Going off the rails: Impaired coherence in the speech of patients with semantic control deficits

Anterior connectivity critical for recovery of connected speech after stroke

Connected speech recovers to different degrees across people after left hemisphere stroke, but white matter predictors of differential recovery from the acute stage of stroke are unknown. We assessed changes in lexical-syntactic aspects of connected speech in a longitudinal analysis of 40 individuals (18 females) from the acute stage of left hemisphere stroke (within an average of 4 days post-stroke) to subacute (within 2 months) and chronic stages (early: 6 months, late: 1 year) while measuring the extent of acute lesions on white matter tracts to identify tracts predictive of recovery. We found that acute damage to the frontal aslant tract led to a decreased recovery of the fluency and structural complexity of connected speech during the year following left hemisphere stroke. The results were independent of baseline performance, overall lesion volume and the proportion of damage to tract-adjacent grey matter. This longitudinal analysis from acute to chronic stroke provides the first evidence that recovery of fluent and structurally complex spontaneous connected speech requires intact left frontal connectivity via the frontal aslant tract. That the frontal aslant tract was critical for recovery at early as well as later stages of stroke demonstrates that anterior connectivity plays a lasting and important role for the reorganization of function related to the successful production of connected speech.

The cognitive and neural underpinnings of discourse coherence in post-stroke aphasia

Although impaired discourse production is one of the prominent features of aphasia, only a handful of investigations have addressed the cognitive, linguistic and neural processes that support the production of coherent discourse. In this study, we investigated the cognitive and neural correlates of discourse coherence in a large mixed cohort of patients with post-stroke aphasia, including the first voxel-based lesion-symptom mapping of coherence deficits. Discourse responses using different tasks were collected from 46 patients with post-stroke aphasia, including a wide range of classifications and severity levels, and 20 matched neuro-typical controls. Global coherence, defined as the degree to which utterances related to the expected topic of discourse, was estimated using a previously validated computational linguistic approach. Coherence was then related to fundamental language and cognitive components in aphasia identified using an extensive neuropsychological battery. Relative to neuro-typical controls, patients with aphasia exhibited impaired coherence, and their ability to maintain coherent discourse was related to their performance on other language components: phonological production, fluency and semantic processing, rather than executive functions or motor speech. These results suggest that impairments in core language components play a role in reducing discourse coherence in post-stroke aphasia. Whole-brain voxel-wise lesion-symptom mapping using univariate and multivariate approaches identified the contribution of the left prefrontal cortex, and particularly the inferior frontal gyrus (pars triangularis), to discourse coherence. These findings provide convergent evidence for the role of the inferior frontal gyrus in maintaining discourse coherence, which is consistent with the established role of this region in producing connected speech and semantic control (organizing and selecting appropriate context-relevant concepts). These results make an important contribution to understanding the root causes of disrupted discourse production in post-stroke aphasia.

Progressive changes in descriptive discourse in First Episode Schizophrenia: a longitudinal computational semantics study

Computational semantics, a branch of computational linguistics, involves automated meaning analysis that relies on how words occur together in natural language. This offers a promising tool to study schizophrenia. At present, we do not know if these word-level choices in speech are sensitive to the illness stage (i.e., acute untreated vs. stable established state), track cognitive deficits in major domains (e.g., cognitive control, processing speed) or relate to established dimensions of formal thought disorder. In this study, we collected samples of descriptive discourse in patients experiencing an untreated first episode of schizophrenia and healthy control subjects (246 samples of 1-minute speech; n = 82, FES = 46, HC = 36) and used a co-occurrence based vector embedding of words to quantify semantic similarity in speech. We obtained six-month follow-up data in a subsample (99 speech samples, n = 33, FES = 20, HC = 13). At baseline, semantic similarity was evidently higher in patients compared to healthy individuals, especially when social functioning was impaired; but this was not related to the severity of clinically ascertained thought disorder in patients. Across the study sample, higher semantic similarity at baseline was related to poorer Stroop performance and processing speed. Over time, while semantic similarity was stable in healthy subjects, it increased in patients, especially when they had an increasing burden of negative symptoms. Disruptions in word-level choices made by patients with schizophrenia during short 1-min descriptions are sensitive to interindividual differences in cognitive and social functioning at first presentation and persist over the early course of the illness.

Validated measures of semantic knowledge and semantic control: normative data from young and older adults for more than 300 semantic judgements

Recent studies suggest that knowledge representations and control processes are the two key components underpinning semantic cognition, and are also crucial indicators of the shifting cognitive architecture of semantics in later life. Although there are many standardized assessments that provide measures of the quantity of semantic knowledge participants possess, normative data for tasks that probe semantic control processes are not yet available. Here, we present normative data from more than 200 young and older participants on a large set of stimuli in two semantic tasks, which probe controlled semantic processing (feature-matching task) and semantic knowledge (synonym judgement task). We verify the validity of our norms by replicating established age- and psycholinguistic-property-related effects on semantic cognition. Specifically, we find that older people have more detailed semantic knowledge than young people but have less effective semantic control processes. We also obtain expected effects of word frequency and inter-item competition on performance. Parametrically varied difficulty levels are defined for half of the stimuli based on participants' behavioural performance, allowing future studies to produce customized sets of experimental stimuli based on our norms. We provide all stimuli, data and code used for analysis, in the hope that they are useful to other researchers.

Similar Neural Networks Respond to Coherence during Comprehension and Production of Discourse

When comprehending discourse, listeners engage default-mode regions associated with integrative semantic processing to construct a situation model of its content. We investigated how similar networks are engaged when we produce, as well as comprehend, discourse. During functional magnetic resonance imaging, participants spoke about a series of specific topics and listened to discourse on other topics. We tested how activation was predicted by natural fluctuations in the global coherence of the discourse, that is, the degree to which utterances conformed to the expected topic. The neural correlates of coherence were similar across speaking and listening, particularly in default-mode regions. This network showed greater activation when less coherent speech was heard or produced, reflecting updating of mental representations when discourse did not conform to the expected topic. In contrast, regions that exert control over semantic activation showed task-specific effects, correlating negatively with coherence during listening but not during production. Participants who showed greater activation in left inferior prefrontal cortex also produced more coherent discourse, suggesting a specific role for this region in goal-directed regulation of speech content. Results suggest strong correspondence of discourse representations during speaking and listening. However, they indicate that the semantic control network plays different roles in comprehension and production.