Disrupted temporal lobe connections in semantic dementia

Neural regions essential for distinct cognitive processes underlying picture naming

We hypothesized that distinct cognitive processes underlying oral and written picture naming depend on intact function of different, but overlapping, regions of the left hemisphere cortex, such that the distribution of tissue dysfunction in various areas can predict the component of the naming process that is disrupted. To test this hypothesis, we evaluated 116 individuals within 24 h of acute ischaemic stroke using a battery of oral and written naming and other lexical tests, and with magnetic resonance diffusion and perfusion imaging to identify the areas of tissue dysfunction. Discriminant function analysis, using the degree of hypoperfusion in various Brodmann's areas--BA 22 (including Wernicke's area), BA 44 (part of Broca's area), BA 45 (part of Broca's area), BA 21 (inferior temporal cortex), BA 37 (posterior, inferior temporal/fusiform gyrus), BA 38 (anterior temporal cortex) and BA 39 (angular gyrus)--as discriminant variables, classified patients on the basis of the primary component of the naming process that was impaired (defined as visual, semantics, modality-independent lexical access, phonological word form, orthographic word form and motor speech by the pattern of performance and types of errors across lexical tasks). Additionally, linear regression analysis demonstrated that the areas contributing the most information to the identification of patients with particular levels of impairment in the naming process were largely consistent with evidence for the roles of these regions from functional imaging. This study provides evidence that the level of impairment in the naming process reflects the distribution of tissue dysfunction in particular regions of the left anterior, inferior and posterior middle/superior temporal cortex, posterior inferior frontal and inferior parietal cortex. While occipital cortex is also critical for picture naming, it is likely that bilateral occipital damage is necessary to disrupt visual recognition. These findings provide new evidence that a network of brain regions supports naming, but separate components of this network are differentially required for distinct cognitive processes or representations underlying the complex task of naming pictures.

Anterior temporal cortex and semantic memory: reconciling findings from neuropsychology and functional imaging

Studies of semantic impairment arising from brain disease suggest that the anterior temporal lobes are critical for semantic abilities in humans; yet activation of these regions is rarely reported in functional imaging studies of healthy controls performing semantic tasks. Here, we combined neuropsychological and PET functional imaging data to show that when healthy subjects identify concepts at a specific level, the regions activated correspond to the site of maximal atrophy in patients with relatively pure semantic impairment. The stimuli were color photographs of common animals or vehicles, and the task was category verification at specific (e.g., robin), intermediate (e.g., bird), or general (e.g., animal) levels. Specific, relative to general, categorization activated the antero-lateral temporal cortices bilaterally, despite matching of these experimental conditions for difficulty. Critically, in patients with atrophy in precisely these areas, the most pronounced deficit was in the retrieval of specific semantic information.

Altered effective connectivity within the language network in primary progressive aphasia

Primary progressive aphasia (PPA) is a neurodegenerative dementia syndrome principally characterized by the gradual dissolution of language functions, especially in the early stages of disorder. In a previous functional neuroimaging study, PPA patients were found to activate core language areas similarly to control subjects when performing semantic and phonological processing tasks (Sonty et al., 2003). In the present study, functional magnetic resonance imaging (fMRI) and dynamic causal modeling (DCM) were used to study multiregional effective connectivity in early-stage PPA (n = 8) and control (n = 8) subjects performing semantic word matching and visual letter matching tasks. fMRI analysis showed semantic task-specific activations in the left inferior frontal (Broca's area) and posterior superior temporal (Wernicke's area) regions, in addition to other language regions, in both groups. Using a model language network consisting of six left hemisphere regions, the DCM analysis demonstrated reduced language-specific effective connectivity between Wernicke's and Broca's areas in the PPA patient group. Furthermore, this decrement in connectivity was predictive of semantic task accuracy. These results demonstrate for the first time that dysfunctional network interactions (effective connectivity), rather than hypoactivity within individual brain regions, may contribute to the emergence of language deficits seen in PPA.

Refractory effects in stroke aphasia: A consequence of poor semantic control

This study examined the full range of effects associated with "semantic access impairment" - namely, refractory variables (semantic relatedness, speed of presentation and item repetition), inconsistency, the absence of frequency effects and facilitation by cues - in a series of stroke patients with multimodal semantically impairment. By investigating all of these factors in a group of patients who were not specifically selected to show "access" effects, we were able to establish (1) whether this pattern is a common consequence of infarcts that produce semantic impairment and (2) if these symptoms co-occur. All of the patients showed effects of cueing and an absence of frequency effects in comprehension. Patients whose brain damage included the left inferior prefrontal cortex (LIPC) also showed marked effects of refractory variables; in contrast, two patients with temporal-parietal but not frontal lesions were less sensitive to these variables. Parallel results were obtained for cyclical naming and word-picture matching tasks suggesting that the LIPC plays a role in semantic selection as well as lexical retrieval. Rapid presentation and item repetition is likely to have increased the selection demands in both of these tasks in a similar fashion. Unlike patients with classical "semantic access impairment", our semantically impaired stroke patients showed significant test-retest consistency, indicating that their difficulties did not result from an unpredictable failure of semantic access--instead, their deficits were interpreted as arising from failures of semantic control.

Degraded Semantic Knowledge And Accurate Object Use

In the present paper we report the performance on object use and on semantic tasks of two patients, D.L. with probable semantic dementia, and A.M. with an atypical onset of dementia of Alzheimer, assessed twice two years apart. In particular, we investigated whether the patients' ability to use objects degraded as a function of their semantic knowledge about those objects. Results from the two assessments in 2002 and in 2004 confirmed that both patients had a selective loss of the lexical-semantic knowledge, despite a relative preservation of the other cognitive abilities including object use. This pattern of results suggests that semantic knowledge is not necessarily involved in the correct use of objects.

Colour knowledge in semantic dementia: It is not all black and white

In three experiments we assessed the colour knowledge of patients with semantic dementia, a neuro-degenerative condition that gradually erodes conceptual knowledge. In Experiment 1, the patients' colour naming performance correlated strongly with their object naming for frequency-matched items, with no patient showing better-than-expected naming of colours relative to objects. In Experiment 2, where patients were asked to colour black-and-white line drawings of common objects, all patients were impaired relative to controls, and performance correlated strongly with degree of semantic deficit. The fact that patients often erroneously selected green for fruits or vegetables, and brown for animals, suggests some preservation of general knowledge about the colours that typify a given domain. In Experiment 3, patients were given pairs of identical line drawings of familiar animals, fruits and vegetables--one of each pair coloured correctly, and one incorrectly--and were asked to choose the correct one. When the target's colour was characteristic of the domain, patients scored well; but when the distractor had a typical hue and the target's colour was unusual (e.g. a green versus an orange carrot), performance was far poorer. The results are discussed with reference to alternative theories about the neural basis of conceptual knowledge.

Distinct patterns of olfactory impairment in Alzheimer's disease, semantic dementia, frontotemporal dementia, and corticobasal degeneration

Performance on tests of odour discrimination, naming, and matching was compared in patients with four distinct forms of neurodegenerative disease: Alzheimer's disease (AD), semantic dementia (SD), frontotemporal dementia (FTD), and corticobasal degeneration (CBD). The SD patients were found to have a severe impairment of identification from olfaction despite having normal discrimination, consistent with the multimodal semantic impairment characteristic of this patient group. The AD patients' poor odour discrimination suggests that a perceptual impairment is the root of their poor odour identification. Mild impairments in odour identification observed in FTD and CBD are consistent with their generalised executive dysfunction. The findings illustrate that breakdown in olfaction can occur at a perceptual or semantic level, analogous to the distinction between apperceptive and associative forms of deficit in the visual and auditory modalities. The findings add further insights into the nature of the semantic deficit in SD by exploring a hitherto neglected modality and may have relevance in explaining the altered eating habits commonly associated with SD.

The Neural Basis of Language Development and Its Impairment

The neural correlates of early language development and language impairment are described, with the adult language-related brain systems as a target model. Electrophysiological and hemodynamic studies indicate that language functions to be installed in the child's brain are similar to those of adults, with lateralization being present at birth, phonological processes during the first months, semantic processes at 12 months, and syntactic processes around 30 months. These findings support the view that the brain basis of language develops continuously over time. Discontinuities are observed in children with language impairment. Here, the observed functional abnormalities are accompanied by structural abnormalities in inferior frontal and temporal brain regions.

The anatomy of category-specific object naming in neurodegenerative diseases

Neuropsychological studies suggest that knowledge about living and nonliving objects is processed in separate brain regions. However, lesion and functional neuroimaging studies have implicated different areas. To address this issue, we used voxel-based morphometry to correlate accuracy in naming line drawings of living and nonliving objects with gray matter volumes in 152 patients with various neurodegenerative diseases. The results showed a significant positive correlation between gray matter volumes in bilateral temporal cortices and total naming accuracy regardless of category. Naming scores for living stimuli correlated with gray matter volume in the medial portion of the right anterior temporal pole, whereas naming accuracy for familiarity-matched nonliving items correlated with the volume of the left posterior middle temporal gyrus. A previous behavioral study showed that the living stimuli used here also had in common the characteristic that they were defined by shared sensory semantic features, whereas items in the nonliving group were defined by their action-related semantic features. We propose that the anatomical segregation of living and nonliving categories is the result of their defining semantic features and the distinct neural subsystems used to process them.

Neuroanatomic Organization of Sound Memory in Humans

The neural interface between sensory perception and memory is a central issue in neuroscience, particularly initial memory organization following perceptual analyses. We used functional magnetic resonance imaging to identify anatomic regions extracting initial auditory semantic memory information related to environmental sounds. Two distinct anatomic foci were detected in the right superior temporal gyrus when subjects identified sounds representing either animals or threatening items. Threatening animal stimuli elicited signal changes in both foci, suggesting a distributed neural representation. Our results demonstrate both category- and feature-specific responses to nonverbal sounds in early stages of extracting semantic memory information from these sounds. This organization allows for these category-feature detection nodes to extract early, semantic memory information for efficient processing of transient sound stimuli. Neural regions selective for threatening sounds are similar to those of nonhuman primates, demonstrating semantic memory organization for basic biological/survival primitives are present across species.

A neuropsychological study of patients with temporal lobe epilepsy and chronic interictal psychosis

PURPOSE

To characterize the pattern of cognitive deficits in patients with temporal lobe epilepsy (TLE) and interictal (schizophrenia-like) psychosis and to examine the relationship between neuropsychological deficits and Magnetization transfer imaging.

METHODS

Twenty patients with TLE and interictal psychosis were compared to 20 non-psychotic TLE patients. Patients were matched with respect to premorbid IQ, age and conventional MRI findings. A battery of neuropsychological tests was administered. The neuropsychological tests which showed significant group differences were used for correlational analysis with magnetization transfer ratio (MTR) which provides a quantitative measure of macromolecular structural integrity.

RESULTS

Patients with interictal psychosis were significantly more impaired on executive and semantic memory tasks than the non-psychotic TLE group. Vocabulary test scores correlated significantly with MTR reduction in the left fusiform gyrus in the psychotic but not the non-psychotic group.

DISCUSSION

In this study, patients with TLE and interictal psychosis were more cognitively impaired than non-psychotic TLE patients. Our findings suggest that the cognitive deterioration in these patients may occur as the illness progresses and the causes for this are probably multifactorial. Our study also provides further evidence that MTR may be useful in investigating structural correlates of cognitive impairment.

Semantic knowledge in mild cognitive impairment and mild Alzheimer's disease

The aim of this study was to investigate memory in patients with mild cognitive impairment (MCI) and mild Alzheimer's disease (AD). Ten patients with MCI, 11 with AD and a group of age and education matched healthy control participants were assessed on a comprehensive battery of semantic memory tests, including traditional semantic memory measures and a non-verbal test of knowledge of object use. The MCI group was impaired on tests of category fluency and all three conditions of an object knowledge test (matching to recipient, function and action), plus a difficult object-naming test. The mild AD group showed additional impairments on traditional measures of semantic memory, including naming high frequency items, comprehension and semantic association. Together these findings suggest that semantic memory impairments occur early in the course of AD, more specifically in patients with "amnesic" MCI, and provide further evidence that impaired category fluency reflects semantic breakdown.

Anatomical and functional alterations in semantic dementia: a voxel-based MRI and PET study

Rare studies have used magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) to assess atrophy, and only two positron emission tomography (PET) studies used SPM to examine functional changes in semantic dementia (SD). Our aim was to highlight both morphological and functional abnormalities in a same group of 10 SD patients, in the entire brain, using a "state of the art" methodology (optimized VBM procedure, PET data corrected for partial volume effects and voxel-based analyses). We also used an extensive neuropsychological battery. We showed that main alterations concerned the left temporal lobe, in accordance with the striking impairment of semantic memory in SD patients, as well as the hippocampal region, which may partly explain their moderate episodic memory deficits. Hypometabolism was more extensive than grey matter loss in both temporal lobes, and specifically concerned the orbitofrontal areas, consistent with the moderate impairment of executive functions and behavioural changes. While PET is more sensitive than MRI, there is striking concordance between morphological and functional abnormalities, which contrasts with the discordance observed in Alzheimer's disease and might be a typical feature of SD.

[Q:] When would you prefer a SOSSAGE to a SAUSAGE? [A:] At about 100 msec. ERP correlates of orthographic typicality and lexicality in written word recognition

Using a speeded lexical decision task, event-related potentials (ERPs), and minimum norm current source estimates, we investigated early spatiotemporal aspects of cortical activation elicited by words and pseudo-words that varied in their orthographic typicality, that is, in the frequency of their component letter pairs (bi-grams) and triplets (tri-grams). At around 100 msec after stimulus onset, the ERP pattern revealed a significant typicality effect, where words and pseudo-words with atypical orthography (e.g., yacht, cacht) elicited stronger brain activation than items characterized by typical spelling patterns (cart, yart). At approximately 200 msec, the ERP pattern revealed a significant lexicality effect, with pseudo-words eliciting stronger brain activity than words. The two main factors interacted significantly at around 160 msec, where words showed a typicality effect but pseudo-words did not. The principal cortical sources of the effects of both typicality and lexicality were localized in the inferior temporal cortex. Around 160 msec, atypical words elicited the stronger source currents in the left anterior inferior temporal cortex, whereas the left perisylvian cortex was the site of greater activation to typical words. Our data support distinct but interactive processing stages in word recognition, with surface features of the stimulus being processed before the word as a meaningful lexical entry. The interaction of typicality and lexicality can be explained by integration of information from the early form-based system and lexicosemantic processes.

Object perception impairments predict instrumental activities of daily living dependence in Alzheimer's disease

This study examined the contribution of object perception and spatial localization to functional dependence among Alzheimer's disease (AD) patients. Forty patients with probable AD completed measures assessing verbal recognition memory, working memory, object perception, spatial localization, semantic knowledge, and global cognition. Primary caregivers completed a measure of activities of daily living (ADLs) that included instrumental and basic self-care subscales (i.e., IADLs and BADLs, respectively). Stepwise multiple regressions revealed that global cognition accounted for significant portions of variance among the ADL total, IADL, and BADL scores. However, when global cognition was removed from the model, object perception was the only significant cognitive predictor of the ADL total and IADL subscale scores, accounting for 18.5% and 19.3% of the variance, respectively. When considering multiple cognitive components simultaneously, object perception and the integrity of the inferotemporal cortex is important in the completion of functional abilities in general and IADLs in particular among AD patients.

Neural Response Suppression Predicts Repetition Priming of Spoken Words and Pseudowords

An important method for studying how the brain processes familiar stimuli is to present the same item on more than one occasion and measure how responses change with repetition. Here we use repetition priming in a sparse functional magnetic resonance imaging (fMRI) study to probe the neuroanatomical basis of spoken word recognition and the representations of spoken words that mediate repetition priming effects. Participants made lexical decisions to words and pseudowords spoken by a male or female voice that were presented twice, with half of the repetitions in a different voice. Behavioral and neural priming was observed for both words and pseudowords and was not affected by voice changes. The fMRI data revealed an elevated response to words compared to pseudowords in both posterior and anterior temporal regions, suggesting that both contribute to word recognition. Both reduced and elevated activation for second presentations (repetition suppression and enhancement) were observed in frontal and posterior regions. Correlations between behavioral priming and neural repetition suppression were observed in frontal regions, suggesting that repetition priming effects for spoken words reflect changes within systems involved in generating behavioral responses. Based on the current results, these processes are sufficiently abstract to display priming despite changes in the physical form of the stimulus and operate equivalently for words and pseudowords.

Dissociation of automatic and strategic lexical-semantics: functional magnetic resonance imaging evidence for differing roles of multiple frontotemporal regions

Behavioral research has demonstrated three major components of the lexical-semantic processing system: automatic activation of semantic representations, strategic retrieval of semantic representations, and inhibition of competitors. However, these component processes are inherently conflated in explicit lexical-semantic decision tasks typically used in functional magnetic resonance imaging (fMRI) research. Here, we combine the logic of behavioral priming studies and the neurophysiological phenomenon of fMRI priming to dissociate the neural bases of automatic and strategic lexical-semantic processes across a series of three studies. A single lexical decision task was used in all studies, with stimulus onset asynchrony or linguistic relationship between prime and target being manipulated. Study 1 demonstrated automatic semantic priming in the left mid-fusiform gyrus (mid-FFG) and strategic semantic priming in five regions: left middle temporal gyrus (MTG), bilateral anterior cingulate, anterior left inferior prefrontal cortex (aLIPC), and posterior LIPC (pLIPC). These priming effects were explored in more detail in two subsequent studies. Study 2 replicated the automatic priming effect in mid-FFG and demonstrated that automatic priming in this region is preferential for the semantic domain. Study 3 demonstrated a neural dissociation in regions contributing to the strategic semantic priming effect. Strategic semantic facilitation was observed in the aLIPC and MTG, whereas strategic semantic inhibition was observed in the pLIPC and anterior cingulate. These studies provide reproducible evidence for a neural dissociation between three well established components of the lexical-semantic processing system.

Cerebral pathways in processing of affective prosody: A dynamic causal modeling study

This study was conducted to investigate the connectivity architecture of neural structures involved in processing of emotional speech melody (prosody). 24 subjects underwent event-related functional magnetic resonance imaging (fMRI) while rating the emotional valence of either prosody or semantics of binaurally presented adjectives. Conventional analysis of fMRI data revealed activation within the right posterior middle temporal gyrus and bilateral inferior frontal cortex during evaluation of affective prosody and left temporal pole, orbitofrontal, and medial superior frontal cortex during judgment of affective semantics. Dynamic causal modeling (DCM) in combination with Bayes factors was used to compare competing neurophysiological models with different intrinsic connectivity structures and input regions within the network of brain regions underlying comprehension of affective prosody. Comparison on group level revealed superiority of a model in which the right temporal cortex serves as input region as compared to models in which one of the frontal areas is assumed to receive external inputs. Moreover, models with parallel information conductance from the right temporal cortex were superior to models in which the two frontal lobes accomplish serial processing steps. In conclusion, connectivity analysis supports the view that evaluation of affective prosody requires prior analysis of acoustic features within the temporal and that transfer of information from the temporal cortex to the frontal lobes occurs via parallel pathways.

Convergence of connected language and SPECT in variants of frontotemporal lobar degeneration

The characterization of frontotemporal lobar degeneration (FTLD) is complicated and not widely recognized. Connected language measures (ie, discourse) and functional neuroimaging may advance knowledge specifying early distinctions among frontal dementias. The present study examined the correspondence of discourse measures with (1) clinical diagnosis and (2) single photon emission computed tomography (SPECT) imaging. Nineteen subjects were selected from Alzheimer's Disease Center (ADC) participants if they were diagnosed with early-stage frontotemporal lobar degeneration and also underwent single photon emission computed tomography and discourse evaluation. First, clinical diagnoses given by specialists at an Alzheimer's Disease Center were compared with the discourse-based diagnostic profiles. Secondly, compromised brain regions that were predicted from discourse profiles were compared with SPECT findings. Results revealed a significant correspondence between the ADC diagnosis and the discourse-based diagnoses. Also, the discourse profiles across frontotemporal lobar degeneration subtypes were consistently associated with distinctive patterns of SPECT hypometabolism in the right frontal, left frontal, or left temporal lobes. These findings suggest that discourse methods may be systematized to provide an efficient adjunct measure beyond the traditional word and sentential level measures. Objectifying complex language performance may contribute to early detection and differentiation among frontotemporal lobar degeneration variants because consensus in the literature states that language is a core disturbance of frontotemporal lobar degeneration.

One month of human memory consolidation enhances retrieval-related hippocampal activity

We studied the role of the hippocampus in memory retrieval at 1 day and 1 month following associative learning of word pairs. Retrieval-related brain activity was recorded using functional magnetic resonance imaging in 20 healthy students, of which 12 were good learners and eight were poor learners. At the day lag, the poor learners exhibited enhanced neural recruitment in the hippocampus and neocortex to reach a retrieval performance comparable to that of the good learners. Over the 20 subjects, there was a positive correlation between retrieval-related hippocampal activity at the day lag and forgetting over the month retention interval (the greater the activity, the more forgetting). Although the poor learners' retrieval performance declined dramatically from the day to the month lag, the good learners maintained a high retrieval performance, which distinguishes them as good memory consolidators. Their retrieval-related hippocampal and neocortical activity increased from the day to the month lag. This increase was observed both when retrieval performance was matched between the day and the month lag and when the learning procedure for information retrieved at the day and the month lag was matched. This activity increase in the task-specialized neural network from the day lag to the month lag may reflect an increase in task demands or the proliferation of hippocampal-neocortical memory traces during memory consolidation as suggested by the multiple trace theory.

How reading differs from object naming at the neuronal level

This paper uses whole brain functional neuroimaging in neurologically normal participants to explore how reading aloud differs from object naming in terms of neuronal implementation. In the first experiment, we directly compared brain activation during reading aloud and object naming. This revealed greater activation for reading in bilateral premotor, left posterior superior temporal and precuneus regions. In a second experiment, we segregated the object-naming system into object recognition and speech production areas by factorially manipulating the presence or absence of objects (pictures of objects or their meaningless scrambled counterparts) with the presence or absence of speech production (vocal vs. finger press responses). This demonstrated that the areas associated with speech production (object naming and repetitively saying "OK" to meaningless scrambled pictures) corresponded exactly to the areas where responses were higher for reading aloud than object naming in Experiment 1. Collectively the results suggest that, relative to object naming, reading increases the demands on shared speech production processes. At a cognitive level, enhanced activation for reading in speech production areas may reflect the multiple and competing phonological codes that are generated from the sublexical parts of written words. At a neuronal level, it may reflect differences in the speed with which different areas are activated and integrate with one another.

How does the brain support script comprehension? A study of executive processes and semantic knowledge in dementia

The neuropsychological substrate of scripts, routines which guide much of human behavior, is unclear. We propose a model of script comprehension characterized by the interaction of semantic knowledge for script content, and executive resources that organize this knowledge into goal directed behavior. We examined these neuropsychological components by asking participants with Alzheimer's disease (AD) and frontotemporal dementia (behavioral disorder/dysexecutive syndrome (BDD) and semantic dementia (SD) subtypes), to judge the coherence of four-phrase scripts. The BDD group detected significantly fewer sequencing errors than semantic errors; the AD and SD groups detected these errors with equal frequency. Independent semantic measures predicted both semantic and sequencing script errors, while executive measures predicted sequencing errors only. Findings support a multi-component model of script comprehension.

Decomposition of metabolic brain clusters in the frontal variant of frontotemporal dementia

Previous studies that measured brain activity in frontotemporal dementia (FTD) used univariate analyses, examining each region of interest separately. We explored in a multicenter European research program the principal brain clusters characterized by a common variability in cerebral metabolism in FTD. Seventy patients with frontal variant (fv) FTD were selected according to international clinical recommendations; principal component analysis (PCA) was performed on FDG-PET metabolic images, looking for covariance clusters in this large population. A first metabolic cluster included most of the lateral and medial prefrontal cortex, bilaterally; PC1 scores correlated with performances on memory and executive neuropsychological tasks. Moreover, FDG-PET images in fv-FTD were further characterized by a metabolic covariance in two clusters comprising the subcallosal medial frontal region, the temporal pole, medial temporal structures and the striatum, separately in the left and in the right hemisphere. The study provides original data-driven arguments for metabolic involvement of separate brain clusters in the rostral limbic system, corresponding to pathological poles differentially affected in each FTD patient.

Mapping of temporal and parietal cortex in progressive nonfluent aphasia and Alzheimer's disease using chemical shift imaging, voxel-based morphometry and positron emission tomography

Little and controversial evidence is available from neuroimaging studies in progressive nonfluent aphasia (PNA). The goal of this study was to combine information from different imaging modalities in PNA compared with Alzheimer's disease (AD). Chemical shift imaging (CSI), voxel-based morphometry (VBM) and fluorodeoxyglucose positron emission tomography (FDG-PET) were used in 5 PNA, 10 AD patients and 10 normal subjects. Group comparisons revealed left anterior lateral temporal abnormalities (BA20/21) in PNA using CSI, VBM and PET in comparison to normal subjects. AD patients showed more limited hypometabolism within the same area. In addition left lateral parietal (BA40) abnormalities were demonstrated in our PNA as well as our AD group using PET and VBM (AD group only). Combining information from all imaging modalities on a single case basis revealed pathology within the left anterior lateral temporal and lateral parietal lobe both in PNA and AD. PNA and AD patients differed significantly, however, with respect to the frequency of medial temporal lobe and posterior cingulate/precuneus involvement. Although our results might not be generalizable to all subgroups of PNA, we conclude that medial temporal and posterior cingulate/precuneus cortex pathology as assessed by CSI and VBM or PET distinguish PNA from AD, whereas lateral temporal and parietal areas are involved in both conditions.

Right anterior superior temporal activation predicts auditory sentence comprehension following aphasic stroke

Previous studies have suggested that recovery of speech comprehension after left hemisphere infarction may depend on a mechanism in the right hemisphere. However, the role that distinct right hemisphere regions play in speech comprehension following left hemisphere stroke has not been established. Here, we used functional magnetic resonance imaging (fMRI) to investigate narrative speech activation in 18 neurologically normal subjects and 17 patients with left hemisphere stroke and a history of aphasia. Activation for listening to meaningful stories relative to meaningless reversed speech was identified in the normal subjects and in each patient. Second level analyses were then used to investigate how story activation changed with the patients' auditory sentence comprehension skills and surprise story recognition memory tests post-scanning. Irrespective of lesion site, performance on tests of auditory sentence comprehension was positively correlated with activation in the right lateral superior temporal region, anterior to primary auditory cortex. In addition, when the stroke spared the left temporal cortex, good performance on tests of auditory sentence comprehension was also correlated with the left posterior superior temporal cortex (Wernicke's area). In distinct contrast to this, good story recognition memory predicted left inferior frontal and right cerebellar activation. The implication of this double dissociation in the effects of auditory sentence comprehension and story recognition memory is that left frontal and left temporal activations are dissociable. Our findings strongly support the role of the right temporal lobe in processing narrative speech and, in particular, auditory sentence comprehension following left hemisphere aphasic stroke. In addition, they highlight the importance of the right anterior superior temporal cortex where the response was dissociated from that in the left posterior temporal lobe.

The relationship of structural alterations to cognitive deficits in schizophrenia: a voxel-based morphometry study

BACKGROUND

Region of interest studies have identified a number of structure-cognition associations in schizophrenia and revealed alterations in structure-cognition relationship in this population.

METHODS

We examined the relationship of structural brain alterations, identified using voxel-based morphometry, to cognitive deficits in 45 schizophrenia patients relative to 43 healthy control subjects and tested the hypothesis that structure-cognition relationship is altered in schizophrenia.

RESULTS

Patients had smaller total brain, gray matter, and white matter volumes. Regional alterations were left-hemisphere specific, including: gray matter reduction of inferior frontal, lingual, and anterior superior temporal gyri; white matter reduction of posterior and occipital lobes; and gray matter increase of the putamen and the precuneus. Smaller whole brain and gray matter volumes were associated with lower premorbid intelligence quotient (IQ) and poorer performance on IQ-dependent cognitive measures in patients and to a similar extent in control subjects. Larger precuneus was associated with better immediate verbal memory in patients, whereas verbal and nonverbal memory were positively associated with inferior frontal gyrus volume in control subjects. Smaller occipital white matter volume was associated with slower information processing speed in patients but not in control subjects.

CONCLUSIONS

Regional volume alterations are associated with specific cognitive deficits in schizophrenia. Some structure-cognition relationships differentiate this population from healthy control subjects.

Language network specializations: an analysis with parallel task designs and functional magnetic resonance imaging

Although the classical core regions of the language system (Broca's and Wernicke's areas) were defined over a century ago, it took the advent of functional imaging to sharpen our understanding of how these regions and adjacent parts of the brain are associated with particular aspects of language. One limitation of such studies has been the need to compare results across different subject groups, each performing a different type of language task. Thus, this study was designed to examine overlapping versus segregated brain activations associated with three fundamental language tasks, orthography, phonology and semantics performed by the same subjects during a single experimental session. The results demonstrate a set of primarily left-sided core language regions in ventrolateral frontal, supplementary motor, posterior mid-temporal, occipito-temporal and inferior parietal areas, which were activated for all language tasks. Segregated task-specific activations were demonstrated within the ventrolateral frontal, mid-temporal and inferior parietal areas. Within the inferior frontal cortex (Broca's regional complex), segregated activations were seen for the semantic and phonological tasks. These findings demonstrate both common and task specific activations within the language system.

Retrieving accurate and distorted memories: Neuroimaging evidence for effects of emotion

While limbic activity is known to be associated with successful encoding of emotional information, it is less clear whether it is related to successful retrieval. The present fMRI study assessed the effects of emotion on the neural processes engaged during retrieval of accurate compared to distorted memories. Prior to the scan, participants (16 young adults) viewed names of neutral (e.g., frog) and emotional (e.g., snake) objects and formed a mental image of the object named. They were shown photos of half of the objects. During the fMRI scan, participants saw object names and indicated whether or not they had seen the corresponding photo. Memory distortions (misattributions) occurred when participants incorrectly indicated whether or not a photo had been studied. Activity in some regions (e.g., L anterior hippocampus) was related to accurate retrieval (correct attributions > misattributions) for emotional and neutral items. However, activity in other regions corresponded with accurate retrieval specifically for emotional items (e.g., in R amygdala/periamygdaloid cortex and L orbitofrontal cortex) or for neutral items (e.g., in lateral inferior prefrontal cortex and R posterior hippocampus). Results indicate that emotional salience modulates the processes engaged during accurate retrieval and that activity in limbic regions corresponds with accurate memory assignment for emotional items. To our knowledge, this study is the first to demonstrate a link between limbic engagement at retrieval and accurate memory attribution.

Aging affects both perceptual and lexical/semantic components of word stem priming: An event-related fMRI study

In this event-related fMRI study, brain activity patterns were compared in extensive groups of young (N=25) and older (N=38) adults, while they were performing a word stem completion priming task. Based on behavioral findings, we tested the hypothesis that aging affects only the lexical/semantic, but not the perceptual component of word stem priming. To this end, we distinguished between priming-related activity reductions in posterior regions involved in visual processing, and regions associated with lexical/semantic retrieval processes, i.e., left lateral temporal and left prefrontal regions. Both groups revealed significant priming-related response time reductions. However, in accordance with earlier findings, a larger priming effect was found in the group of young participants. In line with previous imaging studies, the groups showed common priming-related activity reductions in the anterior cingulate, and the left inferior prefrontal cortex extending into the anterior portion of the left superior temporal gyrus, and at lower thresholds also in the right occipital lobe. However, when directly comparing the groups, greater priming-related reductions were found for the young group in the left anterior superior temporal gyrus and the right posterior occipital lobe. These findings suggest that, converse to current psychological views, aging affects both perceptual and lexical/semantic components of repetition priming.

Dissociating neuro-cognitive component processes: voxel-based correlational methodology

Relating behavioural deficits to lesion site has long been an important tool for localising the brain bases of cognitive function. Voxel-based methods, based on statistical analyses of structural brain images, allow a major step forward in the effectiveness of this approach. These methods provide a fine-grained assessment of damaged tissue by assigning a continuous value to each voxel over the entire brain. This information, correlated with continuous behavioural data reflecting specific aspects of cognition, offers new opportunities for identifying the neural organisation underlying cognitive function. The research reported here demonstrates the ability of this correlational methodology to differentiate between the neuro-cognitive components involved in word recognition and lexical decision, providing an important new tool for directly linking brain areas to specific aspects of psychological performance.

Semantic memory retrieval: cortical couplings in object recognition in the N400 window

To characterize the regional changes in neuronal couplings and information transfer related to semantic aspects of object recognition in humans we used partial-directed EEG-coherence analysis (PDC). We examined the differences of processing recognizable and unrecognizable pictures as reflected by changes in cortical networks within the time-window of a determined event-related potential (ERP) component, namely the N400. Fourteen participants performed an image recognition task, while sequentially confronted with pictures of recognizable and unrecognizable objects. The time-window of N400 as indicative of object semantics was defined from the ERP. Differences of PDC in the beta-band between these tasks were represented topographically as patterns of electrical couplings, possibly indicating changing degrees of functional cooperation between brain areas. Successful memory retrieval of picture meaning appears to be supported by networks comprising left temporal and parietal regions and bilateral frontal brain areas.

Reading skills after left anterior temporal lobe resection: an fMRI study

Maintaining language functions after left hemisphere lesions has been associated with compensatory right hemisphere activation. It remains unclear whether recruitment of right hemisphere regions necessarily provides an effective mechanism to compensate for language deficits. To investigate the compensatory mechanisms that mediate good reading skills in patients after left anterior temporal lobe resection for mesial temporal lobe epilepsy (mTLE), we tested for the effect of their reading ability on the regional fMRI (functional MRI) signal elicited by sentence reading. Sixteen control subjects and 16 patients participated in the study. In the activation condition, they silently read nine-word sentences, and in the baseline condition they viewed nine-word sentences after all the letters were transformed into false fonts. Reading ability in controls and patients significantly (P < 0.05, corrected) predicted activations in a left hemisphere middle temporal region that was part of the normal sentence reading system. In addition, reading ability in patients, but not controls, significantly predicted activation in the right inferior frontal sulcus, right hippocampus and right inferior temporal sulcus. Right inferior frontal activation was only observed in the patients. In contrast, right hippocampal and inferior temporal activation was observed in all controls and in patients whose reading ability was within the normal range, indicating the importance of these regions for efficient encoding during normal sentence reading. We conclude that proficient reading skills following left anterior temporal lobe resection for mTLE rely on two mechanisms: (i) integrating regions from the normal system (i.e. the left middle temporal, right hippocampus and anterior superior temporal sulcus); and (ii) recruiting right hemisphere regions (i.e. the right inferior frontal sulcus) that are not activated in control subjects.

Remembering and forgetting of semantic knowledge in amnesia: a 16-year follow-up investigation of RFR

We report our long-term follow-up investigations of RFR, a post-encephalitic case of very grave anterograde and retrograde amnesia. We also describe the results of quantitative neuroimaging of his brain injury that showed bilateral and severe reduction in the hippocampal formation and medial temporal structures with sparing of left lateral/posterior and right posterior temporal cortex. We established that RFR had a persistent severe anterograde and retrograde amnesia for personal and public events. His personal semantic knowledge was relatively spared for the retrograde period. There was a modest and global reduction in RFR's vocabulary for words acquired in adulthood before he became amnesic but there was no evidence of any retrograde gradient. His retrograde knowledge of people was also without any gradient. Remarkably, there had been no change in the extent of his semantic knowledge across a prolonged re-test interval indicating that the loss of semantic knowledge was stable and likely to have arisen at the time of his initial lesion. RFR also showed evidence of a limited but significant ability to acquire new word meanings and a more restricted capacity for learning about new celebrities. While he was able to demonstrate face and name familiarity for newly famous people, he was unable to provide much semantic detail. RFR's amnesia can be partially explained by contemporary theories that allow for parallel cortical and hippocampal memory systems but is difficult to reconcile in detail with any extant view.

Anterior temporal laterality in primary progressive aphasia shifts to the right

In aphasia due to stroke, language-related activity shifts not only to undamaged cortex within the dominant hemisphere but also toward right-sided areas homotopical to the left-sided lesion. We examined whether a rightward shift takes place in primary progressive aphasia (PPA). Nineteen PPA patients participated, 19 healthy subjects and 14 patients with amnestic mild cognitive impairment who served as controls. Subjects underwent neuropsychological assessment, structural magnetic resonance imaging (MRI), and a functional MRI with a factorial design: words versus pictures and associative-semantic versus visuoperceptual task. Measures of neuropsychological performance were entered as regressors into a multiple linear regression analysis, with response amplitude during the associative-semantic versus control conditions as outcome variable. Language competence correlated negatively with responses in the right anterior temporal cortex and positively with volume and responses in the left-sided homotope. In normal subjects, anterior temporal activation was more extensive to the left than the right (laterality index [LI], +0.64; standard error [SE], 0.11). Laterality was inverted in PPA with word comprehension deficit (LI, - 0.34; SE, 0.19), with an intermediate pattern in PPA without comprehension deficit (LI, +0.23; SE, 0.14). The rightward laterality shift previously reported in aphasic stroke extends to PPA, in particular, when comprehension is deficient.

Distinct unimodal and multimodal regions for word processing in the left temporal cortex

How are word recognition circuits organized in the left temporal lobe? We used functional magnetic resonance imaging (fMRI) to dissect cortical word-processing circuits using three diagnostic criteria: the capacity of an area (1) to respond to words in a single modality (visual or auditory) or in both modalities, (2) to modulate its response in a top-down manner as a function of the graphemic or phonemic emphasis of the task, and (3) to show repetition suppression in response to the conscious repetition of the target word within the same sensory modality or across different modalities. The results clarify the organization of visual and auditory word-processing streams. In particular, the visual word form area (VWFA) in the left occipitotemporal sulcus appears strictly as a visual unimodal area. It is, however, bordered by a second lateral inferotemporal area which is multimodal [lateral inferotemporal multimodal area (LIMA)]. Both areas might have been confounded in past work. Our results also suggest a possible homolog of the VWFA in the auditory stream, the auditory word form area, located in the left anterior superior temporal sulcus.

Cerebral metabolic patterns at early stages of frontotemporal dementia and semantic dementia. A PET study

OBJECTIVE

To determine the patterns of cerebral glucose metabolism in frontotemporal dementia (FTD) and semantic dementia (SD).

METHODS

25 patients with mild FTD and 9 patients with mild SD as well as 15 healthy age-matched control subjects underwent 18F-FDG- positron emission tomography. Patient scans were compared with control scans using SPM-99.

RESULTS

As compared with healthy control subjects patients with FTD showed an extensive symmetrical hypometabolism of the frontal lobes (height threshold P <0.01) which spared the motor cortex. Patients with SD showed a hypometabolism in the whole left temporal lobe and in the right temporal pole.

CONCLUSIONS

In the clinical syndromes of FTD and SD two distinct patterns of cerebral metabolism were identified. FTD was associated with frontal hypometabolism, whereas in SD cerebral glucose metabolism was exclusively reduced in the temporal lobes. Our findings are consistent with the notion that FTD and SD begin as strictly lobar neuronal degenerations and that a spread of pathological changes is not seen until more advanced stages.

Dorsal and ventral streams: a framework for understanding aspects of the functional anatomy of language

Despite intensive work on language-brain relations, and a fairly impressive accumulation of knowledge over the last several decades, there has been little progress in developing large-scale models of the functional anatomy of language that integrate neuropsychological, neuroimaging, and psycholinguistic data. Drawing on relatively recent developments in the cortical organization of vision, and on data from a variety of sources, we propose a new framework for understanding aspects of the functional anatomy of language which moves towards remedying this situation. The framework posits that early cortical stages of speech perception involve auditory fields in the superior temporal gyrus bilaterally (although asymmetrically). This cortical processing system then diverges into two broad processing streams, a ventral stream, which is involved in mapping sound onto meaning, and a dorsal stream, which is involved in mapping sound onto articulatory-based representations. The ventral stream projects ventro-laterally toward inferior posterior temporal cortex (posterior middle temporal gyrus) which serves as an interface between sound-based representations of speech in the superior temporal gyrus (again bilaterally) and widely distributed conceptual representations. The dorsal stream projects dorso-posteriorly involving a region in the posterior Sylvian fissure at the parietal-temporal boundary (area Spt), and ultimately projecting to frontal regions. This network provides a mechanism for the development and maintenance of "parity" between auditory and motor representations of speech. Although the proposed dorsal stream represents a very tight connection between processes involved in speech perception and speech production, it does not appear to be a critical component of the speech perception process under normal (ecologically natural) listening conditions, that is, when speech input is mapped onto a conceptual representation. We also propose some degree of bi-directionality in both the dorsal and ventral pathways. We discuss some recent empirical tests of this framework that utilize a range of methods. We also show how damage to different components of this framework can account for the major symptom clusters of the fluent aphasias, and discuss some recent evidence concerning how sentence-level processing might be integrated into the framework.

Dissociation of numbers and objects in corticobasal degeneration and semantic dementia

BACKGROUND

Semantic memory is thought to consist of category-specific representations of knowledge that may be selectively compromised in patients with neurodegenerative diseases, but this has been difficult to demonstrate reliably across object categories.

METHODS

The authors evaluated performance on several simple measures requiring number representations (including addition and magnitude judgments of single digits), and on a task that requires object representations (an object naming task) in patients with corticobasal degeneration (CBD; n = 13) and semantic dementia (SD; n = 15). They also examined regional cortical atrophy using voxel-based morphometric analyses of high resolution structural MRI in subgroups of five CBD patients and three SD patients.

RESULTS

CBD patients were consistently more impaired on simple addition and magnitude judgment tasks requiring number representations compared to object representations. Impaired performance with numbers in CBD was associated with cortical atrophy in right parietal cortex. By comparison, SD patients demonstrated a greater impairment on a naming task requiring object representations relative to their performance on measures involving number representations. This was associated with left anterior temporal cortical atrophy.

CONCLUSION

The cognitive and neuroanatomic dissociations between CBD and SD are consistent with the hypothesis that number and object representations constitute distinct domains in semantic memory, and these domains appear to be associated with distinct neural substrates.

A Neurocomputational Model of Analogical Reasoning and its Breakdown in Frontotemporal Lobar Degeneration

Analogy is important for learning and discovery and is considered a core component of intelligence. We present a computational account of analogical reasoning that is compatible with data we have collected from patients with cortical degeneration of either their frontal or anterior temporal cortices due to frontotemporal lobar degeneration (FTLD). These two patient groups showed different deficits in picture and verbal analogies: frontal lobe FTLD patients tended to make errors due to impairments in working memory and inhibitory abilities, whereas temporal lobe FTLD patients tended to make errors due to semantic memory loss. Using the “Learning and Inference with Schemas and Analogies” model, we provide a specific account of how such deficits may arise within neural networks supporting analogical problem solving.

Alzheimer’s disease and frontotemporal dementia exhibit distinct atrophy-behavior correlates

RATIONALE AND OBJECTIVES

The purpose of this study was to test the hypothesis that distinct patterns of gray matter atrophy are responsible for unique interruptions of the naming process in Alzheimer's disease (AD) and frontotemporal dementia (FTD).

MATERIALS AND METHODS

Voxel-based morphometry (VBM) was performed to characterize at the voxel level the neuroanatomic changes that occur in AD and FTD based on high-resolution T1-weighted three-dimensional (3D) spoiled-gradient echo images of patients (AD, n = 12; FTD, n = 29) and healthy control subjects (n = 12). The cortical atrophy measurements were correlated with performance on behavioral measures of naming and related processes to identify brain regions that may contribute to this language function.

RESULTS

Both AD and FTD have significant naming difficulty, and this difficulty in naming correlates with a measure of lexical retrieval in both patient groups as well. However, only FTD patients showed a correlation with semantic memory. Areas of cortical atrophy common to AD and FTD were found in the anterior temporal, posterolateral temporal, and dorsolateral prefrontal regions of the left hemisphere. Correlation with naming in both AD and FTD was seen in the left anterior temporal cortex, suggesting that this area may play a role in the lexical retrieval component of naming. We also observed several unique areas of cortical atrophy in temporal and frontal cortices of these patients. Right anterior temporal and left posterolateral temporal regions of atrophy correlated with naming difficulty in FTD, suggesting that these areas may contribute to the semantic memory component of naming. Cortical areas correlating with naming that are not atrophic may represent regions that play an optional role in naming.

CONCLUSION

VBM provides an important first step in analyzing brain-behavior relations in vivo in patients with neurodegenerative diseases. More refined analyses of brain morphology via high-dimensional normalization methods that are capable of modeling local as well as global variability in neuroanatomical structure promise to be even more informative.

A combined neuropsychological and neuroimaging study of topographical and non-verbal memory in semantic dementia

A combined neuropsychological and neuroimaging investigation was carried out on a patient (O.I.) with semantic dementia who had asymmetrical temporal lobe atrophy, greater on the left. His performance on tests of verbal memory was gravely impaired. Similarly, his visual memory as indexed by recognition of unfamiliar faces was impaired. By contrast, his recognition memory for topographical memoranda (e.g. buildings, landscapes) and ability to find his way around was preserved. In order to identify the neural substrates supporting the preserved recognition of static topographical memoranda, O.I. was scanned using positron emission tomography (PET) during the encoding and recognition of building and landscape stimuli. In common with control subjects, during encoding O.I. activated parahippocampal cortex bilaterally, along with bilateral temporo-parietal, retrosplenial and left frontal cortices. During recognition, both patient and controls activated right parahippocampal, right superior parietal and right frontal cortices. Notably, control subjects, but not O.I., also activated at encoding the precuneus and at recognition the retrosplenial cortex. This allows the conclusion that these two areas while involved may not be necessary for topographical memory. Interestingly, the patient also activated regions that were not evident in control subjects both during encoding and recognition. These additional areas of activation may be necessary in a compensatory role. Overall, these data represent the first reported assessment of the functional integrity of degenerating brain tissue and its contribution to preserved topographical memory. The combination of the neuropsychological and neuroimaging approaches may provide insights into the functional-anatomy of memory while having clinical utility for the assessment of residual brain tissue.

Neural mechanisms of visual object priming: evidence for perceptual and semantic distinctions in fusiform cortex

Previous functional imaging studies have shown that facilitated processing of a visual object on repeated, relative to initial, presentation (i.e., repetition priming) is associated with reductions in neural activity in multiple regions, including fusiform/lateral occipital cortex. Moreover, activity reductions have been found, at diminished levels, when a different exemplar of an object is presented on repetition. In one previous study, the magnitude of diminished priming across exemplars was greater in the right relative to the left fusiform, suggesting greater exemplar specificity in the right. Another previous study, however, observed fusiform lateralization modulated by object viewpoint, but not object exemplar. The present fMRI study sought to determine whether the result of differential fusiform responses for perceptually different exemplars could be replicated. Furthermore, the role of the left fusiform cortex in object recognition was investigated via the inclusion of a lexical/semantic manipulation. Right fusiform cortex showed a significantly greater effect of exemplar change than left fusiform, replicating the previous result of exemplar-specific fusiform lateralization. Right fusiform and lateral occipital cortex were not differentially engaged by the lexical/semantic manipulation, suggesting that their role in visual object recognition is predominantly in the visual discrimination of specific objects. Activation in left fusiform cortex, but not left lateral occipital cortex, was modulated by both exemplar change and lexical/semantic manipulation, with further analysis suggesting a posterior-to-anterior progression between regions involved in processing visuoperceptual and lexical/semantic information about objects. The results are consistent with the view that the right fusiform plays a greater role in processing specific visual form information about objects, whereas the left fusiform is also involved in lexical/semantic processing.