Boston Naming Test Scores Research Articles

Normative Data Study of Verbal Fluency and Naming Tests in Elderly People in Costa Rica

Abstract Objective To generate normative data for the Verbal Fluency Test (VFT) and the Boston Naming Test (BNT) in the Costa Rican population. Method The sample consisted of 563 healthy older people (aged 59–90 years). Polynomial multiple regression analyses were run to evaluate the effects of the age, sex, and education variables on VFT and BNT scores. Results The results showed a significant linear effect of education on the four-letter VF scores and an effect of sex on the letter P score, with females performing better than males. The explained variance ranged from 20.9% to 28.3%. A linear effect of age and education was also found for the four semantic VF scores, with scores decreasing with increasing age and lower education. The sex variable was significant for all semantic categories, with females performing better than males except in the animal category. The explained variance ranged from 21.7% to 30.9%. In the BNT, a linear effect of education was found, so that the more education, the better the score. In addition, a sex effect was also found, with males having higher scores than females. The predictors of the model explained 9.6% of the variance. Conclusions This is the first study that generates normative data for the VF and BNT in the Costa Rican population over 59 years of age based on demographic variables. The use of these normative data will help clinicians in Costa Rica to better understand language functioning in the elderly, allowing for better classification and diagnosis in the future.

Effect of high-frequency repetitive transcranial magnetic stimulation on cognitive impairment in WD patients based on inverse probability weighting of propensity scores.

Hepatolenticular degeneration [Wilson disease (WD)] is an autosomal recessive metabolic disease characterized by copper metabolism disorder. Cognitive impairment is a key neuropsychiatric symptom of WD. At present, there is no effective treatment for WD-related cognitive impairment. In this study, high-frequency repetitive transcranial magnetic stimulation (rTMS) was used to treat WD-related cognitive impairment, and inverse probability weighting of propensity scores was used to correct for confounding factors. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Auditory Verbal Learning Test (AVLT), Boston Naming Test (BNT), Clock Drawing Test (CDT) and Trail Making Test (TMT) were used to evaluate overall cognition and specific cognitive domains. The MMSE, MoCA and CDT scores after treatment were significantly different from those before treatment (MMSE: before adjustment: OR = 1.404, 95% CI: 1.271-1.537; after adjustment: OR = 1.381, 95% CI: 1.265-1.497, p < 0.001; MoCA: before adjustment: OR = 1.306, 95% CI: 1.122-1.490; after adjustment: OR = 1.286, 95% CI: 1.104; AVLT: OR = 1.161, 95% CI: 1.074-1.248; after adjustment: OR = 1.145, 95% CI: 1.068-1.222, p < 0.05; CDT: OR = 1.524, 95% CI: 1.303-1.745; after adjustment: OR = 1.518, 95% CI: 1.294-1.742, p < 0.001). The BNT and TMT scores after adjustment were not significantly different from those before adjustment (BNT: before adjustment: OR = 1.048, 95% CI: 0.877-1.219; after adjustment: OR = 1.026, 95% CI: 0.863-1.189, p > 0.05; TMT: before adjustment: OR = 0.816, 95% CI: 1.122-1.490; after adjustment: OR = 0.791, 95% CI: 0.406-1.176, p > 0.05). High-frequency rTMS can effectively improve cognitive impairment, especially memory and visuospatial ability, in WD patients. The incidence of side effects is low, and the safety is good.

Abstract WMP32: Effect of Immersive Motor-Cognitive Training on Executive Function in Patients With Vascular Mild Cognitive Impairment: Aquasi-Experimental Study

Background: Cerebrovascular disease is a common cause of vascular cognitive impairment (VCI) and may progress to vascular dementia at a relatively fast rate. Strengthening intervention in patients with mild VCI can delay cognitive decline and prevent vascular dementia. Purpose: To investigate the effect of an immersive motor-cognitive training program on executive function in patients with mild VCI. Methods: A total of 60 patients with mild VCI were divided into two groups: the intervention group (n=30) and control group (n=30). The participants were recruited from an outpatient Neurology clinic between May 2021 and January 2022. The intervention group was received immersive motor-cognitive training for 2 months, while the control group was received traditional motor-cognitive training during the same duration. Before the intervention and at the end of the first and second months of the intervention, executive function was assessed as the primary outcome using the Trail-Making Test (TMT)-A/B. General cognitive, speech function and balance function were evaluated as secondary outcomes using the Mini-Mental State Examination (MMSE)/Montreal Cognitive Assessment (MoCA), Boston Naming Test, and Berg Balance Scale, respectively. Data analysis was performed using independent sample t-test, Chi-Square test, nonparametric test, and generalized estimation equation model. Results: Among 60 patients, 54 were completed the 2 month-follow-up. Our results showed that there is a significant time effect ( F =14.36, P =0.001) regarding the TMT-A score. In addition, significant time (F=7.28, P =0.001) and interaction effects (F=7.43, P =0.001) on the TMT-B score were noted. The MMSE score showed significant time (F=64.66, P =0.001) and interaction effects (F=12.01, P =0.002), and similar results were observed for the MoCA score with significant time (F=38.29, P=0.001) and interaction effects (F=22.89, P =0.001). The time effect of the Boston Naming Test score was also found to be statistically significant ( F =2.92, P =0.003). However, no significant differences were observed in the Berg Balance Scale score. Conclusion: Immersive motor-cognitive training may improve the executive function and general cognitive function in patients with mild VCI.

Influence of Nutritional Status and Physical Fitness on Cognitive Domains among Older Adults: A Cross-Sectional Study.

The health issues presented by the aging population can result in reduced muscle mass, poorer physical function, and cognitive impairment. The goal of this study was to determine how nutritional status and physical fitness relate to cognitive impairment in older adults. A cross-sectional descriptive and analytical study involving 100 participants was carried out to analyze the impact of nutritional status and physical fitness on cognitive impairment. Nutritional status was assessed with the Eating Assessment Tool (EAT-10) and The Mini Nutritional Assessment-Short Form (MNA-SF); physical fitness via the implementation of manual grip evaluation, the 4-m walking test (4-MWT), and the Timed Up and Go (TUG) test; and cognitive impairment evaluation was conducted using the Mini-Mental State Examination (MMSE), the Boston Naming Test (BNT) and the Controlled Oral Word Association Test (COWAT). Data analysis revealed that higher malnutrition status was associated with fewer correct responses in the COWAT (R2 = 0.421), while a correlation between higher MMSE and BNT scores, faster completion times for the 4-m walking and TUG tests, and an increase in handgrip strength load was also observed. The analysis of the data revealed that those individuals with superior nutritional status and greater levels of physical fitness outperformed others on the cognitive evaluation.

Is semantic feature analysis effective when applied intensively? A randomized pilot study with non-fluent aphasic individuals

Objective: In this study, it was investigated the effects of intensive aphasia treatment applied to individuals with non-fluent aphasia. Methods: Sixteen patients diagnosed with non-fluent aphasia were included in the study and were randomly divided into two groups. The therapy interventions were one day per week for the eight patients in the first group, for a total of 8 hours in 2 months (standard intervention). For the eight patients in the second group, therapy was applied for a total of 48 hours in 2 months, for one hour per day, six days a week, excluding Sundays (intensive intervention). Participants were tested using the Turkish aphasia test (ADD), Aphasia Impact Scale-21 (AIQ-21), and Boston Naming Test (BNT) before starting the treatment (pretest), after the treatment (posttest), and one month after the treatment ended (follow-up). Results: At the end of the treatments, a significant increase in ADD and BNT scores and a significant decrease in AIQ-21 scores were observed in both groups. Although there was a change in the follow-up test, the scores were still significantly different than the pretest scores. The rate of improvement in test scores of group II patients who received intensive aphasia treatment was superior to the group I patients. Conclusion: Intensive application was superior to once-weekly aphasia treatment, and post-treatment improvement continued for at least one month after the treatments.

Intersectional sociodemographic and neurological relationships in the naming ability of persons with post-stroke aphasia

IntroductionSignificant attention has been given to the role of brain function and disruption in determining performance on naming tasks among individuals with aphasia. However, scholarly pursuit of a neurological explanation has overlooked the fundamental cornerstone of individual health—the underlying social, economic, and environmental factors that shape how they live, work, and age, also known as the social determinants of health (SDOH). This study examines the correlation between naming performance and these underlying factors. MethodsIndividual level data from the 2010 Moss Aphasia Psycholinguistic Project Database (MAPPD) was matched with the 2009–2011 Medical Expenditure Panel Survey (MEPS) using a propensity score algorithm based on functional, health, and demographic characteristics. Multilevel, generalized, nonlinear regression models were applied to the resulting data set to assess the correlation between the Boston Naming Test (BNT) percentile score and age, income, sex, race, household size, marital status, aphasia type, and region of residence. Poisson regression models with bootstrapped standard errors were used to estimate these relationships ResultsDiscrete dependent variable estimation with non-normal prior specification included individual level (age, marital status, years of education), socioeconomic (family income), health (aphasia type), household (family size), and environmental (region of residence) characteristics. Regression results indicated that, relative to individuals with Wernicke's, individuals with Anomic (0.74, SE = 0.0008) and Conduction (0.42, SE = 0.0009) aphasia performed better on the BNT. While age at the time of testing was not significantly correlated, higher income level (0.15, SE = 0.0003) and larger family size (0.002, SE = 0.002) was associated with higher BNT score percentiles. Finally, Black persons with aphasia (PWA) (-0.0124, SE = 0.0007) had lower average score percentiles when other factors were held constant. ConclusionsThe findings reported here suggest higher income and larger family size are associated with better outcomes. As expected, aphasia type was significantly associated with naming outcomes. However, poorer performance by Black PWA and individuals with low income suggests that SDOH can play a critical role (positive and negative) in naming impairment in some populations with aphasia.

Asymmetry of radiomics features in the white matter of patients with primary progressive aphasia.

Primary Progressive Aphasia (PPA) is a neurological disease characterized by linguistic deficits. Semantic (svPPA) and non-fluent/agrammatic (nfvPPA) variants are the two main clinical subtypes. We applied a novel analytical framework, based on radiomic analysis, to investigate White Matter (WM) asymmetry and to examine whether asymmetry is associated with verbal fluency performance. Analyses were performed on T1-weighted images including 56 patients with PPA (31 svPPA and 25 nfvPPA) and 53 age- and sex-matched controls. Asymmetry Index (AI) was computed for 86 radiomics features in 34 white matter regions. The relationships between AI, verbal fluency performance (semantic and phonemic) and Boston Naming Test score (BNT) were explored through Spearman correlation analysis. Relative to controls, WM asymmetry in svPPA patients involved regions adjacent to middle temporal cortex as part of the inferior longitudinal (ILF), fronto-occipital (IFOF) and superior longitudinal fasciculi. Conversely, nfvPPA patients showed an asymmetry of WM in lateral occipital regions (ILF/IFOF). A higher lateralization involving IFOF, cingulum and forceps minor was found in nfvPPA compared to svPPA patients. In nfvPPA patients, semantic fluency was positively correlated to asymmetry in ILF/IFOF tracts. Performances at BNT were associated with AI values of the middle temporal (ILF/SLF) and parahippocampal (ILF/IFOF) gyri in svPPA patients. Radiomics features depicted distinct pathways of asymmetry in svPPA and nfvPPA involving damage of principal fiber tracts associated with speech and language. Assessing asymmetry of radiomics in PPA allows achieving a deeper insight into the neuroanatomical damage and may represent a candidate severity marker for language impairments in PPA patients.

Effect and safety of C7 neurotomy at the intervertebral foramen in patients with chronic poststroke aphasia: a multicentre, randomised, controlled study protocol

IntroductionAphasia affects many stroke survivors; therefore, effective treatments are urgently needed. Preliminary clinical findings have suggested an association between contralateral C7–C7 cross nerve transfer and recovery from chronic aphasia. Randomised...

Elevated serum platelet count inhibits the effects of brain functional changes on cognitive function in patients with mild cognitive impairment: A resting-state functional magnetic resonance imaging study.

Brain function remodeling has been observed in patients with mild cognitive impairment (MCI) and is closely associated with cognitive performance. However, it is not clear if this relationship is influenced by complete blood counts. This study investigated the role of complete blood counts in the relationship between brain function and cognitive performance. Twenty-two MCI patients and eighteen controls were enrolled. All subjects underwent resting-state functional magnetic resonance imaging. A neuropsychological battery [Mini-Mental Status Examination, Auditory Verbal Learning Test (AVLT), Symbol Digit Modalities Test, Boston Naming Test (BNT), Shape Trails Test B (STT-B), Rey Complex Figure Test (RCFT), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Scale] was used to assess cognitive function, and MCI patients received complete blood counts tests for red blood cells (RBC), white blood cells, hemoglobin (HGB), monocytes, and platelet counts (PLT). Compared with controls, MCI patients demonstrated significantly decreased amplitude of low-frequency fluctuation (ALFF) values in the left dorsolateral superior frontal gyrus, left post orbitofrontal cortex, right medial superior frontal gyrus, right insula, and left triangular inferior frontal gyrus. In the MCI group, there were associations between ALFF values of the left hippocampus (HIP.L) and AVLT (p = 0.003) and AVLT-N5 scores (p = 0.001); ALFF values of the right supramarginal gyrus (SMG.R) and BNT scores (p = 0.044); ALFF values of the right superior temporal gyrus (STG.R) and BNT scores (p = 0.022); ALFF values of the left precuneus (PCUN.L) and STT-B time (p = 0.012); and ALFF values of the left caudate nucleus (CAU.L) and RCFT-time (p = 0.036). Moreover, the HAMA scores were negatively correlated with RBC and HGB levels, and positively correlated with monocyte count. The PLT count was positively correlated with STT-B time. Additionally, high PLT count inhibited the effect of ALFF values of the PCUN. L on STT-B performance in MCI patients (p = 0.0207). ALFF values of the HIP. L, SMG.R, STG. R, PCUN.L, and CAU. L were associated with decreased memory, language, executive function, and visuospatial ability in MCI patients. Notably, elevated PLT count could inhibit the effect of brain functional changes in the PCUN.L on executive function in MCI patients.

Study of gray matter atrophy pattern with subcortical ischemic vascular disease-vascular cognitive impairment no dementia based on structural magnetic resonance imaging.

This study explored the structural imaging changes in patients with subcortical ischemic vascular disease (SIVD)-vascular cognitive impairment no dementia (VCIND) and the correlation between the changes in gray matter volume and the field of cognitive impairment to provide new targets for early diagnosis and treatment. Our study included 15 patients with SIVD-normal cognitive impairment (SIVD-NCI), 63 with SIVD-VCIND, 26 with SIVD-vascular dementia (SIVD-VD), and 14 normal controls (NC). T1-weighted images of all participants were collected, and DPABI and SPM12 software were used to process the gray matter of the four groups based on voxels. Fisher's exact test, one-way ANOVA and Kruskal-Wallis H test were used to evaluate all clinical and demographic data and compare the characteristics of diencephalic gray matter atrophy in each group. Finally, the region of interest (ROI) of the SIVD-VCIND was extracted, and Pearson correlation analysis was performed between the ROI and the results of the neuropsychological scale. Compared to the NC, changes in gray matter atrophy were observed in the bilateral orbitofrontal gyrus, right middle temporal gyrus, superior temporal gyrus, and precuneus in the SIVD-VCIND. Gray matter atrophy was observed in the left cerebellar region 6, cerebellar crural region 1, bilateral thalamus, right precuneus, and calcarine in the SIVD-VD. Compared with the SIVD-VCIND, gray matter atrophy changes were observed in the bilateral thalamus in the SIVD-VD (p < 0.05, family-wise error corrected). In the SIVD-VCIND, the total gray matter volume, bilateral medial orbital superior frontal gyrus, right superior temporal gyrus, middle temporal gyrus, and precuneus were positively correlated with Boston Naming Test score, whereas the total gray matter volume, right superior temporal gyrus, and middle temporal gyrus were positively correlated with overall cognition. Structural magnetic resonance imaging can detect extensive and subtle structural changes in the gray matter of patients with SIVD-VCIND and SIVD-VD, providing valuable evidences to explain the pathogenesis of subcortical vascular cognitive impairment and contributing to the early diagnosis of SIVD-VCIND and early warning of SIVD-VD.

Association of Cerebrovascular Reactivity and Cognitive Performance in a Racially Diverse Cohort

AbstractBackgroundCerebrovascular reactivity (CVR) to increased carbon dioxide (CO2) reflects cerebral microvascular function and is impaired in hypertension and stroke. Limited studies have looked at its relationship with cognitive performance in African Americans and Whites.MethodsWe used data from the Brain‐Stress Hypertension and Aging Program cohort (B‐SHARP) consisting of racially diverse individuals with normal cognition or mild cognitive impairment (MCI). CVR was measured using advanced signal modeling approach developed by BH/IH during blood oxygenation level dependent (BOLD) resting state ‐fMRI. Participants underwent cognitive assessment using global and domain‐specific tests such as Montreal Cognitive Assessment (MoCA), Boston Naming Test (BNT), Hopkins Verbal Learning Test‐Revised (HVLT‐R), and Trail Making Test. We used multivariate regression models to assess the relationship of CVR and cognitive domains and tested interaction of CVR with race.ResultsSuccessful CVR data were completed on 219 participants with mean age= 65.3 years (SD 7.8), 46% African American and 65% women. An increased resting whole brain CVR was associated with a higher MoCA score (β = 6.46, SE 2.43, p‐value 0.008), higher BNT score (β =2.15, SE 0.93 p‐value 0.02), and shorter time on Trail B‐A, (β= ‐113.4, SE 42.0, p‐value 0.007) after adjusting for mean arterial pressure. After adjusting for age, sex, and race, increased resting whole brain CVR was associated with higher MoCA (β =4.4, SE 2.26, p‐value 0.05), BNT score (β =1.46, SE 0.89, p‐value 0.1) and Trail B‐A score (β =‐86.7, SE 40.3, p‐value 0.03). There was no association with delayed memory based on HVLT‐R. The results were similar for individuals with normal cognition or MCI. There was a significant interaction by race (p&lt;0.01) such that whole brain CVR was associated with better performance on all cognitive tests for African Americans but not for Whites.ConclusionsHigher CVR, reflected by resting state BOLD‐fMRI, was associated with higher overall cognitive status and specific domains including language and executive functioning in individuals with normal cognition or MCI. The differential effect in African Americans vs Whites could suggest a greater contribution of microvascular dysfunction for the higher prevalence of cognitive impairment in African Americans.

Associations between blood-based biomarkers of Alzheimer's disease with cognition in motoric cognitive risk syndrome: A pilot study using plasma Aβ42 and total tau.

BackgroundMotoric cognitive risk (MCR) syndrome is a conceptual construct that combines slow gait speed with subjective cognitive complaints and has been shown to be associated with an increased risk of developing dementia. However, the relationships between the pathology of Alzheimer’s disease (AD) and MCR syndrome remain uncertain. Therefore, the purpose of this study was to determine the levels of plasma AD biomarkers (Aβ42 and total tau) and their relationships with cognition in individuals with MCR.Materials and methodsThis was a cross-sectional pilot study that enrolled 25 individuals with normal cognition (NC), 27 with MCR, and 16 with AD. Plasma Aβ42 and total tau (t-tau) levels were measured using immunomagnetic reduction (IMR) assays. A comprehensive neuropsychological assessment was also performed.ResultsThe levels of plasma t-tau proteins did not differ significantly between the MCR and AD groups, but that of plasma t-tau was significantly increased in the MCR and AD groups, compared to the NC group. Visuospatial performance was significantly lower in the MCR group than in the NC group. The levels of plasma t-tau correlated significantly with the Montreal Cognitive Assessment (MoCA) and Boston naming test scores in the MCR group.ConclusionIn this pilot study, we found significantly increased plasma t-tau proteins in the MCR and AD groups, compared with the NC group. The plasma t-tau levels were also significantly correlated with the cognitive function of older adults with MCR. These results implied that MCR and AD may share similar pathology. However, these findings need further confirmation in longitudinal studies.

Disruption of Cerebellar-Cerebral Functional Connectivity in Temporal Lobe Epilepsy and the Connection to Language and Cognitive Functions.

ObjectiveTo investigate the changes in the cerebellar-cerebral language network in temporal lobe epilepsy (TLE) patients from the cerebellar perspective, the research analyzes the changes of language and cognitive network in terms of functional connectivity (FC), as well as their efficiency of the reorganization were evaluated basing on relationship between the network metrics and neuropsychological scale scores.Methods30 TLE patients and 30 healthy controls were recruited. Brain activity was evaluated by voxel-mirrored homotopic connectivity analysis (VMHC). Two groups were analyzed and compared in terms of language FC using the following methods: Seed-to-Voxel analysis, pairwise correlations [region of interest(ROI)-to-ROI] and graph theory. Correlation analysis was performed between network properties and neuropsychological score.ResultsCompared with healthy participants, VMHC values in the Cerebellum Anterior Lobe, Frontal Lobe, Frontal_Sup_R/L, Cingulum_Ant_R/L, and Cingulum_Mid_R/L were decreased in TLE patients. Decreased FC was observed from the Cerebelum_10_R to the left inferior frontal gyrus, from the Cerebelum_6_R to the left Lingual Gyrus, from the Cerebelum_4_5_R to left Lingual Gyrus, left Cuneal Cortex and Precuneous Cortex, from the Cerebelum_3_R to Brain-Stem, and from the Cerebelum_Crus1_L to Cerebelum_6_R in TLE patients. The FC was enhanced between bilateral Cingulum_Mid and angular gyrus and frontoparietal insular cranium, between Frontal_Sup_Med L and left/right superior temporal gyrus (pSTG l/r), while it was decreased between left middle temporal gyrus and pSTG l/r. Compared with controls, the Betweenness Centrality (BC) of the right superior marginal gyrus (SMG), Temporal_Pole_Mid_R and Temporal_Mid_L as well as the Degree Centrality (DC) and Nodal Efficiency (NE) of the right SMG were lower in TLE patients. Further analysis showed that decreased VMHC in bilateral Cerebellum Anterior Lobe was positively correlated with the Boston Naming Test score in TLE patients, but it was negatively correlated with the Verbal Fluency Test score. The NE and DC of SMG_R were both negatively correlated with visual perception score in Montreal Cognitive Assessment.ConclusionOur results suggest that presence of abnormalities in the static functional connectivity and the language and cognitive network of TLE patients. Cerebellum potentially represents an intervention target for delaying or improving language and cognitive deficits in patients with TLE.

When words first fail: Predicting the emergence of primary progressive aphasia variants from unclassifiable anomic performance in early disease

ABSTRACT Background The majority of patients with primary progressive aphasia (PPA) can be distinguished into one of three variants: semantic, non-fluent/agrammatic, or logopenic. However, many do not meet criteria for any one variant. Aim To identify aspects of cognitive-linguistic performance that yield an early unclassifiable PPA designation that predicted the later emergence of a given variant. Methods & Procedures Of 256 individuals with PPA evaluated, 19 initially were unclassifiable and later met criteria for a variant. Receiver operating characteristic curves were used to evaluate the binary ability of a given task to predict eventual classification as a given variant. Tasks with a high area under the curve were examined using regression analyses to determine their ability to predict variant. Outcomes & Results High mean predictive value was observed for multiple naming assessments targeting nouns and verbs. The Boston Naming Test (BNT) was the only test that, in isolation, resulted in a significant model and high classification accuracy. Conclusions Although naming impairment is common across PPA variants, very low initial BNT scores emerged as a uniquely accurate basis for predicting eventual semantic variant, and normal BNT scores predicted eventual nonfluent/agrammatic variant. High performance on picture-verb verification was useful in identifying future lvPPA.

Prediction of Naming Outcome With fMRI Language Lateralization in Left Temporal Epilepsy Surgery.

Naming decline after left temporal lobe epilepsy (TLE) surgery is common and difficult to predict. Preoperative language fMRI may predict naming decline, but this application is still lacking evidence. We performed a large multicenter cohort study of the effectiveness of fMRI in predicting naming deficits after left TLE surgery. At 10 US epilepsy centers, 81 patients with left TLE were prospectively recruited and given the Boston Naming Test (BNT) before and ≈7 months after anterior temporal lobectomy. An fMRI language laterality index (LI) was measured with an auditory semantic decision-tone decision task contrast. Correlations and a multiple regression model were built with a priori chosen predictors. Naming decline occurred in 56% of patients and correlated with fMRI LI (r = -0.41, p < 0.001), age at epilepsy onset (r = -0.30, p = 0.006), age at surgery (r = -0.23, p = 0.039), and years of education (r = 0.24, p = 0.032). Preoperative BNT score and duration of epilepsy were not correlated with naming decline. The regression model explained 31% of the variance, with fMRI contributing 14%, with a 96% sensitivity and 44% specificity for predicting meaningful naming decline. Cross-validation resulted in an average prediction error of 6 points. An fMRI-based regression model predicted naming outcome after left TLE surgery in a large, prospective multicenter sample, with fMRI as the strongest predictor. These results provide evidence supporting the use of preoperative language fMRI to predict language outcome in patients undergoing left TLE surgery. This study provides Class I evidence that fMRI language lateralization can help in predicting naming decline after left TLE surgery.

Language processing in glioma patients: speed or accuracy as a sensitive measure?

ABSTRACT Background Glioma (brain tumour) patients can suffer from mild linguistic and non-linguistic cognitive problems when the glioma is localised in an eloquent brain area. Word-finding problems are among the most frequently reported complaints. However, mild problems are difficult to measure with standard language tests because they are generally designed for more severe aphasic patients. Aims The aim of the present study was to investigate whether word-finding problems reported by patients with a glioma can be objectified with a standard object naming test, and a linguistic processing speed test. In addition, we examined whether word-finding problems and linguistic processing speed are related to non-verbal cognitive abilities. Methods & Procedures We tested glioma patients (N=36) as part of their standard pre-treatment clinical work-up. Word-finding problems were identified by a clinical linguist during the anamnesis. Linguistic processing speed was assessed with a newly designed sentence judgment test (SJT) as part of the Diagnostic Instrument for Mild Aphasia (DIMA), lexical retrieval with the Boston Naming Test (BNT), presence of aphasia with a Token Test (TT), and non-verbal processing with the Trail Making Test A and B (TMT). Test performances of glioma patients were compared to those of healthy control participants (N=35). Outcomes & Results The results show that many glioma patients (58%) report word-finding problems; these complaints were in only half of the cases supported by deviant scores on the BNT. Moreover, the presence of reported word-finding problems did not correlate with the BNT scores. However, word-finding problems were significantly correlated with reaction times on the SJT and the TMT. Although there were no significant differences between the patient and control group on the SJT, a subgroup of patients with a glioma in the frontal lobe of the language-dominant hemisphere was slower on the SJT. Finally, performance on the SJT and TMT were significantly correlated in the patient group but not in the control group. Conclusions Linguistic processing speed appears to be an important factor in explaining reported word-finding problems. Moreover, the overlap between speed of language processing and non-verbal processing indicates that patients may rely on more domain-general cognitive abilities as compared to healthy participants. The variability observed between patients emphasises the need for tailored neuro-linguistic assessments including an extensive anamnesis regarding language problems in clinical work-up.

A disease-specific metabolic imaging marker for diagnosis and progression evaluation of semantic variant primary progressive aphasia.

The diagnosis and monitoring of semantic variant primary progressive aphasia (sv-PPA) are clinically challenging. We aimed to establish a distinctive metabolic pattern in sv-PPA for diagnosis and severity evaluation. Fifteen sv-PPA patients and 15 controls were enrolled to identify sv-PPA-related pattern (sv-PPARP) by principal component analysis of 18 F-fluorodeoxyglucose positron emission tomography. Eighteen Alzheimer disease dementia (AD) and 14 behavioral variant frontotemporal dementia (bv-FTD) patients were enrolled to test the discriminatory power. Correspondingly, regional metabolic activities extracted from the voxelwise analysis were evaluated for the discriminatory power. The sv-PPARP was characterized as decreased metabolic activity mainly in the bilateral temporal lobe (left predominance), middle orbitofrontal gyrus, left hippocampus/parahippocampus gyrus, fusiform gyrus, insula, inferior orbitofrontal gyrus, and striatum, with increased activity in the bilateral lingual gyrus, cuneus, calcarine gyrus, and right precentral and postcentral gyrus. The pattern expression had significant discriminatory power (area under the curve [AUC]=0.98, sensitivity=100%, specificity=94.4%) in distinguishing sv-PPA from AD, and the asymmetry index offered complementary discriminatory power (AUC=0.91, sensitivity=86.7%, specificity=92.9%) in distinguishing sv-PPA from bv-FTD. In sv-PPA patients, the pattern expression correlated with Boston Naming Test scores at baseline and showed significant increase in the subset of patients with follow-up. The voxelwise analysis showed similar topography, and the regional metabolic activities had equivalent or better discriminatory power and clinical correlations with Boston Naming Test scores. The ability to reflect disease progression in longitudinal follow-up seemed to be inferior to the pattern expression. The sv-PPARP might serve as an objective biomarker for diagnosis and progression evaluation.

EFFECT OF OBSTRUCTIVE SLEEP APNEA (OSA) RISK LEVELS ON BOSTON NAMING TEST SCORES TO THE POPULATION IN MATARAM

Background: Obstructive Sleep Apnea (OSA) is one of the most common respiratory disorders found in society. This condition is often found in men with obesity, men with hypertension history, and elderly. In relation to this, it is found that the researches on the effect of OSA risk level on language functions is rarely done. Therefore, this study is aimed at investigating the effect of OSA risk levels on Boston Naming Test score to the population in Mataram. Objective: to investigate the effect of OSA risk levels on language functions used the Boston Naming Test to the population in Mataram. Methods: This study belongs to analytic descriptive study with cross sectional approach. Held in Udayana Park, Dasan Sari, Mataram in May 2017 and September 2018. This study involved 132 respondents by ages among 40-74 years old. They are Chosen based on inclusion criteria. The OSA risk level was measured using The STOP-Bang questionnaire while language functions was measured using the Boston Naming Test. After That, the Mann-whitney comparative test was employed to analyzed the data. Results: The result of this study showed that, from 132 respondents, it was found that there were 66 (50%) respondents had a high risk level of OSA, and 82 (62%) respondents had language function disorders. Besides, the Mann-Whitney comparative analysis showed no effect on the risk level of OSA on Boston Naming Test score (p &gt; 0.05). Conclusion: The risk level of OSA has no effect on Boston Naming Test score to the population aged 40-74 years in Mataram.

Thalamic Nuclei and Thalamocortical Pathways After Left Hemispheric Stroke and Their Association with Picture Naming.

Background: Previous studies utilized lesion-centric approaches to study the role of the thalamus in language. In this study, we tested the hypotheses that non-lesioned dorsomedial and ventral anterior nuclei (DMVAC) and pulvinar lateral posterior nuclei complexes (PLC) of the thalamus and their projections to the left hemisphere show secondary effects of the strokes, and that their microstructural integrity is closely related to language-related functions. Methods: Subjects with language impairments after a left-hemispheric cortical and/or subcortical, early stroke (n = 31, ≤6 months) or late stroke (n = 30, ≥12 months) sparing thalamus underwent the Boston Naming Test (BNT) and diffusion tensor imaging (DTI). The tissue integrity of DMVAC, PLC, and their cortical projections was quantified with DTI. The right-left asymmetry profiles of these structures were evaluated in relation to the time since stroke. The association between microstructural integrity and BNT score was investigated in relation to stroke chronicity with partial correlation analyses adjusted for confounds. Results: In both early stroke and late stroke groups, left-sided tracts showed significantly higher mean diffusivities (MDs), which were likely due to Wallerian degeneration. Higher MD values of the cortical projections from the left PLC (r = -0.5, p = 0.005) and DMVAC (r = -0.53, p = 0.002) were correlated with lower BNT score in the late stroke but not early stroke group. Conclusion: Nonlesioned thalamic nuclei and thalamocortical pathways show rightward lateralization of the microstructural integrity after a left hemispheric stroke, and this pattern is associated with poorer naming. Impact statement To the best of our knowledge, our study is the first diffusion tensor imaging study suggesting that the thalamic nuclei and pathways of the left hemisphere spared by direct ischemic insult undergo secondary degeneration over time that is associated with poorer picture naming. Our study may pave the way for targeted interventions such as invasive or noninvasive brain stimulation techniques that engage these spared pathways to prevent secondary degeneration and lead to better outcomes in poststroke aphasia.

Community-informed connectomics of cortical intrinsic organization in subjective cognitive decline

Objective: To investigate the intrinsic organization of cortical circuitry in individuals with subjective cognitive decline (SCD) via resting-state functional magnetic resonance imaging (rs-fMRI) connectome analysis and its correlation with cognitive level. Methods: From June 2017 to November 2019, thirty-six middle-aged and elderly individuals with complaints of memory decline and 32 normal controls (NC) were enrolled from communities in Nanjing. We collected cognitive scale performance,T1-weighted imaging (T1WI) and rs-fMRI data of all subjects. There were 5 males and 31 females in the SCD group, with an average age of (64±5) years. In the NC group, there were 8 males and 24 females, with an average age of (65±5) years. Preprocessing of rs-fMRI data was conducted, then the cerebral cortex was divided into 333 cortical parcels (nodes) and 10 predefined communities according to the prior template. Further, we established full connection matrices between cortical parcels and calculated the within-module degree (WMD) and participation coefficient (PC) of each node based on the matrices. The WMD and PC values were compared between the SCD and NC groups,and their correlations with cognitive scale performance were analyzed. Results: Compared to the NC group,the SCD group showed increased WMD in the dorsolateral prefrontal cortex (DLPFC)(P<0.05,FDR corrected) and the middle frontal gyrus (P<0.005,uncorrected) of the right frontoparietal network (FPN). The SCD group also showed decreased WMD(P<0.05,FDR corrected) in the superior occipital gyrus of the left visual network (VN) and decreased PC (P<0.005,uncorrected) in the supramarginal gyrus of the left dorsal attention network (DAN). The WMD values in the DLPFC showed significant positive correlations with the auditory verbal learning test (AVLT)short-delayed memory (r=0.364,P=0.029),recognition memory (r=0.364, P=0.029) and the Boston naming test scores (BNT, r=0.356, P=0.033)in the SCD group. The PC values in the supramarginal gyrus were significantly positively correlated with the BNT scores (r=0.413, P=0.012) in the SCD group. Conclusion: Cortical network imbalance and reconstruction characterized by decreased intra-module connectivity of VN and inter-module connectivity of DAN exist in SCD subjects,while increased intra-module connectivity of FPN may serve in a compensatory way for the early cognitive decline.