Anterior Middle Temporal Gyrus Research Articles

"All the Stars Will Be Wells With a Rusty Pulley": Neural Processing of the Social and Pragmatic Content in a Narrative.

Making sense of natural language and narratives requires building and manipulating a situation model by adding incoming information to the model and using the context stored in the model to comprehend subsequent details and events. Situation model maintenance is supported by the default mode network (DMN), but comprehension of the individual moments in the narratives relies on access to the conceptual store within the semantic system. The present study examined how these systems are engaged by different narrative content to investigate whether highly informative, or semantic, content is a particularly strong driver of semantic system activation compared with contextually driven content that requires using the situation model, which might instead engage DMN regions. The study further investigated which subregions of the graded semantic hub in the left anterior temporal lobe (ATL) were engaged by the type of narrative content. To do this, we quantified the semantic, pragmatic, social, ambiguous, and emotional content for each sentence in a complete narrative, the English translation of The Little Prince. Increased activation in the transmodal hub in the ventral ATL was only observed for high semantic (i.e., informative) relative to low semantic sentences. Activation in the dorsolateral and ventrolateral ATL subregions was observed for both high relative to low semantic and social content sentences, but the ventrolateral ATL effects were more extensive in the social condition. There was high correspondence between the social and pragmatic content results, particularly in the ventrolateral ATL. We argue that the ventrolateral ATL may be particularly engaged by internal, or endogenous, processing demands, aided by functional connections between the anterior middle temporal gyrus and the DMN. Pragmatic and social content may have driven endogenous processing given the pervasive and plot-progressing nature of this content in the narrative. We put forward a revised account of how the semantic system is engaged in naturalistic contexts, a critical step toward better understanding real-world semantic and social processing.

Conversational production and comprehension: fMRI-evidence reminiscent of but deviant from the classical Broca-Wernicke model.

A key question in research on the neurobiology of language is to which extent the language production and comprehension systems share neural infrastructure, but this question has not been addressed in the context of conversation. We utilized a public fMRI dataset where 24 participants engaged in unscripted conversations with a confederate outside the scanner, via an audio-video link. We provide evidence indicating that the two systems share neural infrastructure in the left-lateralized perisylvian language network, but diverge regarding the level of activation in regions within the network. Activity in the left inferior frontal gyrus was stronger in production compared to comprehension, while comprehension showed stronger recruitment of the left anterior middle temporal gyrus and superior temporal sulcus, compared to production. Although our results are reminiscent of the classical Broca-Wernicke model, the anterior (rather than posterior) temporal activation is a notable difference from that model. This is one of the findings that may be a consequence of the conversational setting, another being that conversational production activated what we interpret as higher-level socio-pragmatic processes. In conclusion, we present evidence for partial overlap and functional asymmetry of the neural infrastructure of production and comprehension, in the above-mentioned frontal vs temporal regions during conversation.

Brain connectivity patterns associated with individual differences in the access to experience-near personal semantics: a resting-state fMRI study

It has been proposed that a continuum of specificity exists between episodic and semantic autobiographical memory. Personal semantics have been theorized to situate intermediately on this continuum, with more “experience-near” personal semantics (enPS) closer to the episodic end. We used individual differences in behavior as a model to investigate brain networks associated with the access to episodic autobiographical (EAM) and enPS information, assessing the relation between performance in the EAM and enPS conditions of the Autobiographical Fluency Task (AFT) and intrinsic brain connectivity. Results of an intrinsic connectivity contrast analysis showed that the global connectivity of two clusters in the left and right posterior cingulate cortex (PCC) was predicted by performance in the enPS conditions. Moreover, enPS scores predicted the connectivity strength of the right PCC with the bilateral anterior hippocampus (aHC), anterior middle temporal gyrus (aMTG) and medial orbitofrontal cortex, and the left aMTG and PCC. enPS scores also predicted the connectivity strength of the left PCC with the bilateral HC and MTG. The network highlighted involves parts of the core and of the dorsal medial subsystems of the Default Mode Network, in line with the proposal that enPS represents an intermediate entity between episodic and semantic memory.

Speech-language within and between network disruptions in primary progressive aphasia variants

Primary progressive aphasia (PPA) variants present with distinct disruptions in speech-language functions with little known about the interplay between affected and spared regions within the speech-language network and their interaction with other functional networks.The Neurodegenerative Research Group, Mayo Clinic, recruited 123 patients with PPA (55 logopenic (lvPPA), 44 non-fluent (nfvPPA) and 24 semantic (svPPA)) who were matched to 60 healthy controls. We investigated functional connectivity disruptions between regions within the left-speech-language network (Broca, Wernicke, anterior middle temporal gyrus (aMTG), supplementary motor area (SMA), planum temporale (PT) and parietal operculum (PO)), and disruptions to other networks (visual association, dorsal-attention, frontoparietal and default mode networks (DMN)).Within the speech-language network, multivariate linear regression models showed reduced aMTG-Broca connectivity in all variants, with lvPPA and nfvPPA findings remaining significant after Bonferroni correction. Additional loss in Wernicke-Broca connectivity in nfvPPA, Wernicke-PT connectivity in lvPPA and greater aMTG-PT connectivity in svPPA were also noted. Between-network connectivity findings in all variants showed reduced aMTG-DMN and increased aMTG-dorsal-attention connectivity, with additional disruptions between aMTG-visual association in both lvPPA and svPPA, aMTG-frontoparietal in lvPPA, and Wernicke-DMN breakdown in svPPA.These findings suggest that aMTG connectivity breakdown is a shared feature in all PPA variants, with lvPPA showing more extensive connectivity disruptions with other networks.

Neuropsychological, plasma marker, and functional connectivity changes in Alzheimer's disease patients infected with COVID-19.

Patients with COVID-19 may experience various neurological conditions, including cognitive impairment, encephalitis, and stroke. This is particularly significant in individuals who already have Alzheimer's disease (AD), as the cognitive impairments can be more pronounced in these cases. However, the extent and underlying mechanisms of cognitive impairments in COVID-19-infected AD patients have yet to be fully investigated through clinical and neurophysiological approaches. This study included a total of 77 AD patients. Cognitive functions were assessed using neuropsychiatric scales for all participants, and plasma biomarkers of amyloid protein and tau protein were measured in a subset of 25 participants. To investigate the changes in functional brain connectivity induced by COVID-19 infection, a cross-sectional neuroimaging design was conducted involving a subset of 37 AD patients, including a control group of 18 AD participants without COVID-19 infection and a COVID-19 group consisting of 19 AD participants. For the 77 AD patients between the stages of pre and post COVID-19 infection, there were significant differences in cognitive function and psychobehavioral symptoms on the Montreal Scale (MoCA), the neuropsychiatric inventory (NPI), the clinician's global impression of change (CIBIC-Plus), and the activity of daily living scale (ADL). The COVID-19 infection significantly decreased the plasma biomarker level of Aβ42 and increased the plasma p-tau181 level in AD patients. The COVID-19-infected AD patients show decreased local coherence (LCOR) in the anterior middle temporal gyrus and decreased global correlation (GCOR) in the precuneus and the medial prefrontal cortex. The findings suggest clinical, cognitive, and neural alterations following COVID-19 infection in AD patients and emphasize the need for close monitoring of symptoms in AD patients who have had COVID-19 and further exploration of the underlying mechanisms.

Within‐network changes in strength of the default mode network relate to Alzheimer’s Disease biomarkers in APOE e4 carriers

AbstractBackgroundResting state functional connectivity measured with MRI (rsfMRI) is disrupted in Alzheimer’s Disease (AD), although reports of rsfMRI changes in adults with the apolipoprotein E (APOE) ε4 genotype (e4+) have been inconsistent. Here, we compare default mode network (DMN) connectivity between e4+ and non‐carriers (e4‐) groups and assess the relationship to AD‐related biomarkers.MethodSixty‐five e4+ (mean age 70.2 ± 4.1; 33 males) and 60 e4‐ (mean age 71.9 ± 4.1; 28 males) subjects underwent a whole‐brain anatomical MPRAGE and a rsfMRI scan. To focus on the DMN, ROIs were placed in the bilateral posterior cingulate cortex (PCC). The most highly correlated voxels between the left and right PCC ROIs were used to calculate left and right PCC rsfMRI z‐maps. Group differences were assessed and mean connectivity in each significant region was correlated with Aβ PET centiloid values and cerebrospinal fluid (CSF) Aβ42/ Aβ40 ratio, phosphorylated‐tau (p‐tau 181), and total‐tau (t‐tau).ResultEight regions showed group differences (p < 0.05; Figure 1). In the e4+ group, right PCC connectivity to the bilateral anterior middle temporal gyri (Figure 1: ROIs 1 and 2) was negatively related to both centiloid score (p < 0.03) and to CSF p‐tau (p < 0.008; Figure 2). Left PCC connectivity to the right anterior middle temporal gyrus was negatively related to centiloid score (r = ‐0.26, p < 0.042) and CSF p‐tau (r = ‐0.31, p < 0.024). Biomarker values in the e4‐ group were not significantly related to connectivity.ConclusionOur findings are consistent with reports of weakened DMN connectivity in e4+ adults and suggest that differences in connectivity strength may be mediated by amyloid or tau deposition.This work was supported by the National Institutes of Health (R01AG022304).

Word-producing brain: Contribution of the left anterior middle temporal gyrus to word production patterns in spoken language

Vocabulary is based on semantic knowledge. The anterior temporal lobe (ATL) has been considered an essential region for processing semantic knowledge; nonetheless, the association between word production patterns and the structural and functional characteristics of the ATL remains unclear. To examine this, we analyzed over one million words from group conversations among community-dwelling older adults and their multimodal magnetic resonance imaging data. A quantitative index for the word production patterns, namely the exponent β of Heaps’ law, positively correlated with the left anterior middle temporal gyrus volume. Moreover, β negatively correlated with its resting-state functional connectivity with the precuneus. There was no significant correlation with the diffusion tensor imaging metrics in any fiber. These findings suggest that the vocabulary richness in spoken language depends on the brain status characterized by the semantic knowledge-related brain structure and its activation dissimilarity with the precuneus, a core region of the default mode network.

Altered intrinsic cerebellar-cerebral functional connectivity is related to negative symptoms in patients with first-episode psychosis

BackgroundNegative symptoms in schizophrenia include cognitive and affective dysfunction, such as diminished expression and amotivation. Although the cerebellar posterior hemisphere and vermis are involved in cognitive and affective functioning, previous studies on the neural mechanism of negative symptoms have mostly been confined to the cerebral cortex. This study aimed to investigate whether resting-state cerebellar-cerebral functional connectivity (FC) is altered in first-episode psychosis (FEP) patients and whether this connectivity is related to negative symptoms. MethodsResting-state functional magnetic resonance images were obtained from 38 FEP patients and 100 healthy controls (HCs). Using the posterior hemisphere and vermis of the cerebellum as seeds, whole-brain FC was compared between FEP patients and HCs. As cerebellar-parietal cortex connectivity is associated with negative symptoms and sociocognitive dysfunctions in schizophrenia patients, its correlation with negative symptoms was explored in FEP patients. ResultsFEP patients showed hyperconnectivity between the cerebellum and bilateral frontal pole (FP), occipital pole, fusiform gyrus, right lingual gyrus, central opercular cortex, anterior middle temporal gyrus, precuneus, and subcallosal cortex. Hypoconnectivity was found between the cerebellum and left FP, right anterior supramarginal gyrus (aSMG), and cerebellum crus I. FC between the left crus II and right aSMG was negatively correlated with the severity of negative symptoms and diminished expression. ConclusionsAltered FC between the cerebellum and cerebral regions related to cognitive, affective, and sensory processing was found in FEP patients and was connected to negative symptoms. These results suggest that the cerebellum plays a role in the pathophysiology of negative symptoms in schizophrenia.

Temporal Organization of Episodic and Experience-near Semantic Autobiographical Memories: Neural Correlates and Context-dependent Connectivity.

Autobiographical memory includes a representation of personal life events with a unique spatiotemporal context (episodic autobiographical memory) and factual self-knowledge (personal semantics). Whereas "experience-far" personal semantics have undergone complete abstraction, "experience-near" personal semantics are still linked to a spatiotemporal context. The representation of one's own past involves an autobiographical knowledge base, in the form of a personal timeline, along which autobiographical information is temporally organized into different lifetime periods. Commonalities and differences between brain networks supporting this temporal organization for autobiographical information with different contextual specificity, however, have not been investigated to date. Here, we used task-based fMRI to assess neural substrates of temporal ordering along the personal timeline for real autobiographical episodic and experience-near personal semantic memories. Within a distributed network, the left calcarine cortex was more strongly activated for episodic autobiographical memory than personal semantics, whereas the left ventromedial pFC and right posterior cingulate cortex (PCC), angular gyrus (AG), and anterior middle temporal gyrus (aMTG) showed stronger activation for personal semantics than episodic autobiographical memory. Findings were confirmed by analyses in independently derived ROIs. Generalized psychophysiological interaction analyses between the same regions showed that, during personal semantics compared with episodic autobiographical memory, memory category modulated activity in the left PCC and right PCC, AG, and aMTG. Findings provide insights on how personal events and facts are represented in the timescale of years, suggesting that the temporal organization of autobiographical memory exploits properties of situation models developed within posteromedial, lateral parietal, and medial prefrontal regions.

Functional connectivity of brain networks during semantic processing in older adults.

The neural systems underlying semantic processing have been characterized with functional neuroimaging in young adults. Whether the integrity of these systems degrade with advanced age remains unresolved. The current study examined functional connectivity during abstract and concrete word processing. Thirty-eight adults, aged 55-91, engaged in semantic association decision tasks during a mixed event-related block functional magnetic resonance imaging (fMRI) paradigm. During the semantic trials, the task required participants to make a judgment as to whether pairs were semantically associated. During the rhyme trials, the task required participants to determine if non-word pairs rhymed. Seeds were placed in putative semantic hubs of the left anterior middle temporal gyrus (aMTG) and the angular gyrus (AG), and also in the left inferior frontal gyrus (IFG), an area considered important for semantic control. Greater connectivity between aMTG, AG, and IFG and multiple cortical areas occurred during semantic processing. Connectivity from the three seeds differed during semantic processing: the left AG and aMTG were strongly connected with frontal, parietal, and occipital areas bilaterally, whereas the IFG was most strongly connected with other frontal cortical areas and the AG in the ipsilateral left hemisphere. Notably, the strength and extent of connectivity differed for abstract and concrete semantic processing; connectivity from the left aMTG and AG to bilateral cortical areas was greater during abstract processing, whereas IFG connectivity with left cortical areas was greater during concrete processing. With advanced age, greater connectivity occurred only between the left AG and supramarginal gyrus during the processing of concrete word-pairs, but not abstract word-pairs. Among older adults, robust functional connectivity of the aMTG, AG, and IFG to widely distributed bilateral cortical areas occurs during abstract and concrete semantic processing in a manner consistent with reports from past studies of young adults. There was not a significant degradation of functional connectivity during semantic processing between the ages of 55 and 85 years. As the study focused on semantic functioning in older adults, a comparison group of young adults was not included, limiting generalizability. Future longitudinal neuroimaging studies that compare functional connectivity of young and older adults under different semantic demands will be valuable.

Anterior transtemporal endoscopic selective amygdalohippocampectomy: a virtual and cadaveric feasibility study.

Selective amygdalohippocampectomy (SelAH) is one of the most common surgical treatments for mesial temporal sclerosis. Microsurgical approaches are associated with the risk of cognitive and visual deficits due to damage to the cortex and white matter (WM) pathways. Our objective is to test the feasibility of an endoscopic approach through the anterior middle temporal gyrus (aMTG) to perform a SelAH. Virtual simulation with MRI scans of ten patients (20 hemispheres) was used to identify the endoscopic trajectory through the aMTG. A cadaveric study was performed on 22 specimens using a temporal craniotomy. The anterior part of the temporal horn was accessed using a tubular retractor through the aMTG after performing a 1.5cm corticectomy at 1.5cm posterior to the temporal pole. Then, an endoscope was introduced. SeIAH was performed in each specimen. The specimens underwent neuronavigation-assisted endoscopic SeIAH to confirm our surgical trajectory. WM dissection using Klingler's technique was performed on five specimens to assess WM integrity. This approach allowed the identification of collateral eminence, lateral ventricular sulcus, choroid plexus, inferior choroidal point, amygdala, hippocampus, and fimbria. SelAH was successfully performed on all specimens, and CT neuronavigation confirmed the planned trajectory. WM dissection confirmed the integrity of language pathways and optic radiations. Endoscopic SelAH through the aMTG can be successfully performed with a corticectomy of 15mm, presenting a reduced risk of vascular injury and damage to WM pathways. This could potentially help to reduce cognitive and visual deficits associated with SelAH.

Professional chess expertise modulates whole brain functional connectivity pattern homogeneity and couplings.

Previous studies have revealed changed functional connectivity patterns between brain areas in chess players using resting-state functional magnetic resonance imaging (rs-fMRI). However, how to exactly characterize the voxel-wise whole brain functional connectivity pattern changes in chess players remains unclear. It could provide more convincing evidence for establishing the relationship between long-term chess practice and brain function changes. In this study, we employed newly developed whole brain functional connectivity pattern homogeneity (FcHo) method to identify the voxel-wise changes of functional connectivity patterns in 28 chess master players and 27 healthy novices. Seed-based functional connectivity analysis was used to identify the alteration of corresponding functional couplings. FcHo analysis revealed significantly increased whole brain functional connectivity pattern similarity in anterior cingulate cortex (ACC), anterior middle temporal gyrus (aMTG), primary visual cortex (V1), and decreased FcHo in thalamus and precentral gyrus in chess players. Resting-state functional connectivity analyses identified chess players showing decreased functional connections between V1 and precentral gyrus. Besides, a linear support vector machine (SVM) based classification achieved an accuracy of 85.45%, a sensitivity of 85.71% and a specificity of 85.19% to differentiate chess players from novices by leave-one-out cross-validation. Finally, correlation analyses revealed that the mean FcHo values of thalamus were significantly negatively correlated with the training time. Our findings provide new evidences for the important roles of ACC, aMTG, V1, thalamus and precentral gyrus in chess players. The findings also indicate that long-term professional chess training may enhance the semantic and episodic processing, efficiency of visual-motor transformation, and cognitive ability.

Specific Functional Connectivity Patterns of Middle Temporal Gyrus Subregions in Children and Adults with Autism Spectrum Disorder.

As one of the key regions in the "social brain" network, the middle temporal gyrus (MTG) has been widely reported to be associated with autism spectrum disorder (ASD), but there have been contradictory results in terms of whether it shows hyperconnectivity or hypoconnectivity. Delineating roles of MTG at the subregional level may eliminate the observed inconsistencies and provide a new avenue to reveal the neurophysiologic mechanism of ASD. Thus, we first performed connectivity-based parcellation using the BrainMap database to identify fine-grained functional topography of the MTG. Then, the MTG subregions were used to investigate differences in the functional connectivity in children and adults with ASD using two data sets from Autism Brain Imaging Data Exchange database. Four distinct subregions in the human left and right MTG were identified, including the anterior MTG (aMTG), middle-anterior MTG (maMTG), middle-posterior MTG, and posterior MTG (pMTG). The bilateral pMTG was more vulnerable in both children and adults with ASD than in the typically developing (TD) group, mainly showing hypoconnectivity with different brain regions. In addition, the bilateral aMTG and right maMTG also showed altered functional connectivity in adults with ASD compared to the TD group. Moreover, all these altered MTG subregions were mainly associated with social cognition and language, as revealed by functional characterization. Further correlation analyses also showed trends of association between altered connectivity of the left aMTG and the Autism Diagnostic Observation Schedule scores in adults with ASD. Together, these results suggest a potential objective way to explore sub-regional differences associated with such disorders. Autism Res 2020, 13: 410-422. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Four distinct subregions in the human left and right middle temporal gyrus (MTG) were identified, including the anterior MTG (aMTG), middle-anterior MTG (maMTG), middle-posterior MTG, and posterior MTG (pMTG). The bilateral pMTG was more vulnerable in both children and adults with autism spectrum disorder (ASD) than in the typically developing (TD) group, mainly showing hypoconnectivity with different brain regions. In addition, the bilateral aMTG and right maMTG also showed altered functional connectivity in adults with ASD compared to the TD group. Moreover, all these altered MTG subregions were mainly associated with social cognition and language, as revealed by functional characterization. Further correlation analyses also showed trends of association between altered connectivity of the left aMTG and the Autism Diagnostic Observation Schedule scores in adults with ASD.

Understanding Body Language Does Not Require Matching the Body's Egocentric Map to Body Posture: A Brain Activation fMRI Study.

Body language (BL) is a type of nonverbal communication in which the body communicates the message. We contrasted participants' cognitive processing of body representations or meanings versus body positions. Participants (N = 20) were shown pictures depicting body postures and were instructed to focus on their meaning (BL) or on the position of a body part relative to the position of another part (body structural description [BSD]). We examined activation in brain areas related to the two types of body representation-body schema and BSD-as modulated by the two tasks. We presumed that if understanding BL triggers embodiment of body posture, a matching procedure between the egocentric map coding the position of one's body segments in space and time should occur. We found that BL (vs. BSD) differentially activated the angular gyrus bilaterally, the anterior middle temporal gyrus, the temporal pole, and the right superior temporal gyrus, the inferior frontal gyrus, the superior medial gyrus, and the left superior frontal gyrus. BSD (vs. BL) differentially activated the superior parietal lobule (Area 7A) bilaterally, the posterior inferior temporal gyrus, the middle frontal gyrus, and the left precentral gyrus. Sensorimotor areas were differentially activated by BSD when compared with BL. Inclusive masking showed significant voxels in the superior colliculus and pulvinar, fusiform gyrus, inferior temporal gyrus, superior temporal gyrus, the intraparietal sulcus bilaterally, inferior frontal gyrus bilaterally, and precentral gyrus. These results indicate common brain networks for processing BL and BSD, for which some areas show differentially stronger or weaker processing of one task or the other, with the precuneus and the superior parietal lobule, the intraparietal sulcus, and sensorimotor areas most related to the BSD as activated by the BSD task. In contrast, the parietal operculum, an area related to the body schema, a representation crucial during embodiment of body postures, was not activated for implicit masking or for the differential contrasts.

Neural substrates of amodal and modality-specific semantic processing within the temporal lobe: A lesion-behavior mapping study of semantic dementia

Although the human temporal lobe has been documented to participate in semantic processing of both verbal and nonverbal stimuli, the exact neural basis underlying the common and unique processing of the two modalities is unclear. Semantic dementia (SD), a disease with a semantic-selective deficit due to predominant temporal lobe atrophy is an ideal lesion model to address this issue. However, many previous studies of SD used an impure patient sample or did not appropriately control for common components between tasks. To overcome these limitations, the present study aims to identify amodal semantic hubs and modality-specific regions in the temporal lobe by investigating behavioral performance on a verbal modality task (word associative matching) and a nonverbal modality task (picture associative matching) and neuroimaging data in 33 SD patients. We found that the left anterior fusiform gyrus was an amodal semantic hub whose gray matter volume correlated significantly with both modalities. We also observed two verbal modality-specific regions (the left posterior inferior temporal gyrus and the left middle superior temporal gyrus) and a nonverbal modality-specific region (the right lateral anterior middle temporal gyrus) whose gray matter volume correlated significantly with one modality when performance on the other modality was partialled out. The results remained significant when we excluded a wide range of potential confounding variables. Furthermore, to confirm the observed effects, we compared the performance of left- and right-hemispheric-predominant atrophic patients on the verbal and nonverbal tasks. The left-predominant patients showed more severe deficits in performance of the verbal task than the right-predominant patients, whereas the two groups of patients presented comparable deficits in the performance of the nonverbal task. These findings refined the structure of semantic network in the temporal lobe, deepening our understanding of the critical role of the temporal lobe in semantic processing.

Dissociating action and abstract verb comprehension post-stroke

The neural bases of action and abstract concept representations remain a topic of debate. While several lines of research provide evidence for grounding of action-related conceptual content into sensory-motor systems, results of traditional lesion-deficit studies have been somewhat inconsistent. Further, few studies have directly compared the neural substrates of action and relatively abstract verb comprehension post-stroke. Here, we investigated the impact of the disruption of two neural networks on comprehension of action and relatively abstract verbs in 48 unilateral left-hemisphere stroke patients using two methodologies: 1) lesion-deficit association and 2) resting-state functional connectivity (RSFC) analyses. Disruption of RSFC between the left inferior frontal gyrus and right hemisphere primary and secondary sensory-motor areas predicted greater relative impairment of action semantics. Voxel-based lesion-symptom mapping revealed that damage to frontal white matter, extending towards the inferior frontal gyrus, also predicted greater relative impairment of action semantics. On the other hand, damage to the left anterior middle temporal gyrus significantly impaired the more abstract category relative to action. These findings support the view that action and non-action/abstract semantic processing rely on partially dissociable brain networks, with action concepts relying more heavily on sensory-motor areas. The results also have wider implications for lesion-deficit association studies and show how the contralateral hemisphere can play a compensatory role following unilateral stroke.

Neural correlates of acute apraxia: Evidence from lesion data and functional MRI in stroke patients

Behavioral deficits after stroke like apraxia can be related to structural lesions and to a functional state of the underlying network – three factors, reciprocally influencing each other. Combining lesion data, behavioral performance and passive functional activation of the network-of-interest, this study aims to disentangle those mutual influences and to identify 1) activation patterns associated with the presence or absence of acute apraxia in tool-associated actions and 2) the specific impact of lesion location on those activation patterns.Brain activity of 48 patients (63.31 ± 13.68 years, 35 male) was assessed in a fMRI paradigm with observation of tool-related actions during the acute phase after first-ever left-hemispheric stroke (4.83 ± 2.04 days). Behavioral assessment of apraxia in tool-related tasks was obtained independently. Brain activation was compared between patients versus healthy controls and between patient with versus without apraxia. Interaction effects of lesion location (frontal vs parietal) and behavioral performance (apraxia vs no apraxia) were assessed in a 2 × 2 factorial design.Action observation activated the ventro-dorsal parts of the network for cognitive motor function; activation was globally downregulated after stroke. Apraxic compared to non-apraxic patients showed relatively increased activity in bilateral posterior middle temporal gyrus and middle frontal gyrus/superior frontal sulcus. Altered activation occurred in regions for tool-related cognition, corroborating known functions of the ventro-dorsal and ventral streams for praxis, and comprised domain-general areas, functionally related to cognitive control. The interaction analyses revealed different levels of activation in the left anterior middle temporal gyrus in the ventral stream in apraxic patients with frontal compared to parietal lesions, suggesting a modulation of network activation in relation to behavioral performance and lesion location as separate factors.By detecting apraxia-specific activation patterns modulated by lesion location, this study underlines the necessity to combine structural lesion information, behavioral parameters and functional activation to comprehensively examine cognitive functions in acute stroke patients.

Endoscopic Transanterior Middle Temporal Approach to the Atrium—An Anatomical Feasibility Study

The atrium is the most common location for masses in the lateral ventricle. However, access to this area is limited owing to its deep location and adjacent eloquent neurovascular structures, such as the choroidal arteries, perisylvian white matter (WM) tracts, and optic radiations. We investigated the feasibility and safety of an endoscopic approach to the atrium via the anterior middle temporal gyrus (MTG). Radiological assessment of a minimally invasive surgical trajectory to the atrium was achieved in 10 patients. Surgical simulation to assess the feasibility of our endoscopic approach was performed on 24 cadaveric specimens using a transzygomatic corridor and temporal craniotomy. Preoperative computed tomography was performed to confirm the surgical trajectory using neuronavigation. Using Klinger's method, 5 hemispheres were dissected to assess the relationship of our approach to the WM tracts. The optimal entry angle to reach the atrium through the anterior MTG was related to the temporal horn in the axial plane and to the Sylvian fissure in the sagittal plane. Our entry point in the anterior MTG was 19 ± 1.92 mm from the temporal pole. The transparenchymal distance to atrium was 24.55 ± 4.3 mm. The WM dissections confirmed that our approach did not violate the optic radiations, uncinate fasciculus, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, or superior longitudinal fasciculus. Our findings have confirmed the feasibility of an anterior endoscopic approach to the atrium through the anterior MTG, with preservation of the functional integrity of the eloquent cortex and WM tracts.

“Looks familiar, but I do not know who she is”: The role of the anterior right temporal lobe in famous face recognition

Processing a famous face involves a cascade of steps including detecting the presence of a face, recognizing it as familiar, accessing semantic/biographical information about the person, and finally, if required, production of the proper name. Decades of neuropsychological and neuroimaging studies have identified a network of occipital and temporal brain regions ostensibly comprising the ‘core’ system for face processing. Recent research has also begun to elucidate upon an ‘extended’ network, including anterior temporal and frontal regions. However, there is disagreement about which brain areas are involved in each step, as many aspects of face processing occur automatically in healthy individuals and rarely dissociate in patients. Moreover, some common phenomena are not easily induced in an experimental setting, such as having a sense of familiarity without being able to recall who the person is. Patients with the semantic variant of Primary Progressive Aphasia (svPPA) often recognize a famous face as familiar, even when they cannot specifically recall the proper name or biographical details. In this study, we analyzed data from a large sample of 105 patients with neurodegenerative disorders, including 43 svPPA, to identify the neuroanatomical substrates of three different steps of famous face processing. Using voxel-based morphometry, we correlated whole-brain grey matter volumes with scores on three experimental tasks that targeted familiarity judgment, semantic/biographical information retrieval, and naming. Performance in naming and semantic association significantly correlates with grey matter volume in the left anterior temporal lobe, whereas familiarity judgment with integrity of the right anterior middle temporal gyrus. These findings shed light on the neuroanatomical substrates of key components of overt face processing, addressing issues of functional lateralization, and deepening our understanding of neural substrates of semantic knowledge.

Relationship between cortical connectivity and aphasia therapy response

Introduction Individual response to aphasia therapy is highly variable and difficult to predict. While different therapies for word retrieval are often given based on assumptions regarding the underlying breakdown, behavioural symptoms do not consistently predict which type of naming therapy will be most effective. Measures of cortical connectivity derived from EEG before and after therapy may provide additional important information for predicting and understanding response to therapy. Methods Twenty-three adults were recruited including eight adults with chronic, post-stroke aphasia who successfully completed 12 therapy sessions over 4 weeks, alternating between semantic and phonological approaches to word retrieval based on semantic feature analysis and phonological components analysis. Fifteen age-matched healthy controls were included for comparison. High-density electroencephalography (128 channel EEG) was measured during a picture-word judgement task performed before and after treatment for the aphasia group. Analysis of EEG via a dynamic causal modelling (DCM) approach was used to assess semantic and phonological processing pre and post therapy. DCM was applied using five fronto-temporo-parietal regions of interest based on source imaging analysis in the control and aphasia groups. Results Post-treatment naming improvement was associated with cortical responses measured bilaterally in a DCM connectivity model. Specifically, naming improvement for items treated with semantic feature analysis was correlated with (a) increased pre-treatment coupling between the left inferior parietal lobule and left inferior frontal gyrus (r = 0.63, pFDR=0.016) (b) increased coupling from left to right inferior parietal lobule (r = .77, FDRp = .0005) and (c) decreased pre-treatment coupling between the right inferior parietal lobule and right anterior middle temporal gyrus (r = -0.76, pFDR = 0.03). Post-treatment, reduced coupling between right inferior frontal gyrus and right posterior superior temporal gyrus was also significantly correlated with naming improvement for semantic treatment items (r= −0.53, pFDR=0.010). Conclusions This preliminary study on a small cohort of individuals with chronic aphasia has demonstrated the potential of DCM connectivity models derived from EEG data to predict and understand aphasia therapy response. In addition to highlighting the importance of connectivity within left hemisphere networks and inter-hemispheric coupling for treatment, the observation of reduced right intrahemispheric coupling in those individuals with improved outcomes supports the view that right hemisphere mechanisms may not invariably support treatment-induced recovery. Elucidating effective ipsilateral and contralateral connectivity before and after aphasia treatment provides new insights into therapy-induced reorganisation of cortical networks associated with successful therapy outcomes.