Karine Marcotte

Therapy-induced neuroplasticity in chronic aphasia

Research on the neural substrate of aphasia recovery has consistently increased since the advent of functional neuroimaging. The evidence from therapy-induced aphasia recovery studies shows that better recovery results from the reactivation of left hemisphere function; still, the specific left hemisphere key areas that sign successful outcome with a specific therapy approach remain to be identified. Nine participants suffering from aphasia received brief and intensive therapy with Semantic Feature Analysis (SFA). Behavioural and neuroimaging data during overt picture naming were obtained prior to and after therapy. This paper reports on a group of participants having benefited from SFA, and two distinct patterns of improvement. Correlational analysis showed that differences in outcome were not related to lesion size, but were negatively correlated with damage to Brocas area (BA45). Moreover, a group analysis showed that therapy-induced recovery following SFA was characterized by (a) a significant correlation between improvement and activation in the left precentral gyrus (BA4/6) before therapy, and (b) the recruitment of the left inferior parietal lobule, an area known for its role in semantic integration, following therapy with SFA. Individual fMRI analyses showed that although adaptive brain plasticity appeared to operate differently in each patient, best responders to SFA therapy recruited less areas after training compared to participants having shown less recovery who showed a larger number of activated areas sustaining recovery. The results of the present study suggest that a significant activation of BA4/6 could indicate the use of SFA to achieve successful outcome. Also our results suggest that greater SFA improvement in chronic aphasia is associated with recruitment of areas in the left hemisphere.

The neural correlates of semantic feature analysis in chronic aphasia: discordant patterns according to the etiology.

This event-related functional magnetic resonance imaging (fMRI) study reports on the impact of semantic feature analysis (SFA) therapy on the neural substrate sustaining the recovery from severe anomia in two patients: one participant was diagnosed with primary progressive aphasia (PPA) 2 years before this study; the other participant acquired aphasia 8 years before this study. The participant with PPA showed severe progressive nonfluent aphasia (PNFA), the language profile being similar to a Brocas aphasia; the stroke patient presented with Brocas aphasia and a severe apraxia of speech (AOS). To examine the neural substrate allowing for recovery, both patients received brief and intensive therapy with SFA; behavioral and event-related (ER)-fMRI measures during oral picture naming were obtained pre- and post-therapy. Both patients benefitted from SFA to improve their naming performance. Functional MRI performances on trained and correct pretraining items were contrasted. Adaptive brain plasticity appeared to operate differently in each patient, despite the similarity of naming recovery profiles.

Default-Mode Network Functional Connectivity in Aphasia: Therapy-Induced Neuroplasticity.

Previous research on participants with aphasia has mainly been based on standard functional neuroimaging analysis. Recent studies have shown that functional connectivity analysis can detect compensatory activity, not revealed by standard analysis. Little is known, however, about the default-mode network in aphasia. In the current study, we studied changes in the default-mode network in subjects with aphasia who underwent semantic feature analysis therapy. We studied nine participants with chronic aphasia and compared them to 10 control participants. For the first time, we identified the default-mode network using spatial independent component analysis, in participants with aphasia. Intensive therapy improved integration in the posterior areas of the default-mode network concurrent with language improvement. Correlations between integration and improvement did not reach significance, but the trend suggests that pre-therapy integration of the default-mode network may predict therapy outcomes. Functional connectivity allows a better understanding of the impact of semantic feature analysis in aphasia.

Brain activation and lexical learning: The impact of learning phase and word type

This study investigated the neural correlates of second-language lexical acquisition in terms of learning phase and word type. Ten French-speaking participants learned 80 Spanish words-40 cognates, 40 non-cognates-by means of a computer program. The learning process included the early learning phase, which comprised 5 days, and the consolidation phase, which lasted 2 weeks. After each phase, participants performed an overt naming task during an er-fMRI scan. Naming accuracy was better for cognates during the early learning phase only. However, cognates were named faster than non-cognates during both phases. The early learning phase was characterized by activations in the left iFG and Brocas area, which were associated with effortful lexical retrieval and phonological processing, respectively. Further, the activation in the left ACC and DLPFC suggested that monitoring may be involved during the early phases of lexical learning. During the consolidation phase, the activation in the left premotor cortex, the right supramarginal gyrus and the cerebellum indicated that articulatory planning may contribute to the consolidation of second-language phonetic representations. No dissociation between word type and learning phase could be supported. However, a Fisher r-to-z test showed that successful cognate retrieval was associated with activations in Brocas area, which could reflect the adaptation of known L1 phonological sequences. Moreover, successful retrieval of non-cognates was associated with activity in the anterior-medial left fusiform and right posterior cingulate cortices, suggesting that their successful retrieval may rely upon the access to semantic and lexical information, and even on the greater likelihood of errors.

Impaired L1 and executive control after left basal ganglia damage in a bilingual Basque-Spanish person with aphasia

Bilinguals must focus their attention to control competing languages. In bilingual aphasia, damage to the fronto-subcortical loop may lead to pathological language switching and mixing and the attrition of the more automatic language (usually L1). We present the case of JZ, a bilingual Basque–Spanish 53-year-old man who, after haematoma in the left basal ganglia, presented with executive deficits and aphasia, characterised by more impaired language processing in Basque, his L1. Assessment with the Bilingual Aphasia Test revealed impaired spontaneous and automatic speech production and speech rate in L1, as well as impaired L2-to-L1 sentence translation. Later observation led to the assessment of verbal and non-verbal executive control, which allowed JZs impaired performance on language tasks to be related to executive dysfunction. In line with previous research, we report the significant attrition of L1 following damage to the left basal ganglia, reported for the first time in a Basque–Spanish bilingual. Implications for models of declarative and procedural memory are discussed.

Syntactic processing in bilinguals: An fNIRS study

The study of the neural basis of syntactic processing has greatly benefited from neuroimaging techniques. Research on syntactic processing in bilinguals has used a variety of techniques, including mainly functional magnetic resonance imaging (fMRI) and event-related potentials (ERP). This paper reports on a functional near-infrared spectroscopy (fNIRS) study on syntactic processing in highly proficient young adult speakers of Portuguese (mother tongue) (L1) and French (second language) (L2). They made a syntactic judgment of visually presented sentences, which either did or did not contain noun-verb agreement violations. The results showed that syntactic processing in both languages resulted in significant activation in anterior frontal regions of the left hemisphere and in the temporal superior posterior areas of the right hemisphere, with a more prominent activation for L2 in some areas. These findings corroborate previously reported neuroimaging evidence, showing the suitability of fNIRS for the study of syntactic processing in the bilingual brain.

Neurofunctional (re)organization underlying narrative discourse processing in aging: Evidence from fNIRS

Relatively few studies have analyzed the mechanisms underlying the cognitive changes that affect language in the elderly, and fewer have done so for narrative discourse. The goal of this study was to explore the neurofunctional changes associated with aging for different components of narrative discourse. Functional near-infrared spectroscopy (fNIRS) and behavioral data on 10 younger adults and 10 healthy elderly participants were collected. Ten younger adults in a non-proficient second language condition were included to explore the possibility that the age-related neurofunctional reorganization partly expresses demanding resource allocation. Results show within- and across-hemispheric differences in the neurofunctional pattern of activation in the older participants with reference to the younger ones, partially shared with the low-proficiency young adults, providing support for the recognized mechanisms underlying neural reserve and compensation. fNIRS was shown to be appropriate for studying the age-related neurofunctional reorganization of complex cognitive abilities.

Verb production in the nonfluent and semantic variants of primary progressive aphasia: The influence of lexical and semantic factors

Differential patterns of impairment with respect to noun and verb production have been observed in the nonfluent and semantic variants of primary progressive aphasia. However, the factors influencing this discrepancy remain unclear. The present study evaluates verb retrieval in primary progressive aphasia using a naming task and a story completion task. Findings indicate that patients with the semantic variant are influenced by familiarity, frequency, and age of acquisition in both object and action naming, whereas patients with the nonfluent variant are not. Surprisingly, there were no differences in either group between object and action naming, presumably because the lists were well matched on pertinent variables. In the story completion task, greater impairment in semantically heavier than in semantically lighter verbs was observed for the semantic variant, and grammaticality and verb tense agreement was significantly lower in the nonfluent variant. The present findings suggest that lexicosemantic attributes affect verb production in the semantic variant, whereas both lexicosemantic and syntactic attributes affect verb production in the nonfluent variant.

Age-related behavioural and neurofunctional patterns of second language word learning: Different ways of being successful

This study aimed at investigating the neural basis of word learning as a function of age and word type. Ten young and ten elderly French-speaking participants were trained by means of a computerized Spanish word program. Both age groups reached a similar naming accuracy, but the elderly required significantly more time. Despite equivalent performance, distinct neural networks characterized the ceiling. While the young cohort showed subcortical activations, the elderly recruited the left inferior frontal gyrus, the left lingual gyrus and the precuneus. The learning trajectory of the elderly, the neuroimaging findings together with their performance on the Stroop suggest that the young adults relied on control processing areas whereas the elderly relied on episodic memory circuits, which may reflect resorting to better preserved cognitive resources. Finally, the recruitment of visual processing areas by the elderly may reflect the impact of the language training method used.

White Matter Disruption and Connected Speech in Non-Fluent and Semantic Variants of Primary Progressive Aphasia

Differential patterns of white matter disruption have recently been reported in the non-fluent (nfvPPA) and semantic (svPPA) variants of primary progressive aphasia (PPA). No single measure is sufficient to distinguish between the PPA variants, but connected speech allows for the quantification of multiple measures. The aim of the present study was to further investigate the white matter correlates associated with connected speech features in PPA. We examined the relationship between white matter metrics and connected speech deficits using an automated analysis of transcriptions of connected speech and diffusion tensor imaging in language-related tracts. Syntactic, lexical, and semantic features were automatically extracted from transcriptions of topic-directed interviews conducted with groups of individuals with nfvPPA or svPPA as well as with a group of healthy controls. A principal component analysis was performed in order to reduce the number of language measures and yielded a five-factor solution. The results indicated that nfvPPA patients differed from healthy controls on a syntactic factor, and svPPA patients differed from controls on two semantic factors. However, the patient groups did not differ on any factor. Moreover, a correlational analysis revealed that the lexical richness factor was significantly correlated with radial diffusivity in the left inferior longitudinal fasciculus, which suggests that semantic deficits in connected speech reflect a disruption of this ventral pathway, and which is largely consistent with the results of previous studies. Using an automated approach for the analysis of connected speech combined with probabilistic tractography, the present findings demonstrate that nfvPPA patients are impaired relative to healthy controls on syntactic measures and have increased radial diffusivity in the left superior longitudinal fasciculus, whereas the svPPA group was impaired on lexico-semantic measures relative to controls and showed increased radial diffusivity in the uncinate and inferior longitudinal fasciculus bilaterally.