Clinical, imaging and pathological correlates of a hereditary deficit in verb and action processing

Editing reality in the brain

Recent information technologies such as virtual reality (VR) and augmented reality (AR) allow the creation of simulated sensory worlds with which we can interact. Using programming language, digital details can be overlaid onto displays of our environment, confounding what is real and what has been artificially engineered. Natural language, particularly the use of direct verbal suggestion (DVS) in everyday and hypnotic contexts, can also manipulate the meaning and significance of objects and events in ourselves and others. In this review, we focus on how socially rewarding language can construct and influence reality. Language is symbolic, automatic and flexible and can be used to augment bodily sensations e.g. feelings of heaviness in a limb or suggest a colour that is not there. We introduce the term ‘suggested reality’ (SR) to refer to the important role that language, specifically DVS, plays in constructing, maintaining and manipulating our shared reality. We also propose the term edited reality to encompass the wider influence of information technology and linguistic techniques that results in altered subjective experience and review its use in clinical settings, while acknowledging its limitations. We develop a cognitive model indicating how the brain’s central executive structures use our personal and linguistic-based narrative in subjective awareness, arguing for a central role for language in DVS. A better understanding of the characteristics of VR, AR and SR and their applications in everyday life, research and clinical settings can help us to better understand our own reality and how it can be edited.

What matters is the underlying experience: Similar motor responses during processing observed hand actions and hand-related verbs

It is well-accepted that processing observed actions involves at some extent the same neural mechanisms responsible for action execution. More recently, it has been forwarded that also the processing of verbs expressing a specific motor content is subserved by the neural mechanisms allowing individuals to perform the content expressed by that linguistic material. This view is also known as embodiment and contrasts with a more classical approach to language processing that considers it as amodal. In the present study, we used a go/no-go paradigm, in which participants were requested to respond to real words and pictures and refrain from responding when presented stimuli were pseudowords and scrambled images. Real stimuli included pictures depicting hand- and foot-related actions and verbs expressing hand- and foot-related actions. We, therefore, directly compared the modulation of hand motor responses during the observation of actions and the presentation of verbs, expressing actions in the same category. The results have shown that participants gave slower hand motor responses during the observation of hand actions and the processing of hand-related verbs as than observed foot actions and related verbs. These findings support embodiment showing that whatever the modality of presentation (observed action or verb), the modulation of hand motor responses was similar, thus suggesting that processing seen actions and related verbs shares common mechanisms most likely involving the motor system and the underlying motor experience.

Semantic Memory and Lexical Availability in Parkinson's Disease: A Statistical Learning Study

Parkinson’s disease (PD) is a neurodegenerative disorder that causes a progressive impairment in motor and cognitive functions. Although semantic fluency deficits have been described in PD, more specific semantic memory (SM) and lexical availability (LA) domains have not been previously addressed. Here, we aimed to characterize the cognitive performance of PD patients in a set of SM and LA measures and determine the smallest set of neuropsychological (lexical, semantic, or executive) variables that most accurately classify groups. Thirty early-stage non-demented PD patients (age 35–75, 10 females) and thirty healthy controls (age 36–76, 12 females) were assessed via general cognitive, SM [three subtests of the CaGi battery including living (i.e., elephant) and non-living things (i.e., fork)], and LA (eliciting words from 10 semantic categories related to everyday life) measures. Results showed that PD patients performed lower than controls in two SM global scores (picture naming and naming in response to an oral description). This impairment was particularly pronounced in the non-living things subscale. Also, the number of words in the LA measure was inferior in PD patients than controls, in both larger and smaller semantic fields, showing a more inadequate recall strategy. Notably, the classification algorithms indicated that the SM task had high classification accuracy. In particular, the denomination of non-living things had a classification accuracy of ∼80%. These results suggest that frontostriatal deterioration in PD leads to search strategy deficits in SF and the potential disruption in semantic categorization. These findings are consistent with the embodied view of cognition.

Language impairment in progressive supranuclear palsy and corticobasal syndrome

Although commonly known as movement disorders, progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) may present with changes in speech and language alongside or even before motor symptoms. The differential diagnosis of these two disorders can be challenging, especially in the early stages. Here we review their impact on speech and language. We discuss the neurobiological and clinical-phenomenological overlap of PSP and CBS with each other, and with other disorders including non-fluent agrammatic primary progressive aphasia and primary progressive apraxia of speech. Because language impairment is often an early and persistent problem in CBS and PSP, there is a need for improved methods for language screening in primary and secondary care, and more detailed language assessments in tertiary healthcare settings. Improved language assessment may aid differential diagnosis as well as inform clinical management decisions.

Towards Strong Inference in Research on Embodiment - Possibilities and Limitations of Causal Paradigms

A central question in the cognitive sciences is which role embodiment plays for high-level cognitive functions, such as conceptual processing. Here, we propose that one reason why progress regarding this question has been slow is a lacking focus on what Platt (1964) called “strong inference”. Strong inference is possible when results from an experimental paradigm are not merely consistent with a hypothesis, but they provide decisive evidence for one particular hypothesis compared to competing hypotheses. We discuss how causal paradigms, which test the functional relevance of sensory-motor processes for high-level cognitive functions, can move the field forward. In particular, we explore how congenital sensory-motor disorders, acquired sensory-motor deficits, and interference paradigms with healthy participants can be utilized as an opportunity to better understand the role of sensory experience in conceptual processing. Whereas all three approaches can bring about valuable insights, we highlight that the study of congenitally and acquired sensorimotor disorders is particularly effective in the case of conceptual domains with strong unimodal basis (e.g., colors), whereas interference paradigms with healthy participants have a broader application, avoid many of the practical and interpretational limitations of patient studies, and allow a systematic and step-wise progressive inference approach to causal mechanisms.

Why Language Processing Recruits Modality Specific Brain Regions: It Is Not About Understanding Words, but About Modelling Situations

Whether language comprehension requires the participation of brain structures that evolved for perception and action has been a subject of intense debate. While brain-imaging evidence for the involvement of such modality-specific regions has grown, the fact that lesions to these structures do not necessarily erase word knowledge has invited the conclusion that language-induced activity in these structures might not be essential for word recognition. Why language processing recruits these structures remains unanswered, however. Here, we examine the original findings from a slightly different perspective. We first consider the 'original' function of structures in modality-specific brain regions that are recruited by language activity. We propose that these structures help elaborate 'internal forward models' in motor control (c.f. emulators). Emulators are brain systems that capture the relationship between an action and its sensory consequences. During language processing emulators could thus allow accessing associative memories. We further postulate the existence of a linguistic system that exploits, in a rule-based manner, emulators and other nonlinguistic brain systems, to gain complementary (and redundant) information during language processing. Emulators are therefore just one of several sources of information. We emphasize that whether a given word-form triggers activity in modality-specific brain regions depends on the linguistic context and not on the word-form as such. The role of modality-specific systems in language processing is thus not to help understanding words but to model the verbally depicted situation by supplying memorized context information. We present a model derived from these assumptions and provide predictions and perspectives for future research.

Brain Activation During Conceptual Processing of Action and Sound Verbs

Grounded cognition approaches to conceptual representations postulate a close link between conceptual knowledge and the sensorimotor brain systems. The present fMRI study tested, whether a feature-specific representation of concepts, as previously demonstrated for nouns, can also be found for action- and sound-related verbs. Participants were presented with action- and soundrelated verbs along with pseudoverbs while performing a lexical decision task. Sound-related verbs activated auditory areas in the temporal cortex, whereas action-related verbs activated brain regions in the superior frontal gyrus and the cerebellum, albeit only at a more liberal threshold. This differential brain activation during conceptual verb processing partially overlapped with or was adjacent to brain regions activated during the functional localizers probing sound perception or action execution. Activity in brain areas involved in the processing of action information was parametrically modulated by ratings of action relevance. Comparisons of action- and sound-related verbs with pseudoverbs revealed activation for both verb categories in auditory and motor areas. In contrast to proposals of strong grounded cognition approaches, our study did not demonstrate a considerable overlap of activations for action- and sound-related verbs and for the corresponding functional localizer tasks. However, in line with weaker variants of grounded cognition theories, the differential activation pattern for action- and sound-related verbs was near corresponding sensorimotor brain regions depending on conceptual feature relevance. Possibly, action-sound coupling resulted in a mutual activation of the motor and the auditory system for both action- and sound-related verbs, thereby reducing the effect sizes for the differential contrasts.

Task-Dependent Recruitment of Modality-Specific and Multimodal Regions during Conceptual Processing

Conceptual knowledge is central to cognitive abilities such as word comprehension. Previous neuroimaging evidence indicates that concepts are at least partly composed of perceptual and motor features that are represented in the same modality-specific brain regions involved in actual perception and action. However, it is unclear to what extent the retrieval of perceptual-motor features and the resulting engagement of modality-specific regions depend on the concurrent task. To address this issue, we measured brain activity in 40 young and healthy participants using functional magnetic resonance imaging, while they performed three different tasks-lexical decision, sound judgment, and action judgment-on words that independently varied in their association with sounds and actions. We found neural activation for sound and action features of concepts selectively when they were task-relevant in brain regions also activated during auditory and motor tasks, respectively, as well as in higher-level, multimodal regions which were recruited during both sound and action feature retrieval. For the first time, we show that not only modality-specific perceptual-motor areas but also multimodal regions are engaged in conceptual processing in a flexible, task-dependent fashion, responding selectively to task-relevant conceptual features.

Embodied Semantics in a Second Language: Critical Review and Clinical Implications

The role of the sensorimotor system in second language (L2) semantic processing as well as its clinical implications for bilingual patients has hitherto been neglected. We offer an overview of the issues at stake in this under-investigated field, presenting the theoretical and clinical relevance of studying L2 embodiment and reviewing the few studies on this topic. We highlight that (a) the sensorimotor network is involved in L2 processing, and that (b) in most studies, L2 is differently embodied than L1, reflected in a lower degree or in a different pattern of L2 embodiment. Importantly, we outline critical issues to be addressed in order to guide future research. We also delineate the subsequent steps needed to confirm or dismiss the value of language therapeutic approaches based on embodiment theories as a complement of speech and language therapies in adult bilinguals.

The concreteness of abstract language: an ancient issue and a new perspective

This paper addresses the debated issue of abstract language in the framework of embodiment. First, we discuss the notion of abstractness in the light of the Western philosophical thought, with a focus on the English empiricist tradition. Second, we review the most relevant psychological models and neuroscientific empirical findings on abstract language. It turns out that abstract words are not such, because their meaning is "far from experience", but, because of the high complexity of the attached experiential clusters. Finally, we spell out the consequences of this understanding of abstractness in relation to the neural mechanisms subserving abstract language processing. If abstract words, as compared to concrete ones, imply an increasing complexity of the associated experiential clusters, then the processing of abstract language relies on the recruitment of several neural substrates coding for those experiences. We forward that, at the neural level, this complexity is coded by means of three main mechanisms: (1) the recruitment of the motor representations of different biological effectors (abstract meaning as effector-unspecific); (2) the recruitment of different systems, including sensory, motor, and emotional ones (abstract meaning as multi-systemic); (3) the recruitment of neural substrates coding for social contexts and levels of self-relatedness (abstract meaning as dynamic). As compared to the current approaches in the literature on abstract language that combine embodiment with some a-modal aspects, our proposal is fully embodied and rules out additional aspects. Our proposal may spur future empirical research on abstract language in the embodied approach.

The language profile of progressive supranuclear palsy

A progressive speech/language disorder, such as the non fluent/agrammatic variant of primary progressive aphasia and progressive apraxia of speech, can be due to neuropathologically verified Progressive Supranuclear Palsy (PSP). The prevalence of linguistic deficits and the linguistic profile in PSP patients who present primarily with a movement disorder is unknown. In the present study, we investigated speech and language performance in a sample of clinically diagnosed PSP patients using a comprehensive language battery, including, besides traditional language tests, a detailed analysis of connected speech (picture description task assessing 26 linguistic features). The aim was to identify the most affected linguistic levels in seventeen PSP with a movement disorder presentation, compared to 21 patients with Parkinson's disease and 27 healthy controls. Machine learning methods were used to detect the most relevant language tests and linguistic features characterizing the language profile of PSP patients. Our results indicate that even non-clinically aphasic PSP patients have subtle language deficits, in particular involving the lexical-semantic and discourse levels. Patients with the Richardson's syndrome showed a lower performance in the word comprehension task with respect to the other PSP phenotypes with predominant frontal presentation, parkinsonism and progressive gait freezing. The present findings support the usefulness of a detailed language assessment in all patients in the PSP spectrum.

Aphasia in Progressive Supranuclear Palsy: As Severe as Progressive Non-Fluent Aphasia

BACKGROUND

Adynamic speech is characteristic of progressive supranuclear palsy (PSP), but higher language deficits have been reported inconsistently, in the context of clinical and pathological overlaps with progressive non-fluent aphasia (PNFA).

OBJECTIVE

The present study tested two hypotheses: 1) PSP and PNFA display impaired single word repetition, object naming, semantic knowledge, and syntactic comprehension; and 2) PSP have reduced speed on timed cognitive tasks.

METHODS

Structured clinical and neuropsychological assessments of language were performed on patients with clinically defined PSP and PNFA. Language was tested using the Sydney Language Battery (SYDBAT) and the Test of Reception of Grammar (TROG).

RESULTS

In total, 144 participants were studied (PSP 22, PNFA 29, and Control 93). PSP patients had prominent eye movement abnormalities, parkinsonism, and falls. All 4 PSP patients who underwent postmortem examination had 4-Repeat tauopathy, with PSP pathology in 3. The frequency and severity of impairment on the SYDBAT (naming, word comprehension, semantic association), and TROG (syntactic comprehension) did not differ between PSP and PNFA, but PSP were significantly slower on timed non-language cognitive tests.

CONCLUSION

Tested formally, aphasia may be seen in PSP, with a severity similar to that seen in PNFA.

Action Semantics at the Bottom of the Brain: Insights From Dysplastic Cerebellar Gangliocytoma

Recent embodied cognition research shows that access to action verbs in shallow-processing tasks becomes selectively compromised upon atrophy of the cerebellum, a critical motor region. Here we assessed whether cerebellar damage also disturbs explicit semantic processing of action pictures and its integration with ongoing motor responses. We evaluated a cognitively preserved 33-year-old man with severe dysplastic cerebellar gangliocytoma (Lhermitte-Duclos disease), encompassing most of the right cerebellum and the posterior part of the left cerebellum. The patient and eight healthy controls completed two semantic association tasks (involving pictures of objects and actions, respectively) that required motor responses. Accuracy results via Crawford’s modified t-tests revealed that the patient was selectively impaired in action association. Moreover, reaction-time analysis through Crawford’s Revised Standardized Difference Test showed that, while processing of action concepts involved slower manual responses in controls, no such effect was observed in the patient, suggesting that motor-semantic integration dynamics may be compromised following cerebellar damage. Notably, a Bayesian Test for a Deficit allowing for Covariates revealed that these patterns remained after covarying for executive performance, indicating that they were not secondary to extra-linguistic impairments. Taken together, our results extend incipient findings on the embodied functions of the cerebellum, offering unprecedented evidence of its crucial role in processing non-verbal action meanings and integrating them with concomitant movements. These findings illuminate the relatively unexplored semantic functions of this region while calling for extensions of motor cognition models.

Falls in frontotemporal dementia and related syndromes

Frontotemporal dementia (FTD) and related diseases are important causes of younger-onset dementia. Falls may be a source of morbidity and mortality in FTD, but remain underreported, and very few high-quality studies have been performed. In this chapter, we briefly review the clinical features of FTD and related syndromes such as motor neuron disease (MND) and atypical parkinsonian syndromes, such as progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). Falls are frequently encountered in patients who present with FTD syndromes. Although cognitive impairment is associated with falls generally, motor symptoms and signs, as seen in FTD cases that overlap with atypical parkinsonian disorders such as PSP or CBS, or MND, appear to pose the greatest risk. At present, very few systematic studies have been performed to determine the precise frequency, timing, diagnostic implications, and complications of falls in FTD. Further studies are required to understand the scope of this problem, and to develop effective treatments and management strategies.

EEG source reconstruction evidence for the noun-verb neural dissociation along semantic dimensions

One of the long-standing issues in neurolinguistic research is about the neural basis of word representation, concerning whether grammatical classification or semantic difference causes the neural dissociation of brain activity patterns when processing different word categories, especially nouns and verbs. To disentangle this puzzle, four orthogonalized word categories in Chinese: unambiguous nouns (UN), unambiguous verbs (UV), ambiguous words with noun-biased semantics (AN), and ambiguous words with verb-biased semantics (AV) were adopted in an auditory task for recording electroencephalographic (EEG) signals from 128 electrodes on the scalps of twenty-two subjects. With the advanced current density reconstruction (CDR) algorithm and the constraint of standardized low-resolution electromagnetic tomography, the spatiotemporal brain dynamics of word processing were explored with the results that in multiple time periods including P1 (60-90ms), N1 (100-140ms), P200 (150-250ms) and N400 (350-450ms), noun-verb dissociation over the parietal-occipital and frontal-central cortices appeared not only between the UN-UV grammatical classes but also between the grammatically identical but semantically different AN-AV pairs. The apparent semantic dissociation within one grammatical class strongly suggests that the semantic difference rather than grammatical classification could be interpreted as the origin of the noun-verb neural dissociation. Our results also revealed that semantic dissociation occurs from an early stage and repeats in multiple phases, thus supporting a functionally hierarchical word processing mechanism.

The neuro-cognitive representations of symbols: the case of concrete words

We live our lives surrounded by symbols (e.g., road signs, logos, but especially words and numbers), and throughout our life we use them to evoke, communicate and reflect upon ideas and things that are not currently present to our senses. Symbols are represented in our brains at different levels of complexity: at the first and most simple level, as physical entities, in the corresponding primary and secondary sensory cortices. The crucial property of symbols, however, is that, despite the simplicity of their surface forms, they have the power of evoking higher order multifaceted representations that are implemented in distributed neural networks spanning a large portion of the cortex. The rich internal states that reflect our knowledge of the meaning of symbols are what we call semantic representations. In this review paper, we summarize our current knowledge of both the cognitive and neural substrates of semantic representations, focusing on concrete words (i.e., nouns or verbs referring to concrete objects and actions), which, together with numbers, are the most-studied and well defined classes of symbols. Following a systematic descriptive approach, we will organize this literature review around two key questions: what is the content of semantic representations? And, how are semantic representations implemented in the brain, in terms of localization and dynamics? While highlighting the main current opposing perspectives on these topics, we propose that a fruitful way to make substantial progress in this domain would be to adopt a geometrical view of semantic representations as points in high dimensional space, and to operationally partition the space of concrete word meaning into motor-perceptual and conceptual dimensions. By giving concrete examples of the kinds of research that can be done within this perspective, we illustrate how we believe this framework will foster theoretical speculations as well as empirical research.

The role of the motor system in action naming in patients with neurodegenerative extrapyramidal syndromes

Previous studies of patients with brain damage have suggested a close relationship between aphasia and movement disorders. Neurodegenerative extrapyramidal syndromes associated with cognitive impairment provide an interesting model for studying the neural substrates of cognitive and motor symptoms. In this review, we focused on studies investigating language production abilities in patients with Parkinson's disease (PD), Corticobasal Syndrome (CBS) and Progressive Supranuclear Palsy (PSP). According to some reports, these patients exhibit a reduction in performance in both action and object naming or verb production compared to healthy individuals. Furthermore, a disproportional impairment of action naming compared to object naming was systematically observed in patients with these disorders. The study of these clinical conditions offers the unique opportunity to examine the close link between linguistic features and motor characteristics of action. This particular pattern of language impairment may contribute to the debate on embodiment theory and on the involvement of the basal ganglia in language and in integrating language and movement. From a translational perspective, we suggest that language ability assessments are useful in the clinical work-up, along with neuropsychological and motor evaluations. Specific protocols should be developed in the near future to better characterize language deficits and to permit an early cognitive diagnosis. Moreover, the link between language deficits and motor impairment opens a new issue for treatment approaches. Treatment of one of these two symptoms may ameliorate the other, and treating both may produce a greater improvement in patients' global clinical conditions.

The midbrain-to-pons ratio distinguishes progressive supranuclear palsy from non-fluent primary progressive aphasias

BACKGROUND AND PURPOSE

To determine the clinical utility of the midbrain-to-pons (M/P) ratio as a clinical biomarker of progressive supranuclear palsy (PSP) in patients with non-fluent primary progressive aphasia syndromes.

METHODS

Patients with PSP, progressive non-fluent aphasia (PNFA) and logopenic progressive aphasia (LPA) were recruited. Patients were diagnosed clinically, but pathological confirmation was available in a proportion of patients. Midbrain and pons areas were measured using Osirix Lite, a free DICOM viewer. The M/P ratio and Magnetic Resonance Parkinsonism Index were calculated and their diagnostic utility compared.

RESULTS

A total of 72 participants were included (16 PSP, 18 PNFA, 16 LPA and 22 controls). Patients with PSP had motor features typical of the syndrome. Both the M/P ratio and Magnetic Resonance Parkinsonism Index differed significantly in PSP compared with controls. The M/P ratio was disproportionately reduced in PSP compared with PNFA and LPA (PSP, 0.182 ± 0.043; PNFA, 0.255 ± 0.034; LPA, 0.258 ± 0.033; controls, 0.292 ± 0.031; P < 0.001). An M/P ratio of ≤0.215 produced a positive predictive value of 77.8% for the diagnosis of PSP syndrome. Pathological examination revealed Alzheimer's disease in three cases (all LPA), pathological PSP in two cases (one clinical PSP and one PNFA) and corticobasal degeneration in one case (PNFA). The M/P ratio was ≤0.215 in both pathological cases of PSP.

CONCLUSIONS

The M/P ratio was disproportionately reduced in PSP, suggesting its potential as a clinical marker of the PSP syndrome. Larger studies of pathologically confirmed cases are needed to establish the M/P ratio as a biomarker of PSP pathology.

Dissociation between Semantic Representations for Motion and Action Verbs: Evidence from Patients with Left Hemisphere Lesions

This multiple single case study contrasted left hemisphere stroke patients (N = 6) to healthy age-matched control participants (N = 15) on their understanding of action (e.g., holding, clenching) and motion verbs (e.g., crumbling, flowing). The tasks required participants to correctly identify the matching verb or associated picture. Dissociations on action and motion verb content depending on lesion site were expected. As predicted for verbs containing an action and/or motion content, modified t-tests confirmed selective deficits in processing motion verbs in patients with lesions involving posterior parietal and lateral occipitotemporal cortex. In contrast, deficits in verbs describing motionless actions were found in patients with more anterior lesions sparing posterior parietal and lateral occipitotemporal cortex. These findings support the hypotheses that semantic representations for action and motion are behaviorally and neuro-anatomically dissociable. The findings clarify the differential and critical role of perceptual and motor regions in processing modality-specific semantic knowledge as opposed to a supportive but not necessary role. We contextualize these results within theories from both cognitive psychology and cognitive neuroscience that make claims over the role of sensory and motor information in semantic representation.

Lexical-retrieval and semantic memory in Parkinson's disease: The question of noun and verb dissociation

The dissociation between the processing of verbs and nouns has been debated in light of the Embodied Cognition Theory (EC). The objective of this paper is to verify how action and verb processing deficits of PD patients are modulated by different tasks with different cognitive demands. Action and object lexical-semantic processing was evaluated in patients with Parkinson's Disease (PD) and cognitively healthy controls through three different tasks (verbal fluency, naming and semantic association). Compared to controls, PD patients presented worse performance in naming actions and in the two semantic association tasks (action/object). Action verbal fluency performance was significantly associated with PD severity whereas object semantic association deficits and noun verbal fluency scores were associated to lower scores in measures of global cognitive functioning. Our data suggest that semantic deficits are related to the type of cognitive processing and this is in the line with more flexible EC accounts.

Language Deficits as a Preclinical Window into Parkinson's Disease: Evidence from Asymptomatic Parkin and Dardarin Mutation Carriers

OBJECTIVES

The worldwide spread of Parkinson's disease (PD) calls for sensitive and specific measures enabling its early (or, ideally, preclinical) detection. Here, we use language measures revealing deficits in PD to explore whether similar disturbances are present in asymptomatic individuals at risk for the disease.

METHODS

We administered executive, semantic, verb-production, and syntactic tasks to sporadic PD patients, genetic PD patients with PARK2 (parkin) or LRRK2 (dardarin) mutation, asymptomatic first-degree relatives of the latter with similar mutations, and socio-demographically matched controls. Moreover, to detect sui generis language disturbances, we ran analysis of covariance tests using executive functions as covariate.

RESULTS

The two clinical groups showed impairments in all measures, most of which survived covariation with executive functions. However, the key finding concerned asymptomatic mutation carriers. While these subjects showed intact executive, semantic, and action-verb production skills, they evinced deficits in a syntactic test with minimal working memory load.

CONCLUSIONS

We propose that this sui generis disturbance may constitute a prodromal sign anticipating eventual development of PD. Moreover, our results suggest that mutations on specific genes (PARK2 and LRRK2) compromising basal ganglia functioning may be subtly related to language-processing mechanisms. (JINS, 2017, 23, 150-158).

Representational Similarity Mapping of Distributional Semantics in Left Inferior Frontal, Middle Temporal, and Motor Cortex

Language comprehension engages a distributed network of frontotemporal, parietal, and sensorimotor regions, but it is still unclear how meaning of words and their semantic relationships are represented and processed within these regions and to which degrees lexico-semantic representations differ between regions and semantic types. We used fMRI and representational similarity analysis to relate word-elicited multivoxel patterns to semantic similarity between action and object words. In left inferior frontal (BA 44-45-47), left posterior middle temporal and left precentral cortex, the similarity of brain response patterns reflected semantic similarity among action-related verbs, as well as across lexical classes-between action verbs and tool-related nouns and, to a degree, between action verbs and food nouns, but not between action verbs and animal nouns. Instead, posterior inferior temporal cortex exhibited a reverse response pattern, which reflected the semantic similarity among object-related nouns, but not action-related words. These results show that semantic similarity is encoded by a range of cortical areas, including multimodal association (e.g., anterior inferior frontal, posterior middle temporal) and modality-preferential (premotor) cortex and that the representational geometries in these regions are partly dependent on semantic type, with semantic similarity among action-related words crossing lexical-semantic category boundaries.

Persistent sparing of action conceptual processing in spite of increasing disorders of action production: A case against motor embodiment of action concepts

In this study, we addressed the issue of whether the brain sensorimotor circuitry that controls action production is causally involved in representing and processing action-related concepts. We examined the three-year pattern of evolution of brain atrophy, action production disorders, and action-related concept processing in a patient (J.R.) diagnosed with corticobasal degeneration. During the period of investigation, J.R. presented with increasing action production disorders resulting from increasing bilateral atrophy in cortical and subcortical regions involved in the sensorimotor control of actions (notably, the superior parietal cortex, the primary motor and premotor cortex, the inferior frontal gyrus, and the basal ganglia). In contrast, the patient's performance in processing action-related concepts remained intact during the same period. This finding indicated that action concept processing hinges on cognitive and neural resources that are mostly distinct from those underlying the sensorimotor control of actions.

Is the Motor System Necessary for Processing Action and Abstract Emotion Words? Evidence from Focal Brain Lesions

Neuroimaging and neuropsychological experiments suggest that modality-preferential cortices, including motor- and somatosensory areas, contribute to the semantic processing of action related concrete words. Still, a possible role of sensorimotor areas in processing abstract meaning remains under debate. Recent fMRI studies indicate an involvement of the left sensorimotor cortex in the processing of abstract-emotional words (e.g., "love") which resembles activation patterns seen for action words. But are the activated areas indeed necessary for processing action-related and abstract words? The current study now investigates word processing in two patients suffering from focal brain lesion in the left frontocentral motor system. A speeded Lexical Decision Task on meticulously matched word groups showed that the recognition of nouns from different semantic categories - related to food, animals, tools, and abstract-emotional concepts - was differentially affected. Whereas patient HS with a lesion in dorsolateral central sensorimotor systems next to the hand area showed a category-specific deficit in recognizing tool words, patient CA suffering from lesion centered in the left supplementary motor area was primarily impaired in abstract-emotional word processing. These results point to a causal role of the motor cortex in the semantic processing of both action-related object concepts and abstract-emotional concepts and therefore suggest that the motor areas previously found active in action-related and abstract word processing can serve a meaning-specific necessary role in word recognition. The category-specific nature of the observed dissociations is difficult to reconcile with the idea that sensorimotor systems are somehow peripheral or 'epiphenomenal' to meaning and concept processing. Rather, our results are consistent with the claim that cognition is grounded in action and perception and based on distributed action perception circuits reaching into modality-preferential cortex.

Neural dynamics of object noun, action verb and action noun production in picture naming

The verb/noun dissociation has often involved the semantic/grammatical confound. We conducted two event-related potentials (ERPs) studies with the aim of minimizing this confound. In Experiment 1 participants named pictures depicting actions, with verbs or nouns and pictures depicting objects with nouns. In Experiment 2, participants named objects (nouns) or actions (verbs/nouns) from the same set of action pictures. Compatible with lexical-semantic processes, semantic category modulated waveform amplitudes and topographic patterns between 250 and 380 ms after picture-onset in Experiment 1. No such effects were observed in Experiment 2. No effects were found for grammatical class in both experiments suggesting that grammatical information is not mandatorily activated during lexical-semantic processes. Given the absence of dissociation when same pictures were used the results are described as feed-forward effects from visual to semantic processing, indicating differential neural networks for lexical selection of action and object words from their corresponding visual referents.

Inferior frontal oscillations reveal visuo-motor matching for actions and speech: evidence from human intracranial recordings

The neural correspondence between the systems responsible for the execution and recognition of actions has been suggested both in humans and non-human primates. Apart from being a key region of this visuo-motor observation-execution matching (OEM) system, the human inferior frontal gyrus (IFG) is also important for speech production. The functional overlap of visuo-motor OEM and speech, together with the phylogenetic history of the IFG as a motor area, has led to the idea that speech function has evolved from pre-existing motor systems and to the hypothesis that an OEM system may exist also for speech. However, visuo-motor OEM and speech OEM have never been compared directly. We used electrocorticography to analyze oscillations recorded from intracranial electrodes in human fronto-parieto-temporal cortex during visuo-motor (executing or visually observing an action) and speech OEM tasks (verbally describing an action using the first or third person pronoun). The results show that neural activity related to visuo-motor OEM is widespread in the frontal, parietal, and temporal regions. Speech OEM also elicited widespread responses partly overlapping with visuo-motor OEM sites (bilaterally), including frontal, parietal, and temporal regions. Interestingly a more focal region, the inferior frontal gyrus (bilaterally), showed both visuo-motor OEM and speech OEM properties independent of orolingual speech-unrelated movements. Building on the methodological advantages in human invasive electrocorticography, the present findings provide highly precise spatial and temporal information to support the existence of a modality-independent action representation system in the human brain that is shared between systems for performing, interpreting and describing actions.

Communication impairments in people with progressive supranuclear palsy: A tutorial

Progressive supranuclear palsy (PSP) is a progressive neurological condition, whose main features include supranuclear gaze palsy, frequent falls, bradykinesia, axial rigidity, cognitive decline and communication impairments. Even though communication impairments are early and prominent manifestations, there is a significant lack of research on the nature of these impairments in PSP and the role of speech-language pathologists (SLPs). This tutorial article aims to describe the communication impairments observed in people with PSP; provide clinical guidelines for SLPs when assessing motor speech, language and other communication impairments; and to present facilitation and compensation approaches to treatment for people with PSP. The predominant motor speech impairment is mixed dysarthria, but there is a lack of consensus about the classification of language impairments. The involvement of SLPs in the assessment and treatment of people with PSP should be early, on-going and in collaboration with other health professionals, with the primary focus of maintaining quality of life for these patients and their family members.

Lost for emotion words: what motor and limbic brain activity reveals about autism and semantic theory

Autism spectrum conditions (ASC) are characterised by deficits in understanding and expressing emotions and are frequently accompanied by alexithymia, a difficulty in understanding and expressing emotion words. Words are differentially represented in the brain according to their semantic category and these difficulties in ASC predict reduced activation to emotion-related words in limbic structures crucial for affective processing. Semantic theories view 'emotion actions' as critical for learning the semantic relationship between a word and the emotion it describes, such that emotion words typically activate the cortical motor systems involved in expressing emotion actions such as facial expressions. As ASC are also characterised by motor deficits and atypical brain structure and function in these regions, motor structures would also be expected to show reduced activation during emotion-semantic processing. Here we used event-related fMRI to compare passive processing of emotion words in comparison to abstract verbs and animal names in typically-developing controls and individuals with ASC. Relatively reduced brain activation in ASC for emotion words, but not matched control words, was found in motor areas and cingulate cortex specifically. The degree of activation evoked by emotion words in the motor system was also associated with the extent of autistic traits as revealed by the Autism Spectrum Quotient. We suggest that hypoactivation of motor and limbic regions for emotion word processing may underlie difficulties in processing emotional language in ASC. The role that sensorimotor systems and their connections might play in the affective and social-communication difficulties in ASC is discussed.

Hearing and music in dementia

Music is a complex acoustic signal that relies on a number of different brain and cognitive processes to create the sensation of hearing. Changes in hearing function are generally not a major focus of concern for persons with a majority of neurodegenerative diseases associated with dementia, such as Alzheimer disease (AD). However, changes in the processing of sounds may be an early, and possibly preclinical, feature of AD and other neurodegenerative diseases. The aim of this chapter is to review the current state of knowledge concerning hearing and music perception in persons who have a dementia as a result of a neurodegenerative disease. The review focuses on both peripheral and central auditory processing in common neurodegenerative diseases, with a particular focus on the processing of music and other non-verbal sounds. The chapter also reviews music interventions used for persons with neurodegenerative diseases.

Constructional apraxia in frontotemporal dementia associated with the C9orf72 mutation: broadening the clinical and neuropsychological phenotype

In our study we analysed clinical and neuropsychological data in a cohort of 57 Sardinian patients with FTD (55 apparently unrelated and two belonging to the same family), who underwent genetic screening for the C9orf72 mutation. Eight out of 56 patients were found positive for the C9orf72 mutation representing 14% of the entire cohort and 31.6% of the familial cases (6/19). C9orf72 mutated patients differed from the other FTD cases of the cohort for a younger age of onset, higher frequency of familial history for FTD and higher prevalence of delusional psychotic symptoms and hallucinations. In the neuropsychological assessment, C9orf72 mutated patients differed from non-mutated for the high frequency of visuospatial dysfunction regarding constructional apraxia (p = 0.02). In conclusion, our study confirms that Sardinian FTD patients have peculiar genetic characteristics and that C9orf72 mutated patients have a distinctive clinical and neuropsychological profile that could help differentiate them from other FTD patients. In our cohort we found that constructional apraxia, rarely reported in FTD, can properly discriminate between C9orf72 mutated and non-mutated patients and contribute to broaden the neuropsychological profile in frontotemporal dementia associated with this mutation.

Semantic memory for actions as assessed by the Kissing and Dancing Test: Education and age effects in cognitively healthy individuals

Action semantics is a relevant part of cognitive-linguistic assessment and the "Kissing and Dancing Test" (KDT) has been used extensively for this purpose, evidencing clinical distinctions among brain-damaged patients. To enhance its use, reference values are necessary, especially for populations with heterogeneous educational levels and socioeconomic backgrounds.

Objective

To analyze the effects of schooling and age on the KDT in cognitively unimpaired individuals.

Methods

The KDT was applied to seventy-four healthy subjects. Sociodemographic factors were investigated through correlational and between-group analyses. Reference values according to age and schooling were provided.

Results

KDT performance correlated significantly with schooling (r=0.757, p<0.01), age (r=-0.496, p<0.01) and socioeconomic status (r=0.418 p<0.01) but these variables were intercorrelated. Correlation with schooling and age remained significant when controlling for age and socioeconomic status (r=0.530, p<0.01), and for schooling (-0.305,<0.01), respectively. When controlling for schooling, correlation between socioeconomic status and KDT was not significant (p=0.164). Between-group analyses revealed no age effects. Significant differences were found in performance according to educational level. Scores below 39/52 and below 47/52 (percentile 25) for individuals with 8 or less years of schooling and for individuals with 9 or more years of schooling, respectively, seem suggestive of an impairment in Action Semantics Processing and shall be further investigated.

Conclusion

KDT performance was influenced both by age and schooling, indicating the need to consider these demographic features as covariates when analyzing performance on the test and to adjust cut-off scores according to these demographic characteristics in clinical practice.

Nouns, verbs, objects, actions, and abstractions: local fMRI activity indexes semantics, not lexical categories

Noun/verb dissociations in the literature defy interpretation due to the confound between lexical category and semantic meaning; nouns and verbs typically describe concrete objects and actions. Abstract words, pertaining to neither, are a critical test case: dissociations along lexical-grammatical lines would support models purporting lexical category as the principle governing brain organisation, whilst semantic models predict dissociation between concrete words but not abstract items. During fMRI scanning, participants read orthogonalised word categories of nouns and verbs, with or without concrete, sensorimotor meaning. Analysis of inferior frontal/insula, precentral and central areas revealed an interaction between lexical class and semantic factors with clear category differences between concrete nouns and verbs but not abstract ones. Though the brain stores the combinatorial and lexical-grammatical properties of words, our data show that topographical differences in brain activation, especially in the motor system and inferior frontal cortex, are driven by semantics and not by lexical class.

Action/Verb processing: Debates in neuroimaging and the contribution of studies in patients with Parkinson's disease

The objective of the current review was to verify whether studies investigating lexical-semantic difficulties in patients with Parkinson's disease (PD) support the Embodied Cognition model. Under this framework, it is predicted that patients with PD will have more difficulties in the semantic processing of action concepts (action verbs) than of motionless objects. We also verified how and whether these studies are following current debates of Neuroscience, particularly the debate between the Lexical and the Embodied Cognition models. Recent neuroimaging studies on the neural basis of the semantics of verbs were presented, as well as others that focused on the neural processing of verbs in PD. We concluded that few studies suitably verified the Embodied Cognition theory in the context of PD, especially using neuroimaging techniques. These limitations show there is much to investigate on the semantic difficulties with action verbs in these patients, where it is particularly important to control for psycholinguistic variables and the inherent semantic characteristics of verbs in future studies.

Words in motion: Motor-language coupling in Parkinson’s disease

A growing body of evidence indicates that neurodegenerative motor disorders involved high-order cognitive dysfunctions. Crucially, evidence obtained in multiple behavioral, neuroimaging, and electrophysiological studies points to selective impairments of action language -that is, processing of linguistic stimuli denoting motor actions, including idioms (e.g., cut a rug) and action verbs (e.g., clap). Action-verb deficits (with relative preservation of noun processing) have been repeatedly documented in Parkinson’s disease (PD). However, research on relevant biomarkers is still scant, and clinical implications of these findings have not yet been formally discussed. Relevant insights may be obtained through the assessment of motor-language coupling (i.e., the behavioral and neural integration of action-verb processing and ongoing motor actions). We propose that motorlanguage coupling deficits, as indexed by a cortical-subcortical network, may constitute an early neurocognitive marker of PD. Specifically, deficits in this domain at the prodromal stage may be detected through the actionsentence compatibility (ACE) paradigm, which induces a contextual coupling of ongoing motor actions and action-verb processing. Our translational proposal is supported and illustrated by recent studies demonstrating the sensitivity of the ACE technique as well as its potential to assist in differential diagnosis and interventionprogram design.

Brain routes for reading in adults with and without autism: EMEG evidence

Reading utilises at least two neural pathways. The temporal lexical route visually maps whole words to their lexical entries, whilst the nonlexical route decodes words phonologically via parietal cortex. Readers typically employ the lexical route for familiar words, but poor comprehension plus precocity at mechanically 'sounding out' words suggests that differences might exist in autism. Combined MEG/EEG recordings of adults with autistic spectrum conditions (ASC) and controls while reading revealed preferential recruitment of temporal areas in controls and additional parietal recruitment in ASC. Furthermore, a lack of differences between semantic word categories was consistent with previous suggestion that people with ASC may lack a 'default' lexical-semantic processing mode. These results are discussed with reference to dual-route models of reading.

Tracking the Cognitive, Social, and Neuroanatomical Profile in Early Neurodegeneration: Type III Cockayne Syndrome

Cockayne syndrome (CS) is an autosomal recessive disease associated with premature aging, progressive multiorgan degeneration, and nervous system abnormalities including cerebral and cerebellar atrophy, brain calcifications, and white matter abnormalities. Although several clinical descriptions of CS patients have reported developmental delay and cognitive impairment with relative preservation of social skills, no previous studies have carried out a comprehensive neuropsychological and social cognition assessment. Furthermore, no previous research in individuals with CS has examined the relationship between brain atrophy and performance on neuropsychological and social cognition tests. This study describes the case of an atypical late-onset type III CS patient who exceeds the mean life expectancy of individuals with this pathology. The patient and a group of healthy controls underwent a comprehensive assessment that included multiple neuropsychological and social cognition (emotion recognition, theory of mind, and empathy) tasks. In addition, we compared the pattern of atrophy in the patient to controls and to its concordance with ERCC8 gene expression in a healthy brain. The results showed memory, language, and executive deficits that contrast with the relative preservation of social cognition skills. The cognitive profile of the patient was consistent with his pattern of global cerebral and cerebellar loss of gray matter volume (frontal structures, bilateral cerebellum, basal ganglia, temporal lobe, and occipito-temporal/occipito-parietal regions), which in turn was anatomically consistent with the ERCC8 gene expression level in a healthy donor’s brain. The study of exceptional cases, such as the one described here, is fundamental to elucidating the processes that affect the brain in premature aging diseases, and such studies provide an important source of information for understanding the problems associated with normal and pathological aging.

Putting an “End” to the Motor Cortex Representations of Action Words

Language processing is an example of implicit learning of multiple statistical cues that provide probabilistic information regarding word structure and use. Much of the current debate about language embodiment is devoted to how action words are represented in the brain, with motor cortex activity evoked by these words assumed to selectively reflect conceptual content and/or its simulation. We investigated whether motor cortex activity evoked by manual action words (e.g., caress) might reflect sensitivity to probabilistic orthographic–phonological cues to grammatical category embedded within individual words. We first review neuroimaging data demonstrating that nonwords evoke activity much more reliably than action words along the entire motor strip, encompassing regions proposed to be action category specific. Using fMRI, we found that disyllabic words denoting manual actions evoked increased motor cortex activity compared with non-body-part-related words (e.g., canyon), activity which overlaps that evoked by observing and executing hand movements. This result is typically interpreted in support of language embodiment. Crucially, we also found that disyllabic nonwords containing endings with probabilistic cues predictive of verb status (e.g., -eve) evoked increased activity compared with nonwords with endings predictive of noun status (e.g., -age) in the identical motor area. Thus, motor cortex responses to action words cannot be assumed to selectively reflect conceptual content and/or its simulation. Our results clearly demonstrate motor cortex activity reflects implicit processing of ortho-phonological statistical regularities that help to distinguish a word's grammatical class.

Parkinson's disease disrupts both automatic and controlled processing of action verbs

The problem of how word meaning is processed in the brain has been a topic of intense investigation in cognitive neuroscience. While considerable correlational evidence exists for the involvement of sensory-motor systems in conceptual processing, it is still unclear whether they play a causal role. We investigated this issue by comparing the performance of patients with Parkinson's disease (PD) with that of age-matched controls when processing action and abstract verbs. To examine the effects of task demands, we used tasks in which semantic demands were either implicit (lexical decision and priming) or explicit (semantic similarity judgment). In both tasks, PD patients' performance was selectively impaired for action verbs (relative to controls), indicating that the motor system plays a more central role in the processing of action verbs than in the processing of abstract verbs. These results argue for a causal role of sensory-motor systems in semantic processing.