the primary auditory cortex (Heschl's gyrus, HES), auditory association cortex (AAC, including Brodmann's areas 22 and 42), and medial geniculate nucleus (MGN) was conducted to build a whole-brain dFC diagram, then inter group comparison and correlation analysis were performed. RESULTS In comparison to the NAVH and HC groups, the AVH group showed increased dFC from left ACC to the right middle temporal gyrus and right middle occipital gyrus, decreased dFC from left HES to the left superior occipital gyrus, left cuneus gyrus, left precuneus gyrus, decreased dFC from right HES to the posterior cingulate gyrus, and decreased dFC from left MGN to the bilateral calcarine gyrus, bilateral cuneus gyrus, bilateral lingual gyrus. The Auditory Hallucination Rating Scale (AHRS) was significantly positively correlated with the dFC values of cluster 1 (bilateral calcarine gyrus, cuneus gyrus, lingual gyrus, superior occipital gyrus, precuneus gyrus, and posterior cingulate gyrus) using left AAC seed, cluster 2 (right middle temporal gyrus and right middle occipital gyrus) using left AAC seed, cluster 1 (bilateral calcarine gyrus, cuneus gyrus, lingual gyrus, superior occipital gyrus, precuneus gyrus and posterior cingulate gyrus) using right AAC seed and cluster 2 (posterior cingulate gyrus) using right HES seed in the AVH group. In both AVH and NAVH groups, a significantly negative correlation is also found between the dFC values of cluster 2 (posterior cingulate gyrus) using the right HES seed and the PANSS negative sub-scores. CONCLUSIONS The present findings demonstrate that schizophrenia patients with AVH showed multiple abnormal dFC regions using auditory related cortex and nucleus as seeds, particularly involving the occipital lobe, default mode network (DMN), and middle temporal lobe, implying that the different dFC patterns of auditory related areas could provide a neurological mechanism of AVH in schizophrenia.
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Affiliation(s)
- Kangkang Xue
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingli Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Caihong Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Python G, Pellet Cheneval P, Bonnans C, Laganaro M. Facilitating Word Retrieval in Aphasia: Which Type of Cues for Which Aphasic Speakers? Front Hum Neurosci 2021; 15:747391. [PMID: 34899216 PMCID: PMC8662555 DOI: 10.3389/fnhum.2021.747391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Even if both phonological and semantic cues can facilitate word retrieval in aphasia, it remains unclear if their respective effectiveness varies according to the underlying anomic profile. Aim: The aim of the present facilitation study is to compare the effect of phonological and semantic cues on picture naming accuracy and speed in different types of anomia. Methods: In the present within-subject design study, 15 aphasic persons following brain damage underwent picture naming paradigms with semantic cues (categorically- or associatively related) and phonological cues (initial phoneme presented auditorily, visually or both). Results: At the group level, semantic cueing was as effective as phonological cueing to significantly speed up picture naming. However, while phonological cues were effective regardless of the anomic profile, semantic cueing effects varied depending on the type of anomia. Participants with mixed anomia showed facilitation after both semantic categorical and associative cues, but individuals with lexical-phonological anomia only after categorical cues. Crucially, semantic cues were ineffective for participants with lexical-semantic anomia. These disparities were confirmed by categorical semantic facilitation decreasing when semantic/omission errors prevailed in the anomic profile, but increasing alongside phonological errors. Conclusion: The effectiveness of phonological vs semantic cues seems related to the underlying anomic profile: phonological cues benefit any type of anomia, but semantic cues only lexical-phonological or mixed anomia.
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Affiliation(s)
- Grégoire Python
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Neurorehabilitation Unit, University Hospital CHUV, Lausanne, Switzerland
| | | | - Caroline Bonnans
- Neurorehabilitation Unit, Lavigny Institution, Lavigny, Switzerland
| | - Marina Laganaro
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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BONEs not CATs attract DOGs: Semantic context effects for picture naming in the lesioned language network. Neuroimage 2021; 246:118767. [PMID: 34856377 DOI: 10.1016/j.neuroimage.2021.118767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/08/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022] Open
Abstract
The breakdown of rapid and accurate retrieval of words is a hallmark of aphasic speech and a prime target of therapeutic intervention. Complementary, psycho- and neurolinguistic research have developed a spectrum of models, how and by which neuronal network uncompromised speakers can rely on remarkable lexical retrieval capacities. Motivated by both lines of research we invited 32 participants with a chronic left hemispheric brain lesion to name pictures in the presence of distractor words. This picture-word-interference (PWI) paradigm is widely used in psycho- and neurolinguistic research. We find that also after brain lesion categorically related words (CAT → [dog]picture) impede naming, while associatively related words (BONE → [dog]picture) ease access, when compared to unrelated distractor words. The effects largely affecting latencies in neurotypical populations, are reproduced for error rate in our participants with lesions in the language network. Unsurprisingly, overall naming abilities varied greatly across patients. Notably, however, the two effects (categorical interference / associative facilitation) differ between participants. Correlating performance with lesion patterns we find support for the notion of a divergence of brain areas affording different aspects of the task: (i) lesions in the left middle temporal gyurs (MTG) deteriorate overall naming, confirming previous work; more notably, (ii) lesions comprising the inferior frontal hub (inferior frontal gyrus, IFG) of the language-network increase the interference effect for the categorical condition; on the contrary, (iii) lesions to the mid-to-posterior temporal hub (posterior middle and superior temporal gyri, pMTG/ pSTG) increase the facilitatory effect for the associative condition on error rates. The findings can be accommodated in a neuro-linguistic framework, which localizes lexical activation but also lexical interference in posterior parts of the language network (pMTG/pITG); conversely, selection between co-activated categorically related entries is afforded by frontal language areas (IFG). While purely experimental in nature our study highlights that lesion site differentially influences specific aspects of word retrieval. Since confrontational naming is a cornerstone of aphasia rehabilitation, this may be of note when designing and evaluating novel therapeutic regimes.
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Ovando-Tellez M, Rohaut B, George N, Bieth T, Hugueville L, Ibrahim Y, Courbet O, Naccache L, Levy R, Garcin B, Volle E. Does adding beer to coffee enhance the activation of drinks? An ERP study of semantic category priming. Cogn Neurosci 2021; 13:61-76. [PMID: 34232829 DOI: 10.1080/17588928.2021.1940117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Categorization - whether of objects, ideas, or events - is a cognitive process that is essential for human thinking, reasoning, and making sense of everyday experiences. Categorization abilities are typically measured by the Wechsler Adult Intelligence Scale (WAIS) similarity subtest, which consists of naming the shared category of two items (e.g., 'How are beer and coffee alike'). Previous studies show that categorization, as measured by similarity tasks, requires executive control functions. However, other theories and studies indicate that semantic memory is organized into taxonomic and thematic categories that can be activated implicitly in semantic priming tasks. To explore whether categories can be primed during a similarity task, we developed a double semantic priming paradigm. We measured the priming effect of two primes on a target word that was taxonomically or thematically related to both primes (double priming) or only one of them (single priming). Our results show a larger and additive priming effect in the double priming condition compared to the single priming condition, as measured by both response times and, more consistently, event-related potentials. Our results support the view that taxonomic and thematic categorization can occur during a double priming task and contribute to improving our knowledge on the organization of semantic memory into categories. These findings show how abstract categories can be activated, which likely shapes the way we think and interact with our environment. Our study also provides a new cognitive tool that could be useful to understand the categorization difficulties of neurological patients.
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Affiliation(s)
- Marcela Ovando-Tellez
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - Benjamin Rohaut
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France.,Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Department of Neurology, Columbia University, New York, NY, USA
| | - Nathalie George
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France.,Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Centre MEG-EEG, CENIR, Paris, France
| | - Theophile Bieth
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France.,Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Laurent Hugueville
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Centre MEG-EEG, CENIR, Paris, France
| | - Yoan Ibrahim
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - Ophelie Courbet
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - Lionel Naccache
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - Richard Levy
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France.,Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Béatrice Garcin
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France.,Neurology Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Emmanuelle Volle
- Paris Brain Institute (ICM), Sorbonne University, Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
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Breining BL, Faria AV, Caffo B, Meier EL, Sheppard SM, Sebastian R, Tippett DC, Hillis AE. Neural regions underlying object and action naming: Complementary evidence from acute stroke and primary progressive aphasia. APHASIOLOGY 2021; 36:732-760. [PMID: 35832655 PMCID: PMC9272983 DOI: 10.1080/02687038.2021.1907291] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Naming impairment is commonly noted in individuals with aphasia. However, object naming receives more attention than action naming. Furthermore, most studies include participants with aphasia due to only one aetiology, commonly stroke. We developed a new assessment, the Hopkins Action Naming Assessment (HANA), to evaluate action naming impairments. AIMS Our aims were to show that the HANA is a useful tool that can (1) identify action naming impairments and (2) be used to investigate the neural substrates underlying naming. We paired the HANA with the Boston Naming Test (BNT) to compare action and object naming. We considered participants with aphasia due to primary progressive aphasia (PPA) or acute left hemisphere stroke to provide a more comprehensive picture of brain-behaviour relationships critical for naming. Behaviourally, we hypothesised that there would be a double dissociation between object and action naming performance. Neuroanatomically, we hypothesised that different neural substrates would be implicated in object vs. action naming and that different lesion-deficit associations would be identified in participants with PPA vs. acute stroke. METHODS & PROCEDURES Participants (N=138 with PPA, N=37 with acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N=31 with PPA, N=37 with acute stroke) provided neuroimaging data. The whole brain was automatically segmented into regions of interest (ROIs). For participants with PPA, the image variables were the ROI volumes, normalised by the brain volume. For participants with acute stroke, the image variables were the percentage of each ROI affected by the lesion. The relationship between ROIs likely to be involved in naming performance was modelled with LASSO regression. OUTCOMES & RESULTS Behavioural results showed a double dissociation in performance: in each group, some participants displayed intact performance relative to healthy controls on actions but not objects and/or significantly better performance on actions than objects, while others showed the opposite pattern. These results support the need to assess both objects and actions when evaluating naming deficits. Neuroimaging results identified different regions associated with object vs. action naming, implicating overlapping but distinct networks of regions. Furthermore, results differed for participants with PPA vs. acute stroke, indicating that critical information may be missed when only one aetiology is considered. CONCLUSIONS Overall, the study provides a more comprehensive picture of the neural bases of naming, underscoring the importance of assessing both objects and actions and considering different aetiologies of damage. It demonstrates the utility of the HANA.
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Affiliation(s)
- Bonnie L. Breining
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Andreia V. Faria
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Erin L. Meier
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Communication Sciences & Disorders, Chapman University, Irvine, CA 92618, USA
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
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11
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Gobbo M, De Pellegrin S, Bonaudo C, Semenza C, Della Puppa A, Salillas E. Two dissociable semantic mechanisms predict naming errors and their responsive brain sites in awake surgery. DO80 revisited. Neuropsychologia 2020; 151:107727. [PMID: 33338472 DOI: 10.1016/j.neuropsychologia.2020.107727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022]
Abstract
How do we choose words, and what affects the selection of a specific term? Naming tests such as the DO80 are frequently used to assess language function during brain mapping in awake surgery. The present study aimed to explore whether specific semantic errors become more probable under the stimulation of specific brain areas. Moreover, it meant to determine whether specific semantic characteristics of the items may evoke specific types of error. A corpus-based qualitative semantic analysis of the DO80 items, and the emitted naming errors to those items during direct cortical electrostimulation (DCE) revealed that the number of hyperonyms (i.e. 'vehicle' for car') of an item predicted the emission of a synonym ('automobile' for 'car'). This association occurred mainly in frontal tumor patients, which was corroborated by behavior to lesion analyses. In contrast, the emission of co-hyponyms was associated with tumors located in temporal areas. These two behavior-lesion associations thus dissociated, and were also dependent on item semantic characteristics. Co-hyponym errors might generate from the disruption in a temporal semantic-to-lexical process, and the production of synonyms could be the result of an impairment in a frontal lexical-selection mechanism. A hypothesis on the lexical selection mechanisms exerted by the inferior frontal gyrus is proposed. Crucially, the present data suggest the need for more restrictive naming tasks, with items conditioned by tumor location.
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Affiliation(s)
- Marika Gobbo
- UOC Neurologic Clinic, University Hospital of Padova, Padova, Italy.
| | | | - Camilla Bonaudo
- Neurosurgery, Department of NEUROFARBA, University Hospital of Careggi, University of Florence, Florence, Italy
| | - Carlo Semenza
- Department of Neurosciences, University of Padova, Padova, Italy; IRCCS San Camillo Hospital, Venice, Italy
| | - Alessandro Della Puppa
- Neurosurgery, Department of NEUROFARBA, University Hospital of Careggi, University of Florence, Florence, Italy
| | - Elena Salillas
- Department of Neurosciences, University of Padova, Padova, Italy.
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12
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Piai V, Nieberlein L, Hartwigsen G. Effects of transcranial magnetic stimulation over the left posterior superior temporal gyrus on picture-word interference. PLoS One 2020; 15:e0242941. [PMID: 33253319 PMCID: PMC7703954 DOI: 10.1371/journal.pone.0242941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/11/2020] [Indexed: 12/01/2022] Open
Abstract
Word-production theories argue that during language production, a concept activates multiple lexical candidates in left temporal cortex, and the intended word is selected from this set. Evidence for theories on spoken-word production comes, for example, from the picture-word interference task, where participants name pictures superimposed by congruent (e.g., picture: rabbit, distractor "rabbit"), categorically related (e.g., distractor "sheep"), or unrelated (e.g., distractor "fork") words. Typically, whereas congruent distractors facilitate naming, related distractors slow down picture naming relative to unrelated distractors, resulting in semantic interference. However, the neural correlates of semantic interference are debated. Previous neuroimaging studies have shown that the left mid-to-posterior STG (pSTG) is involved in the interference associated with semantically related distractors. To probe the functional relevance of this area, we targeted the left pSTG with focal repetitive transcranial magnetic stimulation (rTMS) while subjects performed a picture-word interference task. Unexpectedly, pSTG stimulation did not affect the semantic interference effect but selectively increased the congruency effect (i.e., faster naming with congruent distractors). The facilitatory TMS effect selectively occurred in the more difficult list with an overall lower name agreement. Our study adds new evidence to the causal role of the left pSTG in the interaction between picture and distractor representations or processing streams, only partly supporting previous neuroimaging studies. Moreover, the observed unexpected condition-specific facilitatory rTMS effect argues for an interaction of the task- or stimulus-induced brain state with the modulatory TMS effect. These issues should be systematically addressed in future rTMS studies on language production.
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Affiliation(s)
- Vitória Piai
- Donders Centre for Cognition, Radboud University, Nijmegen, the Netherlands
- Department of Medical Psychology, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, the Netherlands
| | - Laura Nieberlein
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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13
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Fedorenko E, Blank IA, Siegelman M, Mineroff Z. Lack of selectivity for syntax relative to word meanings throughout the language network. Cognition 2020; 203:104348. [PMID: 32569894 PMCID: PMC7483589 DOI: 10.1016/j.cognition.2020.104348] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/14/2020] [Accepted: 05/31/2020] [Indexed: 12/31/2022]
Abstract
To understand what you are reading now, your mind retrieves the meanings of words and constructions from a linguistic knowledge store (lexico-semantic processing) and identifies the relationships among them to construct a complex meaning (syntactic or combinatorial processing). Do these two sets of processes rely on distinct, specialized mechanisms or, rather, share a common pool of resources? Linguistic theorizing, empirical evidence from language acquisition and processing, and computational modeling have jointly painted a picture whereby lexico-semantic and syntactic processing are deeply inter-connected and perhaps not separable. In contrast, many current proposals of the neural architecture of language continue to endorse a view whereby certain brain regions selectively support syntactic/combinatorial processing, although the locus of such "syntactic hub", and its nature, vary across proposals. Here, we searched for selectivity for syntactic over lexico-semantic processing using a powerful individual-subjects fMRI approach across three sentence comprehension paradigms that have been used in prior work to argue for such selectivity: responses to lexico-semantic vs. morpho-syntactic violations (Experiment 1); recovery from neural suppression across pairs of sentences differing in only lexical items vs. only syntactic structure (Experiment 2); and same/different meaning judgments on such sentence pairs (Experiment 3). Across experiments, both lexico-semantic and syntactic conditions elicited robust responses throughout the left fronto-temporal language network. Critically, however, no regions were more strongly engaged by syntactic than lexico-semantic processing, although some regions showed the opposite pattern. Thus, contra many current proposals of the neural architecture of language, syntactic/combinatorial processing is not separable from lexico-semantic processing at the level of brain regions-or even voxel subsets-within the language network, in line with strong integration between these two processes that has been consistently observed in behavioral and computational language research. The results further suggest that the language network may be generally more strongly concerned with meaning than syntactic form, in line with the primary function of language-to share meanings across minds.
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Affiliation(s)
- Evelina Fedorenko
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA; McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, USA.
| | - Idan Asher Blank
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA; Department of Psychology, UCLA, Los Angeles, CA 90095, USA
| | - Matthew Siegelman
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA; Department of Psychology, Columbia University, New York, NY 10027, USA
| | - Zachary Mineroff
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, USA; Eberly Center for Teaching Excellence & Educational Innovation, CMU, Pittsburgh, PA 15213, USA
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14
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Todorova L, Neville DA, Piai V. Lexical-semantic and executive deficits revealed by computational modelling: A drift diffusion model perspective. Neuropsychologia 2020; 146:107560. [DOI: 10.1016/j.neuropsychologia.2020.107560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 04/30/2020] [Accepted: 07/10/2020] [Indexed: 11/30/2022]
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15
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Abstract
Comparative studies on brain asymmetry date back to the 19th century but then largely disappeared due to the assumption that lateralization is uniquely human. Since the reemergence of this field in the 1970s, we learned that left-right differences of brain and behavior exist throughout the animal kingdom and pay off in terms of sensory, cognitive, and motor efficiency. Ontogenetically, lateralization starts in many species with asymmetrical expression patterns of genes within the Nodal cascade that set up the scene for later complex interactions of genetic, environmental, and epigenetic factors. These take effect during different time points of ontogeny and create asymmetries of neural networks in diverse species. As a result, depending on task demands, left- or right-hemispheric loops of feedforward or feedback projections are then activated and can temporarily dominate a neural process. In addition, asymmetries of commissural transfer can shape lateralized processes in each hemisphere. It is still unclear if interhemispheric interactions depend on an inhibition/excitation dichotomy or instead adjust the contralateral temporal neural structure to delay the other hemisphere or synchronize with it during joint action. As outlined in our review, novel animal models and approaches could be established in the last decades, and they already produced a substantial increase of knowledge. Since there is practically no realm of human perception, cognition, emotion, or action that is not affected by our lateralized neural organization, insights from these comparative studies are crucial to understand the functions and pathologies of our asymmetric brain.
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Affiliation(s)
- Onur Güntürkün
- Department of Biopsychology, Institute of Cognitive Neuroscience, Ruhr University Bochum, Bochum, Germany
| | - Felix Ströckens
- Department of Biopsychology, Institute of Cognitive Neuroscience, Ruhr University Bochum, Bochum, Germany
| | - Sebastian Ocklenburg
- Department of Biopsychology, Institute of Cognitive Neuroscience, Ruhr University Bochum, Bochum, Germany
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Recla M, Molteni E, Manfredi V, Arrigoni F, Nordio A, Galbiati S, Pastore V, Modat M, Strazzer S. Feasibility Randomized Trial for an Intensive Memory-Focused Training Program for School-Aged Children with Acquired Brain Injury. Brain Sci 2020; 10:E430. [PMID: 32645968 PMCID: PMC7407971 DOI: 10.3390/brainsci10070430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Memory deficits are common sequelae of pediatric Acquired Brain Injury (ABI). Only methods for non-focused cognitive remediation are available to the pediatric field. The aims of this feasibility trial are the description, implementation, and test of an intensive program specific to the training and re-adaptation of memory function in children, called Intensive Memory-Focused Training Program (IM-FTP); (2) Methods: Eleven children and adolescents with ABI (mean age at injury = 12.2 years, brain tumor survivors excluded) were clinically assessed and rehabilitated over 1-month through IM-FTP, including physio-kinesis/occupational, speech, and neuropsychology treatments. Each patient received a psychometric evaluation and a brain functional MRI at enrollment and at discharge. Ten pediatric controls with ABI (mean age at injury = 13.8 years) were clinically assessed, and rehabilitated through a standard program; (3) Results: After treatment, both groups had marked improvement in both immediate and delayed recall. IM-FTP was associated with better learning of semantically related and unrelated words, and larger improvement in immediate recall in prose memory. Imaging showed functional modification in the left frontal inferior cortex; (4) Conclusions: We described an age-independent reproducible multidisciplinary memory-focused rehabilitation protocol, which can be adapted to single patients while preserving inter-subject comparability, and is applicable up to a few months after injury. IM-FTP will now be employed in a powered clinical trial.
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Affiliation(s)
- Monica Recla
- Neurophysiatric Department, Neuropsychological and Cognitive-behavioral Service, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy; (V.M.); (S.G.); (V.P.)
| | - Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, and Centre for Medical Engineering, King’s College, London SE1 7EU, UK; (E.M.); (M.M.)
| | - Valentina Manfredi
- Neurophysiatric Department, Neuropsychological and Cognitive-behavioral Service, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy; (V.M.); (S.G.); (V.P.)
| | - Filippo Arrigoni
- Neuroimaging Lab, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy; (F.A.); (A.N.)
| | - Andrea Nordio
- Neuroimaging Lab, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy; (F.A.); (A.N.)
| | - Susanna Galbiati
- Neurophysiatric Department, Neuropsychological and Cognitive-behavioral Service, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy; (V.M.); (S.G.); (V.P.)
| | - Valentina Pastore
- Neurophysiatric Department, Neuropsychological and Cognitive-behavioral Service, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy; (V.M.); (S.G.); (V.P.)
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, and Centre for Medical Engineering, King’s College, London SE1 7EU, UK; (E.M.); (M.M.)
| | - Sandra Strazzer
- Neurophysiatric Department, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy;
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17
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Zhang Z, Zhou X, Liu J, Qin L, Ye W, Zheng J. Aberrant executive control networks and default mode network in patients with right-sided temporal lobe epilepsy: a functional and effective connectivity study. Int J Neurosci 2019; 130:683-693. [PMID: 31851554 DOI: 10.1080/00207454.2019.1702545] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: We aimed to explore functional connectivity (FC) and effective connectivity (EC) of the executive control networks (ECNs) and the default mode network (DMN) in patients with right-sided TLE (rTLE) by applying independent component analysis (ICA) and Granger causal analysis (GCA).Methods: Twenty-seven patients with rTLE and 20 healthy controls (HCs) matched for age, gender underwent resting-state functional magnetic resonance imaging and Attention Network Test (ANT).Results: The FC analysis showed compared to HCs, patients with rTLE demonstrated reduced FC strength in the right inferior parietal gyrus (IPG) and the right middle temporal gyrus (MTG). The left superior temporal gyrus (STG) displayed reduced FC values whereas the left thalamus revealed increased FC values in rTLE. ROI-wise GCA revealed that patients with rTLE displayed increased EC from the left thalamus to the left STG, and as well as enhanced EC from the right IPG to the right MTG compared to HCs. Voxel-wise GCA showed positive EC from the left thalamus to the left insula while the right middle occipital gyrus (MOG) exhibited increased EC to the right MTG in patients. The ANT results demonstrated executive dysfunction in patients compared to HCs. The increased FC in the left thalamus showed a negative association with ECF in patients.Conclusion: We speculated that recurrent seizures take effect on disruption among the brain networks, and self-modulation occurs simultaneously to compensate for cognitive decline. Our findings revealed new insights on the neuropathophysiological mechanisms of rTLE.
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Affiliation(s)
- Zhao Zhang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinping Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lu Qin
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Ye
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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