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de Leon J, Grasso S, Allen IE, Escueta DP, Vega Y, Eshghavi M, Watson C, Dronkers N, Gorno-Tempini ML, Henry ML. Examining the relation between bilingualism and age of symptom onset in frontotemporal dementia. Biling (Camb Engl) 2024; 27:274-286. [PMID: 38707508 PMCID: PMC11065430 DOI: 10.1017/s1366728923000226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Bilingualism is thought to confer advantages in executive functioning, thereby contributing to cognitive reserve and a later age of dementia symptom onset. While the relation between bilingualism and age of onset has been explored in Alzheimer's dementia, there are few studies examining bilingualism as a contributor to cognitive reserve in frontotemporal dementia (FTD). In line with previous findings, we hypothesized that bilinguals with behavioral variant FTD would be older at symptom onset compared to monolinguals, but that no such effect would be found in patients with nonfluent/agrammatic variant primary progressive aphasia (PPA) or semantic variant PPA. Contrary to our hypothesis, we found no significant difference in age at symptom onset between monolingual and bilingual speakers within any of the FTD variants, and there were no notable differences on neuropsychological measures. Overall, our results do not support a protective effect of bilingualism in patients with FTD-spectrum disease in a U.S. based cohort.
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Affiliation(s)
- Jessica de Leon
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Stephanie Grasso
- Department of Speech, Language and Hearing Sciences, University of Texas At Austin, Texas, USA
| | - Isabel Elaine Allen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Danielle P. Escueta
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Yvette Vega
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Malihe Eshghavi
- Department of International and Multicultural Education, University of San Francisco, California, USA
| | - Christa Watson
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Nina Dronkers
- Department of Psychology, University of California, Berkeley, California, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Maya L. Henry
- Department of Speech, Language and Hearing Sciences, University of Texas At Austin, Texas, USA
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Battistella G, Borghesani V, Henry M, Shwe W, Lauricella M, Miller Z, Deleon J, Miller BL, Dronkers N, Brambati SM, Seeley WW, Mandelli ML, Gorno-Tempini ML. Task-Free Functional Language Networks: Reproducibility and Clinical Application. J Neurosci 2020; 40:1311-1320. [PMID: 31852732 PMCID: PMC7002153 DOI: 10.1523/jneurosci.1485-19.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 11/06/2019] [Accepted: 12/01/2019] [Indexed: 01/17/2023] Open
Abstract
Intrinsic connectivity networks (ICNs) identified through task-free fMRI (tf-fMRI) offer the opportunity to investigate human brain circuits involved in language processes without requiring participants to perform challenging cognitive tasks. In this study, we assessed the ability of tf-fMRI to isolate reproducible networks critical for specific language functions and often damaged in primary progressive aphasia (PPA). First, we performed whole-brain seed-based correlation analyses on tf-fMRI data to identify ICNs anchored in regions known for articulatory, phonological, and semantic processes in healthy male and female controls (HCs). We then evaluated the reproducibility of these ICNs in an independent cohort of HCs, and recapitulated their functional relevance with a post hoc meta-analysis on task-based fMRI. Last, we investigated whether atrophy in these ICNs could inform the differential diagnosis of nonfluent/agrammatic, semantic, and logopenic PPA variants. The identified ICNs included a dorsal articulatory-phonological network involving inferior frontal and supramarginal regions; a ventral semantic network involving anterior middle temporal and angular gyri; a speech perception network involving superior temporal and sensorimotor regions; and a network between posterior inferior temporal and intraparietal regions likely linking visual, phonological, and attentional processes for written language. These ICNs were highly reproducible across independent groups and revealed areas consistent with those emerging from task-based meta-analysis. By comparing ICNs' spatial distribution in HCs with patients' atrophy patterns, we identified ICNs associated with each PPA variant. Our findings demonstrate the potential use of tf-fMRI to investigate the functional status of language networks in patients for whom activation studies can be methodologically challenging.SIGNIFICANCE STATEMENT We showed that a single, short, task-free fMRI acquisition is able to identify four reproducible and relatively segregated intrinsic left-dominant networks associated with articulatory, phonological, semantic, and multimodal orthography-to-phonology processes, in HCs. We also showed that these intrinsic networks relate to syndrome-specific atrophy patterns in primary progressive aphasia. Collectively, our results support the application of task-free fMRI in future research to study functionality of language circuits in patients for whom tasked-based activation studies might be methodologically challenging.
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Affiliation(s)
- Giovanni Battistella
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158,
| | - Valentina Borghesani
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Maya Henry
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
- Department of Communication Sciences and Disorders, University of Texas, Austin, Texas 78712
| | - Wendy Shwe
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Michael Lauricella
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Zachary Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Jessica Deleon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Nina Dronkers
- Department of Psychology, University of California, Berkeley, California 94720, and
| | - Simona M Brambati
- Département de Psychologie, Université de Montréal, Quebec H3T 1J4, Canada
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California 94158
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De Witte E, Piai V, Kurteff G, Cai R, Mariën P, Dronkers N, Chang E, Berger M. A valid alternative for in-person language assessments in brain tumor patients: feasibility and validity measures of the new TeleLanguage test. Neurooncol Pract 2019; 6:93-102. [PMID: 31386040 PMCID: PMC6656337 DOI: 10.1093/nop/npy020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although language deficits after awake brain surgery are usually milder than post-stroke, postoperative language assessments are needed to identify these. Follow-up of brain tumor patients in certain geographical regions can be difficult when most patients are not local and come from afar. We developed a short telephone-based test for pre- and postoperative language assessments. METHODS The development of the TeleLanguage Test was based on the Dutch Linguistic Intraoperative Protocol and existing standardized English batteries. Two parallel versions were composed and tested in healthy native English speakers. Subsequently, the TeleLanguage Test was administered in a group of 14 tumor patients before surgery and at 1 week, 1 month, and 3 months after surgery. The test includes auditory comprehension, repetition, semantic selection, sentence or story completion, verbal naming, and fluency tests. It takes less than 20 minutes to administer. RESULTS Healthy participants had no difficulty performing any of the language tests via the phone, attesting to the feasibility of a phone assessment. In the patient group, all TeleLanguage test scores significantly declined shortly after surgery with a recovery to preoperative levels at 3 months postsurgery for naming and fluency tasks and a recovery to normal levels for the other language tasks. Analysis of the in-person language assessments (until 1 month) revealed a similar profile. CONCLUSION The use of the TeleLanguage battery to conduct language assessments from afar can provide convenience, might optimize patient care, and enables longitudinal clinical research. The TeleLanguage is a valid tool for various clinical and scientific purposes.
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Affiliation(s)
- Elke De Witte
- University of California San Francisco Medical Center, Department of Neurological Surgery, San Francisco, California, USA
- Vrije Universiteit Brussel, Department of Clinical and Experimental Neurolinguistics, Center of Linguistics and Literary Studies, Brussels, Belgium
| | - Vitória Piai
- Radboud University Medical Center, Department of Medical Psychology, Nijmegen, the Netherlands
- Radboud University, Donders Centre for Cognition, Nijmegen, the Netherlands
| | - Garret Kurteff
- University of California San Francisco Medical Center, Department of Neurological Surgery, San Francisco, California, USA
| | - Ruofan Cai
- University of California San Francisco Medical Center, Department of Neurological Surgery, San Francisco, California, USA
| | - Peter Mariën
- Vrije Universiteit Brussel, Department of Clinical and Experimental Neurolinguistics, Center of Linguistics and Literary Studies, Brussels, Belgium
- ZNA Middelheim, Department of Neurology & Memory Clinic, Antwerp, Belgium
| | - Nina Dronkers
- VA Northern California Health Care System, Center for Aphasia and Related Disorders, Martinez, California, USA
| | - Edward Chang
- University of California San Francisco Medical Center, Department of Neurological Surgery, San Francisco, California, USA
| | - Mitchel Berger
- University of California San Francisco Medical Center, Department of Neurological Surgery, San Francisco, California, USA
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Dronkers N, Wilson S, Baldo J, Miller B, Gorno-Tempini ML. Neural correlates of auditory verbal short-term memory deficits in vascular and neurodegenerative aphasia. Front Hum Neurosci 2019. [DOI: 10.3389/conf.fnhum.2019.01.00107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ivanova M, Zhong A, Turken A, Curran B, Dronkers N. Beyond the cortex: A look at unique contributions of the arcuate fasciculus to language processing. Front Hum Neurosci 2018. [DOI: 10.3389/conf.fnhum.2018.228.00087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Paulraj S, Dronkers N, Schendel Parker K, Curran B, Baldo J. Role of Left Hemisphere Language Areas in Visuospatial Working Memory. Front Hum Neurosci 2017. [DOI: 10.3389/conf.fnhum.2017.223.00113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Witte ED, Piai V, Dronkers N, Berger MS. NCOG-06. USABILITY AND VALIDITY OF A PHONE BATTERY TO ASSESS LANGUAGE FUNCTIONS IN BRAIN TUMOR PATIENTS UNDERGOING AWAKE SURGERY. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mandelli ML, Vitali P, Santos M, Henry M, Gola K, Rosenberg L, Dronkers N, Miller B, Seeley WW, Gorno-Tempini ML. Two insular regions are differentially involved in behavioral variant FTD and nonfluent/agrammatic variant PPA. Cortex 2015; 74:149-57. [PMID: 26673947 DOI: 10.1016/j.cortex.2015.10.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 09/03/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022]
Abstract
The non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) and the behavioral variant frontotemporal dementia (bvFTD) are focal neurodegenerative disorders belonging to the FTD-spectrum clinical syndromes. NfvPPA is characterized by effortful speech and/or agrammatism and left frontal atrophy, while bvFTD is characterized by social-emotional dysfunction often accompanied by right-lateralized frontal damage. Despite their contrasting clinical presentations, both disorders show prominent left anterior insula atrophy. We investigated differential patterns of insular sub-region atrophy in nfvPPA and bvFTD. Based on knowledge of insular connectivity and physiology, we hypothesized that the left superior precentral region of the dorsal anterior insula (SPGI) would be more atrophic in nvfPPA due to its critical role in motor speech, whereas the ventral anterior region would be more atrophied in bvFTD reflecting its known role in social-emotional-autonomic functions. Early stage nfvPPA and bvFTD patients matched for disease severity, age, gender and education and healthy controls participated in the study. Detailed clinical history, neurological examination, neuropsychological screening evaluation, and high-resolution T1-weighted brain magnetic resonance imaging (MRI) were collected. Voxel-based morphometry (VBM) was applied to perform group comparisons across the whole brain and in bilateral insula region of interest (ROI). Correlation analyses between insular sub-region atrophy and relevant clinical features were performed. Whole brain group comparisons between nfvPPA and bvFTD showed the expected predominantly left or right anterior insular atrophy pattern. ROI analysis of bilateral insula showed that the left SPGI was significantly more atrophied in nfvPPA compared to bvFTD, while the bilateral ventral anterior and right dorsal anterior insula sub-regions were more atrophied in bvFTD than nfvPPA. Only left SPGI volume correlated with speech production abilities, while left and right ventral anterior insula volumes correlated with ratings of aberrant eating behavior. These two FTD clinical variants show different patterns of insular sub-region atrophy in the left precentral dorsal anterior and bilateral ventral anterior regions, providing further evidence for the role of these sub-regions in speech production and social-emotional function.
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Affiliation(s)
- Maria Luisa Mandelli
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States.
| | - Paolo Vitali
- Division of Neurology, Department of Medicine, Centre hospitalier de l'Université de Montreal (CHUM), Montreal, Canada
| | - Miguel Santos
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Maya Henry
- Department of Communication Sciences and Disorders, University of Texas, Austin, United States
| | - Kelly Gola
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Lynne Rosenberg
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - Nina Dronkers
- Center for Aphasia and Related Disorders, VA Northern California Health Care System, Martinez, CA, United States; Department of Neurology, University of California, Davis, United States
| | - Bruce Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States; Department of Pathology, University of California, San Francisco, United States
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, United States
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Brambati SM, Amici S, Racine CA, Neuhaus J, Miller Z, Ogar J, Dronkers N, Miller BL, Rosen H, Gorno-Tempini ML. Longitudinal gray matter contraction in three variants of primary progressive aphasia: A tenser-based morphometry study. Neuroimage Clin 2015; 8:345-55. [PMID: 26106560 PMCID: PMC4473099 DOI: 10.1016/j.nicl.2015.01.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 01/14/2015] [Accepted: 01/17/2015] [Indexed: 12/13/2022]
Abstract
The present study investigated the pattern of longitudinal changes in cognition and anatomy in three variants of primary progressive aphasia (PPA). Eight patients with the non-fluent variant of PPA (nfvPPA), 13 patients with the semantic variant (svPPA), seven patients with the logopenic variant (lvPPA), and 29 age-matched, neurologically healthy controls were included in the study. All participants underwent longitudinal MRI, neuropsychological and language testing at baseline and at a 1-year follow-up. Tenser-based morphometry (TBM) was applied to T1-weighted MRI images in order to map the progression of gray and white matter atrophy over a 1-year period. Results showed that each patient group was characterized by a specific pattern of cognitive and anatomical changes. Specifically, nfvPPA patients showed gray matter atrophy progression in the left frontal and subcortical areas as well as a decline in motor speech and executive functions; svPPA patients presented atrophy progression in the medial and lateral temporal lobe and decline in semantic memory abilities; and lvPPA patients showed atrophy progression in lateral/posterior temporal and medial parietal regions with a decline in memory, sentence repetition and calculations. In addition, in all three variants, the white matter fibers underlying the abovementioned cortical areas underwent significant volume contraction over a 1-year period. Overall, these results indicate that the three PPA variants present distinct patterns of neuroanatomical contraction, which reflect their clinical and cognitive progression.
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Affiliation(s)
- Simona Maria Brambati
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Serena Amici
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Caroline A Racine
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - John Neuhaus
- Department of Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Zachary Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Jenny Ogar
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA ; Department of Veteran's Affairs, Martinez, CA, USA ; University of California, Davis, CA, USA
| | - Nina Dronkers
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA ; Department of Veteran's Affairs, Martinez, CA, USA ; University of California, Davis, CA, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Howard Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
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Caso F, Mandelli ML, Henry M, Gesierich B, Bettcher BM, Ogar J, Filippi M, Comi G, Magnani G, Sidhu M, Trojanowski JQ, Huang EJ, Grinberg LT, Miller BL, Dronkers N, Seeley WW, Gorno-Tempini ML. In vivo signatures of nonfluent/agrammatic primary progressive aphasia caused by FTLD pathology. Neurology 2013; 82:239-47. [PMID: 24353332 DOI: 10.1212/wnl.0000000000000031] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify early cognitive and neuroimaging features of sporadic nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA) caused by frontotemporal lobar degeneration (FTLD) subtypes. METHODS We prospectively collected clinical, neuroimaging, and neuropathologic data in 11 patients with sporadic nfvPPA with FTLD-tau (nfvPPA-tau, n = 9) or FTLD-transactive response DNA binding protein pathology of 43 kD type A (nfvPPA-TDP, n = 2). We analyzed patterns of cognitive and gray matter (GM) and white matter (WM) atrophy at presentation in the whole group and in each pathologic subtype separately. We also considered longitudinal clinical data. RESULTS At first evaluation, regardless of pathologic FTLD subtype, apraxia of speech (AOS) was the most common cognitive feature and atrophy involved the left posterior frontal lobe. Each pathologic subtype showed few distinctive features. At presentation, patients with nfvPPA-tau presented with mild to moderate AOS, mixed dysarthria with prominent hypokinetic features, clear agrammatism, and atrophy in the GM of the left posterior frontal regions and in left frontal WM. While speech and language deficits were prominent early, within 3 years of symptom onset, all patients with nfvPPA-tau developed significant extrapyramidal motor signs. At presentation, patients with nfvPPA-TDP had severe AOS, dysarthria with spastic features, mild agrammatism, and atrophy in left posterior frontal GM only. Selective mutism occurred early, when general neurologic examination only showed mild decrease in finger dexterity in the right hand. CONCLUSIONS Clinical features in sporadic nfvPPA caused by FTLD subtypes relate to neurodegeneration of GM and WM in frontal motor speech and language networks. We propose that early WM atrophy in nfvPPA is suggestive of FTLD-tau pathology while early selective GM loss might be indicative of FTLD-TDP.
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Affiliation(s)
- Francesca Caso
- From the Memory and Aging Center (F.C., M.L.M., M.H., B.G., B.M.B., J.O., M.S., L.T.G., B.L.M., W.W.S., M.L.G.-T.) and Department of Pathology (E.J.H.), University of California, San Francisco; Department of Neurology (F.C., M.F., G.C., G.M.) and Neuroimaging Research Unit (F.C., M.F.), Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy; Department of Pathology and Laboratory Medicine (J.Q.T.), University of Pennsylvania, Philadelphia; Center for Aphasia and Related Disorders (N.D.), VA Northern California Health Care System, Martinez, CA; and Department of Neurology (N.D.), University of California, Davis
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Caso F, Henry M, Gesierich B, Wilson S, Dronkers N, Miller B, Seeley W, Gorno-Tempini ML. Clinical, Neuroimaging, and Pathologic Features in a Group of Nonfluent Variant Primary Progressive Aphasia (nfvPPA) Studied Prospectively (P07.172). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Buchsbaum BR, Baldo J, Okada K, Berman KF, Dronkers N, D’Esposito M, Hickok G. Conduction aphasia, sensory-motor integration, and phonological short-term memory - an aggregate analysis of lesion and fMRI data. Brain Lang 2011; 119:119-28. [PMID: 21256582 PMCID: PMC3090694 DOI: 10.1016/j.bandl.2010.12.001] [Citation(s) in RCA: 196] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 12/11/2010] [Indexed: 05/13/2023]
Abstract
Conduction aphasia is a language disorder characterized by frequent speech errors, impaired verbatim repetition, a deficit in phonological short-term memory, and naming difficulties in the presence of otherwise fluent and grammatical speech output. While traditional models of conduction aphasia have typically implicated white matter pathways, recent advances in lesions reconstruction methodology applied to groups of patients have implicated left temporoparietal zones. Parallel work using functional magnetic resonance imaging (fMRI) has pinpointed a region in the posterior most portion of the left planum temporale, area Spt, which is critical for phonological working memory. Here we show that the region of maximal lesion overlap in a sample of 14 patients with conduction aphasia perfectly circumscribes area Spt, as defined in an aggregate fMRI analysis of 105 subjects performing a phonological working memory task. We provide a review of the evidence supporting the idea that Spt is an interface site for the integration of sensory and vocal tract-related motor representations of complex sound sequences, such as speech and music and show how the symptoms of conduction aphasia can be explained by damage to this system.
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Affiliation(s)
| | - Juliana Baldo
- VA Northern California Health Care System, Center for Aphasia and Related Disorders, Martinez, CA. USA
| | - Kayoko Okada
- Department of Cognitive Sciences, University of California, Irvine, CA. USA
| | - Karen F. Berman
- Section on Integrative Neuroimaging, National Institute of Mental Health, Bethesda, MD, USA
| | - Nina Dronkers
- VA Northern California Health Care System, Center for Aphasia and Related Disorders, Martinez, CA. USA
| | - Mark D’Esposito
- Department of Psychology, University of California, Berkeley, CA. USA
| | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA. USA
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Justus T, Larsen J, Yang J, Davies PDM, Dronkers N, Swick D. The role of Broca's area in regular past-tense morphology: an event-related potential study. Neuropsychologia 2011; 49:1-18. [PMID: 21035476 PMCID: PMC3026293 DOI: 10.1016/j.neuropsychologia.2010.10.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 08/29/2010] [Accepted: 10/20/2010] [Indexed: 11/20/2022]
Abstract
It has been suggested that damage to anterior regions of the left hemisphere results in a dissociation in the perception and lexical activation of past-tense forms. Specifically, in a lexical-decision task in which past-tense primes immediately precede present-tense targets, such patients demonstrate significant priming for irregular verbs (spoke-speak), but, unlike control participants, fail to do so for regular verbs (looked-look). Here, this behavioral dissociation was first confirmed in a group of eleven patients with damage to the pars opercularis (BA 44) and pars triangularis (BA 45) of the left inferior frontal gyrus (i.e., Broca's area). Two conditions containing word-onset orthographic-phonological overlap (bead-bee, barge-bar) demonstrated that the disrupted regular-verb priming was accompanied by, and covaried with, disrupted ortho-phonological priming, regardless of whether prime stimuli contained the regular inflectional rhyme pattern. Further, the dissociation between impaired regular-verb and preserved irregular-verb priming was shown to be continuous rather than categorical; priming for weak-irregular verbs (spent-spend) was intermediate in size between that of regular verbs and strong verbs. Such continuous dissociations grounded in ortho-phonological relationships between present- and past-tense forms are predicted by single-system, connectionist approaches to inflectional morphology and not predicted by current dual-system, rule-based models. Event-related potential data demonstrated that N400 priming effects were intact for both regular and irregular verbs, suggesting that the absence of significant regular-verb priming in the response time data did not result from a disruption of lexical access, and may have stemmed instead from post-lexical events such as covert articulation, segmentation strategies, and/or cognitive control.
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Affiliation(s)
- Timothy Justus
- Medical Research Service, VA Northern California Health Care System, Martinez, CA 94553-4668, USA.
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Vitali P, Dronkers N, Pincherle A, Giovagnoli AR, Marras C, D'Incerti L, Ghielmetti F, Spreafico R, Villani F. Accuracy of pre-surgical fMRI confirmed by subsequent crossed aphasia. Neurol Sci 2010; 32:175-80. [PMID: 21088978 DOI: 10.1007/s10072-010-0426-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 09/08/2010] [Indexed: 11/30/2022]
Abstract
Atypical patterns of language activation in functional MRI (fMRI) are not unusual, particularly in patients with severe epilepsy. Still, the functional significance of these activations is under debate. We describe a case of a right-handed patient affected by drug-refractory right temporal lobe epilepsy in whom pre-surgical fMRI showed bilateral language activations, greater in the right hemisphere (RH). After surgery, a right subdural hematoma caused epileptic status and severe aphasia. This post-surgical complication of a crossed aphasia confirmed the prior fMRI findings of RH language thus stressing the value of pre-surgical fMRI evaluations, even when surgery is planned in the RH of a right-handed patient.
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Affiliation(s)
- Paolo Vitali
- Division of Neuroradiology, Department of Diagnostics and Applied Technology, Foundation IRCCS National Neurological Institute C. Besta, Milan, Italy
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Borovsky A, Saygin AP, Bates E, Dronkers N. Lesion correlates of conversational speech production deficits. Neuropsychologia 2007; 45:2525-33. [PMID: 17499317 PMCID: PMC5610916 DOI: 10.1016/j.neuropsychologia.2007.03.023] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2006] [Revised: 02/17/2007] [Accepted: 03/16/2007] [Indexed: 10/23/2022]
Abstract
We assess brain areas involved in speech production using a recently developed lesion-symptom mapping method (voxel-based lesion-symptom mapping, VLSM) with 50 aphasic patients with left-hemisphere lesions. Conversational speech was collected through a standardized biographical interview, and used to determine mean length of utterance in morphemes (MLU), type token ratio (TTR) and overall tokens spoken for each patient. These metrics are used as indicators of grammatical complexity, semantic variation, and amount of speech, respectively. VLSM analysis revealed that damage to the anterior insula was predictive of low scores on MLU and tokens, consistent with prior findings of the role of this region in speech production [Dronkers, N. F. (1996). A new brain region for coordinating speech articulation. Nature, 384(6605), 159-161]. Additionally, the inferior frontal gyrus, sensorimotor and anterior temporal areas were also associated with lower scores on both of these measures. Overall, token and MLU maps were highly similar, suggesting an overlap between grammatical language networks and overall fluency. TTR maps also shared some portions of this network, but damage to posterior temporal regions also reduced scores on this measure. These results represent the first voxel-based lesion analysis of speech production performance in aphasic patients.
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Arévalo A, Perani D, Cappa SF, Butler A, Bates E, Dronkers N. Action and object processing in aphasia: from nouns and verbs to the effect of manipulability. Brain Lang 2007; 100:79-94. [PMID: 16949143 DOI: 10.1016/j.bandl.2006.06.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Revised: 03/17/2006] [Accepted: 06/01/2006] [Indexed: 05/11/2023]
Abstract
The processing of words and pictures representing actions and objects was tested in 21 aphasic patients and 20 healthy controls across three word production tasks: picture-naming (PN), single word reading (WR) and word repetition (WRP). Analysis 1 targeted task and lexical category (noun-verb), revealing worse performance on PN and verb items for both patients and control participants. For Analysis 2 we used data collected in a concurrent gesture norming study to re-categorize the noun-verb items along hand imagery parameters (i.e., objects that can/cannot be manipulated and actions which do/do not involve fine hand movements). Here, patients displayed relative difficulty with the 'manipulable' items, while controls displayed the opposite pattern. Therefore, whereas the noun-verb distinction resulted simply in lower verb accuracy across groups, the 'manipulability' distinction revealed a 'double-dissociation' between patients and control participants. These results carry implications for theories of embodiment, lexico-semantic dissociations, and the organization of meaning in the brain.
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Affiliation(s)
- A Arévalo
- Center for Research in Language, University of California, San Diego, CA, USA.
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Rosen HJ, Allison SC, Ogar JM, Amici S, Rose K, Dronkers N, Miller BL, Gorno-Tempini ML. Behavioral features in semantic dementia vs other forms of progressive aphasias. Neurology 2006; 67:1752-6. [PMID: 17130406 DOI: 10.1212/01.wnl.0000247630.29222.34] [Citation(s) in RCA: 144] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare the behavioral profiles in different variants of primary progressive aphasia (PPA). METHODS We classified 67 patients with PPA into three clinical variants: semantic dementia (SEMD), progressive nonfluent aphasia (PNFA), and logopenic progressive aphasia (LPA), and we compared the severity of behavioral dysfunction, as measured by the Neuropsychiatric Inventory, in these groups and patients with frontotemporal dementia (FTD) and Alzheimer disease (AD). RESULTS SEMD was associated with significantly more socioemotional behavioral dysfunction than the other two variants of PPA and than AD, specifically more disinhibition, aberrant motor behavior, and eating disorders-behaviors that are typical of FTD. In contrast, PNFA and LPA did not differ from each other or from AD in the type or severity of behavioral dysfunction. Behavioral abnormalities increased in severity with disease duration in SEMD, but this association was not detected in PNFA or LPA. CONCLUSIONS Semantic dementia is associated with significantly more behavioral dysfunction than other variants of primary progressive aphasia, specifically behavioral features typical of frontotemporal dementia.
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Affiliation(s)
- H J Rosen
- University of California at San Francisco Department of Neurology , San Francisco, CA 94143-1207, USA.
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Ogar J, Willock S, Baldo J, Wilkins D, Ludy C, Dronkers N. Clinical and anatomical correlates of apraxia of speech. Brain Lang 2006; 97:343-50. [PMID: 16516956 DOI: 10.1016/j.bandl.2006.01.008] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2005] [Revised: 01/12/2006] [Accepted: 01/23/2006] [Indexed: 05/06/2023]
Abstract
In a previous study (Dronkers, 1996), stroke patients identified as having apraxia of speech (AOS), an articulatory disorder, were found to have damage to the left superior precentral gyrus of the insula (SPGI). The present study sought (1) to characterize the performance of patients with AOS on a classic motor speech evaluation, and (2) to examine whether severity of AOS was influenced by the extent of the lesion. Videotaped speech evaluations of stroke patients with and without AOS were reviewed by two speech-language pathologists and independently scored. Results indicated that patients with AOS made the most errors on tasks requiring the coordination of complex, but not simple, articulatory movements. Patients scored lowest on the repetition of multisyllabic words and sentences that required immediate shifting between place and manner of articulation and rapid coordination of the lips, tongue, velum, and larynx. Last, all patients with AOS had lesions in the SPGI, whereas patients without apraxia of speech did not. Additional involvement of neighboring brain areas was associated with more severe forms of both AOS as well as language deficits, such as aphasia.
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Affiliation(s)
- Jennifer Ogar
- VA Northern California Health Care System, Martinez, CA, USA.
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Abstract
Apraxia of speech (AOS) is a motor speech disorder that can occur in the absence of aphasia or dysarthria. AOS has been the subject of some controversy since the disorder was first named and described by Darley and his Mayo Clinic colleagues in the 1960s. A recent revival of interest in AOS is due in part to the fact that it is often the first symptom of neurodegenerative diseases, such as primary progressive aphasia and corticobasal degeneration. This article will provide a brief review of terminology associated with AOS, its clinical hallmarks and neuroanatomical correlates. Current models of motor programming will also be addressed as they relate to AOS and finally, typical treatment strategies used in rehabilitating the articulation and prosody deficits associated with AOS will be summarized.
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Affiliation(s)
- Jennifer Ogar
- UCSF Memory and Aging Center, San Francisco, CA 94143-1207, USA
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Bates E, Reilly J, Wulfeck B, Dronkers N, Opie M, Fenson J, Kriz S, Jeffries R, Miller L, Herbst K. Differential effects of unilateral lesions on language production in children and adults. Brain Lang 2001; 79:223-265. [PMID: 11712846 DOI: 10.1006/brln.2001.2482] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We present the first direct comparison of language production in brain-injured children and adults, using age-corrected z scores for multiple lexical and grammatical measures. Spontaneous speech samples were elicited in a structured biographical interview from 38 children (5-8 years of age), 24 with congenital left-hemisphere damage (LHD) and 14 with congenital right-hemisphere damage (RHD), compared with 38 age- and gender-matched controls, 21 adults with unilateral injuries (14 LHD and 7 RHD), and 12 adult controls. Adults with LHD showed severe and contrasting profiles of impairment across all measures (including classic differences between fluent and nonfluent aphasia). Adults with RHD (and three nonaphasic adults with LHD) showed fluent but disinhibited and sometimes empty speech. None of these qualitative or quantitative deviations were observed in children with unilateral brain injury, who were in the normal range for their age on all measures. There were no significant differences between children with LHD and RHD on any measure. When LHD children were compared directly with LHD adults using age-corrected z scores, the children scored far better than their adult counterparts on structural measures. These results provide the first systematic confirmation of differential free-speech outcomes in children and adults and offer strong evidence for neural and behavioral plasticity following early brain damage.
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Affiliation(s)
- E Bates
- Center for Research in Language, University of California, San Diego, La Jolla 92093-0526, USA.
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Dick F, Bates E, Wulfeck B, Utman JA, Dronkers N, Gernsbacher MA. Language deficits, localization, and grammar: evidence for a distributive model of language breakdown in aphasic patients and neurologically intact individuals. Psychol Rev 2001; 108:759-88. [PMID: 11699116 PMCID: PMC4301444 DOI: 10.1037/0033-295x.108.4.759] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Selective deficits in aphasic patients' grammatical production and comprehension are often cited as evidence that syntactic processing is modular and localizable in discrete areas of the brain (e.g., Y. Grodzinsky, 2000). The authors review a large body of experimental evidence suggesting that morpho-syntactic deficits can be observed in a number of aphasic and neurologically intact populations. They present new data showing that receptive agrammatism is found not only over a range of aphasic groups, but is also observed in neurologically intact individuals processing under stressful conditions. The authors suggest that these data are most compatible with a domain-general account of language, one that emphasizes the interaction of linguistic distributions with the properties of an associative processor working under normal or suboptimal conditions.
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Affiliation(s)
- F Dick
- Center for Research in Language and Department of Cognitive Science, 9500 Gilman Drive, Mail Code 0526, University of California, San Diego, La Jolla, California 92093-0526, USA.
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Walker-Batson D, Curtis S, Natarajan R, Ford J, Dronkers N, Salmeron E, Lai J, Unwin DH. A double-blind, placebo-controlled study of the use of amphetamine in the treatment of aphasia. Stroke 2001; 32:2093-8. [PMID: 11546902 DOI: 10.1161/hs0901.095720] [Citation(s) in RCA: 209] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE A number of studies suggest that drugs which increase the release of norepinephrine promote recovery when administered late (days to weeks) after brain injury in animals. A small number of clinical studies have investigated the effects of the noradrenergic agonist dextroamphetamine in patients recovering from motor deficits following stroke. To determine whether these findings extend to communication deficits subsequent to stroke, we administered dextroamphetamine, paired with speech/language therapy, to patients with aphasia. METHODS In a prospective, double-blind study, 21 aphasic patients with an acute nonhemorrhagic infarction were randomly assigned to receive either 10 mg dextroamphetamine or a placebo. Patients were entered between days 16 and 45 after onset and were treated on a 3-day/4-day schedule for 10 sessions. Thirty minutes after drug/placebo administration, subjects received a 1-hour session of speech/language therapy. The Porch Index of Communicative Ability was used at baseline, at 1 week off the drug, and at 6 months after onset as the dependent language measure. RESULTS Although there were no differences between the drug and placebo groups before treatment (P=0.807), by 1 week after the 10 drug treatments ended there was a significant difference in gain scores between the groups (P=0.0153), with the greater gain in the dextroamphetamine group. The difference was still significant when corrected for initial aphasia severity and age. At the 6-month follow-up, the difference in gain scores between the groups had increased; however, the difference was not significant (P=0.0482) after correction for multiple comparisons. CONCLUSIONS Administration of dextroamphetamine paired with 10 1-hour sessions of speech/language therapy facilitated recovery from aphasia in a small group of patients in the subacute period after stroke. Neuromodulation with dextroamphetamine, and perhaps other drugs that increase central nervous system noradrenaline levels, may facilitate recovery when paired with focused behavioral treatment.
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Affiliation(s)
- D Walker-Batson
- Stroke Center-Dallas, Department of Communication Sciences & Disorders, Texas Woman's University, The Mobility Foundation Center, Dallas, Texas, USA.
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Friedland RP, Koss E, Lerner A, Hedera P, Ellis W, Dronkers N, Ober BA, Jagust WJ. Functional imaging, the frontal lobes, and dementia. Dementia 1993; 4:192-203. [PMID: 8401792 DOI: 10.1159/000107323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A 58-year-old man developed progressive difficulty with comprehension and verbal output with dementia. Positron emission tomography with 18F 2-fluoro-2-deoxy-D-glucose demonstrated asymmetrical frontal and anterior temporal lobe loss of glucose use. Scopolamine infusion (0.3 mg) did not influence memory. Postmortem studies revealed evidence of Pick's disease, with Pick bodies, loss of somatostatin, preservation of choline acetyltransferase and immunostaining with neurofilament antibodies. Pharmacological challenge and positron imaging offer valuable means for the noninvasive assessment of dementing illness. The contributions of functional imaging to our knowledge of frontal involvement in dementing illness are reviewed.
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Affiliation(s)
- R P Friedland
- Alzheimer Center, University Hospital of Cleveland, OH 44106
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Abstract
Several tachistoscopic visual half-field experiments using exposure times in excess of 150 msec have been reported and arguments have been put forth justifying this procedure. An experiment was done investigating visual field accuracy under conditions where eye movement was allowed, following parafoveal exposure. Two control experiments were done to evaluate the viewing conditions. When eye movement is permitted, accuracy in both visual fields reaches 100%. It is concluded that visual field differences found with exposure times greater than 150 msec are due to the active cooperation of the subjects and not due to the justifications advanced by experimenters using long exposure times.
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