Comparing two picture naming tasks in primary progressive aphasia: Insights from behavioural and neural results

Picture naming tests are widely used to evaluate language impairments in neurodegenerative diseases, especially in Primary Progressive Aphasia (PPA). The available tests differ for many factors affecting the performance, e.g. format of stimuli and their psycholinguistic properties. We aim to identify the most appropriate naming test to be used on PPA according to the clinical and research demands. We investigated the behavioural characteristics, i.e. proportion of correct responses and error type, and their neural correlates in two Italian naming tests, CaGi naming (CaGi) and naming subtest of the Screening for Aphasia in NeuroDegeneration battery (SAND), administered to 52 PPA patients who underwent an FDG-PET scan. We analysed the effectiveness of the tests in distinguishing PPA versus controls and among PPA variants, considering the psycholinguistic variables affecting performance. We explored the brain metabolic correlates of behavioural performance in the tests. SAND, differently from CaGi, has time limits for the response and its items are less frequent and acquired later. SAND and CaGi differed in terms of number of correct responses and error profile, suggesting a higher difficulty to name SAND items compared to CaGi. Semantic errors predominated in CaGi, while anomic and semantic errors were equally frequent in SAND. Both tests distinguished PPA from controls, but SAND outperformed CaGi in discriminating among PPA variants. FDG-PET imaging revealed a shared metabolic involvement of temporal areas associated with lexico-semantic processing, encompassing anterior fusiform, temporal pole, and extending to posterior fusiform in sv-PPA. Concluding, a picture naming test with response time limit and items which are less frequent and acquired later in life, as SAND, may be effective at highlighting subtle distinctions between PPA variants, improving the diagnosis. Conversely, a naming test without time limit for the response, as CaGi, may be useful for a better characterization of the nature of the naming impairment at the behavioural level, eliciting more naming errors than anomia, possibly helping in the development of rehabilitation protocols.

Saying thirteen instead of forty-two but saying lale instead of tale: is number production special?

Stimulus Type Effect on Phonological and Semantic errors (STEPS) occurs when a person, following brain damage, produces phonemic errors with non-number words (e.g., lale for tale), but produces semantic errors with number words (e.g., thirteen for forty-two). Despite the relative frequency of this phenomenon, it has received little scholarly attention thus far. To explain STEPS, the Building Blocks hypothesis has been proposed (Cohen, Verstichel, & Dehaene, 1997; Dotan & Friedmann, 2015): the phonological output buffer includes single phonemes as the units of speech production for words, whereas entire number words are the building blocks of multi-digit production. Impairment in the phonological output buffer results in the incorrect selection of these units, leading to phonemic errors when producing non-number words, but semantic errors when producing numbers. In the present study we consider two patients, one with a deficit in the phonological output buffer, and one with a deficit in the phonological input buffer but with a preserved phonological output buffer. Number word and non-number word repetition, naming, and reading abilities were assessed. As expected, STEPS was found in the patient with deficits in the phonological output buffer in the three tasks; more notably, evidence of STEPS was also found for the patient with deficits in the phonological input buffer in the repetition task. Since our results cannot be fully explained by the Building Blocks hypothesis in its present form, we discuss the suitability of this hypothesis for the current data, and consider alternative accounts of STEPS.

Multivariate analysis reveals anatomical correlates of naming errors in primary progressive aphasia

Primary progressive aphasia (PPA) is an overarching term for a heterogeneous group of neurodegenerative diseases which affect language processing. Impaired picture naming has been linked to atrophy of the anterior temporal lobe in the semantic variant of PPA. Although atrophy of the anterior temporal lobe proposedly impairs picture naming by undermining access to semantic knowledge, picture naming also entails object recognition and lexical retrieval. Using multivariate analysis, we investigated whether cortical atrophy relates to different types of naming errors generated during picture naming in 43 PPA patients (13 semantic, 9 logopenic, 11 nonfluent, and 10 mixed variant). Omissions were associated with atrophy of the anterior temporal lobes. Semantic errors, for example, mistaking a rhinoceros for a hippopotamus, were associated with atrophy of the left mid and posterior fusiform cortex and the posterior middle and inferior temporal gyrus. Semantic errors and atrophy in these regions occurred in each PPA subtype, without major between-subtype differences. We propose that pathological changes to neural mechanisms associated with semantic errors occur across the PPA spectrum.

Did I say dog or cat? A study of semantic error detection and correction in children

Although naturalistic studies of spontaneous speech suggest that young children can monitor their speech, the mechanisms for detection and correction of speech errors in children are not well understood. In particular, there is little research on monitoring semantic errors in this population. This study provides a systematic investigation of detection and correction of semantic errors in children between the ages of 5 and 8years as they produced sentences to describe simple visual events involving nine highly familiar animals (the moving animals task). Results showed that older children made fewer errors and corrected a larger proportion of the errors that they made than younger children. We then tested the prediction of a production-based account of error monitoring that the strength of the language production system, and specifically its semantic-lexical component, should be correlated with the ability to detect and repair semantic errors. Strength of semantic-lexical mapping, as well as lexical-phonological mapping, was estimated individually for children by fitting their error patterns, obtained from an independent picture-naming task, to a computational model of language production. Children's picture-naming performance was predictive of their ability to monitor their semantic errors above and beyond age. This relationship was specific to the strength of the semantic-lexical part of the system, as predicted by the production-based monitor.

The ins and outs of meaning: Behavioral and neuroanatomical dissociation of semantically-driven word retrieval and multimodal semantic recognition in aphasia

Theories about the architecture of language processing differ with regard to whether verbal and nonverbal comprehension share a functional and neural substrate and how meaning extraction in comprehension relates to the ability to use meaning to drive verbal production. We (re-)evaluate data from 17 cognitive-linguistic performance measures of 99 participants with chronic aphasia using factor analysis to establish functional components and support vector regression-based lesion-symptom mapping to determine the neural correlates of deficits on these functional components. The results are highly consistent with our previous findings: production of semantic errors is behaviorally and neuroanatomically distinct from verbal and nonverbal comprehension. Semantic errors were most strongly associated with left ATL damage whereas deficits on tests of verbal and non-verbal semantic recognition were most strongly associated with damage to deep white matter underlying the frontal lobe at the confluence of multiple tracts, including the inferior fronto-occipital fasciculus, the uncinate fasciculus, and the anterior thalamic radiations. These results suggest that traditional views based on grey matter hub(s) for semantic processing are incomplete and that the role of white matter in semantic cognition has been underappreciated.