Left posterior BA37 is involved in object recognition: a TMS study

Visual Cortical Thickness Increases with Prolonged Artificial Vision Restoration

The Argus II retinal prosthesis restores visual perception to late blind patients. It has been shown that structural changes occur in the brain due to late-onset blindness, including cortical thinning in visual regions of the brain. Following vision restoration, it is not yet known whether these visual regions are reinvigorated and regain a normal cortical thickness or retain the diminished thickness from blindness. We evaluated the cortical thicknesses of ten Argus II Retinal Prostheses patients, ten blind patients, and thirteen sighted participants. The Argus II patients on average had a thicker left Cuneus Cortex and Lateral Occipital Cortex relative to the blind patients. The duration of the Argus II use (time since implant in active users) significantly partially correlated with thicker visual cortical regions in the left hemisphere. Furthermore, in the two case studies (scanned before and after implantation), the patient with longer device use (44.5 months) had an increase in the cortical thickness of visual regions, whereas the shorter-using patient did not (6.5 months). Finally, a third case, scanned at three time points post-implantation, showed an increase in cortical thickness in the Lateral Occipital Cortex between 43.5 and 57 months, which was maintained even after 3 years of disuse (106 months). Overall, the Argus II patients' cortical thickness was on average significantly rejuvenated in two higher visual regions and, patients using the implant for a longer duration had thicker visual regions. This research raises the possibility of structural plasticity reversing visual cortical atrophy in late-blind patients with prolonged vision restoration.

Post-stroke Chinese pure alexia: linguistic features and neuropsychological profiles

PURPOSE

Very few cases of Chinese pure alexia have been reported to date. We aim to summarize the linguistic features and neuropsychological profiles of Chinese pure alexia through a case series study.

METHODS

11 consecutive patients with post-stroke Chinese pure alexia and 11 healthy controls were included. The Aphasia Battery of Chinese (ABC) and 68-Chinese character oral reading test (68-character test) were used to evaluate the reading and writing ability. Reading errors were classified based on the performance of 68-character test. Neuropsychological profiles were evaluated with corresponding scales. The possible correlation between the reading ability and the writing ability or neuropsychological performance was analyzed.

RESULTS

The patients had a correct rate of 43.7 ± 23.2% in the 68-character test, significantly lower (P < 0.001) than that of controls. Shape-similar error was the most common type of reading error (101/209, 48.3%). The ABC total writing score rate of the patients ranged from 68.9% to 98.7% (median, 90.5%), significantly lower (P < 0.001) than that of the controls. The patients also showed worse performance in MMSE, auditory verbal learning test, Boston naming test, intersecting pentagons copying and clock-drawing test (all P < 0.05). In the patient group, the correct rate of 68-character test was significantly correlated with the ABC total writing score rate (P = 0.008), the score rate of Boston naming test (P = 0.017), and the clock-drawing test score (P = 0.010).

CONCLUSION

Shape-similar errors may be a characteristic of Chinese pure alexia. The correlation between visuospatial dysfunction and pure alexia might explain the frequent occurrence of shape-similar errors in Chinese pure alexia.

Exploring the neurobiology of reading through non-invasive brain stimulation: A review

Non-invasive brain stimulation (NIBS) has gained increasing popularity as a modulatory tool for drawing causal inferences and exploring task-specific network interactions. Yet, a comprehensive synthesis of reading-related NIBS studies is still missing. We fill this gap by synthesizing the results of 78 NIBS studies investigating the causal involvement of brain regions for reading processing, and then link these results to a neurobiological model of reading. The included studies provide evidence for a functional-anatomical double dissociation for phonology versus semantics during reading-related processes within left inferior frontal and parietal areas. Additionally, the posterior parietal cortex and the anterior temporal lobe are identified as critical regions for reading-related processes. Overall, the findings provide some evidence for a dual-stream neurobiological model of reading, in which a dorsal stream (left temporo-parietal and inferior frontal areas) processes unfamiliar words and pseudowords, and a ventral stream (left occipito-temporal and inferior frontal areas, with assistance from the angular gyrus and the anterior temporal lobe) processes known words. However, individual differences in reading abilities and strategies, as well as differences in stimulation parameters, may impact the neuromodulatory effects induced by NIBS. We emphasize the need to investigate task-specific network interactions in future studies by combining NIBS with neuroimaging.

Receptive language is associated with visual perception in typically developing children and sensorimotor skills in autism spectrum conditions

A number of studies have evidenced marked difficulties in language in autism spectrum conditions (ASC). Studies have also shown that language and word knowledge are associated with the same area of brain that is also responsible for visual perception in typically developing (TD) individuals. However, in ASC, research suggests word meaning is mapped differently, on to situational sensorimotor components within the brain. Furthermore, motor coordination is associated with communication skills. The current study explores whether motor coordination and visual perception are impaired in children with ASC, and whether difficulties in coordination and visual perception correlate with receptive language levels. 36 children took part: 18 with ASC and 18 TD children, matched on age and non-verbal reasoning. Both groups completed the Movement ABC, Beery-Buktenica Developmental Test of Visual-Motor Integration, British Picture Vocabulary Scale and Matrices (WASI). Results showed that ASC children scored significantly lower on receptive language, coordination and visual motor integration than the TD group. In the TD group receptive language significantly correlated with visual perception; in the ASC group receptive language significantly correlated with balance. These results imply that sensorimotor skills are associated with the understanding of language in ASC and thus the relationship between sensorimotor experiences and language warrants further investigation.

Language processing in age-related macular degeneration associated with unique functional connectivity signatures in the right hemisphere

Age-related macular degeneration (AMD) is a retinal disease associated with significant vision loss among older adults. Previous large-scale behavioral studies indicate that people with AMD are at increased risk of cognitive deficits in language processing, particularly in verbal fluency tasks. The neural underpinnings of any relationship between AMD and higher cognitive functions, such as language processing, remain unclear. This study aims to address this issue using independent component analysis of spontaneous brain activity at rest. In 2 components associated with visual processing, we observed weaker functional connectivity in the primary visual cortex and lateral occipital cortex in AMD patients compared with healthy controls, indicating that AMD might lead to differences in the neural representation of vision. In a component related to language processing, we found that increasing connectivity within the right inferior frontal gyrus was associated with better verbal fluency performance across all older adults, and the verbal fluency effect was greater in AMD patients than controls in both right inferior frontal gyrus and right posterior temporal regions. As the behavioral performance of our patients is as good as that of controls, these findings suggest that preservation of verbal fluency performance in AMD patients might be achieved through higher contribution from right hemisphere regions in bilateral language networks. If that is the case, there may be an opportunity to promote cognitive resilience among seniors with AMD or other forms of late-life vision loss.

Normal aging and Parkinson's disease are associated with the functional decline of distinct frontal-striatal circuits

Impaired ability to shift attention between stimuli (i.e. shifting attentional ‘set’) is a well-established part of the dysexecutive syndrome in Parkinson's Disease (PD), nevertheless cognitive and neural bases of this deficit remain unclear. In this study, an fMRI-optimised variant of a classic paradigm for assessing attentional control (Hampshire and Owen 2006) was used to contrast activity in dissociable executive circuits in early-stage PD patients and controls. The results demonstrated that the neural basis of the executive performance impairments in PD is accompanied by hypoactivation within the striatum, anterior cingulate cortex (vACC), and inferior frontal sulcus (IFS) regions. By contrast, in aging it is associated with hypoactivation of the anterior insula/inferior frontal operculum (AI/FO) and the pre-supplementary motor area (preSMA). Between group behavioural differences were also observed; whereas normally aging individuals exhibited routine-problem solving deficits, PD patients demonstrated more global task learning deficits. These findings concur with recent research demonstrating model-based reinforcement learning deficits in PD and provide evidence that the AI/FO and IFS circuits are differentially impacted by PD and normal aging.

The involvement of the dorsal stream in processing implied actions between paired objects: A TMS study

Perceiving and selecting the action possibilities (affordances) provided by objects is an important challenge to human vision, and is not limited to single-object scenarios. Xu et al. (2015) identified two effects of implied actions between paired objects on response selection: an inhibitory effect on responses aligned with the passive object in the pair (e.g. a bowl) and an advantage associated with responses aligned with the active objects (e.g. a spoon). The present study investigated the neurocognitive mechanisms behind these effects by examining the involvement of the ventral (vision for perception) and the dorsal (vision for action) visual streams, as defined in Goodale and Milner's (1992) two visual stream theory. Online repetitive transcranial magnetic stimulation (rTMS) applied to the left anterior intraparietal sulcus (aIPS) reduced both the inhibitory effect of implied actions on responses aligned with the passive objects and the advantage of those aligned with the active objects, but only when the active objects were contralateral to the stimulation. rTMS to the left lateral occipital areas (LO) did not significantly alter the influence of implied actions. The results reveal that the dorsal visual stream is crucial not only in single-object affordance processing, but also in responding to implied actions between objects.

Preserved Haptic Shape Processing after Bilateral LOC Lesions

The visual and haptic perceptual systems are understood to share a common neural representation of object shape. A region thought to be critical for recognizing visual and haptic shape information is the lateral occipital complex (LOC). We investigated whether LOC is essential for haptic shape recognition in humans by studying behavioral responses and brain activation for haptically explored objects in a patient (M.C.) with bilateral lesions of the occipitotemporal cortex, including LOC. Despite severe deficits in recognizing objects using vision, M.C. was able to accurately recognize objects via touch. M.C.'s psychophysical response profile to haptically explored shapes was also indistinguishable from controls. Using fMRI, M.C. showed no object-selective visual or haptic responses in LOC, but her pattern of haptic activation in other brain regions was remarkably similar to healthy controls. Although LOC is routinely active during visual and haptic shape recognition tasks, it is not essential for haptic recognition of object shape.

SIGNIFICANCE STATEMENT

The lateral occipital complex (LOC) is a brain region regarded to be critical for recognizing object shape, both in vision and in touch. However, causal evidence linking LOC with haptic shape processing is lacking. We studied recognition performance, psychophysical sensitivity, and brain response to touched objects, in a patient (M.C.) with extensive lesions involving LOC bilaterally. Despite being severely impaired in visual shape recognition, M.C. was able to identify objects via touch and she showed normal sensitivity to a haptic shape illusion. M.C.'s brain response to touched objects in areas of undamaged cortex was also very similar to that observed in neurologically healthy controls. These results demonstrate that LOC is not necessary for recognizing objects via touch.

Electrophysiological evidence of separate pathways for the perception of depth and 3D objects

Previous studies have investigated the neural mechanism of 3D perception, but the neural distinction between 3D-objects and depth processing remains unclear. In the present study, participants viewed three types of graphics (planar graphics, perspective drawings, and 3D objects) while event-related potentials (ERP) were recorded. The ERP results revealed the following: (1) 3D objects elicited a larger and delayed N1 component than the other two types of stimuli; (2) during the P2 time window, significant differences between 3D objects and the perspective drawings were found mainly over a group of electrode sites in the left lateral occipital region; and (3) during the N2 complex, differences between planar graphics and perspective drawings were found over a group of electrode sites in the right hemisphere, whereas differences between perspective drawings and 3D objects were observed at another group of electrode sites in the left hemisphere. These findings support the claim that depth processing and object identification might be processed by separate pathways and at different latencies.

Neurocognitive stages of spatial cognitive mapping measured during free exploration of a large-scale virtual environment

Using a novel, fully mobile virtual reality paradigm, we investigated the EEG correlates of spatial representations formed during unsupervised exploration. On day 1, subjects implicitly learned the location of 39 objects by exploring a room and popping bubbles that hid the objects. On day 2, they again popped bubbles in the same environment. In most cases, the objects hidden underneath the bubbles were in the same place as on day 1. However, a varying third of them were misplaced in each block. Subjects indicated their certainty that the object was in the same location as the day before. Compared with bubble pops revealing correctly placed objects, bubble pops revealing misplaced objects evoked a decreased negativity starting at 145 ms, with scalp topography consistent with generation in medial parietal cortex. There was also an increased negativity starting at 515 ms to misplaced objects, with scalp topography consistent with generation in inferior temporal cortex. Additionally, misplaced objects elicited an increase in frontal midline theta power. These findings suggest that the successive neurocognitive stages of processing allocentric space may include an initial template matching, integration of the object within its spatial cognitive map, and memory recall, analogous to the processing negativity N400 and theta that support verbal cognitive maps in humans.

Transcranial magnetic stimulation for investigating causal brain-behavioral relationships and their time course

Transcranial magnetic stimulation (TMS) is a safe, non-invasive brain stimulation technique that uses a strong electromagnet in order to temporarily disrupt information processing in a brain region, generating a short-lived "virtual lesion." Stimulation that interferes with task performance indicates that the affected brain region is necessary to perform the task normally. In other words, unlike neuroimaging methods such as functional magnetic resonance imaging (fMRI) that indicate correlations between brain and behavior, TMS can be used to demonstrate causal brain-behavior relations. Furthermore, by varying the duration and onset of the virtual lesion, TMS can also reveal the time course of normal processing. As a result, TMS has become an important tool in cognitive neuroscience. Advantages of the technique over lesion-deficit studies include better spatial-temporal precision of the disruption effect, the ability to use participants as their own control subjects, and the accessibility of participants. Limitations include concurrent auditory and somatosensory stimulation that may influence task performance, limited access to structures more than a few centimeters from the surface of the scalp, and the relatively large space of free parameters that need to be optimized in order for the experiment to work. Experimental designs that give careful consideration to appropriate control conditions help to address these concerns. This article illustrates these issues with TMS results that investigate the spatial and temporal contributions of the left supramarginal gyrus (SMG) to reading.

Can tDCS enhance treatment of aphasia after stroke?

BACKGROUND: Recent advances in the application of transcranial direct current stimulation (tDCS) in healthy populations have led to the exploration of the technique as an adjuvant method to traditional speech therapies in patients with post-stroke aphasia. AIMS: THE PURPOSE OF THE REVIEW IS: (i) to review the features of tDCS that make it an attractive tool for research and potential future use in clinical contexts; (ii) to describe recent studies exploring the facilitation of language performance using tDCS in post-stroke aphasia; (iii) to explore methodological considerations of tDCS that may be key to understanding tDCS in treatment of aphasia post stroke; and (iv) to highlight several caveats and outstanding questions that need to be addressed in future work. MAIN CONTRIBUTION: This review aims to highlight our current understanding of the methodological and theoretical issues surrounding the use of tDCS as an adjuvant tool in the treatment of language difficulties after stroke. CONCLUSIONS: Preliminary evidence shows that tDCS may be a useful tool to complement treatment of aphasia, particularly for speech production in chronic stroke patients. To build on this exciting work, further systematic research is needed to understand the mechanisms of tDCS-induced effects, its application to current models of aphasia recovery, and the complex interactions between different stimulation parameters and language rehabilitation techniques. The potential of tDCS is to optimise language rehabilitation techniques and promote long-term recovery of language. A stimulating future for aphasia rehabilitation!

The spatial and temporal signatures of word production components: a critical update

In the first decade of neurocognitive word production research the predominant approach was brain mapping, i.e., investigating the regional cerebral brain activation patterns correlated with word production tasks, such as picture naming and word generation. Indefrey and Levelt (2004) conducted a comprehensive meta-analysis of word production studies that used this approach and combined the resulting spatial information on neural correlates of component processes of word production with information on the time course of word production provided by behavioral and electromagnetic studies. In recent years, neurocognitive word production research has seen a major change toward a hypothesis-testing approach. This approach is characterized by the design of experimental variables modulating single component processes of word production and testing for predicted effects on spatial or temporal neurocognitive signatures of these components. This change was accompanied by the development of a broader spectrum of measurement and analysis techniques. The article reviews the findings of recent studies using the new approach. The time course assumptions of Indefrey and Levelt (2004) have largely been confirmed requiring only minor adaptations. Adaptations of the brain structure/function relationships proposed by Indefrey and Levelt (2004) include the precise role of subregions of the left inferior frontal gyrus as well as a probable, yet to date unclear role of the inferior parietal cortex in word production.

Effects of traumatic brain injury on a virtual reality social problem solving task and relations to cortical thickness in adolescence

Social problem solving was assessed in 28 youth ages 12-19 years (15 with moderate to severe traumatic brain injury (TBI), 13 uninjured) using a naturalistic, computerized virtual reality (VR) version of the Interpersonal Negotiations Strategy interview (Yeates, Schultz, & Selman, 1991). In each scenario, processing load condition was varied in terms of number of characters and amount of information. Adolescents viewed animated scenarios depicting social conflict in a virtual microworld environment from an avatar's viewpoint, and were questioned on four problem solving steps: defining the problem, generating solutions, selecting solutions, and evaluating the likely outcome. Scoring was based on a developmental scale in which responses were judged as impulsive, unilateral, reciprocal, or collaborative, in order of increasing score. Adolescents with TBI were significantly impaired on the summary VR-Social Problem Solving (VR-SPS) score in Condition A (2 speakers, no irrelevant information), p=0.005; in Condition B (2 speakers+irrelevant information), p=0.035; and Condition C (4 speakers+irrelevant information), p=0.008. Effect sizes (Cohen's D) were large (A=1.40, B=0.96, C=1.23). Significant group differences were strongest and most consistent for defining the problems and evaluating outcomes. The relation of task performance to cortical thickness of specific brain regions was also explored, with significant relations found with orbitofrontal regions, the frontal pole, the cuneus, and the temporal pole. Results are discussed in the context of specific cognitive and neural mechanisms underlying social problem solving deficits after childhood TBI.

Deficits in the left inferior longitudinal fasciculus results in impairments in object naming

The functional characteristics of the left inferior longitudinal fasciculus (ILF) remain unclear. The present study describes a case of a right-handed 74-year-old woman with a brain tumor who showed marked deterioration in object naming ability after invasion of the tumor into the medial region of the left posterior (middle and inferior) temporal lobe just beside the atrium of the lateral ventricle. Diffusion tensor imaging showed possible interruption of the left ILF after invasion of tumor at this site. By contrast, the left superior longitudinal fasciculus (SLF) remained intact after invasion of tumor, and the inferior fronto-occipital fasciculus (IFOF) was already disrupted prior to tumor invasion. These observations indicate that intact ILF function may be required for object naming ability.

The lateral-occipital and the inferior-frontal cortex play different roles during the naming of visually presented objects

We reasoned that if an area is devoted to processing only the visual features of objects, then transcranial magnetic stimulation (TMS) applied to this area in either hemisphere would affect the naming of objects presented in contralateral but not ipsilateral space. In contrast, if an area is involved in language, then one might expect to see effects of TMS when applied over the left but not the right hemisphere, regardless whether objects are in contralateral or ipsilateral space. Our experiments reveal two important findings. First, TMS delivered to the lateral-occipital complex (LOC), a visual-form area, affected the naming of objects presented in contralateral but not ipsilateral space, independent of which hemisphere was stimulated. In two additional experiments, when participants named the color of objects or made judgments about the size of stimuli as shown physically on a computer screen, TMS over the contralateral LOC did not affect color naming but did affect the participants' ability to make size judgments. Second, TMS delivered to the left but not the right posterior inferior-frontal gyrus (pIFG) affected the naming of objects irrespective of whether objects were presented in contralateral or ipsilateral space. In a separate experiment, when participants were asked to either read or categorize words, TMS over the left but not the right pIFG affected word categorization but not word reading. On the basis of these findings, we propose that when people name visually-presented objects, LOC processes the visual form of objects while the left pIFG processes the semantics of objects.

Neural substrates of visuospatial processing in distinct reference frames: evidence from unilateral spatial neglect

There is evidence for different levels of visuospatial processing with their own frames of reference: viewer-centered, stimulus-centered, and object-centered. The neural locus of these levels can be explored by examining lesion location in subjects with unilateral spatial neglect (USN) manifest in these reference frames. Most studies regarding the neural locus of USN have treated it as a homogenous syndrome, resulting in conflicting results. In order to further explore the neural locus of visuospatial processes differentiated by frame of reference, we presented a battery of tests to 171 subjects within 48 hr after right supratentorial ischemic stroke before possible structural and/or functional reorganization. The battery included MR perfusion weighted imaging (which shows hypoperfused regions that may be dysfunctional), diffusion weighted imaging (which reveals areas of infarct or dense ischemia shortly after stroke onset), and tests designed to disambiguate between various types of neglect. Results were consistent with a dorsal/ventral stream distinction in egocentric/allocentric processing. We provide evidence that portions of the dorsal stream of visual processing, including the right supramarginal gyrus, are involved in spatial encoding in egocentric coordinates, whereas parts of the ventral stream (including the posterior inferior temporal gyrus) are involved in allocentric encoding.

Comprehension of concrete and abstract words in semantic dementia

The vast majority of brain-injured patients with semantic impairment have better comprehension of concrete than abstract words. In contrast, several patients with semantic dementia (SD), who show circumscribed atrophy of the anterior temporal lobes bilaterally, have been reported to show reverse imageability effects, that is, relative preservation of abstract knowledge. Although these reports largely concern individual patients, some researchers have recently proposed that superior comprehension of abstract concepts is a characteristic feature of SD. This would imply that the anterior temporal lobes are particularly crucial for processing sensory aspects of semantic knowledge, which are associated with concrete not abstract concepts. However, functional neuroimaging studies of healthy participants do not unequivocally predict reverse imageability effects in SD because the temporal poles sometimes show greater activation for more abstract concepts. The authors examined a case-series of 11 SD patients on a synonym judgment test that orthogonally varied the frequency and imageability of the items. All patients had higher success rates for more imageable as well as more frequent words, suggesting that (1) the anterior temporal lobes underpin semantic knowledge for both concrete and abstract concepts, (2) more imageable items--perhaps because of their richer multimodal representations--are typically more robust in the face of global semantic degradation and (3) reverse imageability effects are not a characteristic feature of SD.

Perceptual load interacts with stimulus processing across sensory modalities

According to perceptual load theory, processing of task-irrelevant stimuli is limited by the perceptual load of a parallel attended task if both the task and the irrelevant stimuli are presented to the same sensory modality. However, it remains a matter of debate whether the same principles apply to cross-sensory perceptual load and, more generally, what form cross-sensory attentional modulation in early perceptual areas takes in humans. Here we addressed these questions using functional magnetic resonance imaging. Participants undertook an auditory one-back working memory task of low or high perceptual load, while concurrently viewing task-irrelevant images at one of three object visibility levels. The processing of the visual and auditory stimuli was measured in the lateral occipital cortex (LOC) and auditory cortex (AC), respectively. Cross-sensory interference with sensory processing was observed in both the LOC and AC, in accordance with previous results of unisensory perceptual load studies. The present neuroimaging results therefore warrant the extension of perceptual load theory from a unisensory to a cross-sensory context: a validation of this cross-sensory interference effect through behavioural measures would consolidate the findings.

How does interhemispheric communication in visual word recognition work? Deciding between early and late integration accounts of the split fovea theory

It has recently been shown that interhemispheric communication is needed for the processing of foveally presented words. In this study, we examine whether the integration of information happens at an early stage, before word recognition proper starts, or whether the integration is part of the recognition process itself. Two lexical decision experiments are reported in which words were presented at different fixation positions. In Experiment 1, a masked form priming task was used with primes that had two adjacent letters transposed. The results showed that although the fixation position had a substantial influence on the transposed letter priming effect, the priming was not smaller when the transposed letters were sent to different hemispheres than when they were projected to the same hemisphere. In Experiment 2, stimuli were presented that either had high frequency hemifield competitors or could be identified unambiguously on the basis of the information in one hemifield. Again, the lexical decision times did not vary as a function of hemifield competitors. These results are consistent with the early integration account, as presented in the SERIOL model of visual word recognition.

Functional Representation of Living and Nonliving Domains across the Cerebral Hemispheres: A Combined Event-related Potential/Transcranial Magnetic Stimulation Study

Transcranial magnetic stimulation (TMS) over the left hemisphere has been shown to disrupt semantic processing but, to date, there has been no direct demonstration of the electrophysiological correlates of this interference. To gain insight into the neural basis of semantic systems, and in particular, study the temporal and functional organization of object categorization processing, we combined repetitive TMS (rTMS) and ERPs. Healthy volunteers performed a picture–word matching task in which Snodgrass drawings of natural (e.g., animal) and artifactual (e.g., tool) categories were associated with a word. When short trains of high-frequency rTMS were applied over Wernicke's area (in the region of the CP5 electrode) immediately before the stimulus onset, we observed delayed response times to artifactual items, and thus, an increased dissociation between natural and artifactual domains. This behavioral effect had a direct ERP correlate. In the response period, the stimuli from the natural domain elicited a significant larger late positivity complex than those from the artifactual domain. These differences were significant over the centro-parietal region of the right hemisphere. These findings demonstrate that rTMS interferes with postperceptual categorization processing of natural and artifactual stimuli that involve separate subsystems in distinct cortical areas.

The Role of the Right Cerebral Hemisphere in Processing Novel Metaphoric Expressions: A Transcranial Magnetic Stimulation Study

Previous research suggests that the right hemisphere (RH) may contribute uniquely to the processing of metaphoric language. However, causal relationships between local brain activity in the RH and metaphors comprehension were never established. In addition, most studies have focused on familiar metaphoric expressions which might be processed similarly to any conventional word combination. The present study was designed to overcome these two problems by employing repetitive transcranial magnetic stimulation (rTMS) to examine the role of the RH in processing novel metaphoric expressions taken from poetry. Right-handed participants were presented with four types of word pairs, literal, conventional metaphoric and novel metaphoric expressions, and unrelated word pairs, and were asked to perform a semantic judgment task. rTMS of the right posterior superior temporal sulcus disrupted processing of novel but not conventional metaphors, whereas rTMS over the left inferior frontal gyrus selectively impaired processing of literal word pairs and conventional but not novel metaphors (Experiment 1). In a further experiment, we showed that these effects were due to right-left asymmetries rather than posterior-anterior differences (Experiment 2). This is the first demonstration of TMS-induced impairment in processing novel metaphoric expressions, and as such, confirms the specialization of the RH in the activation of a broader range of related meanings than the left hemisphere, including novel, nonsalient meanings. The findings thus suggest that the RH may be critically involved in at least one important component of novel metaphor comprehension, the integration of the individual meanings of two seemingly unrelated concepts into a meaningful metaphoric expression.

Enhancing language performance with non-invasive brain stimulation--a transcranial direct current stimulation study in healthy humans

In humans, transcranial direct current stimulation (tDCS) can be used to induce, depending on polarity, increases or decreases of cortical excitability by polarization of the underlying brain tissue. Cognitive enhancement as a result of tDCS has been reported. The purpose of this study was to test whether weak tDCS (current density, 57 microA/cm(2)) can be used to modify language processing. Fifteen healthy subjects performed a visual picture naming task before, during and after tDCS applied over the posterior perisylvian region (PPR), i.e. an area which includes Wernicke's area [BA 22]. Four different sessions were carried out: (1) anodal and (2) cathodal stimulation of left PPR and, for control, (3) anodal stimulation of the homologous region of the right hemisphere and (4) sham stimulation. We found that subjects responded significantly faster following anodal tDCS to the left PPR (p<0.01). No decreases in performance were detected. Our finding of a transient improvement in a language task following the application of tDCS together with previous studies which investigated the modulation of picture naming latency by transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS) suggest that tDCS applied to the left PPR (including Wernicke's area [BA 22]) can be used to enhance language processing in healthy subjects. Whether this safe, low cost, and easy to use brain stimulation technique can be used to ameliorate deficits of picture naming in aphasic patients needs further investigations.

The spatial distribution and temporal dynamics of brain regions activated during the perception of object and non-object patterns

Both animal and human studies suggest that the efficiency with which we are able to grasp objects is attributable to a repertoire of motor signals derived directly from vision. This is in general agreement with the long-held belief that the automatic generation of motor signals by the perception of objects is based on the actions they afford. In this study, we used magnetoencephalography (MEG) to determine the spatial distribution and temporal dynamics of brain regions activated during passive viewing of object and non-object targets that varied in the extent to which they afforded a grasping action. Synthetic Aperture Magnetometry (SAM) was used to localize task-related oscillatory power changes within specific frequency bands, and the time course of activity within given regions-of-interest was determined by calculating time-frequency plots using a Morlet wavelet transform. Both single subject and group-averaged data on the spatial distribution of brain activity are presented. We show that: (i) significant reductions in 10-25 Hz activity within extrastriate cortex, occipito-temporal cortex, sensori-motor cortex and cerebellum were evident with passive viewing of both objects and non-objects; and (ii) reductions in oscillatory activity within the posterior part of the superior parietal cortex (area Ba7) were only evident with the perception of objects. Assuming that focal reductions in low-frequency oscillations (<30 Hz) reflect areas of heightened neural activity, we conclude that: (i) activity within a network of brain areas, including the sensori-motor cortex, is not critically dependent on stimulus type and may reflect general changes in visual attention; and (ii) the posterior part of the superior parietal cortex, area Ba7, is activated preferentially by objects and may play a role in computations related to grasping.

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.

Transient functional suppression and facilitation of Japanese ideogram writing induced by repetitive transcranial magnetic stimulation of posterior inferior temporal cortex

The Japanese writing system is unique in that it is composed of two different orthographies: kanji (morphograms) and kana (syllabograms). The retrieval of the visual orthographic representations of Japanese kanji is crucial to the process of writing in Japanese. We used low-frequency repetitive transcranial magnetic stimulation (rTMS) to clarify the functional relevance of the left and right posterior inferior temporal cortex (PITC) to this process in native Japanese speakers. The experimental paradigms included the mental recall of kanji, kana-to-kanji transcription, semantic judgment, oral reading, and copying of kana and kanji. The first two tasks require the visualization of the kanji image of the word. We applied 0.9 Hz rTMS (600 total pulses) over individually determined left or right PITC to suppress cortical activity and measured subsequent task performance. In the mental recall of kanji and kana-to-kanji transcription, rTMS over the left PITC prolonged reaction times (RTs), whereas rTMS over the right PITC reduced RTs. In the other tasks, which do not involve the mental visualization of kanji, rTMS over the left or right PITC had no effect on performance. These results suggest that the left PITC is crucial for the retrieval of the visual graphic representation of kanji. Furthermore, the right PITC may work to suppress the dominant left PITC in the neural network for kanji writing, which involves visual word recognition.

Safety of rTMS to non-motor cortical areas in healthy participants and patients

OBJECTIVE

rTMS is increasingly being used for stimulation to non-motor areas, but available safety guidelines are derived from experience with motor cortex rTMS. We reviewed the literature and our own data to assess the safety of rTMS to non-motor areas.

METHODS

We reviewed for adverse effects all articles published from January 1998 to December 2003 that applied rTMS to non-motor areas, and analyzed data from our own studies from January 1997 to December 2003.

RESULTS

Adverse effects were infrequent and generally mild. Headache was the most common, occurring in 23% of the subjects and more frequent with frontal rTMS. More serious adverse effects were rare and consisted of two seizures and four instances of psychotic symptoms induced by rTMS to the dorsolateral prefrontal cortex in patients with depression.

CONCLUSIONS

Overall, as currently applied rTMS to non-motor areas appears to be safe with few, generally mild adverse effects. In future studies, we recommend systematic reporting of adverse effects and careful documentation of machine type, coils used, and actual intensity as a function of maximum stimulator output. Phosphene threshold might be used to index stimulation intensity when rTMS is applied to the visual cortex, and research should be directed to identifying other indexes of intensity for TMS to other non-motor areas.

SIGNIFICANCE

rTMS under the present guidelines is safe, with minimal adverse effects, when applied to non-motor areas.

Impact of Low-Frequency Transcranial Magnetic Stimulation on Brain Automatic Information Processing

Repetitive transcranial magnetic stimulation (rTMS) is considered a powerful method for the study of the relationships between cortical activity and cognitive processes. Previous ERPs studies that focused on P300 response have shown that inhibitory/excitatory effects on prefrontal cortex (PFC), induced by low- and high-frequency rTMS, were able to modulate controlled but not automatic information processing. The present study assessed the impact of inhibition over left and right PFC induced by rTMS on mismatch negativity (MMN), which is known to represent automatic cerebral processes for detecting change. Auditory MMN was recorded in 20 subjects before and after application of left and right PFC 1-Hz rTMS for 15 min. MMN was also recorded before and after a sham-occipital 1-Hz rTMS as control condition. Results showed that 1-Hz rTMS induced no modification to either MMN latency or amplitude. In addition, N100 and P200 components to the frequent tones were not affected by rTMS. These results are consistent with previous findings showing that rTMS over both PFC is unable to disrupt automatic information processing. However, since two sites were stimulated in the present study, no definite conclusions about the inability of rTMS to disrupt automatic processing can be made.

Linking out-of-body experience and self processing to mental own-body imagery at the temporoparietal junction

The spatial unity of self and body is challenged by various philosophical considerations and several phenomena, perhaps most notoriously the "out-of-body experience" (OBE) during which one's visual perspective and one's self are experienced to have departed from their habitual position within one's body. Although researchers started examining isolated aspects of the self, the neurocognitive processes of OBEs have not been investigated experimentally to further our understanding of the self. With the use of evoked potential mapping, we show the selective activation of the temporoparietal junction (TPJ) at 330-400 ms after stimulus onset when healthy volunteers imagined themselves in the position and visual perspective that generally are reported by people experiencing spontaneous OBEs. Interference with the TPJ by transcranial magnetic stimulation (TMS) at this time impaired mental transformation of one's own body in healthy volunteers relative to TMS over a control site. No such TMS effect was observed for imagined spatial transformations of external objects, suggesting the selective implication of the TPJ in mental imagery of one's own body. Finally, in an epileptic patient with OBEs originating from the TPJ, we show partial activation of the seizure focus during mental transformations of her body and visual perspective mimicking her OBE perceptions. These results suggest that the TPJ is a crucial structure for the conscious experience of the normal self, mediating spatial unity of self and body, and also suggest that impaired processing at the TPJ may lead to pathological selves such as OBEs.

The neural correlate of very-long-term picture priming

Repetition priming denotes a behavioural change caused by prior exposure to a stimulus. The effect is known to last for weeks. This study addresses the underlying neural mechanisms for very-long-term picture priming by using event-related functional magnetic resonance imaging complemented by a behavioural paradigm. Previous functional imaging studies with shorter retention intervals have shown that priming is associated with changes in the activity of both the occipital and posterior temporal cortex. In this study we compared retention intervals of 1 day and 6 weeks after initial exposure to a picture stimulus. Priming-related decreases in cortical activity in posterior extrastriate and dorsal left inferior frontal areas were found only for the shorter retention interval. In contrast, fMRI activation in the inferior posterior temporal and anterior left inferior frontal cortex was reduced following priming for both retention intervals. In the behavioural paradigm, the priming effect was stable over time. We conclude that the left inferior frontal and inferior posterior temporal cortex play a key role in the very-long-term priming effect.

Impact of low frequency transcranial magnetic stimulation on event-related brain potentials

Contradictory findings exist concerning the inhibitory function of low frequency repetitive transcranial magnetic stimulation (rTMS). Therefore, the study examines the impact of different duration of low frequency rTMS on ERPs. In 17 subjects, auditory ERPs were measured before and after 1 Hz rTMS delivered over the left prefrontal cortex during 10 min (600 pulses) and 15 min (900 pulses). Results showed that 15 min of 1 Hz rTMS induced a significant increase of P300 latency. There was no effect for early ERP components (N100, P200 and N200). This study confirms and extends that 1 Hz rTMS produces a real inhibitory effect only when the duration of the stimulation is about 15 min. The data suggest that rTMS modifies the speed of cognitive processing rather than the energetical aspect of information processing, and that cortical inhibition induced by the magnetic stimulation affects principally the controlled cognitive processes and not the automatic ones.

Specific and nonspecific effects of transcranial magnetic stimulation on picture-word verification

Repetitive transcranial magnetic stimulation (rTMS) can temporarily impair or improve performance, including language processing. It remains unclear, however, (i) which scalp sites are most appropriate to achieve the desired effects and (ii) which experimental setups produce facilitation or inhibition of language functions. We assessed the effects of TMS at different stimulation sites on picture-word verification in healthy volunteers. Twenty healthy volunteers with left language lateralization, as determined by functional transcranial Dopplersonography, performed picture-word verification prior to and after rTMS (1 Hz for 600 s at 110% of subjects' resting motor thresholds). Stimulation sites were the classical language areas (Broca's and Wernicke's), their homolog brain regions of the right hemisphere, and the occipital cortex. Additionally, sham stimulation over Broca's area was applied in a subsample of 11 subjects. As a control task, 10 volunteers performed a colour-tone matching task under the same experimental conditions. There was a general nonspecific arousal effect for both verum and sham TMS for both the picture-word verification and for the control task. However, superimposed there were opposite effects on picture-word verification for stimulation of Wernicke's area and Broca's area, namely a relative inhibition in the case of Wernicke's area and a relative facilitation in the case of Broca's area. These results demonstrate that low frequency rTMS has both general arousing effects and domain-specific effects.

Functional MRI follow-up study of language processes in healthy subjects and during recovery in a case of aphasia

BACKGROUND AND PURPOSE

The goal of this study was to develop a functional MRI (fMRI) paradigm robust and reproducible enough in healthy subjects to be adapted for a follow-up study aiming at evaluating the anatomical substratum of recovery in poststroke aphasia.

METHODS

Ten right-handed subjects were studied longitudinally using fMRI (7 of them being scanned twice) and compared with a patient with conduction aphasia during the first year of stroke recovery.

RESULTS

Controls exhibited reproducible activation patterns between subjects and between sessions during language tasks. In contrast, the patient exhibited dynamic changes in brain activation pattern, particularly in the phonological task, during the 2 fMRI sessions. At 1 month after stroke, language homotopic right areas were recruited, whereas large perilesional left involvement occurred later (12 months).

CONCLUSIONS

We first demonstrate intersubject robustness and intrasubject reproducibility of our paradigm in 10 healthy subjects and thus its validity in a patient follow-up study over a stroke recovery time course. Indeed, results suggest a spatiotemporal poststroke brain reorganization involving both hemispheres during the recovery course, with an early implication of a new contralateral functional neural network and a later implication of an ipsilateral one.

The spatial and temporal signatures of word production components

This paper presents the results of a comprehensive meta-analysis of the relevant imaging literature on word production (82 experiments). In addition to the spatial overlap of activated regions, we also analyzed the available data on the time course of activations. The analysis specified regions and time windows of activation for the core processes of word production: lexical selection, phonological code retrieval, syllabification, and phonetic/articulatory preparation. A comparison of the word production results with studies on auditory word/non-word perception and reading showed that the time course of activations in word production is, on the whole, compatible with the temporal constraints that perception processes impose on the production processes they affect in picture/word interference paradigms.

The Inferior Frontal Gyrus and Phonological Processing: An Investigation using rTMS

Repetitive transcranial magnetic stimulation (rTMS) offers a powerful new technique for investigating the distinct contributions of the cortical language areas. We have used this method to examine the role of the left inferior frontal gyrus (IFG) in phonological processing and verbal working memory. Functional neuroimaging studies have implicated the posterior part of the left IFG in both phonological decision making and subvocal rehearsal mechanisms, but imaging is a correlational method and it is therefore necessary to determine whether this region is essential for such processes. In this paper we present the results of two experiments in which rTMS was applied over the frontal operculum while subjects performed a delayed phonological matching task. We compared the effects of disrupting this area either during the delay (memory) phase or at the response (decision) phase of the task. Delivered at a time when subjects were required to remember the sound of a visually presented word, rTMS impaired the accuracy with which they subsequently performed the task. However, when delivered later in the trial, as the subjects compared the remembered word with a given pseudoword, rTMS did not impair accuracy. Performance by the same subjects on a control task that required the processing of nonverbal visual stimuli was unaffected by the rTMS. Similarly, performance on both tasks was unaffected by rTMS delivered over a more anterior site (pars triangularis). We conclude that the opercular region of the IFG is necessary for the normal operation of phonologically based working memory mechanisms. Furthermore, this study shows that rTMS can shed further light on the precise role of cortical language areas in humans.

Neural correlates of implicit object identification

The present study sought to assess neural correlates of implicit identification of objects by means of fMRI, using tasks that require matching of the physical properties of objects. Behavioural data suggests that there is automatic access to object identity when observers attend to a physical property of the form of an object (e.g. the object's orientation) and no evidence for semantic processing when subjects attend to colour. We evaluated whether, in addition to neural areas associated with decisions to specific perceptual properties, areas associated with access to semantic information were activated when tasks demanded processing of the global configuration of pictures. We used two perceptual matching tasks based on the global orientation or on the colour of line drawings. Our results confirmed behavioural data. Activations in the inferior occipital cortex, fusiform and inferior temporal gyri in both tasks (orientation and colour) account for perceptual and structural processing involved in each task. In contrast, activations in the posterior and medial parts of the fusiform gyrus, shown to be involved in explicit semantic judgements, were more pronounced in the orientation-matching task, suggesting that semantic information from the pictures is processed in an implicit way even when not required by the task. Thus, this study suggests that cortical regions usually involved in explicit semantic processing are also activated when implicit processing of objects occurs.

Evaluation of the dual route theory of reading: a metanalysis of 35 neuroimaging studies

Numerous studies concerned with cerebral structures underlying word reading have been published during the last decade. A few controversies, however, together with methodological or theoretical discrepancies between laboratories, still contribute to blurring the overall view of advances effected in neuroimaging. Carried out within the dual route of reading framework, the aim of this metanalysis was to provide an objective picture of these advances. To achieve this, we used an automated analysis method based on the inventory of activation peaks issued from word or pseudoword reading contrasts of 35 published neuroimaging studies. A first result of this metanalysis was that no cluster of activations has been found more recruited by word than pseudoword reading, implying that the first steps of word access may be common to word and word-like stimuli and would take place within a left occipitotemporal region (previously referred to as the Visual Word Form Area-VWFA) situated in the ventral route, at the junction between inferior temporal and fusiform gyri. The results also indicated the existence of brain regions predominantly involved in one of the two routes to access word. The graphophonological conversion seems indeed to rely on left lateralized brain structures such as superior temporal areas, supramarginal gyrus, and the opercular part of the inferior frontal gyrus, these last two regions reflecting a greater load in working memory during such an access. The lexicosemantic route is thought to arise from the coactivation of the VWFA and semantic areas. These semantic areas would encompass a basal inferior temporal area, the posterior part of the middle temporal gyrus, and the triangular part of inferior frontal gyrus. These results confirm the suitability of the dual route framework to account for activations observed in nonpathological subjects while they read.

Effects of gender on blood flow correlates of naming concrete entities

A cross-cohort PET analysis was performed in 62 normal subjects (31 men and 31 women) to address the issue of whether men and women have different physiologic correlates of naming visually presented concrete entities. The subjects named nonunique concrete entities in one or more conceptual categories and also performed a face orientation decision task. A second analysis was performed in 24 additional subjects to assess whether there were gender effects related to the face orientation decision task and to constrain the interpretation of the first analysis. Male subjects engaged the left inferotemporal region and several other left hemisphere regions more than female subjects did during visual naming. Areas showing more activity in female subjects included the right inferior frontal gyrus and right precentral cortex, regions that were less active in visual naming than in the face orientation decision task. In other words, the male subjects engaged the latter regions less or deactivated them more than female subjects. The results can be interpreted as showing a greater modulation of activity in both hemispheres for men compared to women. Although the gender effects we found are smaller than the task effects, they are not negligible for the purposes of performing and interpreting functional imaging studies.

Category-specific naming deficit identified by intraoperative stimulation mapping and postoperative neuropsychological testing. Case report

Category-specific naming deficits and differential brain activation patterns have been reported in patients naming living as opposed to nonliving objects. The authors report on a case in which they used preoperative functional magnetic resonance (fMR) imaging, intraoperative electrocortical stimulation mapping (ESM), and postoperative neuropsychological testing to map language function. Using the latter two modalities, the authors identified a specific locus for category-specific naming in the posterior inferior temporal lobe, presumably a part of the basal temporal language area. Preoperative fMR imaging findings revealed the presence of a language area in the inferior temporal lobe; intraoperative ESM results indicated that this cortical area may be category specific for living objects; and after resection of the area, the results of postoperative neuropsychological testing confirmed that the patient made significantly more errors while naming living objects compared with nonliving ones (p < 0.001), independent of the effects of word frequency and with an intact system of object recognition and comprehension. These authors are the first to identify a specific and well-localized area of category-specific naming in the inferior temporal lobe and to demonstrate congruence of intraoperative and postoperative category-specific naming deficits. They also emphasize the roles of preoperative and intraoperative testing in predicting clinical outcomes.

Conversion of semantic information into phonological representation: a function in left posterior basal temporal area

A unique feature of Japanese language is that its written sentences consist of both morphograms (kanji) and syllabograms (kana). Despite extensive research by PET, functional MRI and magnetoencephalography, the issues of the difference (or the similarities) between the processing of kanji and kana, and between word reading and object/picture naming have not been resolved as yet. This study investigated the function of the posterior basal temporal area in the language dominant hemisphere in auditory and visual language processing, with special emphasis on semantic and phonological recognition. Subdural electrode grids were placed on the left temporal area of a right-handed woman with intractable temporal lobe epilepsy as part of a pre-surgical evaluation. Her dominant hemisphere for language was shown to be the left on the Wada test. Electric stimulation of 50 Hz was applied to the electrodes during the tasks related to language. Our results showed a clear distinction in the responses and/or performance of the subject depending on the type of characters presented and the tasks employed. Electric stimulation of a localized area in the posterior basal temporal lobe caused neither comprehensive nor productive deficit in the tasks using auditory stimuli. In the tasks using visual stimuli, in contrast, impairments were observed in (i) reading of kanji words and (ii) naming of objects/pictures and geometric designs, but not in (iii) reading of kana, (iv) copying of kanji, kana and geometric designs, and (v) using tools. The subject maintained full comprehension of spoken language, suggesting that the auditory tasks are not processed in the posterior basal temporal area. The fact that the impairment of kanji reading and disturbance of object/picture naming were elicited by electric stimulation of the same area indicates that there is at least one anatomical area that is used commonly for kanji (but not kana) and object processing. The conceptual entity of the test items supposedly was recognized correctly, but the concept failed to be matched to correct phonological representation. The left posterior basal temporal area, therefore, has an important function of connecting visual semantic information into phonological representation.

Semantic processing in the left inferior prefrontal cortex: a combined functional magnetic resonance imaging and transcranial magnetic stimulation study

The involvement of the left inferior prefrontal cortex (LIPC) in phonological processing is well established from both lesion-deficit studies with neurological patients and functional neuroimaging studies of normals. Its involvement in semantic processing, on the other hand, is less clear. Although many imaging studies have demonstrated LIPC activation during semantic tasks, this may be due to implicit phonological processing. This article presents two experiments investigating semantic functions in the LIPC. Results from a functional magnetic resonance imaging experiment demonstrated that both semantic and phonological processing activated a common set of areas within this region. In addition, there was a reliable increase in activation for semantic relative to phonological decisions in the anterior LIPC while the opposite comparison (phonological vs. semantic decisions) revealed an area of enhanced activation within the posterior LIPC. A second experiment used transcranial magnetic stimulation (TMS) to temporarily interfere with neural information processing in the anterior portion of the LIPC to determine whether this region was essential for normal semantic performance. Both repetitive and single pulse TMS significantly slowed subjects' reactions for the semantic but not for the perceptual control task. Our results clarify the functional anatomy of the LIPC by demonstrating that anterior and posterior regions contribute to both semantic and phonological processing, albeit to different extents. In addition, the findings go beyond simply establishing a correlation between semantic processing and activation in the LIPC and demonstrate that a transient disruption of processing selectively interfered with semantic processing.