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Andriuta D, Roussel M, Chene G, Fischer C, Mangin JF, Dubois B, Vellas B, Pasquier F, Tison F, Blanc F, Hanon O, Paquet C, Gabelle A, Ceccaldi M, Annweiler C, Krolak-Salmon P, David R, Rouch-Leroyer I, Benetos A, Moreaud O, Sellal F, Jalenques I, Vandel P, Bouteloup V, Godefroy O. The pattern of cortical thickness associated with executive dysfunction in MCI and SCC: The MEMENTO cohort. Rev Neurol (Paris) 2024:S0035-3787(24)00534-4. [PMID: 38866655 DOI: 10.1016/j.neurol.2024.02.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND The association between the pattern of cortical thickness (CT) and executive dysfunction (ED) in mild cognitive impairment (MCI) and subjective cognitive complaints (SCC) is still poorly understood. We aimed to investigate the association between CT and ED in a large French cohort (MEMENTO) of 2323 participants with MCI or SCC. METHODS All participants with available CT and executive function data (verbal fluency and Trail Making Test [TMT]) were selected (n=1924). Linear regressions were performed to determine relationships between executive performance and the brain parenchymal fraction (BPF) and CT using FreeSurfer. RESULTS The global executive function score was related to the BPF (sß: 0.091, P<0.001) and CT in the right supramarginal (sß: 0.060, P=0.041) and right isthmus cingulate (sß: 0.062, P=0.011) regions. Literal verbal fluency was related to the BPF (sß: 0.125, P<0.001) and CT in the left parsorbitalis region (sß: 0.045, P=0.045). Semantic verbal fluency was related to the BPF (sß: 0.101, P<0.001) and CT in the right supramarginal region (sß: 0.061, P=0.042). The time difference between the TMT parts B and A was related to the BPF (sß: 0.048, P=0.045) and CT in the right precuneus (sß: 0.073, P=0.019) and right isthmus cingulate region (sß: 0.054, P=0.032). CONCLUSIONS In a large clinically based cohort of participants presenting with either MCI or SCC (a potential early stage of Alzheimer's disease [AD]), ED was related to the BPF and CT in the left pars orbitalis, right precuneus, right supramarginal, and right isthmus cingulate regions. This pattern of lesions adds knowledge to the conventional anatomy of ED and could contribute to the early diagnosis of AD.
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Affiliation(s)
- D Andriuta
- Department of Neurology and Functional Neuroscience and Pathology Laboratory, Jules-Verne University of Picardy, Amiens University Hospital, CHU de Amiens-Picardie, 80054 Amiens, France.
| | - M Roussel
- Department of Neurology and Functional Neuroscience and Pathology Laboratory, Jules-Verne University of Picardy, Amiens University Hospital, CHU de Amiens-Picardie, 80054 Amiens, France
| | - G Chene
- School of Public Health, Inserm U1219, institut de santé publique, d'épidémiologie et de développement, université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - C Fischer
- University Hospital, Sorbonne Universities, Pierre-et-Marie-Curie University, 75006 Paris, France; Institut du cerveau et la moelle (ICM), hôpital Pitié-Salpêtrière, Paris, France
| | - J-F Mangin
- University Hospital, Sorbonne Universities, Pierre-et-Marie-Curie University, 75006 Paris, France; Institut du cerveau et la moelle (ICM), hôpital Pitié-Salpêtrière, Paris, France
| | - B Dubois
- University Hospital, Sorbonne Universities, Pierre-et-Marie-Curie University, 75006 Paris, France; Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Brain and Spine Institute (ICM) UMR S 1127, AP-HP Pitié-Salpêtrière, Paris, France
| | - B Vellas
- Memory Resource and Research Centre of Toulouse, CHU de Toulouse, hôpital La Grave-Casselardit, Toulouse, France
| | - F Pasquier
- Memory Resource and Research Centre of Lille, hôpital Roger-Salengro, CHRU de Lille, 59000 Lille, France
| | - F Tison
- Institute for Neurodegenerative diseases, CMRR, University and University Hospital of Bordeaux, Bordeaux, France
| | - F Blanc
- Department of Neurology, CHU de Strasbourg, Strasbourg, France
| | - O Hanon
- Memory Resource and Research Centre of Paris Broca, hôpital Broca, AP-HP, 75013 Paris, France; Université Paris Descartes, Sorbonne-Paris-Cité, EA 4468, Paris, France
| | - C Paquet
- Cognitive Neurology Centre, groupe hospitalier Saint-Louis-Lariboisière-Fernand-Widal, université de Paris, Paris, France
| | - A Gabelle
- Memory Resource and Research Centre of Montpellier, Hôpital Gui-de-Chauliac, CHU de Montpellier, 34000 Montpellier, France
| | - M Ceccaldi
- Memory Resource and Research Centre of Marseille, hôpital La Timone, CHU de Marseille, 13000 Marseille, France
| | - C Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; UPRES EA 4638, University of Angers, Angers, France; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - P Krolak-Salmon
- Memory Resource and Research Centre of Lyon, hospices civils de Lyon, hôpital des Charpennes, 69000 Lyon, France
| | - R David
- Memory Resource and Research Centre of Nice, CHU de Nice, Nice, France; Institut Claude-Pompidou, EA 7276 CoBTeK "Cognition Behaviour Technology", 06100 Nice, France
| | - I Rouch-Leroyer
- Memory Resource and Research Centre of Saint-Étienne, hôpital Nord, CHU de Saint-Étienne, 42000 Saint-Étienne, France
| | - A Benetos
- Memory Resource and Research Centre of Nancy, CHU de Nancy, 54000 Nancy, France
| | - O Moreaud
- Memory Resource and Research Centre of Grenoble, hôpital de la Tronche, CHU de Grenoble Alpes, 38000 Grenoble, France
| | - F Sellal
- Memory Resource and Research Centre of Strasbourg/Colmar, hôpitaux civils de Colmar, 68000 Colmar, France; Inserm U-1118, Strasbourg University, 67000 Strasbourg, France
| | - I Jalenques
- Memory Resource and Research Centre of Clermont-Ferrand, Clermont-Auvergne University, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - P Vandel
- Memory Resource and Research Centre of Besançon, hôpital Jean-Minjoz, hôpital Saint-Jacques, CHU de Besançon, 25000 Besançon, France
| | - V Bouteloup
- School of Public Health, Inserm U1219, institut de santé publique, d'épidémiologie et de développement, université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - O Godefroy
- Department of Neurology and Functional Neuroscience and Pathology Laboratory, Jules-Verne University of Picardy, Amiens University Hospital, CHU de Amiens-Picardie, 80054 Amiens, France
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Wang Z, Gallegos J, Tippett D, Onyike CU, Desmond JE, Hillis AE, Frangakis CE, Caffo B, Tsapkini K. Baseline functional connectivity predicts who will benefit from neuromodulation: evidence from primary progressive aphasia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.19.24305354. [PMID: 38699365 PMCID: PMC11065007 DOI: 10.1101/2024.04.19.24305354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background Identifying the characteristics of individuals who demonstrate response to an intervention allows us to predict who is most likely to benefit from certain interventions. Prediction is challenging in rare and heterogeneous diseases, such as primary progressive aphasia (PPA), that have varying clinical manifestations. We aimed to determine the characteristics of those who will benefit most from transcranial direct current stimulation (tDCS) of the left inferior frontal gyrus (IFG) using a novel heterogeneity and group identification analysis. Methods We compared the predictive ability of demographic and clinical patient characteristics (e.g., PPA variant and disease progression, baseline language performance) vs. functional connectivity alone (from resting-state fMRI) in the same cohort. Results Functional connectivity alone had the highest predictive value for outcomes, explaining 62% and 75% of tDCS effect of variance in generalization (semantic fluency) and in the trained outcome of the clinical trial (written naming), contrasted with <15% predicted by clinical characteristics, including baseline language performance. Patients with higher baseline functional connectivity between the left IFG (opercularis and triangularis), and between the middle temporal pole and posterior superior temporal gyrus, were most likely to benefit from tDCS. Conclusions We show the importance of a baseline 7-minute functional connectivity scan in predicting tDCS outcomes, and point towards a precision medicine approach in neuromodulation studies. The study has important implications for clinical trials and practice, providing a statistical method that addresses heterogeneity in patient populations and allowing accurate prediction and enrollment of those who will most likely benefit from specific interventions.
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Ohm DT, Xie SX, Capp N, Arezoumandan S, Cousins KAQ, Rascovsky K, Wolk DA, Van Deerlin VM, Lee EB, McMillan CT, Irwin DJ. Cytoarchitectonic gradients of laminar degeneration in behavioral variant frontotemporal dementia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.05.588259. [PMID: 38644997 PMCID: PMC11030243 DOI: 10.1101/2024.04.05.588259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a clinical syndrome primarily caused by either tau (bvFTD-tau) or TDP-43 (bvFTD-TDP) proteinopathies. We previously found lower cortical layers and dorsolateral regions accumulate greater tau than TDP-43 pathology; however, patterns of laminar neurodegeneration across diverse cytoarchitecture in bvFTD is understudied. We hypothesized that bvFTD-tau and bvFTD-TDP have distinct laminar distributions of pyramidal neurodegeneration along cortical gradients, a topologic order of cytoarchitectonic subregions based on increasing pyramidal density and laminar differentiation. Here, we tested this hypothesis in a frontal cortical gradient consisting of five cytoarchitectonic types (i.e., periallocortex, agranular mesocortex, dysgranular mesocortex, eulaminate-I isocortex, eulaminate-II isocortex) spanning anterior cingulate, paracingulate, orbitofrontal, and mid-frontal gyri in bvFTD-tau (n=27), bvFTD-TDP (n=47), and healthy controls (HC; n=32). We immunostained all tissue for total neurons (NeuN; neuronal-nuclear protein) and pyramidal neurons (SMI32; non-phosphorylated neurofilament) and digitally quantified NeuN-immunoreactivity (ir) and SMI32-ir in supragranular II-III, infragranular V-VI, and all I-VI layers in each cytoarchitectonic type. We used linear mixed-effects models adjusted for demographic and biologic variables to compare SMI32-ir between groups and examine relationships with the cortical gradient, long-range pathways, and clinical symptoms. We found regional and laminar distributions of SMI32-ir expected for HC, validating our measures within the cortical gradient framework. While SMI32-ir loss was not related to the cortical gradient in bvFTD-TDP, SMI32-ir progressively decreased along the cortical gradient of bvFTD-tau and included greater SMI32-ir loss in supragranular eulaminate-II isocortex in bvFTD-tau vs bvFTD-TDP ( p =0.039). In a structural model for long-range laminar connectivity between infragranular mesocortex and supragranular isocortex, we found a larger laminar ratio of mesocortex-to-isocortex SMI32-ir in bvFTD-tau vs bvFTD-TDP ( p =0.019), suggesting select long-projecting pathways may contribute to isocortical-predominant degeneration in bvFTD-tau. In cytoarchitectonic types with the highest NeuN-ir, we found lower SMI32-ir in bvFTD-tau vs bvFTD-TDP ( p =0.047), suggesting pyramidal neurodegeneration may occur earlier in bvFTD-tau. Lastly, we found that reduced SMI32-ir related to behavioral severity and frontal-mediated letter fluency, not temporal-mediated confrontation naming, demonstrating the clinical relevance and specificity of frontal pyramidal neurodegeneration to bvFTD-related symptoms. Our data suggest loss of neurofilament-rich pyramidal neurons is a clinically relevant feature of bvFTD that selectively worsens along a frontal cortical gradient in bvFTD-tau, not bvFTD-TDP. Therefore, tau-mediated degeneration may preferentially involve pyramidal-rich layers that connect more distant cytoarchitectonic types. Moreover, the hierarchical arrangement of cytoarchitecture along cortical gradients may be an important neuroanatomical framework for identifying which types of cells and pathways are differentially involved between proteinopathies.
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Picard EH, Bopp LL, Rosenfeld B. Neuropsychological Functioning in Sexual Offenders With and Without Pedophilic Disorder. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:43-56. [PMID: 37749338 DOI: 10.1007/s10508-023-02689-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/27/2023]
Abstract
This study sought to examine neuropsychological functioning in men with pedophilic disorder (PD), in order to assess whether findings from prior neuropsychological studies are replicated in a diverse sample including men with non-contact sexual offenses. It was hypothesized that when non-contact offenders are included in the study, a slowed processing speed will emerge as the only finding unique to men with PD. A comprehensive neuropsychological battery was administered to 58 men convicted of a sexual offense, 20 of whom were classified as having PD. The sample included men with contact sexual offenses (n = 33), non-contact sexual offenses (n = 5), and child sexual abuse material (CSAM) offenses (n = 20). Test performance was compared by PD status. Participants with PD performed significantly better on verbal memory and visual discrimination than those without PD. Men with PD made more errors on a set-shifting task but no significant differences were seen in domains of attention, intellectual functioning, visual learning and memory, visuospatial ability, or language ability. Effect sizes were generally small, although some medium effects were seen (visual discrimination and verbal learning and memory). Scores in both groups (with and without PD) were generally in the average range across tasks. Within the subgroup of CSAM offenders, minimal differences emerged between those with and without PD, although those with PD were slower on visuomotor set-shifting but made fewer errors (d = - 0.89). CSAM offenders with PD were in the high average range on many tasks of intellectual functioning; however, a potential trend was identified such that CSAM offenders without PD had lower scores on a task of verbal learning and memory, with medium effect sizes observed. As few differences in neuropsychological functioning emerged when comparing offenders with and without PD, differences demonstrated in prior research may be better attributed to contact offending status rather than sexual interest.
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Affiliation(s)
- Emilie H Picard
- Department of Psychiatry, University of Virginia Medical Center, West Complex, Rm. 4472, 1300 Jefferson Park Ave., Charlottesville, VA, 22903, USA.
| | - Lillian L Bopp
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, New York, NY, USA
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Gianina T, Lorena S, Dilaxy K, Patrick C, Florian K, Thomas M, Ursi K, Andreas UM, Kate P, Rankin KP, Felbecker A. The German version of the tablet-based UCSF Brain Health Assessment is sensitive to early symptoms of neurodegenerative disorders. Brain Behav 2023; 13:e3329. [PMID: 38041514 PMCID: PMC10726871 DOI: 10.1002/brb3.3329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 12/03/2023] Open
Abstract
INTRODUCTION Cognition often remains unassessed in primary care. To improve early diagnosis of neurocognitive disorder (NCD) in Switzerland, the tablet-based UCSF brain health assessment (BHA) and brain health survey (BHS) were validated. METHODS The German BHA, BHS, and Montreal Cognitive Assessment (MoCA) were administered to 67 patients with mild/major NCD and 50 controls. BHA includes subtests of memory, executive, visuospatial, and language functioning, and informant-based BHS asks about behavior and motor functioning. RESULTS The complete instrument (BHA + BHS) was most accurate at detecting mild NCD (AUC = 0.95) and NCD without amyloid pathology (AUC = 0.96), followed by the BHA. All measures were accurate (all AUCs > 0.95) at distinguishing major NCD and NCD with amyloid pathology (Alzheimer's disease [AD]) from controls. DISCUSSION The German BHA and BHS are more sensitive to mild NCD and non-AD presentations than the MoCA and thus have a high potential to identify patients with NCD in primary care earlier than currently used screens.
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Affiliation(s)
- Toller Gianina
- Department of NeurologyKantonsspital St. GallenGallenSwitzerland
| | - Stäger Lorena
- Department of NeurologyKantonsspital St. GallenGallenSwitzerland
| | | | - Callahan Patrick
- Memory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | | | | | - Kunze Ursi
- Memory Clinic, University Department of Geriatric Medicine Felix PlatterBaselSwitzerland
| | - U. Monsch Andreas
- Memory Clinic, University Department of Geriatric Medicine Felix PlatterBaselSwitzerland
| | - Possin Kate
- Memory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Katherine P. Rankin
- Memory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Ansgar Felbecker
- Department of NeurologyKantonsspital St. GallenGallenSwitzerland
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Jiskoot LC, van den Berg E, Laenen SAAM, Poos JM, Giannini LAA, Satoer DD, van Hemmen J, Pijnenburg YAL, Vonk JMJ, Seelaar H. Longitudinal changes in qualitative aspects of semantic fluency in presymptomatic and prodromal genetic frontotemporal dementia. J Neurol 2023; 270:5418-5435. [PMID: 37462752 PMCID: PMC10576727 DOI: 10.1007/s00415-023-11845-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND The semantic fluency test is one of the most widely used neuropsychological tests in dementia diagnosis. Research utilizing the qualitative, psycholinguistic information embedded in its output is currently underexplored in presymptomatic and prodromal genetic FTD. METHODS Presymptomatic MAPT (n = 20) and GRN (n = 43) mutation carriers, and controls (n = 55) underwent up to 6 years of neuropsychological assessment, including the semantic fluency test. Ten mutation carriers became symptomatic (phenoconverters). Total score and five qualitative fluency measures (lexical frequency, age of acquisition, number of clusters, cluster size, number of switches) were calculated. We used multilevel linear regression modeling to investigate longitudinal decline. We assessed the co-correlation of the qualitative measures at each time point with principal component analysis. We explored associations with cognitive decline and grey matter atrophy using partial correlations, and investigated classification abilities using binary logistic regression. RESULTS The interrater reliability of the qualitative measures was good (ICC = 0.75-0.90). There was strong co-correlation between lexical frequency and age of acquisition, and between clustering and switching. At least 4 years pre-phenoconversion, GRN phenoconverters had fewer but larger clusters (p < 0.001), and fewer switches (p = 0.004), correlating with lower executive function (r = 0.87-0.98). Fewer switches was predictive of phenoconversion, correctly classifying 90.3%. Starting at least 4 years pre-phenoconversion, MAPT phenoconverters demonstrated an increase in lexical frequency (p = 0.009) and a decline in age of acquisition (p = 0.034), correlating with lower semantic processing (r = 0.90). Smaller cluster size was predictive of phenoconversion, correctly classifying 89.3%. Increase in lexical frequency and decline in age of acquisition were associated with grey matter volume loss of predominantly temporal areas, while decline in the number of clusters, cluster size, and switches correlated with grey matter volume loss of predominantly frontal areas. CONCLUSIONS Qualitative aspects of semantic fluency could give insight into the underlying mechanisms as to why the "traditional" total score declines in the different FTD mutations. However, the qualitative measures currently demonstrate more fluctuation than the total score, the measure that seems to most reliably deteriorate with time. Replication in a larger sample of FTD phenoconverters is warranted to identify if qualitative measures could be sensitive cognitive biomarkers to identify and track mutation carriers converting to the symptomatic stage of FTD.
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Affiliation(s)
- Lize C. Jiskoot
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
- Dementia Research Centre, University College London, London, UK
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sascha A. A. M. Laenen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jackie M. Poos
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lucia A. A. Giannini
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Djaina D. Satoer
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Judy van Hemmen
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
| | | | - Jet M. J. Vonk
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA USA
- Department of Epidemiology, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Room NF-331, Post Box 2040, 3000 CA Rotterdam, The Netherlands
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Gonzalez-Recober C, Nevler N, Shellikeri S, Cousins KAQ, Rhodes E, Liberman M, Grossman M, Irwin D, Cho S. Comparison of category and letter fluency tasks through automated analysis. Front Psychol 2023; 14:1212793. [PMID: 37901072 PMCID: PMC10600440 DOI: 10.3389/fpsyg.2023.1212793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/17/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Category and letter fluency tasks are commonly used neuropsychological tasks to evaluate lexical retrieval. Methods This study used validated automated methods, which allow for more expansive investigation, to analyze speech production of both category ("Animal") and letter ("F") fluency tasks produced by healthy participants (n = 36) on an online platform. Recordings were transcribed and analyzed through automated pipelines, which utilized natural language processing and automatic acoustic processing tools. Automated pipelines calculated overall performance scores, mean inter-word response time, and word start time; errors were excluded from analysis. Each word was rated for age of acquisition (AoA), ambiguity, concreteness, frequency, familiarity, word length, word duration, and phonetic and semantic distance from its previous word. Results Participants produced significantly more words on the category fluency task relative to the letter fluency task (p < 0.001), which is in line with previous studies. Wilcoxon tests also showed tasks differed on several mean speech measures of words, and category fluency was associated with lower mean AoA (p<0.001), lower frequency (p < 0.001), lower semantic ambiguity (p < 0.001), lower semantic distance (p < 0.001), lower mean inter-word RT (p = 0.03), higher concreteness (p < 0.001), and higher familiarity (p = 0.02), compared to letter fluency. ANOVAs significant interactions for fluency task on total score and lexical measures showed that lower category fluency scores were significantly related to lower AoA and higher prevalence, and this was not observed for letter fluency scores. Finally, word-characteristics changed over time and significant interactions were noted between the tasks, including word familiarity (p = 0.019), semantic ambiguity (p = 0.002), semantic distance (p=0.001), and word duration (p<0.001). Discussion These findings showed that certain lexical measures such as AoA, word familiarity, and semantic ambiguity were important for understanding how these tasks differ. Additionally, it found that acoustic measures such as inter-word RT and word duration are also imperative to analyze when comparing the two tasks. By implementing these automated techniques, which are reproducible and scalable, to analyze fluency tasks we were able to quickly detect these differences. In future clinical settings, we expect these methods to expand our knowledge on speech feature differences that impact not only total scores, but many other speech measures among clinical populations.
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Affiliation(s)
- Carmen Gonzalez-Recober
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Naomi Nevler
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Sanjana Shellikeri
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Katheryn A. Q. Cousins
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Emma Rhodes
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - David Irwin
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, United States
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Wang Z, Ficek BN, Webster KT, Herrmann O, Frangakis CE, Desmond JE, Onyike CU, Caffo B, Hillis AE, Tsapkini K. Specificity in Generalization Effects of Transcranial Direct Current Stimulation Over the Left Inferior Frontal Gyrus in Primary Progressive Aphasia. Neuromodulation 2023; 26:850-860. [PMID: 37287321 PMCID: PMC10250817 DOI: 10.1016/j.neurom.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Generalization (or near-transfer) effects of an intervention to tasks not explicitly trained are the most desirable intervention outcomes. However, they are rarely reported and even more rarely explained. One hypothesis for generalization effects is that the tasks improved share the same brain function/computation with the intervention task. We tested this hypothesis in this study of transcranial direct current stimulation (tDCS) over the left inferior frontal gyrus (IFG) that is claimed to be involved in selective semantic retrieval of information from the temporal lobes. MATERIALS AND METHODS In this study, we examined whether tDCS over the left IFG in a group of patients with primary progressive aphasia (PPA), paired with a lexical/semantic retrieval intervention (oral and written naming), may specifically improve semantic fluency, a nontrained near-transfer task that relies on selective semantic retrieval, in patients with PPA. RESULTS Semantic fluency improved significantly more in the active tDCS than in the sham tDCS condition immediately after and two weeks after treatment. This improvement was marginally significant two months after treatment. We also found that the active tDCS effect was specific to tasks that require this IFG computation (selective semantic retrieval) but not to other tasks that may require different computations of the frontal lobes. CONCLUSIONS We provided interventional evidence that the left IFG is critical for selective semantic retrieval, and tDCS over the left IFG may have a near-transfer effect on tasks that depend on the same computation, even if they are not specifically trained. CLINICAL TRIAL REGISTRATION The Clinicaltrials.gov registration number for the study is NCT02606422.
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Affiliation(s)
- Zeyi Wang
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Bronte N Ficek
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Kimberly T Webster
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Olivia Herrmann
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Constantine E Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine, Baltimore, MD, USA; Department of Radiology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - John E Desmond
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Neuroscience Program, Johns Hopkins University, Baltimore, MD, USA
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Cognitive Science, Johns Hopkins Medicine, Baltimore, MD, USA; Department of Physical Medicine & Rehabilitation, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Kyrana Tsapkini
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Cognitive Science, Johns Hopkins Medicine, Baltimore, MD, USA.
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9
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Henderson SK, Peterson KA, Patterson K, Lambon Ralph MA, Rowe JB. Verbal fluency tests assess global cognitive status but have limited diagnostic differentiation: evidence from a large-scale examination of six neurodegenerative diseases. Brain Commun 2023; 5:fcad042. [PMID: 36910418 PMCID: PMC9999359 DOI: 10.1093/braincomms/fcad042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/23/2022] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Verbal fluency is widely used as a clinical test, but its utility in differentiating between neurodegenerative dementias and progressive aphasias, and from healthy controls, remains unclear. We assessed whether various measures of fluency performance could differentiate between Alzheimer's disease, behavioural variant of frontotemporal dementia, non-fluent and semantic variants of primary progressive aphasia, progressive supranuclear palsy, corticobasal syndrome and healthy controls. Category and letter fluency tasks were administered to 33 controls and 139 patients at their baseline clinical visit. We assessed group differences for total number of words produced, psycholinguistic word properties and associations between production order and exemplar psycholinguistic properties. Receiver operating characteristic curves determined which measure could best discriminate patient groups and controls. The total word count distinguished controls from all patient groups, but neither this measure nor the word properties differentiated the patient groups. Receiver operating characteristic curves revealed that, when comparing controls to patients, the strongest discriminators were total word count followed by word frequency. Word frequency was the strongest discriminator for semantic variant of primary progressive aphasia versus other groups. Fluency word counts were associated with global severity as measured by Addenbrooke's Cognitive Examination Revised. Verbal fluency is an efficient test for assessing global brain-cognitive health but has limited utility in differentiating between cognitively and anatomically disparate patient groups. This outcome is consistent with the fact that verbal fluency requires many different aspects of higher cognition and language.
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Affiliation(s)
- Shalom K Henderson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 7EF, UK
| | - Katie A Peterson
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 7EF, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 7EF, UK
| | - Karalyn Patterson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 7EF, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 7EF, UK
| | - Matthew A Lambon Ralph
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 7EF, UK
| | - James B Rowe
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 7EF, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 7EF, UK
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10
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Barreto Chang OL, Possin KL, Maze M. Age-Related Perioperative Neurocognitive Disorders: Experimental Models and Druggable Targets. Annu Rev Pharmacol Toxicol 2023; 63:321-340. [PMID: 36100220 DOI: 10.1146/annurev-pharmtox-051921-112525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
With the worldwide increase in life span, surgical patients are becoming older and have a greater propensity for postoperative cognitive impairment, either new onset or through deterioration of an existing condition; in both conditions, knowledge of the patient's preoperative cognitive function and postoperative cognitive trajectory is imperative. We describe the clinical utility of a tablet-based technique for rapid assessment of the memory and attentiveness domains required for executive function. The pathogenic mechanisms for perioperative neurocognitive disorders have been investigated in animal models in which excessive and/or prolonged postoperative neuroinflammation has emerged as a likely contender. The cellular and molecular species involved in postoperative neuroinflammation are the putative targets for future therapeutic interventions that are efficacious and do not interfere with the surgical patient's healing process.
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Affiliation(s)
- Odmara L Barreto Chang
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA;
| | - Katherine L Possin
- Memory and Aging Center, Department of Neurology, and Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Mervyn Maze
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA; .,Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, USA
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11
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Emrani S, Lamar M, Price CC, Swenson R, Libon DJ, Baliga G. Neurocognitive Operations Underlying Working Memory Abilities: An Analysis of Latency and Time-Based Parameters. J Alzheimers Dis 2023; 94:1535-1547. [PMID: 37458036 DOI: 10.3233/jad-230288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND The theory of executive attention (Fuster, 2015) suggests considerable plasticity regarding when specific neurocognitive operations are recruited to bring executive tasks to fruition. OBJECTIVE We tested the hypothesis that differing neurocognitive operations are recruited upon the initiation of a response, but that other distinct neurocognitive operations are recruited towards the middle or end of a response. METHODS The Backward Digit Span Test (BDST) was administered to 58 memory clinic patients (MCI, n = 22; no-MCI, n = 36). Latency to generate all correct 5-span responses was obtained. Statistical analyses found that optimal group classification was achieved using the first and third digit backward. First and third response latencies were analyzed in relation to verbal working memory (WM), visual WM, processing speed, visuospatial operations, naming/lexical access, and verbal episodic memory tests. RESULTS For the first response, slower latencies were associated with better performance in relation to verbal WM and visuospatial test performance. For the third response, faster latencies were associated with better processing speed and visuospatial test performance. CONCLUSION Consistent with the theory of executive attention, these data show that the neurocognitive operations underlying successful executive test performance are not monolithic but can be quite nuanced with differing neurocognitive operations associated with specific time epochs. Results support the efficacy of obtaining time-based latency parameters to help disambiguate successful executive neurocognitive operations in memory clinic patients.
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Affiliation(s)
- Sheina Emrani
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Rod Swenson
- Department of Psychiatry and Behavioral Science at the University of North Dakota, School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - David J Libon
- New Jersey Institute for Successful Aging, School of Osteopathic Medicine and the Department of Psychology, Rowan University, Stratford, NJ, USA
| | - Ganesh Baliga
- Department of Computer Science, Rowan University, Glassboro, NJ, USA
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12
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Design and Verbal Fluency in Alzheimer's Disease and Frontotemporal Dementia: Clinical and Metabolic Correlates. J Int Neuropsychol Soc 2022; 28:947-962. [PMID: 34569460 DOI: 10.1017/s1355617721001144] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Cognitive processes underlying verbal and design fluency, and their neural correlates in patients with Alzheimer's disease (AD) and behavioural variant Frontotemporal Dementia (bvFTD) remain unclear. We hypothesised that verbal and design fluency may be associated with distinct neuropsychological processes in AD and FTD, showing different patterns of impairment and neural basis. METHODS We enrolled 142 participants including patients with AD (n = 80, mean age = 74.71), bvFTD (n = 34, mean age = 68.18), and healthy controls (HCs) (n = 28, mean age = 71.14), that underwent cognitive assessment and 18F-fluorodeoxyglucose positron emission tomography imaging. RESULTS Semantic and phonemic fluency showed the largest effect sizes between groups, showing lower scores in bvFTD than AD and HCs, and lower scores in AD than HC. Both AD and bvFTD showed a lower number of unique designs in design fluency in comparison to HC. Semantic fluency was correlated with left frontotemporal lobe in AD, and with left frontal, caudate, and thalamus in bvFTD. Percentage of unique designs in design fluency was associated with the metabolism of the bilateral fronto-temporo-parietal cortex in AD, and the bilateral frontal cortex with right predominance in bvFTD. Repetitions in AD were correlated with bilateral frontal, temporal, and parietal lobes, and with left prefrontal cortex in bvFTD. CONCLUSIONS Our findings demonstrate differential underlying cognitive processes in verbal and design fluency in AD and bvFTD. While memory and executive functioning associated with fronto-temporo-parietal regions were key in AD, attention and executive functions correlated with the frontal cortex and played a more significant role in bvFTD during fluency tasks.
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13
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Isella V, Licciardo D, Ferri F, Crivellaro C, Morzenti S, Appollonio I, Ferrarese C. Reduced phonemic fluency in progressive supranuclear palsy is due to dysfunction of dominant BA6. Front Aging Neurosci 2022; 14:969875. [PMID: 36158541 PMCID: PMC9492952 DOI: 10.3389/fnagi.2022.969875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Reduced phonemic fluency is extremely frequent in progressive supranuclear palsy (PSP), but its neural correlate is yet to be defined. Objective We explored the hypothesis that poor fluency in PSP might be due to neurodegeneration within a dominant frontal circuit known to be involved in speech fluency, including the opercular area, the superior frontal cortex (BA6), and the frontal aslant tract connecting these two regions. Methods We correlated performance on a letter fluency task (F, A, and S, 60 s for each letter) with brain metabolism as measured with Fluoro-deoxy-glucose Positron Emission Tomography, using Statistical Parametric Mapping, in 31 patients with PSP. Results Reduced letter fluency was associated with significant hypometabolism at the level of left BA6. Conclusion Our finding is the first evidence that in PSP, as in other neurogical disorders, poor self-initiated, effortful verbal retrieval appears to be linked to dysfunction of the dominant opercular-aslant-BA6 circuit.
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Affiliation(s)
- Valeria Isella
- Department of Neurology, School of Medicine, University of Milano - Bicocca, Monza, Italy
- Milan Center for Neurosciences, Milan, Italy
| | - Daniele Licciardo
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
| | - Francesca Ferri
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
| | | | | | - Ildebrando Appollonio
- Department of Neurology, School of Medicine, University of Milano - Bicocca, Monza, Italy
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
| | - Carlo Ferrarese
- Department of Neurology, School of Medicine, University of Milano - Bicocca, Monza, Italy
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
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14
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van den Berg E, Dijkzeul JCM, Poos JM, Eikelboom WS, van Hemmen J, Franzen S, de Jong FJ, Dopper EGP, Vonk JMJ, Papma JM, Satoer D, Jiskoot LC, Seelaar H. Differential linguistic features of verbal fluency in behavioral variant frontotemporal dementia and primary progressive aphasia. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 35416098 PMCID: PMC10069460 DOI: 10.1080/23279095.2022.2060748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Frontotemporal dementia (FTD) is an early-onset neurodegenerative disorder with a heterogeneous clinical presentation. Verbal fluency is regularly used as a sensitive measure of language ability, semantic memory, and executive functioning, but qualitative changes in verbal fluency in FTD are currently overlooked. This retrospective study examined qualitative, linguistic features of verbal fluency in 137 patients with behavioral variant (bv)FTD (n = 50), or primary progressive aphasia (PPA) [25 non-fluent variant (nfvPPA), 27 semantic variant (svPPA), and 34 logopenic variant (lvPPA)] and 25 control participants. Between-group differences in clustering, switching, lexical frequency (LF), age of acquisition (AoA), neighborhood density (ND), and word length (WL) were examined in the category and letter fluency with analysis of variance adjusted for age, sex, and the total number of words. Associations with other cognitive functions were explored with linear regression analysis. The results showed that the verbal fluency performance of patients with svPPA could be distinguished from controls and other patient groups by fewer and smaller clusters, more switches, higher LF, and lower AoA (all p < 0.05). Patients with lvPPA specifically produced words with higher ND than the other patient groups (p < 0.05). Patients with bvFTD produced longer words than the PPA groups (p < 0.05). Clustering, switching, LF, AoA, and ND-but not WL-were differentially predicted by measures of language, memory, and executive functioning (range standardized regression coefficient 0.25-0.41). In addition to the total number of words, qualitative linguistic features differ between subtypes of FTD. These features provide additional information on lexical processing and semantic memory that may aid the differential diagnosis of FTD.
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Affiliation(s)
- E. van den Berg
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - J. C. M. Dijkzeul
- Department of Child Psychiatry, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - J. M. Poos
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - W. S. Eikelboom
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - J. van Hemmen
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - S. Franzen
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - F. J. de Jong
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - E. G. P. Dopper
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - J. M. J. Vonk
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - J. M. Papma
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - D. Satoer
- Department of Neurosurgery, Erasmus MC University Medical Center, Rotterdam, Netherland
| | - L. C. Jiskoot
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Dementia Research Centre, University College London, London, UK
| | - H. Seelaar
- Department of Neurology, Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, Netherlands
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15
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López-Higes R, Rubio-Valdehita S, Llorente-Morales C, Sánchez-Beato A, Delgado-Lima AH, Delgado-Losada ML. Animals in multidimensional space: Interpreting coordinates throughout lexical-semantic features in mild cognitive impairment and control subjects. J Clin Exp Neuropsychol 2022; 43:1018-1031. [PMID: 35341460 DOI: 10.1080/13803395.2022.2057443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Semantic verbal fluency is a useful neuropsychological tool since it involves language and executive abilities that can be impaired in patients with neurodegenerative diseases in comparison to healthy controls. The present study explores retrieve and executive control processes using traditional quantitative and qualitative raw scores and examines the utility of multidimensional scaling combined with linear regression to provide new insights about the underlying semantic network in mild cognitive impairment and in healthy older adults. METHOD A total of 165 Spanish older adults, 81 patients and 84 controls, were assessed in different cognitive domains and evoked animal names in one minute. Group differences on fluency raw scores were first explored. Regressions using tests to predict groups' fluency scores were also performed. The 12 animals that had been produced more frequently were selected to perform a multidimensional scaling analysis for each group. Four features related to animal names were extracted from normative studies and then were used as predictors in linear regression to provide an interpretation of the resulting dimensions' coordinates. RESULTS Patients performed worse on memory and naming and produced a shorter list of animals than controls. In controls, naming and visual memory explained a small part of variance related to the total of animals produced and to the number of switches. Both groups exhibited similar semantic maps. CONCLUSIONS Results suggest that patients' map is influenced by words with a dense associative neighborhood that were acquired at an early age, whereas in controls none of the predictors explained dimensions.
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Affiliation(s)
- Ramón López-Higes
- Department of Experimental Psychology, Universidad Complutense de Madrid, Spain
| | - Susana Rubio-Valdehita
- Department of Social, Work and Differential Psychology, Universidad Complutense de Madrid, Campus de Somosaguas S/n, Pozuelo de Alarcón, Spain
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16
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Riello M, Frangakis CE, Ficek B, Webster KT, Desmond JE, Faria AV, Hillis AE, Tsapkini K. Neural Correlates of Letter and Semantic Fluency in Primary Progressive Aphasia. Brain Sci 2021; 12:1. [PMID: 35053745 PMCID: PMC8773895 DOI: 10.3390/brainsci12010001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/21/2022] Open
Abstract
Verbal fluency (VF) is an informative cognitive task. Lesion and functional imaging studies implicate distinct cerebral areas that support letter versus semantic fluency and the understanding of neural and cognitive mechanisms underlying task performance. Most lesion studies include chronic stroke patients. People with primary progressive aphasia (PPA) provide complementary evidence for lesion-deficit associations, as different brain areas are affected in stroke versus PPA. In the present study we sought to determine imaging, clinical and demographic correlates of VF in PPA. Thirty-five patients with PPA underwent an assessment with letter and category VF tasks, evaluation of clinical features and an MRI scan for volumetric analysis. We used stepwise regression models to determine which brain areas are associated with VF performance while acknowledging the independent contribution of clinical and demographic factors. Letter fluency was predominantly associated with language severity (R2 = 38%), and correlated with the volume of the left superior temporal regions (R2 = 12%) and the right dorsolateral prefrontal area (R2 = 5%). Semantic fluency was predominantly associated with dementia severity (R2 = 47%) and correlated with the volume of the left inferior temporal gyrus (R2 = 7%). No other variables were significantly associated with performance in the two VF tasks. We concluded that, independently of disease severity, letter fluency is significantly associated with the volume of frontal and temporal areas whereas semantic fluency is associated mainly with the volume of temporal areas. Furthermore, our findings indicated that clinical severity plays a critical role in explaining VF performance in PPA, compared to the other clinical and demographic factors.
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Affiliation(s)
- Marianna Riello
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
| | - Constantine E. Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD 21227, USA;
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA;
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
| | - Kimberly T. Webster
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA
| | - John E. Desmond
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
| | - Andreia V. Faria
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21227, USA;
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA; (M.R.); (B.F.); (K.T.W.); (J.E.D.); (A.E.H.)
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
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17
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Scheffel L, Duffy JR, Strand EA, Josephs KA. Word Fluency Test Performance in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2635-2642. [PMID: 34674540 PMCID: PMC9132020 DOI: 10.1044/2021_ajslp-21-00058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/21/2021] [Accepted: 07/15/2021] [Indexed: 06/05/2023]
Abstract
Purpose This study compared performance on three-word fluency measures among individuals with primary progressive aphasia (PPA) and primary progressive apraxia of speech (PPAOS), and examined the relationship between word fluency and other measures of language and speech. Method This study included 106 adults with PPA and 30 adults with PPAOS. PPA participants were divided into three clinical subgroups: semantic (svPPA), logopenic (lvPPA), and nonfluent/agrammatic with or without apraxia of speech (nfPPA). Category fluency, letter fluency, and action/verb fluency tasks were administered to all participants. Results The four clinical groups performed abnormally on the word fluency measures, although not to a degree that represented high sensitivity to their PPA or PPAOS diagnosis. All PPA subgroups produced fewer words compared to individuals with PPAOS on all word fluency measures. Moderate correlations were found between word fluency and aphasia severity and naming performance in some of the clinical groups. Conclusions Word fluency measures are often challenging for individuals with PPA and PPAOS, but they are not of equal difficulty, with letter fluency being the most difficult. Differences among word fluency tests also vary to some degree as a function of the clinical group in question, with least impairment in PPAOS. However, the findings of this study do not support statistically significant differences in word fluency task performance among the PPA subgroups. Correlations suggest that word fluency performance in PPA is at least partly related to aphasia severity.
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Affiliation(s)
- Lucia Scheffel
- Department of Special Education and Communication Disorders, University of Nebraska at Omaha
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18
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Amaral-Carvalho V, Lima-Silva TB, Mariano LI, de Souza LC, Guimarães HC, Bahia VS, Nitrini R, Barbosa MT, Yassuda MS, Caramelli P. Brazilian Version of Addenbrooke's Cognitive Examination-Revised in the Differential Diagnosis of Alzheimer'S Disease and Behavioral Variant Frontotemporal Dementia. Arch Clin Neuropsychol 2021; 37:437-448. [PMID: 34530438 DOI: 10.1093/arclin/acab071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 07/29/2021] [Accepted: 08/20/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are frequent causes of dementia and, therefore, instruments for differential diagnosis between these two conditions are of great relevance. OBJECTIVE To investigate the diagnostic accuracy of Addenbrooke's Cognitive Examination-Revised (ACE-R) for differentiating AD from bvFTD in a Brazilian sample. METHODS The ACE-R was administered to 102 patients who had been diagnosed with mild dementia due to probable AD, 37 with mild bvFTD and 161 cognitively healthy controls, matched according to age and education. Additionally, all subjects were assessed using the Mattis Dementia Rating Scale and the Neuropsychiatric Inventory. The performance of patients and controls was compared by using univariate analysis, and ROC curves were calculated to investigate the accuracy of ACE-R for differentiating AD from bvFTD and for differentiating AD and bvFTD from controls. The verbal fluency plus language to orientation plus name and address delayed recall memory (VLOM) ratio was also calculated. RESULTS The optimum cutoff scores for ACE-R were <80 for AD, <79 for bvFTD, and <80 for dementia (AD + bvFTD), with area under the receiver operating characteristic curves (ROC) (AUC) >0.85. For the differential diagnosis between AD and bvFTD, a VLOM ratio of 3.05 showed an AUC of 0.816 (Cohen's d = 1.151; p < .001), with 86.5% sensitivity, 71.4% specificity, 72.7% positive predictive value, and 85.7% negative predictive value. CONCLUSIONS The Brazilian ACE-R achieved a good diagnostic accuracy for differentiating AD from bvFTD patients and for differentiating AD and bvFTD from the controls in the present sample.
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Affiliation(s)
- Viviane Amaral-Carvalho
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.,Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Bento Lima-Silva
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.,Escola de Artes, Ciências e Humanidades da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Luciano Inácio Mariano
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo Cruz de Souza
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Henrique Cerqueira Guimarães
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Valéria Santoro Bahia
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Maira Tonidandel Barbosa
- Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mônica Sanches Yassuda
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.,Escola de Artes, Ciências e Humanidades da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Paulo Caramelli
- Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.,Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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19
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Bonete-López B, Oltra-Cucarella J, Marín M, Antón C, Balao N, López E, Macià ES. Validation and Norms for a Recognition Task for the Spanish Version of the Free and Cued Selective Reminding Test. Arch Clin Neuropsychol 2021; 36:954-964. [PMID: 33264394 DOI: 10.1093/arclin/acaa117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/25/2020] [Accepted: 11/01/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of the present work was to develop and validate a recognition task to be used with the Spanish version of the 16 items Free and Cued Selective Reminding Test (FCSRT). METHOD A total of 96 (67.7% women) cognitively healthy, functionally independent community-dwelling participants aged 55 years or older underwent a comprehensive neuropsychological assessment. A recognition task for the FCSRT was developed that included the original 16 items, 16 semantically related items, and eight unrelated foils. Indices of discriminability (d') and response bias (C), as well as 95% confidence intervals for chance-level responding were calculated. RESULTS On average, our sample was 65.71 years old (SD = 6.68, range: 55-87), had 11.39 years of formal education (SD = 3.37, range: 3-19), and a Mini-Mental State Examination score = 28.42 (SD = 1.49, range: 25-30). Recognition scores did not differ statistically between sexes, nor did they correlate with demographics. Participants scored at ceiling levels (mean number of Hits = 15.52, SD = 0.906, mean number of False Alarms = 0.27, SD = 0.589). All the participants scored above chance levels. CONCLUSIONS Normative data from a novel recognition task for the Spanish version of the FCSRT are provided for use in clinical and research settings. Including a recognition task in the assessment of memory functioning might help uncover the pattern of memory impairments in older adults, and can help improve the memory profile of people with amnestic Mild Cognitive Impairment. Future research is warranted to validate and expand the recognition task.
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Affiliation(s)
- Beatriz Bonete-López
- Departmento Psicología de la Salud, Universidad Miguel Hernández de Elche, Alicante, Spain.,SABIEX, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Javier Oltra-Cucarella
- Departmento Psicología de la Salud, Universidad Miguel Hernández de Elche, Alicante, Spain.,SABIEX, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Marta Marín
- SABIEX, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Carolina Antón
- SABIEX, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Nerea Balao
- SABIEX, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Elena López
- SABIEX, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Esther Sitges Macià
- Departmento Psicología de la Salud, Universidad Miguel Hernández de Elche, Alicante, Spain.,SABIEX, Universidad Miguel Hernández de Elche, Alicante, Spain
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20
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Geraudie A, Díaz Rivera M, Montembeault M, García AM. Language in Behavioral Variant Frontotemporal Dementia: Another Stone to Be Turned in Latin America. Front Neurol 2021; 12:702770. [PMID: 34447348 PMCID: PMC8383282 DOI: 10.3389/fneur.2021.702770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/12/2021] [Indexed: 12/03/2022] Open
Abstract
Beyond canonical deficits in social cognition and interpersonal conduct, behavioral variant frontotemporal dementia (bvFTD) involves language difficulties in a substantial proportion of cases. However, since most evidence comes from high-income countries, the scope and relevance of language deficits in Latin American bvFTD samples remain poorly understood. As a first step toward reversing this scenario, we review studies reporting language measures in Latin American bvFTD cohorts relative to other groups. We identified 24 papers meeting systematic criteria, mainly targeting phonemic and semantic fluency, naming, semantic processing, and comprehension skills. The evidence shows widespread impairments in these domains, often related to overall cognitive disturbances. Some of these deficits may be as severe as in other diseases where they are more widely acknowledged, such as Alzheimer's disease. Considering the prevalence and informativeness of language deficits in bvFTD patients from other world regions, the need arises for more systematic research in Latin America, ideally spanning multiple domains, in diverse languages and dialects, with validated batteries. We outline key challenges and pathways of progress in this direction, laying the ground for a new regional research agenda on the disorder.
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Affiliation(s)
- Amandine Geraudie
- Neurology Department, Toulouse University Hospital, Toulouse, France
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Mariano Díaz Rivera
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- Agencia Nacional de Promoción Científica y Tecnológica, Buenos Aires, Argentina
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Adolfo M. García
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Faculty of Education, National University of Cuyo, Mendoza, Argentina
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
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21
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Cho S, Nevler N, Parjane N, Cieri C, Liberman M, Grossman M, Cousins KAQ. Automated Analysis of Digitized Letter Fluency Data. Front Psychol 2021; 12:654214. [PMID: 34393894 PMCID: PMC8359864 DOI: 10.3389/fpsyg.2021.654214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
The letter-guided naming fluency task is a measure of an individual's executive function and working memory. This study employed a novel, automated, quantifiable, and reproducible method to investigate how language characteristics of words produced during a fluency task are related to fluency performance, inter-word response time (RT), and over task duration using digitized F-letter-guided fluency recordings produced by 76 young healthy participants. Our automated algorithm counted the number of correct responses from the transcripts of the F-letter fluency data, and individual words were rated for concreteness, ambiguity, frequency, familiarity, and age of acquisition (AoA). Using a forced aligner, the transcripts were automatically aligned with the corresponding audio recordings. We measured inter-word RT, word duration, and word start time from the forced alignments. Articulation rate was also computed. Phonetic and semantic distances between two consecutive F-letter words were measured. We found that total F-letter score was significantly correlated with the mean values of word frequency, familiarity, AoA, word duration, phonetic similarity, and articulation rate; total score was also correlated with an individual's standard deviation of AoA, familiarity, and phonetic similarity. RT was negatively correlated with frequency and ambiguity of F-letter words and was positively correlated with AoA, number of phonemes, and phonetic and semantic distances. Lastly, the frequency, ambiguity, AoA, number of phonemes, and semantic distance of words produced significantly changed over time during the task. The method employed in this paper demonstrates the successful implementation of our automated language processing pipelines in a standardized neuropsychological task. This novel approach captures subtle and rich language characteristics during test performance that enhance informativeness and cannot be extracted manually without massive effort. This work will serve as the reference for letter-guided category fluency production similarly acquired in neurodegenerative patients.
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Affiliation(s)
- Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, United States
| | - Naomi Nevler
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Natalia Parjane
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher Cieri
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, United States
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Katheryn A Q Cousins
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
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22
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He X, Li X, Fu J, Xu J, Liu H, Zhang P, Li W, Yu C, Ye Z, Qin W. The morphometry of left cuneus mediating the genetic regulation on working memory. Hum Brain Mapp 2021; 42:3470-3480. [PMID: 33939221 PMCID: PMC8249898 DOI: 10.1002/hbm.25446] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
Working memory is a basic human cognitive function. However, the genetic signatures and their biological pathway remain poorly understood. In the present study, we tried to clarify this issue by exploring the potential associations and pathways among genetic variants, brain morphometry and working memory performance. We first carried out association analyses between 2‐back accuracy and 212 image‐derived phenotypes from 1141 Human Connectome Project (HCP) subjects using a linear mixed model (LMM). We found a significantly positive correlation between the left cuneus volume and 2‐back accuracy (T = 3.615, p = 3.150e−4, Cohen's d = 0.226, corrected using family‐wise error [FWE] method). Based on the LMM‐based genome‐wide association study (GWAS) on the HCP dataset and UK Biobank 33 k GWAS summary statistics, we identified eight independent single nucleotide polymorphisms (SNPs) that were reliably associated with left cuneus volume in both UKB and HCP dataset. Within the eight SNPs, we found a negative correlation between the rs76119478 polymorphism and 2‐back accuracy accuracy (T = −2.045, p = .041, Cohen's d = −0.129). Finally, an LMM‐based mediation analysis elucidated a significant effect of left cuneus volume in mediating rs76119478 polymorphism on the 2‐back accuracy (indirect effect = −0.007, 95% BCa CI = [−0.045, −0.003]). These results were also replicated in a subgroup of Caucasians in the HCP population. Further fine mapping demonstrated that rs76119478 maps on intergene CTD‐2315A10.2 adjacent to protein‐encoding gene DAAM1, and is significantly associated with L3HYPDH mRNA expression. Our study suggested this new variant rs76119478 may regulate the working memory through exerting influence on the left cuneus volume.
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Affiliation(s)
- Xiaoxi He
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin, China.,Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Xi Li
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Jilian Fu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiayuan Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Huaigui Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Peng Zhang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Wei Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,National Clinical Research Center for Cancer, Tianjin, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.,Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
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23
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Peet BT, Spina S, Mundada N, La Joie R. Neuroimaging in Frontotemporal Dementia: Heterogeneity and Relationships with Underlying Neuropathology. Neurotherapeutics 2021; 18:728-752. [PMID: 34389969 PMCID: PMC8423978 DOI: 10.1007/s13311-021-01101-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 12/11/2022] Open
Abstract
Frontotemporal dementia encompasses a group of clinical syndromes defined pathologically by degeneration of the frontal and temporal lobes. Historically, these syndromes have been challenging to diagnose, with an average of about three years between the time of symptom onset and the initial evaluation and diagnosis. Research in the field of neuroimaging has revealed numerous biomarkers of the various frontotemporal dementia syndromes, which has provided clinicians with a method of narrowing the differential diagnosis and improving diagnostic accuracy. As such, neuroimaging is considered a core investigative tool in the evaluation of neurodegenerative disorders. Furthermore, patterns of neurodegeneration correlate with the underlying neuropathological substrates of the frontotemporal dementia syndromes, which can aid clinicians in determining the underlying etiology and improve prognostication. This review explores the advancements in neuroimaging and discusses the phenotypic and pathologic features of behavioral variant frontotemporal dementia, semantic variant primary progressive aphasia, and nonfluent variant primary progressive aphasia, as seen on structural magnetic resonance imaging and positron emission tomography.
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Affiliation(s)
- Bradley T Peet
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
| | - Salvatore Spina
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Nidhi Mundada
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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24
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Barker MS, Manoochehri M, Rizer SJ, Appleby BS, Brushaber D, Dev SI, Devick KL, Dickerson BC, Fields JA, Foroud TM, Forsberg LK, Galasko DR, Ghoshal N, Graff-Radford NR, Grossman M, Heuer HW, Hsiung GY, Kornak J, Litvan I, Mackenzie IR, Mendez MF, Pascual B, Rankin KP, Rascovsky K, Staffaroni AM, Tartaglia MC, Weintraub S, Wong B, Boeve BF, Boxer AL, Rosen HJ, Goldman J, Huey ED, Cosentino S. Recognition memory and divergent cognitive profiles in prodromal genetic frontotemporal dementia. Cortex 2021; 139:99-115. [PMID: 33857770 DOI: 10.1016/j.cortex.2021.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/28/2021] [Accepted: 03/01/2021] [Indexed: 01/01/2023]
Abstract
Although executive dysfunction is the characteristic cognitive marker of behavioral variant frontotemporal dementia (bvFTD), episodic memory deficits are relatively common, and may be present even during the prodromal disease phase. In a cohort of mutation carriers with mild behavioral and/or cognitive symptoms consistent with prodromal bvFTD, we aimed to investigate patterns of performance on an abbreviated list learning task, with a particular focus on recognition memory. We further aimed to characterize the cognitive prodromes associated with the three major genetic causes of frontotemporal dementia, as emerging evidence suggests there may be subtle differences in cognitive profiles among carriers of different genetic mutations. Participants included 57 carriers of a pathogenic mutation in microtubule-associated protein tau (MAPT, N = 23), or progranulin (GRN, N = 15), or a or a hexanucleotide repeat expansion in chromosome 9 open reading frame 72 (C9orf72, N = 19), with mild cognitive and/or behavioral symptoms consistent with prodromal bvFTD. Familial non-carriers were included as controls (N = 143). All participants completed a comprehensive neuropsychological examination, including an abbreviated list learning test assessing episodic memory recall and recognition. MAPT mutation carriers performed worse than non-carriers in terms of list recall, and had difficulty discriminating targets from distractors on the recognition memory task, primarily due to the endorsement of distractors as targets. MAPT mutation carriers also showed nonverbal episodic memory and semantic memory dysfunction (object naming). GRN mutation carriers were variable in performance and overall the most dysexecutive. Slowed psychomotor speed was evident in C9orf72 repeat expansion carriers. Identifying the earliest cognitive indicators of bvFTD is of critical clinical and research importance. List learning may be a sensitive cognitive marker for incipient dementia in MAPT and potentially a subset of GRN carriers. Our results highlight that distinct cognitive profiles may be evident in carriers of the three disease-causing genes during the prodromal disease stage.
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Affiliation(s)
- Megan S Barker
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University Medical Center, New York, NY, USA.
| | - Masood Manoochehri
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University Medical Center, New York, NY, USA
| | - Sandra J Rizer
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University Medical Center, New York, NY, USA
| | - Brian S Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Danielle Brushaber
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sheena I Dev
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Katrina L Devick
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Bradford C Dickerson
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Julie A Fields
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Tatiana M Foroud
- National Centralized Repository for Alzheimer's Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | - Douglas R Galasko
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
| | - Nupur Ghoshal
- Department of Neurology, Washington University, St. Louis, MO, USA
| | | | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Irene Litvan
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
| | - Ian R Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mario F Mendez
- Department of Neurology, University of California, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Belen Pascual
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX, USA; Weill Cornell Medicine, NY, USA
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Maria Carmela Tartaglia
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sandra Weintraub
- Northwestern Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer's Disease Northwestern University, Chicago, IL, USA
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Jill Goldman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University Medical Center, New York, NY, USA; Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Edward D Huey
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University Medical Center, New York, NY, USA; Department of Neurology, Columbia University Medical Center, New York, NY, USA; Department of Psychiatry and New York Psychiatric Institute, Columbia University Medical Center, New York, USA
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University Medical Center, New York, NY, USA; Department of Neurology, Columbia University Medical Center, New York, NY, USA; Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
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25
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Takeda S, Fukuzaki T. Development of a Neuropsychological Test to Evaluate Cognitive Flexibility. Yonago Acta Med 2021; 64:162-167. [PMID: 34025190 DOI: 10.33160/yam.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/02/2021] [Indexed: 01/05/2023]
Abstract
Background Cognitive flexibility is also referred to as set-shifting and is considered to be an important activity of the frontal lobe. The objective of this study was to produce a Cognitive Flexibility Test (CFT) that can evaluate cognitive flexibility in a short time and in a simple manner and to verify the usefulness of the test. Methods The CFT, Mini Mental State Examination (MMSE), Verbal Fluency Test (VFT), and Geriatric Depression Scale 15 (GDS-15) were implemented among a total of 94 elderly people who live at home. An "A" version of CFT (CFT-A), which asked about the possible uses of a plastic bottle other than drinking and a "B" version (CFT-B), which asked about the possible uses of a ballpoint pen other than writing, were produced. Results In the case of CFT-A, after adjusting the number of years of education, a significant correlation was found between CFT-A and the variables age, VFT, and MMSE. As for CFT-B, after adjusting the number of years of education, it was found to have a significant correlation with age and VFT. The number of responses for CFT-A and CFT-B were significantly lower than that of VFT. The number of responses for CFT-B was significantly lower than that of CFT-A. Conclusion The CFT-A may be useful as a neuropsychological test to evaluate cognitive flexibility among elderly people that can be implemented easily in a short time.
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Affiliation(s)
- Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503, Japan
| | - Toshiki Fukuzaki
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503, Japan
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26
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Manera AL, Dadar M, Van Swieten JC, Borroni B, Sanchez-Valle R, Moreno F, Laforce R, Graff C, Synofzik M, Galimberti D, Rowe JB, Masellis M, Tartaglia MC, Finger E, Vandenberghe R, de Mendonca A, Tagliavini F, Santana I, Butler CR, Gerhard A, Danek A, Levin J, Otto M, Frisoni G, Ghidoni R, Sorbi S, Rohrer JD, Ducharme S, Collins DL. MRI data-driven algorithm for the diagnosis of behavioural variant frontotemporal dementia. J Neurol Neurosurg Psychiatry 2021; 92:jnnp-2020-324106. [PMID: 33722819 DOI: 10.1136/jnnp-2020-324106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/24/2020] [Accepted: 12/22/2020] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Structural brain imaging is paramount for the diagnosis of behavioural variant of frontotemporal dementia (bvFTD), but it has low sensitivity leading to erroneous or late diagnosis. METHODS A total of 515 subjects from two different bvFTD cohorts (training and independent validation cohorts) were used to perform voxel-wise morphometric analysis to identify regions with significant differences between bvFTD and controls. A random forest classifier was used to individually predict bvFTD from deformation-based morphometry differences in isolation and together with semantic fluency. Tenfold cross validation was used to assess the performance of the classifier within the training cohort. A second held-out cohort of genetically confirmed bvFTD cases was used for additional validation. RESULTS Average 10-fold cross-validation accuracy was 89% (82% sensitivity, 93% specificity) using only MRI and 94% (89% sensitivity, 98% specificity) with the addition of semantic fluency. In the separate validation cohort of definite bvFTD, accuracy was 88% (81% sensitivity, 92% specificity) with MRI and 91% (79% sensitivity, 96% specificity) with added semantic fluency scores. CONCLUSION Our results show that structural MRI and semantic fluency can accurately predict bvFTD at the individual subject level within a completely independent validation cohort coming from a different and independent database.
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Affiliation(s)
- Ana L Manera
- McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Mahsa Dadar
- McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
- Radiology and Nuclear Medicine, Laval University, Quebec City, Quebec, Canada
| | | | - Barbara Borroni
- Department of Clinical and Experimental Sciences, Centre for Ageing Brain and Neurodegenerative Disorders, University of Brescia, Brescia, Italy
| | - Raquel Sanchez-Valle
- Alzheimer's disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, Quebec City, Quebec, Canada
| | - Caroline Graff
- Department of Geriatric Medicine, Karolinska University Hospital-Huddinge, Stockholm, Sweden
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
| | - Daniela Galimberti
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- LANE - Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - James Benedict Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Mario Masellis
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Disease, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - Fabrizio Tagliavini
- Neurology and Neuropathology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - Alex Gerhard
- Institute of Brain, Behaviour and Mental Health, The University of Manchester, Manchester, UK
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians Universitat, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians Universitat, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Markus Otto
- Department of Neurology, University Hospital Ulm, Ulm, Germany
| | - Giovanni Frisoni
- LANE - Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Roberta Ghidoni
- Molecular Markers Lab, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Simon Ducharme
- McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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ÖZDEMİR Ş, TUNÇER A. Verbal Fluency: An Investigation of Time Variable among Elderly People. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.727477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Frontotemporal dementia, music perception and social cognition share neurobiological circuits: A meta-analysis. Brain Cogn 2021; 148:105660. [PMID: 33421942 DOI: 10.1016/j.bandc.2020.105660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/27/2020] [Accepted: 11/26/2020] [Indexed: 01/18/2023]
Abstract
Frontotemporal dementia (FTD) is a neurodegenerative disease that presents with profound changes in social cognition. Music might be a sensitive probe for social cognition abilities, but underlying neurobiological substrates are unclear. We performed a meta-analysis of voxel-based morphometry studies in FTD patients and functional MRI studies for music perception and social cognition tasks in cognitively normal controls to identify robust patterns of atrophy (FTD) or activation (music perception or social cognition). Conjunction analyses were performed to identify overlapping brain regions. In total 303 articles were included: 53 for FTD (n = 1153 patients, 42.5% female; 1337 controls, 53.8% female), 28 for music perception (n = 540, 51.8% female) and 222 for social cognition in controls (n = 5664, 50.2% female). We observed considerable overlap in atrophy patterns associated with FTD, and functional activation associated with music perception and social cognition, mostly encompassing the ventral language network. We further observed overlap across all three modalities in mesolimbic, basal forebrain and striatal regions. The results of our meta-analysis suggest that music perception and social cognition share neurobiological circuits that are affected in FTD. This supports the idea that music might be a sensitive probe for social cognition abilities with implications for diagnosis and monitoring.
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White matter pathways underlying Chinese semantic and phonological fluency in mild cognitive impairment. Neuropsychologia 2020; 149:107671. [PMID: 33189733 DOI: 10.1016/j.neuropsychologia.2020.107671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/21/2022]
Abstract
Neuroimaging evidence has suggested that Chinese-language processing differs from that of its alphabetic-language counterparts. However, the underlying white matter pathway correlations between semantic and phonological fluency in Chinese-language processing remain unknown. Thus, we investigated the differences between two verbal fluency tests on 50 participants with amnestic mild cognitive impairment (aMCI) and 36 healthy controls (HC) with respect to five groups (ventral and dorsal stream fibers, frontal-striatal fibers, hippocampal-related fibers, and the corpus callosum) of white matter microstructural integrity. Diffusion spectrum imaging was used. The results revealed a progressive reduction in advantage in semantic fluency relative to phonological fluency from HC to single-domain aMCI to multidomain aMCI. Common and dissociative white matter correlations between tests of the two types of fluency were identified. Both types of fluency relied on the corpus callosum and ventral stream fibers, semantic fluency relied on the hippocampal-related fibers, and phonological fluency relied on the dorsal stream and frontal-striatal fibers. The involvement of bilateral tracts of interest as well as the association with the corpus callosum indicate the uniqueness of Chinese-language fluency processing. Dynamic associations were noted between white matter tract involvement and performance on the two fluency tests in four time blocks. Overall, our findings suggest the clinical utility of verbal fluency tests in geriatric populations, and they elucidate both task-specific and language-specific brain-behavior associations.
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Stalpaert J, Cocquyt EM, Criel Y, Segers L, Miatton M, Van Langenhove T, van Mierlo P, De Letter M. Language and Speech Markers of Primary Progressive Aphasia: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2206-2225. [PMID: 32810414 DOI: 10.1044/2020_ajslp-20-00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This systematic review aimed to establish language and speech markers to support the clinical diagnosis of primary progressive aphasia (PPA) and its clinical phenotypes. Our first objective was to identify behavioral language and speech markers of early-stage PPA. Our second objective was to identify the electrophysiological correlates of the language and speech characteristics in PPA. Method The databases MEDLINE, Web of Science, and Embase were searched for relevant articles. To identify behavioral markers, the initial subjective complaints and the language and speech deficits detected during the initial diagnostic evaluation were summarized for PPA in general and each clinical variant according to the 2011 consensus diagnostic criteria (nonfluent variant [NFV], semantic variant, and logopenic variant [LV]). To identify electrophysiological markers, the studies in which event-related potentials (ERPs) were elicited by a language or speech paradigm in patients with PPA were included. Results In total, 114 relevant studies were identified, including 110 behavioral studies and only four electrophysiological studies. This review suggests that patients with the semantic variant could be accurately differentiated from the NFV and LV in the initial stages based on the consensus criteria. Nonetheless, the early differentiation between the NFV and LV is not straightforward. In the four electrophysiological studies, differences in the latency, amplitude, and topographical distribution of the semantic N400 component were found between patients with PPA and healthy controls. Conclusions To accurately differentiate the NFV from the LV, it could be important to assess the language and speech degeneration by more specific assessments and by more objective diagnostic methods that offer insights into the language-related processes. Electrophysiological markers of PPA were not identified in this review due to the low number of studies that investigated language-related ERPs. More controlled ERP studies in larger patient cohorts are needed to investigate the diagnostic applicability of language-related ERPs in PPA. Supplemental Material https://doi.org/10.23641/asha.12798080.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | - Yana Criel
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Lieselot Segers
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | | | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Belgium
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Hatta T, Hotta C, Kato K, Hatta T, Hatta J, Fujiwara K, Iwahara A. Dissociation in Age-Related Developmental Trajectories Between Phonetic Fluency and Semantic Fluency Tests: Analysis of Longitudinal Data From the Yakumo Study. AMERICAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.5406/amerjpsyc.133.2.0197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Possible age-related differences in Phonemic Fluency Test (PFT) and Semantic Fluency Test (SFT) performance were examined by using longitudinal data of healthy older adults. The performance trajectories of 81 older adults in the 2 tests were analyzed for 11 years, from 65 to 75 years of age, via individually calculated linear regression coefficients. The results indicated that the PFT and SFT performance showed an age-related decline. However, the declining slope of the SFT was steeper than that of the PFT performance. These findings correspond with those of previous cross-sectional studies and suggest a future need to examine neurobiological substrates underlying the two domains of verbal fluency abilities.
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Luo C, Hu N, Xiao Y, Zhang W, Gong Q, Lui S. Comparison of Gray Matter Atrophy in Behavioral Variant Frontal Temporal Dementia and Amyotrophic Lateral Sclerosis: A Coordinate-Based Meta-Analysis. Front Aging Neurosci 2020; 12:14. [PMID: 32116647 PMCID: PMC7026505 DOI: 10.3389/fnagi.2020.00014] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/16/2020] [Indexed: 02/05/2023] Open
Abstract
Background: There is growing evidence supporting behavioral variant frontotemporal dementia (bvFTD) and amyotrophic lateral sclerosis (ALS) as extreme points of a disease spectrum. The aim of this study was to delineate the common and different patterns of gray matter atrophy associated with bvFTD and with ALS by pooling together the results of previous voxel-based morphometry (VBM) studies. Methods: We retrieved VBM studies that investigated gray matter atrophy in bvFTD patients vs. controls and in ALS patients vs. controls. Stereotactic data were extracted from those studies and subsequently tested for convergence and differences using activation likelihood estimation (ALE). A behavioral analysis using the BrainMap database was performed to assess the functional roles of the regions affected by bvFTD and/or ALS. Results: Our study demonstrated a convergence of gray matter atrophy in the frontolimbic structures that involve the bilateral anterior insula and anterior cingulate cortex. Comparing the pattern of GM atrophy in bvFTD and ALS patients revealed greater atrophy in the frontomedial cortex, bilateral caudate, left anterior insula, and right thalamus in those with bvFTD and a higher degree of atrophy in the right motor cortex of those with ALS. Behavioral analysis revealed that the pattern of the affected regions contributed to the dysfunction of emotional and cognitive processing in bvFTD patients and the dysfunction of motor execution in ALS patients. Conclusion: Our results revealed a shared neural basis between bvFTD and ALS subjects, as well as a specific and distinct neural signature that underpinned the clinical manifestations of those two diseases. Those findings outlined the role of the frontomedial-caudate circuit in the development of bvFTD-like deficits in ALS patients.
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Affiliation(s)
- Chunyan Luo
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
| | - Na Hu
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Xiao
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
| | - Wenjing Zhang
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
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33
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Tao L, Zhu M, Cai Q. Neural substrates of Chinese lexical production: The role of domain-general cognitive functions. Neuropsychologia 2020; 138:107354. [DOI: 10.1016/j.neuropsychologia.2020.107354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/27/2019] [Accepted: 01/17/2020] [Indexed: 11/15/2022]
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34
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Cognition and functionality in delusional disorder. Eur Psychiatry 2020; 55:52-60. [DOI: 10.1016/j.eurpsy.2018.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/15/2018] [Accepted: 09/30/2018] [Indexed: 12/16/2022] Open
Abstract
AbstractBackground:Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional disorder (DD). We aimed to assess the effect of clinical characteristics, symptom dimensions and neuropsychological performance on psychosocial functioning and self-perceived functional impairment in DD.Methods:Seventy-five patients with a SCID-I confirmed diagnosis of DD underwent neurocognitive testing using a neuropsychological battery examining verbal memory, attention, working memory and executive functions. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale, and calculated factor scores for four clinical dimensions: Paranoid, Cognitive, Affective and Schizoid. We conducted hierarchical linear regression models to identify predictors of psychosocial functioning, as measured with the Global Assessment of Functioning scale, and self-perceived functional impairment, as measured with the Sheehan’s Disability Inventory.Results:In the final linear regression models, higher scores in the Paranoid (β= 0.471, p <.001, r2 = 0.273) and Cognitive (β = 0.325, p <.001, r2 = 0.180) symptomatic dimensions and lower scores in verbal memory (β = −0.273, p <.05, r2 = 0.075) were significantly associated with poorer psychosocial functioning in patients with DD. Lower scores in verbal memory (β= −0.337, p <.01, r2 = 0.158) and executive functions (β= −0.323, p <.01, r2 = 0.094) were significantly associated with higher self-perceived disability.Conclusions:Impaired verbal memory and cognitive symptoms seem to affect functionality in DD, above and beyond the severity of the paranoid idea. This suggests a potential role for cognitive interventions in the management of DD.
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Kiselica AM, Benge JF. Quantitative and qualitative features of executive dysfunction in frontotemporal and Alzheimer's dementia. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:449-463. [PMID: 31424275 DOI: 10.1080/23279095.2019.1652175] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Behavioral variant fronto-temporal degeneration (bvFTD) is typically distinguished from Alzheimer's disease (AD) by early, prominent dysexecutive findings, in addition to other clinical features. However, differences in executive functioning between these groups are not consistently found. The current study sought to investigate quantitative and qualitative differences in executive functioning between those with bvFTD and AD in a large sample, while controlling for dementia severity and demographic variables. Secondary data analyses were completed on a subset of cases from the National Alzheimer's Coordinating Center collected from 36 Alzheimer's Disease Research Centers and consisting of 1,577 individuals with AD and 406 individuals with bvFTD. Groups were compared on 1) ability to complete three commonly administered executive tasks (letter fluency, Trail Making Test Part B [TMTB], and digits backward); 2) quantitative test performance; and 3) errors on these tasks. Findings suggested that individuals with bvFTD were less likely to complete letter fluency, χ2(2) = 178.62, p < .001, and number span tasks, χ2(1) = 11.49, p < .001), whereas individuals with AD were less likely to complete TMTB, χ2(2) = 460.38, p < .001. Individuals with bvFTD performed more poorly on letter fluency, F(1) = 28.06, p = .013, but there were not group differences in TMTB lines per second or number span backwards. Errors generally did not differentiate the diagnostic groups. In summary, there is substantial overlap in executive dysfunction between those with bvFTD and AD, though individuals with bvFTD tend to demonstrate worse letter fluency performance.
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Affiliation(s)
- Andrew M Kiselica
- Division of Neuropsychology, Baylor Scott and White Health, Dallas, TX, USA
| | - Jared F Benge
- Division of Neuropsychology, Baylor Scott and White Health, Dallas, TX, USA.,Plummer Movement Disorders Center, Baylor Scott and White Health, Dallas, TX, USA.,Texas A&M College of Medicine, Bryan, TX, USA
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36
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Trojsi F, Caiazzo G, Siciliano M, Femiano C, Passaniti C, Russo A, Bisecco A, Monsurrò MR, Cirillo M, Esposito F, Tedeschi G, Santangelo G. Microstructural correlates of Edinburgh Cognitive and Behavioural ALS Screen (ECAS) changes in amyotrophic lateral sclerosis. Psychiatry Res Neuroimaging 2019; 288:67-75. [PMID: 30987770 DOI: 10.1016/j.pscychresns.2019.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/30/2019] [Accepted: 04/01/2019] [Indexed: 11/17/2022]
Abstract
Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was designed for testing patients with amyotrophic lateral sclerosis (ALS), a multi-system neurodegenerative disease characterized by progressive physical disability. In this study, we aim to explore the potential brain microstructural substrates associated with performance on ECAS in the early stages of ALS, using a whole-brain tract-based spatial statistics diffusion tensor imaging approach. Thirty-six non-demented ALS patients, assessed using ECAS, and 35 age-, sex- and education-matched healthy controls underwent magnetic resonance imaging at 3 Tesla. The ALS patients showed decreased fractional anisotropy (FA) in the cortico-spinal tracts and corpus callosum (CC) and significant association between verbal fluency score, among ALS-specific ECAS scores, and FA measures in several long association fiber tracts in the frontal, temporal and parietal lobes. Furthermore, the ALS non-specific total score was inversely related to axial diffusivity (AD) in the mediodorsal nucleus of the thalamus, with more extended areas of correlation in the CC, when considering only the memory subscore. Our results point towards microstructural degeneration across motor and extra-motor areas in ALS, underlining that alterations in verbal fluency performances may be related to impairment of frontotemporal connectivity, while alterations of memory may be associated with damage of thalamocortical circuits.
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Affiliation(s)
- Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy.
| | - Giuseppina Caiazzo
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Cinzia Femiano
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy
| | - Carla Passaniti
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonio Russo
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy
| | - Alvino Bisecco
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy
| | - Maria Rosaria Monsurrò
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy
| | - Mario Cirillo
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Baronissi, Salerno, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, MRI Research Centre "SUN-FISM", University of Campania "Luigi Vanvitelli", P.zza Miraglia 2, Naples 80138, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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Johnen A, Bertoux M. Psychological and Cognitive Markers of Behavioral Variant Frontotemporal Dementia-A Clinical Neuropsychologist's View on Diagnostic Criteria and Beyond. Front Neurol 2019; 10:594. [PMID: 31231305 PMCID: PMC6568027 DOI: 10.3389/fneur.2019.00594] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is the second leading cognitive disorder caused by neurodegeneration in patients under 65 years of age. Characterized by frontal, insular, and/or temporal brain atrophy, patients present with heterogeneous constellations of behavioral and psychological symptoms among which progressive changes in social conduct, lack of empathy, apathy, disinhibited behaviors, and cognitive impairments are frequently observed. Since the histopathology of the disease is heterogeneous and identified genetic mutations only account for ~30% of cases, there are no reliable biomarkers for the diagnosis of bvFTD available in clinical routine as yet. Early detection of bvFTD thus relies on correct application of clinical diagnostic criteria. Their evaluation however, requires expertise and in-depth assessments of cognitive functions, history taking, clinical observations as well as caregiver reports on behavioral and psychological symptoms and their respective changes. With this review, we aim for a critical appraisal of common methods to access the behavioral and psychological symptoms as well as the cognitive alterations presented in the diagnostic criteria for bvFTD. We highlight both, practical difficulties as well as current controversies regarding an overlap of symptoms and particularly cognitive impairments with other neurodegenerative and primary psychiatric diseases. We then review more recent developments and evidence on cognitive, behavioral and psychological symptoms of bvFTD beyond the diagnostic criteria which may prospectively enhance the early detection and differential diagnosis in clinical routine. In particular, evidence on specific impairments in social and emotional processing, praxis abilities as well as interoceptive processing in bvFTD is summarized and potential links with behavior and classic cognitive domains are discussed. We finally outline both, future opportunities and major challenges with regard to the role of clinical neuropsychology in detecting bvFTD and related neurocognitive disorders.
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Affiliation(s)
- Andreas Johnen
- Section for Neuropsychology, Department of Neurology, University Hospital Münster, Münster, Germany
| | - Maxime Bertoux
- Univ Lille, Inserm UMR 1171 Degenerative and Vascular Cognitive Disorders, CHU Lille, Lille, France
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38
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Irwin DJ, McMillan CT, Xie SX, Rascovsky K, Van Deerlin VM, Coslett HB, Hamilton R, Aguirre GK, Lee EB, Lee VMY, Trojanowski JQ, Grossman M. Asymmetry of post-mortem neuropathology in behavioural-variant frontotemporal dementia. Brain 2019; 141:288-301. [PMID: 29228211 DOI: 10.1093/brain/awx319] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 10/14/2017] [Indexed: 12/12/2022] Open
Abstract
Antemortem behavioural and anatomic abnormalities have largely been associated with right hemisphere disease in behavioural-variant frontotemporal dementia, but post-mortem neuropathological examination of bilateral hemispheres remains to be defined. Here we measured the severity of post-mortem pathology in both grey and white matter using a validated digital image analysis method in four cortical regions sampled from each hemisphere in 26 patients with behavioural-variant frontotemporal dementia, including those with frontotemporal degeneration (i.e. tau = 9, TDP-43 = 14, or FUS = 1 proteinopathy) or Alzheimer's pathology (n = 2). We calculated an asymmetry index based on the difference in measured pathology from each left-right sample pair. Analysis of the absolute value of the asymmetry index (i.e. degree of asymmetry independent of direction) revealed asymmetric pathology for both grey and white matter in all four regions sampled in frontototemporal degeneration patients with tau or TDP-43 pathology (P ≤ 0.01). Direct interhemispheric comparisons of regional pathology measurements within-subjects in the combined tauopathy and TDP-43 proteinopathy group found higher pathology in the right orbitofrontal grey matter compared to the left (P < 0.01) and increased pathology in ventrolateral temporal lobe grey matter of the left hemisphere compared to the right (P < 0.02). Preliminary group-wise comparisons between tauopathy and TDP-43 proteinopathy groups found differences in patterns of interhemispheric burden of grey and white matter regional pathology, with greater relative white matter pathology in tauopathies. To test the association of pathology measurement with ante-mortem observations, we performed exploratory analyses in the subset of patients with imaging data (n = 15) and found a direct association for increasing pathologic burden with decreasing cortical thickness in frontotemporal regions on ante-mortem imaging in tauopathy (P = 0.001) and a trend for TDP-43 proteinopathy (P = 0.06). Exploratory clinicopathological correlations demonstrated an association of socially-inappropriate behaviours with asymmetric right orbitofrontal grey matter pathology, and reduced semantically-guided category naming fluency was associated asymmetric white matter pathology in the left ventrolateral temporal region. We conclude that pathologic disease burden is distributed asymmetrically in behavioural-variant frontotemporal dementia, although not universally in the right hemisphere, and this asymmetry contributes to the clinical heterogeneity of the disorder. The basis for this asymmetric profile is enigmatic but may reflect distinct species or strains of tau and TDP-43 pathologies with propensities to spread by distinct cell- and region-specific mechanisms. Patterns of region-specific pathology in the right hemisphere as well as the left hemisphere may play a role in antemortem clinical observations, and these observations may contribute to antemortem identification of molecular pathology in frontotemporal degeneration.
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Affiliation(s)
- David J Irwin
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sharon X Xie
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Vivianna M Van Deerlin
- Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - H Branch Coslett
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Center for Cognitive Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Roy Hamilton
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Center for Cognitive Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Geoffrey K Aguirre
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Center for Cognitive Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Edward B Lee
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Translational Neuropathology Research Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Virginia M Y Lee
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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van den Berg E, Jiskoot LC, Grosveld MJH, van Swieten JC, Papma JM. Qualitative Assessment of Verbal Fluency Performance in Frontotemporal Dementia. Dement Geriatr Cogn Disord 2018. [PMID: 28624827 DOI: 10.1159/000477538] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND/AIMS Verbal fluency is impaired in patients with frontotemporal dementia (FTD) and primary progressive aphasia (PPA). This study explored qualitative differences in verbal fluency (clustering of words, switching between strategies) between FTD and PPA variants. METHODS Twenty-nine patients with behavioral variant FTD (bvFTD) and 50 with PPA (13 nonfluent/agrammatic, 14 semantic, and 23 logopenic) performed a semantic and letter fluency task. Clustering (number of multiword strings) and switching (number of transitions between clustered and nonclustered words) were recorded by two independent raters. Between-group differences, associations with memory, language, and executive functioning, and longitudinal change (subsample) in clustering and switching were examined. RESULTS Interrater reliability was high (median 0.98). PPA patients generated (a) smaller (number of) clusters on semantic and letter fluency than bvFTD patients (p < 0.05). Semantic variant patients used more switches than nonfluent/agrammatic or logopenic variant patients (p < 0.05). Clustering in semantic fluency was significantly associated with memory and language (range standardized regression coefficients 0.24-0.38). Switching in letter fluency was associated with executive functioning (0.32-0.35). CONCLUSION Clustering and switching in verbal fluency differed between patients with subtypes of FTD and PPA. Qualitative aspects of verbal fluency provide additional information on verbal ability and executive control which can be used for clinically diagnostic purposes.
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Affiliation(s)
- Esther van den Berg
- Alzheimer Center and Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
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40
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Tinson D, Crockford C, Gharooni S, Russell H, Zoeller S, Leavy Y, Lloyd R, Duncan S. Memory complaints in epilepsy: An examination of the role of mood and illness perceptions. Epilepsy Behav 2018; 80:221-228. [PMID: 29414556 DOI: 10.1016/j.yebeh.2017.11.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/22/2017] [Indexed: 11/17/2022]
Abstract
UNLABELLED The study examined the role of mood and illness perceptions in explaining the variance in the memory complaints of patients with epilepsy. METHOD Forty-four patients from an outpatient tertiary care center and 43 volunteer controls completed a formal assessment of memory and a verbal fluency test, as well as validated self-report questionnaires on memory complaints, mood, and illness perceptions. RESULTS In hierarchical multiple regression analyses, objective memory test performance and verbal fluency did not contribute significantly to the variance in memory complaints for either patients or controls. In patients, illness perceptions and mood were highly correlated. Illness perceptions correlated more highly with memory complaints than mood and were therefore added to the multiple regression analysis. This accounted for an additional 25% of the variance, after controlling for objective memory test performance and verbal fluency, and the model was significant (model B). In order to compare with other studies, mood was added to a second model, instead of illness perceptions. This accounted for an additional 24% of the variance, which was again significant (model C). In controls, low mood accounted for 11% of the variance in memory complaints (model C2). SUMMARY A measure of illness perceptions was more highly correlated with the memory complaints of patients with epilepsy than with a measure of mood. In a hierarchical multiple regression model, illness perceptions accounted for 25% of the variance in memory complaints. Illness perceptions could provide useful information in a clinical investigation into the self-reported memory complaints of patients with epilepsy, alongside the assessment of mood and formal memory testing.
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Affiliation(s)
- Deborah Tinson
- Department of Clinical Neurology, Western General Hospital, Edinburgh EH42UX, UK.
| | - Christopher Crockford
- Department of Human Cognitive Neuroscience, University of Edinburgh, Edinburgh EH89JZ, UK
| | - Sara Gharooni
- Department of Human Cognitive Neuroscience, University of Edinburgh, Edinburgh EH89JZ, UK
| | - Helen Russell
- Department of Human Cognitive Neuroscience, University of Edinburgh, Edinburgh EH89JZ, UK
| | - Sophie Zoeller
- Department of Human Cognitive Neuroscience, University of Edinburgh, Edinburgh EH89JZ, UK
| | - Yvonne Leavy
- Department of Clinical Neurology, Western General Hospital, Edinburgh EH42UX, UK
| | - Rachel Lloyd
- Department of Clinical Neurology, Western General Hospital, Edinburgh EH42UX, UK
| | - Susan Duncan
- Department of Clinical Neurology, Western General Hospital, Edinburgh EH42UX, UK
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41
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Faroqi-Shah Y, Milman L. Comparison of animal, action and phonemic fluency in aphasia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:370-384. [PMID: 29160019 DOI: 10.1111/1460-6984.12354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The ability to generate words that follow certain constraints, or verbal fluency, is a sensitive indicator of neurocognitive impairment, and is impacted by a variety of variables. AIMS To investigate the effect of post-stroke aphasia, elicitation category and linguistic variables on verbal fluency performance. METHODS & PROCEDURES Twenty-eight persons with aphasia (PWA) with a single left-hemisphere lesion and 40 age-matched neurotypical community-dwelling adults were administered three verbal fluency tasks: two semantic (animals and actions) and one phonemic (the letters F, A and S). Data analysis included comparison of total scores, clusters and perseverations. Individual responses were coded for frequency of occurrence, age of acquisition and syllable length to investigate qualitative differences in word generation. OUTCOMES & RESULTS PWA performed worse than neurotypical participants across all verbal fluency tasks, and animal fluency scores were farthest from neurotypical performance. PWAs' animal and action fluency were correlated with other language measures, while phonemic fluency was uncorrelated with language measures. While some PWAs showed dissociations between verbal fluency tasks, the dissociations did not pattern along with aphasia fluency. PWAs produced fewer clusters and responses with higher word frequency across all three verbal fluency tasks. Responses had earlier age of acquisition and shorter word length for animal and phonemic fluency, but not action fluency. CONCLUSIONS & IMPLICATIONS Verbal fluency, particularly animal fluency, is sensitive to even mild aphasia. PWA produced lexically simpler responses than their neurotypical peers. This study identifies the relevance of qualitative analysis of verbal fluency responses.
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Affiliation(s)
- Yasmeen Faroqi-Shah
- Department of Hearing & Speech Sciences, University of Maryland, College Park, MD, USA
| | - Lisa Milman
- Department of Communicative Disorders & Deaf Education, Utah State University, Logan, UT, USA
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Nikolai T, Bezdicek O, Markova H, Stepankova H, Michalec J, Kopecek M, Dokoupilova M, Hort J, Vyhnalek M. Semantic verbal fluency impairment is detectable in patients with subjective cognitive decline. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 25:448-457. [PMID: 28548549 DOI: 10.1080/23279095.2017.1326047] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Patients with subjective cognitive decline (SCD) are at higher risk for conversion to dementia due to Alzheimer's disease (AD). Semantic verbal fluency (SVF) seems to be impaired in the early stages of AD. The goal of the present study was to identify the discriminative potential of verbal fluency (VF) in patients with SCD to show if very early signs of cognitive decline may be detected in SCD. We examined 93 normal controls (NC) and 61 participants with SCD. Each participant was administered a comprehensive neuropsychological battery. All participants underwent tests of VF: phonemic verbal fluency (PVF), letters K and P and SVF (animals and vegetables categories). In addition to the total score, two 30-second intervals, and clustering and switching indices in SVF were evaluated. SCD generated fewer words in the total score and 30- to 60-second interval in vegetables category and they performed more switches in animals category. There was no significant difference between the SCD and the NC groups in all other VF measures. Quantitative measures of SVF (a decreased number of vegetables) as well as qualitative measures were detected in SCD group and could be considered as an early neuropsychological marker of subtle cognitive impairment.
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Affiliation(s)
- Tomas Nikolai
- a Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague , Charles University , Prague , Czech Republic.,b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Ondrej Bezdicek
- a Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague , Charles University , Prague , Czech Republic.,c National Institute of Mental Health , Klecany , Czech Republic
| | - Hana Markova
- b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Hana Stepankova
- c National Institute of Mental Health , Klecany , Czech Republic
| | - Jiri Michalec
- e Department of Psychiatry, First Faculty of Medicine , Charles University, and General University Hospital , Prague , Czech Republic
| | - Miloslav Kopecek
- c National Institute of Mental Health , Klecany , Czech Republic
| | - Monika Dokoupilova
- a Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague , Charles University , Prague , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Jakub Hort
- b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Martin Vyhnalek
- b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
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43
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Li M, Zhang Y, Song L, Huang R, Ding J, Fang Y, Xu Y, Han Z. Structural connectivity subserving verbal fluency revealed by lesion-behavior mapping in stroke patients. Neuropsychologia 2017; 101:85-96. [PMID: 28495601 DOI: 10.1016/j.neuropsychologia.2017.05.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 12/28/2022]
Abstract
Tests of verbal fluency have been widely used to assess the cognitive functioning of persons, and are typically classified into two categories (semantic and phonological fluency). While widely-distributed divergent and convergent brain regions have been found to be involved in semantic and phonological fluency, the anatomical connectivity underlying the fluency is not well understood. The present study aims to construct a comprehensive white-matter network associated with semantic and phonological fluency by investigating the relationship between the integrity of 22 major tracts in the whole brain and semantic fluency (measured by 3 cues) and phonological fluency (measured by 2 cues) in a group of 51 stroke patients. We found five left-lateralized tracts including the anterior thalamic radiation (ATR), inferior fronto-occipital fasciculus (IFOF), uncinate fasciculus (UF), superior longitudinal fasciculus (SLF) and frontal aslant tract (FAT) were significantly correlated with the scores of both semantic and phonological fluencies. These effects persisted even when we ruled out the influence of potential confounding factors (e.g., total lesion volume). Moreover, the damage to the first three tracts caused additional impairments in the semantic compared to the phonological fluency. These findings reveal the white-matter neuroanatomical connectivity underlying semantic and phonological fluency, and deepen the understanding of the neural network of verbal fluency.
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Affiliation(s)
- Mingyang Li
- National Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Yumei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Luping Song
- Rehabilitation College and China Rehabilitation Research Center, Capital Medical University, Beijing 100038, China
| | - Ruiwang Huang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, South China Normal University, Guangzhou 510631, China
| | - Junhua Ding
- National Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Yuxing Fang
- National Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Yangwen Xu
- National Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Zaizhu Han
- National Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.
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44
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Macoir J, Lavoie M, Laforce R, Brambati SM, Wilson MA. Dysexecutive Symptoms in Primary Progressive Aphasia: Beyond Diagnostic Criteria. J Geriatr Psychiatry Neurol 2017; 30:151-161. [PMID: 28355946 DOI: 10.1177/0891988717700507] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Primary progressive aphasia (PPA) is a heterogeneous neurodegenerative condition in which the most prominent clinical feature is language difficulties. Other cognitive domains have been described to remain unaffected at the early stages of the disease and, therefore, excluded from diagnostic criteria. However, we show in this article that executive function (EF) disorders may be present in the 3 variants (nonfluent/agrammatic, logopenic, and semantic) of PPA. We also illustrate changes in language and EF by means of a 3-year behavioral and neuroimaging longitudinal study of a patient suffering from the semantic variant of PPA. This review provides an update on current knowledge of PPA, suggesting that dysexecutive symptoms may be encountered in the 3 PPA variants, in their early phases and/or in more advanced stages, when atrophy extends to adjacent brain areas.
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Affiliation(s)
- Joël Macoir
- 1 Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada.,2 Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Monica Lavoie
- 1 Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada.,2 Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Robert Laforce
- 3 Clinique interdisciplinaire de mémoire, CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, Canada.,4 Département de médecine, Faculté de médecine, Université Laval, Québec, Canada
| | - Simona M Brambati
- 5 Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Maximiliano A Wilson
- 1 Département de réadaptation, Faculté de médecine, Université Laval, Québec, Canada.,2 Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
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45
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Chapleau M, Aldebert J, Montembeault M, Brambati SM. Atrophy in Alzheimer’s Disease and Semantic Dementia: An ALE Meta-Analysis of Voxel-Based Morphometry Studies. J Alzheimers Dis 2016; 54:941-955. [DOI: 10.3233/jad-160382] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Marianne Chapleau
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Joséphine Aldebert
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Maxime Montembeault
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Simona M. Brambati
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
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46
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Bisenius S, Neumann J, Schroeter ML. Response to the letter on 'Validating new diagnostic imaging criteria for primary progressive aphasia via anatomical likelihood estimation meta-analyses'. Eur J Neurol 2016; 23:e52-3. [PMID: 27431027 DOI: 10.1111/ene.13046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 04/21/2016] [Indexed: 12/01/2022]
Affiliation(s)
- S Bisenius
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - J Neumann
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany
| | - M L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany.,Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,FTLD Consortium Germany, Leipzig, Germany
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47
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Zhong J, Shi H, Ma H, Sheng L. Comment on 'Validating new diagnostic imaging criteria for primary progressive aphasia via anatomical likelihood estimation meta-analyses'. Eur J Neurol 2016; 23:e38. [PMID: 27272109 DOI: 10.1111/ene.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 03/22/2016] [Indexed: 11/29/2022]
Affiliation(s)
- J Zhong
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - H Shi
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - H Ma
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China
| | - L Sheng
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China
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48
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Cousins KAQ, York C, Bauer L, Grossman M. Cognitive and anatomic double dissociation in the representation of concrete and abstract words in semantic variant and behavioral variant frontotemporal degeneration. Neuropsychologia 2016; 84:244-51. [PMID: 26944874 DOI: 10.1016/j.neuropsychologia.2016.02.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 02/26/2016] [Accepted: 02/28/2016] [Indexed: 10/22/2022]
Abstract
We examine the anatomic basis for abstract and concrete lexical representations in semantic memory by assessing patients with focal neurodegenerative disease. Prior evidence from healthy adult studies suggests that there may be an anatomical dissociation between abstract and concrete representations: abstract words more strongly activate the left inferior frontal gyrus relative to concrete words, while concrete words more strongly activate left anterior-inferior temporal regions. However, this double dissociation has not been directly examined. We test this dissociation in two patient groups with focal cortical atrophy in each of these regions, the behavioral variant of Frontotemporal Degeneration (bvFTD) and the semantic variant of Primary Progressive Aphasia (svPPA). We administered an associativity judgment task for abstract and concrete words, where subjects select which of two words is best associated with a given target word. Both bvFTD and svPPA patients were significantly impaired in their overall performance compared to controls. While controls treated concrete and abstract words equally, we found a category-specific double dissociation in patients' judgments: bvFTD patients showed a concreteness effect (CE), with significantly worse performance for abstract compared to concrete words, while svPPA patients showed reversal of the CE, with significantly worse performance for concrete over abstract words. Regression analyses also revealed an anatomic double dissociation: The CE is associated with inferior frontal atrophy in bvFTD, while reversal of the CE is associated with left anterior-inferior temporal atrophy in svPPA. These results support a cognitive and anatomic model of semantic memory organization where abstract and concrete representations are supported by dissociable neuroanatomic substrates.
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Affiliation(s)
- Katheryn A Q Cousins
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, United States.
| | - Collin York
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, United States
| | - Laura Bauer
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, United States
| | - Murray Grossman
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, United States.
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49
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Zhou LX, Sun CL, Wei LJ, Gu ZM, Lv L, Dang Y. Lower cognitive function in patients with age-related macular degeneration: a meta-analysis. Clin Interv Aging 2016; 11:215-23. [PMID: 26966358 PMCID: PMC4771401 DOI: 10.2147/cia.s102213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the cognitive impairment in patients with age-related macular degeneration (AMD). Methods Relevant articles were identified through a search of the following electronic databases through October 2015, without language restriction: 1) PubMed; 2) the Cochrane Library; 3) EMBASE; 4) ScienceDirect. Meta-analysis was conducted using STATA 12.0 software. Standardized mean differences with corresponding 95% confidence intervals were calculated. All of the included studies met the following four criteria: 1) the study design was a case–control or randomized controlled trial (RCT) study; 2) the study investigated cognitive function in the patient with AMD; 3) the diagnoses of AMD must be provided; 4) there were sufficient scores data to extract for evaluating cognitive function between cases and controls. The Newcastle–Ottawa Scale criteria were used to assess the methodological quality of the studies. Results Of the initial 278 literatures, only six case–control and one RCT studies met all of the inclusion criteria. A total of 794 AMD patients and 1,227 controls were included in this study. Five studies were performed with mini-mental state examination (MMSE), two studies with animal fluency, two studies with trail making test (TMT)-A and -B, one study with Mini-Cog. Results of the meta-analysis revealed lower cognitive function test scores in patients with AMD, especially with MMSE and Mini-Cog test (P≤0.001 for all). The results also showed that differences in the TMT-A (except AMD [total] vs controls) and TMT-B test had no statistical significance (P>0.01). The Newcastle–Ottawa Scale score was ≥5 for all of the included studies. Based on the sensitivity analysis, no single study influenced the overall pooled estimates. Conclusion This meta-analysis suggests lower cognitive function test scores in patients with AMD, especially with MMSE and Mini-Cog test. The other cognitive impairment screening tests, such as animal fluency test and TMT, need more studies to assess.
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Affiliation(s)
- Li-Xiao Zhou
- Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Cheng-Lin Sun
- Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Li-Juan Wei
- Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zhi-Min Gu
- Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Liang Lv
- Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yalong Dang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
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50
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Abstract
Frontotemporal dementia (FTD) was one of the lesser known dementias until the recent advancements revealing its genetic and pathological foundation. This common neurodegenerative disorder has three clinical subtypes- behavioral, semantic and progressive non fluent aphasia. The behavioral variant mostly exhibits personality changes, while the other two encompass various language deficits. This review discusses the basic pathology, genetics, clinical and histological presentation and the diagnosis of the 3 subtypes. It also deliberates the different therapeutic modalities currently available for frontotemporal dementia and the challenges faced by the caregivers. Lastly it explores the scope of further research into the diagnosis and management of FTD.
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Affiliation(s)
- Sayantani Ghosh
- Department of Neurology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Carol F Lippa
- Department of Neurology, Drexel University College of Medicine, Philadelphia, PA, USA
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