Applicability and usefulness of pupillometry in the study of lexical access. A scoping review of primary research

Pupil dilation has been associated with the effort required to perform various cognitive tasks. At the lexical level, some studies suggest that this neurophysiological measure would provide objective, real-time information during word processing and lexical access. However, due to the scarcity and incipient advancement of this line of research, its applicability, use, and sensitivity are not entirely clear. This scoping review aims to determine the applicability and usefulness of pupillometry in the study of lexical access by providing an up-to-date overview of research in this area. Following the PRISMA protocol, 16 articles were included in this review. The results show that pupillometry is a highly applicable, useful, and sensitive method for assessing lexical skills of word recognition, word retrieval, and semantic activation. Moreover, it easily fits into traditional research paradigms and methods in the field. Because it is a non-invasive, objective, and automated procedure, it can be applied to any population or age group. However, the emerging development of this specific area of research and the methodological diversity observed in the included studies do not yet allow for definitive conclusions in this area, which in turn does not allow for meta-analyses or fully conclusive statements about what the pupil response actually reflects when processing words. Standardized pupillary recording and analysis methods need to be defined to generate more accurate, replicable research designs with more reliable results to strengthen this line of research.

Differences in electroencephalography oscillations between normal aging and mild cognitive impairment during semantic memory retrieval

Semantic memory remains relatively stable with normal cognitive aging and declines in early stages of neurodegenerative disease. We measured electroencephalography (EEG) oscillatory correlates of semantic memory retrieval to examine the effects of normal and pathological aging. Twenty-nine cognitively healthy young adults (YA), 22 cognitively healthy aging adults (HA) and 20 patients with mild cognitive impairment (MCI) completed a semantic memory retrieval task with concurrent EEG recording in which they judged whether two words (features of objects) led to retrieval of an object (retrieval) or not (non-retrieval). Event-related power changes contrasting the two conditions (retrieval vs. non-retrieval) within theta, alpha, low-beta and high-beta EEG frequency bands were examined for normal aging (YA vs. HA) and pathological aging effects (HA vs. MCI). With no behavioural differences between the two normal age groups, we found later theta and alpha event-related power differences between conditions only in YA and a high-beta event-related power difference only in HA. For pathological aging effects, with reduced accuracy in MCI, we found different EEG patterns of early event-related beta power differences between conditions in MCI compared with HA and an event-related low-beta power difference only in HA. Beta oscillations were correlated with behavioural performance only in HA. We conclude that the aging brain relies on faster (beta) oscillations during the semantic memory task. With pathological aging, retrieval accuracy declines and pattern of beta oscillation changes. The findings provide insights about age-related neural mechanisms underlying semantic memory and have implications for early detection of pathological aging.

Identifying an Appropriate Picture Stimulus for a Bangla Picture Description Task

PURPOSE

The absence of culture- and language-specific aphasia assessment in Bangla underscores a critical problem in communication sciences and disorders. Aphasia occurs in ~41% of Bangla-speaking stroke survivors. In the past 40 years, stroke incidence has doubled in low- and middle-income countries, such as Bangladesh and India, where there are ~250 million native Bangla speakers. This study aims to initiate the first step toward identifying an appropriate picture stimulus for the Bangla picture description task (PDT) intended for inclusion in a Bangla aphasia assessment. Researchers have reported the importance of cultural relevance and three visuographic variables of a picture (high-context, color, and photograph vs. black-and-white line drawing) for faster comprehension and comprehensive language production in people with aphasia and neurologically healthy adults.

METHOD

Ninety-six neurologically healthy native Bangla speakers of three age groups (young 19-30, middle age 40-55, and older 65-89 years) were recruited to compare spontaneous language production for four selected culturally related and nonrelated picture stimuli with and without the three visuographic variables. Five linguistic variables were used to analyze the language samples.

RESULTS

The results demonstrated a significant (a) picture type effect for moving-average type-token ratio, words per minute (WPM), and mean length of utterance in morphemes (MLU) and (b) age group effect for WPM, MLU, and complexity index.

CONCLUSIONS

This study suggests that a culturally related high-context color photograph is the optimal choice for the Bangla PDT. This study also indicates reduced fluency, grammatical complexity, and syntactic complexity in healthy Bangla-speaking adults aged 65 years and above.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22233664.

Neural Correlates of Naturally Occurring Speech Errors during Picture Naming in Healthy Participants

Most of our knowledge about the neuroanatomy of speech errors comes from lesion-symptom mapping studies in people with aphasia and laboratory paradigms designed to elicit primarily phonological errors in healthy adults, with comparatively little evidence from naturally occurring speech errors. In this study, we analyzed perfusion fMRI data from 24 healthy participants during a picture naming task, classifying their responses into correct and different speech error types (e.g., semantic, phonological, omission errors). Total speech errors engaged a wide set of left-lateralized frontal, parietal, and temporal regions that were almost identical to those involved during the production of correct responses. We observed significant perfusion signal decreases in the left posterior middle temporal gyrus and inferior parietal lobule (angular gyrus) for semantic errors compared to correct trials matched on various psycholinguistic variables. In addition, the left dorsal caudate nucleus showed a significant perfusion signal decrease for omission (i.e., anomic) errors compared with matched correct trials. Surprisingly, we did not observe any significant perfusion signal changes in brain regions proposed to be associated with monitoring mechanisms during speech production (e.g., ACC, superior temporal gyrus). Overall, our findings provide evidence for distinct neural correlates of semantic and omission error types, with anomic speech errors likely resulting from failures to initiate articulatory-motor processes rather than semantic knowledge impairments as often reported for people with aphasia.

The Rapid Naming Test: Development and initial validation in typically aging adults

ObjectiveProgressive word-finding difficulty is a primary cognitive complaint among healthy older adults and a symptom of pathological aging. Classic measures of visual confrontation naming, however, show ceiling effects among healthy older adults. To address the need for a naming test that is sensitive to subtle, age-related word-finding decline, we developed the Rapid Naming Test (RNT), a computerized, one-minute, speeded visual naming test.MethodFunctionally intact older (n = 145) and younger (n = 69) adults completed the RNT. Subsets of older adults also completed neuropsychological tests, a self-report scale of functional decline, amyloid-β PET imaging, and repeat RNT administration to determine test-retest reliability.ResultsRNT scores were normally distributed and exhibited good test-retest reliability. Younger adults performed better than older adults. Within older adults, lower scores were associated with older age. Higher scores correlated with measures of language, processing speed, and episodic learning and memory. Scores were not correlated with visuospatial or working memory tests. Worse performance was related to subjective language decline, even after controlling for a classic naming test and speed. The RNT was also negatively associated with amyloid-β burden.ConclusionsThe RNT appears to be a reliable test that is sensitive to subtle, age-related word-finding decline. Convergent and divergent validity are supported by its specific associations with measures relying on visual naming processes. Ecological validity is supported by its relationship with subjective real-world language difficulties. Lastly, worse performance was related to amyloid-β deposition, an Alzheimer's disease biomarker. This study represents a key step toward validating a novel, sensitive naming test in typically aging adults.

Naming in Older Adults: Complementary Auditory and Visual Assessment

OBJECTIVES

Naming difficulty is a common symptom of multiple age-related neurodegenerative disorders. As naming difficulty increases with age, valid, up-to-date naming assessment tools are crucial for differentiating between neurotypical changes in healthy aging and pathological naming difficulty. We aimed to develop and provide normative data for complementary auditory description naming and visual naming tests for older adults. Furthermore, these measures would include not only untimed accuracy, typically the sole naming performance measure, but also additional scores that incorporate features characteristic of actual word finding difficulty.

METHODS

A normative sample of 407 healthy older adults, aged 56-100 years, were administered the Auditory Naming Test (ANT) and Visual Naming Test (VNT), and other standardized measures.

RESULTS

Item analyses resulted in 36 stimuli for both tests. Age-stratified, education-based normative data are provided for accuracy, response time, tip-of-the-tongue (i.e., delayed, yet accurate responses plus correct responses following phonemic cueing), and multiple Summary Scores. Internal and test-retest reliability coefficients were reasonable (.59-.84). Untimed accuracy scores were high across age groups, seemingly reflecting stability of naming into late adulthood; however, time- and cue-based scores revealed reduced efficiency in word retrieval with increasing age.

CONCLUSIONS

These complementary auditory and visual naming test for older adults improve upon the current standard by providing more sensitive performance measures and the addition of an auditory-verbal component for assessing naming. Detection of subtle naming changes in healthy aging holds promise for capturing symptomatic naming changes during the early stages of neurocognitive disorders involving expressive language, potentially assisting in earlier diagnoses and more timely treatment.

Strategies and cognitive reserve to preserve lexical production in aging

In the absence of any neuropsychiatric condition, older adults may show declining performance in several cognitive processes and among them, in retrieving and producing words, reflected in slower responses and even reduced accuracy compared to younger adults. To overcome this difficulty, healthy older adults implement compensatory strategies, which are the focus of this paper. We provide a review of mainstream findings on deficient mechanisms and possible neurocognitive strategies used by older adults to overcome the deleterious effects of age on lexical production. Moreover, we present findings on genetic and lifestyle factors that might either be protective or risk factors of cognitive impairment in advanced age. We propose that "aging-modulating factors" (AMF) can be modified, offering prevention opportunities against aging effects. Based on our review and this proposition, we introduce an integrative neurocognitive model of mechanisms and compensatory strategies for lexical production in older adults (entitled Lexical Access and Retrieval in Aging, LARA). The main hypothesis defended in LARA is that cognitive aging evolves heterogeneously and involves complementary domain-general and domain-specific mechanisms, with substantial inter-individual variability, reflected at behavioral, cognitive, and brain levels. Furthermore, we argue that the ability to compensate for the effect of cognitive aging depends on the amount of reserve specific to each individual which is, in turn, modulated by the AMF. Our conclusion is that a variety of mechanisms and compensatory strategies coexist in the same individual to oppose the effect of age. The role of reserve is pivotal for a successful coping with age-related changes and future research should continue to explore the modulating role of AMF.

Linking L2 proficiency and patterns of functional connectivity during L1 word retrieval

Second language (L2) learners differ greatly in language proficiency, which is partially explained by variability in native language (L1) skills. The present fMRI study explored the neural underpinnings of the L1-L2 link. Twenty L2 learners completed a tip-of-the-tongue (TOT) task that required retrieving words in L1. Low-proficiency L2 learners showed greater functional connectivity for correct and TOT responses between the left inferior frontal gyrus and right-sided homologues of the temporoparietal regions that support phonological processing (e.g., supramarginal gyrus), possibly reflecting difficulty with phonological retrieval. High-proficiency L2 learners showed greater connectivity for erroneous responses (TOT in particular) between the left inferior frontal gyrus and regions of left medial temporal lobe (e.g., hippocampus), associated with implicit learning processes. The difference between low- and high-proficiency L2 learners in functional connectivity, which is evident even during L1 processing, may affect L2 learning processes and outcomes.

The Role of Processing Speed and Cognitive Control on Word Retrieval in Aging and Aphasia

Purpose When speakers retrieve words, they do so extremely quickly and accurately-both speed and accuracy of word retrieval are compromised in persons with aphasia (PWA). This study examined the contribution of two domain-general mechanisms: processing speed and cognitive control on word retrieval in PWA. Method Three groups of participants, neurologically healthy young and older adults and PWA (n = 15 in each group), performed processing speed, cognitive control, lexical decision, and word retrieval tasks on a computer. The relationship between word retrieval speed and other tasks was examined for each group. Results Both aging and aphasia resulted in slower processing speed but did not affect cognitive control. Word retrieval response time delays in PWA were eliminated when processing speed was accounted for. Word retrieval speed was predicted by individual differences in cognitive control in young and older adults and additionally by processing speed in older adults. In PWA, word retrieval speed was predicted by severity of language deficit and cognitive control. Conclusions This study shows that processing speed is compromised in aphasia and could account for their slowed response times. Individual differences in cognitive control predicted word retrieval speed in healthy adults and PWA. These findings highlight the need to include nonlinguistic cognitive mechanisms in future models of word retrieval in healthy adults and word retrieval deficits in aphasia.

Neural sensitivity to phonological characteristics is stable across the lifespan

Aging is often associated with declines in language production. For example, compared to younger adults, older adults experience more tip-of-the-tongue (TOT) states, show decreased speed and accuracy in naming objects, and have more pauses and fillers in speech, all of which indicate age-related increases in retrieval difficulty. While prior work has suggested that retrieval difficulty may be phonologically based, it is unclear whether there are age-related differences in the organization of phonological information per se or whether age-related difficulties may arise from accessing that information. Here we used fMRI to investigate the neural and behavioral basis of phonological neighborhood denisty (PND) effects on picture naming across the lifespan (N=91, ages 20-75). Consistent with prior work, behavioral results revealed that higher PND led to faster picture naming times and higher accuracies overall, and that older adults were less accurate in their responses. Consistent with the behavioral analyses, fMRI analyses showed that increasing PND was associated with decreased activation in auditory and motor language regions, including bilateral superior temporal gyri and bilateral precentral gyri. Interestingly, although there were age-related increases in functional activation to picture naming, there were no age-related modulations of neural sensitivity to PND. Overall, these results suggest that having a large cohort of phonological neighbors facilitates language production, and although aging is associated with increases in language production difficulty, sensitivity to phonological features during language production is stable across the lifespan.

Comparing language samples of Bangla speakers using a colour photograph and a black-and-white line drawing

BACKGROUND

A comprehensive aphasia assessment is necessary to diagnose the type and severity of aphasia differentially and guide appropriate interventions. One component of an aphasia assessment is the picture description task (PDT), designed to probe spontaneous speech fluency and information content. Most aphasia assessments use black-and-white line drawings (LD) to elicit spontaneous language samples from people with aphasia (PWA). However, recent studies reported two visuographic variables: (1) colour (over black and white) and (2) photograph (over LD), that tended to encourage easier and faster comprehension and increased overall naturalistic language production from neurologically healthy individuals as well as PWA. Additionally, a suitable stimulus for a PDT should always be culturally relevant to the target population. Therefore, we suggest that a new PDT must include a culturally appropriate colour photograph (CP).

AIMS

To investigate if a culturally appropriate CP elicits longer and more complex utterances than a culturally appropriate black-and-white LD from neurologically healthy native Bangla speakers.

METHODS & PROCEDURES

A total of 30 participants (mean age = 36.03 years) were recruited based on self-reports of no known impairments in cognition, language, vision and hearing. All were of middle socioeconomic status with at least 12 years of formal education. A culturally appropriate CP was selected showing multiple characters performing various functions. Later, an artist prepared the black-and-white LD of that CP. The elicited language samples using these two pictures were transcribed and coded following preset transcription and coding guidelines. The transcribed samples were further analysed using the Bangla adaptation of Systematic Analysis of Language Transcripts (SALT) software. To identify the differences in language production between these two picture types, investigators used four measurement variables: mean length of utterances (MLU), complexity index (CI), total number of words (TNW) and words per minute (WPM).

OUTCOMES & RESULTS

Of the four measures, only MLU showed a statistically significant difference between the CP and the black-and-white LD. CI demonstrated a strong correlation with MLU for the CP, which indicates that the participants who produced higher MLU for the CP also produced a higher CI for the CP. There were no significant differences between the two picture types for CI, TNW and WPM.

CONCLUSIONS & IMPLICATIONS

This study found that the grammatical complexity, as measured by MLU, of spontaneous language production of neurologically healthy adults was higher when a CP was used in a PDT. A CP may also be beneficial for PWA to produce complex language samples. What this paper adds What is already known on the subject There are studies on neurologically healthy individuals as well as on PWA that identified the impact of using different visuographic variables (colour and photograph) separately, which enhanced the picture comprehension and improved performances on associated language production tasks. To our knowledge, no studies have identified the combined impact of these two visuographic variables on spontaneous language production. Therefore, this initial study on neurologically healthy Bangla adults reports the impact of using a CP as a stimulus item for a PDT task to elicit spontaneous language samples. What this paper adds to existing knowledge This study reports that using a culturally appropriate CP for a PDT enhances the grammatical complexity of spontaneous language production of neurologically healthy adults. To our knowledge, this is the first study in Bangla that used the MLU as a measurement variable to analyse adults' spontaneous language production. What are the potential or actual clinical implications of this work? The development of future aphasia assessments should consider incorporating CPs as stimuli for PDTs, which may guide speech-language pathologists to provide accurate diagnoses for aphasia and related language disorders.

Age-related differences in the neural bases of phonological and semantic processes in the context of task-irrelevant information

As we age we have increasing difficulty with phonological aspects of language production. Yet semantic processes are largely stable across the life span. This suggests a fundamental difference in the cognitive and potentially neural architecture supporting these systems. Moreover, language processes such as these interact with other cognitive processes that also show age-related decline, such as executive function and inhibition. The present study examined phonological and semantic processes in the presence of task-irrelevant information to examine the influence of such material on language production. Older and younger adults made phonological and semantic decisions about pictures in the presence of either phonologically or semantically related words, which were unrelated to the task. FMRI activation during the semantic condition showed that all adults engaged typical left-hemisphere language regions, and that this activation was positively correlated with efficiency across all adults. In contrast, the phonological condition elicited activation in bilateral precuneus and cingulate, with no clear brain-behavior relationship. Similarly, older adults exhibited greater activation than younger adults in several regions that were unrelated to behavioral performance. Our results suggest that as we age, brain-behavior relations decline, and there is an increased reliance on both language-specific and domain-general brain regions that are seen most prominently during phonological processing. In contrast, the core semantic system continues to be engaged throughout the life span, even in the presence of task-irrelevant information.

The pressure to communicate efficiently continues to shape language use later in life

Language use is shaped by a pressure to communicate efficiently, yet the tendency towards redundancy is said to increase in older age. The longstanding assumption is that saying more than is necessary is inefficient and may be driven by age-related decline in inhibition (i.e. the ability to filter out irrelevant information). However, recent work proposes an alternative account of efficiency: In certain contexts, redundancy facilitates communication (e.g., when the colour or size of an object is perceptually salient and its mention aids the listener's search). A critical question follows: Are older adults indiscriminately redundant, or do they modulate their use of redundant information to facilitate communication? We tested efficiency and cognitive capacities in 200 adults aged 19-82. Irrespective of age, adults with better attention switching skills were redundant in efficient ways, demonstrating that the pressure to communicate efficiently continues to shape language use later in life.

Correcting Task fMRI Signals for Variability in Baseline CBF Improves BOLD-Behavior Relationships: A Feasibility Study in an Aging Model

Blood Oxygen Level Dependent (BOLD) functional MRI is a complex neurovascular signal whose magnitude depends on baseline physiological factors such as cerebral blood flow (CBF). Because baseline CBF varies across the brain and is altered with aging, the interpretation of stand-alone aging-related BOLD changes can be misleading. The primary objective of this study was to develop a methodology that combines task fMRI and arterial spin labeling (ASL) techniques to sensitize task-induced BOLD activity by covarying out the baseline physiology (i.e., CBF) in an aging model. We recruited 11 younger and 13 older healthy participants who underwent ASL and an overt language fMRI task (semantic category member generation). We measured in-scanner language performance to investigate the effect of BOLD sensitization on BOLD-behavior relationships. The results demonstrate that our correction approach is effective at enhancing the specificity and sensitivity of the BOLD signal in both groups. In addition, the correction strengthens the statistical association between task BOLD activity and behavioral performance. Although CBF has inherent age dependence, our results show that retaining the age factor within CBF aides in greater sensitization of task fMRI signals. From a cognitive standpoint, compared to young adults, the older participants showed a delayed domain-general language-related task activity possibly due to compromised vessel compliance. Further, assessment of functional evolution of corrected BOLD activity revealed biphasic BOLD dynamics in both groups where BOLD deactivation may reflect greater semantic demand or increased premium on domain general executive functioning in response to task difficulty. Although it was promising to note that the predictability of behavior using the proposed methodology outperforms other methodologies (i.e., no correction and normalization by division), and provides moderate stability and adequate power, further work with a larger cohort and other task designs is necessary to improve the stability of predicting associated behavior. In summary, we recommend correction of task fMRI signals by covarying out baseline CBF especially when comparing groups with different neurovascular properties. Given that ASL and BOLD fMRI are well established and widely employed techniques, our proposed multi-modal methodology can be readily implemented into data processing pipelines to obtain more accurate BOLD activation maps.

Blood total antioxidant status is associated with cortical glucose uptake and factors related to accelerated aging

Identifying cerebral vulnerability in late life is of paramount importance to prevent pathological trajectories of aging before the onset of symptoms. Considerable evidence suggests that impaired antioxidant mechanisms are a fingerprint of aging-related conditions, but there is a lack of human research linking total antioxidant capacity (TAC) measured in peripheral blood to in vivo brain changes and other factors featuring accelerated aging. To address this issue, we have assessed in cognitively normal elderly subjects (N = 100) correlations between serum TAC, using the oxygen radical absorbance capacity assay, surface-based cortical thickness, surface-based 18F-fluorodeoxyglucose positron emission tomography cortical uptake, and different factors associated with accelerated aging [i.e., serum homocysteine (HCY), self-reported memory problems, and self-reported patterns of physical activity]. While no relationship was observed between serum TAC and variations in cortical thickness, decreased TAC level was significantly associated with lower FDG uptake in temporal lobes bilaterally. Remarkably, decreased TAC level was linked to increased HCY concentrations, more subjective memory complaints, and lower frequency of physical activity. Overall, our results suggest that decreased serum TAC level may be helpful to detect vulnerable trajectories of aging.

Multivariate analysis reveals anatomical correlates of naming errors in primary progressive aphasia

Primary progressive aphasia (PPA) is an overarching term for a heterogeneous group of neurodegenerative diseases which affect language processing. Impaired picture naming has been linked to atrophy of the anterior temporal lobe in the semantic variant of PPA. Although atrophy of the anterior temporal lobe proposedly impairs picture naming by undermining access to semantic knowledge, picture naming also entails object recognition and lexical retrieval. Using multivariate analysis, we investigated whether cortical atrophy relates to different types of naming errors generated during picture naming in 43 PPA patients (13 semantic, 9 logopenic, 11 nonfluent, and 10 mixed variant). Omissions were associated with atrophy of the anterior temporal lobes. Semantic errors, for example, mistaking a rhinoceros for a hippopotamus, were associated with atrophy of the left mid and posterior fusiform cortex and the posterior middle and inferior temporal gyrus. Semantic errors and atrophy in these regions occurred in each PPA subtype, without major between-subtype differences. We propose that pathological changes to neural mechanisms associated with semantic errors occur across the PPA spectrum.

Expected performance of Quebec-French older adults on the Batterie Rapide de Dénomination (BARD)

Difficulties retrieving words during conversations, called anomia, are frequent in the late preclinical stage of Alzheimer's disease, in mild cognitive impairment, and in major neurocognitive disorders. Picture-naming tests, used to assess anomia, are too lengthy and are unsuitable for medical or nursing practices. The main objective of this study was to confirm the usefulness of the Batterie Rapide de Dénomination (BARD - Battery of Rapid Denomination), an electronically-administered picture-naming test comprising 10 pictures for which perfect naming scores were obtained in French, English and Flemish participants. In this study, the BARD was applied on 207 healthy, French-speaking participants from Quebec, aged 50 years and more, wherein the results demonstrated the ease of naming the 10 pictures of the test. However, their performance was not always flawless. Seven out of the 207 participants of produced one error on one specific picture, which led us to excluding this item from the BARD. Thus, this study established the utility of the BARD for clinical settings of French-Quebec populations. This screening test is ideally suited for bedside assessment in acute care settings, stroke units and medical environments providing primary and secondary care. Its use has the potential for improving referrals to more specialized resources.

Cortical naming sites and increasing age in adults with refractory epilepsy: More might be less

OBJECTIVE

Critical decisions regarding resection boundaries for epilepsy surgery are often based on results of electrical stimulation mapping (ESM). Despite the potentially serious implications for postoperative functioning, age-referenced data that might facilitate the procedure are lacking. Age might be particularly relevant, as pediatric ESM studies have shown a paucity of language sites in young children followed by a rapid increase at approximately 8-10 years. Beyond adolescence, it has generally been assumed that the language system remains stable, and therefore, potential age-related changes across the adult age span have not been examined. However, increasing age during adulthood is associated with both positive and negative language-related changes, such as a broadening vocabulary and increased word finding difficulty. Because most patients who undergo ESM are adults, we aimed to determine the potential impact of age on the incidence of ESM-identified naming sites across the adult age span in patients with refractory epilepsy.

METHODS

We analyzed clinical language ESM results from 47 patients, ages 17-64 years, with refractory dominant-hemisphere epilepsy. Patients had comparable location and number of cortical sites tested. The incidence of naming sites was examined as a function of age, and compared between younger and older adults.

RESULTS

Significantly more naming sites were found in older than younger adults, and age was found to be a significant predictor of number of naming sites identified.

SIGNIFICANCE

Unlike the developmental changes that coincide with increased naming sites in children, increased naming sites in older adults might signify greater vulnerability of the language system to disruption. Because preservation of language sites can limit the extent of the resection, and thereby reduce the likelihood of seizure freedom, further work should aim to determine the clinical relevance of increased naming sites in older adults.

Reduced semantic control in older adults is linked to intrinsic DMN connectivity

Ageing provides an interesting window into semantic cognition: while younger adults generally outperform older adults on many cognitive tasks, knowledge continues to accumulate over the lifespan and consequently, the semantic store (i.e., vocabulary size) remains stable (or even improves) during healthy ageing. Semantic cognition involves the interaction of at least two components - a semantic store and control processes that interact to ensure efficient and context-relevant use of representations. Given older adults perform less well on tasks measuring executive control, their ability to access the semantic store in a goal driven manner may be compromised. Older adults also consistently show reductions in intrinsic brain connectivity, and we examined how these brain changes relate to age-related changes in semantic performance. We found that while older participants outperformed their younger counterparts on tests of vocabulary size (i.e., NART), younger participants were faster and more accurate in tasks requiring semantic control, and these age differences correlated with measures of intrinsic connectivity between the anterior temporal lobe (ATL) and medial prefrontal cortex (mPFC), within the default mode network. Higher intrinsic connectivity from right ATL to mPFC at rest related to better performance on verbal (but not picture) semantic tasks, and older adults showed an exaggerated version of this pattern, suggesting that this within-DMN connectivity may become more important for conceptual access from words as we age. However, this appeared to be at the expense of control over semantic retrieval - there was little relationship between connectivity and performance for strong associations in either group, but older adults with stronger connectivity showed particularly inefficient retrieval of weak associations. Older adults may struggle to harness the default mode network to support demanding patterns of semantic retrieval, resulting in a performance cost.

The Role of Executive Functions in Object- and Action-Naming among Older Adults

Background/Study Context: Lexical retrieval abilities and executive function skills decline with age. The extent to which these processes might be interdependent remains unknown. The aim of the current study was to examine whether individual differences in three executive functions (shifting, fluency, and inhibition) predicted naming performance in older adults. Methods: The sample included 264 adults aged 55-84. Six measures of executive functions were combined to make three executive function composites scores. Lexical retrieval performance was measured by accuracy and response time on two tasks: object naming and action naming. We conducted a series of multiple regressions to test whether executive function performance predicts naming abilities in older adults. Results: We found that different executive functions predicted naming speed and accuracy. Shifting predicted naming accuracy for both object and action naming while fluency predicted response times on both tests as well as object naming accuracy, after controlling for education, gender, age, working memory span, and speed of processing in all regressions. Interestingly, inhibition did not contribute to naming accuracy or response times on either task. Conclusion: The findings support the notion that preservation of some executive functions contributes to successful naming in older adults and that different executive functions are associated with naming speed and accuracy.

Neural activity reveals effects of aging on inhibitory processes during word retrieval

Word retrieval difficulties are one of the most frustrating problems for older adults. Poorer access to phonological representation of the target word has been postulated as the underlying deficit, supported by findings of improved word retrieval after phonological priming. To better understand aging effects in the underlying neurophysiology associated with word retrieval, this study examined electrophysiological correlates of phonological priming and word retrieval in adults. Young, middle-aged, and older adults viewed pictures that were preceded by pseudo-word primes that either shared initial phonemes with or were unrelated to the picture's name. Participants made phonological judgments regarding the prime and picture prior to naming the picture. Behavioral and event-related potential correlates of phonological priming and word retrieval were recorded. All groups benefitted similarly from phonological priming, evidenced by faster phonological judgment response times and increased ease of word retrieval for primed pictures, indexed by the N400 priming effect. The peak latency of the N2, however, showed an incremental delay with age. High correlation between N2 peak latency and clinical measures of inhibition suggested an age-related delay in the inhibition of primed lexical competitors. Taken together, our results indicated intact activation of phonological representation of the picture's name but age-related delays in inhibition of primed competitors. Interestingly, our findings revealed that delays in inhibiting lexical competitors may begin as early as middle age, highlighting the importance of including multiple age groups to better represent the aging trajectory.

Gray Matter Volume and Cognitive Performance During Normal Aging. A Voxel-Based Morphometry Study

Normal aging is characterized by decline in cognitive functioning in conjunction with extensive gray matter (GM) atrophy. A first aim of this study was to determine GM volume differences related to aging by comparing two groups of participants, middle-aged group (MAG, mean age 41 years, N = 16) and older adults (OG, mean age 71 years, N = 14) who underwent an magnetic resonance images (MRI) voxel-based morphometry (VBM) evaluation. The VBM analyses included two optimized pipelines, for the cortex and for the cerebellum. Participants were also evaluated on a wide range of cognitive tests assessing both domain-general and language-specific processes, in order to examine how GM volume differences between OG and MAG relate to cognitive performance. Our results show smaller bilateral GM volume in the OG relative to the MAG, in several cerebral and right cerebellar regions involved in language and executive functions. Importantly, our results also revealed smaller GM volume in the right cerebellum in OG relative to MAG, supporting the idea of a complex cognitive role for this structure. This study provides a broad picture of cerebral, but also cerebellar and cognitive changes associated with normal aging.

Higher physical fitness levels are associated with less language decline in healthy ageing

Healthy ageing is associated with decline in cognitive abilities such as language. Aerobic fitness has been shown to ameliorate decline in some cognitive domains, but the potential benefits for language have not been examined. In a cross-sectional sample, we investigated the relationship between aerobic fitness and tip-of-the-tongue states. These are among the most frequent cognitive failures in healthy older adults and occur when a speaker knows a word but is unable to produce it. We found that healthy older adults indeed experience more tip-of-the-tongue states than young adults. Importantly, higher aerobic fitness levels decrease the probability of experiencing tip-of-the-tongue states in healthy older adults. Fitness-related differences in word finding abilities are observed over and above effects of age. This is the first demonstration of a link between aerobic fitness and language functioning in healthy older adults.

Tip of the Tongue States Increase Under Evaluative Observation

We tested the frequent assumption that the difficulty of word retrieval increases when a speaker is being observed and evaluated. We modified the Trier Social Stress Test (TSST) so that participants believed that its evaluative observation components continued throughout the duration of a subsequent word retrieval task, and measured participants' reported tip of the tongue (TOT) states. Participants in this TSST condition experienced more TOTs than participants in a comparable, placebo TSST condition in which there was no suggestion of evaluative observation. This experiment provides initial evidence confirming the assumption that evaluative observation by a third party can be disruptive to word retrieval. We interpret our findings by proposing an extension to a well-supported theoretical model of TOTs.

Proper name retrieval and structural integrity of cerebral cortex in midlife: A cross-sectional study

There is currently little understanding on whether retrieval of proper names differs in midlife compared to young adulthood and if so, whether the age differences in this ability are associated with differences in structural integrity of the cerebral cortex. To answer these questions, we studied retrieval of proper names in 115 cognitively healthy middle-aged persons (49.7, ±3.2), comparing their performance on a tip-of-the-tongue (TOT) task with that of 68 young persons (25.4, ±3.5) from the Cam-Can data repository (http://www.mrc-cbu.cam.ac.uk/datasets/camcan/). Grey matter (GM) density and cortical thickness were used as indices of structural integrity of the cerebral cortex. The middle-aged (MA) group experienced more TOTs during proper names retrieval than young adults (YA), (t = 3.789, p < .005) and had considerably less GM density and cortical thickness across a range of brain areas bilaterally. Small clusters in left BA 45 and right BA 44 (cortical thickness) and in right BA 40 (volumetry) revealed group differences when accounting for TOTs. However, we observed no correlations between MA's TOT scores and GM volumes or cortical thickness of the brain regions typically reported as implicated in retrieval of proper names: left anterior temporal lobe, left insula, and left superior and middle temporal gyri.

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

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

Age-Related Increases in Tip-of-the-tongue are Distinct from Decreases in Remembering Names: A Functional MRI Study

Tip-of-the-tongue (TOT) experiences increase with age and frequently heighten concerns about memory decline. We studied 73 clinically normal older adults participating in the Harvard Aging Brain Study. They completed a functional magnetic resonance imaging (fMRI) task that required remembering names associated with pictures of famous faces. Older age was associated with more self-reported TOT experiences and a decrease in the percentage of remembered names. However, the percentage of TOT experiences and the percentage of remembered names were not directly correlated. We mapped fMRI activity for recollection of famous names and TOT and examined activity in the hippocampal formation, retrosplenial cortex, and lateral prefrontal cortex. The hippocampal formation was similarly activated in recollection and TOT experiences. In contrast, the retrosplenial cortex was most active for recollection and lateral prefrontal cortex was most active for TOT experiences. Together, the results confirm that age-related increases in TOT experiences are not only solely the consequence of age-related decline in recollection, but also likely reflect functional alterations in the brain networks that support retrieval monitoring and cognitive control. These findings provide behavioral and neuroimaging evidence that age-related TOT experiences and memory failure are partially independent processes.

Neural evidence for phonologically based language production deficits in older adults: An fMRI investigation of age-related differences in picture-word interference

INTRODUCTION

Older adults often show declines in phonological aspects of language production, particularly for low-frequency words, but maintain strong semantic systems. However, there are different theories about the mechanism that may underlie such age-related differences in language (e.g., age-related declines in transmission of activation or inhibition).

METHODS

This study used fMRI to investigate whether age-related differences in language production are associated with transmission deficits or inhibition deficits. We used the picture-word interference paradigm to examine age-related differences in picture naming as a function of both target frequency and the relationship between the target picture and distractor word.

RESULTS

We found that the presence of a categorically related distractor led to greater semantic elaboration by older adults compared to younger adults, as evidenced by older adults' increased recruitment of regions including the left middle frontal gyrus and bilateral precuneus. When presented with a phonologically related distractor, patterns of neural activation are consistent with previously observed age deficits in phonological processing, including age-related reductions in the recruitment of regions such as the left middle temporal gyrus and right supramarginal gyrus. Lastly, older, but not younger, adults show increased brain activation of the pre- and postcentral gyri as a function of decreasing target frequency when target pictures are paired with a phonological distractor, suggesting that cuing the phonology of the target disproportionately aids production of low-frequency items.

CONCLUSIONS

Overall, this pattern of results is generally consistent with the transmission deficit hypothesis, illustrating that links within the phonological system, but not the semantic system, are weakened with age.

Age-related differences in resolving semantic and phonological competition during receptive language tasks

Receptive language (e.g., reading) is largely preserved in the aging brain, and semantic processes in particular may continue to develop throughout the lifespan. We investigated the neural underpinnings of phonological and semantic retrieval in older and younger adults during receptive language tasks (rhyme and semantic similarity judgments). In particular, we were interested in the role of competition on language retrieval and varied the similarities between a cue, target, and distractor that were hypothesized to affect the mental process of competition. Behaviorally, all participants responded faster and more accurately during the rhyme task compared to the semantic task. Moreover, older adults demonstrated higher response accuracy than younger adults during the semantic task. Although there were no overall age-related differences in the neuroimaging results, an Age×Task interaction was found in left inferior frontal gyrus (IFG), with older adults producing greater activation than younger adults during the semantic condition. These results suggest that at lower levels of task difficulty, older and younger adults engaged similar neural networks that benefited behavioral performance. As task difficulty increased during the semantic task, older adults relied more heavily on largely left hemisphere language regions, as well as regions involved in perception and internal monitoring. Our results are consistent with the stability of language comprehension across the adult lifespan and illustrate how the preservation of semantic representations with aging may influence performance under conditions of increased task difficulty.

Aging and the Resting State: Is Cognition Obsolete?

Recent years have seen the rise in popularity of the resting state approach to neurocognitive aging, with many studies examining age differences in functional connectivity at rest and relating these differences to cognitive performance outside the scanner. There are many advantages to the resting state that likely contribute to its popularity and indeed, many insights have been gained from this work. However, there are also several limitations of the resting state approach that restrict its ability to contribute to the study of neurocognitive aging. In this opinion piece, we consider some of those limitations and argue that task-based studies are still essential to developing a mechanistic understanding of how age affects the brain in a cognitively relevant manner - a fundamental goal of neuroscientific research into aging.

Dominant hemisphere functional networks compensate for structural connectivity loss to preserve phonological retrieval with aging

INTRODUCTION

Loss of hemispheric asymmetry during cognitive tasks has been previously demonstrated in the literature. In the context of language, increased right hemisphere activation is observed with aging. Whether this relates to compensation to preserve cognitive function or dedifferentiation implying loss of hemispheric specificity without functional consequence, remains unclear.

METHODS

With a multifaceted approach, integrating structural and functional imaging data during a word retrieval task, in a group of younger and older adults with equivalent cognitive performance, we aimed to establish whether interactions between hemispheres or reorganization of dominant hemisphere networks preserve function. We examined functional and structural connectivity on data from our previously published functional activation study. Functional connectivity was measured using psychophysiological interactions analysis from the left inferior frontal gyrus (LIFG) and the left insula (LINS), based on published literature, and the right inferior frontal gyrus (RIFG) based on our previous study.

RESULTS

Although RIFG showed increased activation, its connectivity decreased with age. Meanwhile, LIFG and LINS connected more bilaterally in the older adults. White matter integrity, measured by fractional anisotropy (FA) from diffusion tensor imaging, decreased significantly in the older group. Importantly, LINS functional connectivity to LIFG correlated inversely with FA.

CONCLUSIONS

We demonstrate that left hemispheric language areas show higher functional connectivity in older adults with intact behavioral performance, and thus, may have a role in preserving function. The inverse correlation of functional and structural connectivity with age is in keeping with emerging literature and merits further investigation with tractography studies and in other cognitive domains.

The neural language systems that support healthy aging: Integrating function, structure, and behavior

Although healthy aging is generally characterized by declines in both brain structure and function, there is variability in the extent to which these changes result in observable cognitive decline. Specific to language, age-related differences in language production are observed more frequently than in language comprehension, although both are associated with increased right prefrontal cortex activation in older adults. The current paper explores these differences in the language system, integrating them with theories of behavioral and neural cognitive aging. Overall, data indicate that frontal reorganization of the dorsal language stream in older adults benefits task performance during comprehension, but not always during production. We interpret these results in the CRUNCH framework (compensation-related utilization of neural circuits hypothesis), which suggests that differences in task and process difficulty may underlie older adults' ability to successfully adapt. That is, older adults may be able to neurally adapt to less difficult tasks (i.e., comprehension), but fail to do so successfully as difficulty increases (i.e., production). We hypothesize greater age-related differences in aspects of language that rely more heavily on the dorsal language stream (e.g., syntax and production) and that recruit general cognitive resources that rely on frontal regions (e.g., executive function, working memory, inhibition). Moreover, there should be a relative sparing of tasks that rely predominantly on ventral stream regions. These results are both consistent with patterns of age-related structural decline and retention and with varying levels of difficulty across comprehension and production. This neurocognitive framework for understanding age-related differences in the language system centers on the interaction between prefrontal cortex activation, structural integrity, and task difficulty.

Functional MRI evidence for the decline of word retrieval and generation during normal aging

This fMRI study aimed to explore the effect of normal aging on word retrieval and generation. The question addressed is whether lexical production decline is determined by a direct mechanism, which concerns the language operations or is rather indirectly induced by a decline of executive functions. Indeed, the main hypothesis was that normal aging does not induce loss of lexical knowledge, but there is only a general slowdown in retrieval mechanisms involved in lexical processing, due to possible decline of the executive functions. We used three tasks (verbal fluency, object naming, and semantic categorization). Two groups of participants were tested (Young, Y and Aged, A), without cognitive and psychiatric impairment and showing similar levels of vocabulary. Neuropsychological testing revealed that older participants had lower executive function scores, longer processing speeds, and tended to have lower verbal fluency scores. Additionally, older participants showed higher scores for verbal automatisms and overlearned information. In terms of behavioral data, older participants performed as accurate as younger adults, but they were significantly slower for the semantic categorization and were less fluent for verbal fluency task. Functional MRI analyses suggested that older adults did not simply activate fewer brain regions involved in word production, but they actually showed an atypical pattern of activation. Significant correlations between the BOLD (Blood Oxygen Level Dependent) signal of aging-related (A > Y) regions and cognitive scores suggested that this atypical pattern of the activation may reveal several compensatory mechanisms (a) to overcome the slowdown in retrieval, due to the decline of executive functions and processing speed and (b) to inhibit verbal automatic processes. The BOLD signal measured in some other aging-dependent regions did not correlate with the behavioral and neuropsychological scores, and the overactivation of these uncorrelated regions would simply reveal dedifferentiation that occurs with aging. Altogether, our results suggest that normal aging is associated with a more difficult access to lexico-semantic operations and representations by a slowdown in executive functions, without any conceptual loss.

Conflict monitoring in speech processing: An fMRI study of error detection in speech production and perception

To minimize the number of errors in speech, and thereby facilitate communication, speech is monitored before articulation. It is, however, unclear at which level during speech production monitoring takes place, and what mechanisms are used to detect and correct errors. The present study investigated whether internal verbal monitoring takes place through the speech perception system, as proposed by perception-based theories of speech monitoring, or whether mechanisms independent of perception are applied, as proposed by production-based theories of speech monitoring. With the use of fMRI during a tongue twister task we observed that error detection in internal speech during noise-masked overt speech production and error detection in speech perception both recruit the same neural network, which includes pre-supplementary motor area (pre-SMA), dorsal anterior cingulate cortex (dACC), anterior insula (AI), and inferior frontal gyrus (IFG). Although production and perception recruit similar areas, as proposed by perception-based accounts, we did not find activation in superior temporal areas (which are typically associated with speech perception) during internal speech monitoring in speech production as hypothesized by these accounts. On the contrary, results are highly compatible with a domain general approach to speech monitoring, by which internal speech monitoring takes place through detection of conflict between response options, which is subsequently resolved by a domain general executive center (e.g., the ACC).

Object naming in epilepsy and epilepsy surgery

The ability to express oneself verbally is critical for success in academic, occupational, and social domains. Unfortunately, word-finding or "naming" difficulty is the most common cognitive complaint among individuals with temporal lobe epilepsy (TLE), and a substantial body of work over the past several decades has documented naming impairment in left (language-dominant) TLE, with further risk to naming ability following left temporal lobe resection for seizure control. With these findings well established, this paper reviews more recent work that has aimed to identify the neuroanatomical substrates of naming, understand how adverse structural and functional effects of TLE might impinge upon these brain regions, predict and potentially reduce the risk of postoperative naming decline, and begin to understand naming difficulty in TLE from a developmental perspective. Factors that have confounded interpretation and hindrances to progress are discussed, and suggestions are provided for improved empirical investigation and directions for future research.

The Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study protocol: a cross-sectional, lifespan, multidisciplinary examination of healthy cognitive ageing

BACKGROUND

As greater numbers of us are living longer, it is increasingly important to understand how we can age healthily. Although old age is often stereotyped as a time of declining mental abilities and inflexibility, cognitive neuroscience reveals that older adults use neural and cognitive resources flexibly, recruiting novel neural regions and cognitive processes when necessary. Our aim in this project is to understand how age-related changes to neural structure and function interact to support cognitive abilities across the lifespan.

METHODS/DESIGN

We are recruiting a population-based cohort of 3000 adults aged 18 and over into Stage 1 of the project, where they complete an interview including health and lifestyle questions, a core cognitive assessment, and a self-completed questionnaire of lifetime experiences and physical activity. Of those interviewed, 700 participants aged 18-87 (100 per age decile) continue to Stage 2 where they undergo cognitive testing and provide measures of brain structure and function. Cognition is assessed across multiple domains including attention and executive control, language, memory, emotion, action control and learning. A subset of 280 adults return for in-depth neurocognitive assessment in Stage 3, using functional neuroimaging experiments across our key cognitive domains.Formal statistical models will be used to examine the changes that occur with healthy ageing, and to evaluate age-related reorganisation in terms of cognitive and neural functions invoked to compensate for overall age-related brain structural decline. Taken together the three stages provide deep phenotyping that will allow us to measure neural activity and flexibility during performance across a number of core cognitive functions. This approach offers hypothesis-driven insights into the relationship between brain and behaviour in healthy ageing that are relevant to the general population.

DISCUSSION

Our study is a unique resource of neuroimaging and cognitive measures relevant to change across the adult lifespan. Because we focus on normal age-related changes, our results may contribute to changing views about the ageing process, lead to targeted interventions, and reveal how normal ageing relates to frail ageing in clinicopathological conditions such as Alzheimer's disease.

Between Thought and Expression, a Magnetoencephalography Study of the “Tip-of-the-Tongue” Phenomenon

“Tip-of-the-tongue” (TOT) is the phenomenon associated with the inaccessibility of a known word from memory. It is universally experienced, increases in frequency with age, and is most common for proper nouns. It is a good model for the symptom of anomia experienced much more frequently by some aphasic patients following brain injury. Here, we induced the TOT state in older participants while they underwent brain scanning with magnetoencephalography to investigate the changes in oscillatory brain activity associated with failed retrieval of known words. Using confrontation naming of pictures of celebrities, we successfully induced the TOT state in 29% of trials and contrasted it with two other states: “Know” where the participants both correctly recognized the celebrity's face and retrieved their name and “Don't Know” when the participants did not recognize the celebrity. We wished to test Levelt's influential model of speech output by carrying out two analyses, one epoching the data to the point in time when the picture was displayed and the other looking back in time from when the participants first articulated their responses. Our main findings supported the components of Levelt's model, but not their serial activation over time as both semantic and motor areas were identified in both analyses. We also found enduring decreases in the alpha frequency band in the left ventral temporal region during the TOT state, suggesting ongoing semantic search. Finally, we identified reduced beta power in classical peri-sylvian language areas for the TOT condition, suggesting that brain regions that encode linguistic memories are also involved in their attempted retrieval.

Age-related differences in effective connectivity of brain regions involved in Japanese kanji processing with homophone judgment task

Reading is a complex process involving neural networks in which connections may be influenced by task demands and other factors. We employed functional magnetic resonance imaging and dynamic causal modeling to examine age-related influences on left-hemispheric kanji reading networks. During a homophone judgment task, activation in the middle frontal gyrus, and dorsal and ventral inferior frontal gyri were identified, representing areas involved in orthographic, phonological, and semantic processing, respectively. The young adults showed a preference for a semantically-mediated pathway from orthographic inputs to the retrieval of phonological representations, whereas the elderly preferred a direct connection from orthographic inputs to phonological lexicons prior to the activation of semantic representations. These sequential pathways are in line with the lexical semantic and non-semantic routes in the dual-route cascaded model. The shift in reading pathways accompanied by slowed reaction time for the elderly might suggest age-related declines in the efficiency of network connectivity.

A systematic review of type 2 diabetes mellitus and hypertension in imaging studies of cognitive aging: time to establish new norms

The rising prevalence of type 2 diabetes (T2DM) and hypertension in older adults, and the deleterious effect of these conditions on cerebrovascular and brain health, is creating a growing discrepancy between the "typical" cognitive aging trajectory and a "healthy" cognitive aging trajectory. These changing health demographics make T2DM and hypertension important topics of study in their own right, and warrant attention from the perspective of cognitive aging neuroimaging research. Specifically, interpretation of individual or group differences in blood oxygenation level dependent magnetic resonance imaging (BOLD MRI) or positron emission tomography (PET H2O(15)) signals as reflective of differences in neural activation underlying a cognitive operation of interest requires assumptions of intact vascular health amongst the study participants. Without adequate screening, inclusion of individuals with T2DM or hypertension in "healthy" samples may introduce unwanted variability and bias to brain and/or cognitive measures, and increase potential for error. We conducted a systematic review of the cognitive aging neuroimaging literature to document the extent to which researchers account for these conditions. Of the 232 studies selected for review, few explicitly excluded individuals with T2DM (9%) or hypertension (13%). A large portion had exclusion criteria that made it difficult to determine whether T2DM or hypertension were excluded (44 and 37%), and many did not mention any selection criteria related to T2DM or hypertension (34 and 22%). Of all the surveyed studies, only 29% acknowledged or addressed the potential influence of intersubject vascular variability on the measured BOLD or PET signals. To reinforce the notion that individuals with T2DM and hypertension should not be overlooked as a potential source of bias, we also provide an overview of metabolic and vascular changes associated with T2DM and hypertension, as they relate to cerebrovascular and brain health.

Age-related differences in the neural bases of phonological and semantic processes

Changes in language functions during normal aging are greater for phonological compared with semantic processes. To investigate the behavioral and neural basis for these age-related differences, we used fMRI to examine younger and older adults who made semantic and phonological decisions about pictures. The behavioral performance of older adults was less accurate and less efficient than younger adults' in the phonological task but did not differ in the semantic task. In the fMRI analyses, the semantic task activated left-hemisphere language regions, and the phonological task activated bilateral cingulate and ventral precuneus. Age-related effects were widespread throughout the brain and most often expressed as greater activation for older adults. Activation was greater for younger compared with older adults in ventral brain regions involved in visual and object processing. Although there was not a significant Age × Condition interaction in the whole-brain fMRI results, correlations examining the relationship between behavior and fMRI activation were stronger for younger compared with older adults. Our results suggest that the relationship between behavior and neural activation declines with age, and this may underlie some of the observed declines in performance.

Written distractor words influence brain activity during overt picture naming

Language production requires multiple stages of processing (e.g., semantic retrieval, lexical selection), each of which may involve distinct brain regions. Distractor words can be combined with picture naming to examine factors that influence language production. Phonologically-related distractors have been found to speed picture naming (facilitation), while slower response times and decreased accuracy (interference) generally occur when a distractor is categorically related to the target image. However, other types of semantically-related distractors have been reported to produce a facilitative effect (e.g., associative, part-whole). The different pattern of results for different types of semantically-related distractors raises the question about how the nature of the semantic relation influences the effect of the distractor. To explore the nature of these semantic effects further, we used functional MRI to examine the influence of four types of written distractors on brain activation during overt picture naming. Distractors began with the same sound, were categorically-related, part of the object to be named, or were unrelated to the picture. Phonologically-related trials elicited greater activation than both semantic conditions (categorically-related and part-whole) in left insula and bilateral parietal cortex, regions that have been attributed to phonological aspects of production and encoding, respectively. Semantic conditions elicited greater activation than phonological trials in left posterior MTG, a region that has been linked to concept retrieval and semantic integration. Overall, the two semantic conditions did not differ substantially in their functional activation which suggests a similarity in the semantic demands and lexical competition across these two conditions.

Functional language shift to the right hemisphere in patients with language-eloquent brain tumors

Objectives

Language function is mainly located within the left hemisphere of the brain, especially in right-handed subjects. However, functional MRI (fMRI) has demonstrated changes of language organization in patients with left-sided perisylvian lesions to the right hemisphere. Because intracerebral lesions can impair fMRI, this study was designed to investigate human language plasticity with a virtual lesion model using repetitive navigated transcranial magnetic stimulation (rTMS).

Experimental design

Fifteen patients with lesions of left-sided language-eloquent brain areas and 50 healthy and purely right-handed participants underwent bilateral rTMS language mapping via an object-naming task. All patients were proven to have left-sided language function during awake surgery. The rTMS-induced language errors were categorized into 6 different error types. The error ratio (induced errors/number of stimulations) was determined for each brain region on both hemispheres. A hemispheric dominance ratio was then defined for each region as the quotient of the error ratio (left/right) of the corresponding area of both hemispheres (ratio >1  =  left dominant; ratio <1  =  right dominant).

Results

Patients with language-eloquent lesions showed a statistically significantly lower ratio than healthy participants concerning “all errors” and “all errors without hesitations”, which indicates a higher participation of the right hemisphere in language function. Yet, there was no cortical region with pronounced difference in language dominance compared to the whole hemisphere.

Conclusions

This is the first study that shows by means of an anatomically accurate virtual lesion model that a shift of language function to the non-dominant hemisphere can occur.

Compensatory networks to counteract the effects of ageing on language

BACKGROUND

Word-retrieval difficulties are a common consequence of healthy ageing and are associated with a reduction in asymmetrical recruitment of the dorsolateral prefrontal cortex (DLPFC), although the significance of this reduction has not yet been clarified. Using repetitive transcranial magnetic stimulation (rTMS) it has been demonstrated that an asymmetrical involvement of the DLPFC during action naming in young subjects, whereas bilateral involvement was shown in elderly participants. By using rTMS during a naming task in a group of elderly subjects, the aim of the present work was to investigate whether the magnitude of DLPFC asymmetry (left-right rTMS effect) during action naming correlates with task performance, proving the presence of a compensation strategy in some but not all elderly participants.

METHODS

We aimed to test if there was a correlation between DLPFC asymmetry (left-right rTMS effect) and naming performance in a group of elderly subjects.

RESULTS

The results show that rTMS affects action naming differently according to individual naming ability. In particular, the predominance of a left vs. right DLPFC effect was observed only in the low-performing older adults, while an asymmetric reduction was selectively shown in the high-performing group. Interestingly, high-performing older adults also displayed better performances on a phonemic fluency test.

CONCLUSION

The present data suggest that successful ageing is linked to less prefrontal asymmetry, an efficient strategy for counteracting age-related declines in cognitive function.

Association between prefrontal activity and volume change in prefrontal and medial temporal lobes in aging and dementia: a review

Functional neuroimaging studies have consistently reported age-related changes in prefrontal cortex (PFC) activity during a variety of cognitive tasks, including episodic memory. These changes are often interpreted within the context of one of the following three neural models of age-related changes in brain function: dedifferentiation, neural inefficiency, and neural plasticity and compensation models. Distinguishing between these competing models has proven difficult when interpreting results using functional imaging data alone. In this paper we suggest that a more accurate interpretation of age-related changes in PFC activity requires consideration of age-related differences in gray matter volume (GMv) in PFC and the medial temporal lobes (MTL). We review fMRI studies of cognitive aging that have directly examined the relationship between PFC activity and both local (PFC) and distal (MTL) GMv in older versus younger adults. We also considered how structure-function relationships may be further modified in pathological aging (i.e. mild cognitive impairment (MCI) and Alzheimer's disease (AD)). We found that when task performance was matched between age-groups there was a negative association between regional PFC volume and activity in older adults. However, when older adults performed worse than young adults we observed a positive association between volume and activity in right lateral PFC. Additionally during memory tasks, several studies revealed that PFC activity is positively related to GM volume in MTL in healthy older adults, but negatively related in MCI and AD patients. We conclude that PFC activity is related to age-related changes in local and distal GM volume reductions and that consideration of these structural measures aids the interpretation of fMRI results. Furthermore, the study of structure-function relationships may provide important insights into the biological mechanisms underlying healthy versus pathological aging.