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Camerino I, Ferreira J, Vonk JM, Kessels RPC, de Leeuw FE, Roelofs A, Copland D, Piai V. Systematic Review and Meta-Analyses of Word Production Abilities in Dysfunction of the Basal Ganglia: Stroke, Small Vessel Disease, Parkinson's Disease, and Huntington's Disease. Neuropsychol Rev 2024; 34:1-26. [PMID: 36564612 DOI: 10.1007/s11065-022-09570-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 10/13/2022] [Accepted: 11/16/2022] [Indexed: 12/25/2022]
Abstract
Clinical populations with basal ganglia pathologies may present with language production impairments, which are often described in combination with comprehension measures or attributed to motor, memory, or processing-speed problems. In this systematic review and meta-analysis, we studied word production in four (vascular and non-vascular) pathologies of the basal ganglia: stroke affecting the basal ganglia, small vessel disease, Parkinson's disease, and Huntington's disease. We compared scores of these clinical populations with those of matched cognitively unimpaired adults on four well-established production tasks, namely picture naming, category fluency, letter fluency, and past-tense verb inflection. We conducted a systematic search in PubMed and PsycINFO with terms for basal ganglia structures, basal ganglia disorders and language production tasks. A total of 114 studies were included, containing results for one or more of the tasks of interest. For each pathology and task combination, effect sizes (Hedges' g) were extracted comparing patient versus control groups. For all four populations, performance was consistently worse than that of cognitively unimpaired adults across the four language production tasks (p-values < 0.010). Given that performance in picture naming and verb inflection across all pathologies was quantified in terms of accuracy, our results suggest that production impairments cannot be fully explained by motor or processing-speed deficits. Our review shows that while language production difficulties in these clinical populations are not negligible, more evidence is necessary to determine the exact mechanism that leads to these deficits and whether this mechanism is the same across different pathologies.
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Affiliation(s)
- Ileana Camerino
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
| | - João Ferreira
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands.
| | - Jet M Vonk
- Department of Neurology, Memory and Aging Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roy P C Kessels
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Centre for Medical Neuroscience, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Centre for Medical Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ardi Roelofs
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
| | - David Copland
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, QLD, Australia
- Queensland Aphasia Research Centre, The University of Queensland, Herston, QLD, Australia
| | - Vitória Piai
- Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
- Donders Centre for Medical Neuroscience, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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Torres K, Singleton M. Analyses of correct responses and errors on measures of verbal fluency among Parkinson's disease and essential tremor patients. Clin Neuropsychol 2023; 37:1479-1497. [PMID: 36550679 DOI: 10.1080/13854046.2022.2157885] [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: 07/31/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Objective: Parkinson's disease (PD) and essential tremor (ET) involve neuroanatomical circuitry that impact frontal lobe functioning, via the striatum and cerebellum, respectively. The aim of this exploratory study was to investigate quantitative and qualitative performance between and within these groups on measures of verbal fluency. Method: Sixty-three PD and 53 ET patients completed neuropsychological testing. Linear regression models with robust variance estimation compared verbal fluency performance between groups related to correct responses and errors. Paired t-tests investigated within group error rates. Results: PD patients gave more correct responses for phonological (β ̂ =5.3, p=.01) and category fluency (β ̂ =4.1, p=.01) than ET patients; however, when processing speed was added as a covariate, this attenuated performance on both measures and only phonological fluency remained significant (β ̂ =4.0, p=.04). There were no statistical differences in error scores between groups. Error rates within groups suggested that PD patients had higher error rates in total errors and perseveration errors on phonological fluency (M = 2.6, p=.00; M = 1.6, p=.00) and higher total errors and set-loss error rates on category switching (M = 5.1, p<.001; M = 4.1, p<.001). ET patients had higher error rate with relation to total errors and set-loss errors on phonological fluency (M = 2.5, p=.00; M = 1.5, p=.02) and category switching (M = 3.9, p=,00; M = 3.9, p<.001). Conclusions: PD patients performed better than ET patients on phonological fluency. PD patients appear to make more perseveration errors on phonological fluency, while ET patients made more set-loss errors. Implications for frontal lobe dysfunction and clinical impact are discussed.
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Affiliation(s)
- Karen Torres
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Michael Singleton
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
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Horne KS, Ceslis A, Mosley P, Adam R, Robinson GA. The Role of Apathy in Spontaneous Verbal and Nonverbal Behaviors: A Transdiagnostic Pilot Study in Neurodegeneration. Cogn Behav Neurol 2023; 36:178-193. [PMID: 37378480 DOI: 10.1097/wnn.0000000000000345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/23/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Apathy, characterized by a quantifiable reduction in motivation or goal-directed behavior, is a multidimensional syndrome that has been observed across many neurodegenerative diseases. OBJECTIVE To develop a novel task measuring spontaneous action initiation (ie, a nonverbal equivalent to spontaneous speech tasks) and to investigate the association between apathy and executive functions such as the voluntary initiation of speech and actions and energization (ie, ability to initiate and sustain a response). METHOD We compared the energization and executive functioning performance of 10 individuals with neurodegenerative disease and clinically significant apathy with that of age-matched healthy controls (HC). We also investigated the association between self-reported scores on the Apathy Evaluation Scale (AES) and performance on energization tasks. RESULTS The individuals with apathy made significantly fewer task-related actions than the HC on the novel spontaneous action task, and their scores on the AES were negatively correlated with spontaneous task-related actions, providing preliminary evidence for the task's construct validity. In addition, the individuals with apathy performed more poorly than the HC on all of the energization tasks, regardless of task type or stimulus modality, suggesting difficulty in sustaining voluntary responding over time. Most of the tasks also correlated negatively with the AES score. However, the individuals with apathy also performed more poorly on some of the executive function tasks, particularly those involving self-monitoring. CONCLUSION Our work presents a novel experimental task for measuring spontaneous action initiation-a key symptom of apathy-and suggests a possible contribution of apathy to neuropsychological deficits such as poor energization.
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Affiliation(s)
- Kristina S Horne
- Queensland Brain Institute, The University of Queensland, Queensland, Australia
| | - Amelia Ceslis
- School of Psychology, The University of Queensland, Queensland, Australia
| | - Philip Mosley
- Queensland Brain Institute, The University of Queensland, Queensland, Australia
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Queensland, Australia
- Biomedical Informatics Group, Commonwealth Scientific and Industrial Research Organisation, Queensland, Australia
| | - Robert Adam
- University of Queensland Centre for Clinical Research, The University of Queensland, Royal Brisbane & Women's Hospital, Queensland, Australia
| | - Gail A Robinson
- Queensland Brain Institute, The University of Queensland, Queensland, Australia
- School of Psychology, The University of Queensland, Queensland, Australia
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Xiong Y, Khlif MS, Egorova-Brumley N, Brodtmann A, Stark BC. Neural correlates of verbal fluency revealed by longitudinal T1, T2 and FLAIR imaging in stroke. Neuroimage Clin 2023; 38:103406. [PMID: 37104929 PMCID: PMC10165164 DOI: 10.1016/j.nicl.2023.103406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/24/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023]
Abstract
Diffusion-weighted imaging has been widely used in the research on post-stroke verbal fluency but acquiring diffusion data is not always clinically feasible. Achieving comparable reliability for detecting brain variables associated with verbal fluency impairments, based on more readily available anatomical, non-diffusion images (T1, T2 and FLAIR), enables clinical practitioners to have complementary neurophysiological information at hand to facilitate diagnosis and treatment of language impairment. Meanwhile, although the predominant focus in the stroke recovery literature has been on cortical contributions to verbal fluency, it remains unclear how subcortical regions and white matter disconnection are related to verbal fluency. Our study thus utilized anatomical scans of ischaemic stroke survivors (n = 121) to identify longitudinal relationships between subcortical volume, white matter tract disconnection, and verbal fluency performance at 3- and 12-months post-stroke. Subcortical grey matter volume was derived from FreeSurfer. We used an indirect probabilistic approach to quantify white matter disconnection in terms of disconnection severity, the proportion of lesioned voxel volume to the total volume of a tract, and disconnection probability, the probability of the overlap between the stroke lesion and a tract. These disconnection variables of each subject were identified based on the disconnectome map of the BCBToolkit. Using a linear mixed multiple regression method with 5-fold cross-validations, we correlated the semantic and phonemic fluency scores with longitudinal measurements of subcortical grey matter volume and 22 bilateral white matter tracts, while controlling for demographic variables (age, sex, handedness and education), total brain volume, lesion volume, and cortical thickness. The results showed that the right subcortical grey matter volume was positively correlated with phonemic fluency averaged over 3 months and 12 months. The finding generalized well on the test data. The disconnection probability of left superior longitudinal fasciculus II and left posterior arcuate fasciculus was negatively associated with semantic fluency only on the training data, but the result aligned with our previous study using diffusion scans in the same clinical population. In sum, our results presented evidence that routinely acquired anatomical scans can serve as a reliable source for deriving neural variables of post-stroke verbal fluency performance. The use of this method might provide an ecologically valid and more readily implementable analysis tool.
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Affiliation(s)
- Yanyu Xiong
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington IN 47408, USA.
| | - Mohamed Salah Khlif
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Natalia Egorova-Brumley
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Amy Brodtmann
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Brielle C Stark
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington IN 47408, USA
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Olfati N, Shoeibi A, Litvan I. Clinical Spectrum of Tauopathies. Front Neurol 2022; 13:944806. [PMID: 35911892 PMCID: PMC9329580 DOI: 10.3389/fneur.2022.944806] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
Tauopathies are both clinical and pathological heterogeneous disorders characterized by neuronal and/or glial accumulation of misfolded tau protein. It is now well understood that every pathologic tauopathy may present with various clinical phenotypes based on the primary site of involvement and the spread and distribution of the pathology in the nervous system making clinicopathological correlation more and more challenging. The clinical spectrum of tauopathies includes syndromes with a strong association with an underlying primary tauopathy, including Richardson syndrome (RS), corticobasal syndrome (CBS), non-fluent agrammatic primary progressive aphasia (nfaPPA)/apraxia of speech, pure akinesia with gait freezing (PAGF), and behavioral variant frontotemporal dementia (bvFTD), or weak association with an underlying primary tauopathy, including Parkinsonian syndrome, late-onset cerebellar ataxia, primary lateral sclerosis, semantic variant PPA (svPPA), and amnestic syndrome. Here, we discuss clinical syndromes associated with various primary tauopathies and their distinguishing clinical features and new biomarkers becoming available to improve in vivo diagnosis. Although the typical phenotypic clinical presentations lead us to suspect specific underlying pathologies, it is still challenging to differentiate pathology accurately based on clinical findings due to large phenotypic overlaps. Larger pathology-confirmed studies to validate the use of different biomarkers and prospective longitudinal cohorts evaluating detailed clinical, biofluid, and imaging protocols in subjects presenting with heterogenous phenotypes reflecting a variety of suspected underlying pathologies are fundamental for a better understanding of the clinicopathological correlations.
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Affiliation(s)
- Nahid Olfati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- UC San Diego Department of Neurosciences, Parkinson and Other Movement Disorder Center, San Diego, CA, United States
| | - Ali Shoeibi
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Irene Litvan
- UC San Diego Department of Neurosciences, Parkinson and Other Movement Disorder Center, San Diego, CA, United States
- *Correspondence: Irene Litvan
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Cipolotti L, Xu T, Harry B, Mole J, Lakey G, Shallice T, Chan E, Nachev P. Multi-model mapping of phonemic fluency. Brain Commun 2021; 3:fcab232. [PMID: 34693285 PMCID: PMC8530259 DOI: 10.1093/braincomms/fcab232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
The voluntary generation of non-overlearned responses is usually assessed with phonemic fluency. Like most frontal tasks, it draws upon different complex processes and systems whose precise nature is still incompletely understood. Many claimed aspects regarding the pattern of phonemic fluency performance and its underlying anatomy remain controversial. Major limitations of past investigations include small sample size, scant analysis of phonemic output and methodologically insufficient lesion analysis approaches. We investigated a large number of patients with focal unilateral right or left frontal (n = 110) or posterior (n = 100) or subcortical (n = 65) lesions imaged with magnetic resonance or computed tomography and compared their performance on the number of overall responses, words produced over time, extremely infrequent/unknown words and inappropriate words generated. We also employed, for the first time parcel-based lesion-symptom mapping, tract-wise statistical analysis as well as Bayesian multi-variate analysis based on meta-analytically defined functional region of interest, including their interactions. We found that left frontal damage was associated with greater impairment than right frontal or posterior damage on overall fluency performance, suggesting that phonemic fluency shows specificity to frontal lesions. We also found that subcorticals, similar to frontals, performed significantly worse than posteriors on overall performance suggesting that subcortical regions are also involved. However, only frontal effects were found for words produced over time, extremely infrequent/unknown and inappropriate words. Parcel-based lesion-symptom mapping analysis found that worse fluency performance was associated with damage to the posterior segment of the left frontal middle and superior gyrus, the left dorsal anterior cingulate gyrus and caudate nucleus. Tract-wise statistical analysis revealed that disconnections of left frontal tracts are critical. Bayesian multi-variate models of lesions and disconnectome maps implicated left middle and inferior frontal and left dorsomedial frontal regions. Our study suggests that a set of well localized left frontal areas together with subcortical regions and several left frontal tracts are critical for word generation. We speculate that a left lateralized network exists. It involves medial, frontal regions supporting the process of 'energization', which sustains activation for the duration of the task and middle and inferior frontal regions concerned with 'selection', required due to the competition produced by associated stored words, respectively. The methodology adopted represents a promising and empirically robust approach in furthering our understanding of the neurocognitive architecture underpinning executive processes.
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Affiliation(s)
- Lisa Cipolotti
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK.,Department of Brain Repair & Rehabilitation, Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Tianbo Xu
- Department of Brain Repair & Rehabilitation, Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Bronson Harry
- The MARCS Institute, University of Western Sydney, Penrith South, NSW NSW 2747, Australia
| | - Joe Mole
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK.,Department of Brain Repair & Rehabilitation, Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Grace Lakey
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Tim Shallice
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK.,International School for Advanced Studies (SISSA-ISAS), Trieste 34136, Italy
| | - Edgar Chan
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK.,Department of Brain Repair & Rehabilitation, Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Parashkev Nachev
- Department of Brain Repair & Rehabilitation, Institute of Neurology, University College London, London WC1N 3BG, UK
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