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Angelopoulou G, Kasselimis D, Varkanitsa M, Tsolakopoulos D, Papageorgiou G, Velonakis G, Meier E, Karavassilis E, Pantoleon V, Laskaris N, Kelekis N, Tountopoulou A, Vassilopoulou S, Goutsos D, Kiran S, Weiller C, Rijntjes M, Potagas C. Investigating silent pauses in connected speech: integrating linguistic, neuropsychological, and neuroanatomical perspectives across narrative tasks in post-stroke aphasia. Front Neurol 2024; 15:1347514. [PMID: 38682034 PMCID: PMC11047180 DOI: 10.3389/fneur.2024.1347514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/07/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Silent pauses are regarded as integral components of the temporal organization of speech. However, it has also been hypothesized that they serve as markers for internal cognitive processes, including word access, monitoring, planning, and memory functions. Although existing evidence across various pathological populations underscores the importance of investigating silent pauses' characteristics, particularly in terms of frequency and duration, there is a scarcity of data within the domain of post-stroke aphasia. Methods The primary objective of the present study is to scrutinize the frequency and duration of silent pauses in two distinct narrative tasks within a cohort of 32 patients with chronic post-stroke aphasia, in comparison with a control group of healthy speakers. Subsequently, we investigate potential correlation patterns between silent pause measures, i.e., frequency and duration, across the two narrative tasks within the patient group, their performance in neuropsychological assessments, and lesion data. Results Our findings showed that patients exhibited a higher frequency of longer-duration pauses in both narrative tasks compared to healthy speakers. Furthermore, within-group comparisons revealed that patients tended to pause more frequently and for longer durations in the picture description task, while healthy participants exhibited the opposite trend. With regard to our second research question, a marginally significant interaction emerged between performance in semantic verbal fluency and the narrative task, in relation to the location of silent pauses-whether between or within clauses-predicting the duration of silent pauses in the patient group. However, no significant results were observed for the frequency of silent pauses. Lastly, our study identified that the duration of silent pauses could be predicted by distinct Regions of Interest (ROIs) in spared tissue within the left hemisphere, as a function of the narrative task. Discussion Overall, this study follows an integrative approach of linguistic, neuropsychological and neuroanatomical data to define silent pauses in connected speech, and illustrates interrelations between cognitive components, temporal aspects of speech, and anatomical indices, while it further highlights the importance of studying connected speech indices using different narrative tasks.
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Affiliation(s)
- G. Angelopoulou
- Neuropsychology&Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - D. Kasselimis
- Neuropsychology&Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - M. Varkanitsa
- Center for Brain Recovery, Boston University, Boston, MA, United States
| | - D. Tsolakopoulos
- Neuropsychology&Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - G. Papageorgiou
- Neuropsychology&Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - G. Velonakis
- 2nd Department of Radiology, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - E. Meier
- The Aphasia Network Lab, Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, United States
| | - E. Karavassilis
- 2nd Department of Radiology, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - V. Pantoleon
- 2nd Department of Radiology, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - N. Laskaris
- Neuropsychology&Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, Athens, Greece
| | - N. Kelekis
- 2nd Department of Radiology, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A. Tountopoulou
- Stroke Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - S. Vassilopoulou
- Stroke Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - D. Goutsos
- Department of Linguistics, School of Philosophy, National and Kapodistrian University of Athens, Athens, Greece
| | - S. Kiran
- Center for Brain Recovery, Boston University, Boston, MA, United States
| | - C. Weiller
- Department of Neurology and Clinical Neuroscience, University Hospital Freiburg, Freiburg, Germany
| | - M. Rijntjes
- Department of Neurology and Clinical Neuroscience, University Hospital Freiburg, Freiburg, Germany
| | - C. Potagas
- Neuropsychology&Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Rook J, Llufriu S, de Kok D, Rofes A. Language impairments in people with autoimmune neurological diseases: A scoping review. JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106368. [PMID: 37717472 DOI: 10.1016/j.jcomdis.2023.106368] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/02/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Autoimmune neurological diseases (ANDs) are a specific type of autoimmune disease that affect cells within the central and peripheral nervous system. ANDs trigger various physical/neuropsychiatric symptoms. However, language impairments in people with ANDs are not well characterized. Here we aimed to determine the kinds of language impairment that most commonly emerge in 10 ANDs, the characteristics of the patients (demographic, neurological damage), and the assessment methods used. METHODS We followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed and Google Scholar were searched. We used a list of search terms containing 10 types of ANDs (e.g., multiple sclerosis, acute disseminated encephalomyelitis) in combination with the terms aphasia, dysphasia, fluency, language, listening, morphology, phonology, pragmatics, reading, semantics, speaking, syntax, writing. The reference lists and citations of the relevant papers were also investigated. The type of AND, patient characteristics, neurological damage and examination technique, language tests administered, and main findings were noted for each study meeting the inclusion criteria. RESULTS We found 171 studies meeting our inclusion criteria. These comprised group studies and case studies. Language impairments differed largely among types of ANDs. Neurological findings were mentioned in most of the papers, but specific language tests were rarely used. CONCLUSIONS Language symptoms in people with ANDs are commonly reported. These are often not full descriptions or only focus on specific time points in the course of the disease. Future research needs to assess specific language functions in people with ANDs and relate their language impairments to brain damage at different stages of disease evolution.
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Affiliation(s)
- Janine Rook
- Center for Language and Cognition, University of Groningen, Groningen, The Netherlands; Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Sara Llufriu
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Dörte de Kok
- Center for Language and Cognition, University of Groningen, Groningen, The Netherlands
| | - Adrià Rofes
- Center for Language and Cognition, University of Groningen, Groningen, The Netherlands.
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Tsolakopoulos D, Kasselimis D, Laskaris N, Angelopoulou G, Papageorgiou G, Velonakis G, Varkanitsa M, Tountopoulou A, Vassilopoulou S, Goutsos D, Potagas C. Exploring Pragmatic Deficits in Relation to Theory of Mind and Executive Functions: Evidence from Individuals with Right Hemisphere Stroke. Brain Sci 2023; 13:1385. [PMID: 37891754 PMCID: PMC10605575 DOI: 10.3390/brainsci13101385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Research investigating pragmatic deficits in individuals with right hemisphere damage focuses on identifying the potential mechanisms responsible for the nature of these impairments. Nonetheless, the presumed shared cognitive mechanisms that could account for these deficits have not yet been established through data-based evidence from lesion studies. This study aimed to examine the co-occurrence of pragmatic language deficits, Theory of Mind impairments, and executive functions while also exploring their associations with brain lesion sites. Twenty-five patients suffering from unilateral right hemisphere stroke and thirty-seven healthy participants were recruited for this study. The two groups were tested in pragmatics, Theory of Mind, and executive function tasks. Structural imaging data were also obtained for the identification of the lesion sites. The findings of this study suggest a potential convergence among the three aforementioned cognitive mechanisms. Moreover, we postulate a hypothesis for a neural circuitry for communication impairments observed in individuals with right hemisphere damage.
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Affiliation(s)
- Dimitrios Tsolakopoulos
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
| | - Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
- Department of Psychology, Panteion University of Social and Political Sciences, 17671 Athens, Greece
| | - Nikolaos Laskaris
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, 12243 Athens, Greece
| | - Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
| | - Georgios Papageorgiou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
| | - Georgios Velonakis
- Second Department of Radiology, Attikon General University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Maria Varkanitsa
- Center for Brain Recovery, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
| | - Argyro Tountopoulou
- Stroke Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Sofia Vassilopoulou
- Stroke Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Dionysis Goutsos
- Department of Linguistics, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Constantin Potagas
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
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Kasselimis DS, Tsolakopoulos D, Simos PG, Makryllou I, Velonakis G, Politis AM, Potagas C. Preserved visuospatial abilities in absence of the right hemisphere: A case of cerebral hemiatrophy with minimal cognitive impairment. J Neuropsychol 2022; 16:555-568. [PMID: 35315225 DOI: 10.1111/jnp.12275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/26/2022] [Indexed: 12/01/2022]
Abstract
Cerebral hemiatrophy is a rare neurological condition, usually resulting in severe and diffuse cognitive impairment. In this paper we present a 69-year old woman with notable congenital hemiatrophy with strikingly preserved cognitive functions. Cognitive assessment indicated that although her executive functions were found impaired, the remaining cognitive domains were relatively unaffected. We argue that this unexpected cognitive profile may be explained by anomalous hemispheric lateralization, driven by neuroplasticity along the developmental course.
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Affiliation(s)
- Dimitrios S Kasselimis
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Tsolakopoulos
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Greece
| | - Panagiotis G Simos
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Greece
| | - Irina Makryllou
- 1st Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Greece
| | - Georgios Velonakis
- 2nd Department of Radiology, Medical School, Attikon Hospital, National & Kapodistrian University of Athens, Greece
| | - Antonios M Politis
- 1st Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Greece
| | - Constantin Potagas
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Greece
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Neurocognitive Profiles of Caucasian Moyamoya Disease Patients in Greece: A Case Series. NEUROSCI 2022. [DOI: 10.3390/neurosci3010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The impact of Moyamoya Disease (MMD) on cognition inadult Caucasian patients has not yet been thoroughly investigated. The current study is the first to present detailed neuropsychological data on a series of Greek patients with MMD. A group of eight patients was assessed with an extensive neuropsychological battery, including measures of episodic memory, working memory, executive functions, language, and social cognition. The results indicated that MMD may be characterized by a trichotomous neurocognitive profile, characterized by prominent impairment in working memory, executive functions, and social cognition. Overall, we stress the need for a thorough cognitive evaluation of MMD patients and further highlight the potential importance of social cognition in this particular disease. Possible associations between the three impaired cognitive domains in our group are also discussed.
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Kourtidou E, Kasselimis D, Angelopoulou G, Karavasilis E, Velonakis G, Kelekis N, Zalonis I, Evdokimidis I, Potagas C, Petrides M. The Role of the Right Hemisphere White Matter Tracts in Chronic Aphasic Patients After Damage of the Language Tracts in the Left Hemisphere. Front Hum Neurosci 2021; 15:635750. [PMID: 34239424 PMCID: PMC8258417 DOI: 10.3389/fnhum.2021.635750] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
The involvement of the right hemisphere (RH) in language, and especially after aphasia resulting from left hemisphere (LH) lesions, has been recently highlighted. The present study investigates white matter structure in the right hemisphere of 25 chronic post-stroke aphasic patients after LH lesions in comparison with 24 healthy controls, focusing on the four cortico-cortical tracts that link posterior parietal and temporal language-related areas with Broca’s region in the inferior frontal gyrus of the LH: the Superior Longitudinal Fasciculi II and III (SLF II and SLF III), the Arcuate Fasciculus (AF), and the Temporo-Frontal extreme capsule Fasciculus (TFexcF). Additionally, the relationship of these RH white matter tracts to language performance was examined. The patients with post-stroke aphasia in the chronic phase and the healthy control participants underwent diffusion tensor imaging (DTI) examination. The aphasic patients were assessed with standard aphasia tests. The results demonstrated increased axial diffusivity in the RH tracts of the aphasic patients. Patients were then divided according to the extent of the left hemisphere white matter loss. Correlations of language performance with radial diffusivity (RD) in the right hemisphere homologs of the tracts examined were demonstrated for the TFexcF, SLF III, and AF in the subgroup with limited damage to the LH language networks and only with the TFexcF in the subgroup with extensive damage. The results argue in favor of compensatory roles of the right hemisphere tracts in language functions when the LH networks are disrupted.
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Affiliation(s)
- Evie Kourtidou
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital "Attikon", Haidari, Greece
| | - Georgios Velonakis
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital "Attikon", Haidari, Greece
| | - Nikolaos Kelekis
- Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital "Attikon", Haidari, Greece
| | - Ioannis Zalonis
- Eginition Hospital, Neuropsychological Laboratory, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Evdokimidis
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Potagas
- Neuropsychology and Language Disorders Unit, Eginition Hospital, First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Petrides
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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Kasselimis D, Karadima G, Angelopoulou G, Breza M, Tsolakopoulos D, Potagas C, Panas M, Koutsis G. Evidence for Cognitive Deficits in X-Linked Charcot-Marie-Tooth Disease. J Int Neuropsychol Soc 2020; 26:294-302. [PMID: 31948496 DOI: 10.1017/s1355617719001188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE X-linked Charcot-Marie-Tooth disease (CMTX) is an hereditary neuropathy caused by mutations in GJB1 coding for connexin-32, found in Schwann cells, but also expressed in oligodendrocytes. Reports have identified CNS involvement in CMTX, but no systematic study of cognitive function has been published. METHODS We assessed 24 CMTX patients (13 males; 9GJB1 mutations) with a comprehensive neuropsychological battery, including tests of memory, language, and executive functions. RESULTS No differences in cognitive performance were observed between males and females. A case-by-case investigation revealed selective deficits in individual patients. One subgroup (29%) demonstrated executive abnormalities; and a non-overlapping subgroup (29%), prominent reading (decoding) abnormalities. CONCLUSIONS The present data provide evidence for cognitive deficits in CMTX. Emerging neuropsychological patterns are also discussed.
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Affiliation(s)
- Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 AthensGreece
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Greece
| | - Georgia Karadima
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 AthensGreece
| | - Marianthi Breza
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Tsolakopoulos
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 AthensGreece
| | - Constantin Potagas
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 AthensGreece
| | - Marios Panas
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Georgios Koutsis
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
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8
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Angelopoulou G, Meier EL, Kasselimis D, Pan Y, Tsolakopoulos D, Velonakis G, Karavasilis E, Kelekis NL, Goutsos D, Potagas C, Kiran S. Investigating Gray and White Matter Structural Substrates of Sex Differences in the Narrative Abilities of Healthy Adults. Front Neurosci 2020; 13:1424. [PMID: 32063823 PMCID: PMC7000661 DOI: 10.3389/fnins.2019.01424] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/16/2019] [Indexed: 12/12/2022] Open
Abstract
Linguistic aspects of narration have been investigated in healthy populations, in a wide variety of languages and speech genres with very different results. There is some evidence indicating that linguistic elements, such as speech rate (i.e., the measure indicating the amount of speech produced in a certain time period), mean length of utterance (MLU) (i.e., the index reflecting sentence grammatical structure), frequency of nouns and verbs, might be affected by non-linguistic factors such as sex. On the other hand, despite the existence of neuroimaging evidence of structural differences between males and females, it is yet unknown how such differences could explain between-sex disparities in linguistic abilities in natural speech contexts. To date, no study has evaluated discourse production elements in relation to sex differences and their neural correlates in terms of brain structure, a topic that could provide unique insights on the relationship between language and the brain. The aim of the present study was to determine sex differences in narrative skills in healthy adults and to investigate white and gray matter structural correlates of linguistic skills in each group. Twenty-seven male and 30 female (N = 57) right-handed, neurologically intact, monolingual Greek speakers, matched for age and years of education, participated. Narrations of a personal medical event were elicited. Linguistic elements of speech rate (words per minute), MLUs, frequency of nouns and verbs were calculated for each speech sample, by two independent raters. Structural 3D T1 images were segmented and parcellated using FreeSurfer and whole-brain between-sex differences in cortical thickness, cortical volume and surface area, were obtained. Between-group differences in white matter diffusion tensor scalars were examined via Tract-Based Spatial-Statistics and whole-brain tractography and automated tract delineation using Automated Fiber Quantification. Speech rate and noun frequency were significantly lower for men, while verb frequency was significantly higher for women, but no differences were identified for MLU. Regarding cortical measures, males demonstrated increased volume, surface area and cortical thickness in several bilateral regions, while no voxel-wise or tractography-based between-group differences in white matter metrics were observed. Regarding the relationship between sex and speech variables, hierarchical regression analyses showed that the superior/middle frontal cluster in surface area may serve as a significant predictor of speech rate variance, but only in females. We discuss several possible interpretations of how sex-related speech abilities could be represented differently in men and women in gray matter structures within the broad language network.
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Affiliation(s)
- Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Erin L. Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Heraklion, Greece
| | - Yue Pan
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Dimitrios Tsolakopoulos
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Velonakis
- 2nd Department of Radiology, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratios Karavasilis
- 2nd Department of Radiology, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos L. Kelekis
- 2nd Department of Radiology, General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dionysios Goutsos
- Department of Linguistics, School of Philosophy, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Potagas
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Swathi Kiran
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, United States
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Cera ML, Romeiro TPP, Mandrá PP, Fukuda MTH. Variables associated with speech and language therapy time for aphasia, apraxia of speech and dysarthria. Dement Neuropsychol 2019; 13:72-77. [PMID: 31073381 PMCID: PMC6497030 DOI: 10.1590/1980-57642018dn13-010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The most common acquired communication disorders are aphasia, dysarthria and apraxia of speech. Determining the factors associated with speech therapy time of adults with these disorders can further the understanding of the speech and language rehabilitation process within the public service and linked to the health education process.
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Affiliation(s)
- Maysa Luchesi Cera
- Speech and Language Therapist, PhD, Professor, Faculdade de Ceilândia, Universidade de Brasília. Brasília, DF, Brazil
| | | | - Patricia Pupin Mandrá
- Speech and Language Therapist, PhD, Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto, SP, Brazil
| | - Marisa Tomoe Hebihara Fukuda
- Speech and Language Therapist, PhD, Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto, SP, Brazil
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10
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Constantinides VC, Kasselimis DS, Paraskevas GP, Zacharopoulou M, Andreadou E, Evangelopoulos ME, Kapaki E, Kilidireas C, Stamboulis E, Potagas C. Anti-NMDA receptor encephalitis presenting as isolated aphasia in an adult. Neurocase 2018; 24:188-194. [PMID: 30293488 DOI: 10.1080/13554794.2018.1524915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Anti-NMDA receptor (NMDA-r) encephalitis is a relatively rare cause of autoimmune encephalitis with divergent clinical presentations. We report a case of an adult patient with anti-NMDA-r encephalitis presenting with isolated, abrupt-onset aphasia. Her condition remained unaltered over a period of 6 months. The patients' electroencephalogram findings were typical for NMDA-r encephalitis; however, her magnetic resonance imaging and cerebrospinal fluid analysis were normal. She responded well to immunotherapy, and aphasia eventually resolved. The natural course of the present case contradicts the rapidly progressive nature of typical NMDA-r encephalitis. Furthermore, it broadens the clinical spectrum of anti-NMDA-r encephalitis, to incorporate isolated, nonprogressive aphasia.
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Affiliation(s)
- Vasilios C Constantinides
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Dimitrios S Kasselimis
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece.,b Department of Psychiatry , School of Medicine, University of Crete , Heraklion , Greece
| | - George P Paraskevas
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Maria Zacharopoulou
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Elisabeth Andreadou
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | | | - Elisabeth Kapaki
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Costas Kilidireas
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Eleftherios Stamboulis
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Constantin Potagas
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
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In Search of Executive Impairment in Pathological Gambling: A Neuropsychological Study on Non-treatment Seeking Gamblers. J Gambl Stud 2018; 34:1327-1340. [DOI: 10.1007/s10899-018-9758-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kasselimis D, Potagas C, Simos P, Evdokimidis I, Whitaker H. Mixed language dominance: insights from a case of unexpected fluent aphasia with semantic jargon resulting from massive left perisylvian lesion. Neurocase 2018; 24:10-15. [PMID: 29277135 DOI: 10.1080/13554794.2017.1420805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We report a right-handed patient with a massive lesion in left perisylvian language cortex, who unexpectedly presented with fluent aphasia with semantic jargon. Language deficits were assessed with a comprehensive battery of language tests. Comprehension, naming, reading, and writing were severely impaired, and verbal expression was moderately fluent with semantic jargon. Although the patient's lesion included brain areas typically essential for motor speech coordination, he was neither nonfluent nor apraxic. He exhibited strikingly unexpected aphasia with semantic jargon and prominent comprehension deficits, suggesting that this is a case of mixed dominance: the right hemisphere likely controls motor speech and basic syntactic skills, while the severely damaged left hemisphere controls semantic processing, predictably severely impaired.
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Affiliation(s)
- Dimitrios Kasselimis
- a Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece.,b Department of Psychiatry, School of Medicine , University of Crete , Crete , Greece
| | - Constantin Potagas
- a Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Panagiotis Simos
- b Department of Psychiatry, School of Medicine , University of Crete , Crete , Greece.,c Institute of Computer Science, Computational Biomedicine Laboratory , Foundation for Research and Technology , Heraklion , Greece
| | - Ioannis Evdokimidis
- a Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Harry Whitaker
- d Department of Psychology , Northern Michigan University , Marquette , MI , USA
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Efthymiopoulou E, Kasselimis DS, Ghika A, Kyrozis A, Peppas C, Evdokimidis I, Petrides M, Potagas C. The effect of cortical and subcortical lesions on spontaneous expression of memory-encoded and emotionally infused information: Evidence for a role of the ventral stream. Neuropsychologia 2017; 101:115-120. [PMID: 28495600 DOI: 10.1016/j.neuropsychologia.2017.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 05/03/2017] [Accepted: 05/07/2017] [Indexed: 10/19/2022]
Abstract
The ventral stream of language processing has been implicated in the spontaneous expression of memory-encoded and emotionally infused information. The present study investigated whether left hemispheric lesions in post-stroke right-handed aphasic patients may be selectively associated with specific language functions. Speech rate was assessed with two tasks, one based on autobiographical memory of an emotionally infused event (stroke story narration) and the other based on information that is visually available at the time of speech generation ("cookie theft" picture description). CT and/or MRI scans were obtained for each patient and lesions located in 16 regions of the left hemisphere were identified and coded. The total number of cortical and subcortical areas affected served as a measure of lesion extent. While mean speech rates were similar across conditions, there were different patterns of association between each index and specific lesion sites. Non-parametric quantile regression statistical models constructed to assess dependence of both speech rate indices on each lesion locus indicated that the speech rate in the stroke story had significant inverse associations with total number of lesioned areas, as well as lesions in the inferior frontal gyrus and the external/extreme capsule region. The cookie theft speech rate had significant inverse associations with total number of lesioned areas as well as lesion in the inferior frontal gyrus, but not with the external/extreme capsule region. In sum, integrity of the extreme/external capsule region appears to be important selectively for the Stroke Story task, supporting the hypothesis that the ventral stream plays a central role in spontaneous expression of memory-encoded and emotionally infused information.
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Affiliation(s)
- Efthymia Efthymiopoulou
- 1st Department of Neurology, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios S Kasselimis
- 1st Department of Neurology, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece.
| | - Apostolia Ghika
- 1st Department of Neurology, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Andreas Kyrozis
- 1st Department of Neurology, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Christos Peppas
- Department of Radiology, Therapeutic Center of Athens ''Lefkos Stavros'', Athens, Greece
| | - Ioannis Evdokimidis
- 1st Department of Neurology, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Michael Petrides
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Constantin Potagas
- 1st Department of Neurology, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
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Nidos A, Kasselimis DS, Simos PG, Rentzos M, Alexakis T, Zalonis I, Zouvelou V, Potagas C, Evdokimidis I, Woolley SC. Frontotemporal Dysfunction in Amyotrophic Lateral Sclerosis: A Discriminant Function Analysis. NEURODEGENER DIS 2015; 16:140-6. [DOI: 10.1159/000381186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 02/12/2015] [Indexed: 11/19/2022] Open
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