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Benhamou E, Zhao S, Sivasathiaseelan H, Johnson JCS, Requena-Komuro MC, Bond RL, van Leeuwen JEP, Russell LL, Greaves CV, Nelson A, Nicholas JM, Hardy CJD, Rohrer JD, Warren JD. Decoding expectation and surprise in dementia: the paradigm of music. Brain Commun 2021; 3:fcab173. [PMID: 34423301 PMCID: PMC8376684 DOI: 10.1093/braincomms/fcab173] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Making predictions about the world and responding appropriately to unexpected events are essential functions of the healthy brain. In neurodegenerative disorders, such as frontotemporal dementia and Alzheimer's disease, impaired processing of 'surprise' may underpin a diverse array of symptoms, particularly abnormalities of social and emotional behaviour, but is challenging to characterize. Here, we addressed this issue using a novel paradigm: music. We studied 62 patients (24 female; aged 53-88) representing major syndromes of frontotemporal dementia (behavioural variant, semantic variant primary progressive aphasia, non-fluent-agrammatic variant primary progressive aphasia) and typical amnestic Alzheimer's disease, in relation to 33 healthy controls (18 female; aged 54-78). Participants heard famous melodies containing no deviants or one of three types of deviant note-acoustic (white-noise burst), syntactic (key-violating pitch change) or semantic (key-preserving pitch change). Using a regression model that took elementary perceptual, executive and musical competence into account, we assessed accuracy detecting melodic deviants and simultaneously recorded pupillary responses and related these to deviant surprise value (information-content) and carrier melody predictability (entropy), calculated using an unsupervised machine learning model of music. Neuroanatomical associations of deviant detection accuracy and coupling of detection to deviant surprise value were assessed using voxel-based morphometry of patients' brain MRI. Whereas Alzheimer's disease was associated with normal deviant detection accuracy, behavioural and semantic variant frontotemporal dementia syndromes were associated with strikingly similar profiles of impaired syntactic and semantic deviant detection accuracy and impaired behavioural and autonomic sensitivity to deviant information-content (all P < 0.05). On the other hand, non-fluent-agrammatic primary progressive aphasia was associated with generalized impairment of deviant discriminability (P < 0.05) due to excessive false-alarms, despite retained behavioural and autonomic sensitivity to deviant information-content and melody predictability. Across the patient cohort, grey matter correlates of acoustic deviant detection accuracy were identified in precuneus, mid and mesial temporal regions; correlates of syntactic deviant detection accuracy and information-content processing, in inferior frontal and anterior temporal cortices, putamen and nucleus accumbens; and a common correlate of musical salience coding in supplementary motor area (all P < 0.05, corrected for multiple comparisons in pre-specified regions of interest). Our findings suggest that major dementias have distinct profiles of sensory 'surprise' processing, as instantiated in music. Music may be a useful and informative paradigm for probing the predictive decoding of complex sensory environments in neurodegenerative proteinopathies, with implications for understanding and measuring the core pathophysiology of these diseases.
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Affiliation(s)
- Elia Benhamou
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Sijia Zhao
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
| | - Harri Sivasathiaseelan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Jeremy C S Johnson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Maï-Carmen Requena-Komuro
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Rebecca L Bond
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Janneke E P van Leeuwen
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Lucy L Russell
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Caroline V Greaves
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Annabel Nelson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Jennifer M Nicholas
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris J D Hardy
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK
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Impairment of homonymous processing in Alzheimer's disease. Neurol Sci 2015; 36:1331-6. [PMID: 25630454 DOI: 10.1007/s10072-015-2085-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
Abstract
An important issue in research on language is how concepts are represented and associated with each other in the brain. Many investigations have focused on language ambiguity and the phenomenon of homonymy in which a single lexical item, presenting the same form, is related to different meanings. Our study aims to test the hypothesis that weak association of meaning characterizing homonyms may be especially prone to brain damage. To verify this hypothesis a test of attribution of the meaning of homonymous words, the Humpty Dumpty (HD) test, was applied to 50 patients with Alzheimer's disease (AD) and 50 healthy subjects. Results show that AD patients are impaired in the HD test in an early phase of disease and that performance correlates with naming ability and phonological fluency. The data are in keeping with a growing body of literature that supports dual impairment to the semantic system in AD, i.e., to semantic knowledge and active processing and access to the semantic field. The evaluation of the ability to resolve homonymous ambiguity, using the HD test, may provide a useful and quick clinical tool to detect the anomalies of the semantic network linked to either a loss of the core system where meaning of words is stored or an impairment of the access to an intact semantic representation.
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Schecker M, Kochler C, Schmidtke K, Rauh R. Are There Any Connections between Language Deficits and Cognitive Slowing in Alzheimer's Disease? Dement Geriatr Cogn Dis Extra 2014; 4:442-9. [PMID: 25538728 PMCID: PMC4264518 DOI: 10.1159/000368317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Speech disorders already occur in the early phases of Alzheimer's disease (AD). As a possible cause, problems of executive processes are discussed. Cognitive slowing is also repeatedly addressed. Aims Are there any connections between cognitive slowing and speech disorders in AD? And is there a relationship between cognitive slowing and executive processes? Methods The data of 72 healthy controls and 52 AD patients were examined with regard to their language performance and their response times in a computerized Stroop paradigm. Results The AD patients showed significantly worse results in all language tests as well as much longer reaction times in all Stroop conditions, especially in the interference condition (Stroop 3). Speech errors and response times correlated with severity (MMSE), and the speech errors correlated with the reaction times in Stroop 3 (interference condition, which reflects the processing time of executive processes). Conclusion The most interesting question now is: How are language processing and executive processing time (Stroop 3) related?
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Affiliation(s)
- Michael Schecker
- Neurolinguistisches Labor NLL, Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Universität Freiburg, Freiburg, Germany
| | - Carsten Kochler
- Neurolinguistisches Labor NLL, Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Universität Freiburg, Freiburg, Germany
| | - Klaus Schmidtke
- Klinik für Hirnleistungsstörungen Klausenbach, Nordrach, Universität Freiburg, Freiburg, Germany
| | - Reinhold Rauh
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Universität Freiburg, Freiburg, Germany
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Taler V, Klepousniotou E, Phillips NA. Comprehension of lexical ambiguity in healthy aging, mild cognitive impairment, and mild Alzheimer's disease. Neuropsychologia 2009; 47:1332-43. [DOI: 10.1016/j.neuropsychologia.2009.01.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 12/30/2008] [Accepted: 01/22/2009] [Indexed: 11/28/2022]
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Taler V, Jarema G. Processing of mass/count information in Alzheimer's disease and mild cognitive impairment. BRAIN AND LANGUAGE 2004; 90:262-275. [PMID: 15172544 DOI: 10.1016/s0093-934x(03)00439-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/03/2003] [Indexed: 05/24/2023]
Abstract
This study examines the processing of a specific linguistic distinction, the mass/count distinction, in patients suffering from Alzheimer's disease (AD) and mild cognitive impairment (MCI). Fourteen AD and 10 MCI subjects were tested using a sentence grammaticality judgement task where grammaticality violations were caused by determiner-noun mismatches, as well as a sentence-picture matching task to assess their ability to access mass and count readings of dual nouns. Considerable heterogeneity was observed within each subject group, and performance across groups was almost identical. It is concluded that a combination of linguistic and attentional and/or learning factors are responsible for the range of impairments; specifically, a subset of subjects exhibit no linguistic nor attentional/learning impairment, another subset exhibit only an attentional and/or learning impairment but no linguistic impairment, and a third subset (comprising more than half of the subjects included in this study) exhibit a linguistic impairment. It is postulated that the latter group have difficulty processing sense extensions in metonymous nouns. It is further claimed that, at least within the limits of the study, language impairments can be of the same severity and nature across AD and MCI subjects.
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Affiliation(s)
- Vanessa Taler
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Que., Canada.
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