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Lukic S, Fan Z, García AM, Welch AE, Ratnasiri BM, Wilson SM, Henry ML, Vonk J, Deleon J, Miller BL, Miller Z, Mandelli ML, Gorno-Tempini ML. Discriminating nonfluent/agrammatic and logopenic PPA variants with automatically extracted morphosyntactic measures from connected speech. Cortex 2024; 173:34-48. [PMID: 38359511 PMCID: PMC11246552 DOI: 10.1016/j.cortex.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/15/2023] [Accepted: 12/12/2023] [Indexed: 02/17/2024]
Abstract
Morphosyntactic assessments are important for characterizing individuals with nonfluent/agrammatic variant primary progressive aphasia (nfvPPA). Yet, standard tests are subject to examiner bias and often fail to differentiate between nfvPPA and logopenic variant PPA (lvPPA). Moreover, relevant neural signatures remain underexplored. Here, we leverage natural language processing tools to automatically capture morphosyntactic disturbances and their neuroanatomical correlates in 35 individuals with nfvPPA relative to 10 healthy controls (HC) and 26 individuals with lvPPA. Participants described a picture, and ensuing transcripts were analyzed via part-of-speech tagging to extract sentence-related features (e.g., subordinating and coordinating conjunctions), verbal-related features (e.g., tense markers), and nominal-related features (e.g., subjective and possessive pronouns). Gradient boosting machines were used to classify between groups using all features. We identified the most discriminant morphosyntactic marker via a feature importance algorithm and examined its neural correlates via voxel-based morphometry. Individuals with nfvPPA produced fewer morphosyntactic elements than the other two groups. Such features robustly discriminated them from both individuals with lvPPA and HCs with an AUC of .95 and .82, respectively. The most discriminatory feature corresponded to subordinating conjunctions was correlated with cortical atrophy within the left posterior inferior frontal gyrus across groups (pFWE < .05). Automated morphosyntactic analysis can efficiently differentiate nfvPPA from lvPPA. Also, the most sensitive morphosyntactic markers correlate with a core atrophy region of nfvPPA. Our approach, thus, can contribute to a key challenge in PPA diagnosis.
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Affiliation(s)
- Sladjana Lukic
- University of California, San Francisco Memory and Aging Center, CA, USA; Ruth S. Ammon College of Education and Health Sciences, Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY, USA.
| | - Zekai Fan
- Heinz College of Information Systems and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Adolfo M García
- Global Brain Health Institute (GBHI), University of California, San Francisco, CA, USA; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Ariane E Welch
- Ruth S. Ammon College of Education and Health Sciences, Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY, USA
| | | | - Stephen M Wilson
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Maya L Henry
- University of Texas at Austin Moody College of Communication, Austin, TX, USA
| | - Jet Vonk
- University of California, San Francisco Memory and Aging Center, CA, USA
| | - Jessica Deleon
- University of California, San Francisco Memory and Aging Center, CA, USA
| | - Bruce L Miller
- University of California, San Francisco Memory and Aging Center, CA, USA
| | - Zachary Miller
- University of California, San Francisco Memory and Aging Center, CA, USA
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Jebahi F, Nickels KV, Kielar A. Patterns of performance on the animal fluency task in logopenic variant of primary progressive aphasia: A reflection of phonological and semantic skills. JOURNAL OF COMMUNICATION DISORDERS 2024; 108:106405. [PMID: 38324949 DOI: 10.1016/j.jcomdis.2024.106405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE This study aimed to characterize the quantitative (total number of correct words generated) and qualitative (psycholinguistic properties of correct words generated) performance patterns on the animal fluency task in individuals with the logopenic variant of primary progressive aphasia and to investigate the influence of phonological and semantic abilities to these patterns. METHODS Fifteen participants with lvPPA and twenty neurotypical adults completed the animal fluency task and an assessment battery to characterize their phonological and semantic abilities. We recorded the total number of correct words produced and their psycholinguistic properties. Group differences were analyzed using independent samples t-tests and analysis of covariance. Stepwise and multiple linear regression analyses were implemented to investigate the contribution of psycholinguistic properties on word generation as well as the role of phonological and semantic abilities on performance. We also investigated the mediating role of phonological and semantic abilities on the relationship between relevant psycholinguistic properties and word generation output. RESULTS Compared to neurotypical controls, participants with lvPPA produced fewer correct responses and more words with lower age of acquisition. The total number of correct words generated was predicted by the age of word acquisition, such that individuals who generated more responses, produced words acquired later in life. Phonology and semantics influenced the number of correct words generated and their frequency, age of acquisition, and semantic neighborhood density. Familiarity and arousal were driven by semantic abilities. Phonological abilities partially mediated the relationship between age of acquisition and word generation output. CONCLUSIONS This study provides valuable insights into the performance patterns of the animal fluency task in lvPPA. Individuals with lvPPA with more intact phonological and semantic abilities generated greater number of words with more complex psycholinguistic properties. Our findings contribute to the understanding of language processes underlying word retrieval in lvPPA.
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Affiliation(s)
- Fatima Jebahi
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA.
| | - Katlyn V Nickels
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
| | - Aneta Kielar
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA
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Quique YM, Gnanateja GN, Dickey MW, Evans WS, Chandrasekaran B. Examining cortical tracking of the speech envelope in post-stroke aphasia. Front Hum Neurosci 2023; 17:1122480. [PMID: 37780966 PMCID: PMC10538638 DOI: 10.3389/fnhum.2023.1122480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction People with aphasia have been shown to benefit from rhythmic elements for language production during aphasia rehabilitation. However, it is unknown whether rhythmic processing is associated with such benefits. Cortical tracking of the speech envelope (CTenv) may provide a measure of encoding of speech rhythmic properties and serve as a predictor of candidacy for rhythm-based aphasia interventions. Methods Electroencephalography was used to capture electrophysiological responses while Spanish speakers with aphasia (n = 9) listened to a continuous speech narrative (audiobook). The Temporal Response Function was used to estimate CTenv in the delta (associated with word- and phrase-level properties), theta (syllable-level properties), and alpha bands (attention-related properties). CTenv estimates were used to predict aphasia severity, performance in rhythmic perception and production tasks, and treatment response in a sentence-level rhythm-based intervention. Results CTenv in delta and theta, but not alpha, predicted aphasia severity. Neither CTenv in delta, alpha, or theta bands predicted performance in rhythmic perception or production tasks. Some evidence supported that CTenv in theta could predict sentence-level learning in aphasia, but alpha and delta did not. Conclusion CTenv of the syllable-level properties was relatively preserved in individuals with less language impairment. In contrast, higher encoding of word- and phrase-level properties was relatively impaired and was predictive of more severe language impairments. CTenv and treatment response to sentence-level rhythm-based interventions need to be further investigated.
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Affiliation(s)
- Yina M. Quique
- Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - G. Nike Gnanateja
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
| | - Michael Walsh Dickey
- VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Bharath Chandrasekaran
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, United States
- Roxelyn and Richard Pepper Department of Communication Science and Disorders, School of Communication. Northwestern University, Evanston, IL, United States
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Sun R, Li X, Zhu Z, Li T, Zhao M, Mo L, Li W, Xi X, Huang P, Gong W. Effects of dual-task training in patients with post-stroke cognitive impairment: A randomized controlled trial. Front Neurol 2022; 13:1027104. [PMID: 36353135 PMCID: PMC9639668 DOI: 10.3389/fneur.2022.1027104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background Evidence for the efficacy of cognitive-motor dual-task (CMDT) training in patients with post-stroke cognitive impairment (PSCI) and no dementia is still lacking. More importantly, although some studies on the cognitive effect of CMDT training show an improvement in cognitive performance, the results are still controversial, and the intervention mechanism of CMDT training on cognitive function improvement is not clear. The main purpose of this study was to analyze the effects of CMDT training on cognitive function, neuron electrophysiology, and frontal lobe hemodynamics in patients with PSCI. Methods Here we tested the effects of CMDT training on cognitive function in PSCI patients. Forty subjects who met the criteria of PSCI were randomly assigned to control and experimental groups. CMDT training or cognitive task (CT) training was administered to each patient in the experimental and control groups, respectively. All subjects performed Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale before and after the intervention, and the event-related potentials (ERP) and functional near-infrared spectroscopy (fNIRS) were used to evaluate the changes in neuron electrophysiology and hemodynamics. Results Forty patients were randomized across Beijing Rehabilitation Hospital Capital Medical University in Beijing. At the end of the intervention, 33 subjects completed the experimental process. The CMDT group showed significant improvement in the MMSE (P = 0.01) and MoCA (P = 0.024) relative to the CT group. The results of ERP and fNIRS showed that CMDT training could shorten the latency of P300 (P = 0.001) and the peak time of oxygenated hemoglobin (P = 0.004). The results showed that CMDT training shortened the response time of central neurons and significantly increased the rate of oxygen supply to the frontal lobe. Conclusion CMDT training in patients with PSCI improved global cognitive function, which was supported by the improved neural efficiency of associated brain areas. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2000034862.
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Affiliation(s)
- Ruifeng Sun
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Xiaoling Li
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Ziman Zhu
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Tiancong Li
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Man Zhao
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Linhong Mo
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Wenshan Li
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Xiaoshuang Xi
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Peiling Huang
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Weijun Gong
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
- *Correspondence: Weijun Gong
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Carthery-Goulart MT, de Oliveira R, de Almeida IJ, Campanha A, da Silva Souza D, Zana Y, Caramelli P, Machado TH. Sentence Comprehension in Primary Progressive Aphasia: A Study of the Application of the Brazilian Version of the Test for the Reception of Grammar (TROG2-Br). Front Neurol 2022; 13:815227. [PMID: 35651345 PMCID: PMC9149594 DOI: 10.3389/fneur.2022.815227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Sentence-comprehension deficits have been described in patients with primary progressive aphasia (PPA). However, most instruments to address this domain in more detail and in a clinical context have not been adapted and translated into several languages, posing limitations to clinical practice and cross-language research. Objectives The study aimed to (1) test the applicability of the Brazilian version of the Test for Reception of Grammar (TROG2-Br) to detect morphosyntactic deficits in patients with PPA; (2) investigate the association between performance in the test and sociodemographic and clinical variables (age, years of formal education, and disease duration); (3) characterize the performance of individuals presenting with the three more common variants of PPA (non-fluent, semantic, and logopenic) and mixed PPA (PPA-Mx) and analyze whether TROG-2 may assist in the distinction of these clinical profiles. Methods A total of 74 cognitively healthy participants and 34 individuals diagnosed with PPA were assessed with TROG2-Br. Overall scores (correct items, passed blocks), types, and categories of errors were analyzed. Results In controls, block scores were significantly correlated with years of formal education (Spearman's r = 0.33, p = 004) but not with age. In PPA, age, education, and disease duration were not significantly associated with performance in the test. Controls presented a significantly higher performance on TROG2-Br compared to PPA individuals and their errors pattern pointed to mild general cognitive processing difficulties (attention, working memory). PPA error types pointed to processing and morphosyntactic deficits in nonfluent or agrammatic PPA, (PPA-NF/A), logopenic PPA (PPA-L), and PPA-Mx. The semantic PPA (PPA-S) subgroup was qualitatively more similar to controls (processing difficulties and lower percentage of morphosyntactic errors). TROG2-Br presented good internal consistency and concurrent validity. Discussion Our results corroborate findings with TROG-2 in other populations. The performance of typical older adults with heterogeneous levels of education is discussed along with recommendations for clinical use of the test and future directions of research.
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Affiliation(s)
- Maria Teresa Carthery-Goulart
- Federal University of ABC (UFABC), Mathematics, Computing and Cognition Center (CMCC), São Bernardo do Campo, Brazil.,INCT-ECCE (Instituto Nacional de Ciência e Tecnologia sobre Comportamento, Cognição e Ensino), São Carlos, Brazil.,Cognitive and Behavioral Neurology Research Group of the Department of Neurology of the University of São Paulo (USP), School of Medicine, São Paulo, Brazil
| | - Rosimeire de Oliveira
- Federal University of ABC (UFABC), Mathematics, Computing and Cognition Center (CMCC), São Bernardo do Campo, Brazil
| | - Isabel Junqueira de Almeida
- Cognitive and Behavioral Neurology Research Group of the Department of Neurology of the University of São Paulo (USP), School of Medicine, São Paulo, Brazil
| | - Aline Campanha
- Cognitive and Behavioral Neurology Research Group, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Dayse da Silva Souza
- Federal University of ABC (UFABC), Mathematics, Computing and Cognition Center (CMCC), São Bernardo do Campo, Brazil
| | - Yossi Zana
- Federal University of ABC (UFABC), Mathematics, Computing and Cognition Center (CMCC), São Bernardo do Campo, Brazil
| | - Paulo Caramelli
- Cognitive and Behavioral Neurology Research Group, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Thais Helena Machado
- Cognitive and Behavioral Neurology Research Group, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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Chiappetta B, Patel AD, Thompson CK. Musical and linguistic syntactic processing in agrammatic aphasia: An ERP study. JOURNAL OF NEUROLINGUISTICS 2022; 62:101043. [PMID: 35002061 PMCID: PMC8740885 DOI: 10.1016/j.jneuroling.2021.101043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Language and music rely on complex sequences organized according to syntactic principles that are implicitly understood by enculturated listeners. Across both domains, syntactic processing involves predicting and integrating incoming elements into higher-order structures. According to the Shared Syntactic Integration Resource Hypothesis (SSIRH; Patel, 2003), musical and linguistic syntactic processing rely on shared resources for integrating incoming elements (e.g., chords, words) into unfolding sequences. One prediction of the SSIRH is that people with agrammatic aphasia (whose deficits are due to syntactic integration problems) should present with deficits in processing musical syntax. We report the first neural study to test this prediction: event-related potentials (ERPs) were measured in response to musical and linguistic syntactic violations in a group of people with agrammatic aphasia (n=7) compared to a group of healthy controls (n=14) using an acceptability judgement task. The groups were matched with respect to age, education, and extent of musical training. Violations were based on morpho-syntactic relations in sentences and harmonic relations in chord sequences. Both groups presented with a significant P600 response to syntactic violations across both domains. The aphasic participants presented with a reduced-amplitude posterior P600 compared to the healthy adults in response to linguistic, but not musical, violations. Participants with aphasia did however present with larger frontal positivities in response to violations in both domains. Intriguingly, extent of musical training was associated with larger posterior P600 responses to syntactic violations of language and music in both groups. Overall, these findings are not consistent with the predictions of the SSIRH, and instead suggest that linguistic, but not musical, syntactic processing may be selectively impaired in stroke-induced agrammatic aphasia. However, the findings also suggest a relationship between musical training and linguistic syntactic processing, which may have clinical implications for people with aphasia, and motivates more research on the relationship between these two domains.
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Affiliation(s)
- Brianne Chiappetta
- Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Aniruddh D. Patel
- Department of Psychology, Tufts University, Medford, MA, USA
- Program in Brain, Mind, and Consciousness, Canadian Institute for Advanced Research (CIFAR), Toronto, ON, CA
| | - Cynthia K. Thompson
- Aphasia and Neurolinguistics Research Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, USA
- Department of Neurology, Northwestern University, Chicago, IL, USA
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Manouilidou C, Nerantzini M, Chiappetta BM, Mesulam MM, Thompson CK. What Language Disorders Reveal About the Mechanisms of Morphological Processing. Front Psychol 2021; 12:701802. [PMID: 34912261 PMCID: PMC8667867 DOI: 10.3389/fpsyg.2021.701802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
We addressed an understudied topic in the literature of language disorders, that is, processing of derivational morphology, a domain which requires integration of semantic and syntactic knowledge. Current psycholinguistic literature suggests that word processing involves morpheme recognition, which occurs immediately upon encountering a complex word. Subsequent processes take place in order to interpret the combination of stem and affix. We investigated the abilities of individuals with agrammatic (PPA-G) and logopenic (PPA-L) variants of primary progressive aphasia (PPA) and individuals with stroke-induced agrammatic aphasia (StrAg) to process pseudowords which violate either the syntactic (word class) rules (*reheavy) or the semantic compatibility (argument structure specifications of the base form) rules (*reswim). To this end, we quantified aspects of word knowledge and explored how the distinct deficits of the populations under investigation affect their performance. Thirty brain-damaged individuals and 10 healthy controls participated in a lexical decision task. We hypothesized that the two agrammatic groups (PPA-G and StrAg) would have difficulties detecting syntactic violations, while no difficulties were expected for PPA-L. Accuracy and Reaction Time (RT) patterns indicated: the PPA-L group made fewer errors but yielded slower RTs compared to the two agrammatic groups which did not differ from one another. Accuracy rates suggest that individuals with PPA-L distinguish *reheavy from *reswim, reflecting access to and differential processing of syntactic vs. semantic violations. In contrast, the two agrammatic groups do not distinguish between *reheavy and *reswim. The lack of difference stems from a particularly impaired performance in detecting syntactic violations, as they were equally unsuccessful at detecting *reheavy and *reswim. Reduced grammatical abilities assessed through language measures are a significant predictor for this performance, suggesting that the "hardware" to process syntactic information is impaired. Therefore, they can only judge violations semantically where both *reheavy and *reswim fail to pass as semantically ill-formed. This finding further suggests that impaired grammatical knowledge can affect word level processing as well. Results are in line with the psycholinguistic literature which postulates the existence of various stages in accessing complex pseudowords, highlighting the contribution of syntactic/grammatical knowledge. Further, it points to the worth of studying impaired language performance for informing normal language processes.
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Affiliation(s)
- Christina Manouilidou
- Department of Comparative and General Linguistics, University of Ljubljana, Ljubljana, Slovenia
| | | | - Brianne M. Chiappetta
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - M. Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Cynthia K. Thompson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
- Department of Neurology, Northwestern University, Chicago, IL, United States
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Stalpaert J, Cocquyt EM, Miatton M, Sieben A, Van Langenhove T, van Mierlo P, De Letter M. A case series of verbal semantic processing in primary progressive aphasia: Evidence from the N400 effect. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1165-1189. [PMID: 34357662 DOI: 10.1111/1460-6984.12658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/15/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The semantic variant of primary progressive aphasia (PPA) is typically associated with a loss of semantic knowledge. Research on the semantic processing in the other clinical variants of PPA is, however, rather sparse and limited to off-line behavioural studies. AIMS This study aimed to investigate verbal semantic processing in patients with the three variants of PPA by the event-related potential technique. The presence, latency, amplitude and/or topographic distribution of the N400 effect may be helpful in the diagnosis of PPA and its clinical variants and it provides temporal information about semantic processing (disturbances) in the three variants of PPA. METHODS & PROCEDURES The N400 effect was studied by a categorical word-priming paradigm and a semantic-anomaly paradigm at sentence level in eight persons with PPA(-plus) and 30 age-matched healthy controls. The mean amplitudes and onset latencies of the N400 effect were compared between each patient and the control group by two methods that are applicable in clinical practice, namely visual inspection and Z-scores. OUTCOMES & RESULTS The N400 effect elicited by the categorical-priming paradigm was only present in the two patients with the non-fluent variant of PPA. This effect was absent in the two patients with the semantic variant(-plus), two patients with the logopenic variant(-plus), one patient with the non-fluent variant-plus, and the patient with PPA not otherwise specified. The results of the N400 effect elicited by the semantic-anomaly task at the sentence level were variable, but differences in the presence, mean amplitudes, onset latencies and/or topographic distributions of the effect were found in all patients with PPA(-plus) in comparison with the control group. CONCLUSIONS & IMPLICATIONS The results of our study showed that the evaluation of the N400 effect might have an added value in the diagnostic process of PPA in general and in the differentiation of patients with the non-fluent variant from patients with the logopenic and semantic variants. Furthermore, our results indicate the presence of difficulties with retrieving stored semantic knowledge or semantic integration of a word in the preceding context in patients with the three variants of PPA. These findings might help the speech-language pathologist in determining individualized therapy goals and indicate that it might be helpful to focus on verbal semantic processing in language therapy in patients with the three variants of PPA and not only in patients with the semantic variant. WHAT THIS PAPER ADDS What is already known on the subject The semantic variant of PPA is characterized by an impaired object knowledge and single-word comprehension and these functions are relatively spared in the non-fluent and logopenic variants following the guidelines of Gorno-Tempini et al. (2011). Research on the semantic processing in patients with the non-fluent and logopenic variant is, however, rather sparse and limited to off-line behavioural studies. Only four group studies investigated verbal semantic processing by the N400 effect, and these studies indicate disturbances in the three variants of PPA. What this paper adds to existing knowledge Our results indicate the presence of difficulties with retrieving stored semantic knowledge or semantic integration of a word in the preceding context during a semantic-priming paradigm in patients with the semantic and logopenic variants of PPA and during a semantic-anomaly task at the sentence level in patients with the three variants of PPA. What are the potential or actual clinical implications of this work? The results of our study showed that the evaluation of the N400 effect might have an added value in the diagnostic process of PPA in general and in the differentiation of patients with the non-fluent variant from patients with the logopenic and semantic variants. The evaluation of the N400 effect might also help the speech-language pathologist in determining individualized therapy goals and indicate that it might be helpful to focus on verbal semantic processing in language therapy in patients with the three variants of PPA and not only in patients with the semantic variant.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Anne Sieben
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | | | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Lukic S, Borghesani V, Weis E, Welch A, Bogley R, Neuhaus J, Deleon J, Miller ZA, Kramer JH, Miller BL, Dronkers NF, Gorno-Tempini ML. Dissociating nouns and verbs in temporal and perisylvian networks: Evidence from neurodegenerative diseases. Cortex 2021; 142:47-61. [PMID: 34182153 PMCID: PMC8556704 DOI: 10.1016/j.cortex.2021.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/27/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022]
Abstract
Naming of nouns and verbs can be selectively impaired in neurological disorders, but the specificity of the neural and cognitive correlates of such dissociation remains unclear. Functional imaging and stroke research sought to identify cortical regions selectively recruited for nouns versus verbs, yet findings are inconsistent. The present study investigated this issue in neurodegenerative diseases known to selectively affect different brain networks, thus providing new critical evidence of network specificity. We examined naming performances on nouns and verbs in 146 patients with different neurodegenerative syndromes (Primary Progressive Aphasia - PPA, Alzheimer's disease - AD, and behavioral variant Frontotemporal Dementia - FTD) and 30 healthy adults. We then correlated naming scores with MRI-derived cortical thickness values as well as with performances in semantic and syntactic tasks, across all subjects. Results indicated that patients with the semantic variant PPA named significantly fewer nouns than verbs. Instead, nonfluent/agrammatic PPA patients named fewer verbs than nouns. Across all subjects, performance on nouns (adjusted for verbs) specifically correlated with cortical atrophy in left anterior temporal regions, and performance on verbs (adjusted for nouns) with atrophy in left inferior and middle frontal, inferior parietal and posterior temporal regions. Furthermore, lower lexical-semantic abilities correlated with deficits in naming both nouns and verbs, while lower syntactic abilities only correlated with naming verbs. Our results show that different neural and cognitive mechanisms underlie naming of specific grammatical categories in neurodegenerative diseases. Importantly, our findings showed that verb processing depends on a widespread perisylvian networks, suggesting that some regions might be involved in processing different types of action knowledge. These findings have important implications for early differential diagnosis of neurodegenerative disorders.
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Affiliation(s)
- Sladjana Lukic
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.
| | - Valentina Borghesani
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Elizabeth Weis
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Ariane Welch
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Rian Bogley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - John Neuhaus
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Jessica Deleon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Nina F Dronkers
- University of California, Berkeley, CA, USA; University of California, Davis, CA, USA
| | - Maria L Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
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