1
|
Tsolakopoulos D, Kasselimis D, Laskaris N, Angelopoulou G, Papageorgiou G, Velonakis G, Varkanitsa M, Tountopoulou A, Vassilopoulou S, Goutsos D, Potagas C. Exploring Pragmatic Deficits in Relation to Theory of Mind and Executive Functions: Evidence from Individuals with Right Hemisphere Stroke. Brain Sci 2023; 13:1385. [PMID: 37891754 PMCID: PMC10605575 DOI: 10.3390/brainsci13101385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Research investigating pragmatic deficits in individuals with right hemisphere damage focuses on identifying the potential mechanisms responsible for the nature of these impairments. Nonetheless, the presumed shared cognitive mechanisms that could account for these deficits have not yet been established through data-based evidence from lesion studies. This study aimed to examine the co-occurrence of pragmatic language deficits, Theory of Mind impairments, and executive functions while also exploring their associations with brain lesion sites. Twenty-five patients suffering from unilateral right hemisphere stroke and thirty-seven healthy participants were recruited for this study. The two groups were tested in pragmatics, Theory of Mind, and executive function tasks. Structural imaging data were also obtained for the identification of the lesion sites. The findings of this study suggest a potential convergence among the three aforementioned cognitive mechanisms. Moreover, we postulate a hypothesis for a neural circuitry for communication impairments observed in individuals with right hemisphere damage.
Collapse
Affiliation(s)
- Dimitrios Tsolakopoulos
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
| | - Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
- Department of Psychology, Panteion University of Social and Political Sciences, 17671 Athens, Greece
| | - Nikolaos Laskaris
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, 12243 Athens, Greece
| | - Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
| | - Georgios Papageorgiou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
| | - Georgios Velonakis
- Second Department of Radiology, Attikon General University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Maria Varkanitsa
- Center for Brain Recovery, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
| | - Argyro Tountopoulou
- Stroke Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Sofia Vassilopoulou
- Stroke Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Dionysis Goutsos
- Department of Linguistics, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Constantin Potagas
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 72-74 Vas. Sofias Av., 11528 Athens, Greece
| |
Collapse
|
2
|
Belan AFR, Pais MV, Camargo MVZDA, Sant'Ana LCFG, Radanovic M, Forlenza OV. Diagnostic Performance of an Eye-Tracking Assisted Visual Inference Language Test in the Assessment of Cognitive Decline due to Alzheimer's Disease. J Alzheimers Dis 2023:JAD230250. [PMID: 37355905 DOI: 10.3233/jad-230250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND The assessment of language changes associated with visual search impairment can be an important diagnostic tool in the Alzheimer's disease (AD) continuum. OBJECTIVE Investigate the performance of an eye-tracking assisted visual inference language task in differentiating subjects with mild cognitive impairment (MCI) or AD dementia from cognitively unimpaired older adults (controls). METHODS We assessed a group of 95 older adults (49 MCI, 18 mild dementia due to AD, and 28 controls). The subjects performed the same task under multiple experimental conditions which generate correlated responses that need to be taken into account. Thus, we performed a non-parametric repeated measures ANOVA model for verbal answers, and a linear mixed model (LMM) or its generalized version for the analysis of eye tracking variables. RESULTS Significant differences were found in verbal answers across all diagnostic groups independently of type of inference, i.e., logic or pragmatic. Also, eye-tracking parameters were able to discriminate AD from MCI and controls. AD patients did more visits to challenge stimulus (Control-AD, -0.622, SE = 0.190, p = 0.004; MCI-AD, -0.514, SE = 0.173, p = 0.011), more visits to the correct response stimulus (Control-AD, -1.363, SE = 0.383, p = 0.002; MCI-AD, -0.946, SE = 0.349, p = 0.022), more fixations on distractors (Control-AD, -4.580, SE = 1.172, p = 0.001; MCI-AD, -2.940, SE = 1.070, p = 0.020), and a longer time to first fixation on the correct response stimulus (Control-AD, -0.622, SE = 0.190, p = 0.004; MCI-AD, -0.514, SE = 0.173, p = 0.011). CONCLUSION The analysis of oculomotor behavior along with language assessment protocols may increase the sensitivity for detection of subtle deficits in the MCI-AD continuum, representing an important diagnostic tool.
Collapse
Affiliation(s)
- Ariella Fornachari Ribeiro Belan
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Sao Paulo, SP, Brazil
| | - Marcos Vasconcelos Pais
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Sao Paulo, SP, Brazil
- UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Marina von Zuben de Arruda Camargo
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Sao Paulo, SP, Brazil
| | - Livea Carla Fidalgo Garcêz Sant'Ana
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Sao Paulo, SP, Brazil
| | - Marcia Radanovic
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Sao Paulo, SP, Brazil
| | - Orestes Vicente Forlenza
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Sao Paulo, SP, Brazil
| |
Collapse
|
3
|
Kim YSG. Inferencing Skill and Attentional Control Account for the Connection Between Reading Comprehension and Mathematics. Front Psychol 2021; 12:709944. [PMID: 34690867 PMCID: PMC8531081 DOI: 10.3389/fpsyg.2021.709944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022] Open
Abstract
We examined the relations of inference, vocabulary, decoding, short-term memory, and attentional control to reading comprehension and mathematics performance for first-grade students in the US (N = 83). The students were composed of 75% Hispanics, 15% Whites, and 6% Asian Americans. Students' performance on mathematics and reading comprehension were very strongly related (r = 0.88). Results from path analysis showed that inference (0.27 ≤ s ≤ 0.38) was independently and positively related to both reading comprehension and mathematics performance after accounting for short-term memory, attentional control, decoding, and vocabulary. Decoding was independently related to reading comprehension, but not mathematics, whereas vocabulary was independently related to mathematics, but not to reading comprehension. Attentional control was directly related to mathematics, and indirectly related to reading comprehension and mathematics via inference, vocabulary, and decoding, with a substantial total effect on reading comprehension and mathematics (0.56 respectively). Short-term memory was not directly nor indirectly related to reading comprehension and mathematics. Overall these results show that language and cognitive skills are shared resources of reading comprehension and mathematics, and highlight the roles of attentional control and inference skill in reading comprehension and mathematics.
Collapse
|
4
|
Lugtmeijer S, Lammers NA, de Haan EHF, de Leeuw FE, Kessels RPC. Post-Stroke Working Memory Dysfunction: A Meta-Analysis and Systematic Review. Neuropsychol Rev 2020; 31:202-219. [PMID: 33230717 PMCID: PMC7889582 DOI: 10.1007/s11065-020-09462-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
This review investigates the severity and nature of post-stroke working memory deficits with reference to the multi-component model of working memory. We conducted a systematic search in PubMed up to March 2019 with search terms for stroke and memory. Studies on adult stroke patients, that included a control group, and assessed working memory function, were selected. Effect sizes (Hedges' g) were extracted from 50 studies (in total 3,084 stroke patients) based on the sample size, mean and standard deviation of patients and controls. Performance of stroke patients was compared to healthy controls on low-load (i.e. capacity) and high-load (executively demanding) working memory tasks, grouped by modality (verbal, non-verbal). A separate analysis compared patients in the sub-acute and the chronic stage. Longitudinal studies and effects of lesion location were systematically reviewed. Stroke patients demonstrated significant deficits in working memory with a moderate effect size for both low-load (Hedges' g = -.58 [-.82 to -.43]) and high-load (Hedges' g = -.59 [-.73 to -.45]) tasks. The effect sizes were comparable for verbal and non-verbal material. Systematically reviewing the literature showed that working memory deficits remain prominent in the chronic stage of stroke. Lesions in a widespread fronto-parietal network are associated with working memory deficits. Stroke patients show decrements of moderate magnitude in all subsystems of working memory. This review clearly demonstrates the global nature of the impairment in working memory post-stroke.
Collapse
Affiliation(s)
- Selma Lugtmeijer
- University of Amsterdam, Amsterdam, the Netherlands. .,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
| | | | | | - Frank-Erik de Leeuw
- Radboud University Medical Center, Department of Neurology, Nijmegen, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| |
Collapse
|
5
|
Loss of white matter connections after severe traumatic brain injury (TBI) and its relationship to social cognition. Brain Imaging Behav 2019; 13:819-829. [PMID: 29948905 DOI: 10.1007/s11682-018-9906-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Adults with severe traumatic brain injury (TBI) often suffer poor social cognition. Social cognition is complex, requiring verbal, non-verbal, auditory, visual and affective input and integration. While damage to focal temporal and frontal areas has been implicated in disorders of social cognition after TBI, the role of white matter pathology has not been examined. In this study 17 adults with chronic, severe TBI and 17 control participants underwent structural MRI scans and Diffusion Tensor Imaging. The Awareness of Social Inference Test (TASIT) was used to assess their ability to understand emotional states, thoughts, intentions and conversational meaning in everyday exchanges. Track-based spatial statistics were used to perform voxelwise analysis of Fractional Anisotropy (FA) and Mean Diffusivity (MD) of white matter tracts associated with poor social cognitive performance. FA suggested a wide range of tracts were implicated in poor TASIT performance including tracts known to mediate, auditory localisation (planum temporale) communication between nonverbal and verbal processes in general (corpus callosum) and in memory in particular (fornix) as well as tracts and structures associated with semantics and verbal recall (left temporal lobe and hippocampus), multimodal processing and integration (thalamus, external capsule, cerebellum) and with social cognition (orbitofrontal cortex, frontopolar cortex, right temporal lobe). Even when controlling for non-social cognition, the corpus callosum, fornix, bilateral thalamus, right external capsule and right temporal lobe remained significant contributors to social cognitive performance. This study highlights the importance of loss of white matter connectivity in producing complex social information processing deficits after TBI.
Collapse
|
6
|
Adams AG, Schweitzer D, Molenberghs P, Henry JD. A meta-analytic review of social cognitive function following stroke. Neurosci Biobehav Rev 2019; 102:400-416. [DOI: 10.1016/j.neubiorev.2019.03.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/14/2019] [Accepted: 03/14/2019] [Indexed: 01/20/2023]
|
7
|
Silagi ML, Radanovic M, Conforto AB, Mendonça LIZ, Mansur LL. Inference comprehension in text reading: Performance of individuals with right- versus left-hemisphere lesions and the influence of cognitive functions. PLoS One 2018; 13:e0197195. [PMID: 29795602 PMCID: PMC5968410 DOI: 10.1371/journal.pone.0197195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 04/27/2018] [Indexed: 11/18/2022] Open
Abstract
Background Right-hemisphere lesions (RHL) may impair inference comprehension. However, comparative studies between left-hemisphere lesions (LHL) and RHL are rare, especially regarding reading comprehension. Moreover, further knowledge of the influence of cognition on inferential processing in this task is needed. Objectives To compare the performance of patients with RHL and LHL on an inference reading comprehension task. We also aimed to analyze the effects of lesion site and to verify correlations between cognitive functions and performance on the task. Methods Seventy-five subjects were equally divided into the groups RHL, LHL, and control group (CG). The Implicit Management Test was used to evaluate inference comprehension. In this test, subjects read short written passages and subsequently answer five types of questions (explicit, logical, distractor, pragmatic, and other), which require different types of inferential reasoning. The cognitive functional domains of attention, memory, executive functions, language, and visuospatial abilities were assessed using the Cognitive Linguistic Quick Test (CLQT). Results The LHL and RHL groups presented difficulties in inferential comprehension in comparison with the CG. However, the RHL group presented lower scores than the LHL group on logical, pragmatic and other questions. A covariance analysis did not show any effect of lesion site within the hemispheres. Overall, all cognitive domains were correlated with all the types of questions from the inference test (especially logical, pragmatic, and other). Attention and visuospatial abilities affected the scores of both the RHL and LHL groups, and only memory influenced the performance of the RHL group. Conclusions Lesions in either hemisphere may cause difficulties in making inferences during reading. However, processing more complex inferences was more difficult for patients with RHL than for those with LHL, which suggests that the right hemisphere plays an important role in tasks with higher comprehension demands. Cognition influences inferential processing during reading in brain-injured subjects.
Collapse
Affiliation(s)
- Marcela Lima Silagi
- Department of Physical Therapy, Speech-Language Pathology and Audiology, and Occupational Therapy, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- * E-mail:
| | - Marcia Radanovic
- Department of Psychiatry, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | | | - Leticia Lessa Mansur
- Department of Physical Therapy, Speech-Language Pathology and Audiology, and Occupational Therapy, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
8
|
Wenke RJ, Cornwell P, Theodoros DG. Changes to articulation following LSVT(R) and traditional dysarthria therapy in non-progressive dysarthria. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2010; 12:203-220. [PMID: 20433339 DOI: 10.3109/17549500903568468] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The present study aimed to evaluate the effects of the Lee Silverman Voice Treatment (LSVT(R)) on acoustic and perceptual measures of articulation in non-progressive dysarthria in comparison to traditional dysarthria therapy. The study involved 26 individuals with non-progressive dysarthria who were randomly allocated to receive either LSVT(R) or traditional dysarthria therapy (TRAD), both of which were administered for 16 hourly sessions over 4 weeks. Participants' speech samples were collected over a total of six testing sessions during three assessment phases: (1) prior to treatment, (2) immediately post-treatment, and (3) 6 months post-treatment (FU). Speech samples were analysed perceptually to determine articulatory precision and intelligibility as well as acoustically using vowel space (and vowel formant measures) and first moment differences. Results revealed short and long-term significant increases in vowel space area following LSVT(R). Significantly increased intelligibility was also found at FU in the LSVT(R) group. No significant differences between groups for any variables were found. The study reveals that LSVT(R) may be a suitable treatment option for improving vowel articulation and subsequent intelligibility in some individuals with non-progressive dysarthria.
Collapse
|
9
|
Wenke RJ, Theodoros D, Cornwell P. The short- and long-term effectiveness of the LSVT®for dysarthria following TBI and stroke. Brain Inj 2009; 22:339-52. [DOI: 10.1080/02699050801960987] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
10
|
Humbert IA, Fitzgerald ME, McLaren DG, Johnson S, Porcaro E, Kosmatka K, Hind J, Robbins J. Neurophysiology of swallowing: effects of age and bolus type. Neuroimage 2008; 44:982-91. [PMID: 19010424 DOI: 10.1016/j.neuroimage.2008.10.012] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Revised: 09/25/2008] [Accepted: 10/07/2008] [Indexed: 11/26/2022] Open
Abstract
This study examined age-related changes in swallowing from an integrated biomechanical and functional imaging perspective in order to more comprehensively characterize changes in swallowing associated with age. We examined swallowing-related fMRI brain activity and videoflouroscopic biomechanics of three bolus types (saliva, water and barium) in 12 young and 11 older adults. We found that age-related neurophysiological changes in swallowing are evident. The group of older adults recruited more cortical regions than young adults, including the pericentral gyri and inferior frontal gyrus pars opercularis and pars triangularis (primarily right-sided). Saliva swallows elicited significantly higher BOLD responses in regions important for swallowing compared to water and barium. In separate videofluoroscopy sessions, we obtained durational measures of supine swallowing. The older cohort had significantly longer delays before the onset of the pharyngeal swallow response and increased residue of ingested material in the pharynx. These findings suggest that older adults without neurological insult elicit more cortical involvement to complete the same swallowing tasks as younger adults.
Collapse
Affiliation(s)
- Ianessa A Humbert
- William S Middleton Memorial Veterans Hospital, Geriatric Research Education and Clinical Center, Madison, WI, USA.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Weed E. Theory of mind impairment in right hemisphere damage: A review of the evidence. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2008; 10:414-424. [PMID: 20840021 DOI: 10.1080/17549500802455429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Among the hypothesized causes of communication impairments in people with damage to the right cerebral hemisphere (RHD) is an underlying impairment in Theory of Mind (ToM) (the ability to make inferences about other peoples' mental states). In this review, evidence is considered for a ToM impairment in adults with RHD by approaching the issue from two directions. First, indirect evidence for impairment of ToM is reviewed by looking at studies on the effects of RHD on the comprehension of indirect requests, that is, requests in which the speaker's wishes are not explicitly stated but must be inferred by the listener. Second, studies that directly investigate the effects of RHD on performance on tasks intended to tap ToM are reviewed. On the basis of the papers reviewed here, it is concluded that although people with RHD do show impairments on a variety of tasks that are thought to involve ToM cognition, evidence for a specific ToM impairment is still inconclusive. It is recommended that future studies take care to distinguish individual differences in participants' linguistic production and lesion location, that more care is taken to control for task difficulty, and that well-controlled studies are combined with more naturalistic, ecologically valid tasks.
Collapse
|