Semantic priming in patients with Alzheimer and semantic dementia

Preserved Extra-Foveal Processing of Object Semantics in Alzheimer's Disease

Alzheimer's disease (AD) patients underperform on a range of tasks requiring semantic processing, but it is unclear whether this impairment is due to a generalised loss of semantic knowledge or to issues in accessing and selecting such information from memory. The objective of this eye-tracking visual search study was to determine whether semantic expectancy mechanisms known to support object recognition in healthy adults are preserved in AD patients. Furthermore, as AD patients are often reported to be impaired in accessing information in extra-foveal vision, we investigated whether that was also the case in our study. Twenty AD patients and 20 age-matched controls searched for a target object among an array of distractors presented extra-foveally. The distractors were either semantically related or unrelated to the target (e.g., a car in an array with other vehicles or kitchen items). Results showed that semantically related objects were detected with more difficulty than semantically unrelated objects by both groups, but more markedly by the AD group. Participants looked earlier and for longer at the critical objects when these were semantically unrelated to the distractors. Our findings show that AD patients can process the semantics of objects and access it in extra-foveal vision. This suggests that their impairments in semantic processing may reflect difficulties in accessing semantic information rather than a generalised loss of semantic memory.

Knowledge Representations Derived From Semantic Fluency Data

The semantic fluency task is commonly used as a measure of one’s ability to retrieve semantic concepts. While performance is typically scored by counting the total number of responses, the ordering of responses can be used to estimate how individuals or groups organize semantic concepts within a category. I provide an overview of this methodology, using Alzheimer’s disease as a case study for how the approach can help advance theoretical questions about the nature of semantic representation. However, many open questions surrounding the validity and reliability of this approach remain unresolved.

Anomia as a marker of distinct semantic memory impairments in Alzheimer's disease and semantic dementia

OBJECTIVE

Many neurologically constrained models of semantic memory have been informed by two primary temporal lobe pathologies: Alzheimer's disease (AD) and Semantic Dementia (SD). However, controversy persists regarding the nature of the semantic impairment associated with these patient populations. Some argue that AD presents as a disconnection syndrome in which linguistic impairment reflects difficulties in lexical or perceptual means of semantic access. In contrast, there is a wider consensus that SD reflects loss of core knowledge that underlies word and object meaning. Object naming provides a window into the integrity of semantic knowledge in these two populations.

METHOD

We examined naming accuracy, errors and the correlation of naming ability with neuropsychological measures (semantic ability, executive functioning, and working memory) in a large sample of patients with AD (n = 36) and SD (n = 21).

RESULTS

Naming ability and naming errors differed between groups, as did neuropsychological predictors of naming ability. Despite a similar extent of baseline cognitive impairment, SD patients were more anomic than AD patients.

CONCLUSIONS

These results add to a growing body of literature supporting a dual impairment to semantic content and active semantic processing in AD, and confirm the fundamental deficit in semantic content in SD. We interpret these findings as supporting of a model of semantic memory premised upon dynamic interactivity between the process and content of conceptual knowledge.

Altered brain response for semantic knowledge in Alzheimer's disease

Word retrieval deficits are common in Alzheimer's disease (AD) and are thought to reflect a degradation of semantic memory. Yet, the nature of semantic deterioration in AD and the underlying neural correlates of these semantic memory changes remain largely unknown. We examined the semantic memory impairment in AD by investigating the neural correlates of category knowledge (e.g., living vs. nonliving) and featural processing (global vs. local visual information). During event-related fMRI, 10 adults diagnosed with mild AD and 22 cognitively normal (CN) older adults named aloud items from three categories for which processing of specific visual features has previously been dissociated from categorical features. Results showed widespread group differences in the categorical representation of semantic knowledge in several language-related brain areas. For example, the right inferior frontal gyrus showed selective brain response for nonliving items in the CN group but living items in the AD group. Additionally, the AD group showed increased brain response for word retrieval irrespective of category in Broca's homologue in the right hemisphere and rostral cingulate cortex bilaterally, which suggests greater recruitment of frontally mediated neural compensatory mechanisms in the face of semantic alteration.

Memory loss in Alzheimer's disease: implications for development of therapeutics

Alzheimer's disease (AD) is a progressive neurodegenerative disease marked by a constellation of cognitive disturbances, the earliest and most prominent being impaired episodic memory. Episodic memory refers to the memory system that allows an individual to consciously retrieve a previously experienced item or episode of life. Many recent studies have focused on characterizing how AD pathology impacts particular aspects of episodic memory and underlying mental and neural processes. This review summarizes the findings of those studies and discusses the effects of current and promising treatments for AD on episodic memory. The goal of this review is to raise awareness of the strides that cognitive neuroscientists have made in understanding intact and dysfunctional memory. Knowledge of the specific memorial processes that are impaired in AD may be of great value to basic scientists developing novel therapies and to clinical researchers assessing the efficacy of those therapies.

The underlying mechanisms of semantic memory loss in Alzheimer's disease and semantic dementia

Patients with Alzheimer's disease (AD) and patients with semantic dementia (SD) both exhibit deficits on explicit tasks of semantic memory such as picture naming and category fluency. These deficits have been attributed to a degradation of the stored semantic network. An alternative explanation attributes the semantic deficit in AD to an impaired ability to consciously retrieve items from the semantic network. The present study used an implicit lexical-decision priming task to examine the integrity of the underlying semantic network in AD and SD patients matched for degree of impairment on explicit semantic memory tasks. The AD (n=11) and SD (n=11) patient groups were matched for age, education, level of dementia and impairment on four explicit semantic memory tasks. Healthy elderly participants (n=22) were matched for age and education. Semantic priming effects were evaluated for three types of semantic relationships (attributes, category coordinates, and category superordinates) and compared to lexical associative priming. Healthy controls showed significant priming across all conditions. In contrast, AD patients showed normal superordinate priming, and significant (although somewhat reduced) coordinate priming, but no attribute priming. SD patients showed no priming effect for any semantic relationship. All groups showed significant associative priming. The results indicate that SD patients do indeed have substantial degradation of semantic memory, while AD patients have a partially intact network, accounting for priming in superordinate and coordinate conditions. These findings suggest that AD patients' impairment on explicit semantic tasks is the product of deficient explicit retrieval in combination with a partially degraded semantic network.

Handwriting Process Variables Discriminating Mild Alzheimer's Disease and Mild Cognitive Impairment

This study's aims were (a) to examine kinematically the handwriting process of persons with mild cognitive impairment (MCI), compared with those with mild Alzheimer's disease and healthy controls; (b) to assess the importance of these measures for the differentiation of the groups; and (c) to assess characteristics of the handwriting process across different functional tasks. Thirty-one persons with MCI, 22 with mild Alzheimer's disease, and 41 healthy controls performed functional tasks while using a computerized system. We found significant differences between the groups in almost all measures, with the MCI group assuming a position between the other groups. Temporal measures were higher and pressure was lower in more cognitively deteriorated groups. Information gathered about kinematic measures, together with cognitive functioning, allowed us to classify 69% to 72% of the participants correctly, although the classification for the MCI group was relatively poor.

Conceptual priming in semantic dementia: A window into the cognitive and neural basis of conceptual implicit memory

The present study examined the impact of impairment in semantic memory on conceptual repetition priming by means of the longitudinal study of a patient with semantic dementia. ST was tested in four consecutive years, during which his semantic memory progressively deteriorated. On each occasion, he performed an abstract/concrete verification task and a verb generation task. In both of these tasks, performance during a test phase was compared for stimuli previously processed in a study phase and stimuli first seen in the test phase. Control subjects showed priming, as indicated by faster responses to studied than to baseline stimuli. ST showed intact priming that was of normal magnitude in the first two years of testing, but failed to show priming in the subsequent two years of testing. This pattern of results is interpreted with reference to the differential decline of item-specific and superordinate knowledge. The implications of these findings for the neural basis of conceptual priming are also discussed.

Information content versus relational knowledge: Semantic deficits in patients with Alzheimer's disease

Studies of semantic impairment in Alzheimer's disease (AD) have yielded conflicting results, some finding evidence of considerable deficits, others finding that semantic knowledge is relatively intact. How do we reconcile findings from picture naming tasks that seem to indicate semantic impairment in AD with results from certain sorting tasks that suggest intact semantics? To investigate the basis of the contradictory results described above, we conducted a study using two types of tasks: (1) picture naming; and (2) board sorting. The board sorting task we used is a simultaneous similarity judgment task, in which participants are asked to place more similar concepts closer together and less similar ones farther apart. We compared the performance of AD patients on these two tasks, using a number of different analyses that yield very different patterns of results. Our results indicate that whether patients show impairment or not depends on both the nature of the task and the subsequent analysis chosen. Specifically, tasks and analyses that focus on relational knowledge (e.g., dog is more related to cat than to camel) lead to different conclusions than those based on specific information about individual items. These findings suggest that the board sorting method, when coupled with multiple analyses, provides a more complete picture of the underlying semantic deficit in AD than previous studies have shown.

On the use of scaling and clustering in the study of semantic deficits

In the past decade, several studies have used scaling and clustering techniques to document semantic storage deficits in patients with Alzheimer's disease and in schizophrenia. In this article the authors argued that many of the conclusions drawn from these studies are unjustified by the data. They reviewed the methodology used in these studies and presented data from simulation studies to further investigate the validity of their conclusions. The authors elaborate on the criteria needed to exclude alternative accounts of the data and present empirical data from patients with Alzheimer's disease and normal control participants to demonstrate that analyses of the patients' proximity data do not provide unambiguous evidence for a generalized semantic storage deficit.

Role of the anterior temporal lobe in repetition and semantic priming: evidence from a patient with a category-specific deficit

Neuroimaging studies in healthy participants have implicated anterior temporal lobe regions and the fusiform gyrus in repetition priming and semantic priming. Only the investigation of patients with selective lesions, however, can establish the necessity of these particular regions. To this end, we administered three tests of repetition priming (pseudoword identification; masked-form priming; category-exemplar generation) and a test of semantic priming to a patient (J.P.) with a category-specific deficit stemming from bilateral damage to the anterior fusiform gyrus and anterior temporal regions. On all of the repetition priming tasks, J.P. showed priming effects within 1 S.D. of 10 age- and education-matched CON; ANOVAs indicated no interaction between group and prime condition. These findings suggest that the anterior fusiform and anterior temporal lobe are not required for these priming effects. J.P. also showed normal repetition priming even for items that he had never been able to name or to provide semantic information about. On the semantic priming task, J.P. showed normal levels of priming across categories. When we separately analyzed his priming for items he could never name or access information about versus items that he had been able to name on at least two testing sessions, we found priming for the latter items, but not for the former. This result suggests that category-specific deficits resulting from damage to the anterior temporal lobes may disrupt the automatic, rapid access of semantic information of some items.