Cognitive neuropsychology and functional brain imaging: implications for functional and anatomical models of cognition

Comparing two picture naming tasks in primary progressive aphasia: Insights from behavioural and neural results

Picture naming tests are widely used to evaluate language impairments in neurodegenerative diseases, especially in Primary Progressive Aphasia (PPA). The available tests differ for many factors affecting the performance, e.g. format of stimuli and their psycholinguistic properties. We aim to identify the most appropriate naming test to be used on PPA according to the clinical and research demands. We investigated the behavioural characteristics, i.e. proportion of correct responses and error type, and their neural correlates in two Italian naming tests, CaGi naming (CaGi) and naming subtest of the Screening for Aphasia in NeuroDegeneration battery (SAND), administered to 52 PPA patients who underwent an FDG-PET scan. We analysed the effectiveness of the tests in distinguishing PPA versus controls and among PPA variants, considering the psycholinguistic variables affecting performance. We explored the brain metabolic correlates of behavioural performance in the tests. SAND, differently from CaGi, has time limits for the response and its items are less frequent and acquired later. SAND and CaGi differed in terms of number of correct responses and error profile, suggesting a higher difficulty to name SAND items compared to CaGi. Semantic errors predominated in CaGi, while anomic and semantic errors were equally frequent in SAND. Both tests distinguished PPA from controls, but SAND outperformed CaGi in discriminating among PPA variants. FDG-PET imaging revealed a shared metabolic involvement of temporal areas associated with lexico-semantic processing, encompassing anterior fusiform, temporal pole, and extending to posterior fusiform in sv-PPA. Concluding, a picture naming test with response time limit and items which are less frequent and acquired later in life, as SAND, may be effective at highlighting subtle distinctions between PPA variants, improving the diagnosis. Conversely, a naming test without time limit for the response, as CaGi, may be useful for a better characterization of the nature of the naming impairment at the behavioural level, eliciting more naming errors than anomia, possibly helping in the development of rehabilitation protocols.

Methods matter: A primer on permanent and reversible interference techniques in animals for investigators of human neuropsychology

The study of patients with brain lesions has contributed greatly to our understanding of the biological bases of human cognition, but this approach also has several unavoidable limitations. Research that uses animal models complements and extends human neuropsychology by addressing many of these limitations. In this review, we provide an overview of permanent and reversible animal lesion techniques for researchers of human neuropsychology, with the aim of highlighting how these methods provide a valuable adjunct to behavioural, neuroimaging, physiological, and clinical investigations in humans. Research in animals has provided important lessons about how the limitations of one or more techniques, or differences in their mechanism of action, has impacted upon the understanding of brain organisation and function. These cautionary tales highlight the importance of striving for a thorough understanding of how any intereference technique works (whether in animal or human), and for how to best use animal research to clarify the precise mechanisms underlying temporary lesion methods in humans.

The cart before the horse: When cognitive neuroscience precedes cognitive neuropsychology

Cognitive neuropsychology (CN) has had an immense impact on the understanding of the normal cognitive processes underlying reading, spelling, spoken language comprehension and production, spatial attention, memory, visual perception, and orchestration of actions, through detailed analysis of behavioural performance by neurologically impaired individuals. However, there are other domains of cognition and communication that have rarely been investigated with this approach. Many cognitive neuropsychologists have extended their work in language, perception, or attention by turning to functional neuroimaging or lesion-symptom mapping to identify the neural mechanisms underlying the cognitive mechanisms they have identified. Another approach to extending one's research in CN is to apply the methodology to other cognitive functions. We briefly review the domains evaluated using methods of CN to develop cognitive architectures and computational models and the domains that have used functional neuroimaging and other brain mapping approaches in healthy controls to identify the neural substrates involved in cognitive tasks over the past 20 years. We argue that in some domains, neuroimaging studies have preceded the careful analysis of the cognitive processes underlying tasks that are studied, with the consequence that results are difficult to interpret. We use this analysis as the basis for discussing opportunities for expanding the field.

Amnesia and future thinking: Exploring the role of memory in the quantity and quality of episodic future thoughts

OBJECTIVES

To examine the impact of memory accessibility on episodic future thinking.

DESIGN

Single-case study of neurological patient HCM and an age-matched comparison group of neurologically Healthy Controls.

METHODS

We administered a full battery of tests assessing general intelligence, memory, and executive functioning. To assess autobiographical memory, the Autobiographical Memory Interview (Kopelman, Wilson, & Baddeley, 1990. The Autobiographical Memory Interview. Bury St. Edmunds, UK: Thames Valley Test Company) was administered. The Past Episodic and Future Episodic sections of Dalla Barba's Confabulation Battery (Dalla Barba, 1993, Cogn. Neuropsychol., 1, 1) and a specifically tailored Mental Time Travel Questionnaire were administered to assess future thinking in HCM and age-matched controls.

RESULTS

HCM presented with a deficit in forming new memories (anterograde amnesia) and recalling events from before the onset of neurological impairment (retrograde amnesia). HCM's autobiographical memory impairments are characterized by a paucity of memories from Recent Life. In comparison with controls, two features of his future thoughts are apparent: Reduced episodic future thinking and outdated content of his episodic future thoughts.

CONCLUSIONS

This article suggests neuropsychologists should look beyond popular conceptualizations of the past-future relation in amnesia via focussing on reduced future thinking. Investigating both the quantity and quality of future thoughts produced by amnesic patients may lead to developments in understanding the complex nature of future thinking disorders resulting from memory impairments.

PRACTITIONER POINTS

We highlight the clinical importance of examining the content of future thoughts in amnesic patients, rather than only its quantitative reduction. We propose an explanation of how quantitative and qualitative aspects of future thinking could be affected by amnesia. This could provide a useful approach to understand clinical cases of impaired prospection.

LIMITATIONS

Systematic group investigations are required to fully examine our hypothesis. Although the current study utilized typical future thinking measures, these may be limited and we highlight the need to develop clinically relevant measures of prospection.

Functional imaging of working memory in Parkinson's disease: compensations and deficits

BACKGROUND AND PURPOSE

Over and above typical motor alterations, executive and working memory (WM) impairment can also occur in early idiopathic Parkinson's disease (PD). We aimed to investigate the compensatory neural processes involved in WM performance, as well as the networks involved in the long-term memory transfer from short-term stores in PD.

METHODS

Relative cerebral blood flow (rCBF) was mapped with H2O(15)-PET in eight treated nondemented PD patients while performing a WM verbal double-task (Brown-Peterson paradigm) using both short (6-second) and long (18-second) delays.

RESULTS

As compared to nine age-matched healthy subjects, performance of the PD group was only slightly reduced on the short-delay but markedly impaired on the long-delay task. Underlying the relatively preserved short-delay performance, the PD group exhibited overactivation of prefrontal and parietal areas involved in attention-demanding processes, suggestive of efficient compensatory processes. Further supporting this, significant positive correlations were found between short-delay performance and rCBF in the bilateral inferior parietal cortex. In contrast, the lack of overactivation with the long-delay task together with posterior cingulate hypoactivation would support the idea of functional disconnection impairing transfer of information from prefrontal onto (para)limbic areas. These findings suggest novel areas of investigation into early cognitive impairments in PD.

Traces of vocabulary acquisition in the brain: Evidence from covert object naming

One of the strongest predictors of the speed with which adults can name a pictured object is the age at which the object and its name are first learned. Age of acquisition also predicts the retention or loss of individual words following brain damage in conditions like aphasia and Alzheimer's disease. Functional Magnetic Resonance Imaging (fMRI) was used to reveal brain areas differentially involved in naming objects with early or late acquired names. A baseline task involved passive viewing of non-objects. The comparison between the silent object naming conditions (early and late) with baseline showed significant activation in frontal, parietal and mediotemporal regions bilaterally and in the lingual and fusiform gyri on the left. Direct comparison of early and late items identified clusters with significantly greater activation for early acquired items at the occipital poles (in the posterior parts of the middle occipital gyri) and at the left temporal pole. In contrast, the left middle occipital and fusiform gyri showed significantly greater activation for late than early acquired items. We propose that greater activation to early than late objects at the occipital poles and at the left temporal pole reflects the more detailed visual and semantic representations of early than late acquired items. We propose that greater activation to late than early objects in the left middle occipital and fusiform gyri occurs because those areas are involved in mapping visual onto semantic representations, which is more difficult, and demands more resource, for late than for early items.

Task-order coordination in dual-task performance and the lateral prefrontal cortex: an event-related fMRI study

A crucial demand in dual tasks suffering from a capacity limited processing mechanism is task-order scheduling, i.e. the control of the order in which the two component tasks are processed by this limited processing mechanism. The present study aims to test whether the lateral prefrontal cortex (LPFC) is associated with this demand. For this, 15 participants performed a psychological refractory paradigm (PRP) type dual task in an event-related functional magnetic resonance (fMRI) experiment. In detail, two choice reaction tasks, a visual (response with right hand) and an auditory (response with left hand), were presented with a temporal offset of 200 ms, while the participants were required to respond to the tasks in the order of their presentation. Importantly, the presentation order of the tasks changed randomly. Based on previous evidence, we argue that trials in which the present task order changed as compared to the previous trial (different-order trials) impose higher demands on task coordination than same-order trials do. The analyses showed that cortical areas along the posterior part of the left inferior frontal sulcus as well as the right posterior middle frontal gyrus were more strongly activated in different-order than in same-order trials, thus supporting the conclusion that one function of the LPFC for dual-task performance is the temporal coordination of two tasks. Furthermore, it is discussed that the present findings favour the active scheduling over the passive queuing hypothesis of dual-task processing.

A neuroscientific approach to normative judgment in law and justice

Developments in cognitive neuroscience are providing new insights into the nature of normative judgment. Traditional views in such disciplines as philosophy, religion, law, psychology and economics have differed over the role and usefulness of intuition and emotion in judging blameworthiness. Cognitive psychology and neurobiology provide new tools and methods for studying questions of normative judgment. Recently, a consensus view has emerged, which recognizes important roles for emotion and intuition and which suggests that normative judgment is a distributed process in the brain. Testing this approach through lesion and scanning studies has linked a set of brain regions to such judgment, including the ventromedial prefrontal cortex, orbitofrontal cortex, posterior cingulate cortex and posterior superior temporal sulcus. Better models of emotion and intuition will help provide further clarification of the processes involved. The study of law and justice is less well developed. We advance a model of law in the brain which suggests that law can recruit a wider variety of sources of information and paths of processing than do the intuitive moral responses that have been studied so far. We propose specific hypotheses and lines of further research that could help test this approach.

Variability of fMRI activation during a phonological and semantic language task in healthy subjects

Assessing inter-individual variability of functional activations is of practical importance in the use of functional magnetic resonance imaging (fMRI) in a clinical context. In this fMRI study we addressed this issue in 30 right-handed, healthy subjects using rhyme detection (phonologic) and semantic categorization tasks. Significant activations, found mainly in the left hemisphere, concerned the inferior frontal gyrus, the superior/middle temporal gyri, the prefrontal cortex, the inferior parietal lobe, the superior parietal lobule/superior occipital gyrus, the pre-central gyrus, and the supplementary motor area. Intensity/spatial analysis comparing activations in both tasks revealed an increased involvement of frontal regions in the semantic task and of temporo-parietal regions in the phonologic task. The frequency of activation analyzed in nine regional subdivisions revealed a high inter-subject variability but showed that the most frequently activated regions were the inferior frontal gyrus and the prefrontal cortex. Laterality indices, strongly lateralizing in both tasks, were slightly higher in the semantic (0.76 +/- 0.19) than the phonologic task (0.66 +/- 0.27). Frontal dominance indices (a measure of frontal vs. posterior left hemisphere dominance) indicated more robust frontal activations in the semantic than the phonologic task. Our study allowed the characterization of the most frequently involved foci in two language tasks and showed that the combination of these tasks constitutes a suitable tool for determining language lateralization and for mapping major language areas.

Conscious visual representations built from multiple binding processes: evidence from neuropsychology

I review neuropsychological evidence, from patients with selective brain lesions, indicating that there can be several kinds of binding in vision. Damage to early processes within the ventral visual stream impairs the binding of contours into shapes. This impairment can leave unaffected a more elementary operation of binding form elements into contours. Thus the process of binding elements into a contour is distinct from the process of binding contours into more wholistic shapes. In other patients with damage to the parietal lobe, there can be poor binding of shape to surface information in objects. This problem in turn can co-exist with a relatively intact process of binding of contours into shapes. These findings suggest that there are multiple stages of binding in vision, including binding to derive shape descriptions (in the ventral visual stream) and binding shape and surface detail together (involving interactions between the ventral and dorsal streams). I also discuss evidence for transient binding based on common onsets of stimuli. I conclude that the unity of consciousness is derived from several separable neural processes of binding.

Attention, spatial representation, and visual neglect: simulating emergent attention and spatial memory in the selective attention for identification model (SAIM)

The selective attention for identification model (SAIM) is presented. This uses a spatial window to select visual information for recognition, binding parts to objects and generating translation-invariant recognition. The model provides a qualitative account of both normal and disordered attention. Simulations of normal attention demonstrate 2-object costs and effects of object familiarity on selection, global precedence, spatial cueing, and inhibition of return. When lesioned, SAIM demonstrated either view- or object-centered neglect or spatial extinction, depending on the type and extent of lesion. The model provides a framework to unify (a) object- and space-based theories of normal selection, (b) dissociations within the syndrome of unilateral neglect, and (c) attentional and representational accounts of neglect.

The role of transcranial magnetic stimulation (TMS) in studies of vision, attention and cognition

Transcranial magnetic stimulation (TMS) can be conceptualized as a virtual lesion technique, capable of disrupting organized cortical activity, transiently and reversibly. The technique combines good spatial and temporal resolution and, moreover, because it represents an interference technique, can be said to have excellent functional resolution. The following is a review and discussion of the contribution which TMS has made to the study of vision, attention, development and plasticity and speech and language.

fMR-adaptation: a tool for studying the functional properties of human cortical neurons

The invariant properties of human cortical neurons cannot be studied directly by fMRI due to its limited spatial resolution. One voxel obtained from a fMRI scan contains several hundred thousands neurons. Therefore, the fMRI signal may average out a heterogeneous group of highly selective neurons. Here, we present a novel experimental paradigm for fMRI, functional magnetic resonance-adaptation (fMR-A), that enables to tag specific neuronal populations within an area and investigate their functional properties. This approach contrasts with conventional mapping methods that measure the averaged activity of a region. The application of fMR-A to study the functional properties of cortical neurons proceeds in two stages: First, the neuronal population is adapted by repeated presentation of a single stimulus. Second, some property of the stimulus is varied and the recovery from adaptation is assessed. If the signal remains adapted, it will indicate that the neurons are invariant to that attribute. However, if the fMRI signal will recover from the adapted state it would imply that the neurons are sensitive to the property that was varied. Here, an application of fMR-A for studying the invariant properties of high-order object areas (lateral occipital complex--LOC) to changes in object size, position, illumination and rotation is presented. The results show that LOC is less sensitive to changes in object size and position compared to changes of illumination and viewpoint. fMR-A can be extended to other neuronal systems in which adaptation is manifested and can be used with event-related paradigms as well. By manipulating experimental parameters and testing recovery from adaptation it should be possible to gain insight into the functional properties of cortical neurons which are beyond the spatial resolution limits imposed by conventional fMRI.

Defining the cortical visual systems: "what", "where", and "how"

The visual system historically has been defined as consisting of at least two broad subsystems subserving object and spatial vision. These visual processing streams have been organized both structurally as two distinct pathways in the brain, and functionally for the types of tasks that they mediate. The classic definition by Ungerleider and Mishkin labeled a ventral "what" stream to process object information and a dorsal "where" stream to process spatial information. More recently, Goodale and Milner redefined the two visual systems with a focus on the different ways in which visual information is transformed for different goals. They relabeled the dorsal stream as a "how" system for transforming visual information using an egocentric frame of reference in preparation for direct action. This paper reviews recent research from psychophysics, neurophysiology, neuropsychology and neuroimaging to define the roles of the ventral and dorsal visual processing streams. We discuss a possible solution that allows for both "where" and "how" systems that are functionally and structurally organized within the posterior parietal lobe.