Cognitive Neuropsychological Models Research Articles

A case of acquired phonological dyslexia with selective impairment of Kanji: analysis of reading impairment mechanism using cognitive neuropsychological models for reading

ABSTRACT We report a Japanese-speaking patient who showed acquired phonological dyslexia only in Kanji; difficulty in reading two-character Kanji nonwords despite her ability to read Kana nonwords, Kana words, and two-character Kanji inconsistent-atypical words; and inability to repeat reversal nonwords. We investigated the mechanism of nonword reading impairment using the dual-route cascaded model, it was likely that the reading deficit of Kanji nonwords with multiple pronunciations resulted from the dysfunction of the character-to-sound conversion rule system. The patient’s reading performance on the dissociation of Kana and Kanji was considered to reflect the difference in the consistency of orthography-to-phonology mapping.

The neural basis of hot and cold cognition in depressed patients, unaffected relatives, and low-risk healthy controls: An fMRI investigation

BackgroundModern cognitive neuropsychological models of depression posit that negatively biased emotional (“hot”) processing confers risk for depression, while preserved executive function (“cold”) cognition promotes resilience. MethodsWe compared neural responses during hot and cold cognitive tasks in 99 individuals: those at familial risk for depression (N = 30 unaffected first-degree relatives of depressed individuals) and those currently experiencing a major depressive episode (N = 39 unmedicated depressed patients) with low-risk healthy controls (N = 30). Primary analyses assessed neural activation on two functional magnetic resonance imaging tasks previously associated with depression: dorsolateral prefrontal cortex (DLPFC) responsivity during the n-back working memory task; and amygdala and subgenual anterior cingulate cortex (sgACC) responsivity during incidental emotional face processing. ResultsDepressed patients exhibited significantly attenuated working memory-related DLPFC activation, compared to low-risk controls and unaffected relatives; unaffected relatives did not differ from low-risk controls. We did not observe a complementary pattern during emotion processing. However, we found preliminary support that greater DLPFC activation was associated with lower amygdala response during emotion processing. LimitationsThese findings require confirmation in a longitudinal study to observe each individual's risk of developing depression; without this, we cannot identify the true risk level of the first-degree relative or low-risk control group. ConclusionsThese findings have implications for understanding the neural mechanisms of risk and resilience in depression: they are consistent with the suggestion that preserved executive function might confer resilience to developing depression in first-degree relatives of depressed patients.

Rehabilitation Treatment In Aphasia Caused By Stroke(Review)

Aphasia is a relatively common language disorder, occurring in about 25% of all stroke patients. The ultimate aim of aphasia treatment is to improve patients oral and written language abilities and to facilitate their participation in everyday communication. Over the last decades, a range of approaches in aphasia therapy have been introduced, based on cognitive neuropsychological models, psycholinguistic theories, and socio-pragmatic approaches. In view of the range of different approaches and findings of therapy studies, the challenge for therapists is to decide which approach is the most appropriate one for an aphasic individual at a specific stage of recovery.The Findings showed that, therapy plan for aphasic individuals involves selecting the therapeutic approach most appropriate for dealing with a particular type of disorder, degree of severity, stage of recovery and the extent of the patient's participation in social life. A framework of aphasia treatment is outlined which considers the rehabilitation process at the various stages of recovery, and Different approaches are combined into a comprehensive treatment regimen which differentiates three stages of recovery: the acute, post-acute, and chronic stage. Also ,The intensive therapy in the treatment of language disorders have a great effect, and Brain imaging studies have shown that the linguistic reorganization of a damaged brain is aided by intensive speech therapy even in the chronic phase.

Elemental spatial and temporal association formation in left temporal lobe epilepsy.

The mesial temporal lobe (MTL) is typically understood as a memory structure in clinical settings, with the sine qua non of MTL damage in epilepsy being memory impairment. Recent models, however, understand memory as one of a number of higher cognitive functions that recruit the MTL through their reliance on more fundamental processes, such as “self-projection” or “association formation”. We examined how damage to the left MTL influences these fundamental processes through the encoding of elemental spatial and temporal associations. We used a novel fMRI task to image the encoding of simple visual stimuli, either rich or impoverished, in spatial or spatial plus temporal information. Participants included 14 typical adults (36.4 years, sd. 10.5 years) and 14 patients with left mesial temporal lobe damage as evidenced by a clinical diagnosis of left temporal lobe epilepsy (TLE) and left MTL impairment on imaging (34.3 years, sd. 6.6 years). In-scanner behavioral performance was equivalent across groups. In the typical group whole-brain analysis revealed highly significant bilateral parahippocampal activation (right > left) during spatial associative processing and left hippocampal/parahippocampal deactivation in joint spatial-temporal associative processing. In the left TLE group identical analyses indicated patients used MTL structures contralateral to the seizure focus differently and relied on extra-MTL regions to a greater extent. These results are consistent with the notion that epileptogenic MTL damage is followed by reorganization of networks underlying elemental associative processes. In addition, they provide further evidence that task-related fMRI deactivation can meaningfully index brain function. The implications of these findings for clinical and cognitive neuropsychological models of MTL function in TLE are discussed.

A Neuropsychological Model of Free-Drawing from Memory in Constructional Apraxia: A Theoretical Review

Constructional apraxia is an impairment in synthetic activities or abilities such as building, assembling and drawing and it is a major reason for functional disability and for neuropsychological or neurological patients inability to return to work. In this theoretical review a survey of the development of cognitive neuropsychological models of constructional apraxia will be discussed as these relate specifically to drawing abilities. Persons with schizophrenia, somatoform disorders, eating disorders, anosagnosia and right hemisphere disease conditions often present with impairments in the representations or drawings of the body. A plausible cognitive neuropsychological model of constructional apraxia was developed by extracting useful features of previous models and integrating common elements. It is hypothesized that given the relation of the integrity of body-specific representations in the drawings of these neuropsychiatric groups a better understanding of the association between constructional apraxia and free-drawing will provide insights into future clinical and applied neuroscience research.

Phonological short-term memory in conduction aphasia

Background: Within cognitive neuropsychological models conduction aphasia has been conceptualised as a phonological buffer deficit. It may affect the output buffer, the input buffer, or both. The phonological output buffer is a short-term storage, responsible for the short-term maintenance of phonological units until their articulation, as well as for phonological and morphological composition. The phonological input buffer holds input strings until they are identified in the input lexicon. Thus the phonological buffers are closely related to phonological short-term memory (pSTM), and hence it is important to assess pSTM in conduction aphasia. Because the input and output buffers play different roles, impairment in each of them predicts different impairments in the patient's ability to understand certain sentences, to learn new words and names, and to remember and recall lists of words and numbers for short time periods. This research was supported by a research grant from the National Institute for Psychobiology in Israel (Friedmann 2004-5-2b), by the Israel Science Foundation (grant no. 1296/06, Friedmann), and by the ARC Centre of Excellence in Cognition and its Disorders (CCD), Macquarie University. Aims: This study explored in detail pSTM in individuals with conduction aphasia, comparing individuals with input and output deficits, recall and recognition tasks, and stimuli of various types. It also tested pSTM in six age groups of healthy individuals, assessing the effect of age on various types of stimuli. This paper presents a new battery of 10 recall and recognition span tests, designed to assess pSTM in aphasia and to measure spans and effects on spans. Methods & Procedures: The participants were 14 Hebrew-speaking individuals with conduction aphasia, 12 with input or input-output phonological buffer deficit, and 2 with only output deficit, and 296 healthy individuals. Outcomes & Results: The analyses of the spans and effects on pSTM in the 10 tests indicated that all the participants with conduction aphasia had limited pSTM, significantly poorer than that of the control participants, and no semantic STM impairment. They had shorter spans, smaller length and similarity effects, and larger sentential effect than the controls. The individuals with conduction aphasia who had an impairment in the phonological input buffer showed deficit in both the recall and recognition span tasks. The individuals with the output conduction aphasia showed impairment only in the recall tasks. The healthy individuals showed age effect on span tasks involving words, but no effect of age on span tasks of nonwords. Conclusions: pSTM is impaired in conduction aphasia, and different pSTM impairments characterise different types of conduction aphasia. Output conduction aphasia causes difficulties only when verbal output is required, whereas input conduction aphasia also causes a deficit when only recognition is required. This suggests that rehearsal can take place without the phonological output buffer. Age differentially affects pSTM for words and nonwords in healthy adults: whereas the encoding of words changes, the ability to remember nonwords is unchanged.

Acquired Dyslexia and Dysgraphia across Scripts

Many studies have investigated the cognitive processes used to read and to spell in English. Much of our kowledge about these processes comes from reports of patients with acquired dyslexia and dysgraphia, first identified in the behavioral neurology clinic. As in all clinical studies, the detail in these reports includes description of preserved and impaired abilities of the patient, usually with reference to a cognitive neuropsychological model of reading and spelling [6,12,13,26, 28,29]. The beauty of these reports is the insight provided to the clinician and to theorist about the topography of cognitive processing, allowing science to ‘carve nature at its joints’. One criticism of this research is the emphasis on European languages. However, a review of acquired dyslexia and dysgraphia in languages other than English reveals an interesting fact. Many cases are reported in Behavioral Neurology – a revelation that reflects the global reach and sophistication of this readership. It is therefore a great privilege to present this Special Issue on the topic of Reading and Writing Disorders Across Scripts. The question posed to the authors (and readers) of the papers in this Special Issue is whether the processes identified for reading and spelling in cognitive neuropsychological models developed for English, extend to other languages. This is not a trivial question that is limited to the armchair. Language processing in bilingual speakers is moving towards the front of cognitive neuropsychological enquiry simply because bilingual speakers are the majority of speakers in many language environments. Thus, it is of interest to know about dyslexia and dysgraphia in Chinese, Korean and Urdu for theoretical reasons but also because it is necessary to know if the cognitive processes used to read and to spell in one language have any effects on reading and spelling in another language [see 8, 9, 16 for interesting answers]. If the cognitive mechanisms used to read and to spell in one language impact on reading and spelling in another language then several clinical implications follow, specifically for the treatment of acquired dyslexia and dysgraphia in bilingual speakers [23,26, 40]. The contributors to this Special Issue report on patterns of acquired dyslexia and dysgraphia in Arabic, Chinese, Greek, Hebrew, Hungarian, Italian, Japanese, Russian, Slovak and Spanish. One unique feature is reports of multilingual speakers with reading and spelling disorders in different languages (Druks et al.; Friedmann and Haddad; Kambanaros et al.; Senaha and Parente). These cases not only highlight the striking similarities in the patterns of dyslexia and dysgraphia across languages, they converge on the view that cognitive processes used to read and to spell are independent of linguistic differences. Such reports have implications for theoretical models of bilingual language processing because they suggest language ‘non-selective’ access to the reading system. For example, the Bilingual Interac-

Acquired Dyslexia and Dysgraphia across Scripts

Many studies have investigated the cognitive processes used to read and to spell in English. Much of our kowledge about these processes comes from reports of patients with acquired dyslexia and dysgraphia, first identified in the behavioral neurology clinic. As in all clinical studies, the detail in these reports includes description of preserved and impaired abilities of the patient, usually with reference to a cognitive neuropsychological model of reading and spelling [6,12,13,26, 28,29]. The beauty of these reports is the insight provided to the clinician and to theorist about the topography of cognitive processing, allowing science to ‘carve nature at its joints’. One criticism of this research is the emphasis on European languages. However, a review of acquired dyslexia and dysgraphia in languages other than English reveals an interesting fact. Many cases are reported in Behavioral Neurology – a revelation that reflects the global reach and sophistication of this readership. It is therefore a great privilege to present this Special Issue on the topic of Reading and Writing Disorders Across Scripts. The question posed to the authors (and readers) of the papers in this Special Issue is whether the processes identified for reading and spelling in cognitive neuropsychological models developed for English, extend to other languages. This is not a trivial question that is limited to the armchair. Language processing in bilingual speakers is moving towards the front of cognitive neuropsychological enquiry simply because bilingual speakers are the majority of speakers in many language environments. Thus, it is of interest to know about dyslexia and dysgraphia in Chinese, Korean and Urdu for theoretical reasons but also because it is necessary to know if the cognitive processes used to read and to spell in one language have any effects on reading and spelling in another language [see 8, 9, 16 for interesting answers]. If the cognitive mechanisms used to read and to spell in one language impact on reading and spelling in another language then several clinical implications follow, specifically for the treatment of acquired dyslexia and dysgraphia in bilingual speakers [23,26, 40]. The contributors to this Special Issue report on patterns of acquired dyslexia and dysgraphia in Arabic, Chinese, Greek, Hebrew, Hungarian, Italian, Japanese, Russian, Slovak and Spanish. One unique feature is reports of multilingual speakers with reading and spelling disorders in different languages (Druks et al.; Friedmann and Haddad; Kambanaros et al.; Senaha and Parente). These cases not only highlight the striking similarities in the patterns of dyslexia and dysgraphia across languages, they converge on the view that cognitive processes used to read and to spell are independent of linguistic differences. Such reports have implications for theoretical models of bilingual language processing because they suggest language ‘non-selective’ access to the reading system. For example, the Bilingual Interac-

Cognitive Structure of Writing Disorders in Russian: What Would Luria Say?

Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian neuropsychology and is dominated by the syndrome approach most notably by the writings of Luria. Indeed, our understanding of acquired dysgraphia in Russian speakers is conceptualized according to the classical approach in Modern Russia. In this review, we describe the classical approach and compare it to the cognitive neuropsychological models of writing disorders that are developed to explain dysgraphia in English and in other Western European languages. We argue that the basic theoretical assumptions of the two approaches – cognitive and classical or syndrome approach – share similarities. It is therefore proposed that identification of acquired cases of dysgraphia in Russian could potentially benefit from taking the cognitive neuropsychological perspective. We also conclude that adopting elements of the syndrome approach would substantially enrich the understanding of acquired dysgraphia since these offer an insight into processes not described in the cognitive neuropsychological approach.

Cognitive structure of writing disorders in Russian: what would Luria say?

Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian neuropsychology and is dominated by the syndrome approach most notably by the writings of Luria. Indeed, our understanding of acquired dysgraphia in Russian speakers is conceptualized according to the classical approach in Modern Russia. In this review, we describe the classical approach and compare it to the cognitive neuropsychological models of writing disorders that are developed to explain dysgraphia in English and in other Western European languages. We argue that the basic theoretical assumptions of the two approaches – cognitive and classical or syndrome approach – share similarities. It is therefore proposed that identification of acquired cases of dysgraphia in Russian could potentially benefit from taking the cognitive neuropsychological perspective. We also conclude that adopting elements of the syndrome approach would substantially enrich the understanding of acquired dysgraphia since these offer an insight into processes not described in the cognitive neuropsychological approach.

Reviewing the limb apraxia concept: From definition to cognitive neuropsychological models.

Apraxia is a disorder of learned skilled movements, in the absence of elementary motor or sensory deficits and general cognitive impairment such as inattention to commands, object-recognition deficits or poor oral comprehension. The first studies on apraxia were performed between the late 19th and early 20th centuries, however controversy remains in praxis literature concerning apraxia types, neuroanatomical and functional correlates, as well as assessment and treatment of apraxia. Thus, a critical review of the literature was conducted searching the literature for evidence contributing to a more detailed description of apraxia and its clinical patterns, physiopathology and clinico-anatomical correlations, as well as apraxia assessment.

Applying Cognitive Neuropsychological Principles to the Rehabilitation of Spanish Readers with Acquired Dyslexia

Cognitive neuropsychological models (CNMs) have been useful to generate a theory of aphasia rehabilitation. In contrast to the traditional syndrome approach, CNMs employ cognitive accounts to interpret language disturbances after brain damage. In this article, we apply CNMs to monolingual Spanish and bilingual Spanish-English readers with acquired dyslexia whose first language is Spanish. Although there are many studies of acquired dyslexia (reading errors associated with aphasia), they primarily have focused on English and French readers. Similar investigations on Spanish readers are limited. Unlike the opaque orthographic systems of English and French (inconsistent grapheme-to-phoneme relationships), Spanish has a mostly transparent orthography (regular grapheme-to-phoneme relationships). Thus evaluating and treating dyslexia secondary to brain damage in Spanish readers may involve different strategies from those employed with English and French readers. The increasingly large numbers of Spanish speakers in aphasia rehabilitation worldwide underscore the critical need to develop plausible theoretically grounded clinical strategies to serve these individuals.

Neuropsychiatrie cognitive des délires d’identification des personnes. Une revue historico-critique

Cognitive neuropsychiatry is defined as the application of cognitive neuropsychological models to some defined psychiatric disorders. It has been hypothesized that the various delusional misidentification syndromes are at first functional deficits and that they can be analyzed within models of face/person processing, whether these delusions occur in primary or secondary psychiatric disorders. The best interest of this approach is to make testable hypothesis; another goal is to improve our understandings of face/person recognition. The aim of this review is to examine the results of the main studies conducted within this framework.

Even broken clocks are right twice a day: The utility of models in the clinical reasoning process

The use of cognitive neuropsychological models in rehabilitation has been widely debated among professionals in a variety of disciplines. Some believe that models can be used to develop “model-based” treatment, while others maintain that the role of models in rehabilitation is more limited in scope. Despite the debate, it is widely accepted that models do contribute to the rehabilitation process. While models can assist in clinical decision making, it is important to understand the underlying assumptions of the model and be aware that the “truth” of a model is something we seek and rarely achieve, and this evolution remains a continuing process. This article compares the Praxis Model of Rothi and Heilman () and the Sketch Model of de Ruiter (), highlighting the contrasting underlying assumptions regarding the relationship of gesture and language. The limitations of these models is then used as segue for the discussion of the current debate regarding cognitive neuropsychological models and rehabilitation. ...

Using computational, parallel distributed processing networks to model rehabilitation in patients with acquired dyslexia: An initial investigation

Background : Traditional cognitive neuropsychological models are good at diagnosing deficits but are limited when it comes to studying recovery and rehabilitation. Parallel distributed processing (PDP) models have more potential in this regard as they are dynamic and can actually learn. However, to date very little work has been done in using PDP models to study recovery and rehabilitation. Aims : This study seeks to demonstrate how a PDP model of acquired dyslexia can be extended to provide a computational framework that is capable of making predictions about the relative effectiveness of therapeutic interventions. Methods & Procedures : A replication of Plaut, McClelland, Seidenberg, and Patterson's (1996, simulation 2) model of word reading was trained and then damaged. This damaged network was then retrained in a number of different ways designed to model both natural (spontaneous) recovery and recovery that can be attributed to a specific therapeutic intervention. Outcomes & Results : Interventions that used regular words were more effective than interventions based on inconsistent words. Early intervention (during the period of spontaneous recovery) was more effective than late intervention. Conclusions : These results suggest that this technique has the potential to provide a useful input to the therapeutic arena. The potential opportunities for further work are discussed.

A process for translating evidence-based aphasia treatment into clinical practice

Background: Increased attention in the field of speech-language pathology is directed towards evidence-based treatment, particularly with regard to neurogenic communication disorders.Aims: The paper describes the development of an evidence-based aphasia clinic. Core principles of the clinic are the use of language treatment techniques that have support in efficacy data, and the objective measurement of treatment effectiveness.Main Contribution: Care paths for aphasia treatment are developed according to levels of evidence (Class I, II, III evidence); cognitive neuropsychological and life participation models; and the World Health Organisation International Classification of Health, Disability and Function (ICF). Multi-layered assessments are obtained at the ICF impairment and activity/participation levels throughout treatment (i.e., weekly treatment probes, monthly discourse probes, and biannual aphasia and neuropsychological assessments). Weekly multidisciplinary staffings address patient progress. The paper discusses limitations and challenges of addressing treatment effectiveness and efficacy within a typical outpatient clinical setting.Conclusions: The principles of evidence-based aphasia therapy and single-subject methodology can be applied in routine clinical rehabilitation settings.

Arithmetic Education and Learning Disabilities in Italy

In the first part of this article, we briefly present the context of mathematics education in Italy and its specific programs, teaching and assessment methods, use of psychological concepts, and policies in favor of pupils with difficulties. We illustrate the importance and the role of mathematics teachers' associations. In the second part, we focus more directly on the issue of arithmetic learning and learning disabilities in Italy. Despite the absence of a specific strong tradition in the field, new perspectives regarding mathematics education are evident in Italy. The preparation of new assessment tools has proceeded together with an effort toward the identification of subtypes of arithmetic learning disabilities. A basic distinction has been made between difficulties in number processing/calculation and problem-solving tasks. Within the area of calculation, a finer distinction between numerical knowledge, speed, and accuracy seems critical, but a more articulated differentiation of subcomponents relying on modern cognitive-neuropsychological models can be used also.

Pure Global Acalculia Following a Left Subangular Lesion

We describe the case of a right-handed patient who presented a severe acalculia in the context of a pure Gerstmann syndrome following a subangular lesion that spared the left inferior parietal lobule (IPL). The patient showed impairments in Arabic and verbal codes, in number production and comprehension, as well as in numerical facts and problem solving. By using the EC301 calculation battery, semantic and syntactic tasks in Arabic and verbal codes, we tested the different hypotheses raised by the cognitive neuropsychological models of acalculia. The patients’ difficulties, which were not associated with a general intellectual deterioration, and those affecting number processing as a particular semantic class, were indicative of a “ global acalculia ”. This deficit, which exceeded the anarithmetia usually described in Gerstmann syndrome following left IPL lesion, suggested that the isolation of this area may constitute a sufficient condition for producing such a global acalculia. These results are discussed in terms of a disorder in the manipulation of mental images of spatially related objects.

Treatment of lexical processing in mixed dyslexia: A case study

In the field of dyslexia, cognitive neuropsychological models provide a useful framework for detailed analyses of an individual's reading performance. However, the application of this work to remediation, especially in children, remains relatively unexplored. This study evaluates a lexical treatment programme that has been used successfully in cases of adult acquired surface dyslexia (e.g., Coltheart & Byng, 1989; Weekes & Coltheart, 1986) in the context of severe mixed developmental dyslexia. The results indicate a significant treatment effect that is stable over time and that generalises to untreated words, to spelling, and to some aspects of sublexical processing. Questions related to the use of adult models and methods for developmental conditions and the usefulness of such models in cases of severe mixed dyslexia are discussed. Issues related to treatment generalisation are also explored, with consideration of generalisation of lexical training to sublexical processes, improvement in reading of untreated words, and the effect of reading interventions on spelling performance.

Training grapheme to phoneme conversion in patients with oral reading and naming deficits: A model-based approach

A model-based treatment focused on improving grapheme to phoneme conversion as well as phoneme to grapheme conversion was implemented to train oral reading skills in two patients with severe oral reading and naming deficits. Initial assessment based on current cognitive neuropsychological models of naming indicated a deficit in the phonological output lexicon and in grapheme to phoneme conversion. Using a single subject experimental design across subjects, the effects of treatment were evaluated by periodic probing of both trained and untrained regular words across lexical tasks: oral reading, oral naming, written naming, and writing to dictation. Results indicated successful acquisition of trained reading targets for both patients, as well as generalisation to untrained reading items, oral and written naming of trained items, and writing to dictation of trained and untrained items. Irregular words probed across the four lexical tasks did not demonstrate any improvement, as the trained grapheme to phoneme conversion skills were unsuccessful when applied to irregular words. The present experiment provides evidence for incorporating cognitive neuropsychological models in aiding the development of appropriate treatment protocols, and demonstrates the importance of rule-based learning, rather than compensatory strategies, in maximising the effects of generalisation.