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Barker MS, Knight JL, Dean RJ, Richards LJ, Robinson GA. Adynamic spoken language in corpus callosum dysgenesis. Cortex 2024; 180:42-54. [PMID: 39317110 DOI: 10.1016/j.cortex.2024.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/08/2024] [Accepted: 07/30/2024] [Indexed: 09/26/2024]
Abstract
Corpus callosum dysgenesis (CCD) is a congenital brain malformation that occurs when the development of the corpus callosum is disrupted, either partially or completely. The cognitive outcomes in individuals with CCD vary greatly, but generally the neuropsychological profile is characterised by slow processing speed, poor transfer of interhemispheric sensory-motor information, and impaired complex problem solving. Core language skills are often preserved in CCD, but there is some evidence that complex language may be impaired. Thus, the current study sought to examine whether spontaneous speech output was reduced in a cohort of individuals with CCD compared to age-matched controls. We further explored a series of factors that may be contributing to poor spontaneous speech in CCD, such as difficulties generating, selecting, and sequencing ideas for expression, as well as apathy and slowed processing speed. A cohort of 25 individuals with CCD and 39 neurotypical controls were enrolled in this study. Participants completed a picture description task to measure spontaneous speech output, alongside a series of cognitive and language baseline tests. Verbal and nonverbal fluency tasks gauged idea generation and sequencing, and sentence-level selection tasks measured idea selection. We found that, despite having largely intact core language skills, individuals with CCD produced significantly less spontaneous speech on the picture description task than controls. This language profile may be described as "adynamic". Further, we found that poor spontaneous speech output in CCD was related to problems generating ideas for expression, as individuals with CCD performed below controls on the verbal and nonverbal fluency tasks. Exploratory analyses revealed that apathy and slowed processing speed may be contributing factors. Adynamia in CCD is a novel finding that may be an intervention target for improving communication skills in this population.
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Affiliation(s)
- Megan S Barker
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, Australia; Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
| | - Jacquelyn L Knight
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Ryan J Dean
- Department of Neuroscience, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Linda J Richards
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia; Department of Neuroscience, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, QLD, Australia; Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia.
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Phillips MR, Byrne J, Gibson EC, Gilbert C, Ford L, Marsh G, Chow J, Robinson GA. The brief executive language screen: sensitivity and specificity in acute to early sub-acute stroke. Top Stroke Rehabil 2024:1-13. [PMID: 38833512 DOI: 10.1080/10749357.2024.2356412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/23/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Propositional language and underlying executive functions can be impaired post-stroke and affect communication and quality of life. Current stroke screening tools are largely tailored to patients with aphasia, being either non-verbal or focussed on core language skills such as naming and repetition. The Brief Executive Language Screening Test (BELS) is a newly developed cognitive screening tool that assesses memory, oral apraxia, core language, as well as propositional language and associated executive functions that can be impacted and overlooked in stroke patients without aphasia. This study examines BELS sensitivity and specificity, and performance in acute to early sub-acute stroke relative to controls. METHOD Cross-sectional BELS data from 88 acute left and right hemisphere stroke patients (within 7 weeks of stroke) and 116 age-matched healthy controls were compared using independent samples t-tests. ROC Curve Analysis was performed to determine a cutoff score for the BELS. RESULTS Left and right stroke patients were reduced on all propositional language subtests, and executive function subtests of inhibition, strategy, and selection. Differences were also observed for Oral Apraxia, Naming, and Memory. By contrast, Word Comprehension and Repetition, and Sentence Completion Initiation (after corrections applied) did not differ between groups. A total BELS score of 79.25/100 was highly sensitive (.89) and specific (.89) when classifying stroke patients and healthy controls. CONCLUSION The BELS is brief, sensitive, suitable for bedside administration, and can aid in detection and rehabilitation of subtle executive language impairments. This in turn will help improve relationships and quality of life post-stroke.
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Affiliation(s)
- Mia R Phillips
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia
| | - Jessica Byrne
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Emily C Gibson
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Casey Gilbert
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Lucy Ford
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Georgia Marsh
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Jessica Chow
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Gail A Robinson
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
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Barker MS, Knight JL, Dean RJ, Mandelstam S, Richards LJ, Robinson GA. Verbal Adynamia and Conceptualization in Partial Rhombencephalosynapsis and Corpus Callosum Dysgenesis. Cogn Behav Neurol 2021; 34:38-52. [PMID: 33652468 DOI: 10.1097/wnn.0000000000000261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/02/2020] [Indexed: 11/26/2022]
Abstract
Verbal adynamia is characterized by markedly reduced spontaneous speech that is not attributable to a core language deficit such as impaired naming, reading, repetition, or comprehension. In some cases, verbal adynamia is severe enough to be considered dynamic aphasia. We report the case of a 40-year-old, left-handed, male native English speaker who presented with partial rhombencephalosynapsis, corpus callosum dysgenesis, and a language profile that is consistent with verbal adynamia, or subclinical dynamic aphasia, possibly underpinned by difficulties selecting and generating ideas for expression. This case is only the second investigation of dynamic aphasia in an individual with a congenital brain malformation. It is also the first detailed neuropsychological report of an adult with partial rhombencephalosynapsis and corpus callosum dysgenesis, and the only known case of superior intellectual abilities in this context.
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Affiliation(s)
- Megan S Barker
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, Australia
- Taub Institute, Columbia University Medical Center, New York, New York
| | - Jacquelyn L Knight
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, Australia
| | - Ryan J Dean
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
| | - Simone Mandelstam
- Department of Radiology, University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Linda J Richards
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
- School of Biomedical Sciences, The University of Queensland, St. Lucia, Brisbane, Australia
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St Lucia, Brisbane, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, Australia
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Barker MS, Ceslis A, Robinson GA. Idea selection for propositional language production. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 29:260-283. [PMID: 33356844 DOI: 10.1080/13825585.2020.1862044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The ability to select an idea from an array of competing options is critical for successful propositional language production, and deficient idea selection contributes to propositional language impairments in clinical populations. We investigate whether three clinical idea selection tasks are sensitive to selection demands in neurologically unimpaired adults, and whether performance relates to age. 154 neurologically normal adults aged 18-89 years completed a neuropsychological baseline and three idea selection tasks. Stimuli either activated a dominant response or multiple competing response options. All three idea selection tasks were sensitive to selection demands in terms of reaction times but not errors. Older age was associated with greater effects of selection demands on Sentence Completion task performance only. Exploratory analyses revealed a potential role of executive functioning. Overall, we demonstrate that clinical idea selection tasks are sensitive to idea selection demands in a non-clinical sample, and show some age-related differences in performance.
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Affiliation(s)
- Megan S Barker
- Neuropsychology Research Clinic, School of Psychology, The University of Queensland, Brisbane, Australia.,Taub Institute, Columbia University Medical Center, New York, NY, USA
| | - Amelia Ceslis
- Neuropsychology Research Clinic, School of Psychology, The University of Queensland, Brisbane, Australia
| | - Gail A Robinson
- Neuropsychology Research Clinic, School of Psychology, The University of Queensland, Brisbane, Australia.,Queensland Brain Institute, The University of Queensland, Brisbane, Australia
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Zyryanov A, Malyutina S, Dragoy O. Left frontal aslant tract and lexical selection: Evidence from frontal lobe lesions. Neuropsychologia 2020; 147:107385. [PMID: 32057935 DOI: 10.1016/j.neuropsychologia.2020.107385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/28/2019] [Accepted: 02/09/2020] [Indexed: 10/25/2022]
Abstract
The frontal aslant tract (FAT) is a white-matter tract connecting the inferior frontal gyrus (IFG) and the supplementary motor complex (SMC). Damage to either component of the network causes spontaneous speech dysfluency, indicating its critical role in language production. However, spontaneous speech dysfluency may stem from various lower-level linguistic deficits, precluding inferences about the nature of linguistic processing subserved by the IFG-SMC network. Since the IFG and the SMC are attributed a role in conceptual and lexical selection during language production, we hypothesized that these processes rely on the IFG-SMC connectivity via the FAT. We analysed the effects of FAT volume on conceptual and lexical selection measures following frontal lobe stroke. The measures were obtained from the sentence completion task, tapping into conceptual and lexical selection, and the picture-word interference task, providing a more specific measure of lexical selection. Lower FAT volume was not associated with lower conceptual or lexical selection abilities in our patient cohort. Current findings stand in marked discrepancy with previous lesion and neuroimaging evidence for the joint contribution of the IFG and the SMC to lexical and conceptual selection. A plausible explanation reconciling this discrepancy is that the IFG-SMC connectivity via the FAT does contribute to conceptual and/or lexical selection but its disrupted function undergoes reorganisation over the course of post-stroke recovery. Thus, our negative findings stress the importance of testing the causal role of the FAT in lexical and conceptual selection in patients with more acute frontal lobe lesions.
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Affiliation(s)
- Andrey Zyryanov
- Center for Language and Brain, National Research University Higher School of Economics, 21/4 Staraya Basmannaya St., Office 510, Moscow, 105066, Russia.
| | - Svetlana Malyutina
- Center for Language and Brain, National Research University Higher School of Economics, 21/4 Staraya Basmannaya St., Office 510, Moscow, 105066, Russia
| | - Olga Dragoy
- Center for Language and Brain, National Research University Higher School of Economics, 21/4 Staraya Basmannaya St., Office 510, Moscow, 105066, Russia; Department of Medical Rehabilitation, Federal Center for Cerebrovascular Pathology and Stroke, 1 Ostrovityanova St., 117997, Russia
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Abstract
BACKGROUND Language and communication are fundamental to the human experience, and, traditionally, spoken language is studied as an isolated skill. However, before propositional language (i.e., spontaneous, voluntary, novel speech) can be produced, propositional content or 'ideas' must be formulated. OBJECTIVE This review highlights the role of broader cognitive processes, particularly 'executive attention', in the formulation of propositional content (i.e., 'ideas') for propositional language production. CONCLUSIONS Several key lines of evidence converge to suggest that the formulation of ideas for propositional language production draws on executive attentional processes. Larger-scale clinical research has demonstrated a link between attentional processes and language, while detailed case studies of neurological patients have elucidated specific idea formulation mechanisms relating to the generation, selection and sequencing of ideas for expression. Furthermore, executive attentional processes have been implicated in the generation of ideas for propositional language production. Finally, neuroimaging studies suggest that a widely distributed network of brain regions, including parts of the prefrontal and parietal cortices, supports propositional language production. IMPLICATIONS Theoretically driven experimental research studies investigating mechanisms involved in the formulation of ideas are lacking. We suggest that novel experimental approaches are needed to define the contribution of executive attentional processes to idea formulation, from which comprehensive models of spoken language production can be developed. Clinically, propositional language impairments should be considered in the context of broader executive attentional deficits.
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