Lexical Access Speed Research Articles

Cognitive-Motor Training Improves Reading-Related Executive Functions: A Randomized Clinical Trial Study in Dyslexia.

Children with developmental dyslexia (DD) often struggle with executive function difficulties which can continue into adulthood if not addressed. This double-blinded randomized clinical trial study evaluated the short-term effects of the Verbal Working Memory-Balance (VWM-B) program on reading-related executive functions, reading skills, and reading comprehension in Persian children with DD. The active control group [12 children with DD with a mean age of 9 years (SD = 0.90)] received training using the single-task VWM program, while the experiment group [15 children with DD with a mean age of 8 years (SD = 0.74)] received training with the dual-task VWM-B program. Both groups received fifteen training sessions, and assessments were conducted before and after the intervention. The groups were homogenized for possible confounders of age, gender, IQ level, and attention level. The study employed separate mixed ANOVA analyses to estimate the impact of training programs on various measured functions. Significant improvements were observed in the outcome measures of backward digit span, text comprehension, verbal fluency, Stroop color-word test and interference, and the reading subtests. Additionally, significant correlations were found between reading skills and backward digit span, text comprehension, verbal fluency, and Stroop variables. In conclusion, the dual-task VWM-B program was found to be more effective than the single-task VWM program in improving selective attention, cognitive inhibition, verbal working memory capacity, information processing speed, naming ability, and lexical access speed. These enhanced executive functions were associated with improved reading skills in children with DD.

34 Verbal Memory as a Language Function: Phonological Processing Contributes to Word List Recall in Persons with Multiple Sclerosis

Objective:Verbal memory deficits are present in multiple sclerosis (MS), but neither inflammatory T2 lesion volume nor cerebral atrophy (generalized or localized hippocampal atrophy) fully explain disease-related verbal memory changes. Importantly, the hippocampus does not function in a vacuum; memory encoding and retrieval requires interactions between the hippocampus and cortical areas where information is processed and represented. Indeed, we have previously shown that lexical access speed (a language function assessed by rapid automatized naming) independently predicted delayed recall of verbal information (word list) for persons with MS, even when controlling for total learning. Informed by this work and recent ultra high field (7.0 Tesla) MRI research reporting high cortical lesion count in regions associated with phonological processing (e.g., plenum temporale, superior temporal gyrus), we assessed whether phonological processing independently explains verbal memory deficits in persons with MS.Participants and Methods:Analyses were performed on a clinical sample of persons with MS aged 18 to 59 years (n=60: 49 relapsing, 11 progressive). Word-list memory was assessed by the Hopkins Verbal Learning Test, Revised (HVLT-R), which yielded scores for Total Learning (TL) and Delayed Recall (DR). Phonological processing was assessed with WIAT-4 Phonemic Proficiency. WIAT-4 Sentence Repetition was utilized as a non-phonological language control task, and WIAT-4 Word Reading was administered to control for premorbid verbal ability. CANTAB Paired Associate Learning served as a nonverbal memory comparison. Performance on tasks was standardized using published age-adjusted norms. Primary analyses used partial correlations to assess relationships between Phonemic Proficiency and (a) HVLT-R TL and DR controlling for WIAT-4 Word Reading, and (b) HVLT-R DR controlling for WIAT-4 Word Reading and HVLT-R TL. To assess specificity to phonological processing, the same partial correlations assessed relationships between Sentence Repetition and HVLT-R variables, and between Phonemic Proficiency and nonverbal memory (CANTAB PAL).Results:When controlling for premorbid verbal ability, Phonemic Proficiency performance accounted for 7.8% of the variance in HVLT-R TL (rpartial=0.28, p=0.031) and 16% of the variance in HVLT-R DR (rpartial=0.40, p=0.002). Moreover, when additionally controlling for HVLT-R TL, Phonemic Proficiency still accounted for 10% of the variance in HVLT-R DR (r partial— 0.32, p=0.016). Showing specificity to phonological processing ability, performance on Sentence Repetition was not significantly related to HVLT-R DR when controlling for premorbid verbal ability (WIAT-4 Word Reading) and HVLT-R TL (rpartial=0.09, p=0.510). Showing specificity to verbal memory, neither Phonemic Proficiency nor Sentence Repetition performance were reliably related to CANTAB PAL for any variance in performance in nonverbal memory (Ps>0.9).Conclusions:Results suggest that language ability, specifically phonological processing, contributes to delayed recall of word lists independent of premorbid verbal ability and initial total learning scores in persons with MS. These findings demonstrate contributions of language ability to verbal memory and highlight the need for further research into language ability changes in persons with MS. This may have implications for verbal memory rehabilitation in MS.

Noise-Vocoded Sentence Recognition and the Use of Context in Older and Younger Adult Listeners.

When listening to speech under adverse conditions, older adults, even with "age-normal" hearing, face challenges that may lead to poorer speech recognition than their younger peers. Older listeners generally demonstrate poorer suprathreshold auditory processing along with aging-related declines in neurocognitive functioning that may impair their ability to compensate using "top-down" cognitive-linguistic functions. This study explored top-down processing in older and younger adult listeners, specifically the use of semantic context during noise-vocoded sentence recognition. Eighty-four adults with age-normal hearing (45 young normal-hearing [YNH] and 39 older normal-hearing [ONH] adults) participated. Participants were tested for recognition accuracy for two sets of noise-vocoded sentence materials: one that was semantically meaningful and the other that was syntactically appropriate but semantically anomalous. Participants were also tested for hearing ability and for neurocognitive functioning to assess working memory capacity, speed of lexical access, inhibitory control, and nonverbal fluid reasoning, as well as vocabulary knowledge. The ONH and YNH listeners made use of semantic context to a similar extent. Nonverbal reasoning predicted recognition of both meaningful and anomalous sentences, whereas pure-tone average contributed additionally to anomalous sentence recognition. None of the hearing, neurocognitive, or language measures significantly predicted the amount of context gain, computed as the difference score between meaningful and anomalous sentence recognition. However, exploratory cluster analyses demonstrated four listener profiles and suggested that individuals may vary in the strategies used to recognize speech under adverse listening conditions. Older and younger listeners made use of sentence context to similar degrees. Nonverbal reasoning was found to be a contributor to noise-vocoded sentence recognition. However, different listeners may approach the problem of recognizing meaningful speech under adverse conditions using different strategies based on their hearing, neurocognitive, and language profiles. These findings provide support for the complexity of bottom-up and top-down interactions during speech recognition under adverse listening conditions.

Differential relations of auditory and cognitive functions to speech recognition tasks in adult cochlear implant users

Clinical testing for assessing adult cochlear implant (CI) candidacy and outcomes relies primarily on tasks of open-set recognition for words and sentences. However, it is not clear in what ways performance on these different tasks relates differentially to auditory and cognitive functions. We tested the hypothesis that auditory and cognitive functions would contribute differentially to performance on recognition of isolated words (CID-W22 words), meaningful sentences (Harvard Standard), nonsense sentences (Harvard Anomalous), and sentences with high talker variability (PRESTO) in adult CI users. Sixty-five experienced CI users completed a battery of auditory and cognitive tests to assess auditory spectro-temporal processing, vocabulary size, working memory capacity, inhibition-concentration, nonverbal reasoning, and speed of lexical access. Findings were that spectro-temporal processing, lexical access speed, and nonverbal reasoning predicted scores across all word and sentence recognition tests. In contrast, inhibition-concentration contributed to nonsense sentence recognition, while vocabulary knowledge contributed to high talker variability sentence recognition. Results suggest that there is a core set of auditory and cognitive functions that contribute broadly to speech recognition, while more specific cognitive functions contribute to performance on some speech recognition tasks. Clinical implications are that individual cognitive abilities should be considered when evaluating CI candidacy and outcomes.

The need to consider return to work as a main outcome in patients undergoing surgery for diffuse low-grade glioma: a systematic review.

For a long time, return to work (RTW) has been neglected in patients harboring a diffuse low-grade glioma (LGG). However, a majority of LGG patients worked at time of diagnosis. Moreover, these patients now live longer given current treatment paradigms, especially thanks to early maximal surgery. We systematically searched available medical databases for studies that reported data on RTW in patients who underwent resection for LGG. A total of 30 studies were selected: 19 considered RTW (especially rate and timing) as an outcome and 11 used scales of health-related quality of life (HRQoL) which included work-related aspects. Series that considered RTW as a main endpoint were composed of 1014 patients, with postoperative RTW rates ranging from 31 to 97.1% (mean 73.1%). Timing to RTW ranged from 15days to 22months (mean 6.3months). Factors related to an increased proportion of RTW were: younger age, better neurologic status, having a white-collar occupation, working pre-operatively, being the sole breadwinner, the use of awake surgery, and greater extent of resection. Female sex, older age, poor neurologic status, pre-operative history of work absences, slow lexical access speed, and postoperative seizures were negatively related to RTW. No studies that used HRQoL scales directly investigated RTW rate or timing. RTW was scarcely analyzed in LGG patients who underwent resection. However, because they are usually young, with no or only mild functional deficits and have a longer life expectancy, postoperative RTW should be assessed more systematically and accurately as a main outcome. As majority (61.5-100%) of LGG patients were working at time of surgery, the responsibility of neurosurgeons is to bring these patients back to their previous activities according to his/her wishes. RTW might also be included as a critical endpoint for future prospective studies and randomized control trials on LGGs.

Lexical Access Speed and the Development of Phonological Recoding during Immediate Serial Recall

ABSTRACT A recent Registered Replication Report (RRR) of the development of verbal rehearsal during serial recall revealed that children verbalized at younger ages than previously thought, but did not identify sources of individual differences. Here, we use mediation analysis to reanalyze data from the 934 children ranging from 5 to 10 years old from the RRR for that purpose. From ages 5 to 7, the time taken for a child to label pictures (i.e. isolated naming speed) predicted the child’s spontaneous use of labels during a visually presented serial reconstruction task, despite no need for spoken responses. For 6- and 7-year-olds, isolated naming speed also predicted recall. The degree to which verbalization mediated the relation between isolated naming speed and recall changed across development. All relations dissipated by age 10. The same general pattern was observed in an exploratory analysis of delayed recall for which greater demands are placed on rehearsal for item maintenance. Overall, our findings suggest that spontaneous phonological recoding during a standard short-term memory task emerges around age 5, increases in efficiency during the early elementary school years, and is sufficiently automatic by age 10 to support immediate serial recall in most children. Moreover, the findings highlight the need to distinguish between phonological recoding and rehearsal in developmental studies of short-term memory.

Contributions of executive functions and linguistic skills to verbal fluency in children

ABSTRACT Despite the widespread use of verbal fluency (VF) tasks in child neuropsychological research and clinical practice, the contribution of executive and linguistic processes to variability in children’s fluency performance is still unclear. This is particularly important when considering the development of orthographic knowledge and semantic network during childhood. The present study investigated the contributions of executive functions and linguistic skills to performance in VF tasks in children. We examined the contributions of basic executive functions (i.e.,inhibitory control, working memory, and flexibility) and high-order executive functions (i.e., planning), vocabulary, lexical access speed, and phonological awareness to VF performance in 111 typically developing children (8–10 years old). Multiple regression analyses showed that phonological awareness was a predictor of performance in phonemic verbal fluency (PVF), and lexical access speed was the best predictor of performance in semantic verbal fluency (SVF). Among the executive function components, working memory was a predictor of performance in PVF and most categories of SVF (except animal fluency). In addition to working memory resources (i.e., a basic executive function), planning (i.e., a high-level executive function) was also recruited in the clothing category of SVF. These results highlight the importance of phonological processing skills in children’s performance on VF tasks and show similarities and differences in the contributions of various linguistic and executive skills to PVF and SVF. These findings have implications for interpreting the results of these measures in research and clinical practice.

The effect of Japanese proficiency and lexical accessing speed on the comprehension of indirect speech act in L2 Japanese

This study examined the comprehension accuracy scores and response time of indirect speech act by 63 native Chinese speakers learning Japanese, and discussed the effect from Japanese proficiency, as well as the speed of lexical access. The results showed that: (1) Japanese proficiency effects the accuracy rate of indirect speech act, the higher the Japanese proficiency, the higher the accuracy rate. However, there is no clear linear relationship between the learners' Japanese proficiency and the indirect speech act's response time. (2) The lexical accessing speed effects the learners' response time of indirect speech act, the faster the accessing speed is, the shorter the indirect speech acts' response time. The lexical accessing speed also affects the comprehension accuracy rate of the high-level learners. The faster the lexical accessing speed of the high-level learners, the higher the comprehension accuracy rate.

Bottom-Up Signal Quality Impacts the Role of Top-Down Cognitive-Linguistic Processing During Speech Recognition by Adults with Cochlear Implants.

Significant variability persists in speech recognition outcomes in adults with cochlear implants (CIs). Sensory ("bottom-up") and cognitive-linguistic ("top-down") processes help explain this variability. However, the interactions of these bottom-up and top-down factors remain unclear. One hypothesis was tested: top-down processes would contribute differentially to speech recognition, depending on the fidelity of bottom-up input. Bottom-up spectro-temporal processing, assessed using a Spectral-Temporally Modulated Ripple Test (SMRT), is associated with CI speech recognition outcomes. Similarly, top-down cognitive-linguistic skills relate to outcomes, including working memory capacity, inhibition-concentration, speed of lexical access, and nonverbal reasoning. Fifty-one adult CI users were tested for word and sentence recognition, along with performance on the SMRT and a battery of cognitive-linguistic tests. The group was divided into "low-," "intermediate-," and "high-SMRT" groups, based on SMRT scores. Separate correlation analyses were performed for each subgroup between a composite score of cognitive-linguistic processing and speech recognition. Associations of top-down composite scores with speech recognition were not significant for the low-SMRT group. In contrast, these associations were significant and of medium effect size (Spearman's rho = 0.44-0.46) for two sentence types for the intermediate-SMRT group. For the high-SMRT group, top-down scores were associated with both word and sentence recognition, with medium to large effect sizes (Spearman's rho = 0.45-0.58). Top-down processes contribute differentially to speech recognition in CI users based on the quality of bottom-up input. Findings have clinical implications for individualized treatment approaches relying on bottom-up device programming or top-down rehabilitation approaches.

Representational and Computational Changes in Heritage Language Grammars

Abstract The notion of complexity has been applied to descriptions and comparisons of languages and to explanations related to ease and difficulty of various linguistic phenomena in first and second language acquisition. It has been noted that compared to baseline grammars, heritage language grammars are less complex, displaying morphological simplification and structural shrinking, especially among heritage speakers with lower proficiency in the language. On some recent proposals of gender agreement in Spanish and Norwegian (Fuchs et al., 2015; Lohndal & Putnam, 2020), these differences are representational, affecting the projection of functional categories and feature specifications in the syntax. An alternative possibility is that differences between baseline and heritage grammars arise from computational considerations related to bilingualism, affecting speed of lexical access and feature reassembly online in the minority language. We illustrate this proposal with empirical data from gender agreement and differential object marking. Although presented as alternatives, the representational and computational explanations are not incompatible, and may both be adequate to capture varying levels of variability modulated by linguistic proficiency. These proposals formalize bilingual acquisition models of grammar competition and directly relate the availability and type of input (the acquisition evidence) to the locus and nature of the grammatical differences between heritage and baseline grammars.

The Symbol Digit Modalities Test (SDMT) is sensitive but non-specific in MS: Lexical access speed, memory, and information processing speed independently contribute to SDMT performance

BackgroundThe Symbol Digit Modalities Test (SDMT) is the most sensitive metric of neurocognitive function in multiple sclerosis (MS), and is consistently interpreted as a measure of information processing speed (IPS). ObjectiveTo evaluate the cognitive psychometric profile captured by the SDMT to identify whether different cognitive processes independently underlie performance. MethodsThree samples of MS patients (total n=661; 185 research patients at MS center; 370 clinical patients at MS center; 106 persons with MS from the community) completed objective assessments of neuropsychological function across cognitive domains. Exploratory factor analysis (EFA) was used to derive latent cognitive factor scores, and operationalize cognitive domain composite scores, to understand the unique, shared and redundant contribution of different cognitive domains to SDMT performance using hierarchical multiple regression and commonality analysis. ResultsAcross three independent samples we provide converging strong evidence that the cognitive domains of Memory, IPS and Rapid Automatized Naming (lexical access speed) jointly and uniquely contribute to SDMT performance. ConclusionThe SDMT measures multiple cognitive processes, which likely explains the high degree of sensitivity to cognitive change in MS. Researchers and clinicians should interpret the SDMT as a multifarious measure of general cognition rather than a specific test of IPS.

The hunt for structure-dependent interpretation: The case of Principle C

Jacques Mehler's earliest work concerned the independence of syntactic and semantic representations in adult sentence understanding, probing for independent contributions of sentence structure and sentence meaning in the psychological processes that underlie linguistic perception (e.g., Mehler, 1963; Mehler & Miller, 1964). The bulk of his career was spent pioneering the study of infants' linguistic cognition. In this paper, we bring these two streams together, using data from a suite of infant looking tasks to probe the syntactic representations that underlie sentence understanding for 30-month-olds. Each participant completed a battery of 3 tasks: one measuring knowledge of Principle C, one measuring lexical access speed and one measuring syntactic processing. We find that variability in performance on a Principle C task is predicted by variability in vocabulary, but not by either lexical access speed or a new measure of syntactic integration. Successful deployment of Principle C in 30-month-olds may therefore depend on factors related to vocabulary, but distinct from either lexical access or structure building. Identification of such factors remains an important goal for future work.

Word and Nonword Reading Efficiency in Postlingually Deafened Adult Cochlear Implant Users.

This study tested the hypotheses that 1) experienced adult cochlear implants (CI) users demonstrate poorer reading efficiency relative to normal-hearing controls, 2) reading efficiency reflects basic, underlying neurocognitive skills, and 3) reading efficiency relates to speech recognition outcomes in CI users. Weak phonological processing skills have been associated with poor speech recognition outcomes in postlingually deaf adult CI users. Phonological processing can be captured in nonauditory measures of reading efficiency, which may have wide use in patients with hearing loss. This study examined reading efficiency in adults CI users, and its relation to speech recognition outcomes. Forty-eight experienced, postlingually deaf adult CI users (ECIs) and 43 older age-matched peers with age-normal hearing (ONHs) completed the Test of Word Reading Efficiency (TOWRE-2), which measures word and nonword reading efficiency. Participants also completed a battery of nonauditory neurocognitive measures and auditory sentence recognition tasks. ECIs and ONHs did not differ in word (ECIs: M = 78.2, SD = 11.4; ONHs: M = 83.3, SD = 10.2) or nonword reading efficiency (ECIs: M = 42.0, SD = 11.2; ONHs: M = 43.7, SD = 10.3). For ECIs, both scores were related to untimed word reading with moderate to strong effect sizes (r = 0.43-0.69), but demonstrated differing relations with other nonauditory neurocognitive measures with weak to moderate effect sizes (word: r = 0.11-0.44; nonword: r = (-)0.15 to (-)0.42). Word reading efficiency was moderately related to sentence recognition outcomes in ECIs (r = 0.36-0.40). Findings suggest that postlingually deaf adult CI users demonstrate neither impaired word nor nonword reading efficiency, and these measures reflect different underlying mechanisms involved in language processing. The relation between sentence recognition and word reading efficiency, a measure of lexical access speed, suggests that this measure may be useful for explaining outcome variability in adult CI users.

A surgeon-scientist's perspective and review of cognitive-linguistic contributions to adult cochlear implant outcomes.

Objective(s)Enormous variability in speech recognition outcomes persists in adults who receive cochlear implants (CIs), which leads to a barrier to progress in predicting outcomes before surgery, explaining “poor” outcomes, and determining how to provide tailored rehabilitation therapy for individual CI users. The primary goal of my research program over the past 9 years has been to extend our understanding of the contributions of “top‐down” cognitive‐linguistic skills to CI outcomes in adults, acknowledging that “bottom‐up” sensory processes also contribute substantially. The main objective of this invited narrative review is to provide an overview of this work. A secondary objective is to provide career “guidance points” to budding surgeon‐scientists in Otolaryngology.MethodsA narrative, chronological review covers work done by our group to explore top‐down and bottom‐up processing in adult CI outcomes. A set of ten guidance points is also provided to assist junior Otolaryngology surgeon‐scientists.ResultsWork in our lab has identified substantial contributions of cognitive skills (working memory, inhibition‐concentration, speed of lexical access, nonverbal reasoning, verbal learning and memory) as well as linguistic abilities (acoustic cue‐weighting, phonological sensitivity) to speech recognition outcomes in adults with CIs. These top‐down skills interact with the quality of the bottom‐up input.ConclusionAlthough progress has been made in understanding speech recognition variability in adult CI users, future work is needed to predict CI outcomes before surgery, to identify particular patients' strengths and weaknesses, and to tailor rehabilitation approaches for individual CI users.Level of Evidence4

Exploring the effects of phonetic overlap and background noise on incremental processing in children

In everyday conversation, individuals actively process speech in order to comprehend and respond in real-time. As a word unfolds, listeners activate possible lexical candidates and actively determine the target word as soon as possible. This process requires knowledge of one's native spoken language and the ability to recognize individual phonemes. Phonetic overlap between the target and candidate words can influence the speed of lexical access. For example, phonological onset (e.g., candy), but not rhyming words (e.g., sandal), can yield lexical competition with target words (e.g., candle). When the auditory input is spectrally degraded, however, the effect is different: rhyme words have greater lexical competition with target words. The purpose of the present study is to test the extent to which rhyme words compete with target words in the present of background noise. In a visual world paradigm, the present study examines the time course of spoken word recognition when target words (e.g., candle) are contrasted with full (e.g., sandal) and offset (e.g., poodle) rhymes in 5-to-7-year-olds. Target words are presented in both quiet and in steady-state speech-shaped noise at 0 dB SNR. Preliminary data suggest that rhyming overlap does not impact processing in quiet but may show differences in noise.

Home language and societal language skills in second-generation bilingual adults.

Research aims were (a) to test competing predictions regarding the levels of heritage and societal language proficiency among young adults who experienced early exposure to both languages, and (b) to identify sources of individual differences in degree of bilingualism. Participants comprised 65 Spanish-English bilinguals who reported using both languages on a weekly basis, 25 native English monolinguals, and 25 native Spanish monolinguals. Language and literacy skills were assessed with a battery of standardized and research-based assessments. Degree of bilingualism was calculated for the bilingual participants. Paired sample t-tests compared the bilinguals' skills in English to their skills in Spanish. Hierarchical regression evaluated factors related to their degree of bilingualism. Independent sample t-tests compared bilinguals' single-language skills to monolinguals. The bilinguals' English skills were stronger than their Spanish skills on every measure. Thus, degree of bilingualism was largely a function of level of Spanish skill and was associated with concurrent Spanish exposure. Bilinguals' English skills were not different from the monolinguals except in speed of lexical access. The bilinguals' Spanish skills were significantly lower than the Spanish monolinguals on every measure except in accuracy judgments for grammatically correct sentences. Previous studies of bilingual adults have focused on sequential bilinguals and previous studies of heritage language speakers have focused on their grammatical skills. This is the first study, to our knowledge, to assess a wide range of functionally relevant skills in adults with early exposure to a heritage and societal language. These findings demonstrate that early exposure to and continued use of a home language does not interfere with the achievement of societal language and literacy skills, while also demonstrating that even a widely and frequently used home language may not be acquired to the same skill level as a societal language used in school.

CAN CAPTIONED VIDEO BENEFIT SECOND LANGUAGE PRONUNCIATION?

AbstractThe present study investigated the potential benefits of extended exposure to captioned videos for second language pronunciation. We tested 90 L2 adult learners of English on speech processing skills (segmentation, speed of lexical access, and sentence processing) and phonological accuracy in perception (ABX discrimination) and production (accentedness ratings) before and after an 8-week treatment consisting of regular exposure to audiovisual materials. Participants were randomly assigned to four experimental conditions involving two viewing modes (captioned or uncaptioned) and two task focus conditions (focus on phonetic form or focus on meaning). Results showed benefits in speech segmentation and speech processing skills irrespective of viewing mode. No significant benefits were found for phonological accuracy in perception. In production, a focus on phonetic form improved pronunciation only in the absence of captions, whereas captioned viewing led to pronunciation gains as long as there was no focus on phonetic form. These findings suggest that pronunciation improvement can take place with the help of captions or, in the absence of captions, when learners’ attention is directed to pronunciation. Cognitive overload might explain why no benefits were obtained when attention was directed to pronunciation in a captioned viewing mode.

Effects of anodal transcranial direct current stimulation on cognitive dysfunction in patients with progressive supranuclear palsy.

Progressive supranuclear palsy (PSP) is a tauopathy characterized by motor, neurobehavioral and disabling brainstem deficits. No disease-modifying therapeutic options exist. The therapeutic potential of transcranial direct current stimulation (tDCS) has been highlighted in studies on patients with other neurodegenerative diseases. Therefore, by drawing upon the limited tDCS literature on PSP, we conducted a pilot study in order to evaluate the effect of tDCS over motor and premotor cortex in patients with PSP, with a particular emphasis on cognitive dysfunction. Eight patients affected by PSP were included (4 males and 4 females with mean age 67.4±7.4 years, range: 55-80 years and mean disease duration: 4.6±3.3 years, range: 1-11 years). The mean Unified Parkinson's Disease Rating Scale Part III (UPDRS III) was 49±16.1 and the mean Hoehn & Yahr (H&Y) scale was 3.9±1 at baseline. All pharmacological treatments (L-dopa, pramipexole, rotigotine, rasagiline, amantadine) were maintained stable during the study. We aimed at evaluating along with the motor outcome (as it is reflected on a disease-specific rating scale), the post-tDCS cognitive status after the completion of the intervention. The clinical evaluation involved the PSP-Rating Scale, the UPDRS III and the Timed Up and Go test. Neuropsychological assessment focused on auditory-verbal memory and learning, episodic memory, visuo-motor coordination and speed of information processing, executive functions and verbal fluency (phonemic and semantic). Anodal tDCS was applied over primary motor and pre-motor cortices in 10 daily sessions. During the tDCS stimulation a constant current of 2 mA was delivered for 30 minutes. Clinical evaluations were performed at baseline, day 11, day 30 and at day 90. The PSP-Rating score (total and sections I & III) improved significantly on day 11 compared to baseline and similarly on day 30. A positive effect was also seen on action tremor. In addition to the global mental status improvement, patients showed increases in neuropsychological performance in the domains of visuo-motor co-ordination and processing speed, auditory-verbal learning, episodic memory,phonological and semantic fluency (access and retrieval from lexical memory, selective inhibition and lexical access speed). Our results suggest that tDCS has a beneficial effect on Progressive Supranuclear Palsy patients' bulbar and motor symptoms, cognitive dysfunction, as well as daily activities, which lasts beyond the duration of the treatment.

Word-finding difficulty is a prevalent disease-related deficit in early multiple sclerosis

Background: Persons with multiple sclerosis (MS) commonly report word-finding difficulty clinically, yet this language deficit remains underexplored. Objective: To investigate the prevalence and nature of word-finding difficulty in persons with early MS on three levels: patient report, cognitive substrates, and neuroimaging. Methods: Two samples of early MS patients (n = 185 and n = 55; ⩽5 years diagnosed) and healthy controls (n = 50) reported frequency/severity of cognitive deficits and underwent objective assessment with tasks of rapid automatized naming (RAN), measuring lexical access speed, memory, word generation, and cognitive efficiency. High-resolution brain magnetic resonance imaging (MRI) derived measurements of regional cortical thickness, global and deep gray matter volume, and T2 lesion volume. Relationships among patient-reported word-finding difficulty, cognitive performance, and neural correlates were examined. Results: Word-finding difficulty was the most common cognitive complaint of MS patients and the only complaint reported more by patients than healthy controls. Only RAN performance discriminated MS patients with subjective word-finding deficits from those without subjective complaints and from healthy controls. Thinner left parietal cortical gray matter independently predicted impaired RAN performance, driven primarily by the left precuneus. Conclusion: Three levels of evidence (patient-report, objective behavior, regional gray matter) support word-finding difficulty as a prevalent, measurable, disease-related deficit in early MS linked to left parietal cortical thinning.

Visual Perception and Oculomotor Activity during Reading Tasks of Varying Complexity in Children Aged Seven to Ten Years

The paper presents the results of comparative analysis of visual perception (VP) and oculomotor activity in reading tasks of varying complexity in children aged seven to ten years with different levels of reading skills. We observed higher VP variables in children with good reading skills compared with poor readers. The formation of the VP system underlying the basic mechanism of reading, especially at the initial stage of learning, can be assessed by the following key parameters: noise tolerance, spatial relationships, and visual analysis/synthesis affording recognition of the graphic configuration of words, spelling (letter order), and semantics (word meaning). The speed of lexical access and eye movement programming, the accuracy of fixation point positioning, the amount of perceived symbolic information and lexemes and general context stored in the working memory are much higher in children with better qualification and reading experience. When a highly complex text beyond the current educational program is read, discrepancy in the oculomotor activity parameters (duration of progressive and adjustable fixations and the reading speed and time) between groups of children with different reading skills decreases.