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Peña-Casanova J, Sánchez-Benavides G, Sigg-Alonso J. Updating functional brain units: Insights far beyond Luria. Cortex 2024; 174:19-69. [PMID: 38492440 DOI: 10.1016/j.cortex.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/15/2024] [Accepted: 02/15/2024] [Indexed: 03/18/2024]
Abstract
This paper reviews Luria's model of the three functional units of the brain. To meet this objective, several issues were reviewed: the theory of functional systems and the contributions of phylogenesis and embryogenesis to the brain's functional organization. This review revealed several facts. In the first place, the relationship/integration of basic homeostatic needs with complex forms of behavior. Secondly, the multi-scale hierarchical and distributed organization of the brain and interactions between cells and systems. Thirdly, the phylogenetic role of exaptation, especially in basal ganglia and cerebellum expansion. Finally, the tripartite embryogenetic organization of the brain: rhinic, limbic/paralimbic, and supralimbic zones. Obviously, these principles of brain organization are in contradiction with attempts to establish separate functional brain units. The proposed new model is made up of two large integrated complexes: a primordial-limbic complex (Luria's Unit I) and a telencephalic-cortical complex (Luria's Units II and III). As a result, five functional units were delineated: Unit I. Primordial or preferential (brainstem), for life-support, behavioral modulation, and waking regulation; Unit II. Limbic and paralimbic systems, for emotions and hedonic evaluation (danger and relevance detection and contribution to reward/motivational processing) and the creation of cognitive maps (contextual memory, navigation, and generativity [imagination]); Unit III. Telencephalic-cortical, for sensorimotor and cognitive processing (gnosis, praxis, language, calculation, etc.), semantic and episodic (contextual) memory processing, and multimodal conscious agency; Unit IV. Basal ganglia systems, for behavior selection and reinforcement (reward-oriented behavior); Unit V. Cerebellar systems, for the prediction/anticipation (orthometric supervision) of the outcome of an action. The proposed brain units are nothing more than abstractions within the brain's simultaneous and distributed physiological processes. As function transcends anatomy, the model necessarily involves transition and overlap between structures. Beyond the classic approaches, this review includes information on recent systemic perspectives on functional brain organization. The limitations of this review are discussed.
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Affiliation(s)
- Jordi Peña-Casanova
- Integrative Pharmacology and Systems Neuroscience Research Group, Neuroscience Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Bellaterra, Barcelona, Spain; Test Barcelona Services, Teià, Barcelona, Spain.
| | | | - Jorge Sigg-Alonso
- Department of Behavioral and Cognitive Neurobiology, Institute of Neurobiology, National Autonomous University of México (UNAM), Queretaro, Mexico
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Sanati M, Bayat S, Panahi MM, Khodadadi A, Rezaee S, Ghasimi M, Besharat S, Fooladi ZM, Dooghaee MA, Taheri MS, Dickerson BC, Goldberg A, Rezaii N. Impaired language in Alzheimer's disease: A comparison between English and Persian implicates content-word frequency rather than the noun-verb distinction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.09.24305534. [PMID: 38645255 PMCID: PMC11030473 DOI: 10.1101/2024.04.09.24305534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
This study challenges the conventional psycholinguistic view that the distinction between nouns and verbs is pivotal in understanding language impairments in neurological disorders. Traditional views link frontal brain region damage with verb processing deficits and posterior temporoparietal damage with noun difficulties. However, this perspective is contested by findings from patients with Alzheimer's disease (pwAD), who show impairments in both word classes despite their typical temporoparietal atrophy. Notably, pwAD tend to use semantically lighter verbs in their speech than healthy individuals. By examining English-speaking pwAD and comparing them with Persian-speaking pwAD, this research aims to demonstrate that language impairments in Alzheimer's disease (AD) stem from the distributional properties of words within a language rather than distinct neural processing networks for nouns and verbs. We propose that the primary deficit in AD language production is an overreliance on high-frequency words. English has a set of particularly high-frequency verbs that surpass most nouns in usage frequency. Since pwAD tend to use high-frequency words, the byproduct of this word distribution in the English language would be an over-usage of high-frequency verbs. In contrast, Persian features complex verbs with an overall distribution lacking extremely high-frequency verbs like those found in English. As a result, we hypothesize that Persian-speaking pwAD would not have a bias toward the overuse of high-frequency verbs. We analyzed language samples from 95 English-speaking pwAD and 91 healthy controls, along with 27 Persian-speaking pwAD and 27 healthy controls. Employing uniform automated natural language processing methods, we measured the usage rates of nouns, verbs, and word frequencies across both cohorts. Our findings showed that English-speaking pwAD use higher-frequency verbs than healthy individuals, a pattern not mirrored by Persian-speaking pwAD. Crucially, we found a significant interaction between the frequencies of verbs used by English and Persian speakers with and without AD. Moreover, regression models that treated noun and verb frequencies as separate predictors did not outperform models that considered overall word frequency alone in classifying AD. In conclusion, this study suggests that language abnormalities among English-speaking pwAD reflect the unique distributional properties of words in English rather than a universal noun-verb class distinction. Beyond offering a new understanding of language abnormalities in AD, the study highlights the critical need for further investigation across diverse languages to deepen our insight into the mechanisms of language impairments in neurological disorders.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mostafa Almasi Dooghaee
- Abrar Institute of Higher Education
- Azad University Science and Research Branch
- Institute for Cognitive Science Studies
- Mashhad University of Medical Science
- Shahid Beheshti University of Medical Sciences
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School
- Princeton University
| | | | - Bradford C Dickerson
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | | | - Neguine Rezaii
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School
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Jebahi F, Nickels KV, Kielar A. Patterns of performance on the animal fluency task in logopenic variant of primary progressive aphasia: A reflection of phonological and semantic skills. JOURNAL OF COMMUNICATION DISORDERS 2024; 108:106405. [PMID: 38324949 DOI: 10.1016/j.jcomdis.2024.106405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE This study aimed to characterize the quantitative (total number of correct words generated) and qualitative (psycholinguistic properties of correct words generated) performance patterns on the animal fluency task in individuals with the logopenic variant of primary progressive aphasia and to investigate the influence of phonological and semantic abilities to these patterns. METHODS Fifteen participants with lvPPA and twenty neurotypical adults completed the animal fluency task and an assessment battery to characterize their phonological and semantic abilities. We recorded the total number of correct words produced and their psycholinguistic properties. Group differences were analyzed using independent samples t-tests and analysis of covariance. Stepwise and multiple linear regression analyses were implemented to investigate the contribution of psycholinguistic properties on word generation as well as the role of phonological and semantic abilities on performance. We also investigated the mediating role of phonological and semantic abilities on the relationship between relevant psycholinguistic properties and word generation output. RESULTS Compared to neurotypical controls, participants with lvPPA produced fewer correct responses and more words with lower age of acquisition. The total number of correct words generated was predicted by the age of word acquisition, such that individuals who generated more responses, produced words acquired later in life. Phonology and semantics influenced the number of correct words generated and their frequency, age of acquisition, and semantic neighborhood density. Familiarity and arousal were driven by semantic abilities. Phonological abilities partially mediated the relationship between age of acquisition and word generation output. CONCLUSIONS This study provides valuable insights into the performance patterns of the animal fluency task in lvPPA. Individuals with lvPPA with more intact phonological and semantic abilities generated greater number of words with more complex psycholinguistic properties. Our findings contribute to the understanding of language processes underlying word retrieval in lvPPA.
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Affiliation(s)
- Fatima Jebahi
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA.
| | - Katlyn V Nickels
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
| | - Aneta Kielar
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA; Cognitive Science Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA
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Walenski M, Sostarics T, Mesulam MM, Thompson CK. The production of adjectives in narratives by individuals with primary progressive aphasia. JOURNAL OF NEUROLINGUISTICS 2024; 69:101179. [PMID: 37994312 PMCID: PMC10662918 DOI: 10.1016/j.jneuroling.2023.101179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Adjectives (e.g., hungry) are an important part of language, but have been little studied in individuals with impaired language. Adjectives are used in two different ways in English: attributively, to modify a noun (the hungry dog); or predicatively, after a verb (the dog is hungry). Attributive adjectives have a more complex grammatical structure than predicative adjectives, and may therefore be particularly prone to disruption in individuals with grammatical impairments. We investigated adjective production in three subtypes of primary progressive aphasia (PPA: agrammatic, semantic, logopenic), as well as in agrammatic stroke aphasia and a group of healthy control participants. Participants produced narratives based on picture books, and we coded every adjective they produced for its syntactic structure. Compared to healthy controls, the two agrammatic groups, but not the other two patient groups, produced significantly fewer attributive adjectives per sentence. All four patient groups were similar to controls for their rate of predicative adjective production. In addition, we found a significant correlation in the agrammatic PPA participants between their rate of producing attributive adjective and impaired production of sentences with complex syntactic structure (subject cleft sentences like It was the boy that chased the girl); no such correlation was found for predicative adjectives. Irrespective of structure, we examined the lexical characteristics of the adjectives that were produced, including length, frequency, semantic diversity and neighborhood density. Overall, the lexical characteristics of the produced adjectives were largely consistent with the language profile of each group. In sum, the results suggest that attributive adjectives present a particular challenge for individuals with agrammatic language production, and add a new dimension to the description of agrammatism. Our results further suggest that attributive adjectives may be a fruitful target for improved treatment and recovery of agrammatic language.
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Affiliation(s)
- Matthew Walenski
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Thomas Sostarics
- Department of Linguistics, Northwestern University, Evanston, IL, USA
| | - M. Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, USA
| | - Cynthia K. Thompson
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL, USA
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Ramanan S, Halai AD, Garcia-Penton L, Perry AG, Patel N, Peterson KA, Ingram RU, Storey I, Cappa SF, Catricala E, Patterson K, Rowe JB, Garrard P, Ralph MAL. The neural substrates of transdiagnostic cognitive-linguistic heterogeneity in primary progressive aphasia. Alzheimers Res Ther 2023; 15:219. [PMID: 38102724 PMCID: PMC10724982 DOI: 10.1186/s13195-023-01350-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Clinical variants of primary progressive aphasia (PPA) are diagnosed based on characteristic patterns of language deficits, supported by corresponding neural changes on brain imaging. However, there is (i) considerable phenotypic variability within and between each diagnostic category with partially overlapping profiles of language performance between variants and (ii) accompanying non-linguistic cognitive impairments that may be independent of aphasia magnitude and disease severity. The neurobiological basis of this cognitive-linguistic heterogeneity remains unclear. Understanding the relationship between these variables would improve PPA clinical/research characterisation and strengthen clinical trial and symptomatic treatment design. We address these knowledge gaps using a data-driven transdiagnostic approach to chart cognitive-linguistic differences and their associations with grey/white matter degeneration across multiple PPA variants. METHODS Forty-seven patients (13 semantic, 15 non-fluent, and 19 logopenic variant PPA) underwent assessment of general cognition, errors on language performance, and structural and diffusion magnetic resonance imaging to index whole-brain grey and white matter changes. Behavioural data were entered into varimax-rotated principal component analyses to derive orthogonal dimensions explaining the majority of cognitive variance. To uncover neural correlates of cognitive heterogeneity, derived components were used as covariates in neuroimaging analyses of grey matter (voxel-based morphometry) and white matter (network-based statistics of structural connectomes). RESULTS Four behavioural components emerged: general cognition, semantic memory, working memory, and motor speech/phonology. Performance patterns on the latter three principal components were in keeping with each variant's characteristic profile, but with a spectrum rather than categorical distribution across the cohort. General cognitive changes were most marked in logopenic variant PPA. Regardless of clinical diagnosis, general cognitive impairment was associated with inferior/posterior parietal grey/white matter involvement, semantic memory deficits with bilateral anterior temporal grey/white matter changes, working memory impairment with temporoparietal and frontostriatal grey/white matter involvement, and motor speech/phonology deficits with inferior/middle frontal grey matter alterations. CONCLUSIONS Cognitive-linguistic heterogeneity in PPA closely relates to individual-level variations on multiple behavioural dimensions and grey/white matter degeneration of regions within and beyond the language network. We further show that employment of transdiagnostic approaches may help to understand clinical symptom boundaries and reveal clinical and neural profiles that are shared across categorically defined variants of PPA.
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Affiliation(s)
- Siddharth Ramanan
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK.
| | - Ajay D Halai
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK
| | - Lorna Garcia-Penton
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK
| | - Alistair G Perry
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Nikil Patel
- Molecular and Clinical Sciences Research Institute, St. George's, University of London, London, UK
| | - Katie A Peterson
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Ruth U Ingram
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Ian Storey
- Molecular and Clinical Sciences Research Institute, St. George's, University of London, London, UK
| | - Stefano F Cappa
- IUSS Cognitive Neuroscience Center (ICoN), University Institute of Advanced Studies IUSS, Pavia, Italy
- Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Eleonora Catricala
- IUSS Cognitive Neuroscience Center (ICoN), University Institute of Advanced Studies IUSS, Pavia, Italy
- Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Karalyn Patterson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK
| | - James B Rowe
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Peter Garrard
- Molecular and Clinical Sciences Research Institute, St. George's, University of London, London, UK
| | - Matthew A Lambon Ralph
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK
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Akhmadullina DR, Konovalov RN, Shpilyukova YA, Fedotova EY, Illarioshkin SN. Anomia: Deciphering Functional Neuroanatomy in Primary Progressive Aphasia Variants. Brain Sci 2023; 13:1703. [PMID: 38137151 PMCID: PMC10741652 DOI: 10.3390/brainsci13121703] [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: 09/26/2023] [Revised: 11/12/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Naming decline is one of the most common symptoms of primary progressive aphasia (PPA). Most studies on anomia in PPA are performed without taking into account PPA variants, especially for action naming. Only limited data are available for the neuroanatomical basis of anomia considering differences in the pathogenesis of PPAs. The aim of our study is to investigate the associations between anomia severity for both noun and verb naming and gray matter (GM) atrophy, as well as accompanying functional connectivity (FC) changes in three PPA variants. A total of 17 patients with non-fluent (nfvPPA), 11 with semantic (svPPA), and 9 with logopenic (lvPPA) PPA variants were included in the study and underwent cognitive/naming assessments and brain MRIs. Voxel-based morphometry was performed to evaluate GM volume. A resting-state functional MRI was applied to investigate FC changes in the identified GM areas. The study shows that different brain regions are involved in naming decline in each PPA variant with a predominantly temporal lobe involvement in svPPA, parietal lobe involvement in lvPPA, and frontal lobe involvement in nfvPPA. Separate data for object and action naming in PPA variants are provided. The obtained results mainly correspond to the current understanding of language processing and indicate that the evaluation of language impairments is preferable for each PPA variant separately. A further analysis of larger cohorts of patients is necessary to confirm these preliminary results.
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Polito C, Conca F, Santi GC, Esposito V, Caminiti SP, Boccalini C, Berti V, Morinelli C, Mazzeo S, Marcone A, Iannaccone S, Bessi V, Sorbi S, Perani D, Cappa SF, Catricalà E. Comparing two picture naming tasks in primary progressive aphasia: Insights from behavioural and neural results. Cortex 2023; 166:1-18. [PMID: 37295234 DOI: 10.1016/j.cortex.2023.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/24/2023] [Accepted: 04/26/2023] [Indexed: 06/12/2023]
Abstract
Picture naming tests are widely used to evaluate language impairments in neurodegenerative diseases, especially in Primary Progressive Aphasia (PPA). The available tests differ for many factors affecting the performance, e.g. format of stimuli and their psycholinguistic properties. We aim to identify the most appropriate naming test to be used on PPA according to the clinical and research demands. We investigated the behavioural characteristics, i.e. proportion of correct responses and error type, and their neural correlates in two Italian naming tests, CaGi naming (CaGi) and naming subtest of the Screening for Aphasia in NeuroDegeneration battery (SAND), administered to 52 PPA patients who underwent an FDG-PET scan. We analysed the effectiveness of the tests in distinguishing PPA versus controls and among PPA variants, considering the psycholinguistic variables affecting performance. We explored the brain metabolic correlates of behavioural performance in the tests. SAND, differently from CaGi, has time limits for the response and its items are less frequent and acquired later. SAND and CaGi differed in terms of number of correct responses and error profile, suggesting a higher difficulty to name SAND items compared to CaGi. Semantic errors predominated in CaGi, while anomic and semantic errors were equally frequent in SAND. Both tests distinguished PPA from controls, but SAND outperformed CaGi in discriminating among PPA variants. FDG-PET imaging revealed a shared metabolic involvement of temporal areas associated with lexico-semantic processing, encompassing anterior fusiform, temporal pole, and extending to posterior fusiform in sv-PPA. Concluding, a picture naming test with response time limit and items which are less frequent and acquired later in life, as SAND, may be effective at highlighting subtle distinctions between PPA variants, improving the diagnosis. Conversely, a naming test without time limit for the response, as CaGi, may be useful for a better characterization of the nature of the naming impairment at the behavioural level, eliciting more naming errors than anomia, possibly helping in the development of rehabilitation protocols.
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Affiliation(s)
| | | | - Gaia C Santi
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, Pavia, Italy
| | | | - Silvia P Caminiti
- Vita-Salute San Raffaele University, 20132, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, San Raffaele Scientific Institute, 20132, Milan, Italy; Nuclear Medicine Unit, San Raffaele Hospital, 20132, Milan, Italy
| | - Cecilia Boccalini
- Vita-Salute San Raffaele University, 20132, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Valentina Berti
- Nuclear Medicine, Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Italy
| | - Carmen Morinelli
- SOD Neurologia 1, Dipartimento Neuromuscolo-Scheletrico e Degli Organi di Senso, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
| | - Salvatore Mazzeo
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy; NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Alessandra Marcone
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | - Valentina Bessi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy; SOD Neurologia 1, Dipartimento Neuromuscolo-Scheletrico e Degli Organi di Senso, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy; SOD Neurologia 1, Dipartimento Neuromuscolo-Scheletrico e Degli Organi di Senso, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy; NEUROFARBA, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, 20132, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, San Raffaele Scientific Institute, 20132, Milan, Italy; Nuclear Medicine Unit, San Raffaele Hospital, 20132, Milan, Italy
| | - Stefano F Cappa
- IRCCS Mondino Foundation, Pavia, Italy; ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, Pavia, Italy.
| | - Eleonora Catricalà
- ICoN Cognitive Neuroscience Center, Institute for Advanced Studies, IUSS, Pavia, Italy
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Mandelli ML, Lorca‐Puls DL, Lukic S, Montembeault M, Gajardo‐Vidal A, Licata A, Scheffler A, Battistella G, Grasso SM, Bogley R, Ratnasiri BM, La Joie R, Mundada NS, Europa E, Rabinovici G, Miller BL, De Leon J, Henry ML, Miller Z, Gorno‐Tempini ML. Network anatomy in logopenic variant of primary progressive aphasia. Hum Brain Mapp 2023; 44:4390-4406. [PMID: 37306089 PMCID: PMC10318204 DOI: 10.1002/hbm.26388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/21/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023] Open
Abstract
The logopenic variant of primary progressive aphasia (lvPPA) is a neurodegenerative syndrome characterized linguistically by gradual loss of repetition and naming skills resulting from left posterior temporal and inferior parietal atrophy. Here, we sought to identify which specific cortical loci are initially targeted by the disease (epicenters) and investigate whether atrophy spreads through predetermined networks. First, we used cross-sectional structural MRI data from individuals with lvPPA to define putative disease epicenters using a surface-based approach paired with an anatomically fine-grained parcellation of the cortical surface (i.e., HCP-MMP1.0 atlas). Second, we combined cross-sectional functional MRI data from healthy controls and longitudinal structural MRI data from individuals with lvPPA to derive the epicenter-seeded resting-state networks most relevant to lvPPA symptomatology and ascertain whether functional connectivity in these networks predicts longitudinal atrophy spread in lvPPA. Our results show that two partially distinct brain networks anchored to the left anterior angular and posterior superior temporal gyri epicenters were preferentially associated with sentence repetition and naming skills in lvPPA. Critically, the strength of connectivity within these two networks in the neurologically-intact brain significantly predicted longitudinal atrophy progression in lvPPA. Taken together, our findings indicate that atrophy progression in lvPPA, starting from inferior parietal and temporoparietal junction regions, predominantly follows at least two partially nonoverlapping pathways, which may influence the heterogeneity in clinical presentation and prognosis.
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Affiliation(s)
- Maria Luisa Mandelli
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Diego L. Lorca‐Puls
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Sección de Neurología, Departamento de Especialidades, Facultad de MedicinaUniversidad de ConcepciónConcepciónChile
| | - Sladjana Lukic
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of Communication Sciences and DisordersAdelphi UniversityGarden CityNew YorkUSA
| | - Maxime Montembeault
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of PsychiatryDouglas Mental Health University Institute, McGill UniversityMontréalCanada
| | - Andrea Gajardo‐Vidal
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Faculty of Health SciencesUniversidad del DesarrolloConcepciónChile
| | - Abigail Licata
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Aaron Scheffler
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Giovanni Battistella
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of OtolaryngologyHead and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical SchoolBostonMassachusettsUSA
| | - Stephanie M. Grasso
- Department of Speech, Language, and Hearing SciencesUniversity of TexasAustinTexasUSA
| | - Rian Bogley
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Buddhika M. Ratnasiri
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Renaud La Joie
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Nidhi S. Mundada
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Eduardo Europa
- Department of Communicative Disorders and SciencesSan Jose State UniversitySan JoseCaliforniaUSA
| | - Gil Rabinovici
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Jessica De Leon
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Maya L. Henry
- Department of Speech, Language, and Hearing SciencesUniversity of TexasAustinTexasUSA
| | - Zachary Miller
- Memory and Aging Center, Department of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
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Mandelli ML, Lorca-Puls DL, Lukic S, Montembeault M, Gajardo-Vidal A, Licata A, Scheffler A, Battistella G, Grasso SM, Bogley R, Ratnasiri BM, La Joie R, Mundada NS, Europa E, Rabinovici G, Miller BL, De Leon J, Henry ML, Miller Z, Gorno-Tempini ML. Network anatomy in logopenic variant of primary progressive aphasia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.15.23289065. [PMID: 37292690 PMCID: PMC10246009 DOI: 10.1101/2023.05.15.23289065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The logopenic variant of primary progressive aphasia (lvPPA) is a neurodegenerative syndrome characterized linguistically by gradual loss of repetition and naming skills, resulting from left posterior temporal and inferior parietal atrophy. Here, we sought to identify which specific cortical loci are initially targeted by the disease (epicenters) and investigate whether atrophy spreads through pre-determined networks. First, we used cross-sectional structural MRI data from individuals with lvPPA to define putative disease epicenters using a surface-based approach paired with an anatomically-fine-grained parcellation of the cortical surface (i.e., HCP-MMP1.0 atlas). Second, we combined cross-sectional functional MRI data from healthy controls and longitudinal structural MRI data from individuals with lvPPA to derive the epicenter-seeded resting-state networks most relevant to lvPPA symptomatology and ascertain whether functional connectivity in these networks predicts longitudinal atrophy spread in lvPPA. Our results show that two partially distinct brain networks anchored to the left anterior angular and posterior superior temporal gyri epicenters were preferentially associated with sentence repetition and naming skills in lvPPA. Critically, the strength of connectivity within these two networks in the neurologically-intact brain significantly predicted longitudinal atrophy progression in lvPPA. Taken together, our findings indicate that atrophy progression in lvPPA, starting from inferior parietal and temporo-parietal junction regions, predominantly follows at least two partially non-overlapping pathways, which may influence the heterogeneity in clinical presentation and prognosis.
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Nelson MJ, Moeller S, Seckin M, Rogalski EJ, Mesulam MM, Hurley RS. The eyes speak when the mouth cannot: Using eye movements to interpret omissions in primary progressive aphasia. Neuropsychologia 2023; 184:108530. [PMID: 36906222 PMCID: PMC10166577 DOI: 10.1016/j.neuropsychologia.2023.108530] [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: 07/19/2021] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023]
Abstract
Though it may seem simple, object naming is a complex multistage process that can be impaired by lesions at various sites of the language network. Individuals with neurodegenerative disorders of language, known as primary progressive aphasias (PPA), have difficulty with naming objects, and instead frequently say "I don't know" or fail to give a vocal response at all, known as an omission. Whereas other types of naming errors (paraphasias) give clues as to which aspects of the language network have been compromised, the mechanisms underlying omissions remain largely unknown. In this study, we used a novel eye tracking approach to probe the cognitive mechanisms of omissions in the logopenic and semantic variants of PPA (PPA-L and PPA-S). For each participant, we identified pictures of common objects (e.g., animals, tools) that they could name aloud correctly, as well as pictures that elicited an omission. In a separate word-to-picture matching task, those pictures appeared as targets embedded among an array with 15 foils. Participants were given a verbal cue and tasked with pointing to the target, while eye movements were monitored. On trials with correctly-named targets, controls and both PPA groups ceased visual search soon after foveating the target. On omission trials, however, the PPA-S group failed to stop searching, and went on to view many foils "post-target". As further indication of impaired word knowledge, gaze of the PPA-S group was subject to excessive "taxonomic capture", such that they spent less time viewing the target and more time viewing related foils on omission trials. In contrast, viewing behavior of the PPA-L group was similar to controls on both correctly-named and omission trials. These results indicate that the mechanisms of omission in PPA differ by variant. In PPA-S, anterior temporal lobe degeneration causes taxonomic blurring, such that words from the same category can no longer be reliably distinguished. In PPA-L, word knowledge remains relatively intact, and omissions instead appear to be caused by downstream factors (e.g., lexical access, phonological encoding). These findings demonstrate that when words fail, eye movements can be particularly informative.
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Affiliation(s)
- M J Nelson
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL USA, 60611; Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, USA; Department of Neurosurgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
| | - S Moeller
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL USA, 60611; Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA
| | - M Seckin
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL USA, 60611; Department of Neurology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, 34684, Turkey
| | - E J Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL USA, 60611; Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - M-M Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL USA, 60611; Department of Neurology, Feinberg School of Medicine, Northwestern University, USA
| | - R S Hurley
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL USA, 60611; Department of Psychology, Cleveland State University, Cleveland, OH, 44115, USA.
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Meyer AM, Snider SF, Tippett DC, Saloma R, Turkeltaub PE, Hillis AE, Friedman RB. Baseline Conceptual-Semantic Impairment Predicts Longitudinal Treatment Effects for Anomia in Primary Progressive Aphasia and Alzheimer's Disease. APHASIOLOGY 2023; 38:205-236. [PMID: 38283767 PMCID: PMC10809875 DOI: 10.1080/02687038.2023.2183075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 02/16/2023] [Indexed: 01/30/2024]
Abstract
Background An individual's diagnostic subtype may fail to predict the efficacy of a given type of treatment for anomia. Classification by conceptual-semantic impairment may be more informative. Aims This study examined the effects of conceptual-semantic impairment and diagnostic subtype on anomia treatment effects in primary progressive aphasia (PPA) and Alzheimer's disease (AD). Methods & Procedures At baseline, the picture and word versions of the Pyramids and Palm Trees and Kissing and Dancing tests were used to measure conceptual-semantic processing. Based on norming that was conducted with unimpaired older adults, participants were classified as being impaired on both the picture and word versions (i.e., modality-general conceptual-semantic impairment), the picture version (Objects or Actions) only (i.e., visual-conceptual impairment), the word version (Nouns or Verbs) only (i.e., lexical-semantic impairment), or neither the picture nor the word version (i.e., no impairment). Following baseline testing, a lexical treatment and a semantic treatment were administered to all participants. The treatment stimuli consisted of nouns and verbs that were consistently named correctly at baseline (Prophylaxis items) and/or nouns and verbs that were consistently named incorrectly at baseline (Remediation items). Naming accuracy was measured at baseline, and it was measured at three, seven, eleven, fourteen, eighteen, and twenty-one months. Outcomes & Results Compared to baseline naming performance, lexical and semantic treatments both improved naming accuracy for treated Remediation nouns and verbs. For Prophylaxis items, lexical treatment was effective for both nouns and verbs, and semantic treatment was effective for verbs, but the pattern of results was different for nouns -- the effect of semantic treatment was initially nonsignificant or marginally significant, but it was significant beginning at 11 Months, suggesting that the effects of prophylactic semantic treatment may become more apparent as the disorder progresses. Furthermore, the interaction between baseline Conceptual-Semantic Impairment and the Treatment Condition (Lexical vs. Semantic) was significant for verb Prophylaxis items at 3 and 18 Months, and it was significant for noun Prophylaxis items at 14 and 18 Months. Conclusions The pattern of results suggested that individuals who have modality-general conceptual-semantic impairment at baseline are more likely to benefit from lexical treatment, while individuals who have unimpaired conceptual-semantic processing at baseline are more likely to benefit from semantic treatment as the disorder progresses. In contrast to conceptual-semantic impairment, diagnostic subtype did not typically predict the treatment effects.
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Affiliation(s)
- Aaron M. Meyer
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Sarah F. Snider
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Ryan Saloma
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Peter E. Turkeltaub
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Rhonda B. Friedman
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
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Breining BL, Faria AV, Tippett DC, Stockbridge MD, Meier EL, Caffo B, Hermann O, Friedman R, Meyer A, Tsapkini K, Hillis AE. Association of Regional Atrophy With Naming Decline in Primary Progressive Aphasia. Neurology 2023; 100:e582-e594. [PMID: 36319108 PMCID: PMC9946192 DOI: 10.1212/wnl.0000000000201491] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/14/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Primary progressive aphasia (PPA) is a neurodegenerative condition that predominantly impairs language. Most investigations of how focal atrophy affects language consider 1 time point compared with healthy controls. However, true atrophy quantification requires comparing individual brains over time. In this observational cohort study, we identified areas where focal atrophy was associated with contemporaneous decline in naming in the same individuals. METHODS Cross-sectional analyses-related Boston Naming Test (BNT) performance and volume in 22 regions of interests (ROIs) at each time point using Least Absolute Shrinkage and Selection Operator (LASSO) regression. Longitudinal analysis evaluated changes in BNT performance and change in volume in the same ROIs. RESULTS Participants (N = 62; 50% female; mean age = 66.8 ± 7.4 years) with PPA completed the BNT and MRI twice (mean = 343.9 ± 209.0 days apart). In cross-sectional left inferior frontal gyrus pars opercularis, superior temporal pole, middle temporal gyrus, and inferior temporal gyrus were identified as critical for naming at all time points. Longitudinal analysis revealed that increasing atrophy in the left supramarginal gyrus and middle temporal pole predicted greater naming decline, as did female sex and longer intervals between time points. DISCUSSION Although cross-sectional analyses identified classic language areas that were consistently related to poor performance at multiple time points, it was not increasing atrophy in these areas that lead to further decline: longitudinal analysis of each person's atrophy over time instead identified nearby but distinct regions where increased atrophy was related to decreasing performance. The results demonstrate that directly examining atrophy (in each individual) over time furthers understanding of decline in PPA and reveal the importance of left supramarginal gyrus and middle temporal pole in maintaining naming when areas normally critical for language degenerate. The novel results provide insight into how the underlying disease progresses to result in the clinical decline in naming, the deficit most common among all 3 PPA variants.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Argye Elizabeth Hillis
- From the Johns Hopkins University School of Medicine (B.L.B., A.V.F., D.C.T., M.D.S., E.L.M., O.H., K.T., A.E.H.), Baltimore, MD; Johns Hopkins University (B.C.), Bloomberg School of Public Health, Baltimore, MD; and Georgetown University (R.F., A.M.), Washington, DC.
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13
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Characterization of the logopenic variant of Primary Progressive Aphasia: A systematic review and meta-analysis. Ageing Res Rev 2022; 82:101760. [PMID: 36244629 DOI: 10.1016/j.arr.2022.101760] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/11/2022] [Indexed: 01/31/2023]
Abstract
The linguistic and anatomical variability of the logopenic variant of Primary Progressive Aphasia (lv-PPA) as defined by current diagnostic criteria has been the topic of an intense debate. The present review and meta-analysis aims at characterizing the profile of lv-PPA, by a comprehensive analysis of the available literature on the neuropsychological, neuroimaging, electrophysiological, pathological, and genetic features of lv-PPA. We conducted a systematic bibliographic search, leading to the inclusion of 207 papers. Of them, 12 were used for the Anatomical Likelihood Estimation meta-analysis on grey matter revealed by magnetic resonance imaging data. The results suggest that the current guidelines outline a relatively consistent syndrome, characterized by a core set of linguistic and, to a lesser extent, non-linguistic deficits, mirroring the involvement of left temporal and parietal regions typically affected by Alzheimer Disease pathology. Variations of the lv-PPA profile are discussed in terms of heterogeneity of the neuropsychological instruments and the diagnostic criteria adopted.
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14
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Premi E, Cotelli M, Gobbi E, Pagnoni I, Binetti G, Gadola Y, Libri I, Mattioli I, Pengo M, Iraji A, Calhoun VD, Alberici A, Borroni B, Manenti R. Neuroanatomical correlates of screening for aphasia in NeuroDegeneration (SAND) battery in non-fluent/agrammatic variant of primary progressive aphasia. Front Aging Neurosci 2022; 14:942095. [PMID: 36389058 PMCID: PMC9660243 DOI: 10.3389/fnagi.2022.942095] [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: 05/12/2022] [Accepted: 10/11/2022] [Indexed: 06/04/2024] Open
Abstract
Background Non-fluent/agrammatic variant of Primary Progressive Aphasia (avPPA) is primarily characterized by language impairment due to atrophy of the inferior frontal gyrus and the insula cortex in the dominant hemisphere. The Screening for Aphasia in NeuroDegeneration (SAND) battery has been recently proposed as a screening tool for PPA, with several tasks designed to be specific for different language features. Applying multivariate approaches to neuroimaging data and verbal fluency tasks, Aachener Aphasie Test (AAT) naming subtest and SAND data may help in elucidating the neuroanatomical correlates of language deficits in avPPA. Objective To investigate the neuroanatomical correlates of language deficits in avPPA using verbal fluency tasks, AAT naming subtest and SAND scores as proxies of brain structural imaging abnormalities. Methods Thirty-one avPPA patients were consecutively enrolled and underwent extensive neuropsychological assessment and MRI scan. Raw scores of verbal fluency tasks, AAT naming subtest, and SAND subtests, namely living and non-living picture naming, auditory sentence comprehension, single-word comprehension, words and non-words repetition and sentence repetition, were used as proxies to explore structural (gray matter volume) neuroanatomical correlates. We assessed univariate (voxel-based morphometry, VBM) as well as multivariate (source-based morphometry, SBM) approaches. Age, gender, educational level, and disease severity were considered nuisance variables. Results SAND picture naming (total, living and non-living scores) and AAT naming scores showed a direct correlation with the left temporal network derived from SBM. At univariate analysis, the left middle temporal gyrus was directly correlated with SAND picture naming (total and non-living scores) and AAT naming score. When words and non-words repetition (total score) was considered, a direct correlation with the left temporal network (SBM) and with the left fusiform gyrus (VBM) was also evident. Conclusion Naming impairments that characterize avPPA are related to specific network-based involvement of the left temporal network, potentially expanding our knowledge on the neuroanatomical basis of this neurodegenerative condition.
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Affiliation(s)
- Enrico Premi
- Stroke Unit, Azienda Socio Sanitaria Territoriale Spedali Civili Brescia, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Yasmine Gadola
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Owensboro, Italy
| | - Ilenia Libri
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Owensboro, Italy
| | - Irene Mattioli
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Owensboro, Italy
| | - Marta Pengo
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Owensboro, Italy
| | - Armin Iraji
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
- Departments of Psychology and Computer Science, Georgia State University, Atlanta, GA, United States
| | - Vince D. Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
- Departments of Psychology and Computer Science, Georgia State University, Atlanta, GA, United States
- Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Antonella Alberici
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Owensboro, Italy
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Owensboro, Italy
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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15
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Sanches C, Amzallag F, Dubois B, Lévy R, Truong DQ, Bikson M, Teichmann M, Valero-Cabré A. Evaluation of the effect of transcranial direct current stimulation on language impairments in the behavioural variant of frontotemporal dementia. Brain Commun 2022; 4:fcac050. [PMID: 35356034 PMCID: PMC8963324 DOI: 10.1093/braincomms/fcac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 12/05/2021] [Accepted: 03/24/2022] [Indexed: 11/30/2022] Open
Abstract
The behavioural variant of frontotemporal dementia is a neurodegenerative disease characterized by bilateral atrophy of the prefrontal cortex, gradual deterioration of behavioural and executive capacities, a breakdown of language initiation and impaired search mechanisms in the lexicon. To date, only a few studies have analysed the modulation of language deficits in the behavioural variant of frontotemporal dementia patients with transcranial direct current stimulation, yet with inconsistent results. Our goal was to assess the impact on language performance of a single session of transcranial direct current stimulation on patients with the behavioural variant of frontotemporal dementia. Using a sham-controlled double-blind crossover design in a cohort of behavioural frontotemporal dementia patients (n = 12), we explored the impact on language performance of a single transcranial direct current stimulation session delivering anodal or cathodal transcranial direct current stimulation, over the left and right dorsolateral prefrontal cortex, compared with sham stimulation. A Letter fluency and a Picture naming task were performed prior and following transcranial direct current stimulation, to assess modulatory effects on language. Behavioural frontotemporal dementia patients were impaired in all evaluation tasks at baseline compared with healthy controls. Computational finite element method (FEM) models of cortical field distribution corroborated expected impacts of left-anodal and right-cathodal transcranial direct current stimulation over the dorsolateral prefrontal cortex and showed lower radial field strength in case of atrophy. However, none of the two tasks showed statistically significant evidence of language improvement caused by active transcranial direct current stimulation compared with sham. Our findings do not argue in favour of pre-therapeutic effects and suggest that stimulation strategies evaluating the modulatory role of transcranial direct current stimulation in the behavioural variant of frontotemporal dementia must carefully weigh the influence of symptom severity and cortical atrophy affecting prefrontal regions to ensure clinical success.
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Affiliation(s)
- Clara Sanches
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
| | - Fanny Amzallag
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
| | - Bruno Dubois
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Richard Lévy
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Dennis Q. Truong
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of City University of New York, New York, NY, USA
| | - Marom Bikson
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of City University of New York, New York, NY, USA
| | - Marc Teichmann
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Antoni Valero-Cabré
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Laboratory for Cerebral Dynamics Plasticity and Rehabilitation, Boston University School of Medicine, Boston, MA, USA
- Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia (UOC), Barcelona, Spain
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16
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Migliaccio R, Cacciamani F. The temporal lobe in typical and atypical Alzheimer disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:449-466. [PMID: 35964987 DOI: 10.1016/b978-0-12-823493-8.00004-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Alzheimer disease (AD) is defined neuropathologically by abnormal extra-cellular β-amyloid plaques combined with intraneuronal tau aggregation. Patients sharing the same neuropathological features but presenting different clinical manifestations and evolutions have led to the notion of AD spectrum. This spectrum encompasses typical and atypical forms of AD. For all of them, specific parts of the temporal lobes, as well as their structural and functional connections with other brain regions, are affected. In typical amnestic late-onset Alzheimer's disease (>65 years old; LOAD), tau pathology gradually spreads to the brain from the medial temporal lobe (MTL). MTL is an inhomogeneous structure consisting of several subregions densely connected to each other and to other cortical and subcortical brain regions. These regions play a crucial role in the storage of information in episodic memory. In less common early-onset AD (<65 years old; EOAD), a large proportion of patients presents atypical clinical manifestations, in which memory impairment is not inaugural and predominant. Instead, these patients have predominant and/or isolated deficits in language, visuospatial, motor, or executive/behavioral functions. In atypical variants, brain damage is mainly centered on the posterior regions, with relative sparing of the MTL. However, the temporal lobe also appears to be variably and specifically damaged in some subtypes of EOAD. For example, the left superior temporal gyrus is the core of brain damage in the language variant, as well as the ventral regions of the temporal lobe play an important role in the clinic of the visual variant.
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Affiliation(s)
- Raffaella Migliaccio
- Paris Brain Institute, INSERM U1127, Hôpital de la Pitié-Salpêtrière, Paris, France; Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Hôpital de la Pitié-Salpêtrière, Paris, France.
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17
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Ubellacker DM, Hillis AE. The neural underpinnings of word comprehension and production: The critical roles of the temporal lobes. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:211-220. [PMID: 35964973 DOI: 10.1016/b978-0-12-823493-8.00013-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This chapter explores the involvement of the temporal lobes in distinct language functions. The examination of cases of localized damage to the temporal lobes and the resulting pattern of impairment across language tasks and types of errors made can reveal clear neural regions and associated networks essential for word comprehension, semantics, naming, reading, and spelling. Key regions implicated in these functions include left superior temporal gyrus posterior to the temporal pole in word comprehension, bilateral anterior temporal lobes in semantics, left posterior inferior temporal gyrus (pITG) in naming, and left pITG and fusiform cortex in reading and spelling. Results we review provide evidence that the temporal lobes have a critical role in many language tasks. Although various areas and associated white matter tracts work together in supporting language, damage to specific regions of the temporal lobes results in distinct and relatively predictable impairments of language functions.
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Affiliation(s)
- Delaney M Ubellacker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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18
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Riello M, Frangakis CE, Ficek B, Webster KT, Desmond JE, Faria AV, Hillis AE, Tsapkini K. Neural Correlates of Letter and Semantic Fluency in Primary Progressive Aphasia. Brain Sci 2021; 12:1. [PMID: 35053745 PMCID: PMC8773895 DOI: 10.3390/brainsci12010001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/21/2022] Open
Abstract
Verbal fluency (VF) is an informative cognitive task. Lesion and functional imaging studies implicate distinct cerebral areas that support letter versus semantic fluency and the understanding of neural and cognitive mechanisms underlying task performance. Most lesion studies include chronic stroke patients. People with primary progressive aphasia (PPA) provide complementary evidence for lesion-deficit associations, as different brain areas are affected in stroke versus PPA. In the present study we sought to determine imaging, clinical and demographic correlates of VF in PPA. Thirty-five patients with PPA underwent an assessment with letter and category VF tasks, evaluation of clinical features and an MRI scan for volumetric analysis. We used stepwise regression models to determine which brain areas are associated with VF performance while acknowledging the independent contribution of clinical and demographic factors. Letter fluency was predominantly associated with language severity (R2 = 38%), and correlated with the volume of the left superior temporal regions (R2 = 12%) and the right dorsolateral prefrontal area (R2 = 5%). Semantic fluency was predominantly associated with dementia severity (R2 = 47%) and correlated with the volume of the left inferior temporal gyrus (R2 = 7%). No other variables were significantly associated with performance in the two VF tasks. We concluded that, independently of disease severity, letter fluency is significantly associated with the volume of frontal and temporal areas whereas semantic fluency is associated mainly with the volume of temporal areas. Furthermore, our findings indicated that clinical severity plays a critical role in explaining VF performance in PPA, compared to the other clinical and demographic factors.
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Affiliation(s)
- Marianna Riello
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
| | - Constantine E. Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21227, USA;
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA;
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
| | - Kimberly T. Webster
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA
| | - John E. Desmond
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
| | - Andreia V. Faria
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA;
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
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19
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Lukic S, Borghesani V, Weis E, Welch A, Bogley R, Neuhaus J, Deleon J, Miller ZA, Kramer JH, Miller BL, Dronkers NF, Gorno-Tempini ML. Dissociating nouns and verbs in temporal and perisylvian networks: Evidence from neurodegenerative diseases. Cortex 2021; 142:47-61. [PMID: 34182153 PMCID: PMC8556704 DOI: 10.1016/j.cortex.2021.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/27/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022]
Abstract
Naming of nouns and verbs can be selectively impaired in neurological disorders, but the specificity of the neural and cognitive correlates of such dissociation remains unclear. Functional imaging and stroke research sought to identify cortical regions selectively recruited for nouns versus verbs, yet findings are inconsistent. The present study investigated this issue in neurodegenerative diseases known to selectively affect different brain networks, thus providing new critical evidence of network specificity. We examined naming performances on nouns and verbs in 146 patients with different neurodegenerative syndromes (Primary Progressive Aphasia - PPA, Alzheimer's disease - AD, and behavioral variant Frontotemporal Dementia - FTD) and 30 healthy adults. We then correlated naming scores with MRI-derived cortical thickness values as well as with performances in semantic and syntactic tasks, across all subjects. Results indicated that patients with the semantic variant PPA named significantly fewer nouns than verbs. Instead, nonfluent/agrammatic PPA patients named fewer verbs than nouns. Across all subjects, performance on nouns (adjusted for verbs) specifically correlated with cortical atrophy in left anterior temporal regions, and performance on verbs (adjusted for nouns) with atrophy in left inferior and middle frontal, inferior parietal and posterior temporal regions. Furthermore, lower lexical-semantic abilities correlated with deficits in naming both nouns and verbs, while lower syntactic abilities only correlated with naming verbs. Our results show that different neural and cognitive mechanisms underlie naming of specific grammatical categories in neurodegenerative diseases. Importantly, our findings showed that verb processing depends on a widespread perisylvian networks, suggesting that some regions might be involved in processing different types of action knowledge. These findings have important implications for early differential diagnosis of neurodegenerative disorders.
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Affiliation(s)
- Sladjana Lukic
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.
| | - Valentina Borghesani
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Elizabeth Weis
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Ariane Welch
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Rian Bogley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - John Neuhaus
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Jessica Deleon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Nina F Dronkers
- University of California, Berkeley, CA, USA; University of California, Davis, CA, USA
| | - Maria L Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
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20
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Cardona JF, Grisales-Cardenas JS, Trujillo-Llano C, Diazgranados JA, Urquina HF, Cardona S, Torres A, Torres LA, Gonzalez LM, Jaramillo T, Cediel J, Oñate-Cadena N, Mateus-Ferro G, Marmolejo-Ramos F. Semantic Memory and Lexical Availability in Parkinson's Disease: A Statistical Learning Study. Front Aging Neurosci 2021; 13:697065. [PMID: 34393760 PMCID: PMC8361833 DOI: 10.3389/fnagi.2021.697065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/07/2021] [Indexed: 11/15/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder that causes a progressive impairment in motor and cognitive functions. Although semantic fluency deficits have been described in PD, more specific semantic memory (SM) and lexical availability (LA) domains have not been previously addressed. Here, we aimed to characterize the cognitive performance of PD patients in a set of SM and LA measures and determine the smallest set of neuropsychological (lexical, semantic, or executive) variables that most accurately classify groups. Thirty early-stage non-demented PD patients (age 35–75, 10 females) and thirty healthy controls (age 36–76, 12 females) were assessed via general cognitive, SM [three subtests of the CaGi battery including living (i.e., elephant) and non-living things (i.e., fork)], and LA (eliciting words from 10 semantic categories related to everyday life) measures. Results showed that PD patients performed lower than controls in two SM global scores (picture naming and naming in response to an oral description). This impairment was particularly pronounced in the non-living things subscale. Also, the number of words in the LA measure was inferior in PD patients than controls, in both larger and smaller semantic fields, showing a more inadequate recall strategy. Notably, the classification algorithms indicated that the SM task had high classification accuracy. In particular, the denomination of non-living things had a classification accuracy of ∼80%. These results suggest that frontostriatal deterioration in PD leads to search strategy deficits in SF and the potential disruption in semantic categorization. These findings are consistent with the embodied view of cognition.
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Affiliation(s)
- Juan F Cardona
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Johan S Grisales-Cardenas
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Catalina Trujillo-Llano
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Jesús A Diazgranados
- Centro Médico de Atención Neurológica "Neurólogos de Occidente", Santiago de Cali, Colombia
| | - Hugo F Urquina
- Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Sebastián Cardona
- Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Alejandra Torres
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Liliana A Torres
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia
| | - Lina M Gonzalez
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Tania Jaramillo
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | - Judith Cediel
- Facultad de Psicología, Universidad del Valle, Santiago de Cali, Colombia.,Centro de Investigación en Neurociencia Clínica y Comportamental (CINCCO), Universidad del Valle, Santiago de Cali, Colombia
| | | | - Geral Mateus-Ferro
- Departamento de Lenguas, Universidad Pedagógica Nacional, Bogotá, Colombia
| | - Fernando Marmolejo-Ramos
- Centre for Change and Complexity in Learning, University of South Australia, Adelaide, SA, Australia
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21
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Pagnoni I, Gobbi E, Premi E, Borroni B, Binetti G, Cotelli M, Manenti R. Language training for oral and written naming impairment in primary progressive aphasia: a review. Transl Neurodegener 2021; 10:24. [PMID: 34266501 PMCID: PMC8282407 DOI: 10.1186/s40035-021-00248-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a gradual, insidious and progressive loss of language abilities, with naming difficulties being an early and persistent impairment common to all three variants. In the absence of effective pharmacological treatments and given the progressive nature of the disorder, in the past few decades, many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life. MAIN BODY We review language treatments most commonly used in clinical practice among patients with different variants of PPA, with a focus on the enhancement of spoken and written naming abilities. Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed. Forty-eight studies were included in this literature review, identifying four main types of language treatment: a) lexical retrieval treatment, b) phonological and/or orthographic treatment, c) semantic treatment, and d) a multimodality approach treatment. Overall, language training is able to induce immediate improvements of naming abilities in all variants of PPA. Moreover, despite the large variability among results, generalization and long-term effects can be recorded after the training. The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system. CONCLUSION The majority of studies have demonstrated improvements of naming abilities following language treatments. Given the progressive nature of PPA, it is essential to apply language treatment in the early stages of the disease.
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Affiliation(s)
- Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Enrico Premi
- Vascular Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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22
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Paek EJ, Murray LL, Newman SD. Effects of concurrent action and object naming treatment on naming skills and functional brain activation patterns in primary progressive aphasia: An fMRI study with a case-series design. BRAIN AND LANGUAGE 2021; 218:104950. [PMID: 33836414 DOI: 10.1016/j.bandl.2021.104950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 11/18/2020] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Abstract
Individuals with primary progressive aphasia (PPA) exhibit differential impairment patterns in noun and verb naming, but it remains unclear whether anomia treatment results in similar improvements in noun and verb naming. Therefore, we examined the immediate and long-term (3-months post-treatment) behavioral and neural effects of an anomia treatment on object and action naming skills in PPA. A case-series design was utilized involving two individuals with PPA. Object and action words were trained concurrently and probed regularly using word lists matched on a number of lexical characteristics. One participant showed improvements in all word categories with different effect sizes whereas the other participant demonstrated improved naming only on trained object words. Treatment-induced fMRI changes were found in both hemispheres, with distinct patterns observed across participants. Further research is needed to better understand the effects of residual language and cognitive skills on behavioral and neurophysiological outcomes following anomia treatment for PPA.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville, TN 37996, United States.
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario N6G 1H1, Canada.
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States; Department of Psychology, University of Alabama, Tuscaloosa, AL 35487, United States.
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23
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Breining BL, Faria AV, Caffo B, Meier EL, Sheppard SM, Sebastian R, Tippett DC, Hillis AE. Neural regions underlying object and action naming: Complementary evidence from acute stroke and primary progressive aphasia. APHASIOLOGY 2021; 36:732-760. [PMID: 35832655 PMCID: PMC9272983 DOI: 10.1080/02687038.2021.1907291] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Naming impairment is commonly noted in individuals with aphasia. However, object naming receives more attention than action naming. Furthermore, most studies include participants with aphasia due to only one aetiology, commonly stroke. We developed a new assessment, the Hopkins Action Naming Assessment (HANA), to evaluate action naming impairments. AIMS Our aims were to show that the HANA is a useful tool that can (1) identify action naming impairments and (2) be used to investigate the neural substrates underlying naming. We paired the HANA with the Boston Naming Test (BNT) to compare action and object naming. We considered participants with aphasia due to primary progressive aphasia (PPA) or acute left hemisphere stroke to provide a more comprehensive picture of brain-behaviour relationships critical for naming. Behaviourally, we hypothesised that there would be a double dissociation between object and action naming performance. Neuroanatomically, we hypothesised that different neural substrates would be implicated in object vs. action naming and that different lesion-deficit associations would be identified in participants with PPA vs. acute stroke. METHODS & PROCEDURES Participants (N=138 with PPA, N=37 with acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N=31 with PPA, N=37 with acute stroke) provided neuroimaging data. The whole brain was automatically segmented into regions of interest (ROIs). For participants with PPA, the image variables were the ROI volumes, normalised by the brain volume. For participants with acute stroke, the image variables were the percentage of each ROI affected by the lesion. The relationship between ROIs likely to be involved in naming performance was modelled with LASSO regression. OUTCOMES & RESULTS Behavioural results showed a double dissociation in performance: in each group, some participants displayed intact performance relative to healthy controls on actions but not objects and/or significantly better performance on actions than objects, while others showed the opposite pattern. These results support the need to assess both objects and actions when evaluating naming deficits. Neuroimaging results identified different regions associated with object vs. action naming, implicating overlapping but distinct networks of regions. Furthermore, results differed for participants with PPA vs. acute stroke, indicating that critical information may be missed when only one aetiology is considered. CONCLUSIONS Overall, the study provides a more comprehensive picture of the neural bases of naming, underscoring the importance of assessing both objects and actions and considering different aetiologies of damage. It demonstrates the utility of the HANA.
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Affiliation(s)
- Bonnie L. Breining
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Andreia V. Faria
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA
| | - Erin L. Meier
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Communication Sciences & Disorders, Chapman University, Irvine, CA 92618, USA
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
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24
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Teichmann M. The current international consensus criteria can lead to under and over-diagnosis of primary progressive aphasia variants. Rev Neurol (Paris) 2021; 177:370-375. [PMID: 33618891 DOI: 10.1016/j.neurol.2020.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/12/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022]
Abstract
In the field of primary progressive aphasia (PPA), the most recent international consensus criteria of 2011 for diagnosis and variant classification have been shown not to capture accurately the whole range of PPA patients. Up to 30-40% of PPA patients appear not to satisfy the criteria of the three 'classical' PPA variants (non-fluent/agrammatic, logopenic, semantic) and are labelled either 'mixed PPA' or 'unclassifiable PPA'. Based on the PPA literature since 2011, this article discusses why patients might be under-diagnosed with respect to the three PPA variants, thus leading to the default concept of 'mixed/unclassifiable PPA' and, conversely, why the non-fluent/agrammatic variant appears to be over-diagnosed. It analyses and attempts to show how to resolve these issues, and it accordingly proposes clinical criteria, which are more inclusive to diminish the proportion of so-called mixed/unclassifiable PPA diagnoses and to reduce the proportion of questionable non-fluent/agrammatic diagnoses, which frequently correspond to progressive speech apraxia, rather than to aphasia.
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Affiliation(s)
- M Teichmann
- Department of Neurology, Institute of Memory and Alzheimer's Disease, National reference centre for 'rare or early onset dementias', Pitié-Salpêtrière hospital, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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25
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Stalpaert J, Cocquyt EM, Criel Y, Segers L, Miatton M, Van Langenhove T, van Mierlo P, De Letter M. Language and Speech Markers of Primary Progressive Aphasia: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2206-2225. [PMID: 32810414 DOI: 10.1044/2020_ajslp-20-00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This systematic review aimed to establish language and speech markers to support the clinical diagnosis of primary progressive aphasia (PPA) and its clinical phenotypes. Our first objective was to identify behavioral language and speech markers of early-stage PPA. Our second objective was to identify the electrophysiological correlates of the language and speech characteristics in PPA. Method The databases MEDLINE, Web of Science, and Embase were searched for relevant articles. To identify behavioral markers, the initial subjective complaints and the language and speech deficits detected during the initial diagnostic evaluation were summarized for PPA in general and each clinical variant according to the 2011 consensus diagnostic criteria (nonfluent variant [NFV], semantic variant, and logopenic variant [LV]). To identify electrophysiological markers, the studies in which event-related potentials (ERPs) were elicited by a language or speech paradigm in patients with PPA were included. Results In total, 114 relevant studies were identified, including 110 behavioral studies and only four electrophysiological studies. This review suggests that patients with the semantic variant could be accurately differentiated from the NFV and LV in the initial stages based on the consensus criteria. Nonetheless, the early differentiation between the NFV and LV is not straightforward. In the four electrophysiological studies, differences in the latency, amplitude, and topographical distribution of the semantic N400 component were found between patients with PPA and healthy controls. Conclusions To accurately differentiate the NFV from the LV, it could be important to assess the language and speech degeneration by more specific assessments and by more objective diagnostic methods that offer insights into the language-related processes. Electrophysiological markers of PPA were not identified in this review due to the low number of studies that investigated language-related ERPs. More controlled ERP studies in larger patient cohorts are needed to investigate the diagnostic applicability of language-related ERPs in PPA. Supplemental Material https://doi.org/10.23641/asha.12798080.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | - Yana Criel
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Lieselot Segers
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | | | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Belgium
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26
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White Matter Hyperintensities Contribute to Language Deficits in Primary Progressive Aphasia. Cogn Behav Neurol 2020; 33:179-191. [PMID: 32889950 DOI: 10.1097/wnn.0000000000000237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the contribution of white matter hyperintensities (WMH) to language deficits while accounting for cortical atrophy in individuals with primary progressive aphasia (PPA). METHOD Forty-three individuals with PPA completed neuropsychological assessments of nonverbal semantics, naming, and sentence repetition plus T2-weighted and fluid-attenuated inversion recovery scans. Using three visual scales, we rated WMH and cerebral ventricle size for both scan types. We used Spearman correlations to evaluate associations between the scales and scans. To test whether visual ratings-particularly of WMH-are associated with language, we compared a base model (including gray matter component scores obtained via principal component analysis, age, and days between assessment and MRI as independent variables) with full models (ie, the base model plus visual ratings) for each language variable. RESULTS Visual ratings were significantly associated within and between scans and were significantly correlated with age but not with other vascular risk factors. Only the T2 scan ratings were associated with language abilities. Specifically, controlling for other variables, poorer naming was significantly related to larger ventricles (P = 0.033) and greater global (P = 0.033) and periventricular (P = 0.049) WMH. High global WMH (P = 0.034) were also correlated with worse sentence repetition skills. CONCLUSION Visual ratings of global brain health were associated with language deficits in PPA independent of cortical atrophy and age. While WMH are not unique to PPA, measuring WMH in conjunction with cortical atrophy may elucidate more accurate brain structure-behavior relationships in PPA than cortical atrophy measures alone.
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27
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Monroy-Sosa A, Chakravarthi SS, Cortes-Contreras AP, Hernandez-Varela M, Andres-Arrieta V, Epping A, Rovin RA. The Evolution of Cerebral Language Localization: Historical Analysis and Current Trends. World Neurosurg 2020; 145:89-97. [PMID: 32916360 DOI: 10.1016/j.wneu.2020.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/05/2020] [Accepted: 09/05/2020] [Indexed: 01/08/2023]
Abstract
Language localization has been an evolving concept over the past 150 years, with the emergence of several important yet conflicting ideologies. The classical theory, starting from the phrenologic work of Gall to the identification of specific regions of language function by Broca, Wernicke, and others, proposed that discrete subcomponents of language were organized into separate anatomic structural regions. The holism theory was postulated in an attempt to disclose that language function was instead attributed to a larger region of the cortex, in which cerebral regions may have the capability of assuming the function of damaged areas. However, this theory was largely abandoned in favor of discrete structural localizationist viewpoints. The subsequent cortical stimulatory work of Penfield led to the development of maps of localization, assigning an eloquent designation to specific regions. The expanding knowledge of cortical and subcortical anatomy allowed for the development of anatomically and functionally integrative language models. In particular, the dual stream model revisited the concept of regional interconnectivity and expanded the concept of eloquence. Advancements in cortical-subcortical stimulation, neurophysiologic monitoring, magnetic resonance diffusion tensor imaging/functional magnetic resonance imaging, awake neurosurgical technique, and knowledge gained by white matter tract anatomy and the Human Connectome Project, shed new light on the dynamic interconnectivity of the cerebrum. New studies are progressively opening doors to this paradigm, showing the dynamic and interdependent nature of language function. In this review, the evolution of language toward the evolving paradigm of dynamic language function and interconnectivity and its impact on shaping the neurosurgical paradigm are outlined.
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Affiliation(s)
- Alejandro Monroy-Sosa
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin; Skull Base, Brain & Cerebrovascular Laboratory, Advocate Aurora Research Health Institute, Milwaukee, Wisconsin.
| | - Srikant S Chakravarthi
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin; Skull Base, Brain & Cerebrovascular Laboratory, Advocate Aurora Research Health Institute, Milwaukee, Wisconsin
| | | | | | - Victor Andres-Arrieta
- Faculty of Medicine, PECEM, Universidad Nacional Autonónoma de México, Mexico City, Mexico
| | - Austin Epping
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin; Skull Base, Brain & Cerebrovascular Laboratory, Advocate Aurora Research Health Institute, Milwaukee, Wisconsin
| | - Richard A Rovin
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
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28
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Cotelli M, Manenti R, Ferrari C, Gobbi E, Macis A, Cappa SF. Effectiveness of language training and non-invasive brain stimulation on oral and written naming performance in Primary Progressive Aphasia: A meta-analysis and systematic review. Neurosci Biobehav Rev 2020; 108:498-525. [DOI: 10.1016/j.neubiorev.2019.12.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 10/11/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022]
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29
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Bruffaerts R, Schaeverbeke J, De Weer AS, Nelissen N, Dries E, Van Bouwel K, Sieben A, Bergmans B, Swinnen C, Pijnenburg Y, Sunaert S, Vandenbulcke M, Vandenberghe R. Multivariate analysis reveals anatomical correlates of naming errors in primary progressive aphasia. Neurobiol Aging 2019; 88:71-82. [PMID: 31955981 DOI: 10.1016/j.neurobiolaging.2019.12.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/10/2019] [Accepted: 12/15/2019] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Rose Bruffaerts
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium; Neurology Department, University Hospitals Leuven, Leuven, Belgium.
| | - Jolien Schaeverbeke
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - An-Sofie De Weer
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Natalie Nelissen
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Eva Dries
- Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Karen Van Bouwel
- Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Anne Sieben
- Neurology Department, University Hospital Ghent, Ghent, Belgium
| | - Bruno Bergmans
- Neurology Department, University Hospital Ghent, Ghent, Belgium; Neurology Department, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | | | - Yolande Pijnenburg
- Neurology Department, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Stefan Sunaert
- Radiology Department, University Hospitals Leuven, Leuven, Belgium
| | | | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium; Neurology Department, University Hospitals Leuven, Leuven, Belgium
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Bonakdarpour B, Hurley RS, Wang AR, Fereira HR, Basu A, Chatrathi A, Guillaume K, Rogalski EJ, Mesulam MM. Perturbations of language network connectivity in primary progressive aphasia. Cortex 2019; 121:468-480. [PMID: 31530376 DOI: 10.1016/j.cortex.2019.08.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/21/2019] [Accepted: 08/08/2019] [Indexed: 12/17/2022]
Abstract
Aphasias are caused by disruption in structural integrity and interconnectivity within a large-scale distributed language network. We investigated the distribution and behavioral consequences of altered functional connectivity in three variants of primary progressive aphasia (PPA). The goal was to clarify relationships among atrophy, resting connectivity, and the resulting behavioral changes in 73 PPA and 33 control participants. Three core regions of the left perisylvian language network: the inferior frontal gyrus (IFG), middle temporal gyrus (MTG), and anterior temporal lobe (ATL) were evaluated in agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S) PPA variants. All PPA groups showed decreased connectivity between IFG and MTG. The PPA-S group also showed additional loss of connectivity strength between ATL and the other language regions. Decreased connectivity between the IFG and MTG nodes in PPA-G remained significant even when controlled for the effect of atrophy. In the PPA group as a whole, IFG-MTG connectivity strength correlated with repetition and grammar scores, whereas MTG-ATL connectivity correlated with picture naming and single-word comprehension. There was no significant change in the connectivity of homologous regions in the right hemisphere. These results show that language impairments in PPA are associated with perturbations of functional connectivity within behaviorally concordant components of the language network. Altered connectivity in PPA may reflect not only the irreversible loss of cortical components indexed by atrophy, but also the dysfunction of remaining neurons.
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Affiliation(s)
- Borna Bonakdarpour
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Department of Neurology, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Robert S Hurley
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Department of Neurology, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Psychology, Cleveland State University, Cleveland, OH, USA
| | - Allan R Wang
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hernando R Fereira
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anisha Basu
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Arjuna Chatrathi
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kyla Guillaume
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M Marsel Mesulam
- Mesulam Center for Cognitive Neurology & Alzheimer Disease, USA; Department of Neurology, USA; Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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31
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Wilmskoetter J, Fridriksson J, Gleichgerrcht E, Stark BC, Delgaizo J, Hickok G, Vaden KI, Hillis AE, Rorden C, Bonilha L. Neuroanatomical structures supporting lexical diversity, sophistication, and phonological word features during discourse. NEUROIMAGE-CLINICAL 2019; 24:101961. [PMID: 31398554 PMCID: PMC6699249 DOI: 10.1016/j.nicl.2019.101961] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/15/2019] [Accepted: 07/26/2019] [Indexed: 11/23/2022]
Abstract
Deficits in lexical retrieval are commonly observed in individuals with post-stroke aphasia. Successful lexical retrieval is related to lexical diversity, lexical sophistication, and phonological word properties; however, the crucial brain regions supporting these different features are not fully understood. We performed MRI-based lesion symptom mapping in 58 individuals with a chronic left hemisphere stroke to assess how regional damage relates to spoken discourse-extracted measures of lexical diversity, lexical sophistication, and phonological word properties. For discourse transcription and word feature analysis, we used the Computerized Language Analysis (CLAN) program, Stanford Core Natural Language Processing, Irvine Phonotactic Online Dictionary, Lexical Complexity Analyzer, and Gramulator. Lesions involving the left posterior insula and supramarginal gyri and inferior fronto-occipital fasciculus were significant predictors of utterances with, on average, lower lexical diversity. Low lexical sophistication was associated with damage to the left pole of the superior temporal gyrus. Production of words with lower phonological complexity (fewer phonemes, higher phonological similarity) was associated with damage to the left supramarginal gyrus. Our findings indicate that discourse-extracted features of lexical retrieval depend on the integrity of specific brain regions involving insular and peri-Sylvian areas. The identified regions provide insight into potentially underlying mechanisms of lexically diverse, sophisticated and phonologically complex words produced during discourse. Word production in connected speech of individuals with post-stroke aphasia depends on lesion locations Low lexical diversity is linked to lesions to the left insula, supramarginal gyrus and inferior fronto-occipital fasciculus Lexical sophistication is linked to lesions to the left pole of the temporal gyrus Phonological word features are linked to lesions to the left supramarginal gyrus Features of lexical retrieval in connected speech depend on the integrity of ventral and dorsal language processing streams
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Affiliation(s)
- Janina Wilmskoetter
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States of America.
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, United States of America
| | - Ezequiel Gleichgerrcht
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States of America
| | - Brielle C Stark
- Department of Speech and Hearing Sciences, Indiana University, Bloomington, IN 47405, United States of America; Program in Neuroscience, Indiana University, Bloomington, IN 47405, United States of America
| | - John Delgaizo
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States of America
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA 92697, United States of America
| | - Kenneth I Vaden
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, United States of America
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, MD 21287, United States of America
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, United States of America
| | - Leonardo Bonilha
- Department of Neurology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States of America
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Valero-Cabré A, Sanches C, Godard J, Fracchia O, Dubois B, Levy R, Truong DQ, Bikson M, Teichmann M. Language boosting by transcranial stimulation in progressive supranuclear palsy. Neurology 2019; 93:e537-e547. [PMID: 31270217 DOI: 10.1212/wnl.0000000000007893] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 03/22/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To explore whether transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) can improve language capacities in patients with progressive supranuclear palsy (PSP). METHODS We used a sham-controlled double-blind crossover design to assess the efficiency of tDCS over the DLPFC in a cohort of 12 patients with PSP. In 3 separate sessions, we evaluated the ability to boost the left DLPFC via left-anodal (excitatory) and right-cathodal (inhibitory) tDCS, while comparing them to sham tDCS. Tasks assessing lexical access (letter fluency task) and semantic access (category judgment task) were applied immediately before and after the tDCS sessions to provide a marker of potential language modulation. RESULTS The comparison with healthy controls showed that patients with PSP were impaired on both tasks at baseline. Contrasting poststimulation vs prestimulation performance across tDCS conditions revealed language improvement in the category judgment task following right-cathodal tDCS, and in the letter fluency task following left-anodal tDCS. A computational finite element model of current distribution corroborated the intended effect of left-anodal and right-cathodal tDCS on the targeted DLPFC. CONCLUSIONS Our results demonstrate tDCS-driven language improvement in PSP. They provide proof-of-concept for the use of tDCS in PSP and set the stage for future multiday stimulation regimens, which might lead to longer-lasting therapeutic effects promoted by neuroplasticity. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that for patients with PSP, tDCS over the DLPFC improves performance in some language tasks.
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Affiliation(s)
- Antoni Valero-Cabré
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY.
| | - Clara Sanches
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY
| | - Juliette Godard
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY
| | - Oriane Fracchia
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY
| | - Bruno Dubois
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY
| | - Richard Levy
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY
| | - Dennis Q Truong
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY
| | - Marom Bikson
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY
| | - Marc Teichmann
- From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY.
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Leyton CE, Landin-Romero R, Liang CT, Burrell JR, Kumfor F, Hodges JR, Piguet O. Correlates of anomia in non-semantic variants of primary progressive aphasia converge over time. Cortex 2019; 120:201-211. [PMID: 31325799 DOI: 10.1016/j.cortex.2019.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/08/2019] [Accepted: 06/18/2019] [Indexed: 12/12/2022]
Abstract
To track neural correlates of naming performance with disease progression, we estimated key areas affected in nonfluent/agrammatic (nfvPPA) and logopenic (lvPPA) primary progressive aphasia variants over time and changes in naming correlates over time. Twenty-nine non-semantic PPA participants (17 nfvPPA and 12 lvPPA) were selected based upon current diagnostic criteria and PiB-PET status and conducted a confrontation-naming task and a structural MRI. Linear mixed-effect models implemented in FreeSurfer were used for tracking cortical thickness and epicenters of atrophy over time. Using averaged cortical thickness of epicenters and naming performance as variables of interest, two sets of multivariate analyses were conducted to compare atrophy progression and naming correlates across groups. While all PPA participants demonstrated naming deterioration and progressive cortical thinning in the left temporal lobe and the left inferior frontal gyrus, the lvPPA cohort showed greater naming deterioration and thinning in the left posterior inferior parietal cortex over time than it did the nfvPPA cohort. The multivariate analyses confirmed a widespread cortical thinning in lvPPA over time, but a more rapid thinning in the right superior frontal gyrus of nfvPPA participants. Impaired naming correlated with common cortical regions in both groups. These regions included the left anterior superior temporal gyrus and the posterior middle temporal gyrus, which was primarily affected in lvPPA. Non-semantic PPA variants initially present with separate epicenters of atrophy and different spatial-temporal patterns of neurodegeneration over time, but the common involvement in key cortical regions of the left temporal lobe accounts for naming deterioration in both groups.
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Affiliation(s)
- Cristian E Leyton
- The University of Sydney, Brain and Mind Centre, Faculty of Health Sciences, Sydney, NSW, Australia; Frontotemporal Disorders Unit, Department of Neurology Massachusetts, General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Ramon Landin-Romero
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - Cheng Tao Liang
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - James R Burrell
- Concord Repatriation General Hospital, Sydney, NSW, Australia.
| | - Fiona Kumfor
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - John R Hodges
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
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Tetzloff KA, Graff-Radford J, Martin PR, Tosakulwong N, Machulda MM, Duffy JR, Clark HM, Senjem ML, Schwarz CG, Spychalla AJ, Drubach DA, Jack CR, Lowe VJ, Josephs KA, Whitwell JL. Regional Distribution, Asymmetry, and Clinical Correlates of Tau Uptake on [18F]AV-1451 PET in Atypical Alzheimer's Disease. J Alzheimers Dis 2019; 62:1713-1724. [PMID: 29614676 DOI: 10.3233/jad-170740] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite common pathology, Alzheimer's disease (AD) can have multiple clinical presentations which pathological studies suggest result from differences in the regional distribution of tau pathology. Positron emission tomography (PET) ligands are now available that can detect tau proteins in vivo and hence can be used to investigate the biological mechanisms underlying atypical AD. OBJECTIVE To assess regional patterns of tau uptake on PET imaging in two atypical AD variants, posterior cortical atrophy (PCA) and logopenic progressive aphasia (lvPPA). METHODS Eighteen PCA and 19 lvPPA subjects that showed amyloid-β deposition on PET underwent tau-PET imaging with [18F]AV-1451. Group comparisons of tau uptake in PCA and lvPPA were performed using voxel-level and regional-level analyses. We also assessed the degree of lobar tau asymmetry and correlated regional tau uptake to age and performance on clinical evaluations. RESULTS Both syndromes showed diffuse tau uptake throughout all cortical regions, although PCA showed greater uptake in occipital regions compared to lvPPA, and lvPPA showed greater uptake in left frontal and temporal regions compared to PCA. While lvPPA showed predominant left-asymmetric tau deposition, PCA was more bilateral. Younger subjects showed greater tau uptake bilaterally in frontal and parietal lobes than older subjects, and sentence repetition, Boston naming test, simultanagnosia, and visuoperceptual function showed specific regional tau correlates. CONCLUSION Tau deposition is closely related to clinical presentation in atypical AD with age playing a role in determining the degree of cortical tau deposition.
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Affiliation(s)
| | | | - Peter R Martin
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Alemán-Gómez Y, Poch C, Toledano R, Jiménez-Huete A, García-Morales I, Gil-Nagel A, Campo P. Morphometric correlates of anomia in patients with small left temporopolar lesions. J Neuropsychol 2019; 14:260-282. [PMID: 31059211 DOI: 10.1111/jnp.12184] [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: 05/31/2018] [Revised: 03/06/2019] [Indexed: 10/26/2022]
Abstract
Visual object naming is a complex cognitive process that engages an interconnected network of cortical regions moving from occipitotemporal to anterior-inferior temporal cortices, and extending into the inferior frontal cortex. Naming can fail for diverse reasons, and different stages of the naming multi-step process appear to be reliant upon the integrity of different neuroanatomical locations. While the neural correlates of semantic errors have been extensively studied, the neural basis of omission errors remains relatively unspecified. Although a strong line of evidence supports an association between anterior temporal lobe damage and semantic errors, there are some studies suggesting that the anterior temporal lobe could be also associated with omissions. However, support for this hypothesis comes from studies with patients in whom damage affected extensive brain regions, sometimes bilaterally. Here, we availed of a group of 12 patients with epilepsy associated with a small lesion at the tip of the left temporal pole. Using an unbiased surface-based morphometry methodology, we correlated two morphological features with errors observed during visual naming. Analyses revealed a correlation between omission errors and reduced local gyrification index in three cortical clusters: one in the left anteromedial temporal lobe region (AMTL) and two in the left anterior cingulate cortex (ACC). Our findings support the view that regions in ACC and AMTL are critical structures within a network engaged in word selection from semantics.
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Affiliation(s)
- Yasser Alemán-Gómez
- Center for Psychiatric Neuroscience, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Switzerland.,Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Switzerland.,Medical Image Analysis Laboratory (MIAL), Centre d'Imagerie BioMédicale (CIBM), Lausanne, Switzerland
| | - Claudia Poch
- Department of Basic Psychology, University Complutense of Madrid, Spain.,Instituto Pluridisciplinar, University Complutense of Madrid, Spain.,Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Rafael Toledano
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain.,Epilepsy Unit, Neurology Department, University Hospital of Ramón y Cajal, Madrid, Spain
| | - Adolfo Jiménez-Huete
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain
| | - Irene García-Morales
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain.,Epilepsy Unit, Neurology Department, University Hospital of San Carlos, Madrid, Spain
| | - Antonio Gil-Nagel
- Epilepsy Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain
| | - Pablo Campo
- Department of Basic Psychology, Autonoma University of Madrid, Spain
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Jeong HJ, Yoon CW, Seo S, Lee SY, Suh MK, Seo HE, Kim WR, Lee H, Heo JH, Lee YB, Park KH, Choi SH, Ido T, Lee KM, Noh Y. Relationships between [¹⁸F]-THK5351 Retention and Language Functions in Primary Progressive Aphasia. J Clin Neurol 2019; 15:527-536. [PMID: 31591842 PMCID: PMC6785468 DOI: 10.3988/jcn.2019.15.4.527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE There are three distinct subtypes of primary progressive aphasia (PPA): the nonfluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA). We sought to characterize the pattern of [¹⁸F]-THK5351 retention across all three subtypes and determine the topography of [¹⁸F]-THK5351 retention correlated with each neurolinguistic score. METHODS We enrolled 50 participants, comprising 13 PPA patients (3 nfvPPA, 5 svPPA, and 5 lvPPA) and 37 subjects with normal cognition (NC) who underwent 3.0-tesla magnetic resonance imaging, [¹⁸F]-THK5351 positron-emission tomography scans, and detailed neuropsychological tests. The PPA patients additionally participated in extensive neurolinguistic tests. Voxel-wise and region-of-interest-based analyses were performed to analyze [¹⁸F]-THK5351 retention. RESULTS The nfvPPA patients exhibited higher [¹⁸F]-THK5351 retention in the the left inferior frontal and precentral gyri. In svPPA patients, [¹⁸F]-THK5351 retention was elevated in the anteroinferior and lateral temporal cortices compared to the NC group (left>right). The lvPPA patients exhibited predominant [¹⁸F]-THK5351 retention in the inferior parietal, lateral temporal, and dorsolateral prefrontal cortices, and the precuneus (left>right). [¹⁸F]-THK5351 retention in the left inferior frontal area was associated with lower fluency scores. Comprehension was correlated with [¹⁸F]-THK5351 retention in the left temporal cortices. Repetition was associated with [¹⁸F]-THK5351 retention in the left inferior parietal and posterior temporal areas, while naming difficulty was correlated with retention in the left fusiform and temporal cortices. CONCLUSIONS The pattern of [¹⁸F]-THK5351 retention was well matched with clinical and radiological findings for each PPA subtype, in agreement with the anatomical and functional location of each language domain.
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Affiliation(s)
- Hye Jin Jeong
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Cindy W Yoon
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Seongho Seo
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, Korea
| | - Sang Yoon Lee
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, Korea
| | - Mee Kyung Suh
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha Eun Seo
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Woo Ram Kim
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Hyon Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jae Hyeok Heo
- Department of Neurology, Seoul Medical Center, Seoul, Korea
| | - Yeong Bae Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Kee Hyung Park
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Tatsuo Ido
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Kyoung Min Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.,Department of Health Science and Technology, GAIHST, Gachon University, Incheon, Korea.
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Snowden JS, Harris JM, Thompson JC, Kobylecki C, Jones M, Richardson AM, Neary D. Semantic dementia and the left and right temporal lobes. Cortex 2018; 107:188-203. [DOI: 10.1016/j.cortex.2017.08.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/19/2017] [Accepted: 08/21/2017] [Indexed: 12/31/2022]
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38
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Montembeault M, Brambati SM, Gorno-Tempini ML, Migliaccio R. Clinical, Anatomical, and Pathological Features in the Three Variants of Primary Progressive Aphasia: A Review. Front Neurol 2018; 9:692. [PMID: 30186225 PMCID: PMC6110931 DOI: 10.3389/fneur.2018.00692] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022] Open
Abstract
Primary progressive aphasias (PPA) are neurodegenerative diseases clinically characterized by an early and relatively isolated language impairment. Three main clinical variants, namely the nonfluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA) have been described, each with specific linguistic/cognitive deficits, corresponding anatomical and most probable pathological features. Since the discovery and the development of diagnostic criteria for the PPA variants by the experts in the field, significant progress has been made in the understanding of these diseases. This review aims to provide an overview of the literature on each of the PPA variant in terms of their clinical, anatomical and pathological features, with a specific focus on recent findings. In terms of clinical advancements, recent studies have allowed a better characterization and differentiation of PPA patients based on both their linguistic and non-linguistic profiles. In terms of neuroimaging, techniques such as diffusion imaging and resting-state fMRI have allowed a deeper understanding of the impact of PPA on structural and functional connectivity alterations beyond the well-defined pattern of regional gray matter atrophy. Finally, in terms of pathology, despite significant advances, clinico-pathological correspondence in PPA remains far from absolute. Nonetheless, the improved characterization of PPA has the potential to have a positive impact on the management of patients. Improved reliability of diagnoses and the development of reliable in vivo biomarkers for underlying neuropathology will also be increasingly important in the future as trials for etiology-specific treatments become available.
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Affiliation(s)
- Maxime Montembeault
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Simona M Brambati
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, University of California at San Francisco, San Francisco, CA, United States
| | - Raffaella Migliaccio
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Paris, France
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39
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Binney RJ, Ashaie SA, Zuckerman BM, Hung J, Reilly J. Frontotemporal stimulation modulates semantically-guided visual search during confrontation naming: A combined tDCS and eye tracking investigation. BRAIN AND LANGUAGE 2018; 180-182:14-23. [PMID: 29655024 PMCID: PMC5990472 DOI: 10.1016/j.bandl.2018.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/28/2018] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
Transcranial direct current stimulation (tDCS) was paired with eye tracking to elucidate contributions of frontal, temporoparietal and anterior temporal cortex to early visual search patterns during picture naming (e.g., rapid visual scanning to diagnostic semantic features). Neurotypical adults named line drawings of objects prior to and following tDCS in three separate sessions, each employing a unique electrode montage. The gaze data revealed montage by stimulation (pre/post) interaction effects characterized by longer initial visual fixations (mean difference = 89 ms; Cohen's d = .8) and cumulative fixation durations (mean difference = 98 ms; Cohen's d = .9) on key semantic features (e.g., the head of an animal) after cathodal frontotemporal stimulation relative to the pre-stimulation baseline. We interpret these findings as reflecting a tDCS-induced modulation of semantic contributions of the anterior temporal lobe(s) to top-down influences on object recognition. Further, we discuss implications for the optimization of tDCS for the treatment of anomia in aphasia.
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Affiliation(s)
- Richard J Binney
- School of Psychology, Bangor University, Gwynedd, Wales, UK; Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA.
| | - Sameer A Ashaie
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bonnie M Zuckerman
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
| | - Jinyi Hung
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
| | - Jamie Reilly
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
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40
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Sanches C, Routier A, Colliot O, Teichmann M. The structure of the mental lexicon: What primary progressive aphasias reveal. Neuropsychologia 2018; 109:107-115. [DOI: 10.1016/j.neuropsychologia.2017.12.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/11/2017] [Accepted: 12/09/2017] [Indexed: 10/18/2022]
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TING SKS, FOO H, CHIA PS, HAMEED S, NG KP, NG A, KANDIAH N. Dyslexic Characteristics of Chinese-Speaking Semantic Variant of Primary Progressive Aphasia. J Neuropsychiatry Clin Neurosci 2018; 30:31-37. [PMID: 29061089 PMCID: PMC5794526 DOI: 10.1176/appi.neuropsych.17040081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Reading disorder is a recognized feature in primary progressive aphasia (PPA). Surface dyslexia, characterized by regularization errors, is typically seen in the English-speaking semantic variant of PPA (svPPA). However, dyslexic characteristics of other languages, particularly logographical languages such as Chinese, remain sparse in the literature. This study aims to characterize and describe the dyslexic pattern in this group of patients by comparing an English-speaking svPPA group with a Chinese-speaking svPPA group. The authors hypothesized that Chinese-speaking individuals with svPPA would likely commit fewer surface dyslexic errors. By accessing the database of Singapore's National Neuroscience Institute and the National Alzheimer's Coordinating Center of the United States, the authors identified three Chinese-speaking and 18 English-speaking patients with svPPA, respectively, for comparison. The results suggest that, instead of surface dyslexia, svPPA in Chinese-speaking individuals is characterized by a profound deep dyslexic error. Based on current evidence suggesting the role of the temporal pole as a semantic convergence center, the authors conclude that this region also mediates and converges lexical-semantic significance in logographical languages.
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Affiliation(s)
- Simon Kang Seng TING
- Department of Neurology, Singapore General Hospital, Singapore, Singapore,Department of Neurology, National Neuroscience Institute, Singapore, Singapore,Duke-NUS Medical School, Singapore, Singapore
| | - Heidi FOO
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Pei Shi CHIA
- Department of Neurology, Singapore General Hospital, Singapore, Singapore,Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Shahul HAMEED
- Department of Neurology, Singapore General Hospital, Singapore, Singapore,Department of Neurology, National Neuroscience Institute, Singapore, Singapore,Duke-NUS Medical School, Singapore, Singapore
| | - Kok Pin NG
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Adeline NG
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Nagaendran KANDIAH
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore,Duke-NUS Medical School, Singapore, Singapore
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42
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Sperber C, Karnath HO. On the validity of lesion-behaviour mapping methods. Neuropsychologia 2017; 115:17-24. [PMID: 28782546 DOI: 10.1016/j.neuropsychologia.2017.07.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/11/2017] [Accepted: 07/30/2017] [Indexed: 01/13/2023]
Abstract
Brain lesion studies have been criticised for producing partly heterogeneous results; especially the validity of statistical voxel-based lesion-behaviour mapping has been discussed. In fact, planning a lesion-behaviour mapping study is associated with many methodological degrees of freedom. In the present review, we argue that not the lesion-behaviour mapping method itself produces heterogeneous results, but rather its heterogeneous or even erroneous application. We outline which methodological pitfalls and trade-offs can affect the results of lesion analyses, addressing behavioural assessment, recruitment of patients, statistical analysis, neuroimaging, and interpretation with brain atlases. Further, we discuss several methods to actually test the validity of lesion-behaviour mapping. Each of these approaches has specific advantages and disadvantages. In combination, they provide valuable tools to answer most empirical questions related to the validity of lesion-behaviour mapping.
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Affiliation(s)
- Christoph Sperber
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Psychology, University of South Carolina, Columbia, USA.
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Meyer AM, Faria AV, Tippett DC, Hillis AE, Friedman RB. The Relationship Between Baseline Volume in Temporal Areas and Post-Treatment Naming Accuracy in Primary Progressive Aphasia. APHASIOLOGY 2017; 31:1059-1077. [PMID: 29628604 PMCID: PMC5889050 DOI: 10.1080/02687038.2017.1296557] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Structural imaging has not been used previously to predict the effect of treatment in primary progressive aphasia (PPA). AIMS This study examined relationships between baseline brain volume and the effects of phonological and orthographic treatments for anomia in PPA. It was predicted that lower baseline volume would be associated with lower post-treatment naming accuracy for treated items and smaller generalization effects. METHODS & PROCEDURES Twenty-one individuals with PPA participated. The treatment stimuli consisted of nouns that were consistently named correctly at baseline (Prophylaxis items) and/or nouns that were consistently named incorrectly at baseline (Remediation items). All 21 participants had Prophylaxis items, while 10 participants had Remediation items. Naming accuracy for untrained and trained items (Exemplar set 1) was measured. In addition, stimulus generalization was examined by having participants name an alternative exemplar of each untrained and trained item (Exemplar set 2). Correlational analyses focused on the relationships between naming accuracy and volume of regions previously identified as having a role in naming and semantic processing. OUTCOMES & RESULTS Unexpectedly, there were no significant correlations between baseline volume and post-treatment accuracy for treated items. However, baseline volume within the left temporal pole was positively correlated with post-treatment accuracy for Untrained Exemplar set 2 Prophylaxis items, while baseline volume in the left inferior temporal gyrus was positively correlated with post-treatment accuracy for Untrained Exemplar set 1 Remediation items. CONCLUSIONS These findings suggest that lower volume in the left temporal pole is associated with decline for Untrained items, while lower volume in the left inferior temporal gyrus is associated with a lack of improvement for Untrained items. Possible explanations for the different patterns observed across Exemplar sets are discussed.
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Affiliation(s)
- Aaron M. Meyer
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC
| | - Andreia V. Faria
- Department of Neurology, Johns Hopkins University, Baltimore, MD
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins University, Baltimore, MD
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, MD
| | - Rhonda B. Friedman
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC
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