Bilateral Anterior Temporal Lobe Research Articles

Social-semantic knowledge in frontotemporal dementia and after anterior temporal lobe resection

Abstract Degraded semantic memory is a prominent feature of frontotemporal dementia (FTD). It is classically associated with semantic dementia and anterior temporal lobe (ATL) atrophy, but semantic knowledge can also be compromised in behavioural-variant FTD (bvFTD). Motivated by understanding behavioural change in FTD, recent research has focused selectively on social-semantic knowledge, with proposals that the right ATL is specialised for social concepts. Previous studies have assessed very different types of social concepts and have not compared performance to that on matched non-social concepts. Consequently, it remains unclear to what extent various social concepts are (i) concurrently impaired in FTD, (ii) distinct from general semantic memory and (iii) differentially supported by the left and right ATL. This study assessed multiple aspects of social-semantic knowledge and general conceptual knowledge across cohorts with ATL-damage arising from either neurodegeneration or resection. We assembled a test battery measuring knowledge of multiple types of social concept. Performance was compared to non-social general conceptual knowledge, measured using the Cambridge Semantic Memory Test Battery and other matched non-social-semantic tests. Our transdiagnostic approach included bvFTD, semantic dementia and “mixed” intermediate cases to capture the FTD clinical spectrum, as well as age-matched healthy controls. People with unilateral left or right ATL resection for temporal lobe epilepsy (TLE) were also recruited to assess how selective damage to the left or right ATL impacts social- and non-social-semantic knowledge. Social- and non-social-semantic deficits were severe and highly correlated in FTD. Much milder impairments were found after unilateral ATL resection, with no left vs. right differences in social-semantic knowledge or general semantic processing, and with only naming showing a greater deficit following left vs. right damage. A principal component analysis of all behavioural measures in the FTD cohort extracted three components, interpreted as capturing: (1) FTD severity, (2) semantic memory and (3) executive function. Social and non-social measures both loaded heavily on the same semantic memory component, and scores on this factor were uniquely associated with bilateral ATL grey matter volume but not with the degree of ATL asymmetry. Together, these findings demonstrate that both social- and non-social-semantic knowledge degrade in FTD (semantic dementia and bvFTD) following bilateral ATL atrophy. We propose that social-semantic knowledge is part of a broader conceptual system underpinned by a bilaterally-implemented, functionally-unitary semantic hub in the ATLs. Our results also highlight the value of a transdiagnostic approach for investigating the neuroanatomical underpinnings of cognitive deficits in FTD.

Discovering prominent differences in structural and functional connectomes using a multinomial stochastic block model

ABSTRACT Understanding the differences between functional and structural human brain connectivity has been a focus of an extensive amount of neuroscience research. We employ a novel approach using the multinomial stochastic block model (MSBM) to explicitly extract components that characterize prominent differences across graphs. We analyze structural and functional connectomes derived from high-resolution diffusion-weighted MRI and fMRI scans of 250 Human Connectome Project subjects, analyzed at group connectivity level across 50 subjects. The inferred brain partitions revealed consistent, spatially homogeneous clustering patterns across inferred resolutions demonstrating the MSBM’s reliability in identifying brain areas with prominent structure-function differences. Prominent differences in low-resolution brain maps (K = {3, 4} clusters) were attributed to weak functional connectivity in the bilateral anterior temporal lobes, while higher resolution results (K ≥ 25) revealed stronger interhemispheric functional than structural connectivity. Our findings emphasize significant differences in high-resolution functional and structural connectomes, revealing challenges in extracting meaningful connectivity measurements from both modalities, including tracking fibers through the corpus callosum and attenuated functional connectivity in anterior temporal lobe fMRI data, which we attribute to increased noise levels. The MSBM emerges as a valuable tool for understanding differences across graphs, with potential future applications and avenues beyond the current focus on characterizing modality-specific distinctions in connectomics data.

The impact of bilateral versus unilateral anterior temporal lobe damage on face recognition, person knowledge and semantic memory.

The functional importance of the anterior temporal lobes (ATLs) has come to prominence in two active, albeit unconnected literatures-(i) face recognition and (ii) semantic memory. To generate a unified account of the ATLs, we tested the predictions from each literature and examined the effects of bilateral versus unilateral ATL damage on face recognition, person knowledge, and semantic memory. Sixteen people with bilateral ATL atrophy from semantic dementia (SD), 17 people with unilateral ATL resection for temporal lobe epilepsy (TLE; left = 10, right = 7), and 14 controls completed tasks assessing perceptual face matching, person knowledge and general semantic memory. People with SD were impaired across all semantic tasks, including person knowledge. Despite commensurate total ATL damage, unilateral resection generated mild impairments, with minimal differences between left- and right-ATL resection. Face matching performance was largely preserved but slightly reduced in SD and right TLE. All groups displayed the familiarity effect in face matching; however, it was reduced in SD and right TLE and was aligned with the level of item-specific semantic knowledge in all participants. We propose a neurocognitive framework whereby the ATLs underpin a resilient bilateral representation system that supports semantic memory, person knowledge and face recognition.

Graph Theory Further Revealed Visual Spatial Working Memory Impairment in Patients with Inflammatory Bowel Disease.

Inflammatory Bowel Disease (IBD) patients may experience cognitive impairments in Visuospatial Working Memory (VSWM), significantly impacting their quality of life. However, the mechanisms underlying these impairments remain poorly understood. We studied functional MRI and graph theory analysis to investigate changes in functional connectivity networks during the Mental Rotation Task (MRT) in IBD patients. Twenty IBD patients (13 males, 7 females; mean age = 34.95 ± 13.80 years; mean disease duration = 2.43 ± 2.37 years) participated in the study. Exclusion criteria encompassed recent use of analgesics, 5-Aminosalicylate, corticosteroids, or immunosuppressants within the past three months. Additionally, we recruited 20 age-, gender-, and education-matched healthy controls for comparison. Compared to a control group, IBD patients exhibited significantly longer reaction times and reduced accuracy during the MRT. Our analysis revealed abnormalities in multiple nodal attributes within the functional connectivity network, particularly in regions such as the bilateral orbitofrontal cortex, right supplementary motor area, bilateral parahippocampal gyrus, and bilateral anterior temporal lobe. We observed that the nodal efficiency in the left temporal pole is negatively correlated with Red Blood Cell Distribution Width (RDW) and positively correlated with response time of MRT. Our findings revealed notable abnormalities in multiple node attributes among IBD patients during MRT, providing evidence of cognitive impairments in VSWM in IBD patients. This study found RDW maybe can serve as a clinical indicator for predicting early VSWM impairment in patients with IBD.

Decoding Semantics from Dynamic Brain Activation Patterns: From Trials to Task in EEG/MEG Source Space.

The temporal dynamics within the semantic brain network and its dependence on stimulus and task parameters are still not well understood. Here, we addressed this by decoding task as well as stimulus information from source-estimated EEG/MEG human data. We presented the same visual word stimuli in a lexical decision (LD) and three semantic decision (SD) tasks. The meanings of the presented words varied across five semantic categories. Source space decoding was applied over time in five ROIs in the left hemisphere (anterior and posterior temporal lobe, inferior frontal gyrus, primary visual areas, and angular gyrus) and one in the right hemisphere (anterior temporal lobe). Task decoding produced sustained significant effects in all ROIs from 50 to 100 ms, both when categorizing tasks with different semantic demands (LD-SD) as well as for similar semantic tasks (SD-SD). In contrast, a semantic word category could only be decoded in lATL, rATL, PTC, and IFG, between 250 and 500 ms. Furthermore, we compared two approaches to source space decoding: conventional ROI-by-ROI decoding and combined-ROI decoding with back-projected activation patterns. The former produced more reliable results for word category decoding while the latter was more informative for task decoding. This indicates that task effects are distributed across the whole semantic network while stimulus effects are more focal. Our results demonstrate that the semantic network is widely distributed but that bilateral anterior temporal lobes together with control regions are particularly relevant for the processing of semantic information.

Heterogeneous Brain Abnormalities in Schizophrenia Converge on a Common Network Associated With Symptom Remission.

There is a huge heterogeneity of magnetic resonance imaging findings in schizophrenia studies. Here, we hypothesized that brain regions identified by structural and functional imaging studies of schizophrenia could be reconciled in a common network. We systematically reviewed the case-control studies that estimated the brain morphology or resting-state local function for schizophrenia patients in the literature. Using the healthy human connectome (n = 652) and a validated technique "coordinate network mapping" to identify a common brain network affected in schizophrenia. Then, the specificity of this schizophrenia network was examined by independent data collected from 13 meta-analyses. The clinical relevance of this schizophrenia network was tested on independent data of medication, neuromodulation, and brain lesions. We identified 83 morphological and 60 functional studies comprising 7389 patients with schizophrenia and 7408 control subjects. The "coordinate network mapping" showed that the atrophy and dysfunction coordinates were functionally connected to a common network although they were spatially distant from each other. Taking all 143 studies together, we identified the schizophrenia network with hub regions in the bilateral anterior cingulate cortex, insula, temporal lobe, and subcortical structures. Based on independent data from 13 meta-analyses, we showed that these hub regions were specifically connected with regions of cortical thickness changes in schizophrenia. More importantly, this schizophrenia network was remarkably aligned with regions involving psychotic symptom remission. Neuroimaging abnormalities in cross-sectional schizophrenia studies converged into a common brain network that provided testable targets for developing precise therapies.

Representation of event and object concepts in ventral anterior temporal lobe and angular gyrus.

Semantic knowledge includes understanding of objects and their features and also understanding of the characteristics of events. The hub-and-spoke theory holds that these conceptual representations rely on multiple information sources that are integrated in a central hub in the ventral anterior temporal lobes. The dual-hub theory expands this framework with the claim that the ventral anterior temporal lobe hub is specialized for object representation, while a second hub in angular gyrus is specialized for event representation. To test these ideas, we used representational similarity analysis, univariate and psychophysiological interaction analyses of fMRI data collected while participants processed object and event concepts (e.g. "an apple," "a wedding") presented as images and written words. Representational similarity analysis showed that angular gyrus encoded event concept similarity more than object similarity, although the left angular gyrus also encoded object similarity. Bilateral ventral anterior temporal lobes encoded both object and event concept structure, and left ventral anterior temporal lobe exhibited stronger coding for events. Psychophysiological interaction analysis revealed greater connectivity between left ventral anterior temporal lobe and right pMTG, and between right angular gyrus and bilateral ITG and middle occipital gyrus, for event concepts compared to object concepts. These findings support the specialization of angular gyrus for event semantics, though with some involvement in object coding, but do not support ventral anterior temporal lobe specialization for object concepts.

A neuropsychological investigation of social‐semantic knowledge in frontotemporal dementia

AbstractBackgroundThe loss of semantic memory is a key feature of frontotemporal dementia (FTD), and is associated with atrophy of the anterior temporal lobes (ATLs). The role of the left and right ATLs in supporting social‐semantic knowledge is unclear. To address this, we developed a social‐semantic battery comprising exemplars of social concepts such as person‐specific knowledge, abstract social concepts, and understanding of social norms. Performance on this battery was directly compared with non‐social semantic knowledge, measured using the Cambridge Semantic Test Battery.Method48 people with FTD (behavioural‐variant FTD = 26, semantic dementia = 22), and 19 age‐matched healthy controls were recruited. Participants completed both semantic batteries, alongside tests of general cognition and executive function. Participants also underwent a 3T T1‐weighted structural MRI scan. All neuropsychological tasks were entered into a principal component analysis (with varimax rotation) to explore graded variations in cognitive performance in FTD. Voxel‐based morphometry was conducted to explore grey matter correlates of social and non‐social semantic knowledge. The relative contributions of the left and right ATL to social‐semantic knowledge were tested by including ATL volume and asymmetry indices as predictors in a multiple regression analysis.ResultPeople with SD and bvFTD were impaired in both social‐and non‐social knowledge tasks. The principal component analysis indicated separate components for semantic memory and executive function. Both social and non‐social semantic tasks loaded onto the semantic memory component (Figure 1). People with SD scored significantly worse than bvFTD on the semantic memory component (t = 5.18, p<0.0001), while people with bvFTD scored worse than SD on the executive function component (t = 3.97, p<0.001) (Figure 2). Semantic memory factor scores were correlated with grey matter in the bilateral ATLs (Figure 3). There were no significant clusters associated with scores on the executive function component. Multiple regression revealed that performance on the semantic memory component was predicted by the magnitude but not the asymmetry of ATL atrophy.ConclusionBoth social and non‐social forms of semantic knowledge are impaired by FTD, and this degradation is associated with bilateral ATL atrophy. These results suggest a shared representation for all types of semantic memory across the ATLs.

56 Stereological Densities of Neuronal Tau Inclusions in Corticobasal Degeneration are Anatomically Distinct in PPA vs bvFTD

Objective:Primary progressive aphasia (PPA) is a dementia syndrome characterized early in its course by gradual dissolution of language and is associated with asymmetric atrophy in the language-dominant hemisphere (usually left). In contrast, behavioral variant frontotemporal dementia (bvFTD) is a dementia syndrome characterized by a progressive early decline in personality and comportment and is associated with relatively symmetric or rightward predominant bifrontal atrophy. This study analyzed the regional and hemispheric distributions of neuronal tau inclusions of the corticobasal degeneration variant of FTLD-tau pathology (FTLD-CBD) in individuals with PPA or bvFTD. The goal was to establish clinicopathologic concordance between FTLD-CBD and behavioral/comportmental vs aphasic dementia syndromes.Participants and Methods:Seven participants were clinically diagnosed with PPA and 6 were diagnosed with bvFTD. All had FTLD-CBD as the principal neuropathologic diagnosis at postmortem study. Sections from the following cortical regions were stained immunohistochemically with AT-8 to visualize neuronal tau inclusions: bilateral middle frontal gyrus (MFG), inferior parietal lobule (IPL), superior temporal gyrus (STG); and unilateral occipital cortex (OCC). Bilateral anterior temporal lobes (ATL) were analyzed in PPA cases only. Unbiased stereological analysis was performed to compare regional and hemispheric distributions between and within PPA vs. bvFTD groups.Results:Overall neocortical (MFG+STG+IPL) tau densities were significantly greater in the PPA group compared to the bvFTD group (p<0.05). Within the bvFTD group, the highest densities of tau inclusions were observed in the right MFG (mean=6,871.17; SD=3,220). In the PPA group, highest densities were observed in the left ATL (mean=9,901.81; SD=6,871). There was leftward hemispheric asymmetry of tau inclusions in IPL, STG and ATL which trended towards significance in the latter (p=0.083). Cortical distributions were symmetric or rightward predominant within the bvFTD group. Occipital cortex was devoid of inclusions.Conclusions:Preliminary stereological findings of FTLD-CBD tau inclusions suggest that the distributions of pathologic tau are different across two distinct clinical dementia phenotypes. The presence of left-sided neuronal tau inclusions in PPA is concordant with the aphasic phenotype whereas symmetric and frontal-predominant densities in bvFTD are consistent with comportmental dysfunction.

Recurrent petit mal seizures in Erdheim-Chester disease mimicking an intra-axial brain tumor: illustrative case.

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis characterized histologically by foamy histiocytes and Touton giant cells in a background of fibrosis. Bone pain with long bone osteosclerosis is highly specific for ECD. Central nervous system involvement is rare, although dural, hypothalamic, cerebellar, brainstem, and sellar region involvement has been described. A 59-year-old man with a history of ureteral obstruction, medically managed petit mal seizures, and a left temporal lesion followed with serial magnetic resonance imaging (MRI) presented with worsening seizure control. Repeat MRI identified bilateral amygdala region lesions. Gradual growth of the left temporal lesion over 1 year with increasing seizure frequency prompted resection. A non-Langerhans cell histiocytosis with a BRAF V600E mutation was identified on pathology. Imaging findings demonstrated retroperitoneal fibrosis and long bone osteosclerosis with increased fluorodeoxyglucose uptake that, together with the neuropathologic findings, were diagnostic of ECD. This case of biopsy-proven ECD is unique in that the singular symptom was seizures well controlled with medical management in the presence of similarly located bilateral anterior mesial temporal lobe lesions. Although ECD is rare intracranially, its variable imaging presentation, including the potential to mimic seizure-associated medial temporal lobe tumors, emphasizes the need for a wide differential diagnosis.

Semantic knowledge of social interactions is mediated by the hedonic evaluation system in the brain.

Attaching semantic meaning to sensory information received from both inside and outside our bodies is a fundamental function of the human brain. The theory of Controlled Semantic Cognition (CSC) proposes that the formation of semantic knowledge relies on connections between spatially distributed modality-specific spoke-nodes, and a modality-general hub in the anterior temporal lobes (ATLs). This theory can also be applied to social semantic knowledge, though certain domain-specific spoke-nodes may make a disproportionate contribution to the understanding of social concepts. The ATLs have strong connections with spoke-node structures such as the subgenual ACC (sgACC) and the orbitofrontal cortex (OFC) that play an important role in predicting the hedonic value of stimuli. We hypothesized that in addition to the ATL semantic hub, a social semantic task would also require input from hedonic evaluation structures. We used voxel based morphometry (VBM) to examine structural brain-behavior relationships in 152 patients with neurodegeneration (Alzheimer's disease [N=12], corticobasal syndrome (N=18], progressive supranuclear palsy [N=13], behavioral variant frontotemporal dementia [N=56], and primary progressive aphasia (PPA) [N=53]) using the Social Interaction Vocabulary Task (SIVT). This task measures the ability to correctly match a social term (e.g. "gossiping") with a visual depiction of that social interaction. As predicted, VBM showed that worse SIVT scores corresponded with volume loss in bilateral ATL semantic hub regions, but also in the sgACC, OFC, caudate and putamen (pFWE <0.05). These results support the CSC model of a hub-and-spoke organization of social semantic knowledge with the ATL as a domain-general semantic hub, and ventromedial and striatal structures as domain specific spoke-nodes. Importantly, these results suggest that correct comprehension of social semantic concepts requires emotional 'tagging' of a concept by the evaluation system, and that the social deficits observed in some neurodegenerative disease syndromes may be caused by the break-down of this mechanism.

A Semantic Cognition Contribution to Mood and Anxiety Disorder Pathophysiology.

Over the last two decades, the functional role of the bilateral anterior temporal lobes (bATLs) has been receiving more attention. They have been associated with semantics and social concept processing, and are regarded as a core region for depression. In the past, the role of the ATL has often been overlooked in semantic models based on functional magnetic resonance imaging (fMRI) due to geometric distortions in the BOLD signal. However, previous work has unequivocally associated the bATLs with these higher-order cognitive functions following advances in neuroimaging techniques to overcome the geometric distortions. At the same time, the importance of the neural basis of conceptual knowledge in understanding mood disorders became apparent. Theoretical models of the neural basis of mood and anxiety disorders have been classically studied from the emotion perspective, without concentrating on conceptual processing. However, recent work suggests that the ATL, a brain region underlying conceptual knowledge, plays an essential role in mood and anxiety disorders. Patients with anxiety and depression often cope with self-blaming biases and guilt. The theory is that in order to experience guilt, the brain needs to access the related conceptual information via the ATL. This narrative review describes how aberrant interactions of the ATL with the fronto-limbic emotional system could underlie mood and anxiety disorders.

Supramodal Sentence Processing in the Human Brain: fMRI Evidence for the Influence of Syntactic Complexity in More Than 200 Participants.

This study investigated two questions. One is: To what degree is sentence processing beyond single words independent of the input modality (speech vs. reading)? The second question is: Which parts of the network recruited by both modalities is sensitive to syntactic complexity? These questions were investigated by having more than 200 participants read or listen to well-formed sentences or series of unconnected words. A largely left-hemisphere frontotemporoparietal network was found to be supramodal in nature, i.e., independent of input modality. In addition, the left inferior frontal gyrus (LIFG) and the left posterior middle temporal gyrus (LpMTG) were most clearly associated with left-branching complexity. The left anterior temporal lobe showed the greatest sensitivity to sentences that differed in right-branching complexity. Moreover, activity in LIFG and LpMTG increased from sentence onset to end, in parallel with an increase of the left-branching complexity. While LIFG, bilateral anterior temporal lobe, posterior MTG, and left inferior parietal lobe all contribute to the supramodal unification processes, the results suggest that these regions differ in their respective contributions to syntactic complexity related processing. The consequences of these findings for neurobiological models of language processing are discussed.

A consensus definition of supratotal resection for anatomically distinct primary glioblastoma: an AANS/CNS Section on Tumors survey of neurosurgical oncologists.

Supratotal resection (SpTR) of glioblastoma may be associated with improved survival, but published results have varied in part fromlack of consensus on the definition and appropriate use of SpTR. A previous small survey of neurosurgical oncologists with expertise performing SpTR found resection 1-2cm beyond contrast enhancement was an acceptable definition and glioblastoma involving the right frontal and bilateral anterior temporal lobes were considered most amenable to SpTR. The general neurosurgical oncology community has not yet confirmed the practicality of this definition. Seventy-six neurosurgical oncology members of the AANS/CNS Tumor Section were surveyed, representing 34.0% of the 223 members who were administered the survey. Participants were presented with 11 definitions of SpTR and rated each definition's appropriateness. Participants additionally reviewed magnetic resonance imaging for 10 anatomically distinct glioblastomas and assessed the tumor location'seloquence, perceived equipoise of enrolling patients in a randomized trial comparing gross total to SpTR, and their personal treatment plans. Most neurosurgeons surveyed agree that gross total plus resection of some non-contrast enhancement (n = 57, 80.3%) or resection 1-2cm beyond contrast enhancement (n = 52, 73.2%) are appropriate definitions for SpTR. Cases were divided into three anatomically distinct groups by perceived equipoise between gross total and SpTR. The best clinical trial candidates were thought to be right anterior temporal (n = 58, 76.3%) and right frontal (n = 55, 73.3%) glioblastomas. Support exists among neurosurgical oncologists with varying familiarity performing SpTR to adopt the proposed consensus definition of SpTR of glioblastoma and to potentially investigate the utility of SpTR to treat right anterior temporal and right frontal glioblastomas in a clinical trial. A smaller proportion of general neurosurgical oncologists than SpTR experts would personally treat a left anterior temporal glioblastoma with SpTR.

CADASIL with an unusual presentation of prosopagnosia

CADASIL is a rare autosomal dominant arteriopathy due to a NOTCH3 mutation on chromosome 19, known to result in subcortical infarcts and leukoencephalopathy. Here, we present a middle-aged gentleman with an acute onset of prosopagnosia. His MRI brain showed acute infarct of the right fusiform gyri and extensive subcortical leukoencephalopathy with bilateral anterior temporal lobe involvement and was eventually diagnosed with CADASIL. Despite bilateral anterior temporal lobe involvement being a distinctive feature of CADASIL on MRI, there has been no reported case of CADASIL with acute prosopagnosia so far. While CADASIL and prosopagnosia have been extensively studied over the last few decades, this could be the first CADASIL case presented with acute prosopagnosia alone. This case report illustrates the importance of recognizing prosopagnosia to avoid misdiagnosis or a delayed diagnosis of acute stroke.

Neural correlates of Japanese honorific agreement processing mediated by socio-pragmatic factors: An fMRI study

Socio-pragmatic factors, such as social roles and language experience, could be key variables influencing language processing. However, little is known regarding the neural correlates of syntactic processing mediated by socio-pragmatic factors. Honorific agreement in Japanese is well-suited for the investigation of this issue. Japanese honorifics are governed by socio-pragmatic and syntactic rules. Lower social status speakers are expected to address higher social status counterparts in accordance with these rules. This linguistic skill is typically developed through language experience accrued in social contexts. The present functional magnetic resonance imaging study investigated the neural correlates of the honorific agreement processing mediated by socio-pragmatic factors. Thirty-three native Japanese speakers performed a socio-pragmatic judgment task containing sentence conditions manipulated by conventionality (i.e., conventional vs. unconventional) and speaker (lower-status vs. higher-status). The lower-status conditions elicited significantly more activation of the left inferior frontal gyrus (IFG), bilateral insula, and dorsal medial prefrontal cortex than the higher-status ones, irrespective of conventionality. This suggests that social cues (i.e., speaker social status) trigger computation of honorific agreement via the left IFG. Furthermore, the conventional conditions significantly enhanced activation of the bilateral anterior temporal lobes (ATLs), compared with the unconventional conditions. Finally, the listener's experience with honorific use in the workplace was positively correlated with activation of the left inferior parietal lobule (IPL) during comprehension of conventional honorific utterances. Our findings demonstrate the importance of socio-pragmatic factors in Japanese honorific agreement processing, which involves the ATLs and IPL. • Speaker-related social cues mediate neural processing of Japanese honorific agreement. • Left IFG, dmPFC, and insula are jointly involved in processing Japanese honorific agreement. • Language experiences of honorific use influence left IPL activity.

Modulation of proper name recall by transcranial direct current stimulation of the anterior temporal lobes

We often fail to recall another person's name. Proper names might be more difficult to memorize and retrieve than other pieces of knowledge, such as one's profession because they are processed differently in the brain. Neuroimaging and neuropsychological studies associate the bilateral anterior temporal lobes (ATL) in the retrieval of proper names and other person-related knowledge. Specifically, recalling a person's name is thought to be supported by the left ATL, whereas recalling specific information such as a person's occupation is suggested to be subserved by the right ATL. To clarify and further explore the causal relationship between both ATLs and proper name retrieval, we stimulated these regions with anodal, cathodal and sham transcranial direct current stimulation (tDCS) while the participants memorized surnames (e.g., Mr. Baker) and professions (e.g., baker) presented with a person’s face. The participants were then later asked to recall the surname and the profession. Left ATL anodal stimulation resulted in higher intrusion errors for surnames than sham, whereas right ATL anodal stimulation resulted in higher overall intrusion errors, both, surnames and professions, compared to cathodal stimulation. Cathodal stimulation of the left and right ATL had no significant effect on surname and profession recall. The results indicate that the left ATL plays a role in recalling proper names. On the other hand, the specific role of the right ATL remaines to be explored.

Anomia is present pre-symptomatically in frontotemporal dementia due to MAPT mutations

IntroductionA third of frontotemporal dementia (FTD) is caused by an autosomal-dominant genetic mutation in one of three genes: microtubule-associated protein tau (MAPT), chromosome 9 open reading frame 72 (C9orf72) and progranulin (GRN). Prior studies of prodromal FTD have identified impaired executive function and social cognition early in the disease but few have studied naming in detail.MethodsWe investigated performance on the Boston Naming Test (BNT) in the GENetic Frontotemporal dementia Initiative cohort of 499 mutation carriers and 248 mutation-negative controls divided across three genetic groups: C9orf72, MAPT and GRN. Mutation carriers were further divided into 3 groups according to their global CDR plus NACC FTLD score: 0 (asymptomatic), 0.5 (prodromal) and 1 + (fully symptomatic). Groups were compared using a bootstrapped linear regression model, adjusting for age, sex, language and education. Finally, we identified neural correlates of anomia within carriers of each genetic group using a voxel-based morphometry analysis.ResultsAll symptomatic groups performed worse on the BNT than controls with the MAPT symptomatic group scoring the worst. Furthermore, MAPT asymptomatic and prodromal groups performed significantly worse than controls. Correlates of anomia in MAPT mutation carriers included bilateral anterior temporal lobe regions and the anterior insula. Similar bilateral anterior temporal lobe involvement was seen in C9orf72 mutation carriers as well as more widespread left frontal atrophy. In GRN mutation carriers, neural correlates were limited to the left hemisphere, and involved frontal, temporal, insula and striatal regions.ConclusionThis study suggests the development of early anomia in MAPT mutation carriers, likely to be associated with impaired semantic knowledge. Clinical trials focused on the prodromal period within individuals with MAPT mutations should use language tasks, such as the BNT for patient stratification and as outcome measures.

Neurosyphilis with a rare magnetic resonance imaging pattern confirmed by metagenomic next-generation sequencing: a case report

BackgroundNeurosyphilis refers to infection of the central nervous system by Treponema pallidum. The clinical presentation is variable and nonspecific. Neuroimaging findings are complex and that the diagnosis is based on clinical presentation, cerebrospinal fluid (CSF) parameters, and serologic and CSF evidence of syphilis. To date, there is no case report describing Treponema pallidum detected by metagenomic next-generation sequencing (mNGS) in CSF.Case presentationIn this report, we describe a case of neurosyphilis in a HIV-negative, 29-year-old man, who was admitted to our hospital with an epileptic seizure and progressive cognitive impairment. Brain magnetic resonance imaging (MRI) revealed fluid-attenuated inversion recovery (FLAIR) high signal intensities in bilateral medial and anterior temporal lobes, insula, right pulvinar of the thalami, precuneus, frontal and temporo-occipital lobes. Laboratory examination showed positive results by means of nontreponemal or specific treponemal test in serum and CSF. mNGS of the CSF was also performed to identify Treponema pallidum for the first time.ConclusionsThis case underscores the importance of considering neurosyphilis as a potential cause of mesiotemporal abnormality. In addition, the rapid improvement and wide usability of mNGS technology will bring new breakthroughs in the clinical diagnosis of neurosyphilis.

The multidimensional nature of aphasia recovery post-stroke.

Language is not a single function, but instead results from interactions between neural representations and computations that can be damaged independently of each other. Although there is now clear evidence that the language profile in post-stroke aphasia reflects graded variations along multiple underlying dimensions (‘components’), it is still entirely unknown if these distinct language components have different recovery trajectories and rely on the same, or different, neural regions during aphasia recovery. Accordingly, this study examined whether language components in the subacute stage: (i) mirror those observed in the chronic stage; (ii) recover together in a homogeneous manner; and (iii) have recovery trajectories that relate to changing activation in distinct or overlapping underlying brain regions.We analysed longitudinal data from 26 individuals with mild–moderate aphasia following left hemispheric infarct who underwent functional MRI and behavioural testing at ∼2 weeks and ∼4 months post-stroke. The language profiles in early post-stroke aphasia reflected three orthogonal principal components consisting of fluency, semantic/executive function and phonology. These components did not recover in a singular, homogeneous manner; rather, their longitudinal trajectories were uncorrelated, suggesting that aphasia recovery is heterogeneous and multidimensional. Mean regional brain activation during overt speech production in unlesioned areas was compared with patient scores on the three principal components of language at both the early and late time points. In addition, the change in brain activation over time was compared with the change on each of the principal component scores, both before and after controlling for baseline scores. We found that different language components were associated with changing activation in multiple, non-overlapping bilateral brain regions during aphasia recovery. Specifically, fluency recovery was associated with increasing activation in bilateral middle frontal gyri and right temporo-occipital middle temporal gyrus; semantic/executive recovery was associated with reducing activation in bilateral anterior temporal lobes; while phonology recovery was associated with reducing activation in bilateral precentral gyri, dorso-medial frontal poles and the precuneus. Overlapping clusters in the ventromedial prefrontal cortex were positively associated with fluency recovery but negatively associated with semantic/executive and phonology recovery.This combination of detailed behavioural and functional MRI data provides novel insights into the neural basis of aphasia recovery. Because different aspects of language seem to rely on different neural regions for recovery, treatment strategies that target the same neural region in all stroke survivors with aphasia might be entirely ineffective or even impair recovery, depending on the specific language profile of each individual patient.