Functional Theory Research Articles

Brain-phenotype predictions of language and executive function can survive across diverse real-world data: Dataset shifts in developmental populations

Predictive modeling potentially increases the reproducibility and generalizability of neuroimaging brain-phenotype associations. Yet, the evaluation of a model in another dataset is underutilized. Among studies that undertake external validation, there is a notable lack of attention to generalization across dataset-specific idiosyncrasies (i.e., dataset shifts). Research settings, by design, remove the between-site variations that real-world and, eventually, clinical applications demand. Here, we rigorously test the ability of a range of predictive models to generalize across three diverse, unharmonized developmental samples: the Philadelphia Neurodevelopmental Cohort (n=1291), the Healthy Brain Network (n=1110), and the Human Connectome Project in Development (n=428). These datasets have high inter-dataset heterogeneity, encompassing substantial variations in age distribution, sex, racial and ethnic minority representation, recruitment geography, clinical symptom burdens, fMRI tasks, sequences, and behavioral measures. Through advanced methodological approaches, we demonstrate that reproducible and generalizable brain-behavior associations can be realized across diverse dataset features. Results indicate the potential of functional connectome-based predictive models to be robust despite substantial inter-dataset variability. Notably, for the HCPD and HBN datasets, the best predictions were not from training and testing in the same dataset (i.e., cross-validation) but across datasets. This result suggests that training on diverse data may improve prediction in specific cases. Overall, this work provides a critical foundation for future work evaluating the generalizability of brain-phenotype associations in real-world scenarios and clinical settings.

Profiles of functioning of a group of children with cerebral palsy in Argentina: Preliminary data from the first national study.

Cerebral palsy (CP) affects body posture and movement coordination and is the most common cause of severe disability in the pediatric population. The diagnosis of CP is not a description of a person's functioning or interaction with their environment. Therefore, the diagnosis should be complemented with a description of functioning, using tools based on the biopsychosocial model proposed by the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This report describes the preliminary data from a multicenter study conducted in Argentina with the aim of standardizing the description of the profiles of functioning of children and adolescents with CP. These data showed that the participants had some skills in sleep functions, mental functions of language, seeing functions, and in some environmental factors. They showed significant difficulties in categories such as maintaining body position, walking, and toileting.

Clinical and genetic characteristics of children with Pitt-Hopkins syndrome caused by TCF4 gene variants

The clinical data of children with Pitt-Hopkins syndrome (PTHS) who were treated in the Affiliated Women and Children's Hospital of Ningbo University from September 2022 to January 2024 were retrospectively included. The patients were followed up to June 2024, and their clinical and genetic characteristics were analyzed. A total of 4 children were included, 2 males and 2 females, with a diagnostic age [M (Q1, Q3)] of 22 (10, 32) months. All the patients presented with typical facial and overall developmental delay (developmental, motor and language delay). The 4 patients were found to harbor de novo heterozygous variants of the TCF4 gene, including the c.990G>A(p.S330S), c.1417_1418delinsT (p.Pro473ArgfsTer15), c.1028C>G (p.S343*) and c.500-2delinsTC. After 15 months of follow-up, all 4 patients received early rehabilitation treatment, and their gross motor function improved to varying degrees, while 3 patients had no improvement in language function. TCF4 gene variation in 4 children had phenotypic heterogeneity, and the main clinical manifestations were developmental delay, language development disorder and special facial features. Among the gene variation types, there was 1 case each of synonym variation, frameshift variation, nonsense variation and splicing variation.

A Discourse Analysis Perspective of Thematic Structure and Thematic Progression in Students’ Written Narrative Texts: A Case of Mjimpya Secondary School Students in Morogoro Municipality

The study investigated the thematic structure and thematic progression in students’ written narrative texts. Specifically, it analysed types of themes and identified types of thematic progression patterns employed in students’ written narrative texts. It also examined the implications of the theme and thematic progression pattern’s predominance in students’ written narrative texts. 85 participants were selected from among Form Three and Form Four students. Data was collected using the closed test and documentary reviews. Data was coded and analysed using Systemic Functional Linguistics (SFL) and Thematic Progression (TP) theories by Halliday, Mathiessen, and Danes respectively. The findings indicated that students employed the taxonomy of four types of themes in their narrative texts: topical theme, textual theme, interpersonal theme, and macro theme. The topical theme was predominantly used followed by textual theme and interpersonal theme. The findings also revealed the taxonomy of seven types of thematic progression patterns in students’ written narrative texts, namely: constant pattern, zigzag pattern, and multiple patterns, constant-zigzag or zigzag-constant, constant-zigzag-multiple, zigzag-multiple, and constant macro pattern. The constant pattern was predominantly used followed by a zigzag pattern and then multiple patterns. The predominance of topical themes and constant thematic progression patterns implied that students tended to rely on thematic selections like topical themes and constant which seem simpler to use rather than textual themes, interpersonal themes, zigzag patterns and multiple patterns, all of which seem complex for students since they need advanced and sophisticated knowledge and skills to apply these thematic structures and progression patterns in their texts. Thus, students’ dependence on simple thematic selections indicates a lack of knowledge or ability to use complex thematic structures and thematic progression patterns in their written narrative texts while these thematic structures have a crucial role in their writing. Therefore, a systematic approach to teaching thematic selections is crucial. The findings of the current study contribute to the body of knowledge on thematic structure and progression in academic writing due to the detailed taxonomy of thematic structure and progression patterns revealed in this study. The study recommends that educational planners and implementers ensure that the theory of thematic structure and thematic progression are systematically integrated into the teaching and learning of writing activities from lower levels of education, specifically secondary education. Further, the study recommends further research in this area to use different approaches, genres and respondents from different settings such as advanced-level secondary school students

Controlling the narrative: the relationship between narrative ability and executive functioning in children with developmental language disorder

Children with developmental language disorder (DLD) experience problems in language comprehension and/or production. In particular, storytelling or narrative ability is often impaired, as this type of discourse involves all domains of language. These problems may lead to a lower quality of social interaction and mental health. Moreover, problems in oral narrative ability during early development have a negative effect on later literacy. However, telling a story involves more than language alone. Executive functioning is thought to play an important part in stimulating narrative ability, as linguistic utterances need to be planned in a temporal and causal order, and switching is needed between multiple characters and events in the story. Research has shown that children with DLD experience problems with executive functioning, independent of their language ability. Thus, the difficulties in storytelling may be caused by both impaired language and executive functioning, as both domains follow hierarchical developmental paths during the early childhood years. In this review, we discuss three components of narrative ability (comprehension, production of macrostructure and production of microstructure) and how they may be interconnected to the three core components of executive functioning (working memory, switching and inhibition) and attention. This review shows that updating and monitoring information in working memory plays an important part in all three components of narrative ability, across multiple studies. This result may give direction in the development of narrative assessment and intervention, and urge further research to disentangle the interplay between language and executive control in DLD.

Abstract 4126628: Worse Cardiac Structure and Function is Associated with Decline in Multiple Domains of Cognitive Function: the Atherosclerosis Risk in Communities (ARIC) Study

Background: Cognitive impairment is cross-sectionally associated with worse cardiac structure/function. However, limited data exist regarding cardiac structure/function and longitudinal changes in cognitive function. Objective: Determine the association of cardiac structure and function with longitudinal changes in cognitive performance in late life. Methods: Among HF- and dementia-free participants in the community-based ARIC study who attended the 5th study visit (V5; 2011-2013), underwent protocol echocardiography, and completed a neurocognitive test battery at both V5 and study Visit 6 (V6; 2015-17), we assessed associations of cardiac structure and function measures with changes in both domain-specific and global cognitive scores between V5 and V6 using multivariable linear regression. Models were initially adjusted for demographics and education level, with additional models further adjusting for cardiovascular risk factors and disease at both V5 and V6. The neuropsychological test battery consisted of 10 neuropsychological tests that covered 3 domains of cognitive function: memory, executive functioning, and language. Factor scores were constructed for each cognitive domain, and their average represented a global composite score. Results: Among 2,988 included participants, mean age was 74±5 years, 60% were female, 20% reported Black race, and mean LVEF was 66±6%. Over a mean of 4.9±0.6 years (the V5 to V6 interval), raw scores declined for all neuropsychological tests. In fully adjusted models, worse diastolic function (larger LAVi) and LV remodeling (greater LV mass index) were associated with decline in executive function. Lower LVEF was associated with decline in language function, while worse LV longitudinal strain – a more sensitive measure of systolic dysfunction – was associated with decline in executive function, language function, and global cognition performance (all p<0.05; Table). Conclusion: Subclinical LV remodeling and dysfunction is associated with greater declines in cognitive function over 5 years in late life. Differential associations were observed by cognitive domains, with executive function decline most uniformly associated with impairments in cardiac structure/function.

Cerebello-Cerebral Resting-State Functional Connectivity in Poststroke Aphasia.

Introduction: The influence of the cerebellum in poststroke aphasia recovery is poorly understood. Despite the right cerebellum being identified as a critical region involved in both language and cognitive functions, little is known about functional connections between the cerebellum and bilateral cortical hemispheres following stroke. This study investigated the relationship between chronic poststroke naming deficits and cerebello-cerebral resting-state functional connectivity (FC). Methods: Twenty-five cognitively normal participants and 42 participants with chronic poststroke aphasia underwent resting-state functional magnetic resonance imaging. Participants with aphasia also underwent language assessment. We conducted regions of interest (ROI)-to-ROI analyses to investigate the FC between the right cerebellar Crus I/II (seed ROI; Cereb1r/Cereb2r) and bilateral cortical language regions and compared these results to cognitively normal controls. Single-subject connectivity parameters were extracted and used as independent variables in a stepwise multiple linear regression model associating Boston Naming Test (BNT) score with FC measures. Results: FC analyses demonstrated correlations between the right cerebellar Crus I/II and both left and right cortical regions for both cognitively normal controls and stroke participants. Additionally, aphasia severity and lesion load had an effect on the cerebello-cerebral network connectivity in participants with aphasia. In a stepwise multiple linear regression, controlling for aphasia severity, time poststroke and lesion load, FC between the right Cereb2-left Cereb1 (standardized beta [std B]= -0.255, p < 0.004), right Cereb2-right anterior MTG (std B = 0.259, p < 0.004), and the right Cereb2-left anterior STG (std B = -0.208, p < 0.018) were significant predictors of BNT score. The overall model fit was R2 = 0.786 (p = 0.001). Conclusion: Functional connections between the right cerebellum and residual bilateral cerebral hemisphere regions may play a role in predicting naming ability in poststroke aphasia.

ILLOCUTIONARY SPEECH ACTS IN TAYLOR JENKIS REID’S NOVEL MALIBU RISING

This research aims to identify the types of illocutionary speech acts found in the main characters' utterances in Taylor Jenkins Reid's novel Malibu Rising. Using Searle’s theory of illocutionary acts, the study examines the contextual meanings behind these acts. A qualitative descriptive methodology was applied, focusing on character dialogues as data. Data collection involved reading and analyzing dialogues, selecting utterances containing illocutionary acts. Analysis followed Miles and Huberman’s framework, encompassing data reduction, data display, and conclusion/verification. Results reveal that the main characters' utterances incorporate five types of illocutionary acts: representatives, directives, declaratives, commissives, and expressives, with directives and expressives being predominant. The research underscores the role of competitive and conflicting speech acts in character interactions, demonstrating how these acts advance the narrative and depict social dynamics. Findings suggest that illocutionary acts in Malibu Rising illustrate internal states, facilitate social interactions, and navigate interpersonal relationships. This study offers insights into the pragmatic functions of language in literature, enhancing understanding of how speech acts reflect real-life communication and contribute to character development and narrative structure. Future research could build on these findings by examining illocutionary acts in various literary genres and comparing their use across different authors and themes.

Linguistic Landscapes of Social Media Discourse: Exploring Language Practices and Identities on Jordanian Online Platforms

The present research is designed to investigate the language practices and identities of Jordanian users on the selected social media platforms of Facebook and Twitter. A total of 400 posts and tweets were selected from both social media platforms. Based on the Systemic Functional Linguistics theory, the study found that the users demonstrated various language practices on social media like code-switching, emojis, localized expressions, and identity affiliations like racism, patriotism, and feminism. Consequently, the study established that Jordanian Arabic is the most frequently-used language style, while the use of English and MSA as secondary language styles was considerably less popular. Additionally, code-switching was the most prevalent language practice. The study recommended educational policies to advocate bilingualism, while for social media, the strategies need to reflect linguistic characteristics to increase reach and engagement.

Bonding Queer Icon. A Multimodal Analysis of the NYC DragCon 2019

Abstract The word ‘icon’ usually refers to a symbol, a famous person admired by all, or a religious image used for worship. Twentieth and twenty-first century icons are also sacred images of secular societies that help construct collective identities and delineate the zeitgeist. Places can also be considered icons if looked through social semiotic lenses. Through Kress and van Leeuwen (2006) and O’Toole’s (1990; 1994; 2004) re-conceptualisations of Halliday’s Systemic Functional Linguistics (1994) and the concept of Bonding Icons (Stenglin 2008a; 2008b; 2012), this paper investigates the ways in which the New York City DragCon 2019 became a rallying and bonding place that both abstractly, through its website, and concretely, through the actual event, gave people a sense of belonging. The main goal of the study is to underline the extent to which the rallying and bonding is money-driven and to highlight the ties between consumerism and the concept of ‘icons selling icons’.

Systematic Literature Review of Ecological Discourse Analysis From 2014 to 2023

One of the crucial foci of contemporary linguistics is upon the complex human-nature relationship within the Anthropocene. An essential methodology of eco-linguistics is Ecological Discourse Analysis (EDA), a field which combines linguistics and ecology. The philosophical underpinning of EDA is rooted in an ecological thematic framework, emphasising the significance of biodiversity and sustainability in the natural world. Despite gaining attention over the past decade, EDA still lacks a comprehensive explanation to adequately and accurately explain the fundamental assertion of its philosophical framework: it gives undue prominence to language biodiversity and sustainability. This systematic literature review, conducted using the PRISMA 2020 paradigm, covers studies from 2014 to 2023. It examines 38 works on EDA across several genres. Further clues illustrate the application of EDA to various genres, often informed by theoretical frameworks associated with systemic functional linguistics, cognitive linguistics, and corpus linguistics. EDA research concentrates on ecological discourse and advocating for protection, exposing the lack of nomenclature, analytical framework, application domain, theoretical framework, and objectives. Furthermore, EDA faces challenges in effectively addressing ecological issues within discourse construction because it does not have a sound theoretical paradigm or enough systematicity. Furthermore, the texts analysed using EDA predominantly focus on ecological discourse, with only a few studies incorporating non-ecological literary texts. This underscores the necessity of expanding the scope of ecological linguistic research.

NCOG-22. ELDER AGE INSTEAD OF LOW EDUCATION PREDICTS POOR LANGUAGE FUNCTION IN RECURRENT LEFT HEMISPHERIC DIFFUSE GLIOMA PATIENTS

Abstract PURPOSE Language processing is multifactorial, requiring interactions between cognitive functions and connections of cerebral cortexes and subcortical fibers in dominant hemisphere. Previously, we identified distinct patient factors and tumor characters influencing language performance in treatment-naïve diffuse glioma. In this study, we aimed to investigate predictive factors between treatment-naïve and recurrent patients with diffuse glioma. MATERIALS AND METHODS Grade 2 to 4 diffuse glioma patients who underwent awake surgery with completed preoperative language assessment were included. The Chinese version of the short-form Boston Diagnostic Aphasia Examination (sfBDAE) was used for language testing. Patient age, sex, education level, tumor grade, language pathway involvement, T1 contrast enhanced (C+), and FLAIR (T2) volume were selected as variables. Univariate and multivariate logistic regression analysis were used on language function impairment. The statistical significance was defined as a p-value less than 0.05 by SPSS20.0. RESULTS 50.7% of all awake surgeries (112 of 221) in 171 patients had repeated operations in the retrospective cohort. Comparing to treatment-naïve patients, patients with recurrent tumor had higher academic year (p=0.016), more subventricular zone invasion (p=0.03), and more subcortical language pathway involvement (p=0.035), whereas showed no difference on language performance. In language function analysis, low education was the sole predictive factor for poor language function in treatment-naïve patients. In sharp contrast with low education, elder age factor was exclusively correlated with poor language function in recurrent patients. Furthermore, times of craniotomy was also an independent predictive factor in recurrent group. CONCLUSIONS Neurocognitive reserve is considered a protective factor against brain damage. Both age and education level are critical factors for cognitive reserve. Whether the phenomenon of a distinct and mutually exclusive patient factor affecting language function between treatment-naïve and recurrent diffuse glioma patients could be explained by the model of cognitive reserve necessitate more study.

NIMG-11. DISCOVERING POSTOPERATIVE APHASIA RECOVERY IN GLIOMA PATIENTS: THE ROLE OF THE RIGHT BROCA’S HOMOLOG AND VERIFICATION

Abstract OBJECTIVE This study aimed to elucidate the neurological mechanisms that support the recovery of postoperative aphasia by examining alterations in language and extended networks in patients with glioma. Additionally, we sought to determine the causal relationship between the right Broca’s homolog and language recovery using neuro-navigated repetitive transcranial magnetic stimulation (nrTMS). METHODS Sixty-two patients with left hemisphere gliomas were retrospectively analyzed and categorized into aphasia and non-aphasia groups based on Aphasia Quotient (AQ) scores. Resting-state functional MRI (rs-fMRI) data were collected and analyzed to investigate differences in functional connectivity (FC) and topological properties of language-related networks. Additionally, eight patients with surgery-induced aphasia were prospectively treated with nrTMS, targeting the node identified from the retrospective analysis. RESULTS Significant increases in FC between the left auditory cortex and the right inferior frontal gyrus in the Executive Control Network were observed in the non-aphasia group. Nodal properties, such as the nodal efficiency of the right Broca’s homolog, were independently associated with postoperative language function. The nrTMS treatment group demonstrated significant improvements in AQ scores, with correlations between increased nodal efficiency and positive language outcomes. CONCLUSION The right hemisphere, specifically the right inferior frontal gyrus, plays a compensatory role in maintaining language function after glioma resection. These findings suggest the therapeutic potential of nrTMS for enhancing postoperative language recovery, offering insights into individualized patient care and rehabilitation strategies for patients with glioma.

INNV-28. CONNECTOMICS-GUIDED GLIOMA RESECTION: HOW CHANGES IN STRUCTURAL CONNECTIVITY CORRELATE WITH LANGUAGE FUNCTION

Abstract Postoperative aphasia is a risk inherent to resections of brain masses in language eloquent areas. Neurosurgical strategies to minimize damage of functional language structures include awake craniotomies combined with stimulation mapping and intra-operative speech and language pathology (SLP) testing. Until now, consideration of white matter tracts involved in language processing as measured by diffusion tensor imaging (DTI) has been minimally incorporated into resection planning. In addition, there is limited understanding as to the association between specific tracts and aphasia risk. Quicktome™ by Omniscient Neurotechnology is clinically-oriented connectomics software that uses DTI sequences from MRIs to model connectivity between geographically distinct brain regions. This model can then be integrated with intraoperative navigation to avoid language connections during resection. Here, we investigate how language tract changes affect clinical aphasia. Patients with language-eloquent gliomas with available pre- and post-operative DTI and SLP evaluations were included in this retrospective study. Structural networks were quantified using Quicktome™ and compared using Spearman correlation. Changes in language function were evaluated using the Boston Naming Test and the Western Aphasia Battery. Patients with postoperative auditory verbal deficits showed a moderate correlation in connectivity changes (ρ=0.42), whereas patients with postoperative naming deficits showed a weak correlation (ρ=0.19). The inferior frontal junction, anterior portion (IFJa), and the superior temporal sulcus, ventral posterior portion (STSvp), in the right hemisphere demonstrated the most associated structural connectivity changes. To our knowledge, this is the first study which uses Quicktome™ to directly associate postoperative connectivity with aphasia outcomes. Understanding the interplay between structural connectivity and neurological symptoms can elucidate neural pathways underlying cortical function with the potential to reduce neurosurgical postoperative morbidity.

NCMP-19. IMPACT OF SUBVENTRICULAR ZONE INVASION ON PREOPERATIVE COGNITIVE DECLINE IN DIFFUSE GLIOMA PATIENTS

Abstract PURPOSE To determine the impact of subventricular zone (SVZ) invasion on neurocognitive dysfunction in diffuse glioma patients. MATERIALS AND METHODS We collected neuropsychological assessments of treatment-naïve WHO grade 2-4 diffuse glioma patients between 2017 to 2023. The Chi-square test determined the odds ratio (OR), and multiple linear regression identified factors related to cognitive deficits using Python 3.11.4. RESULTS Of the 129 patients, 64 exhibited SVZ invasion (SVZ+) while 65 were SVZ-. Groups were matched for WHO grading. SVZ+ was associated with more defective domains than SVZ- in both lower grade (WHO grade 2,3, 3.2 ± 2.1 vs. 2.1 ± 1.9, p=0.019) and high grade (WHO grade 4, 4.9 ± 1.6 vs. 3.6 ± 2.2, p=0.019) tumors. In lower grade gliomas, SVZ+ increased risks of language (OR 7.500, p&amp;lt;0.001) and visual learning impairments (OR 4.375, p=0.014). In high grade gliomas, SVZ+ rendered greater language (OR 8.556, p=0.003) and auditory learning vulnerability (OR 3.850, p=0.039). In right hemispheric tumors, SVZ+ lesions conferred worse executive (OR 6.667, p=0.006) and language function (OR 9.063, p=0.017); in left hemispheric tumors, SVZ+ lesions increased language (OR 3.125, p=0.012) and auditory learning (OR 2.889, p=0.024) impairment. Frontal horn of SVZ+ was related to working memory decline, and body part of SVZ+ was related to emotional deficits. Age and WHO grade 4 were associate with more defective domains in the SVZ+ group. In the SVZ- group, parietal lobe tumor was associate with more defective domains, while high education, temporal lobe, and WHO grade 2 were associate with fewer defective domains. CONCLUSION SVZ invasion impacts pre-operative neurocognitive function regardless of lesion laterality and WHO grade. Distinct SVZ sub-regions are linked to specific cognitive impairments. These findings highlight the need for precise tumor mapping involving the SVZ to evaluate neurocognitive outcomes and consider preventive or rehabilitative interventions.

NCOG-10. LONGITUDINAL MULTIDISCIPLINARY MONITORING OF NEUROCOGNITIVE FUNCTION FOR COLLOID CYST RESECTION: THE IMPACT OF SURGERY

Abstract Endoscopic resection of colloid cysts, a rare pathology of the third ventricle, is now accepted clinical practice. Owing to their location proximal to numerous deep gray nuclei and to the forniceal columns, colloid cysts have always been feared to cause cognitive decline, whether operated on or not. Detailed cognitive testing before and after endoscopic resection, however, has rarely been described. Thus, out objective was to determine the neurocognitive effects of endoscopic colloid cyst resection. We analyzed formal pre- and postoperative neuropsychological testing performed in 20 patients undergoing endoscopic colloid cyst resection. Performance was compared either for each individual patient on a test-by-test basis or according to aggregated neuropsychological factor scores grouped via expert census. A clinical change was defined significant if (i) reaching statistical significance, and (ii) it was greater than 1.5 times the standard deviation of the preoperative performance distribution. Overall, 20 adult patients with colloid cysts (diameter 13.3 ± 1.3 mm) underwent matched pre- and postoperative testing generating 679 data points. No patient had a significant change in cognitive performance. When neurocognitive metrics assessing cognitive functions typically subsumed by the temporal (p = 0.35), extratemporal (p = 0.20), occipitoparietal (p = 0.31), or frontal lobes (p = 0.11), no statistically significant difference was observed between pre- and postoperative cognitive performance. No significant differences emerged when factor scores were generated according to composite score of different neurocognitive domains: attention (p = 0.32), executive function (p = 0.14), language (p = 0.98), and visuospatial function (p = 0.42). In conclusion, neuropsychological testing allows for the careful longitudinal monitoring of cognitive status and the identification of patients who may benefit from pre- and postoperative cognitive rehabilitation, and should be used as a valuable surgical psychometric marker and adjuvant. No significant cognitive decline was observed, again confirming the safety of endoscopic colloid cyst resection.

Beyond the Synthetic Future: Usage-Based Linguistc

Objective: The objective of this study is to investigate the periphrases with the verb ir, in the third singular person, searching to describe the motivations for semantic change. Theoretical Framework: In this topic, the main concepts and theories that underpin the research are presented. Stand out the Usage-Centered Functional Linguistics - LFCU (Oliveira; Rosário, 2015; Furtado da Cunha, Bispo, Silva, 2016) which is based on Construction Grammar, Cognitive Linguistics (Goldberg, 1995; Traugott; Trousdale, 2021; Bybee, 2016), providing a solid basis for understanding the context ofthe investigation. Method: The methodology adopted for this research it is explanatory-descriptive and can be considered empirically based, focusing on the synchronic character, since the samples are extracted in a single temporal dimension Results and Discussion: The results obtained revealed that metaphorical and metonymic mechanisms are involved in the use of these constructions. In the discussion section, these results are contextualized in light of the theoretical framework, highlighting the implications and relationships identified. Possible discrepancies and limitations of the study are also considered in this section. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how the results can be applied or influence practices in the portuguese language teaching. These implications could encompass to other areas of study, such as cognition. Originality/Value: This study contributes to the literature when highlighting that there is a pattern in linguistic change. The relevance and value of this research are evidenced by describing the change at different levels and the impact on Portuguese language teaching.

RADT-36. FUNCTION-ADAPTED RADIOTHERAPY PLANNING IN THE MANAGEMENT OF HIGH-GRADE GLIOMAS: A COMPARING STUDY FOR DOSE SPARING OF SPEECH-ELOQUENT BRAIN AREAS

Abstract BACKGROUND Radiotherapy (RT) for brain tumors can induce injury of functional white matter tracts. In neurosurgery navigated transcranial magnetic stimulation (nTMS)- and diffusion tensor imaging (DTI)-based fiber tracts (FT) is an established tool to protect functional FT during tumor resection. We investigated it´s applicability in RT planning with the aim of dose reduction of language-associated fiber tracts. METHODS Preoperative, nTMS-generated and DTI-based FT of the functional left hemispheric language network of patients with language-eloquent malignant gliomas (WHO III/IV) were imported into the planning software (ARIA®) according to the DICOM standard and contoured as a risk structure. Brain shift after tumor resection was compensated using elastic fusion (Brainlab®). The treatment plans were optimized or recalculated with the aim of reducing the dose to the fiber tracts outside the planning target volume (PTV). The dosimetric evaluation was performed according to dose volume histogram parameters. RESULTS RT plans of 27 patients were retrospectively evaluated in the study. The mean dose (Dmean) to the fiber tracts was 37.3+/-11.8 Gy, with plan optimization dose was 33.6 +/- 12.2 Gy (-10.9% p&amp;lt;0.01), within the 20 Gy isodose the dose reduction to be achieved was on average - 25.0% (range 0-48.5%). The V54Gy and V20Gy were on average 40.2 +/- 23.7% and 72.3 +/- 21.1% compared to 38.2 +/- 23.5% and 58.1 +/- 23.7% (both p&amp;lt;0.01) with optimization. The Dmean of the PTV did not change (59.8 Gy vs. 59.8 Gy (p=0.5)), nor did the dose homogeneity (HI, (D5-D95)/Dp)(p=0.63)). The dose exposure of the organs at risk was within the specified dose constraints. CONCLUSION This study showed that (nTMS)- and diffusion tensor imaging (DTI)-based fiber tractography could be used in radiotherapy planning to spare language-eloquent brain areas without having to accept dose reductions within the PTV. Whether the concept of tract-based sparing of language function brings clinical benefits to patients needs to be further investigated in prospective studies.

Leisure-time physical activity, cardiorespiratory fitness, and cognitive decline in middle-aged and older adults - The ELSA-Brasil study

ObjectivesDementia is a fast-growing public health problem. This study examined the association of physical activity and estimated cardiorespiratory fitness (eCRF) with the risk of cognitive impairment. Study designMulticentric, prospective cohort study. MethodsWe analyzed 10,121 participants of the ELSA-Brasil study. We assessed leisure-time physical activity using the long version of the IPAQ questionnaire and defined moderate-to-vigorous physical activity (MVPA) per week. We applied a non-exercise prediction equation to estimate eCRF and classified participants as unfit (lowest tertile) and fit. Leisure-time MVPA and eCRF were measured at baseline and follow-up. Incident cognitive impairment was based on memory, language, and executive function assessed at baseline and follow-up. ResultsDuring a median of 8.1 (7.8–8.5) years of follow-up, we identified 396 (3.9 %) incident cases of cognitive impairment. There was an inverse, non-linear association between the incidence of cognitive impairment and both leisure time MVPA and eCRF. Low eCRF (IRR: 1.29; 95%CI: 1.02, 1.64) and low MVPA (IRR: 1.40; 1.09, 1.82) were independently associated with an increased incidence. Increasing 1 MET in eCRF from baseline to follow-up visit was associated with a lower incidence of cognitive impairment (IRR: 0.80; 95%CI: 0.71, 0.91), while a decrease of 13.7 min per day in leisure time MVPA is associated with an increased incidence (IRR: 1.16; 95%CI: 1.01, 1.33) of cognitive impairment. These associations remained statistically significant in adults under 65 but not in older adults. ConclusionLow eCRF and leisure time MVPA are strong and independent predictors of incident cognitive impairment especially in middle-aged adults.

A modified intensive, comprehensive aphasia program (mICAP) has better reported outcomes than usual care: a randomized controlled trial

ABSTRACT Background Intensive Comprehensive Aphasia Programs (ICAPs) are a new model of service delivery that show promising pre-post outcomes but have yet to be compared with usual care. Aim To compare the clinical effectiveness of a modified Intensive Comprehensive Aphasia Program (mICAP) to usual care in a parallel two arm study utilizing stratified block randomisation. Methods & Procedures Participants were a referred sample with post stroke aphasia from ten local speech pathology departments. Assessments were completed prior to, immediately after, and follow up at 3 months after the mICAP. While 269 participants with aphasia were approached for the study, only 52 were eligible to be randomised with 113 participants approached not meeting selection criteria and 99 of eligible participants declining to participate. Block randomization was based on matched moderate/mild versus severe aphasia pairs. Three of the 26 mICAP participants withdrew. In the experimental arm of the mICAP (the LIFT program), participants with aphasia and their family attended goal directed tailored therapy three times weekly for 8 weeks. Therapy included 14 hours each of impairment therapy, functional communication therapy, and computer therapy and 7 hours of group therapy and a challenge task. The main outcome measures were the self-reported Assessment for Living with Aphasia (ALA) and Content Information Units (#CIU’s) in connected speech. Outcomes & Results Linear Mixed Modelling was completed on the remaining 42 participants’ data and found a significant benefit for the mICAP on the ALA Total score (p= .014; 95% CI= −21.48- −2.57) ALA Aphasia domain (p = .027; 95% CI= −3.23 - −0.203), ALA Environment domain (p = .017; 95% CI= −4.70 - −0.493) immediately post intervention with maintenance of effects for the ALA Aphasia domain in the follow up period (p = .014; 95% CI= −3.64 - −0.438). Family members in the mICAP reported significant reduction in caregiving burden in the follow up period (p= .017; CI= −14.12 - −1.52.). There were no significant differences on the other main outcome measure of Content Information Units (95% CI= −34.94 – 55.15). Conclusions For those suitable and interested, the mICAP was more beneficial than usual care for participants with aphasia and their family members. However, lack of significant differences in discourse and other language functions, suggests that individual elements of mICAPs and their evaluation require review. Based on these results, the LIFT program has been refined to become the Comprehensive High-dose Aphasia Therapy (CHAT) program.