Marion Fossard

Psychogenic or neurogenic origin of agrammatism and foreign accent syndrome in a bipolar patient: a case report

BackgroundForeign accent syndrome (FAS) is a rare speech disorder characterized by the appearance of a new accent, different from the speakers native language and perceived as foreign by the speaker and the listener. In most of the reported cases, FAS follows stroke but has also been found following traumatic brain injury, cerebral haemorrhage and multiple sclerosis. In very few cases, FAS was reported in patients presenting with psychiatric disorders but the link between this condition and FAS was confirmed in only one case.Case presentationIn this report, we present the case of FG, a bipolar patient presenting with language disorders characterized by a foreign accent and agrammatism, initially categorized as being of psychogenic origin. The patient had an extensive neuropsychological and language evaluation as well as brain imaging exams. In addition to FAS and agrammatism, FG also showed a working memory deficit and executive dysfunction. Moreover, these clinical signs were related to altered cerebral activity on an FDG-PET scan that showed diffuse hypometabolism in the frontal, parietal and temporal lobes bilaterally as well as a focal deficit in the area of the anterior left temporal lobe. When compared to the MRI, these deficits were related to asymmetric atrophy, which was retrospectively seen in the left temporal and frontal opercular/insular region without a focal lesion.DiscussionTo our knowledge, FG is the first case of FAS imaged with an 18F-FDG-PET scan. The nature and type of neuropsychological and linguistic deficits, supported by neuroimaging data, exclude a neurotoxic or neurodegenerative origin for this patients clinical manifestations. For similar reasons, a psychogenic etiology is also highly improbable.ConclusionTo account for the FAS and agrammatism in FG, various explanations have been ruled out. Because of the focal deficit seen on the brain imaging, involving the left insular and anterior temporal cortex, two brain regions frequently involved in aphasic syndrome but also in FAS, a cerebrovascular origin must be considered the best explanation to account for FGs language deficits.

Do patients with schizophrenia attribute mental states in a referential communication task

Introduction. Many studies have reported that individuals with schizophrenia (SZ) may have impaired social cognition, resulting in communication disorders and theory of mind (ToM) impairments. However, the classical tasks used to assess impaired ToM ability are too complex. The aim of this study was to assess ToM ability using both a classical task and a referential communication task that reproduces a ‘‘natural’’ conversation situation. Methods. Thirty-one participants with schizophrenia and 29 matched healthy participants were tested individually on a referential communication task and on a standard ToM task. Results and Conclusion. The main results showed that SZ participants had difficulties using reference markers and attributing mental states in both ToM tasks. Contrary to healthy participants, they exhibited a tendency to ineffectively mark the information they used (indefinite articles for old information and/or definite articles for new information) and had problems using information they shared with the experimenter.

Theory of mind and cognitive processes in aging and Alzheimer type dementia: a systematic review

Objectives: Theory of mind (ToM) performance in aging and dementia of the Alzheimer type (DAT) has been a growing interest of researchers and recently, theoretical trends in ToM development have led to a focus on determining the cognitive skills involved in ToM performance. The aim of the present review is to answer three main questions: How is ToM assessed in aging and DAT? How does ToM performance evolve in aging and DAT? Do cognitive processes influence ToM performance in aging and DAT? Method: A systematic review was conducted to provide a targeted overview of recent studies relating ToM performance with cognitive processes in aging and DAT. Results: Results suggest a decrease in ToM performance, more pronounced in complex ToM tasks. Moreover, the review points up the strong involvement of executive functions, especially inhibition, and reasoning skills in ToM task achievement. Conclusion: Current data suggest that the structure of ToM tasks itself could lead to poor performance, especially in populations with reduced cognitive abilities.

Adjustment of speaker’s referential expressions to an addressee’s likely knowledge and link with theory of mind abilities

To communicate cooperatively, speakers must determine what constitutes the common ground with their addressee and adapt their referential choices accordingly. Assessing another person’s knowledge requires a social cognition ability termed theory of mind (ToM). This study relies on a novel referential communication task requiring probabilistic inferences of the knowledge already held by an addressee prior to the study. Forty participants were asked to present 10 movie characters and the addressee, who had the same characters in a random order, was asked to place them in order. ToM and other aspects of social cognition were also assessed. Participants used more information when presenting likely unknown than likely known movie characters. They particularly increased their use of physical descriptors, which most often accompanied movie-related information. Interestingly, a significant relationship emerged between our ToM test and the increased amount of information given for the likely unknown characters. These results suggest that speakers use ToM to infer their addressee’s likely knowledge and accordingly adapt their referential expressions.

The Role of Basal Ganglia in Language Production: Evidence from Parkinson's Disease

According to the dominant view in the literature, basal ganglia do not play a direct role in language but are involved in cognitive control required by linguistic and non-linguistic processing. In Parkinsons disease, basal ganglia impairment leads to motor symptoms and language deficits; those affecting the production of verbs have been frequently explored. According to a controversial theory, basal ganglia play a specific role in the conjugation of regular verbs as compared to irregular verbs. We report the results of 15 patients with Parkinsons disease in experimental conjugation tasks. They performed below healthy controls but their performance did not differ for regular and irregular verbs. These results confirm that basal ganglia are involved in language processing but do not play a specific role in verb production.

Between anaphora and deixis...the resolution of the demonstrative noun-phrase ‘that N’

Three experiments examined the hypothesis that the demonstrative noun phrase (NP) that N, as an anadeictic expression, preferentially refers to the less salient referent in a discourse representation when used anaphorically, whereas the anaphoric pronoun he or she preferentially refers to the highly-focused referent. The findings, from a sentence completion task and two reading time experiments that used gender to create ambiguous and unambiguous coreference, reveal that the demonstrative NP specifically orients processing toward a less salient referent when there is no gender cue discriminating between different possible referents. These findings show the importance of taking into account the discourse function of the anaphor itself and its influence on the process of searching for the referent.

Regularity and beyond: Impaired production and comprehension of inflectional morphology in semantic dementia

Studies on inflectional morphology in semantic dementia (SD) have focused on the contrast between the regular and the irregular English past-tense. These studies aimed to contrast the claims of single- and dual-mechanism theories. However, both theories can account for impaired production of irregular verbs observed in SD. According to the dual-mechanism theory, this impairment is related to word-retrieval difficulties, while according to single-mechanism theory it is the consequence of semantic impairment. However, authors suggest that it is time to envision a broader role for semantic memory in the production of semantically encoded aspects of inflectional morphology. This study reports the performance of 10 French-speaking patients with SD in three tasks of inflectional morphology. Their performances were compared to those of a group of 20 age-, gender- and education-matched adults without cognitive impairment. Results show that SD patients had difficulties producing tense and person inflection in verbs and pseudo-verbs, whether regular or pseudo-regular. In a second task in which participants were directly exposed to regularity manipulations, SD patients tended to choose a more typical or predictable alternative over a correctly inflected verb. Results of the third task show that their difficulties in producing semantically encoded aspects of inflection, such as tense, are related to difficulties to understand the semantic content conveyed by inflectional morphemes. Overall, these results support the claim that semantic impairment can cause morphological deficits that do not only affect irregular verbs, but that also have impacts on the production and comprehension of semantic information conveyed by inflectional morphemes.

The application of rules in morphology, syntax and number processing: a case of selective deficit of procedural or executive mechanisms?

Declarative memory is a long-term store for facts, concepts and words. Procedural memory subserves the learning and control of sensorimotor and cognitive skills, including the mental grammar. In this study, we report a single-case study of a mild aphasic patient who showed procedural deficits in the presence of preserved declarative memory abilities. We administered several experiments to explore rule application in morphology, syntax and number processing. Results partly support the differentiation between declarative and procedural memory. Moreover, the patients performance varied according to the domain in which rules were to be applied, which underlines the need for more fine-grained distinctions in cognition between procedural rules.

Working memory and semantic involvement in sentence processing: A case of pure progressive amnesia

ED, a 83-year-old woman, meets the criteria of pure progressive amnesia, with gradual impairment of episodic and autobiographical memory, sparing of semantic processing and strong working memory (WM) deficit. The dissociation between disturbed WM and spared semantic processing permitted testing the role of WM in processing anaphors like pronouns or repeated names. Results showed a globally normal anaphoric behavior in two experiments requiring anaphoric processing in sentence production and comprehension. We suggest that preserved semantic processing in ED would have compensated for working memory deficit in anaphoric processing.

Knowledge likely held by others affects speakers’ choices of referential expressions at different stages of discourse

ABSTRACT Effective communication requires adjusting one’s discourse to be understood by the addressee. While some suggest that choices of referring expressions are dependent on the addressee’s accessibility to the referent, there is also evidence for an egocentric bias in speech production. This study relied on two new experimental tasks designed to assess whether speakers adapt their choices of referential expressions when introducing movie characters that are either likely known or likely unknown by their addressee, and when maintaining or reintroducing these characters at a later point in the discourse. Results revealed an adjustment to the addressee in the use of character’s names (increased for likely known characters) and definite expressions (increased for likely unknown characters) observed at all the discourse stages. Use of indefinite expressions and names was affected by the participant’s own knowledge specifically when introducing the characters. These results indicate that speakers take their addressee’s likely knowledge into account at multiple discourse stages.