A case-study of language-specific executive disorder

Language disorders in patients with striatal lesions: Deciphering the role of the striatum in language performance

The classical neural model of language refers to a cortical network involving frontal, parietal and temporal regions. However, patients with subcortical lesions of the striatum have language difficulties. We investigated whether the striatum is directly involved in language or whether its role in decision-making has an indirect effect on language performance, by testing carriers of Huntington's disease (HD) mutations and controls. HD is a genetic neurodegenerative disease primarily affecting the striatum and causing language disorders. We asked carriers of the HD mutation in the premanifest (before clinical diagnosis) and early disease stages, and controls to perform two discrimination tasks, one involving linguistic and the other non-linguistic stimuli. We used the hierarchical drift diffusion model (HDDM) to analyze the participants' responses and to assess the decision and non-decision parameters separately. We hypothesized that any language deficits related to decision-making impairments would be reflected in the decision parameters of linguistic and non-linguistic tasks. We also assessed the relative contributions of both HDDM decision and non-decision parameters to the participants' behavioral data (response time and discriminability). Finally, we investigated whether the decision and non-decision parameters of the HDDM were correlated with brain atrophy. The HDDM analysis showed that patients with early HD have impaired decision parameters relative to controls, regardless of the task. In both tasks, decision parameters better explained the variance of response time and discriminability performance than non-decision parameters. In the linguistic task, decision parameters were positively correlated with gray matter volume in the ventral striatum and putamen, whereas non-decision parameters were not. Language impairment in patients with striatal atrophy is better explained by a deficit of decision-making than by a deficit of core linguistic processing. These results suggest that the striatum is involved in language through the modulation of decision-making, presumably by regulating the process of choice between linguistic alternatives.

The Role of the Dorsolateral Prefrontal Cortex in the Production and Comprehension of Phonologically and Semantically Related Words

Previous studies suggest that producing and comprehending semantically related words relies on inhibitory control over competitive lexical selection which results in the recruitment of the left inferior frontal gyrus (IFG). Few studies, however, have examined the involvement of other regions of the frontal cortex, such as the dorsolateral prefrontal cortex (DLPFC), despite its role in cognitive control related to lexical processing. The primary objective of this study was to elucidate the role of the DLPFC in the production and comprehension of semantically and phonologically related words in blocked cyclic naming and picture-word matching paradigms. Twenty-one adults participated in neuroimaging with functional near-infrared spectroscopy to measure changes in oxygenated and deoxygenated hemoglobin concentrations across the bilateral frontal cortex during blocked cyclic picture naming and blocked cyclic picture-word-matching tasks. After preprocessing, oxygenated and deoxygenated hemoglobin concentrations were obtained for each task (production, comprehension), condition (semantic, phonological) and region (DLPFC, IFG). The results of pairwise t-tests adjusted for multiple comparisons showed significant increases in oxygenated hemoglobin concentration over baseline in the bilateral DLPFC during picture naming for phonologically related words. For picture-word matching, we found significant increases in oxygenated hemoglobin concentration over baseline in the right DLPFC for semantically related words and in the right IFG for phonologically related words. We discuss the results in light of the inhibitory attentional control over competitive lexical access theory in contrast to alternative potential explanations for the findings.

Distinguishing semantic control and phonological control and their role in aphasic deficits: A task switching investigation

People use cognitive control across many contexts in daily life, yet it remains unclear how cognitive control is used in contexts involving language. Distinguishing language-specific cognitive control components may be critical to understanding aphasia, which can co-occur with cognitive control deficits. For example, deficits in control of semantic representations (i.e., semantic control), are thought to contribute to semantic deficits in aphasia. Conversely, little is known about control of phonological representations (i.e., phonological control) in aphasia. We developed a switching task to investigate semantic and phonological control in 32 left hemisphere stroke survivors with aphasia and 37 matched controls. We found that phonological and semantic control were related, but dissociate in the presence of switching demands. People with aphasia exhibited group-wise impairment at phonological control, although individual impairments were subtle except in one case. Several individuals with aphasia exhibited frank semantic control impairments, and these individuals had relative deficits on other semantic tasks. The present findings distinguish semantic control from phonological control, and confirm that semantic control impairments contribute to semantic deficits in aphasia.