Encoding, rehearsal, and recall in signers and speakers: shared network but differential engagement

A systematic review of altered resting-state networks in early deafness and implications for cochlear implantation outcomes

Auditory deprivation following congenital/pre-lingual deafness (C/PD) can drastically affect brain development and its functional organisation. This systematic review intends to extend current knowledge of the impact of C/PD and deafness duration on brain resting-state networks (RSNs), review changes in RSNs and spoken language outcomes post-cochlear implant (CI) and draw conclusions for future research. The systematic literature search followed the PRISMA guideline. Two independent reviewers searched four electronic databases using combined keywords: 'auditory deprivation', 'congenital/prelingual deafness', 'resting-state functional connectivity' (RSFC), 'resting-state fMRI' and 'cochlear implant'. Seventeen studies (16 cross-sectional and one longitudinal) met the inclusion criteria. Using the Crowe Critical Appraisal Tool, the publications' quality was rated between 65.0% and 92.5% (mean: 84.10%), ≥80% in 13 out of 17 studies. A few studies were deficient in sampling and/or ethical considerations. According to the findings, early auditory deprivation results in enhanced RSFC between the auditory network and brain networks involved in non-verbal communication, and high levels of spontaneous neural activity in the auditory cortex before CI are evidence of occupied auditory cortical areas with other sensory modalities (cross-modal plasticity) and sub-optimal CI outcomes. Overall, current evidence supports the idea that moreover intramodal and cross-modal plasticity, the entire brain adaptation following auditory deprivation contributes to spoken language development and compensatory behaviours.

Neurotopographical Transformations: Dissecting Cortical Reconfigurations in Auditory Deprivation

Within the intricate matrices of cognitive neuroscience, auditory deprivation acts as a catalyst, propelling a cascade of neuroanatomical adjustments that have, until now, been suboptimally articulated in extant literature. Addressing this gap, our study harnesses high-resolution 3 T MRI modalities to unveil the multifaceted cortical transformations that emerge in tandem with congenital auditory deficits. We conducted a rigorous cortical surface analysis on a cohort of 90 congenitally deaf individuals, systematically compared with 90 normoacoustic controls. Our sample encompassed both male and female participants, ensuring a gender-inclusive perspective in our analysis. Expected alterations within prototypical auditory domains were evident, but our findings transcended these regions, spotlighting modifications dispersed across a gamut of cortical and subcortical structures, thereby epitomizing the cerebral adaptive dynamics to sensory voids. Crucially, the study's innovative methodology integrated two pivotal variables: the duration of auditory deprivation and the extent of sign language immersion. By intersecting these metrics with structural changes, our analysis unveiled nuanced layers of cortical reconfigurations, elucidating a more granulated understanding of neural plasticity. This intersectional approach bestows a unique advantage, allowing for a discerning exploration into how varying durations of sensory experience and alternative communication modalities modulate the brain's morphological terrain. In encapsulating the synergy of neuroimaging finesse and incisive scientific rigor, this research not only broadens the current understanding of adaptive neural mechanisms but also paves the way for tailored therapeutic strategies, finely attuned to individual auditory histories and communicative repertoires.

Longitudinal changes in within-salience network functional connectivity mediate the relationship between childhood abuse and neglect, and mental health during adolescence

BACKGROUND

Understanding the neurobiological underpinnings of childhood maltreatment is vital given consistent links with poor mental health. Dimensional models of adversity purport that different types of adversity likely have distinct neurobiological consequences. Adolescence is a key developmental period, during which deviations from normative neurodevelopment may have particular relevance for mental health. However, longitudinal work examining links between different forms of maltreatment, neurodevelopment, and mental health is limited.

METHODS

In the present study, we explored associations between abuse, neglect, and longitudinal development of within-network functional connectivity of the salience (SN), default mode (DMN), and executive control network in 142 community residing adolescents. Resting-state fMRI data were acquired at age 16 (T1; M = 16.46 years, s.d. = 0.52, 66F) and 19 (T2; mean follow-up period: 2.35 years). Mental health data were also collected at T1 and T2. Childhood maltreatment history was assessed prior to T1.

RESULTS

Abuse and neglect were both found to be associated with increases in within-SN functional connectivity from age 16 to 19. Further, there were sex differences in the association between neglect and changes in within-DMN connectivity. Finally, increases in within-SN connectivity were found to mediate the association between abuse/neglect and lower problematic substance use and higher depressive symptoms at age 19.

CONCLUSIONS

Our findings suggest that childhood maltreatment is associated with altered neurodevelopmental trajectories, and that changes in salience processing may be linked with risk and resilience for the development of depression and substance use problems during adolescence, respectively. Further work is needed to understand the distinct neurodevelopmental and mental health outcomes of abuse and neglect.

Brain Morphological Modifications in Congenital and Acquired Auditory Deprivation: A Systematic Review and Coordinate-Based Meta-Analysis

Neuroplasticity following deafness has been widely demonstrated in both humans and animals, but the anatomical substrate of these changes is not yet clear in human brain. However, it is of high importance since hearing loss is a growing problem due to aging population. Moreover, knowing these brain changes could help to understand some disappointing results with cochlear implant, and therefore could improve hearing rehabilitation. A systematic review and a coordinate-based meta-analysis were realized about the morphological brain changes highlighted by MRI in severe to profound hearing loss, congenital and acquired before or after language onset. 25 papers were included in our review, concerning more than 400 deaf subjects, most of them presenting prelingual deafness. The most consistent finding is a volumetric decrease in gray matter around bilateral auditory cortex. This change was confirmed by the coordinate-based meta-analysis which shows three converging clusters in this region. The visual areas of deaf children is also significantly impacted, with a decrease of the volume of both gray and white matters. Finally, deafness is responsible of a gray matter increase within the cerebellum, especially at the right side. These results are largely discussed and compared with those from deaf animal models and blind humans, which demonstrate for example a much more consistent gray matter decrease along their respective primary sensory pathway. In human deafness, a lot of other factors than deafness could interact on the brain plasticity. One of the most important is the use of sign language and its age of acquisition, which induce among others changes within the hand motor region and the visual cortex. But other confounding factors exist which have been too little considered in the current literature, such as the etiology of the hearing impairment, the speech-reading ability, the hearing aid use, the frequent associated vestibular dysfunction or neurocognitive impairment. Another important weakness highlighted by this review concern the lack of papers about postlingual deafness, whereas it represents most of the deaf population. Further studies are needed to better understand these issues, and finally try to improve deafness rehabilitation.

New Perspectives on the Neurobiology of Sign Languages

The first 40 years of research on the neurobiology of sign languages (1960-2000) established that the same key left hemisphere brain regions support both signed and spoken languages, based primarily on evidence from signers with brain injury and at the end of the 20th century, based on evidence from emerging functional neuroimaging technologies (positron emission tomography and fMRI). Building on this earlier work, this review focuses on what we have learned about the neurobiology of sign languages in the last 15-20 years, what controversies remain unresolved, and directions for future research. Production and comprehension processes are addressed separately in order to capture whether and how output and input differences between sign and speech impact the neural substrates supporting language. In addition, the review includes aspects of language that are unique to sign languages, such as pervasive lexical iconicity, fingerspelling, linguistic facial expressions, and depictive classifier constructions. Summary sketches of the neural networks supporting sign language production and comprehension are provided with the hope that these will inspire future research as we begin to develop a more complete neurobiological model of sign language processing.

Early deafness leads to re-shaping of functional connectivity beyond the auditory cortex

Early sensory deprivation, such as deafness, shapes brain development in multiple ways. Deprived auditory areas become engaged in the processing of stimuli from the remaining modalities and in high-level cognitive tasks. Yet, structural and functional changes were also observed in non-deprived brain areas, which may suggest the whole-brain network changes in deaf individuals. To explore this possibility, we compared the resting-state functional network organization of the brain in early deaf adults and hearing controls and examined global network segregation and integration. Relative to hearing controls, deaf adults exhibited decreased network segregation and an altered modular structure. In the deaf, regions of the salience network were coupled with the fronto-parietal network, while in the hearing controls, they were coupled with other large-scale networks. Deaf adults showed weaker connections between auditory and somatomotor regions, stronger coupling between the fronto-parietal network and several other large-scale networks (visual, memory, cingulo-opercular and somatomotor), and an enlargement of the default mode network. Our findings suggest that brain plasticity in deaf adults is not limited to changes in the auditory cortex but additionally alters the coupling between other large-scale networks and the development of functional brain modules. These widespread functional connectivity changes may provide a mechanism for the superior behavioral performance of the deaf in visual and attentional tasks.

Working Memory for Signs with Poor Visual Resolution: fMRI Evidence of Reorganization of Auditory Cortex in Deaf Signers

Stimulus degradation adds to working memory load during speech processing. We investigated whether this applies to sign processing and, if so, whether the mechanism implicates secondary auditory cortex. We conducted an fMRI experiment where 16 deaf early signers (DES) and 22 hearing non-signers performed a sign-based n-back task with three load levels and stimuli presented at high and low resolution. We found decreased behavioral performance with increasing load and decreasing visual resolution, but the neurobiological mechanisms involved differed between the two manipulations and did so for both groups. Importantly, while the load manipulation was, as predicted, accompanied by activation in the frontoparietal working memory network, the resolution manipulation resulted in temporal and occipital activation. Furthermore, we found evidence of cross-modal reorganization in the secondary auditory cortex: DES had stronger activation and stronger connectivity between this and several other regions. We conclude that load and stimulus resolution have different neural underpinnings in the visual–verbal domain, which has consequences for current working memory models, and that for DES the secondary auditory cortex is involved in the binding of representations when task demands are low.

Hemispheric Asymmetries in Deaf and Hearing During Sustained Peripheral Selective Attention

Previous studies have shown that compared to hearing individuals, early deaf individuals allocate relatively more attention to the periphery than central visual field. However, it is not clear whether these two groups also differ in their ability to selectively attend to specific peripheral locations. We examined deaf and hearing participants' selective attention using electroencephalography (EEG) and a frequency tagging paradigm, in which participants attended to one of two peripheral displays of moving dots that changed directions at different rates. Both participant groups showed similar amplifications and reductions in the EEG signal at the attended and unattended frequencies, indicating similar control over their peripheral attention for motion stimuli. However, for deaf participants these effects were larger in a right hemispheric region of interest (ROI), while for hearing participants these effects were larger in a left ROI. These results contribute to a growing body of evidence for a right hemispheric processing advantage in deaf populations when attending to motion.

Individual differences in lexical learning across two language modalities: Sign learning, word learning, and their relationship in hearing non-signing adults

A considerable amount of research has been devoted to understanding individual differences in lexical learning, however, the majority of this research has been conducted with spoken languages rather than signed languages and thus we know very little about the cognitive processes involved in sign learning or the extent to which lexical learning processes are specific to word learning. The present study was conducted to address this gap. Two-hundred thirty-six non-signing adults completed 25 tasks assessing word learning and sign learning (via associative learning paradigms) as well as modality-specific phonological short-term memory, working memory capacity, crystallized intelligence, and fluid intelligence. Latent variable analyses indicated that, when other variables were held constant, fluid intelligence was predictive of both word and sign learning, however, modality-specific phonological short-term memory factors were only predictive of lexical learning within modality-none of the other variables made significant independent contributions. It was further observed that sign and word learning were strongly correlated. Exploratory analyses revealed that all lexical learning tasks loaded onto a general factor, however, sign learning tasks loaded onto an additional specific factor. As such, this study provides insight into the cognitive components that are common to associative L2 lexical learning regardless of language modality and those that are unique to either signed or spoken languages. Results are further discussed in light of established and more recent theories of intelligence, short-term memory, and working memory.

Long-range gamma phase synchronization as a compensatory strategy during working memory in high-performing patients with schizophrenia

Working memory deficits in schizophrenia may be associated with impairments in the integration of neural activity across a distributed network of cortical areas. However, evaluation of the contribution of this integration to working memory impairments in patients is severely confounded by behavioral performance. In the present multidimensional-neuroimaging study, measures of neural oscillations at baseline and during a working memory task, baseline gamma-aminobutyric acid (GABA) level in the left dorsolateral prefrontal cortex (DLPFC), and behavioral performance were obtained. Controlling behavioral performance by recruiting only "high-performing" patients with schizophrenia, we investigated whether the strength of cross-area communications differs between patients with schizophrenia and healthy participants under accurate and equivalent behavioral performance. Results of phase-locking value indicated that these high-performing patients recruited significantly more between frontal and occipital regions in the left hemisphere, t(13) = -2.16, p = .05, Cohen's d = -1.20, and between frontal and temporal regions in the right hemisphere, t(13) = -2.63, p = .02, Cohen's d = -1.46. These cross-area communication patterns may be associated with visuoverbal and visuospatial working memory networks of the left and right hemispheres, respectively. Moreover, correlations of patient's cross-area communication with in vivo GABA levels of the left DLPFC revealed a significant positive relationship (r = .77, p = .04), demonstrating that the critical role of GABA functions in gamma band oscillations may go beyond local neuronal assemblies in the left DLPFC. Altogether, these exploratory findings point to the heterogeneity among schizophrenia patients and highlight the notion that high-performing patients may engage in potential compensatory mechanisms and may represent a subgroup of patients that may be categorically or dimensionally divergent in psychopathology.

Working Memory for Linguistic and Non-linguistic Manual Gestures: Evidence, Theory, and Application

Linguistic manual gestures are the basis of sign languages used by deaf individuals. Working memory and language processing are intimately connected and thus when language is gesture-based, it is important to understand related working memory mechanisms. This article reviews work on working memory for linguistic and non-linguistic manual gestures and discusses theoretical and applied implications. Empirical evidence shows that there are effects of load and stimulus degradation on working memory for manual gestures. These effects are similar to those found for working memory for speech-based language. Further, there are effects of pre-existing linguistic representation that are partially similar across language modalities. But above all, deaf signers score higher than hearing non-signers on an n-back task with sign-based stimuli, irrespective of their semantic and phonological content, but not with non-linguistic manual actions. This pattern may be partially explained by recent findings relating to cross-modal plasticity in deaf individuals. It suggests that in linguistic gesture-based working memory, semantic aspects may outweigh phonological aspects when processing takes place under challenging conditions. The close association between working memory and language development should be taken into account in understanding and alleviating the challenges faced by deaf children growing up with cochlear implants as well as other clinical populations.

Phonological memory in sign language relies on the visuomotor neural system outside the left hemisphere language network

Sign language is an essential medium for everyday social interaction for deaf people and plays a critical role in verbal learning. In particular, language development in those people should heavily rely on the verbal short-term memory (STM) via sign language. Most previous studies compared neural activations during signed language processing in deaf signers and those during spoken language processing in hearing speakers. For sign language users, it thus remains unclear how visuospatial inputs are converted into the verbal STM operating in the left-hemisphere language network. Using functional magnetic resonance imaging, the present study investigated neural activation while bilinguals of spoken and signed language were engaged in a sequence memory span task. On each trial, participants viewed a nonsense syllable sequence presented either as written letters or as fingerspelling (4-7 syllables in length) and then held the syllable sequence for 12 s. Behavioral analysis revealed that participants relied on phonological memory while holding verbal information regardless of the type of input modality. At the neural level, this maintenance stage broadly activated the left-hemisphere language network, including the inferior frontal gyrus, supplementary motor area, superior temporal gyrus and inferior parietal lobule, for both letter and fingerspelling conditions. Interestingly, while most participants reported that they relied on phonological memory during maintenance, direct comparisons between letters and fingers revealed strikingly different patterns of neural activation during the same period. Namely, the effortful maintenance of fingerspelling inputs relative to letter inputs activated the left superior parietal lobule and dorsal premotor area, i.e., brain regions known to play a role in visuomotor analysis of hand/arm movements. These findings suggest that the dorsal visuomotor neural system subserves verbal learning via sign language by relaying gestural inputs to the classical left-hemisphere language network.

The relation between working memory and language comprehension in signers and speakers

This study investigated the relation between linguistic and spatial working memory (WM) resources and language comprehension for signed compared to spoken language. Sign languages are both linguistic and visual-spatial, and therefore provide a unique window on modality-specific versus modality-independent contributions of WM resources to language processing. Deaf users of American Sign Language (ASL), hearing monolingual English speakers, and hearing ASL-English bilinguals completed several spatial and linguistic serial recall tasks. Additionally, their comprehension of spatial and non-spatial information in ASL and spoken English narratives was assessed. Results from the linguistic serial recall tasks revealed that the often reported advantage for speakers on linguistic short-term memory tasks does not extend to complex WM tasks with a serial recall component. For English, linguistic WM predicted retention of non-spatial information, and both linguistic and spatial WM predicted retention of spatial information. For ASL, spatial WM predicted retention of spatial (but not non-spatial) information, and linguistic WM did not predict retention of either spatial or non-spatial information. Overall, our findings argue against strong assumptions of independent domain-specific subsystems for the storage and processing of linguistic and spatial information and furthermore suggest a less important role for serial encoding in signed than spoken language comprehension.

Visual deprivation selectively reshapes the intrinsic functional architecture of the anterior insula subregions

The anterior insula (AI) is the core hub of salience network that serves to identify the most relevant stimuli among vast sensory inputs and forward them to higher cognitive regions to guide behaviour. As blind subjects were usually reported with changed perceptive abilities for salient non-visual stimuli, we hypothesized that the resting-state functional network of the AI is selectively reorganized after visual deprivation. The resting-state functional connectivity (FC) of the bilateral dorsal and ventral AI was calculated for twenty congenitally blind (CB), 27 early blind (EB), 44 late blind (LB) individuals and 50 sighted controls (SCs). The FCs of the dorsal AI were strengthened with the dorsal visual stream, while weakened with the ventral visual stream in the blind than the SCs; in contrast, the FCs of the ventral AI of the blind was strengthened with the ventral visual stream. Furthermore, these strengthened FCs of both the dorsal and ventral AI were partially negatively associated with the onset age of blindness. Our result indicates two parallel pathways that selectively transfer non-visual salient information between the deprived “visual” cortex and salience network in blind subjects.

Detecting Memory Impairment in Deaf People: A New Test of Verbal Learning and Memory in British Sign Language

OBJECTIVE

Most existing tests of memory and verbal learning in adults were created for spoken languages, and are unsuitable for assessing deaf people who rely on signed languages. In response to this need for sign language measures, the British Sign Language Verbal Learning and Memory Test (BSL-VLMT) was developed. It follows the format of the English language Hopkins Verbal Learning Test Revised, using standardized video-presentation with novel stimuli and instructions wholly in British Sign Language, and no English language requirement.

METHOD

Data were collected from 223 cognitively healthy deaf signers aged 50-89 and 12 deaf patients diagnosed with dementia. Normative data percentiles were derived for clinical use, and receiver-operating characteristic curves computed to explore the clinical potential and diagnostic sensitivity and specificity.

RESULTS

The test showed good discrimination between the normative and clinical samples, providing preliminary evidence of clinical utility for identifying learning and memory impairment in older deaf signers with neurodegeneration.

CONCLUSIONS

This innovative video testing approach transforms the ability to accurately detect memory impairments in deaf people and avoids the problems of using interpreters, with international potential for adapting similar tests into other signed languages.

Enhanced spontaneous functional connectivity of the superior temporal gyrus in early deafness

Early auditory deprivation may drive the auditory cortex into cross-modal processing of non-auditory sensory information. In a recent study, we had shown that early deaf subjects exhibited increased activation in the superior temporal gyrus (STG) bilaterally during visual spatial working memory; however, the changes in the organization of the STG related spontaneous functional network, and their cognitive relevance are still unknown. To clarify this issue, we applied resting state functional magnetic resonance imaging on 42 early deafness (ED) and 40 hearing controls (HC). We also acquired the visual spatial and numerical n-back working memory (WM) information in these subjects. Compared with hearing subjects, the ED exhibited faster reaction time of visual WM tasks in both spatial and numerical domains. Furthermore, ED subjects exhibited significantly increased functional connectivity between the STG (especially of the right hemisphere) and bilateral anterior insula and dorsal anterior cingulated cortex. Finally, the functional connectivity of STG could predict visual spatial WM performance, even after controlling for numerical WM performance. Our findings suggest that early auditory deprivation can strengthen the spontaneous functional connectivity of STG, which may contribute to the cross-modal involvement of this region in visual working memory.

Neural systems supporting linguistic structure, linguistic experience, and symbolic communication in sign language and gesture

Sign languages used by deaf communities around the world possess the same structural and organizational properties as spoken languages: In particular, they are richly expressive and also tightly grammatically constrained. They therefore offer the opportunity to investigate the extent to which the neural organization for language is modality independent, as well as to identify ways in which modality influences this organization. The fact that sign languages share the visual-manual modality with a nonlinguistic symbolic communicative system-gesture-further allows us to investigate where the boundaries lie between language and symbolic communication more generally. In the present study, we had three goals: to investigate the neural processing of linguistic structure in American Sign Language (using verbs of motion classifier constructions, which may lie at the boundary between language and gesture); to determine whether we could dissociate the brain systems involved in deriving meaning from symbolic communication (including both language and gesture) from those specifically engaged by linguistically structured content (sign language); and to assess whether sign language experience influences the neural systems used for understanding nonlinguistic gesture. The results demonstrated that even sign language constructions that appear on the surface to be similar to gesture are processed within the left-lateralized frontal-temporal network used for spoken languages-supporting claims that these constructions are linguistically structured. Moreover, although nonsigners engage regions involved in human action perception to process communicative, symbolic gestures, signers instead engage parts of the language-processing network-demonstrating an influence of experience on the perception of nonlinguistic stimuli.

Load and distinctness interact in working memory for lexical manual gestures

The Ease of Language Understanding model (Rönnberg et al., 2013) predicts that decreasing the distinctness of language stimuli increases working memory load; in the speech domain this notion is supported by empirical evidence. Our aim was to determine whether such an over-additive interaction can be generalized to sign processing in sign-naïve individuals and whether it is modulated by experience of computer gaming. Twenty young adults with no knowledge of sign language performed an n-back working memory task based on manual gestures lexicalized in sign language; the visual resolution of the signs and working memory load were manipulated. Performance was poorer when load was high and resolution was low. These two effects interacted over-additively, demonstrating that reducing the resolution of signed stimuli increases working memory load when there is no pre-existing semantic representation. This suggests that load and distinctness are handled by a shared amodal mechanism which can be revealed empirically when stimuli are degraded and load is high, even without pre-existing semantic representation. There was some evidence that the mechanism is influenced by computer gaming experience. Future work should explore how the shared mechanism is influenced by pre-existing semantic representation and sensory factors together with computer gaming experience.

How sensory-motor systems impact the neural organization for language: direct contrasts between spoken and signed language

To investigate the impact of sensory-motor systems on the neural organization for language, we conducted an H₂¹⁵O-PET study of sign and spoken word production (picture-naming) and an fMRI study of sign and audio-visual spoken language comprehension (detection of a semantically anomalous sentence) with hearing bilinguals who are native users of American Sign Language (ASL) and English. Directly contrasting speech and sign production revealed greater activation in bilateral parietal cortex for signing, while speaking resulted in greater activation in bilateral superior temporal cortex (STC) and right frontal cortex, likely reflecting auditory feedback control. Surprisingly, the language production contrast revealed a relative increase in activation in bilateral occipital cortex for speaking. We speculate that greater activation in visual cortex for speaking may actually reflect cortical attenuation when signing, which functions to distinguish self-produced from externally generated visual input. Directly contrasting speech and sign comprehension revealed greater activation in bilateral STC for speech and greater activation in bilateral occipital-temporal cortex for sign. Sign comprehension, like sign production, engaged bilateral parietal cortex to a greater extent than spoken language. We hypothesize that posterior parietal activation in part reflects processing related to spatial classifier constructions in ASL and that anterior parietal activation may reflect covert imitation that functions as a predictive model during sign comprehension. The conjunction analysis for comprehension revealed that both speech and sign bilaterally engaged the inferior frontal gyrus (with more extensive activation on the left) and the superior temporal sulcus, suggesting an invariant bilateral perisylvian language system. We conclude that surface level differences between sign and spoken languages should not be dismissed and are critical for understanding the neurobiology of language.

From gestures to words: spontaneous verbal labeling of complex sequential hand movements reduces fMRI activation of the imitation-related regions

The association of verbal labels with visuo-spatial patterns and sequences detectably alters neuronal activity in the brain in ways that have yet to be fully characterized. This study investigated the neural substrates involved in the effect of spontaneous verbal labeling on memorizing increasingly complex sequences of hand movements. We used functional magnetic resonance imaging (fMRI) to test our hypothesis that when verbal labels were employed, neuronal activity in imitation-related regions, such as the left inferior frontal gyrus (IFG), would be reduced, whereas without verbal labels, neuronal activation would increase. Sixteen healthy adults satisfactorily performed an immediate imitation task involving six levels of increasing complexity. After the fMRI experiment, participants reported at which complexity level they had formed verbal labels. Based on the self-report, we categorized the task blocks at each complexity level as either with verbal labeling (VL+) or without (VL-). Compared with VL+, the VL- condition activated the left IFG, bilateral middle frontal gyri, left precentral gyrus, and the right angular gyrus, whereas the opposite contrast revealed no significant brain activation. Verbal labeling seems to serve as an efficient heuristic that reduces the cost of cortical activation in the imitation-related regions.

Sign language aphasia from a neurodegenerative disease

While Alois Alzheimer recognized the effects of the disease he described on speech and language in his original description of the disease in 1907, the effects of Alzheimer's disease (AD) on language in deaf signers has not previously been reported. We evaluated a 55-year-old right-handed congenitally deaf woman with a 2-year history of progressive memory loss and a deterioration of her ability to communicate in American Sign Language, which she learned at the age of eight. Examination revealed that she had impaired episodic memory as well as marked impairments in the production and comprehension of fingerspelling and grammatically complex sentences. She also had signs of anomia as well as an ideomotor apraxia and visual-spatial dysfunction. This report illustrates the challenges in evaluation of a patient for the presence of degenerative dementia when the person is deaf from birth, uses sign language, and has a late age of primary language acquisition. Although our patient could neither speak nor hear, in many respects her cognitive disorders mirror those of patients with AD who had normally learned to speak.

Levels of processing and language modality specificity in working memory

Neural networks underpinning working memory demonstrate sign language specific components possibly related to differences in temporary storage mechanisms. A processing approach to memory systems suggests that the organisation of memory storage is related to type of memory processing as well. In the present study, we investigated for the first time semantic, phonological and orthographic processing in working memory for sign- and speech-based language. During fMRI we administered a picture-based 2-back working memory task with Semantic, Phonological, Orthographic and Baseline conditions to 11 deaf signers and 20 hearing non-signers. Behavioural data showed poorer and slower performance for both groups in Phonological and Orthographic conditions than in the Semantic condition, in line with depth-of-processing theory. An exclusive masking procedure revealed distinct sign-specific neural networks supporting working memory components at all three levels of processing. The overall pattern of sign-specific activations may reflect a relative intermodality difference in the relationship between phonology and semantics influencing working memory storage and processing.

Routes to short-term memory indexing: lessons from deaf native users of American Sign Language

Models of working memory (WM) have been instrumental in understanding foundational cognitive processes and sources of individual differences. However, current models cannot conclusively explain the consistent group differences between deaf signers and hearing speakers on a number of short-term memory (STM) tasks. Here we take the perspective that these results are not due to a temporal order-processing deficit in deaf individuals, but rather reflect different biases in how different types of memory cues are used to do a given task. We further argue that the main driving force behind the shifts in relative biasing is a consequence of language modality (sign vs. speech) and the processing they afford, and not deafness, per se.

Cholinergic blockade under working memory demands encountered by increased rehearsal strategies: evidence from fMRI in healthy subjects

The connection between cholinergic transmission and cognitive performance has been established in behavioural studies. The specific contribution of the muscarinic receptor system on cognitive performance and brain activation, however, has not been evaluated satisfyingly. To investigate the specific contribution of the muscarinic transmission on neural correlates of working memory, we examined the effects of scopolamine, an antagonist of the muscarinic receptors, using functional magnetic resonance imaging (fMRI). Fifteen healthy male, non-smoking subjects performed a fMRI scanning session following the application of scopolamine (0.4 mg, i.v.) or saline in a placebo-controlled, repeated measure, pseudo-randomized, single-blind design. Working memory was probed using an n-back task. Compared to placebo, challenging the cholinergic transmission with scopolamine resulted in hypoactivations in parietal, occipital and cerebellar areas and hyperactivations in frontal and prefrontal areas. These alterations are interpreted as compensatory strategies used to account for downregulation due to muscarinic acetylcholine blockade in parietal and cerebral storage systems by increased activation in frontal and prefrontal areas related to working memory rehearsal. Our results further underline the importance of cholinergic transmission to working memory performance and determine the specific contribution of muscarinic transmission on cerebral activation associated with executive functioning.

Short-term memory stages in sign vs. speech: the source of the serial span discrepancy

Speakers generally outperform signers when asked to recall a list of unrelated verbal items. This phenomenon is well established, but its source has remained unclear. In this study, we evaluate the relative contribution of the three main processing stages of short-term memory--perception, encoding, and recall--in this effect. The present study factorially manipulates whether American Sign Language (ASL) or English is used for perception, memory encoding, and recall in hearing ASL-English bilinguals. Results indicate that using ASL during both perception and encoding contributes to the serial span discrepancy. Interestingly, performing recall in ASL slightly increased span, ruling out the view that signing is in general a poor choice for short-term memory. These results suggest that despite the general equivalence of sign and speech in other memory domains, speech-based representations are better suited for the specific task of perception and memory encoding of a series of unrelated verbal items in serial order through the phonological loop. This work suggests that interpretation of performance on serial recall tasks in English may not translate straightforwardly to serial tasks in sign language.

Looking for an explanation for the low sign span. Is order involved?

Although signed and speech-based languages have a similar internal organization of verbal short-term memory, sign span is lower than word span. We investigated whether this is due to the fact that signs are not suited for serial recall, as proposed by Bavelier, Newport, Hall, Supalla, and Boutla (2008. Ordered short-term memory differs in signers and speakers: Implications for models of short-term memory. Cognition, 107, 433-459). We administered a serial recall task with stimuli in Italian Sign Language to 12 deaf people, and we compared their performance with that of twelve age-, gender-, and education-matched hearing participants who performed the task in Italian. The results do not offer evidence for the hypothesis that serial order per se is a detrimental factor for deaf participants. An alternative explanation for the lower sign span based on signs being phonologically heavier than words is considered.

Dissociating neural subsystems for grammar by contrasting word order and inflection

An important question in understanding language processing is whether there are distinct neural mechanisms for processing specific types of grammatical structure, such as syntax versus morphology, and, if so, what the basis of the specialization might be. However, this question is difficult to study: A given language typically conveys its grammatical information in one way (e.g., English marks "who did what to whom" using word order, and German uses inflectional morphology). American Sign Language permits either device, enabling a direct within-language comparison. During functional (f)MRI, native signers viewed sentences that used only word order and sentences that included inflectional morphology. The two sentence types activated an overlapping network of brain regions, but with differential patterns. Word order sentences activated left-lateralized areas involved in working memory and lexical access, including the dorsolateral prefrontal cortex, the inferior frontal gyrus, the inferior parietal lobe, and the middle temporal gyrus. In contrast, inflectional morphology sentences activated areas involved in building and analyzing combinatorial structure, including bilateral inferior frontal and anterior temporal regions as well as the basal ganglia and medial temporal/limbic areas. These findings suggest that for a given linguistic function, neural recruitment may depend upon on the cognitive resources required to process specific types of linguistic cues.

Prosodic and narrative processing in American Sign Language: an fMRI study

Signed languages such as American Sign Language (ASL) are natural human languages that share all of the core properties of spoken human languages but differ in the modality through which they are communicated. Neuroimaging and patient studies have suggested similar left hemisphere (LH)-dominant patterns of brain organization for signed and spoken languages, suggesting that the linguistic nature of the information, rather than modality, drives brain organization for language. However, the role of the right hemisphere (RH) in sign language has been less explored. In spoken languages, the RH supports the processing of numerous types of narrative-level information, including prosody, affect, facial expression, and discourse structure. In the present fMRI study, we contrasted the processing of ASL sentences that contained these types of narrative information with similar sentences without marked narrative cues. For all sentences, Deaf native signers showed robust bilateral activation of perisylvian language cortices as well as the basal ganglia, medial frontal, and medial temporal regions. However, RH activation in the inferior frontal gyrus and superior temporal sulcus was greater for sentences containing narrative devices, including areas involved in processing narrative content in spoken languages. These results provide additional support for the claim that all natural human languages rely on a core set of LH brain regions, and extend our knowledge to show that narrative linguistic functions typically associated with the RH in spoken languages are similarly organized in signed languages.

Effects of age on the temporal organization of working memory in deaf signers

Deaf native signers have a general working memory (WM) capacity similar to that of hearing non-signers but are less sensitive to the temporal order of stored items at retrieval. General WM capacity declines with age, but little is known of how cognitive aging affects WM function in deaf signers. We investigated WM function in elderly deaf signers (EDS) and an age-matched comparison group of hearing non-signers (EHN) using a paradigm designed to highlight differences in temporal and spatial processing of item and order information. EDS performed worse than EHN on both item and order recognition using a temporal style of presentation. Reanalysis together with earlier data showed that with the temporal style of presentation, order recognition performance for EDS was also lower than for young adult deaf signers. Older participants responded more slowly than younger participants. These findings suggest that apart from age-related slowing irrespective of sensory and language status, there is an age-related difference specific to deaf signers in the ability to retain order information in WM when temporal processing demands are high. This may be due to neural reorganisation arising from sign language use. Concurrent spatial information with the Mixed style of presentation resulted in enhanced order processing for all groups, suggesting that concurrent temporal and spatial cues may enhance learning for both deaf and hearing groups. These findings support and extend the WM model for Ease of Language Understanding.