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Shah U, Rajeshree S, Sahu A, Kalika M, Ravat S, Reyes A, Stasenko A, Busch RM, Hermann BP, McDonald CR. Cross-cultural application of the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE): Cognitive phenotypes in people with temporal lobe epilepsy in India. Epilepsia 2024; 65:2386-2396. [PMID: 38878272 DOI: 10.1111/epi.18043] [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: 01/17/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Efforts to understand the global variability in cognitive profiles in patients with epilepsy have been stymied by the lack of a standardized diagnostic system. This study examined the cross-cultural applicability of the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) in a cohort of patients with temporal lobe epilepsy (TLE) in India that was diverse in language, education, and cultural background. METHODS A cohort of 548 adults with TLE from Mumbai completed a presurgical comprehensive neuropsychological evaluation. The IC-CoDE taxonomy was applied to derive cognitive phenotypes in the sample. Analyses of variance were conducted to examine differences in demographic and clinical characteristics across the phenotypes, and chi-squared tests were used to determine whether the phenotype distribution differed between the Mumbai sample and published data from a multicenter US sample. RESULTS Using the IC-CoDE criteria, 47% of our cohort showed an intact cognitive profile, 31% a single-domain impairment, 16% a bidomain impairment, and 6% a generalized impairment profile. The distribution of cognitive phenotypes was similar between the Indian and US cohorts for the intact and bidomain phenotypes, but differed for the single and generalized domains. There was a larger proportion of patients with single-domain impairment in the Indian cohort and a larger proportion with generalized impairment in the US cohort. Among patients with single-domain impairment, a greater proportion exhibited memory impairment in the Indian cohort, whereas a greater proportion showed language impairment in the US sample, likely reflecting differences in language administration procedures and sample characteristics including a higher rate of mesial temporal sclerosis in the Indian sample. SIGNIFICANCE Our results demonstrate the applicability of IC-CoDE in a group of culturally and linguistically diverse patients from India. This approach enhances our understanding of cognitive variability across cultures and enables harmonized and inclusive research into the neuropsychological aspects of epilepsy.
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Affiliation(s)
- Urvashi Shah
- Department of Neurology, King Edward Memorial Hospital, Mumbai, India
| | - Shivani Rajeshree
- Department of Neurology, King Edward Memorial Hospital, Mumbai, India
- Department of Physical Medicine and Rehabilitation, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - Aparna Sahu
- Department of Neurology, King Edward Memorial Hospital, Mumbai, India
| | - Mayuri Kalika
- Department of Neurology, King Edward Memorial Hospital, Mumbai, India
| | - Sangeeta Ravat
- Department of Neurology, King Edward Memorial Hospital, Mumbai, India
| | - Anny Reyes
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California, USA
| | - Alena Stasenko
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Robyn M Busch
- Department of Neurology, Neurological Institute, Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
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Abdullah L, Blanco Elorietta E, Valdez DL. "¿Cómo qué, cómo qué? cómo qué?" Single-language echolalia in a bilingual female with progressive supranuclear palsy: a case report. Neurocase 2024:1-8. [PMID: 39037396 DOI: 10.1080/13554794.2024.2377206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024]
Abstract
The case study explores bilingualism and neurodegenerative disorders, specifically progressive supranuclear palsy (PSP) with speech and language disorder (PSP-SL). It features a 78-year-old Mexican American woman who exhibits echolalia only in response to Spanish. This selective impairment suggests unevenly affected language control mechanisms despite her proficiency in both languages. Cognitive function is evaluated with neuropsychological tests; she's diagnosed with PSP-SL, depression, and anxiety. Echolalia in response to one language implies complex phonological retrieval mechanisms. Such observations prompt further inquiry into bilingual language control and processing mechanisms. The case supports evidence that bilingualism may attenuate neurodegeneration effects, suggesting better inhibitory control over disinhibited speech through enhanced executive functioning benefits.
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Affiliation(s)
- Lubnaa Abdullah
- Department of Psychiatry, University of Texas Rio Grande Valley, Edinburg, TX, USA
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Lee S, Faroqi-Shah Y. A Meta-Analysis of Anomia Treatment in Bilingual Aphasia: Within- and Cross-Language Generalization and Predictors of the Treatment Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1558-1600. [PMID: 38629966 PMCID: PMC11087086 DOI: 10.1044/2024_jslhr-23-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/15/2023] [Accepted: 01/14/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE The present meta-analysis investigated the efficacy of anomia treatment in bilingual and multilingual persons with aphasia (BPWAs) by assessing the magnitudes of six anomia treatment outcomes. Three of the treatment outcomes pertained to the "trained language": improvement of trained words (treatment effect [TE]), within-language generalization of semantically related untrained words (WLG-Related), and within-language generalization of unrelated words (WLG-Unrelated). Three treatment outcomes were for the "untrained language": improvement of translations of the trained words (cross-language generalization of trained words [CLG-Tx]), cross-language generalization of semantically related untrained words (CLG-Related), and cross-language generalization of unrelated untrained words (CLG-Unrelated). This study also examined participant- and treatment-related predictors of these treatment outcomes. METHOD This study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42023418147. Nine electronic databases were searched to identify word retrieval treatment studies of poststroke BPWAs of at least 6 months postonset. Pre- and posttreatment single-word naming scores were extracted for each eligible participant and used to calculate effect sizes (within-case Cohen's d) of the six treatment outcomes. Random-effects meta-analyses were conducted to assess weighted mean effect sizes of the treatment outcomes across studies. Multiple linear regression analyses were used to examine the effects of participant-related variables (pretreatment single-word naming and comprehension representing poststroke lexical processing abilities) and treatment-related variables (type, language, and duration). The methodological quality of eligible studies and the risk of bias in this meta-analysis were assessed. RESULTS A total of 17 published studies with 39 BPWAs were included in the meta-analysis. The methodological quality of the included studies ranged from fair (n = 4) to good (n = 13). Anomia treatment produced a medium effect size for TE (M = 8.36) and marginally small effect sizes for WLG-Related (M = 1.63), WLG-Unrelated (M = 0.68), and CLG-Tx (M = 1.56). Effect sizes were nonsignificant for CLG-Related and CLG-Unrelated. TE was significantly larger than the other five types of treatment outcomes. TE and WLG-Related effect sizes were larger for BPWAs with milder comprehension or naming impairments and for treatments of longer duration. WLG-Unrelated was larger when BPWAs received phonological treatment than semantic and mixed treatments. The overall risk of bias in the meta-analysis was low with a potential risk of bias present in the study identification process. CONCLUSIONS Current anomia treatment practices for bilingual speakers are efficacious in improving trained items but produce marginally small within-language generalization and cross-language generalization to translations of the trained items. These results highlight the need to provide treatment in each language of BPWAs and/or investigate other approaches to promote cross-language generalization. Furthermore, anomia treatment outcomes are influenced by BPWAs' poststroke single-word naming and comprehension abilities as well as treatment duration and the provision of phonological treatment. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25595712.
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Affiliation(s)
- Seongsil Lee
- Department of Hearing and Speech Sciences, University of Maryland, College Park
| | - Yasmeen Faroqi-Shah
- Department of Hearing and Speech Sciences, University of Maryland, College Park
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Goral M, Antolovic K, Hejazi Z, Schulz FM. Using a translanguaging framework to examine language production in a trilingual person with aphasia. CLINICAL LINGUISTICS & PHONETICS 2024:1-20. [PMID: 38506332 DOI: 10.1080/02699206.2024.2328240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/02/2024] [Indexed: 03/21/2024]
Abstract
When language abilities in aphasia are assessed in clinical and research settings, the standard practice is to examine each language of a multilingual person separately. But many multilingual individuals, with and without aphasia, mix their languages regularly when they communicate with other speakers who share their languages. We applied a novel approach to scoring language production of a multilingual person with aphasia. Our aim was to discover whether the assessment outcome would differ meaningfully when we count accurate responses in only the target language of the assessment session versus when we apply a translanguaging framework, that is, count all accurate responses, regardless of the language in which they were produced. The participant is a Farsi-German-English speaking woman with chronic moderate aphasia. We examined the participant's performance on two picture-naming tasks, an answering wh-question task, and an elicited narrative task. The results demonstrated that scores in English, the participant's third-learned and least-impaired language did not differ between the two scoring methods. Performance in German, the participant's moderately impaired second language benefited from translanguaging-based scoring across the board. In Farsi, her weakest language post-CVA, the participant's scores were higher under the translanguaging-based scoring approach in some but not all of the tasks. Our findings suggest that whether a translanguaging-based scoring makes a difference in the results obtained depends on relative language abilities and on pragmatic constraints, with additional influence of the linguistic distances between the languages in question.
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Affiliation(s)
- Mira Goral
- Speech-Language-Hearing Sciences, Lehman College, The City University of New York, New York, New York, USA
- Speech-Language-Hearing Sciences, The Graduate Center, The City University of New York, New York, New York, USA
| | - Katarina Antolovic
- Speech-Language-Hearing Sciences, The Graduate Center, The City University of New York, New York, New York, USA
| | - Zahra Hejazi
- Speech-Language-Hearing Sciences, The Graduate Center, The City University of New York, New York, New York, USA
| | - Franziska M Schulz
- Psychology of Language Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
- International Max Planck Research School for Language Science, MPI for Psycholinguistics, Nijmegen, Netherlands
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Scimeca M, Peñaloza C, Kiran S. Multilevel factors predict treatment response following semantic feature-based intervention in bilingual aphasia. BILINGUALISM (CAMBRIDGE, ENGLAND) 2024; 27:246-262. [PMID: 38586504 PMCID: PMC10993298 DOI: 10.1017/s1366728923000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Semantic feature-based treatments (SFTs) are effective rehabilitation strategies for word retrieval deficits in bilinguals with aphasia (BWA). However, few studies have prospectively evaluated the effects of key parameters of these interventions on treatment outcomes. This study examined the influence of intervention-level (i.e., treatment language and treatment sessions), individual-level (baseline naming severity and age), and stimulus-level (i.e., lexical frequency, phonological length, and phonological neighborhood density) factors on naming improvement in a treated and untreated language for 34 Spanish-English BWA who completed 40 hours of SFT. Results revealed significant improvement over time in both languages. In the treated language, individuals who received therapy in their L1 improved more. Additionally, higher pre-treatment naming scores predicted greater response to treatment. Finally, a frequency effect on baseline naming accuracy and phonological effects on accuracy over time were associated with differential treatment gains. These findings indicate that multilevel factors are influential predictors of bilingual treatment outcomes.
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Affiliation(s)
- Michael Scimeca
- Department of Speech, Language, and Hearing Sciences, Boston University, MA, USA
| | - Claudia Peñaloza
- Department of Cognition, Development and Educational Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Swathi Kiran
- Department of Speech, Language, and Hearing Sciences, Boston University, MA, USA
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Marte MJ, Peñaloza C, Kiran S. The cognate facilitation effect on lexical access in bilingual aphasia: Evidence from the Boston Naming Test. BILINGUALISM (CAMBRIDGE, ENGLAND) 2023; 26:1009-1025. [PMID: 38239589 PMCID: PMC10794022 DOI: 10.1017/s1366728923000251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Most cognate research suggests facilitation effects in picture naming, but how these effects manifest in bilinguals after brain damage remains unclear. Additionally, whether this effect is captured in clinical measures is largely unknown. Using data from the Boston Naming Test, we examined the naming of cognates and noncognates, the extent of cognate facilitation produced, and the individual differences in bilingual language experience associated with naming outcomes in forty Spanish-English bilingual persons with aphasia (BPWA) relative to thirty-one Spanish-English healthy bilinguals (HB). Results suggest that naming performance in L1 and L2 in both groups is modulated by lexical frequency, bilingual language experience, and by language impairment in BPWA. Although the two groups showed similarities, they deviated in benefit drawn from the extent of phoneme/grapheme overlap in cognate items. HB showed an association between cognate facilitation and bilingual language experience, while cognate facilitation in BPWA was only associated with L2 language impairment.
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Affiliation(s)
- Manuel Jose Marte
- Department of Speech, Language, & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA
| | - Claudia Peñaloza
- Department of Cognition, Development and Educational Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Swathi Kiran
- Department of Speech, Language, & Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA
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Goral M, Norvik MI, Antfolk J, Agrotou I, Lehtonen M. Cross-language generalization of language treatment in multilingual people with post-stroke aphasia: A meta-analysis. BRAIN AND LANGUAGE 2023; 246:105326. [PMID: 37994828 DOI: 10.1016/j.bandl.2023.105326] [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: 10/08/2022] [Revised: 09/09/2023] [Accepted: 09/26/2023] [Indexed: 11/24/2023]
Abstract
Studies on the efficacy of language treatment for multilingual people with post-stroke aphasia and its generalization to untreated languages have produced mixed results. We conducted a systematic review and a meta-analysis to examine within- and cross-language treatment effects and the variables that affect them. We searched PubMed, PsycINFO, CINAHL, and Google Scholar (February 2020; January 2023), identifying 40 studies reporting on 1573 effect sizes from 85 individuals. We synthesized effect sizes for treatment outcomes using a multi-level model to correct for multiple observations from the same individuals. The results showed significant treatment effects, with robust within-language treatment effects and weaker cross-language treatment effects. Age of language acquisition of the treatment language predicted within-language and cross-language effects. Our results suggest that treating multilingual people with aphasia in one language may generalize to their other languages, especially following treatment in an early-acquired language and a later-learned language that became the language of immersion.
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Affiliation(s)
- Mira Goral
- Lehman College, The City University of New York, Bronx, NY, USA; The Graduate Center, The City University of New York, New York, NY, USA; MultiLing Center for Multilingualism in Society Across the Lifespan, Department of Linguistics and Scandinavian Studies, University of Oslo, Oslo, Norway.
| | - Monica I Norvik
- MultiLing Center for Multilingualism in Society Across the Lifespan, Department of Linguistics and Scandinavian Studies, University of Oslo, Oslo, Norway; Department of Acquired Brain Injury, Statped, Oslo, Norway
| | - Jan Antfolk
- Department of Psychology, Abo Akademi University, Turku, Finland
| | - Ioulia Agrotou
- The Graduate Center, The City University of New York, New York, NY, USA
| | - Minna Lehtonen
- MultiLing Center for Multilingualism in Society Across the Lifespan, Department of Linguistics and Scandinavian Studies, University of Oslo, Oslo, Norway; Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland; Turku Brain and Mind Center, University of Turku, Turku, Finland
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Coemans S, Struys E, Tsapkini K, Paquier P, Vandenborre D, Keulen S. Case report: the effects of cerebellar tDCS in bilingual post-stroke aphasia. Front Hum Neurosci 2023; 17:1173178. [PMID: 37545596 PMCID: PMC10398340 DOI: 10.3389/fnhum.2023.1173178] [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: 02/24/2023] [Accepted: 06/15/2023] [Indexed: 08/08/2023] Open
Abstract
Transcranial Direct Current Stimulation may be a useful neuromodulation tool for enhancing the effects of speech and language therapy in people with aphasia, but research so far has focused on monolinguals. We present the effects of 9 sessions of anodal cerebellar tDCS (ctDCS) coupled with language therapy in a bilingual patient with chronic post-stroke aphasia caused by left frontal ischemia, in a double-blind, sham-controlled within-subject design. Language therapy was provided in his second language (L2). Both sham and anodal treatment improved trained picture naming in the treated language (L2), while anodal ctDCS in addition improved picture naming of untrained items in L2 and his first language, L1. Picture description improved in L2 and L1 after anodal ctDCS, but not after sham.
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Affiliation(s)
- Silke Coemans
- Brussels Centre for Language Studies (BCLS), Vrije Universiteit Brussels, Brussels, Belgium
| | - Esli Struys
- Brussels Centre for Language Studies (BCLS), Vrije Universiteit Brussels, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussels, Brussels, Belgium
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
| | - Philippe Paquier
- Brussels Centre for Language Studies (BCLS), Vrije Universiteit Brussels, Brussels, Belgium
- Center for Research in Cognition and Neurosciences (CRCN), Université Libre de Bruxelles, Brussels, Belgium
- Department of Translational Neurosciences (TNW), Universiteit Antwerpen (UA), Antwerp, Belgium
| | - Dorien Vandenborre
- Health and Wellbeing Research Unit, Thomas More University of Applied Sciences, Antwerp, Belgium
| | - Stefanie Keulen
- Brussels Centre for Language Studies (BCLS), Vrije Universiteit Brussels, Brussels, Belgium
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Li R, Kiran S. Noun and Verb Impairment in Single-Word Naming and Discourse Production in Mandarin-English Bilingual Adults with Aphasia. APHASIOLOGY 2023; 38:337-365. [PMID: 38344709 PMCID: PMC10857756 DOI: 10.1080/02687038.2023.2189994] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/07/2023] [Indexed: 04/21/2024]
Abstract
BACKGROUND Previous studies on bilingualism and aphasia have identified a similar pattern of verb-noun dissociation in single-word naming (i.e., lower accuracy for verbs than nouns) in both languages. However, whether a similar pattern of verb and noun dissociation emerges in discourse production remains unknown, particularly in typologically dissimilar languages. AIMS This study investigated patterns of verb and noun impairment in both single-word naming and discourse production, and whether naming was associated with lexical retrieval in discourse production in Mandarin-English bilingual adults with aphasia (BWA). METHODS Twelve Mandarin-English bilinguals with chronic aphasia completed standardized assessments on object and action naming, and three discourse tasks from the AphasiaBank (i.e., sequential pictures, single-picture, storytelling) in both L1 (Mandarin) and L2 (English). Item-level accuracy of object and action naming was fit into a generalized mixed-effects model to estimate single-word naming ability as a function of grammatical category. Proportion of verb and noun production was fit into a multivariate linear regression model to assess lexical retrieval in discourse. Finally, another linear regression was performed to examine the association between naming and lexical retrieval in discourse production. RESULTS The naming accuracy for verbs was lower than for nouns in both L1 and L2. Mandarin-English BWA also demonstrated less production of verbs than nouns in discourse. However, depending on the type of the task, the effect of word category was greater in L2 than in L1. This cross-linguistic difference of the verb-noun dissociation was diminished in individuals with lower aphasia severity. Our results further showed a direct relationship between naming and lexical retrieval in discourse, irrespective of the language. CONCLUSIONS Our findings suggest an overall similar pattern of verb and noun dissociation across different linguistic contexts. However, depending on the cognitive-linguistic demands of the task, the verb-noun dissociation may emerge in L1 and L2 to varying degrees in individuals with different levels of aphasia severity. This study facilitates better understanding of verb and noun retrieval in Mandarin-English BWA.
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Affiliation(s)
- Ran Li
- Division of Speech and Hearing Sciences, Faculty of Education, The University of Hong Kong, Hong Kong
| | - Swathi Kiran
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, USA
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González DA, Soble JR, Bailey KC, Bain KM, Marceaux JC. Subcortical lesions impact confrontation naming in bilinguals with later age of acquisition: An exploratory study. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:269-277. [PMID: 34100678 DOI: 10.1080/23279095.2021.1934682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The bilingual experience is believed to impact brain development and, possibly, cognitive performance. Subcortical structures, including the striatum and white matter, are believed related to confrontation naming performance among bilingual individuals with later age of acquisition (AoA) and lower proficiency of a second language (L2). However, these findings are primarily derived from healthy adult samples, although there is clinical significance for the interpretation of naming performance. The present study examined whether striatal and white matter lesions were associated with naming tasks in clinic-referred bilingual veterans (n = 29) and whether L2 AoA moderated this relationship. Clinically rated lesions, without regard for AoA, were not consistently correlated with naming performance. Moderation models (lesion × AoA) were significant across naming tasks (i.e., naming scores were negatively correlated with striatal lesions with increasing AoA). Effect sizes were higher among striatal models as compared to white matter models. Results extend prior neuroimaging findings with healthy bilinguals that AoA moderates the relationship between subcortical lesions and naming performance in bilingual patients, and suggests that clinicians should consider specifics of bilingual experience when interpreting test scores.
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Affiliation(s)
- David Andrés González
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jason R Soble
- Department of Neurology & Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K Chase Bailey
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kathleen M Bain
- Psychology Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Janice C Marceaux
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Psychology Service, South Texas Veterans Health Care System, San Antonio, TX, USA
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Carthery-Goulart MT, Privitera AJ, Weekes BS. Does Language Distance Modulate the Contribution of Bilingualism to Cognitive Reserve in Seniors? A Systematic Review. Am J Alzheimers Dis Other Demen 2023; 38:15333175231167223. [PMID: 37186676 PMCID: PMC10623985 DOI: 10.1177/15333175231167223] [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] [Indexed: 05/17/2023]
Abstract
We report a systematic review and exploratory meta-regression investigating the hypothesis that the effects of bilingualism on cognitive reserve are modulated by the distance between the pair of languages a bilingual uses. An inclusive multiple database search was performed in order to identify all relevant published research conducted in bilingual seniors. A combination of qualitative and quantitative synthesis methods were used in order to investigate our research questions. Results suggest that healthy bilingual seniors speaking more distant language pairs show improved monitoring performance on cognitive tasks. Evidence regarding a modulatory influence of language distance (LD) on the age of dementia diagnosis was inconclusive due to the small number of published studies meeting our inclusion criteria. We recommend more detailed reporting of individual differences in bilingual experience to assess the impact of LD and other variables on typical cognitive aging and the development of dementia. Linguistic differences in samples should also be considered as a constraint on bilingual advantages in future studies. Preregistration: PROSPERO CRD42021238705; OSF DOI 10.17605/OSF.IO/VPRBU.
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Affiliation(s)
- Maria Teresa Carthery-Goulart
- Faculty of Education, University of Hong Kong, Hong Kong
- Center for Mathematics, Computing and Cognition, Federal University of ABC, Sao Paulo, Brazil
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital Das Clínicas, University of São Paulo, SP, Brazil
| | - Adam John Privitera
- Faculty of Education, University of Hong Kong, Hong Kong
- Centre for Research and Development in Learning, Nanyang Technological University, Singapore
| | - Brendan Stuart Weekes
- Faculty of Education, University of Hong Kong, Hong Kong
- Department of Psychology, University of Cambridge, Cambridge, UK
- School of Psychology, University of Melbourne, Melbourne, VIA, Australia
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Does bilingualism come with linguistic costs? A meta-analytic review of the bilingual lexical deficit. Psychon Bull Rev 2022:10.3758/s13423-022-02136-7. [DOI: 10.3758/s13423-022-02136-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 11/06/2022]
Abstract
AbstractA series of recent studies have shown that the once-assumed cognitive advantage of bilingualism finds little support in the evidence available to date. Surprisingly, however, the view that bilingualism incurs linguistic costs (the so-called lexical deficit) has not yet been subjected to the same degree of scrutiny, despite its centrality for our understanding of the human capacity for language. The current study implemented a comprehensive meta-analysis to address this gap. By analyzing 478 effect sizes from 130 studies on expressive vocabulary, we found that observed lexical deficits could not be attributed to bilingualism: Simultaneous bilinguals (who acquired both languages from birth) did not exhibit any lexical deficit, nor did sequential bilinguals (who acquired one language from birth and a second language after that) when tested in their mother tongue. Instead, systematic evidence for a lexical deficit was found among sequential bilinguals when tested in their second language, and more so for late than for early second language learners. This result suggests that a lexical deficit may be a phenomenon of second language acquisition rather than bilingualism per se.
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Elman RJ. Still Searching for Understanding: The Importance of Diverse Research Designs, Methods, and Perspectives. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2444-2453. [PMID: 36001820 DOI: 10.1044/2022_ajslp-21-00348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence-based medicine and evidence hierarchies have been widely adopted and have strongly influenced decision making across many fields, including clinical aphasiology. However, questions remain about the creation, usefulness, and validity of current evidence hierarchies. AIMS This article builds on ideas about scientific approaches and evidence originally shared by Elman (1995, 1998, 2006). This article reviews the history of evidence hierarchies and argues that improving the diversity of research designs, methods, and perspectives will improve understanding of the numerous and complex variables associated with aphasia intervention. Researchers and clinicians are encouraged to synthesize diverse types of scientific evidence. It is hoped that this article will stimulate thought and foster discussion in order to encourage high-caliber research of all types. MAIN CONTRIBUTION Concepts from a wide variety of fields including philosophy of science, research design and methodology, and precision medicine are brought together in an attempt to focus research on the scientific understanding of aphasia treatment effects. CONCLUSION It is hoped that by incorporating diverse research designs, methods, and perspectives, clinical aphasiologists will become better able to provide effective, personalized treatments, ensuring that each person with aphasia is able to improve their communication ability and quality of life.
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Sawaki M, Yamamoto H, Motomura K, Yamamoto M, Furukawa K, Saito O. [A case of bilingual aphasia with language mixing between Japanese and English caused by superior longitudinal fasciculus lesion-a study using functional MRI and diffusion tensor imaging]. Rinsho Shinkeigaku 2022; 62:707-715. [PMID: 36031374 DOI: 10.5692/clinicalneurol.cn-001706] [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] [Indexed: 06/15/2023]
Abstract
We report a case of left-handed bilingual aphasia with phonemic paraphasia and language mixing from Japanese as a first language to English as a second language. The lesion caused by cerebral infarction was mainly localized in the left parietal lobe white matter. The patient was a 46-year-old, left-handed woman who was bilingual in Japanese and English. Both auditory and visual comprehensions were well maintained after the acute phase of the disease; however, language mixing between Japanese and English was observed during Japanese speech. A pathophysiological interpretation of this case required a focus on the brain network. Our findings suggest that lesions of the superior longitudinal fasciculus and arcuate fasciculus of the white matter fibers just below the left inferior parietal lobule are associated with bilingual aphasia.
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Affiliation(s)
- Masaharu Sawaki
- Division of Rehabilitation, Kushiro Kojinkai Memorial Hospital
| | | | - Kazuya Motomura
- Department of Neurosurgery, Nagoya University School of Medicine
| | | | - Kenji Furukawa
- Division of Radiology, Kushiro Kojinkai Memorial Hospital
| | - Osamu Saito
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital
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15
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Masson-Trottier M, Dash T, Berroir P, Ansaldo AI. French Phonological Component Analysis and aphasia recovery: A bilingual perspective on behavioral and structural data. Front Hum Neurosci 2022; 16:752121. [PMID: 36211123 PMCID: PMC9535680 DOI: 10.3389/fnhum.2022.752121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
Studies show bilingualism entails an advantage in cognitive control tasks. There is evidence of a bilingual advantage in the context of aphasia, resulting in better cognitive outcomes and recovery in bilingual persons with aphasia compared to monolingual peers. This bilingual advantage also results in structural changes in the right hemisphere gray matter. Very few studies have examined the so-called bilingual advantage by reference to specific anomia therapy efficacy. This study aims to compare the effect of French-Phonological Component Analysis (Fr-PCA) in monolinguals and bilingual persons with aphasia, both at the linguistic and cognitive control level, and to examine the structural impact of left hemisphere lesion location and right hemisphere structural data. Eight participants with chronic aphasia received Fr-PCA for a total of 15 h over 5 weeks. The results showed improved accuracy for treated words and generalization to untreated items and discourse in both groups, and improved Flanker task performance for some participants. Bilingual participants improved more than monolinguals for picture-naming tasks and narrative discourse. Damage to the left postcentral gyrus and the middle frontal gyrus was associated with less therapy-induced improvement. Additionally, left hemisphere damage to the inferior parietal gyrus and postcentral gyrus was associated with reduced cognitive control pre-therapy. Undamaged right hemisphere cortical thicknesses were significantly different between groups; the inferior frontal gyrus and the middle frontal gyrus were greater for the bilingual participants and correlated with cognitive control skills. These results suggest a bilingual advantage in anomia recovery following Fr-PCA, potentially resulting from enhanced cognitive control abilities that could be supported by right hemisphere neural reserve.
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Affiliation(s)
- Michèle Masson-Trottier
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
- École d’Orthophonie et d’Audiologie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Tanya Dash
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
| | - Pierre Berroir
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
| | - Ana Inés Ansaldo
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
- École d’Orthophonie et d’Audiologie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- *Correspondence: Ana Inés Ansaldo,
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16
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Taylor C, Hall S, Manivannan S, Mundil N, Border S. The neuroanatomical consequences and pathological implications of bilingualism. J Anat 2022; 240:410-427. [PMID: 34486112 PMCID: PMC8742975 DOI: 10.1111/joa.13542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/26/2021] [Accepted: 08/23/2021] [Indexed: 01/17/2023] Open
Abstract
In recent years, there has been a rise in the number of people who are able to speak two or more languages. This has been paralleled by an increase in research related to bilingualism. Despite this, much of the neuroanatomical consequences and pathological implications of bilingualism are still subject to discussion. This review aims to evaluate the neuroanatomical structures related to language and to the acquisition of a second language as well as exploring how learning a second language can alter one's susceptibility to and the progression of certain cerebral pathologies. A literature search was conducted on the Medline, Embase, and Web of Science databases. A total of 137 articles regarding the neuroanatomical or pathological implications of bilingualism were included for review. Following analysis of the included papers, this review finds that bilingualism induces significant gray and white matter cerebral changes, particularly in the frontal lobes, anterior cingulate cortex, left inferior parietal lobule and subcortical areas, and that native language and acquired language largely recruit the same neuroanatomical structures with however, subtle functional and anatomical differences dependent on proficiency and age of language acquisition. There is adequate evidence to suggest that bilingualism offsets the symptoms and diagnosis of dementia, and that it is protective against both pathological and age-related cognitive decline. While many of the neuroanatomical changes are known, more remains to be elucidated and the relationship between bilingualism and other neurological pathologies remains unclear.
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Affiliation(s)
- Charles Taylor
- Centre for Learning Anatomical SciencesFaculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Samuel Hall
- Centre for Learning Anatomical SciencesFaculty of MedicineUniversity of SouthamptonSouthamptonUK
- Department of NeurosurgeryUniversity Hospitals Southampton NHS Foundation TrustSouthamptonUK
| | - Susruta Manivannan
- Department of NeurosurgeryUniversity Hospitals Southampton NHS Foundation TrustSouthamptonUK
| | - Nilesh Mundil
- Department of NeurosurgeryUniversity Hospitals Southampton NHS Foundation TrustSouthamptonUK
| | - Scott Border
- Centre for Learning Anatomical SciencesFaculty of MedicineUniversity of SouthamptonSouthamptonUK
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17
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Cargnelutti E, Tomasino B, Fabbro F. Effects of Linguistic Distance on Second Language Brain Activations in Bilinguals: An Exploratory Coordinate-Based Meta-Analysis. Front Hum Neurosci 2022; 15:744489. [PMID: 35069147 PMCID: PMC8770833 DOI: 10.3389/fnhum.2021.744489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
In this quantitative meta-analysis, we used the activation likelihood estimation (ALE) approach to address the effects of linguistic distance between first (L1) and second (L2) languages on language-related brain activations. In particular, we investigated how L2-related networks may change in response to linguistic distance from L1. Thus, we examined L2 brain activations in two groups of participants with English as L2 and either (i) a European language (European group, n = 13 studies) or (ii) Chinese (Chinese group, n = 18 studies) as L1. We further explored the modulatory effect of age of appropriation (AoA) and proficiency of L2. We found that, irrespective of L1-L2 distance-and to an extent-irrespective of L2 proficiency, L2 recruits brain areas supporting higher-order cognitive functions (e.g., cognitive control), although with group-specific differences (e.g., the insula region in the European group and the frontal cortex in the Chinese group). The Chinese group also selectively activated the parietal lobe, but this did not occur in the subgroup with high L2 proficiency. These preliminary results highlight the relevance of linguistic distance and call for future research to generalize findings to other language pairs and shed further light on the interaction between linguistic distance, AoA, and proficiency of L2.
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Affiliation(s)
- Elisa Cargnelutti
- Dipartimento/Unità Operativa Pasian di Prato, Scientific Institute, IRCCS E. Medea, Udine, Italy
| | - Barbara Tomasino
- Dipartimento/Unità Operativa Pasian di Prato, Scientific Institute, IRCCS E. Medea, Udine, Italy
| | - Franco Fabbro
- Cognitive Neuroscience Laboratory, Department of Languages, Literature, Communication, Education, and Society, University of Udine, Udine, Italy
- Institute of Mechanical Intelligence, Scuola Superiore Sant’Anna, Pisa, Italy
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18
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Gray M, Ernst J, Ashworth S, Patel R, Couperus K. Stroke or No Stroke: A Case Report of Bilingual Aphasia. Clin Pract Cases Emerg Med 2021; 5:325-327. [PMID: 34437039 PMCID: PMC8373183 DOI: 10.5811/cpcem.2021.4.51206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/06/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction Bilingual aphasia is an atypical stroke presentation in the multilingual patient where an isolated aphasia occurs in one language while the other remains unaffected. Case Report A multilingual male presented to the emergency department with expressive aphasia to English but who was still able to speak fluently in French. Receptive English was preserved. While his National Institute of Health Stroke Scale score was technically zero, his pure aphasia component qualified him as an exception. He regained some repetitive English, so fibrinolyitic therapy was not initiated. Conclusion Bilingual aphasia is an indication for fibrinolysis given the impact that a pure aphasic stroke has on quality of life.
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Affiliation(s)
- Matthew Gray
- Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington
| | - Jacob Ernst
- Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington
| | - Simeon Ashworth
- Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington
| | - Ronak Patel
- Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington
| | - Kyle Couperus
- Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington
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19
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Blanco-Elorrieta E, Caramazza A. A common selection mechanism at each linguistic level in bilingual and monolingual language production. Cognition 2021; 213:104625. [DOI: 10.1016/j.cognition.2021.104625] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/08/2021] [Accepted: 02/05/2021] [Indexed: 11/29/2022]
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20
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Picture naming in bilingual and monolingual Chinese speakers: Capturing similarity and variability. Behav Res Methods 2021; 53:1677-1688. [PMID: 33483940 DOI: 10.3758/s13428-020-01521-1] [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] [Accepted: 12/10/2020] [Indexed: 11/08/2022]
Abstract
Picture-naming latency differs across languages in bilingual speakers. We compared the effects of key psycholinguistic variables on picture naming among two groups of Chinese bilingual speakers and Mandarin monolingual speakers. First, we asked bilingual and monolingual speakers to estimate the age of acquisition, familiarity, visual complexity, name agreement, and imageability of a set of object and action pictures in Mandarin and Cantonese. Next, we recruited 60 Cantonese-English speakers, 50 Mandarin-Cantonese bilingual speakers, and 30 monolingual speakers who named the object and action pictures in Cantonese and Mandarin, respectively. We observed variability in the effects of item-level characteristics among groups, suggesting an interaction between item-level and individual-level characteristics as predicted. This variability was higher in bilingual speakers who spoke similar languages (Mandarin-Cantonese) in comparison to those speaking more distant languages (Cantonese-English). Our results suggest that monolingual norms and bilingual norms capture the same amount of variability; however, grammatical class interactions with other variables are explained differentially by the bilingual and monolingual norms. We discuss the implications of our findings in terms of norming studies for timed picture naming and effects of bilingualism on language processing.
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21
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De Letter M, Cocquyt EM, Cromheecke O, Criel Y, De Cock E, De Herdt V, Szmalec A, Duyck W. The Protective Influence of Bilingualism on the Recovery of Phonological Input Processing in Aphasia After Stroke. Front Psychol 2021; 11:553970. [PMID: 33479564 PMCID: PMC7814870 DOI: 10.3389/fpsyg.2020.553970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/09/2020] [Indexed: 11/13/2022] Open
Abstract
Language-related potentials are increasingly used to objectify (mal)adaptive neuroplasticity in stroke-related aphasia recovery. Using preattentive [mismatch negativity (MMN)] and attentive (P300) phonologically related paradigms, neuroplasticity in sensory memory and cognitive functioning underlying phonological processing can be investigated. In aphasic patients, MMN amplitudes are generally reduced for speech sounds with a topographic source distribution in the right hemisphere. For P300 amplitudes and latencies, both normal and abnormal results have been reported. The current study investigates the preattentive and attentive phonological discrimination ability in 17 aphasic patients (6 monolinguals and 11 bilinguals, aged 41–71 years) at two timepoints during aphasia recovery. Between the two timepoints, a significant improvement of behavioral language performance in both languages is observed in all patients with the MMN latency at timepoint 1 as a predictive factor for aphasia recovery. In contrast to monolinguals, bilingual aphasic patients have a higher probability to improve their processing speed during rehabilitation, resulting in a shortening of the MMN latency over time, which sometimes progresses toward the normative values.
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Affiliation(s)
- Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Oona Cromheecke
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Yana Criel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Elien De Cock
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Veerle De Herdt
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Arnaud Szmalec
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Wouter Duyck
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
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22
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Reddy Mukku SS, Keshavaprasad YB, Rangarajan SK, Girimaji AS, Mohammed M, Mangalore S, Sivakumar PT. Multilingualism and semantic dementia - A case report. Asian J Psychiatr 2020; 54:102267. [PMID: 32659657 DOI: 10.1016/j.ajp.2020.102267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/25/2022]
Abstract
Language is a vital component of cognition essential for communication. Proficiency in more than one language has become a norm for many in the current era of globalisation. In neurogenerative conditions decline in language ability leads to early dependency. Studies have reported higher cognitive reserve in multilingual compared to monolinguals. Determining preserved language skills in a patient presenting with cognitive concerns helps in understanding the cognitive reserve, early signs of dementia, the extent of impairment due to language deficits and planning for cognitive stimulation. In this article, we have described an elderly woman with multilinguistic abilities who presented with semantic dementia.
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Affiliation(s)
- Shiva Shanker Reddy Mukku
- Geriatric Clinic & Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Yamini Belur Keshavaprasad
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Subashini K Rangarajan
- Geriatric Clinic & Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Akhila S Girimaji
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Marwah Mohammed
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - Sandhya Mangalore
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
| | - P T Sivakumar
- Geriatric Clinic & Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560029, India.
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23
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Peñaloza C, Dekhtyar M, Scimeca M, Carpenter E, Mukadam N, Kiran S. Predicting treatment outcomes for bilinguals with aphasia using computational modeling: Study protocol for the PROCoM randomised controlled trial. BMJ Open 2020; 10:e040495. [PMID: 33208330 PMCID: PMC7677370 DOI: 10.1136/bmjopen-2020-040495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Bilinguals with aphasia (BWA) present varying degrees of lexical access impairment and recovery across their two languages. Because both languages may benefit from therapy, identifying the optimal target language for treatment is a current challenge for research and clinical practice. Prior research has demonstrated that the BiLex computational model can accurately simulate lexical access in healthy bilinguals, and language impairment and treatment response in bilingual aphasia. Here, we aim to determine whether BiLex can predict treatment outcomes in BWA in the treated and the untreated language and compare these outcome predictions to determine the optimal language for rehabilitation. METHODS AND ANALYSIS The study involves a prospective parallel-group, double-blind, randomised controlled trial. Forty-eight Spanish-English BWA will receive 20 sessions of semantic treatment for lexical retrieval deficits in one of their languages and will complete assessments in both languages prior and after treatment. Participants will be randomly assigned to an experimental group receiving treatment in the optimal language determined by the model or a control group receiving treatment in the language opposite to the model's recommendation. Primary treatment outcomes include naming probes while secondary treatment outcomes include tests tapping additional language domains. Treatment outcomes will be compared across the two groups using 2×2 mixed effect models for repeated measures Analysis of variance (ANOVA) on metrics of treatment effects commonly employed in rehabilitation studies (ie, effect size and percentage change). ETHICS AND DISSEMINATION All procedures included in this protocol (protocol number 29, issue date: 19 March 2019) were approved by the Boston University Charles River Campus Institutional Review Board at Boston, Massachusetts (reference number: 4492E). The results of this study will be published in peer-reviewed scientific journals and will be presented at national and international conferences. TRIAL REGISTRATION NUMBER NCT02916524.
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Affiliation(s)
- Claudia Peñaloza
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Maria Dekhtyar
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Michael Scimeca
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Erin Carpenter
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Nishaat Mukadam
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
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24
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Goral M, Lerman A. Variables and Mechanisms Affecting Response to Language Treatment in Multilingual People with Aphasia. Behav Sci (Basel) 2020; 10:E144. [PMID: 32971777 PMCID: PMC7551033 DOI: 10.3390/bs10090144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite substantial literature exploring language treatment effects in multilingual people with aphasia (PWA), inconsistent results reported across studies make it difficult to draw firm conclusions. METHODS We highlight and illustrate variables that have been implicated in affecting cross-language treatment effects in multilingual PWA. MAIN CONTRIBUTION We argue that opposing effects of activation and inhibition across languages, influenced by pertinent variables, such as age of language acquisition, patterns of language use, and treatment-related factors, contribute to the complex picture that has emerged from current studies of treatment in multilingual PWA. We propose a new integrated model-Treatment Effects in Aphasia in Multilingual people (the TEAM model)-to capture this complexity.
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Affiliation(s)
- Mira Goral
- Speech-Language-Hearing Sciences, Graduate Center & Lehman College, City University of New York, New York, NY 10016, USA
- MultiLing Center for Multilingualism in Society across the Lifespan, University of Oslo, 0313 Oslo, Norway
| | - Aviva Lerman
- Program of Communication Disorders, Hadassah Academic College, Jerusalem 9101001, Israel;
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25
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Erkoreka L, Ozamiz-Etxebarria N, Ruiz O, Ballesteros J. Assessment of Psychiatric Symptomatology in Bilingual Psychotic Patients: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4137. [PMID: 32531946 PMCID: PMC7312010 DOI: 10.3390/ijerph17114137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
Language plays an important role in psychiatric conditions. Language disturbances are core symptoms of psychiatric ailments, and language is the main diagnostic tool to assess psychopathological severity. Although the importance of language in psychiatry, the effect of bilingualism, and more specifically of using the mother language or a later acquired language at the time of assessing psychotic symptoms, has been scarcely studied and, thus, remains unclear. We conducted a systematic review and meta-analysis to ascertain whether differences exist in the severity of psychopathology in psychotic patients when assessed either in the mother language or in an acquired language. Of 3121 retrieved references from three databases (PsycINFO, MEDLINE, Embase) and complementary searches, four studies-including 283 psychotic patients-were included in the review. The meta-analytical combined effect suggested that more overall symptomatology is detected when clinical assessment is conducted in the mother language rather than in the acquired language (very low quality evidence, random effects model standardized mean difference (SMD) 0.44, 95% CI = 0.19 to 0.69, p value = 0.0006, I2 = 90%). Considering the growing migration flows and the increasing number of bilingual people in the world population, the effect of the chosen language to conduct at the time of conducting psychopathological assessments of psychotic patients is a clinically relevant issue. Based on our findings, we recommend that clinical interviews with bilingual psychotic patients should be conducted, when feasible, in the patient's mother language.
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Affiliation(s)
- Leire Erkoreka
- Department of Neurosciences, University of the Basque Country UPV/EHU, 48940 Leioa, Spain; (L.E.); (J.B.)
- Department of Psychiatry, Galdakao-Usansolo Hospital, Osakidetza Basque Health Service, 48960 Galdakao, Spain
- Department of Mental Health, BioCruces-Bizkaia Health Research Institute, 48903 Barakaldo, Spain;
| | - Naiara Ozamiz-Etxebarria
- Department of Neurosciences, University of the Basque Country UPV/EHU, 48940 Leioa, Spain; (L.E.); (J.B.)
| | - Onintze Ruiz
- Department of Mental Health, BioCruces-Bizkaia Health Research Institute, 48903 Barakaldo, Spain;
| | - Javier Ballesteros
- Department of Neurosciences, University of the Basque Country UPV/EHU, 48940 Leioa, Spain; (L.E.); (J.B.)
- Department of Mental Health, BioCruces-Bizkaia Health Research Institute, 48903 Barakaldo, Spain;
- CIBERSAM, 48940 Leioa, Spain
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26
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Weekes BSH. Aphasia in Alzheimer's Disease and Other Dementias (ADOD): Evidence From Chinese. Am J Alzheimers Dis Other Demen 2020; 35:1533317520949708. [PMID: 33040568 PMCID: PMC10624002 DOI: 10.1177/1533317520949708] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Speech and language impairments (aphasia) are typical of patients with Alzheimer's Disease and other dementias (ADOD) and in some pathologies are diagnostic e.g. Primary Progressive Aphasia (PPA). One question concerns the reliability and validity of symptomatology across typologically different languages. A review of aphasia in ADOD across languages suggests a similar pattern of word comprehension, naming and word finding difficulties but also evidence of language specific features in symptomatology e.g. processing of tone in Chinese languages. Given differences in linguistic impairments across languages, it is recommended that screening for aphasia in community and epidemiological studies use a Short ScreeningTest (SST) that can be delivered across dialects and languages in indigenous languages and also multilingual populations.
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Affiliation(s)
- Brendan Stuart Hackett Weekes
- University of Cambridge, United Kingdom
- University of Hong Kong, Hong Kong
- University of Melbourne, Victoria, Australia
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27
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Ismail FY, Ljubisavljevic MR, Johnston MV. A conceptual framework for plasticity in the developing brain. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:57-66. [PMID: 32958193 DOI: 10.1016/b978-0-444-64150-2.00007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this chapter, we highlight the various definitions of early brain plasticity commonly used in the scientific literature. We then present a conceptual framework of early brain plasticity that focuses on plasticity at the level of the synapse (synaptic plasticity) and the level of the network (connectivity). The proposed framework is organized around three main domains through which current theories and principles of early brain plasticity can be integrated: (1) the mechanisms of plasticity and constraints at the synaptic level and network connectivity, (2) the importance of temporal considerations related to the development of the immature brain, and (3) the functions early brain plasticity serve. We then apply this framework to discuss some clinical disorders caused by and/or associated with impaired plasticity mechanisms. We propose that a careful examination of the relationship between mechanisms, constraints, and functions of early brain plasticity in health and disease may provide an integrative understanding of the current theories and principles generated by experimental and observational studies.
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Affiliation(s)
- Fatima Y Ismail
- Department of Pediatrics, United Arab Emirates University, Al-Ain, United Arab Emirates; Department of Neurology (adjunct), Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | | | - Michael V Johnston
- Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, United States
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Peñaloza C, Barrett K, Kiran S. The influence of prestroke proficiency on poststroke lexical-semantic performance in bilingual aphasia. APHASIOLOGY 2019; 34:1223-1240. [PMID: 33281268 PMCID: PMC7716615 DOI: 10.1080/02687038.2019.1666082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 09/03/2019] [Indexed: 06/04/2023]
Abstract
BACKGROUND Bilingual persons with aphasia (BWA) may present different degrees and patterns of impairment in their two languages. Previous research suggests that prestroke proficiency may be amongst the factors determining poststroke language impairment in BWA, however this relationship is not well understood. AIMS The purpose of this study was to examine the relationship between prestroke proficiency and poststroke lexical-semantic performance in BWA and to identify common patterns of language impairment in this population. METHODS AND PROCEDURES Twenty-seven Spanish-English BWA (14 female, age range = 29-88 years) were administered a language use questionnaire (LUQ) to measure several aspects of their bilingual language history that contribute to their prestroke proficiency in both languages. They also underwent standardized language assessments tapping lexical-semantic performance in each language. A principal component analysis was first conducted on the LUQ metrics to determine the factors that contributed to prestroke proficiency in each language. Next, regression analyses allowed assessing the relationships between prestroke proficiency and poststroke lexical-semantic performance in both languages. Differences in proficiency and language performance across languages were contrasted prior and after stroke to identify profiles of impairment. OUTCOMES AND RESULTS Prestroke proficiency in the native language was determined by daily use, educational history, lifetime exposure, and language ability rating. Prestroke proficiency in the second language was determined by age of acquisition, daily use, educational history, lifetime exposure, lifetime confidence, family proficiency, and language ability rating. Prestroke proficiency significantly predicted poststroke lexical-semantic performance in BWA in both languages. Twenty-two participants presented parallel impairment while only three presented differential impairment. CONCLUSIONS Our results confirm that prestroke language proficiency is a key predictor of poststroke language impairment in BWA. These findings have important implications for the assessment and diagnosis of aphasia in bilingual individuals.
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Affiliation(s)
- Claudia Peñaloza
- Aphasia Research Laboratory, Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA 02215, USA
| | - Katherine Barrett
- Aphasia Research Laboratory, Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA 02215, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA 02215, USA
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Cargnelutti E, Tomasino B, Fabbro F. Language Brain Representation in Bilinguals With Different Age of Appropriation and Proficiency of the Second Language: A Meta-Analysis of Functional Imaging Studies. Front Hum Neurosci 2019; 13:154. [PMID: 31178707 PMCID: PMC6537025 DOI: 10.3389/fnhum.2019.00154] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 04/23/2019] [Indexed: 12/03/2022] Open
Abstract
Language representation in the bilingual brain is the result of many factors, of which age of appropriation (AoA) and proficiency of the second language (L2) are probably the most studied. Many studies indeed compare early and late bilinguals, although it is not yet clear what the role of the so-called critical period in L2 appropriation is. In this study, we carried out coordinate-based meta-analyses to address this issue and to inspect the role of proficiency in addition to that of AoA. After the preliminary inspection of the early (also very early) and late bilinguals' language networks, we explored the specific activations associated with each language and compared them within and between the groups. Results confirmed that the L2 language brain representation was wider than that associated with L1. This was observed regardless of AoA, although differences were more relevant in the late bilinguals' group. In particular, L2 entailed a greater enrollment of the brain areas devoted to the executive functions, and this was also observed in proficient bilinguals. The early bilinguals displayed many activation clusters as well, which also included the areas involved in cognitive control. Interestingly, these regions activated even in L1 of both early and late bilingual groups, although less consistently. Overall, these findings suggest that bilinguals in general are constantly subjected to cognitive effort to monitor and regulate the language use, although early AoA and high proficiency are likely to reduce this.
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Affiliation(s)
- Elisa Cargnelutti
- Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy
| | - Barbara Tomasino
- Scientific Institute, IRCCS E. Medea, Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy
| | - Franco Fabbro
- Cognitive Neuroscience Laboratory, DILL, University of Udine, Udine, Italy
- PERCRO Perceptual Robotics Laboratory, Scuola Superiore Sant’Anna, Pisa, Italy
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Goral M, Norvik M, Jensen BU. Variation in language mixing in multilingual aphasia. CLINICAL LINGUISTICS & PHONETICS 2019; 33:915-929. [PMID: 30836773 PMCID: PMC6760868 DOI: 10.1080/02699206.2019.1584646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/13/2019] [Accepted: 02/15/2019] [Indexed: 06/09/2023]
Abstract
Mixing languages within a sentence or a conversation is a common practice among many speakers of multiple languages. Language mixing found in multilingual speakers with aphasia has been suggested to reflect deficits associated with the brain lesion. In this paper, we examine language mixing behaviour in multilingual people with aphasia to test the hypothesis that the use of language mixing reflects a communicative strategy. We analysed connected language production elicited from 11 individuals with aphasia. Words produced were coded as mixed or not. Frequencies of mixing were tabulated for each individual in each of her or his languages in each of two elicitation tasks (Picture sequence description, Narrative production). We tested the predictions that there would be more word mixing: for participants with greater aphasia severity; while speaking in a language of lower post-stroke proficiency; during a task that requires more restricted word retrieval; for people with non-fluent aphasia, while attempting to produce function words (compared to content words); and that there would be little use of a language not known to the interlocutors. The results supported three of the five predictions. We interpret our data to suggest that multilingual speakers with aphasia mix words in connected language production primarily to bypass instances of word-retrieval difficulties, and typically avoid pragmatically inappropriate language mixing.
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Affiliation(s)
- Mira Goral
- Program in Speech-Language-Hearing Sciences, Graduate Center, City University of New York , NY , USA
- Department of Speech-Language-Hearing Sciences, Lehman College, City University of New York , NY , USA
- MultiLing Center for Multilingualism in Society across the Lifespan, Department of Linguistics and Scandinavian studies, University of Oslo , Oslo , Norway
| | - Monica Norvik
- MultiLing Center for Multilingualism in Society across the Lifespan, Department of Linguistics and Scandinavian studies, University of Oslo , Oslo , Norway
- Department of Speech and Language Disorders, Statped , Oslo , Norway
- Department of Language and Literature, NTNU - The Norwegian University of Science and Technology , Trondheim , Norway
| | - Bård Uri Jensen
- MultiLing Center for Multilingualism in Society across the Lifespan, Department of Linguistics and Scandinavian studies, University of Oslo , Oslo , Norway
- Department of Humanities, Inland Norway University of Applied Sciences , Hamar , Norway
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