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Lopes da Cunha P, Ruiz F, Ferrante F, Sterpin LF, Ibáñez A, Slachevsky A, Matallana D, Martínez Á, Hesse E, García AM. Automated free speech analysis reveals distinct markers of Alzheimer's and frontotemporal dementia. PLoS One 2024; 19:e0304272. [PMID: 38843210 PMCID: PMC11156374 DOI: 10.1371/journal.pone.0304272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
Dementia can disrupt how people experience and describe events as well as their own role in them. Alzheimer's disease (AD) compromises the processing of entities expressed by nouns, while behavioral variant frontotemporal dementia (bvFTD) entails a depersonalized perspective with increased third-person references. Yet, no study has examined whether these patterns can be captured in connected speech via natural language processing tools. To tackle such gaps, we asked 96 participants (32 AD patients, 32 bvFTD patients, 32 healthy controls) to narrate a typical day of their lives and calculated the proportion of nouns, verbs, and first- or third-person markers (via part-of-speech and morphological tagging). We also extracted objective properties (frequency, phonological neighborhood, length, semantic variability) from each content word. In our main study (with 21 AD patients, 21 bvFTD patients, and 21 healthy controls), we used inferential statistics and machine learning for group-level and subject-level discrimination. The above linguistic features were correlated with patients' scores in tests of general cognitive status and executive functions. We found that, compared with HCs, (i) AD (but not bvFTD) patients produced significantly fewer nouns, (ii) bvFTD (but not AD) patients used significantly more third-person markers, and (iii) both patient groups produced more frequent words. Machine learning analyses showed that these features identified individuals with AD and bvFTD (AUC = 0.71). A generalizability test, with a model trained on the entire main study sample and tested on hold-out samples (11 AD patients, 11 bvFTD patients, 11 healthy controls), showed even better performance, with AUCs of 0.76 and 0.83 for AD and bvFTD, respectively. No linguistic feature was significantly correlated with cognitive test scores in either patient group. These results suggest that specific cognitive traits of each disorder can be captured automatically in connected speech, favoring interpretability for enhanced syndrome characterization, diagnosis, and monitoring.
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Affiliation(s)
- Pamela Lopes da Cunha
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Fabián Ruiz
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Buenos Aires, Argentina
| | - Franco Ferrante
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Facultad de Ingeniería, Universidad de Buenos Aires (FIUBA), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Lucas Federico Sterpin
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Buenos Aires, Argentina
- Latin American Brain Health (BrainLat) Institute, Universidad Adolfo Ibáñez, Santiago, Peñalolén, Región Metropolitana, Chile
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, United States of America
- Trinity College Dublin, Dublin, Ireland
| | - Andrea Slachevsky
- Faculty of Medicine, Neuroscience and East Neuroscience Departments, Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Program – Institute of Biomedical Sciences (ICBM), University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Providencia, Santiago, Chile
- Hospital del Salvador and Faculty of Medicine, Memory and Neuropsychiatric Center (CMYN), Neurology Department, University of Chile, Providencia, Santiago, Chile
- Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, Las Condes, Región Metropolitana, Chile
| | - Diana Matallana
- Facultad de Medicina, Departamento de Psiquiatría (Programa PhD Neurociencias), Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
- Centro de Memoria y Cognición, Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia
- Departamento de Salud Mental, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia
| | - Ángela Martínez
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Eugenia Hesse
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Buenos Aires, Argentina
- Departamento de Matemática, Universidad de San Andres, Victoria, Buenos Aires, Argentina
| | - Adolfo M. García
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Buenos Aires, Argentina
- Latin American Brain Health (BrainLat) Institute, Universidad Adolfo Ibáñez, Santiago, Peñalolén, Región Metropolitana, Chile
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, United States of America
- Facultad de Humanidades, Departamento de Lingüística y Literatura, Universidad de Santiago de Chile, Estación Central, Santiago, Chile
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2
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Taylor D, Gönül G, Alexander C, Züberbühler K, Clément F, Glock HJ. Reading minds or reading scripts? De-intellectualising theory of mind. Biol Rev Camb Philos Soc 2023; 98:2028-2048. [PMID: 37408142 DOI: 10.1111/brv.12994] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023]
Abstract
Understanding the origins of human social cognition is a central challenge in contemporary science. In recent decades, the idea of a 'Theory of Mind' (ToM) has emerged as the most popular way of explaining unique features of human social cognition. This default view has been progressively undermined by research on 'implicit' ToM, which suggests that relevant precursor abilities may already be present in preverbal human infants and great apes. However, this area of research suffers from conceptual difficulties and empirical limitations, including explanatory circularity, over-intellectualisation, and inconsistent empirical replication. Our article breaks new ground by adapting 'script theory' for application to both linguistic and non-linguistic agents. It thereby provides a new theoretical framework able to resolve the aforementioned issues, generate novel predictions, and provide a plausible account of how individuals make sense of the behaviour of others. Script theory is based on the premise that pre-verbal infants and great apes are capable of basic forms of agency-detection and non-mentalistic goal understanding, allowing individuals to form event-schemata that are then used to make sense of the behaviour of others. We show how script theory circumvents fundamental problems created by ToM-based frameworks, explains patterns of inconsistent replication, and offers important novel predictions regarding how humans and other animals understand and predict the behaviour of others.
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Affiliation(s)
- Derry Taylor
- Faculty of Science, Institute of Biology, Department of Comparative Cognition, University of Neuchâtel, Rue-Emile-Argand 11, Neuchâtel, 2000, Switzerland
| | - Gökhan Gönül
- Faculty of Letters and Human Sciences, Institute of Language and Communication Sciences, Cognitive Science Centre, University of Neuchâtel, Pierre-à-Mazel 7, Neuchâtel, 2000, Switzerland
| | - Cameron Alexander
- Department of Philosophy, University of Zürich, Zürichbergstrasse 43, Zurich, CH-8044, Switzerland
| | - Klaus Züberbühler
- Faculty of Science, Institute of Biology, Department of Comparative Cognition, University of Neuchâtel, Rue-Emile-Argand 11, Neuchâtel, 2000, Switzerland
| | - Fabrice Clément
- Faculty of Letters and Human Sciences, Institute of Language and Communication Sciences, Cognitive Science Centre, University of Neuchâtel, Pierre-à-Mazel 7, Neuchâtel, 2000, Switzerland
| | - Hans-Johann Glock
- Department of Philosophy, University of Zürich, Zürichbergstrasse 43, Zurich, CH-8044, Switzerland
- Institute for the Study of Language Evolution, University of Zürich, Affolternstrasse 56, Zürich, CH-8050, Switzerland
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Díaz-Rivera MN, Birba A, Fittipaldi S, Mola D, Morera Y, de Vega M, Moguilner S, Lillo P, Slachevsky A, González Campo C, Ibáñez A, García AM. Multidimensional inhibitory signatures of sentential negation in behavioral variant frontotemporal dementia. Cereb Cortex 2022; 33:403-420. [PMID: 35253864 PMCID: PMC9837611 DOI: 10.1093/cercor/bhac074] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Processing of linguistic negation has been associated to inhibitory brain mechanisms. However, no study has tapped this link via multimodal measures in patients with core inhibitory alterations, a critical approach to reveal direct neural correlates and potential disease markers. METHODS Here we examined oscillatory, neuroanatomical, and functional connectivity signatures of a recently reported Go/No-go negation task in healthy controls and behavioral variant frontotemporal dementia (bvFTD) patients, typified by primary and generalized inhibitory disruptions. To test for specificity, we also recruited persons with Alzheimer's disease (AD), a disease involving frequent but nonprimary inhibitory deficits. RESULTS In controls, negative sentences in the No-go condition distinctly involved frontocentral delta (2-3 Hz) suppression, a canonical inhibitory marker. In bvFTD patients, this modulation was selectively abolished and significantly correlated with the volume and functional connectivity of regions supporting inhibition (e.g. precentral gyrus, caudate nucleus, and cerebellum). Such canonical delta suppression was preserved in the AD group and associated with widespread anatomo-functional patterns across non-inhibitory regions. DISCUSSION These findings suggest that negation hinges on the integrity and interaction of spatiotemporal inhibitory mechanisms. Moreover, our results reveal potential neurocognitive markers of bvFTD, opening a new agenda at the crossing of cognitive neuroscience and behavioral neurology.
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Affiliation(s)
- Mariano N Díaz-Rivera
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,Agencia Nacional de Promoción Científica y Tecnológica (ANPCyT), C1425FQD, Godoy Cruz 2370, Buenos Aires, Argentina
| | - Agustina Birba
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Sol Fittipaldi
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Débora Mola
- Instituto de Investigaciones Psicológicas, CONICET, 5000, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Yurena Morera
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Campus de Guajara, 38205 La Laguna, Santa Cruz de Tenerife, Spain
| | - Manuel de Vega
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Campus de Guajara, 38205 La Laguna, Santa Cruz de Tenerife, Spain
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000, Santiago, Chile
| | - Patricia Lillo
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile, 8380000, Santiago, Chile.,Unidad de Neurología, Hospital San José, 8380000, Santiago, Chile.,Geroscience Center for Brain Health and Metabolism (GERO), 7800003, Santiago, Chile
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), 7800003, Santiago, Chile.,Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Neuroscience and East Neuroscience Departments, Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, 8380000, Santiago, Chile.,Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, 7500000, Santiago, Chile.,Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, 7550000, Santiago, Chile
| | - Cecilia González Campo
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina.,Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000, Santiago, Chile
| | - Adolfo M García
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina.,Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, 7550000, Santiago, Chile
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Jafarpour A, Buffalo EA, Knight RT, Collins AG. Event segmentation reveals working memory forgetting rate. iScience 2022; 25:103902. [PMID: 35252809 PMCID: PMC8891967 DOI: 10.1016/j.isci.2022.103902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/30/2021] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
We encounter the world as a continuous flow and effortlessly segment sequences of events into episodes. This process of event segmentation engages working memory (WM) for tracking the flow of events and impacts subsequent memory accuracy. WM is limited in how much information (i.e., WM capacity) and for how long the information is retained (i.e., forgetting rate). In this study, across multiple tasks, we estimated participants’ WM capacity and forgetting rate in a dynamic context and evaluated their relationship to event segmentation. A U-shaped relationship across tasks shows that individuals who segmented the movie more finely or coarsely than the average have a faster WM forgetting rate. A separate task assessing long-term memory retrieval revealed that the coarse-segmenters have better recognition of temporal order of events compared to the fine-segmenters. These findings show that event segmentation employs dissociable memory strategies and correlates with how long information is retained in WM The event segmentation grain is variable across individuals The event segmentation grain has a U-shaped relationship with the WM forgetting rate The temporal order memory accuracy decreases with the increasing event segmentation The number of recalled events increases with the increasing event segmentation
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5
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Geraudie A, Battista P, García AM, Allen IE, Miller ZA, Gorno-Tempini ML, Montembeault M. Speech and language impairments in behavioral variant frontotemporal dementia: A systematic review. Neurosci Biobehav Rev 2021; 131:1076-1095. [PMID: 34673112 DOI: 10.1016/j.neubiorev.2021.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
Although behavioral variant frontotemporal dementia (bvFTD) is classically defined by behavioral and socio-emotional changes, impairments often extend to other cognitive functions. These include early speech and language deficits related to the disease's core neural disruptions. Yet, their scope and clinical relevance remains poorly understood. This systematic review characterizes such disturbances in bvFTD, considering clinically, neuroanatomically, genetically, and neuropathologically defined subgroups. We included 181 experimental studies, with at least 5 bvFTD patients diagnosed using accepted criteria, comparing speech and language outcomes between bvFTD patients and healthy controls or between bvFTD subgroups. Results reveal extensive and heterogeneous deficits across cohorts, with (a) consistent lexico-semantic, reading & writing, and prosodic impairments; (b) inconsistent deficits in motor speech and grammar; and (c) relative preservation of phonological skills. Also, preliminary findings suggest that the severity of speech and language deficits might be associated with global cognitive impairment, predominantly temporal or fronto-temporal atrophy and MAPT mutations (vs C9orf72). Although under-recognized, these impairments contribute to patient characterization and phenotyping, while potentially informing diagnosis and management.
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Affiliation(s)
- Amandine Geraudie
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Neurology Department, Toulouse University Hospital, Toulouse, France
| | - Petronilla Battista
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA; Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Via Generale Nicola Bellomo, Bari, Italy
| | - Adolfo M García
- Global Brain Health Institute, University of California, San Francisco, USA; Universidad De San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Isabel E Allen
- Global Brain Health Institute, University of California, San Francisco, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA.
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6
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Giovannetti T, Mis R, Hackett K, Simone SM, Ungrady MB. The goal-control model: An integrated neuropsychological framework to explain impaired performance of everyday activities. Neuropsychology 2021; 35:3-18. [PMID: 33393796 DOI: 10.1037/neu0000714] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This review describes the relatively small body of neuropsychological and cognitive research conducted over the past 100 years focused on theoretical models explaining the neurocognitive processes that support everyday functioning and the breakdown of functional abilities in the face of neurological damage or disease. METHOD The historical roots of the theories of everyday activities based on direct observation of behavior in neurology and diary reports of everyday errors in cognitive psychology are presented, followed by a review of the empirical findings and resulting theoretical conceptualizations from case studies and group studies of various clinical populations in neuropsychology. RESULTS We conclude with a new framework (the goal-control model) that integrates the most recent empirical findings in neuropsychology with mechanisms proposed by cognitive models. CONCLUSIONS The goal-control model offers empirically supported solutions to understanding and predicting functioning in the real world. This new model generates testable predictions for future research and provides guidance for clinical assessment and interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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7
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Cho S, Nevler N, Ash S, Shellikeri S, Irwin DJ, Massimo L, Rascovsky K, Olm C, Grossman M, Liberman M. Automated analysis of lexical features in frontotemporal degeneration. Cortex 2021; 137:215-231. [PMID: 33640853 PMCID: PMC8044033 DOI: 10.1016/j.cortex.2021.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/26/2020] [Accepted: 01/22/2021] [Indexed: 12/14/2022]
Abstract
We implemented an automated analysis of lexical aspects of semi-structured speech produced by healthy elderly controls (n = 37) and three patient groups with frontotemporal degeneration (FTD): behavioral variant FTD (n = 74), semantic variant primary progressive aphasia (svPPA, n = 42), and nonfluent/agrammatic PPA (naPPA, n = 22). Based on previous findings, we hypothesized that the three patient groups and controls would differ in the counts of part-of-speech (POS) categories and several lexical measures. With a natural language processing program, we automatically tagged POS categories of all words produced during a picture description task. We further counted the number of wh-words, and we rated nouns for abstractness, ambiguity, frequency, familiarity, and age of acquisition. We also computed the cross-entropy estimation, where low cross-entropy indicates high predictability, and lexical diversity for each description. We validated a subset of the POS data that were automatically tagged with the Google Universal POS scheme using gold-standard POS data tagged by a linguist, and we found that the POS categories from our automated methods were more than 90% accurate. For svPPA patients, we found fewer unique nouns than in naPPA and more pronouns and wh-words than in the other groups. We also found high abstractness, ambiguity, frequency, and familiarity for nouns and the lowest cross-entropy estimation among all groups. These measures were associated with cortical thinning in the left temporal lobe. In naPPA patients, we found increased speech errors and partial words compared to controls, and these impairments were associated with cortical thinning in the left middle frontal gyrus. bvFTD patients' adjective production was decreased compared to controls and was correlated with their apathy scores. Their adjective production was associated with cortical thinning in the dorsolateral frontal and orbitofrontal gyri. Our results demonstrate distinct language profiles in subgroups of FTD patients and validate our automated method of analyzing FTD patients' speech.
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Affiliation(s)
- Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA.
| | - Naomi Nevler
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon Ash
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjana Shellikeri
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren Massimo
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Katya Rascovsky
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Olm
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA; Department of Radiology and Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
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Healey M, Howard E, Ungrady M, Olm CA, Nevler N, Irwin DJ, Grossman M. More Than Words: Extra-Sylvian Neuroanatomic Networks Support Indirect Speech Act Comprehension and Discourse in Behavioral Variant Frontotemporal Dementia. Front Hum Neurosci 2021; 14:598131. [PMID: 33519400 PMCID: PMC7842266 DOI: 10.3389/fnhum.2020.598131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/24/2020] [Indexed: 11/13/2022] Open
Abstract
Indirect speech acts—responding “I forgot to wear my watch today” to someone who asked for the time—are ubiquitous in daily conversation, but are understudied in current neurobiological models of language. To comprehend an indirect speech act like this one, listeners must not only decode the lexical-semantic content of the utterance, but also make a pragmatic, bridging inference. This inference allows listeners to derive the speaker’s true, intended meaning—in the above dialog, for example, that the speaker cannot provide the time. In the present work, we address this major gap by asking non-aphasic patients with behavioral variant frontotemporal dementia (bvFTD, n = 21) and brain-damaged controls with amnestic mild cognitive impairment (MCI, n = 17) to judge simple question-answer dialogs of the form: “Do you want some cake for dessert?” “I’m on a very strict diet right now,” and relate the results to structural and diffusion MRI. Accuracy and reaction time results demonstrate that subjects with bvFTD, but not MCI, are selectively impaired in indirect relative to direct speech act comprehension, due in part to their social and executive limitations, and performance is related to caregivers’ judgment of communication efficacy. MRI imaging associates the observed impairment in bvFTD to cortical thinning not only in traditional language-associated regions, but also in fronto-parietal regions implicated in social and executive cerebral networks. Finally, diffusion tensor imaging analyses implicate white matter tracts in both dorsal and ventral projection streams, including superior longitudinal fasciculus, frontal aslant, and uncinate fasciculus. These results have strong implications for updated neurobiological models of language, and emphasize a core, language-mediated social disorder in patients with bvFTD.
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Affiliation(s)
- Meghan Healey
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.,Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Erica Howard
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Molly Ungrady
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Christopher A Olm
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.,Penn Image Computing and Science Laboratory, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Naomi Nevler
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.,Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.,Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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9
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Cho S, Nevler N, Ash S, Shellikeri S, Irwin DJ, Massimo L, Rascovsky K, Olm C, Grossman M, Liberman M. Automated analysis of lexical features in Frontotemporal Degeneration. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.09.10.20192054. [PMID: 33173922 PMCID: PMC7654918 DOI: 10.1101/2020.09.10.20192054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We implemented an automated analysis of lexical aspects of semi-structured speech produced by healthy elderly controls (n=37) and three patient groups with frontotemporal degeneration (FTD): behavioral variant FTD (n=74), semantic variant primary progressive aphasia (svPPA, n=42), and nonfluent/agrammatic PPA (naPPA, n=22). Based on previous findings, we hypothesized that the three patient groups and controls would differ in the counts of part-of-speech (POS) categories and several lexical measures. With a natural language processing program, we automatically tagged POS categories of all words produced during a picture description task. We further counted the number of wh -words, and we rated nouns for abstractness, ambiguity, frequency, familiarity, and age of acquisition. We also computed the cross-entropy estimation, which is a measure of word predictability, and lexical diversity for each description. We validated a subset of the POS data that were automatically tagged with the Google Universal POS scheme using gold-standard POS data tagged by a linguist, and we found that the POS categories from our automated methods were more than 90% accurate. For svPPA patients, we found fewer unique nouns than in naPPA and more pronouns and wh -words than in the other groups. We also found high abstractness, ambiguity, frequency, and familiarity for nouns and the lowest cross-entropy estimation among all groups. These measures were associated with cortical thinning in the left temporal lobe. In naPPA patients, we found increased speech errors and partial words compared to controls, and these impairments were associated with cortical thinning in the left middle frontal gyrus. bvFTD patients' adjective production was decreased compared to controls and was correlated with their apathy scores. Their adjective production was associated with cortical thinning in the dorsolateral frontal and orbitofrontal gyri. Our results demonstrate distinct language profiles in subgroups of FTD patients and validate our automated method of analyzing FTD patients' speech.
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Affiliation(s)
- Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
| | - Naomi Nevler
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon Ash
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjana Shellikeri
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - David J. Irwin
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren Massimo
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Katya Rascovsky
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Olm
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology and Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
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10
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Divers R, Ham L, Matchanova A, Hackett K, Mis R, Howard K, Rycroft SS, Roll E, Giovannetti T. When and how did you go wrong? Characterizing mild functional difficulties in older adults during an everyday task. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:308-326. [PMID: 32352347 DOI: 10.1080/13825585.2020.1756210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Mild functional difficulties associated with cognitive aging may be reliably measured by coding "micro-errors" during everyday tasks, like meal preparation. Micro-errors made by 25 older adult and 48 younger adults were coded on four dimensions to evaluate the influence of: 1) poor error monitoring; 2) goal decay; 3) competition for response selection when switching to a new subtask; and 4) interference from distractor objects. Micro-errors made by young adults under a dual task load also were analyzed to determine the influence of overall performance level. Older adults' micro-errors were observed when switching to a new subtask and to unrelated distractors. Slowed error monitoring and goal decay also influenced micro-errors in older adults, but not significantly more so than younger adults under the dual task. Interventions to reduce interference from distractors and to increase attention at critical choice points during tasks may optimize everyday functioning and preclude decline in older adults.
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Affiliation(s)
- Ross Divers
- Department of Psychology, Temple University , Philadelphia, PA, USA
| | - Lillian Ham
- Department of Psychology, Temple University , Philadelphia, PA, USA
| | | | | | - Rachel Mis
- Department of Psychology, Temple University , Philadelphia, PA, USA
| | - Kia Howard
- Department of Psychology, Temple University , Philadelphia, PA, USA
| | | | - Emily Roll
- Department of Psychology, Temple University , Philadelphia, PA, USA
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11
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San Lee J, Yoo S, Park S, Kim HJ, Park KC, Seong JK, Suh MK, Lee J, Jang H, Kim KW, Kim Y, Cho SH, Kim SJ, Kim JP, Jung YH, Kim EJ, Suh YL, Lockhart SN, Seeley WW, Na DL, Seo SW. Differences in neuroimaging features of early- versus late-onset nonfluent/agrammatic primary progressive aphasia. Neurobiol Aging 2019; 86:92-101. [PMID: 31784276 DOI: 10.1016/j.neurobiolaging.2019.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 01/18/2023]
Abstract
This study investigated distinct neuroimaging features measured by cortical thickness and subcortical structural shape abnormality in early-onset (EO, onset age <65 years) and late-onset (LO, onset age ≥65 years) nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA) patients. Cortical thickness and subcortical structural shape analyses were performed using a surface-based method from 38 patients with nfvPPA and 76 cognitively normal individuals. To minimize the effects of physiological aging, we used W-scores in comparisons between the groups. The EO-nfvPPA group exhibited more extensive cortical thickness reductions predominantly in the left perisylvian, lateral and medial prefrontal, temporal, posterior cingulate, and precuneus regions than the LO-nfvPPA group. The EO-nfvPPA group also exhibited significantly greater subcortical structural shape abnormality than the LO-nfvPPA group, mainly in the left striatum, hippocampus, and amygdala. Our findings suggested that there were differences in neuroimaging features between these groups by the age of symptom onset, which might be explained by underlying heterogeneous neuropathological differences or the age-related brain reserve hypothesis.
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Affiliation(s)
- Jin San Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea; Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
| | - Sole Yoo
- Department of Cognitive Science, Yonsei University, Seoul, Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Key-Chung Park
- Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
| | - Joon-Kyung Seong
- Department of Bio-convergence Engineering, School of Biomedical Engineering, Korea University, Seoul, Korea
| | - Mee Kyung Suh
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Juyoun Lee
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Ko Woon Kim
- Department of Neurology, Chonbuk National University Medical School & Hospital, Jeonju, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myungji Hospital, Goyang, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Yeon-Lim Suh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Samuel N Lockhart
- Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea; Samsung Alzheimer Research Center, Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; Department of Health Sciences and Technology, Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
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12
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Abstract
Primary progressive aphasia (PPA) refers to a disorder of declining language associated with neurodegenerative diseases such as frontotemporal degeneration and Alzheimer disease. Variants of PPA are important to recognize from a medical perspective because these syndromes are clinical markers suggesting specific underlying pathology. In this review, I discuss linguistic aspects of PPA syndromes that may prove informative for parsing our language mechanism and identifying the neural representation of fundamental elements of language. I focus on the representation of word meaning in a discussion of semantic variant PPA, grammatical comprehension and expression in a discussion of nonfluent/agrammatic variant PPA, the supporting role of short-term memory in a discussion of logopenic variant PPA, and components of language associated with discourse in a discussion of behavioral variant frontotemporal dementia. PPA provides a novel perspective that uniquely addresses facets of language and its disorders while complementing traditional aphasia syndromes that follow stroke.
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Affiliation(s)
- Murray Grossman
- Penn Frontotemporal Degeneration Center and Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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13
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Nevler N, Ash S, Jester C, Irwin DJ, Liberman M, Grossman M. Automatic measurement of prosody in behavioral variant FTD. Neurology 2017; 89:650-656. [PMID: 28724588 PMCID: PMC5562969 DOI: 10.1212/wnl.0000000000004236] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/21/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To help understand speech changes in behavioral variant frontotemporal dementia (bvFTD), we developed and implemented automatic methods of speech analysis for quantification of prosody, and evaluated clinical and anatomical correlations. METHODS We analyzed semi-structured, digitized speech samples from 32 patients with bvFTD (21 male, mean age 63 ± 8.5, mean disease duration 4 ± 3.1 years) and 17 matched healthy controls (HC). We automatically extracted fundamental frequency (f0, the physical property of sound most closely correlating with perceived pitch) and computed pitch range on a logarithmic scale (semitone) that controls for individual and sex differences. We correlated f0 range with neuropsychiatric tests, and related f0 range to gray matter (GM) atrophy using 3T T1 MRI. RESULTS We found significantly reduced f0 range in patients with bvFTD (mean 4.3 ± 1.8 ST) compared to HC (5.8 ± 2.1 ST; p = 0.03). Regression related reduced f0 range in bvFTD to GM atrophy in bilateral inferior and dorsomedial frontal as well as left anterior cingulate and anterior insular regions. CONCLUSIONS Reduced f0 range reflects impaired prosody in bvFTD. This is associated with neuroanatomic networks implicated in language production and social disorders centered in the frontal lobe. These findings support the feasibility of automated speech analysis in frontotemporal dementia and other disorders.
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Affiliation(s)
- Naomi Nevler
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (N.N., S.A., C.J., D.J.I., M.G.), and Linguistic Data Consortium (M.L.), University of Pennsylvania, Philadelphia.
| | - Sharon Ash
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (N.N., S.A., C.J., D.J.I., M.G.), and Linguistic Data Consortium (M.L.), University of Pennsylvania, Philadelphia
| | - Charles Jester
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (N.N., S.A., C.J., D.J.I., M.G.), and Linguistic Data Consortium (M.L.), University of Pennsylvania, Philadelphia
| | - David J Irwin
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (N.N., S.A., C.J., D.J.I., M.G.), and Linguistic Data Consortium (M.L.), University of Pennsylvania, Philadelphia
| | - Mark Liberman
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (N.N., S.A., C.J., D.J.I., M.G.), and Linguistic Data Consortium (M.L.), University of Pennsylvania, Philadelphia
| | - Murray Grossman
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (N.N., S.A., C.J., D.J.I., M.G.), and Linguistic Data Consortium (M.L.), University of Pennsylvania, Philadelphia.
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14
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Zahn R, Green S, Beaumont H, Burns A, Moll J, Caine D, Gerhard A, Hoffman P, Shaw B, Grafman J, Lambon Ralph MA. Frontotemporal lobar degeneration and social behaviour: Dissociation between the knowledge of its consequences and its conceptual meaning. Cortex 2017. [PMID: 28646671 PMCID: PMC5542070 DOI: 10.1016/j.cortex.2017.05.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Inappropriate social behaviour is an early symptom of frontotemporal lobar degeneration (FTLD) in both behavioural variant frontotemporal dementia (bvFTD) and semantic dementia (SD) subtypes. Knowledge of social behaviour is essential for appropriate social conduct. The superior anterior temporal lobe (ATL) has been identified as one key neural component for the conceptual knowledge of social behaviour, but it is unknown whether this is dissociable from knowledge of the consequences of social behaviour. Here, we used a newly-developed test of knowledge about long-term and short-term consequences of social behaviour to investigate its impairment in patients with FTLD relative to a previously-developed test of social conceptual knowledge. We included 19 healthy elderly control participants and 19 consecutive patients with features of bvFTD or SD and defined dissociations as performance differences between tasks for each patient (Bonferroni-corrected p < .05). Knowledge of long-term consequences was selectively impaired relative to short-term consequences in five patients and the reverse dissociation occurred in one patient. Six patients showed a selective impairment of social concepts relative to long-term consequences with the reverse dissociation occurring in one patient. These results corroborate the hypothesis that knowledge of long-term consequences of social behaviour is dissociable from knowledge of short-term consequences, as well as of social conceptual knowledge. Confirming our hypothesis, we found that patients with more marked grey matter (GM) volume loss in frontopolar relative to right superior ATL regions of interest exhibited poorer knowledge of the long-term consequences of social behaviour relative to the knowledge of its conceptual meaning and vice versa (n = 15). These findings support the hypothesis that frontopolar and ATL regions represent distinct aspects of social knowledge. This suggests that rather than being unable to suppress urges to behave inappropriately, FTLD patients often lose the knowledge of what appropriate social behaviour is and can therefore not be expected to behave accordingly.
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Affiliation(s)
- Roland Zahn
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, King's College London, London, SE5 8AZ, UK; Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK.
| | - Sophie Green
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Helen Beaumont
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Alistair Burns
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Jorge Moll
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
| | - Diana Caine
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK; National Hospital for Neurology & Neurosurgery, Queen Square, London, UK
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK; Department of Nuclear Medicine and Geriatric Medicine, University Hospital Essen, Germany
| | - Paul Hoffman
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Benjamin Shaw
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Jordan Grafman
- Rehabilitation Institute of Chicago, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
| | - Matthew A Lambon Ralph
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
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15
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Grossman M, Irwin DJ, Jester C, Halpin A, Ash S, Rascovsky K, Weintraub D, McMillan CT. Narrative Organization Deficit in Lewy Body Disorders Is Related to Alzheimer Pathology. Front Neurosci 2017; 11:53. [PMID: 28228714 PMCID: PMC5296303 DOI: 10.3389/fnins.2017.00053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 01/25/2017] [Indexed: 01/09/2023] Open
Abstract
Background: Day-to-day interactions depend on conversational narrative, and we examine here the neurobiological basis for difficulty organizing narrative discourse in patients with Lewy body disorders (LBD). Method: Narrative organization was examined in 56 non-aphasic LBD patients, including a non-demented cohort (n = 30) with Parkinson's disease (PD) or PD-Mild Cognitive Impairment PD-MCI,) and a cohort with mild dementia (n = 26) including PD-dementia (PDD) and dementia with Lewy bodies (DLB), with similar age and education but differing in MMSE (p < 0.001). We used a previously reported procedure that probes patients' judgments of the organization of brief, familiar narratives (e.g., going fishing, wrapping a present). A subgroup of 24 patients had MRI assessment of regional gray matter (GM) atrophy and cerebrospinal fluid (CSF) levels of biomarkers for Alzheimer's disease (AD) pathology, including beta amyloid (Aβ), total-tau (t-tau), and phosphorylated-tau (p-tau). Results: Mildly demented LBD patients had a significant deficit judging narratives compared to non-demented patients, but this deficit was not correlated with MMSE. Regression analyses instead related narrative organization to regions of frontal GM atrophy, and CSF levels of Aβ and t-tau associated with presumed AD pathology in these frontal regions. Conclusion: These findings are consistent with the hypothesis that CSF markers of AD pathology associated with frontal regions play a role in difficulty organizing narratives in LBD.
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Affiliation(s)
- Murray Grossman
- Departments of Neurology, University of Pennsylvania PA, USA
| | - David J Irwin
- Departments of Neurology, University of Pennsylvania PA, USA
| | - Charles Jester
- Departments of Neurology, University of Pennsylvania PA, USA
| | - Amy Halpin
- Departments of Neurology, University of Pennsylvania PA, USA
| | - Sharon Ash
- Departments of Neurology, University of Pennsylvania PA, USA
| | - Katya Rascovsky
- Departments of Neurology, University of Pennsylvania PA, USA
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16
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Neural networks for harmonic structure in music perception and action. Neuroimage 2016; 142:454-464. [DOI: 10.1016/j.neuroimage.2016.08.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/30/2016] [Accepted: 08/15/2016] [Indexed: 01/21/2023] Open
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17
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Processing structure in language and music: a case for shared reliance on cognitive control. Psychon Bull Rev 2016; 22:637-52. [PMID: 25092390 DOI: 10.3758/s13423-014-0712-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The relationship between structural processing in music and language has received increasing interest in the past several years, spurred by the influential Shared Syntactic Integration Resource Hypothesis (SSIRH; Patel, Nature Neuroscience, 6, 674-681, 2003). According to this resource-sharing framework, music and language rely on separable syntactic representations but recruit shared cognitive resources to integrate these representations into evolving structures. The SSIRH is supported by findings of interactions between structural manipulations in music and language. However, other recent evidence suggests that such interactions also can arise with nonstructural manipulations, and some recent neuroimaging studies report largely nonoverlapping neural regions involved in processing musical and linguistic structure. These conflicting results raise the question of exactly what shared (and distinct) resources underlie musical and linguistic structural processing. This paper suggests that one shared resource is prefrontal cortical mechanisms of cognitive control, which are recruited to detect and resolve conflict that occurs when expectations are violated and interpretations must be revised. By this account, musical processing involves not just the incremental processing and integration of musical elements as they occur, but also the incremental generation of musical predictions and expectations, which must sometimes be overridden and revised in light of evolving musical input.
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18
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Spotorno N, Healey M, McMillan CT, Rascovsky K, Irwin DJ, Clark R, Grossman M. Processing ambiguity in a linguistic context: decision-making difficulties in non-aphasic patients with behavioral variant frontotemporal degeneration. Front Hum Neurosci 2015; 9:583. [PMID: 26578928 PMCID: PMC4621742 DOI: 10.3389/fnhum.2015.00583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/06/2015] [Indexed: 12/04/2022] Open
Abstract
Some extent of ambiguity is ubiquitous in everyday conversations. For example, words have multiple meaning and very common pronouns, like “he” and “she” (anaphoric pronouns), have little meaning on their own and refer to a noun that has been previously introduced in the discourse. Ambiguity triggers a decision process that is not a subroutine of language processing but rather a more general domain resource. Therefore non-aphasic patients with limited decision-making capability can encounter severe limitation in language processing due to extra linguistic limitations. In the present study, we test patients with behavioral variant frontotemporal degeneration (bvFTD), focusing on anaphora as a paradigmatic example of ambiguity resolution in the linguistic domain. bvFTD is characterized by gray matter (GM) atrophy in prefrontal cortex, but relative sparing of peri-Sylvian cortex. A group of patients with parietal disease due to corticobasal syndrome (CBS) was also tested here in order to investigate the specific role of prefrontal cortex in the task employed in the current study. Participants were presented with a pair of sentences in which the first sentence contained two nouns while the second contained a pronoun. In the experimental (ambiguous) condition, both nouns are plausible referents of the pronoun, thus requiring decision-making resources. The results revealed that bvFTD patients are significantly less accurate than healthy seniors in identifying the correct referent of a pronoun in the ambiguous condition, although CBS patients were as accurate as healthy seniors. Imaging analyses related bvFTD patients’ performance to GM atrophy in ventromedial prefrontal cortex (vmPFC). These results suggest that bvFTD patients have difficulties in decision processes that involve the resolution of an ambiguity.
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Affiliation(s)
- Nicola Spotorno
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Perelman School of Medicine Philadelphia, PA, USA
| | - Meghan Healey
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Perelman School of Medicine Philadelphia, PA, USA
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Perelman School of Medicine Philadelphia, PA, USA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Perelman School of Medicine Philadelphia, PA, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Perelman School of Medicine Philadelphia, PA, USA
| | - Robin Clark
- Department of Linguistics, University of Pennsylvania Philadelphia, PA, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Perelman School of Medicine Philadelphia, PA, USA
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19
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Neural substrates of spontaneous narrative production in focal neurodegenerative disease. Neuropsychologia 2015; 79:158-71. [PMID: 26485159 DOI: 10.1016/j.neuropsychologia.2015.10.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 09/21/2015] [Accepted: 10/15/2015] [Indexed: 12/12/2022]
Abstract
Conversational storytelling integrates diverse cognitive and socio-emotional abilities that critically differ across neurodegenerative disease groups. Storytelling patterns may have diagnostic relevance and predict anatomic changes. The present study employed mixed methods discourse and quantitative analyses to delineate patterns of storytelling across focal neurodegenerative disease groups, and to clarify the neuroanatomical contributions to common storytelling characteristics. Transcripts of spontaneous social interactions of 46 participants (15 behavioral variant frontotemporal dementia (bvFTD), 7 semantic variant primary progressive aphasia (svPPA), 12 Alzheimer's disease (AD), and 12 healthy older normal controls (NC)) were analyzed for storytelling frequency and characteristics, and videos of the interactions were rated for patients' level of social attentiveness. Compared to controls, svPPAs told more stories and autobiographical stories, and perseverated on aspects of self during the interaction, whereas ADs told fewer autobiographical stories than NCs. svPPAs and bvFTDs were rated as less attentive to social cues. Aspects of storytelling were related to diverse cognitive and socio-emotional functions, and voxel-based anatomic analysis of structural magnetic resonance imaging revealed that temporal organization, narrative evaluations patterns, and social attentiveness correlated with atrophy corresponding to known intrinsic connectivity networks, including the default mode, limbic, salience, and stable task control networks. Differences in spontaneous storytelling among neurodegenerative groups elucidated diverse cognitive, socio-emotional, and neural contributions to narrative production, with implications for diagnostic screening and therapeutic intervention.
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20
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Maffongelli L, Bartoli E, Sammler D, Kölsch S, Campus C, Olivier E, Fadiga L, D'Ausilio A. Distinct brain signatures of content and structure violation during action observation. Neuropsychologia 2015; 75:30-9. [PMID: 26004058 DOI: 10.1016/j.neuropsychologia.2015.05.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 05/15/2015] [Accepted: 05/20/2015] [Indexed: 11/19/2022]
Abstract
Sentences, musical phrases and goal-directed actions are composed of elements that are linked by specific rules to form meaningful outcomes. In goal-directed actions including a non-canonical element or scrambling the order of the elements alters the action's content and structure, respectively. In the present study we investigated event-related potentials of the electroencephalographic (EEG) activity recorded during observation of both alterations of the action content (obtained by violating the semantic components of an action, e.g. making coffee with cola) and alterations of the action structure (obtained by inverting the order of two temporally adjacent pictures of sequences depicting daily life actions) interfering with the normal flow of the motor acts that compose an action. Action content alterations elicited a bilateral posterior distributed EEG negativity, peaking at around 400 ms after stimulus onset similar to the ERPs evoked by semantic violations in language studies. Alteration of the action structure elicited an early left anterior negativity followed by a late left anterior positivity, which closely resembles the ERP pattern found in language syntax violation studies. Our results suggest a functional dissociation between the processing of action content and structure, reminiscent of a similar dissociation found in the language or music domains. Importantly, this study provides further support to the hypothesis that some basic mechanisms, such as the rule-based structuring of sequential events, are shared between different cognitive domains.
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Affiliation(s)
| | - E Bartoli
- Istituto Italiano di Tecnologia, Genova, Italy
| | - D Sammler
- Max Planck Institute, Leipzig, Germany
| | - S Kölsch
- Freie Universität Berlin, Germany
| | - C Campus
- Istituto Italiano di Tecnologia, Genova, Italy
| | - E Olivier
- Istituto Italiano di Tecnologia, Genova, Italy; Institute of Neuroscience, Université Catholique de Louvain, Belgium
| | - L Fadiga
- Istituto Italiano di Tecnologia, Genova, Italy; Università di Ferrara, Ferrara, Italy
| | - A D'Ausilio
- Istituto Italiano di Tecnologia, Genova, Italy.
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Healey ML, McMillan CT, Golob S, Spotorno N, Rascovsky K, Irwin DJ, Clark R, Grossman M. Getting on the same page: the neural basis for social coordination deficits in behavioral variant frontotemporal degeneration. Neuropsychologia 2015; 69:56-66. [PMID: 25619850 DOI: 10.1016/j.neuropsychologia.2015.01.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/12/2015] [Accepted: 01/21/2015] [Indexed: 11/16/2022]
Abstract
For social interactions to be successful, individuals must establish shared mental representations that allow them to reach a common understanding and "get on the same page". We refer to this process as social coordination. While examples of social coordination are ubiquitous in daily life, relatively little is known about the neuroanatomic basis of this complex behavior. This is particularly true in a language context, as previous studies have used overly complex paradigms to study this. Although traditional views of language processing and the recent interactive-alignment account of conversation focus on peri-Sylvian regions, our model of social coordination predicts prefrontal involvement. To test this hypothesis, we examine the neural basis of social coordination during conversational exchanges in non-aphasic patients with behavioral variant frontotemporal degeneration (bvFTD). bvFTD patients show impairments in executive function and social comportment due to disease in frontal and anterior temporal regions. To investigate social coordination in bvFTD, we developed a novel language-based task that assesses patients' ability to convey an object's description to a conversational partner. Experimental conditions manipulated the amount of information shared by the participant and the conversational partner, and the associated working memory demands. Our results indicate that, although patients did not have difficulty identifying the features of the objects, they did produce descriptions that included insufficient or inappropriate adjectives and thus struggled to communicate effectively. Impaired performance was related to gray matter atrophy particularly in medial prefrontal and orbitofrontal cortices. Our findings suggest an important role for non-language brain areas that belong to a large-scale neurocognitive network for social coordination.
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Affiliation(s)
- Meghan L Healey
- University of Pennsylvania Perelman School of Medicine, Penn Department of Neurology and Frontotemporal Degeneration Center, Philadelphia, 19104 PA, USA; University of Pennsylvania, Neuroscience Graduate Group, Philadelphia, 19104 PA, USA.
| | - Corey T McMillan
- University of Pennsylvania Perelman School of Medicine, Penn Department of Neurology and Frontotemporal Degeneration Center, Philadelphia, 19104 PA, USA; University of Pennsylvania, Institute for Translational Medicine and Therapeutics, Philadelphia, 19104 PA, USA
| | - Stephanie Golob
- University of Pennsylvania Perelman School of Medicine, Penn Department of Neurology and Frontotemporal Degeneration Center, Philadelphia, 19104 PA, USA
| | - Nicola Spotorno
- University of Pennsylvania Perelman School of Medicine, Penn Department of Neurology and Frontotemporal Degeneration Center, Philadelphia, 19104 PA, USA
| | - Katya Rascovsky
- University of Pennsylvania Perelman School of Medicine, Penn Department of Neurology and Frontotemporal Degeneration Center, Philadelphia, 19104 PA, USA
| | - David J Irwin
- University of Pennsylvania Perelman School of Medicine, Penn Department of Neurology and Frontotemporal Degeneration Center, Philadelphia, 19104 PA, USA; University of Pennsylvania, Institute for Translational Medicine and Therapeutics, Philadelphia, 19104 PA, USA
| | - Robin Clark
- University of Pennsylvania, Department of Linguistics, Philadelphia, 19104 PA, USA
| | - Murray Grossman
- University of Pennsylvania Perelman School of Medicine, Penn Department of Neurology and Frontotemporal Degeneration Center, Philadelphia, 19104 PA, USA; University of Pennsylvania, Neuroscience Graduate Group, Philadelphia, 19104 PA, USA.
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22
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Ash S, Menaged A, Olm C, McMillan CT, Boller A, Irwin DJ, McCluskey L, Elman L, Grossman M. Narrative discourse deficits in amyotrophic lateral sclerosis. Neurology 2014; 83:520-8. [PMID: 24991038 DOI: 10.1212/wnl.0000000000000670] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We examined narrative discourse in amyotrophic lateral sclerosis (ALS) to assess the role of executive functioning in support of language and the neuroanatomical basis for such support. METHODS We analyzed a semistructured speech sample in 26 patients with ALS and 19 healthy seniors for narrative discourse features of coherence. Regression analyses related a measure of discourse coherence ("local connectedness") to gray matter atrophy and reduced white matter fractional anisotropy. RESULTS Patients with ALS were impaired relative to controls on measures of discourse adequacy, including local connectedness and maintenance of the theme. These discourse measures were related to measures of executive functioning but not to motor functioning. Regressions related local connectedness to gray matter atrophy in ventral and dorsal prefrontal regions and to reduced fractional anisotropy in white matter tracts mediating projections between prefrontal regions. CONCLUSION Patients with ALS exhibit deficits in their ability to organize narrative discourse. These deficits appear to be related in part to executive limitations. Consistent with the hypothesis that ALS is a multisystem disorder, this deficit is related to disease in prefrontal regions.
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Affiliation(s)
- Sharon Ash
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
| | - Anna Menaged
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christopher Olm
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Corey T McMillan
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ashley Boller
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - David J Irwin
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Leo McCluskey
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Lauren Elman
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Murray Grossman
- From the Department of Neurology and the Penn Frontotemporal Degeneration Center (S.A., A.M., C.O., C.T.M., A.B., D.J.I., L.M., L.E., M.G.), and Center for Neurodegenerative Disease Research (D.J.I.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
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23
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Charles D, Olm C, Powers J, Ash S, Irwin DJ, McMillan CT, Rascovsky K, Grossman M. Grammatical comprehension deficits in non-fluent/agrammatic primary progressive aphasia. J Neurol Neurosurg Psychiatry 2014; 85:249-56. [PMID: 24039027 PMCID: PMC3925677 DOI: 10.1136/jnnp-2013-305749] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
IMPORTANCE Grammatical comprehension difficulty is an essential supporting feature of the non-fluent/agrammatic variant of primary progressive aphasia (naPPA), but well-controlled clinical measures of grammatical comprehension are unavailable. OBJECTIVE To develop a measure of grammatical comprehension and examine this comparatively in PPA variants and behavioural-variant frontotemporal degeneration (bvFTD) and to assess the neuroanatomic basis for these deficits with volumetric grey matter atrophy and whole-brain fractional anisotropy (FA) in white matter tracts. DESIGN Case-control study. SETTING Academic medical centre. PARTICIPANTS 39 patients with variants of PPA (naPPA=12, lvPPA=15 and svPPA=12), 27 bvFTD patients without aphasia and 12 healthy controls. MAIN OUTCOME MEASURE Grammatical comprehension accuracy. RESULTS Patients with naPPA had selective difficulty understanding cleft sentence structures, while all PPA variants and patients with bvFTD were impaired with sentences containing a centre-embedded subordinate clause. Patients with bvFTD were also impaired understanding sentences involving short-term memory. Linear regressions related grammatical comprehension difficulty in naPPA to left anterior-superior temporal atrophy and reduced FA in corpus callosum and inferior frontal-occipital fasciculus. Difficulty with centre-embedded sentences in other PPA variants was related to other brain regions. CONCLUSIONS AND RELEVANCE These findings emphasise a distinct grammatical comprehension deficit in naPPA and associate this with interruption of a frontal-temporal neural network.
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Affiliation(s)
- Dorothy Charles
- Department of Neurology and Penn FTD Center, University of Pennsylvania, , Philadelphia, Pennsylvania, USA
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24
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Braun CMJ, Guimond A, Payette JF, Daigneault S. Specific early vulnerability of high-order executive function to focal brain lesions and long-term impact on educational persistence: Sparing of incidental episodic memory. Dev Neurorehabil 2013; 16:89-101. [PMID: 23477462 DOI: 10.3109/17518423.2012.723761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We investigated mental functions expected to remain impaired or not ain adulthood following childhood-onset brain lesions. METHODS Thirty unilaterally lesioned young adults were tested a decade after lesion onset with an effort-demanding complex executive function (EF) task as well as a task of incidental declarative retrospective episodic recognition memory (IRM). Thirty neurotypical participants were also tested. RESULTS The EF task was significantly impaired in the lesion group and significantly more so than the IRM task. Regarding the lesioned cases, performance on EF, but not IRM, was significantly positively correlated with long-term educational persistence (EP). Both EF and EP but not IRM were significantly positively correlated with the age of onset of the lesion. Severity of neurological impairment was unrelated to any variable. CONCLUSION Mental abilities acquired through early schooling remain impaired into adulthood when early schooling is disturbed, not everyday memory which does not depend on schooling.
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Affiliation(s)
- Claude M J Braun
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.
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25
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Grossman M. Multimodal comparative studies of neurodegenerative diseases. J Alzheimers Dis 2013; 33 Suppl 1:S379-83. [PMID: 22531420 DOI: 10.3233/jad-2012-129002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Here we provide a brief description of our program to improve diagnostic accuracy in cases with phenotypically similar presentations that are due to distinct histopathologic abnormalities. We propose a staged approach to diagnosis, beginning with a screening assessment of specific, quantitative neuropsychological measures, and followed by assessments of imaging and biofluid biomarkers. Our goal is to determine the specific histopathologic abnormalities contributing to an individual's neurodegenerative condition.
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Affiliation(s)
- Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104-4283, USA.
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26
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Gross RG, Camp E, McMillan CT, Dreyfuss M, Gunawardena D, Cook PA, Morgan B, Siderowf A, Hurtig HI, Stern MB, Grossman M. Impairment of script comprehension in Lewy body spectrum disorders. BRAIN AND LANGUAGE 2013; 125:330-343. [PMID: 23566691 PMCID: PMC3940934 DOI: 10.1016/j.bandl.2013.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 12/08/2012] [Accepted: 02/04/2013] [Indexed: 06/02/2023]
Abstract
A disabling impairment of higher-order language function can be seen in patients with Lewy body spectrum disorders such as Parkinson's disease (PD), Parkinson's disease dementia (PDD), and dementia with Lewy bodies (DLB). We focus on script comprehension in patients with Lewy body spectrum disorders. While scripts unfold sequentially, constituent events are thought to contain an internal organization. Executive dysfunction in patients with Lewy body spectrum disorders may interfere with comprehension of this internal structure. We examined 42 patients (30 non-demented PD and 12 mildly demented PDD/DLB patients) and 12 healthy seniors. We presented 22 scripts (e.g., "going fishing"), each consisting of six events. Pilot data from young controls provided the basis for organizing associated events into clusters and arranging them hierarchically into scripts. We measured accuracy and latency to judge the order of adjacent events in the same cluster versus adjacent events in different clusters. PDD/DLB patients were less accurate in their ordering judgments than PD patients and controls. Healthy seniors and PD patients were significantly faster to judge correctly the order of highly associated within-cluster event pairs relative to less closely associated different-cluster event pairs, while PDD/DLB patients did not consistently distinguish between these event-pair types. This relative insensitivity to the clustered-hierarchical organization of events was related to executive impairment and to frontal atrophy as measured by volumetric MRI. These findings extend prior work on script processing to patients with Lewy body spectrum disorders and highlight the potential impact of frontal/executive dysfunction on the daily lives of affected patients.
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Affiliation(s)
- Rachel G Gross
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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27
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Syntax in a pianist's hand: ERP signatures of “embodied” syntax processing in music. Cortex 2013; 49:1325-39. [DOI: 10.1016/j.cortex.2012.06.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 04/02/2012] [Accepted: 06/13/2012] [Indexed: 11/19/2022]
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28
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Kalénine S, Shapiro AD, Buxbaum LJ. Dissociations of action means and outcome processing in left-hemisphere stroke. Neuropsychologia 2013; 51:1224-33. [PMID: 23566892 DOI: 10.1016/j.neuropsychologia.2013.03.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 03/14/2013] [Accepted: 03/26/2013] [Indexed: 10/27/2022]
Abstract
Previous evidence suggests that distinct fronto-parietal regions may be involved in representing action kinematics (means) and action results (outcome) during action observation. However, the evidence is contradictory with respect to the precise regions that are critical for each type of representation. Additionally unknown is the degree to which ability to detect action means and outcome during observation is related to action production performance. We used a behavioral task to evaluate the ability of healthy and left-hemisphere stroke participants to detect differences between pairs of videos that dissociated object-related action means (e.g., wiping with circular or straight movement) and/or outcome (e.g., applying or removing detergent). We expected that deficits in detecting action means would be associated with spatiomotor gesture production deficits, whereas deficits in detecting action outcome would predict impairments in complex naturalistic action. We also hypothesized a posterior to anterior gradient in the regions critical for each type of representation, disproportionately affecting means and outcome encoding, respectively. Results indicated that outcome--but not means--detection predicted naturalistic action performance in stroke participants. Regression and voxel lesion-symptom mapping analyses of lesion data revealed that means--but not outcome--coding relies on the integrity of the left inferior parietal lobe, whereas no selective critical brain region could be identified for outcome detection. Thus, means and outcome representations are dissociable at both the behavioral and neuroanatomical levels. Furthermore, the data are consistent with a degree of parallelism between action perception and production tasks. Finally, they reinforce the evidence for a critical role of the left inferior parietal lobule in the representation of action means, whereas action outcome may rely on a more distributed neural circuit.
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Affiliation(s)
- Solène Kalénine
- Moss Rehabilitation Research Institute, 50 Township Line Road, Elkins Park, PA 19027, United States.
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29
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McMillan CT, Coleman D, Clark R, Liang TW, Gross RG, Grossman M. Converging evidence for the processing costs associated with ambiguous quantifier comprehension. Front Psychol 2013; 4:153. [PMID: 23565102 PMCID: PMC3613595 DOI: 10.3389/fpsyg.2013.00153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 03/11/2013] [Indexed: 11/13/2022] Open
Abstract
Traditional neuroanatomic models of language comprehension have emphasized a core language network situated in peri-Sylvian cortex. More recent evidence appears to extend the neuroanatomic network beyond peri-Sylvian cortex to encompass other aspects of sentence processing. In this study, we evaluate the neuroanatomic basis for processing the ambiguity in doubly-quantified sentences. For example, a sentence like "All the dogs jumped in a lake" can be interpreted with a collective interpretation (e.g., several dogs jumping into a single lake) or a distributive interpretation (e.g., several dogs each jumping into a different lake). In Experiment 1, we used BOLD fMRI to investigate neuroanatomic recruitment by young adults during the interpretation of ambiguous doubly-quantified sentences in a sentence-picture verification task. We observed that young adults exhibited a processing cost associated with interpreting ambiguous sentences and this was related to frontal and parietal cortex recruitment. In Experiment 2, we investigate ambiguous sentence processing with the identical materials in non-aphasic patients with behavioral variant frontotemporal dementia (bvFTD) who have frontal cortex disease and executive and decision-making limitations. bvFTD patients are insensitive to ambiguity associated with doubly-quantified sentences, and this is related to the magnitude of their frontal cortex disease. These studies provide converging evidence that cortical regions that extend beyond peri-Sylvian cortex help support the processing costs associated with the interpretation of ambiguous doubly-quantified sentences.
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Affiliation(s)
- Corey T McMillan
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA
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30
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Ash S, Xie SX, Gross RG, Dreyfuss M, Boller A, Camp E, Morgan B, O'Shea J, Grossman M. The organization and anatomy of narrative comprehension and expression in Lewy body spectrum disorders. Neuropsychology 2012; 26:368-84. [PMID: 22309984 PMCID: PMC3348419 DOI: 10.1037/a0027115] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Patients with Lewy body spectrum disorders (LBSD) such as Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies exhibit deficits in both narrative comprehension and narrative expression. The present research examines the hypothesis that these impairments are due to a material-neutral deficit in organizational executive resources rather than to impairments of language per se. We predicted that comprehension and expression of narrative would be similarly affected and that deficits in both expression and comprehension of narrative would be related to the same anatomic distribution of prefrontal disease. METHOD We examined 29 LBSD patients and 26 healthy seniors on their comprehension and expression of narrative discourse. For comprehension, we measured accuracy and latency in judging events with high and low associativity from familiar scripts such as "going fishing." The expression task involved maintaining the connectedness of events while narrating a story from a wordless picture book. RESULTS LBSD patients were impaired on measures of narrative organization during both comprehension and expression relative to healthy seniors. Measures of organization during narrative expression and comprehension were significantly correlated with each other. These measures both correlated with executive measures but not with neuropsychological measures of lexical semantics or grammar. Voxel-based morphometry revealed overlapping regressions relating frontal atrophy to narrative comprehension, narrative expression, and measures of executive control. CONCLUSIONS Difficulty with narrative discourse in LBSD stems in part from a deficit of organization common to comprehension and expression. This deficit is related to prefrontal cortical atrophy in LBSD.
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Affiliation(s)
- Sharon Ash
- University of Pennsylvania, Philadelphia, PA, USA.
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31
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Ash S, McMillan C, Gross RG, Cook P, Gunawardena D, Morgan B, Boller A, Siderowf A, Grossman M. Impairments of speech fluency in Lewy body spectrum disorder. BRAIN AND LANGUAGE 2012; 120:290-302. [PMID: 22099969 PMCID: PMC3299896 DOI: 10.1016/j.bandl.2011.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 08/08/2011] [Accepted: 09/16/2011] [Indexed: 05/10/2023]
Abstract
Few studies have examined connected speech in demented and non-demented patients with Parkinson's disease (PD). We assessed the speech production of 35 patients with Lewy body spectrum disorder (LBSD), including non-demented PD patients, patients with PD dementia (PDD), and patients with dementia with Lewy bodies (DLB), in a semi-structured narrative speech sample in order to characterize impairments of speech fluency and to determine the factors contributing to reduced speech fluency in these patients. Both demented and non-demented PD patients exhibited reduced speech fluency, characterized by reduced overall speech rate and long pauses between sentences. Reduced speech rate in LBSD correlated with measures of between-utterance pauses, executive functioning, and grammatical comprehension. Regression analyses related non-fluent speech, grammatical difficulty, and executive difficulty to atrophy in frontal brain regions. These findings indicate that multiple factors contribute to slowed speech in LBSD, and this is mediated in part by disease in frontal brain regions.
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Affiliation(s)
- Sharon Ash
- Department of Neurology, University of Pennsylvania School of Medicine, United States.
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32
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Grossman M, Gross RG, Moore P, Dreyfuss M, McMillan CT, Cook PA, Ash S, Siderowf A. Difficulty processing temporary syntactic ambiguities in Lewy body spectrum disorder. BRAIN AND LANGUAGE 2012; 120:52-60. [PMID: 21962945 PMCID: PMC3253921 DOI: 10.1016/j.bandl.2011.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 08/02/2011] [Accepted: 08/26/2011] [Indexed: 05/25/2023]
Abstract
While grammatical aspects of language are preserved, executive deficits are prominent in Lewy body spectrum disorder (LBSD), including Parkinson's disease (PD), Parkinson's dementia (PDD) and dementia with Lewy bodies (DLB). We examined executive control during sentence processing in LBSD by assessing temporary structural ambiguities. Using an on-line word detection procedure, patients heard sentences with a syntactic structure that has high-compatibility or low-compatibility with the main verb's statistically preferred syntactic structure, and half of the sentences were lengthened strategically between the onset of the ambiguity and its resolution. We found selectively slowed processing of lengthened ambiguous sentences in the PDD/DLB subgroup. This correlated with impairments on measures of executive control. Regression analyses related the working memory deficit during ambiguous sentence processing to significant cortical thinning in frontal and parietal regions. These findings emphasize the role of prefrontal disease in the executive limitations that interfere with processing ambiguous sentences in LBSD.
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Affiliation(s)
- Murray Grossman
- Department of Neurology, University of Pennsylvania School of Medicine, United States.
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33
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McMillan CT, Rascovsky K, Khella MC, Clark R, Grossman M. The neural basis for establishing a focal point in pure coordination games. Soc Cogn Affect Neurosci 2011; 7:881-7. [PMID: 22009019 DOI: 10.1093/scan/nsr070] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
When making a decision, humans often have to 'coordinate'-reach the same conclusion-as another individual without explicitly communicating. Relatively, little is known about the neural basis for coordination. Moreover, previous fMRI investigations have supported conflicting hypotheses. One account proposes that individuals coordinate using a 'gut feeling' and that this is supported by insula recruitment. Another account proposes that individuals recruit strategic decision-making mechanisms in prefrontal cortex in order to coordinate. We investigate the neural basis for coordination in individuals with behavioral-variant frontotemporal dementia (bvFTD) who have limitations in social decision-making associated with disease in prefrontal cortex. We demonstrate that bvFTD are impaired at establishing a focal point in a semantic task (e.g. 'Tell me any boy's name') that requires coordination relative to a similar, control semantic task that does not. Additionally, coordination limitations in bvFTD are related to cortical thinning in prefrontal cortex. These findings are consistent with behavioral economic models proposing that, beyond a 'gut feeling', strategic decision-making contributes to the coordination process, including a probabilistic mechanism that evaluates the salience of a response (e.g. is 'John' a frequent boy's name), a hierarchical mechanism that iteratively models an opponent's likely response and a mechanism involved in social perspective taking.
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Affiliation(s)
- Corey T McMillan
- Department of Neurology, University of Pennsylvania, Philadelphia, 19104, USA.
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34
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Pakhomov SVS, Kaiser EA, Boley DL, Marino SE, Knopman DS, Birnbaum AK. Effects of age and dementia on temporal cycles in spontaneous speech fluency. JOURNAL OF NEUROLINGUISTICS 2011; 24:619-635. [PMID: 21909189 PMCID: PMC3168946 DOI: 10.1016/j.jneuroling.2011.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Spontaneous speech of healthy adults consists of alternating periods of fluent and hesitant segments, forming temporal cycles in speech fluency. The regularity of these cycles may be related to the functioning of brain networks during speech planning and execution. This paper investigates the theoretical link between human cognitive functioning and temporal cycles in speech production using a quantitative time series analysis to characterize the regularity and frequency of temporal cycles in adults with differing levels and etiology of cognitive decline. We compare spontaneous speech of adults without a neurological diagnosis, both older and younger, to that of adults with frontotemporal lobar degeneration (FTLD). Two measures of temporal cycle frequency (mean and mode) calculated from the power spectrum of speech fluency represented as a time series were found to be associated with subjects' age, regardless of diagnosis of dementia. Two measures of periodicity (g-statistic and rhythmicity-index), as well as mean frequency, differentiated between adults with and without dementia. Our study confirms the presence of regular temporal cycles in spontaneous speech and suggests that temporal cycle characteristics are affected in different ways by declines in cognitive functioning due to dementia and aging.
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Affiliation(s)
- Serguei V S Pakhomov
- Center for Clinical and Cognitive Neuropharmacology, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA
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35
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Ash S, McMillan C, Gross RG, Cook P, Morgan B, Boller A, Dreyfuss M, Siderowf A, Grossman M. The organization of narrative discourse in Lewy body spectrum disorder. BRAIN AND LANGUAGE 2011; 119:30-41. [PMID: 21689852 PMCID: PMC3163000 DOI: 10.1016/j.bandl.2011.05.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 05/19/2011] [Accepted: 05/23/2011] [Indexed: 05/10/2023]
Abstract
Narrative discourse is an essential component of day-to-day communication, but little is known about narrative in Lewy body spectrum disorder (LBSD), including Parkinson's disease (PD), Parkinson's disease with dementia (PDD), and dementia with Lewy bodies (DLB). We performed a detailed analysis of a semi-structured speech sample in 32 non-aphasic patients with LBSD, and we related their narrative impairments to gray matter (GM) atrophy using voxel-based morphometry. We found that patients with PDD and DLB have significant difficulty organizing their narrative speech. This was correlated with deficits on measures of executive functioning and speech fluency. Regression analyses associated this deficit with reduced cortical volume in inferior frontal and anterior cingulate regions. These findings are consistent with a model of narrative discourse that includes executive as well as language components and with an impairment of the organizational component of narrative discourse in patients with PDD and DLB.
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Affiliation(s)
- Sharon Ash
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-4283, USA.
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