Syntactic Deficits Research Articles

Bimodal aphasia and dysgraphia: Phonological output buffer aphasia and orthographic output buffer dysgraphia in spoken and sign language

We report a case of crossmodal bilingual aphasia -- aphasia in two modalities, spoken and sign language-- and dysgraphia in both writing and fingerspelling. The patient, Sunny, was a 42 year-old woman, after a left temporo-parietal stroke, a speaker of Hebrew, Romanian, and English and an adult learner, daily user of Israeli Sign language (ISL).We assessed Sunny’s spoken and sign languages using a comprehensive test battery of naming, reading, and repetition tasks, and also analysed her spontaneous-speech and sign. Her writing and fingerspelling were assessed using tasks of dictation, naming, and delayed copying.In spoken language production, Sunny showed a classical phonological output buffer (POB) impairment in naming, reading, repetition, and spontaneous production, with phonological errors (transpositions, substitutions, insertions, and omissions) in words and pseudo-words, and whole-unit errors in morphological affixes, function-words, and number-words, with a length effect. Importantly, her error pattern in ISL was remarkably similar in the parallel tasks, with phonological errors in signs and pseudo-signs, affecting all the phonological parameters of the sign (movement, handshape, location, and orientation), and whole-unit errors in morphemes, function-signs, and number-signs. Sunny’s impairment was selective to the POB, without phonological input, semantic-conceptual, or syntactic deficits. This shows for the first time how POB impairment, a kind of conduction aphasia, manifests itself in a sign language, and indicates that the POB for sign-language has the same cognitive architecture as the one for spoken language. It may also indicate similar neural underpinnings for spoken and sign languages.In writing, Sunny forms the first case of a selective type of dysgraphia in fingerspelling, orthographic (graphemic) output buffer dysgraphia. In both writing and fingerspelling, she made letter errors (letter transpositions, substitutions, insertions, and omissions), as well as morphological errors and errors in function words, and showed length effect. Sunny’s impairment was selective to the orthographic output buffer, whereas her reading, including orthographic input processing, was intact. This suggests that the orthographic output buffer is shared for writing and in fingerspelling, at least in a late learner of sign language. The results shed further light on the architecture of phonological and orthographic production.

Relative clause comprehension in Cantonese-speaking children with and without developmental language disorder.

Developmental Language Disorder (DLD), present in 2 out of every 30 children, affects primarily oral language abilities and development in the absence of associated biomedical conditions. We report the first experimental study that examines relative clause (RC) comprehension accuracy and processing (via looking preference) in Cantonese-speaking children with and without DLD, testing the predictions from competing domain-specific versus domain-general theoretical accounts. We compared children with DLD (N = 22) with their age-matched typically-developing (TD) children (AM-TD, N = 23) aged 6;6-9;7 and language-matched (and younger) TD children (YTD, N = 21) aged 4;7-7;6, using a referent selection task. Within-subject factors were: RC type (subject-RCs (SRCs) versus object-RCs (ORCs); relativizer (classifier (CL) versus relative marker ge3 RCs). Accuracy measures and looking preference to the target were analyzed using generalized linear mixed effects models. Results indicated Cantonese children with DLD scored significantly lower than their AM-TD peers in accuracy and processed RCs significantly slower than AM-TDs, but did not differ from the YTDs on either measure. Overall, while the results revealed evidence of a SRC advantage in the accuracy data, there was no indication of additional difficulty associated with ORCs in the eye-tracking data. All children showed a processing advantage for the frequent CL relativizer over the less frequent ge3 relativizer. These findings pose challenges to domain-specific representational deficit accounts of DLD, which primarily explain the disorder as a syntactic deficit, and are better explained by domain-general accounts that explain acquisition and processing as emergent properties of multiple converging linguistic and non-linguistic processes.

Grammatical Parallelism in Aphasia: A Lesion-Symptom Mapping Study.

Sentence structure, or syntax, is potentially a uniquely creative aspect of the human mind. Neuropsychological experiments in the 1970s suggested parallel syntactic production and comprehension deficits in agrammatic Broca's aphasia, thought to result from damage to syntactic mechanisms in Broca's area in the left frontal lobe. This hypothesis was sometimes termed overarching agrammatism, converging with developments in linguistic theory concerning central syntactic mechanisms supporting language production and comprehension. However, the evidence supporting an association among receptive syntactic deficits, expressive agrammatism, and damage to frontal cortex is equivocal. In addition, the relationship among a distinct grammatical production deficit in aphasia, paragrammatism, and receptive syntax has not been assessed. We used lesion-symptom mapping in three partially overlapping groups of left-hemisphere stroke patients to investigate these issues: grammatical production deficits in a primary group of 53 subjects and syntactic comprehension in larger sample sizes (N = 130, 218) that overlapped with the primary group. Paragrammatic production deficits were significantly associated with multiple analyses of syntactic comprehension, particularly when incorporating lesion volume as a covariate, but agrammatic production deficits were not. The lesion correlates of impaired performance of syntactic comprehension were significantly associated with damage to temporal lobe regions, which were also implicated in paragrammatism, but not with the inferior and middle frontal regions implicated in expressive agrammatism. Our results provide strong evidence against the overarching agrammatism hypothesis. By contrast, our results suggest the possibility of an alternative grammatical parallelism hypothesis rooted in paragrammatism and a central syntactic system in the posterior temporal lobe.

Language, cognitive and neuroimaging determinants of Primary Progressive Aphasia in Hebrew Speakers, a case series

AbstractBackgroundPrimary progressive aphasias (PPA) are a group of neurocognitive disorders caused by neurodegenerative diseases and defined by progressive deterioration of language capabilities. PPA are traditionally classified into three predominant variants: nonfluent‐agrammatic, semantic, and logopenic. Emerging studies suggest an individual’s spoken language impacts the clinical presentation of PPA variants, potentially leading to misdiagnosis in languages underrepresented in research. We aimed at phenotyping PPA in native speakers of Hebrew, a Semitic language, with unique characteristics such as: under‐representation of vowels in the orthography, which makes it easier to detect various types of dyslexia, rich inflectional and derivational morphology, making it easier to identify morphosyntactic impairments, and, together with object case, making word order more flexible, enabling the examination of various syntactic deficits (e.g. in syntactic‐movement).MethodsFour native Hebrew speakers diagnosed with PPA (Mesulam 2001 criteria), aged 58‐68, complaint duration prior to assessment 10‐60 months, underwent assessment in Rabin Medical Center, Israel. Each participant underwent neurological evaluation, brain magnetic resonance imaging (MRI), and multi‐domain cognitive testing. Regional brain atrophy on T1 weighted MRI was rated with validated visual atrophy scales. All participants subsequently underwent Hebrew language evaluation using Norm‐referenced tests, assessing syntax, lexical retrieval, reading (including words and nonwords sensitive to various dyslexia types), semantic and conceptual abilities tasks, and phonology.ResultsParticipant’s presenting complaint was word finding difficulty (n = 3) and non‐fluent speech (n = 1). All participants exhibited deficits in the comprehension and production of syntactic movement including one participant with no other language deficits on formal testing and no brain atrophy. Three participants exhibited various dyslexias including morphological deficits,attentional dyslexia, vowel dyslexia, and surface dyslexia. As expected, poor scores on tests of lexical retrieval and syntax were observed in subjects with severe left anterior‐temporal and left fronto‐insular atrophy respectively.ConclusionTo our knowledge, this is the first case series of PPA in native Hebrew speakers. Errors in syntactic movement and various dyslexia types were common in all subjects suggesting they may be useful in early‐stage diagnosis. Full results (language, cognitive and neuroimaging), including additional eight cases will be presented in the AAIC conference.

The ScreeLing: Detecting Semantic, Phonological, and Syntactic Deficits in the Clinical Subtypes of Frontotemporal and Alzheimer's Dementia.

The ScreeLing is a screening instrument developed to assess post-stroke aphasia, via the linguistic levels Syntax, Phonology, and Semantics. It could also be a useful test for the clinical subtypes of frontotemporal dementia (FTD) and Alzheimer's dementia (AD), as specific and often selective disorders are expected. Its ability to differentiate between the clinical subtypes of FTD and AD is, however, still unknown. We investigated differences in ScreeLing total and subscores, linguistic-level disorders' relationship with disease severity, and classification abilities, in patients with behavioral variant FTD (bvFTD; n = 46), patients with primary progressive aphasia (PPA; n = 105) (semantic variant primary progressive aphasia [svPPA], non-fluent variant primary progressive aphasia [nfvPPA], and logopenic variant primary progressive aphasia [lvPPA], AD [n = 20] and controls [n = 35]). We examined group differences in ScreeLing total and subscores, and one-, two- or three-level linguistic disorders using one-way analyses of covariance (ANCOVAs) or Quade's rank ANCOVA. We used frequency analyses to obtain the occurrence of the linguistic-level disorders. We determined sensitivity and specificity by the area under the curve by receiver-operating characteristics analyses to investigate classification abilities. The total score was lower in patients (bvFTD: 63.8 ± 8.5, svPPA: 58.8 ± 11.3, nfvPPA: 63.5 ± 8.4, lvPPA: 61.7 ± 6.6, AD: 63.8 ± 5.5) than controls (71.3 ± 1.0) (p < .001). Syntax subscores were lower in svPPA (19.4 ± 4.6; p < .001) and lvPPA (20.3 ± 3.2; p = .002) than controls (23.8 ± 0.4). Phonology subscores were lower in lvPPA (19.8 ± 2.6) than bvFTD (21.7 ± 2.8) (p = .010). Semantics subscores were lowest in svPPA (17.8 ± 5.0; p < .002). A selective phonological disorder was most prevalent in lvPPA (34.9%). The higher the disease severity, the more linguistic-level disorders. The optimal cutoff for the total score was 70, and 23 for all three subscores. Good classification abilities were found for the Semantics (svPPA vs. bvFTD), Phonology (lvPPA vs. svPPA), and Syntax (nfvPPA vs. lvPPA) subscores. This easy to administer test gives information about language processing with the potential to improve differential diagnosis in memory clinics and in the future potentially also clinical trial planning.

The role of verbal short-term memory in complex sentence comprehension: An observational study on aphasia.

The comprehension profile of people with agrammatism is a debated topic. Syntactic complexity and cognitive resources, in particular phonological short-term memory (pSTM), are considered as crucial components by different interpretative accounts. To investigate the interaction of syntactic complexity and of pSTM in sentence comprehension in a group of persons with aphasia with and without agrammatism. A cohort of 30 participants presenting with aphasia was assessed for syntactic comprehension and for pSTM. A total of 15 presented with agrammatism and 15 had fluent aphasia. Linear nested mixed-model analyses revealed a significant interaction between sentence type and pSTM. In particular, participants with lower pSTM scores showed a reduced comprehension of centre-embedded object relatives and long coordinated sentences. Moreover, a significant interaction was found between sentence type and agrammatism, with a lower performance for passives within the agrammatic group. These results confirm that pSTM is involved in the comprehension of complex structures with an important computational load, in particular coordinated sentences, and long-distance filler gap dependencies. On the contrary, the specific deficit of the agrammatic group with passives is a pure syntactic deficit, with no involvement of pSTM.

Lexical and syntactic deficits analyzed via automated natural language processing: the new monitoring tool in multiple sclerosis.

Impairment of higher language functions associated with natural spontaneous speech in multiple sclerosis (MS) remains underexplored. We presented a fully automated method for discriminating MS patients from healthy controls based on lexical and syntactic linguistic features. We enrolled 120 MS individuals with Expanded Disability Status Scale ranging from 1 to 6.5 and 120 age-, sex-, and education-matched healthy controls. Linguistic analysis was performed with fully automated methods based on automatic speech recognition and natural language processing techniques using eight lexical and syntactic features acquired from the spontaneous discourse. Fully automated annotations were compared with human annotations. Compared with healthy controls, lexical impairment in MS consisted of an increase in content words (p = 0.037), a decrease in function words (p = 0.007), and overuse of verbs at the expense of noun (p = 0.047), while syntactic impairment manifested as shorter utterance length (p = 0.002), and low number of coordinate clause (p < 0.001). A fully automated language analysis approach enabled discrimination between MS and controls with an area under the curve of 0.70. A significant relationship was detected between shorter utterance length and lower symbol digit modalities test score (r = 0.25, p = 0.008). Strong associations between a majority of automatically and manually computed features were observed (r > 0.88, p < 0.001). Automated discourse analysis has the potential to provide an easy-to-implement and low-cost language-based biomarker of cognitive decline in MS for future clinical trials.

The role of left temporo-parietal and inferior frontal cortex in comprehending syntactically complex sentences: A brain stimulation study

Background and objectivesSyntactic competence relies on a left-lateralized network converging on hubs in inferior-frontal and posterior-temporal cortices. We address the question whether anodal transcranial direct current stimulation (a-tDCS) over these hubs can modulate comprehension of sentences, whose syntactic complexity systematically varied along the factors embedding depths and canonicity. Semantic content and length of the sentences were kept identical and forced choice picture matching was required after the full sentence had been presented. MethodsWe used a single-blind, within-subject, sham-controlled design, applying a-tDCS targeting left posterior tempo-parietal (TP) and left inferior frontal cortex (FC). Stimulation sites were determined by individual neuro-navigation. 20 participants were included of whom 19 entered the analysis. Results were analysed using (generalized) mixed models. In a pilot-experiment in another group of 20 participants we validated the manipulation of syntactic complexity by the two factors embedding depth and argument-order. ResultsReaction times increased and accuracy decreased with higher embedding depth and non-canonical argument order in both experiments. Notably a-tDCS over TP enhanced sentence-to-picture matching, while FC-stimulation showed no consistent effect. Moreover, the analysis disclosed a session effect, indicating improvements of task performance especially regarding speed. ConclusionsWe conclude that the posterior ‘hub’ of the neuronal network affording syntactic analysis represents a ‘bottleneck’, likely due to working-memory capacity and the challenges of mapping semantic to syntactic information allowing for role assignment. While this does not challenge the role of left inferior-frontal cortex for syntax processing and novel-grammar learning, the application of highly established syntactic rules during sentence comprehension may be considered optimized, thus not augmentable by a-tDCS in the uncompromised network. Significance statementAnodal transcranial direct current stimulation (a-tDCS) over left temporo-parietal cortex enhances comprehension of complex sentences in uncompromised young speakers. Since a-tDCS over left frontal cortex did not elicit any change, the ‘bottleneck’ for the understanding of complex sentences seems to be the posterior, temporo-parietal rather than the anterior inferior-frontal ‘hub’ of language processing. Regarding the attested role of inferior-frontal cortex in syntax processing, we suggest that its function is optimized in competent young speakers, preventing further enhancement by (facilitatory) tDCS. Results shed light on the functional anatomy of syntax processing during sentence comprehension; moreover, they open perspectives for research in the lesioned language network of people with syntactic deficits due to aphasia.

The Repetition of Relative Clauses in Mandarin Children with Developmental Language Disorder

ABSTRACT This paper attempts to investigate the repetition of Relative Clauses (RCs) in Mandarin children with Developmental Language Disorder (DLD) (aged 4; 5 to 6; 0) and their typically developing (TD) peers. The results of a sentence repetition task indicate that Mandarin children with DLD perform significantly worse than both groups of TD children, and they tend to make errors involving the relativizer DE and are more likely to produce Non-RC responses. Furthermore, the gap type of RC or the adjective’s position does not affect our participants’ recall of the test sentences. We conclude that the symmetric performance of our participants in the subject RC and object RC conditions is because the structural intervention occurs in object RCs, but the linear intervention counts more in subject RCs. The syntactic deficit approach better explained the difficulty experienced by children with DLD in RC repetition. Theoretically, this study demonstrates that the Edge Feature Underspecification Hypothesis captures more characteristics of children with DLD in repeating RCs than previous representational theories.

Measures of Voice Quality as Indicators of Mild Cognitive Impairment

AbstractBackgroundNoticeable decline in communication skills of patients with Alzheimer’s disease are often observed in the early stages of the disease, years before the dementia emerges. Prior literature has identified language abnormalities such as decline of linguistic ability or syntactic deficits influenced by the cognitive impairment. While language‐related measures are able to characterize spoken words of speech samples, they are inherently incapable of quantifying the voice‐related properties such as emotion or voice quality. Focusing on automatically derived voice‐based biomarkers that reflect the voicing quality of speakers, our objective is to explore the usefulness of these measures at detecting mild cognitive impairment (MCI) as early indicators of MCI in machine learning models. We hypothesize that cognitive impairment influences the individual’s voice quality resulting in an abnormal periodicity in speech often known as vocal dysperiodicity.MethodWe analyzed acoustic properties of audio‐recordings of Craft Story test administered to 107 subjects (50 MCI and 57 healthy controls, mean age 81 yrs) from a recently completed randomized control trial aimed to enhance cognitive reserve by increasing social interactions using video‐chats (www.I-conect.org). In the Craft Story test, the examiner reads a short story to the participant who is asked to retell the story first immediately after hearing the story and next retell it after a 20‐minute delay. Using cepstral analysis method, we extracted cepstrum from both immediate recall (IR) and delayed recall (DR) tests, and utilized statistical measures to represent their acoustic characteristics. We also used recursive feature elimination to only select informative measures and utilized the support vector machine for building classification models.ResultCepstrum‐based Measures derived from the IR test achieved higher predictive ability than those derived from the DR test. Combining the measures derived from both IR and DR tests increased the classification results and achieved ROC AUC of 98.83% and 97.09% on gender‐balanced models trained on males and females, respectively.ConclusionOur results indicate that voice‐based measures are capable of detecting MCI from audio samples of the Craft Story capitalizing their potential use in automatic screening and telemonitoring of the disorder in research, clinical trials and ultimately clinical practice.

Auditory brainstem response deficits in learning disorders and developmental language disorder: a systematic review and meta-analysis

Although learning disorders (LD) and developmental language disorder (DLD) can be linked to overlapping psychological and behavioral deficits, such as phonological, morphological, orthographic, semantic, and syntactic deficits, as well as academic (e.g., reading) difficulties, they are currently separate diagnoses in the DSM-5 with explicit phenotypic differences. At a neural level, it is yet to be determined to what extent they have overlapping or distinct signatures. The identification of such neural markers/endophenotypes could be important for the development of physiological diagnostic tools, as well as an understanding of disorders across different dimensions, as recommended by the Research Domain Criteria Initiative (RDoC). The current systematic review and meta-analysis examined whether the two disorders can be differentiated based on the auditory brainstem response (ABR). Even though both diagnoses require hearing problems to be ruled out, a number of articles have demonstrated associations of these disorders with the auditory brainstem response. We demonstrated that both LD and DLD are associated with longer latencies in ABR Waves III, V, and A, as well as reduced amplitude in Waves V and A. However, multilevel subgroup analyses revealed that LD and DLD do not significantly differ for any of these ABR waves. Results suggest that less efficient early auditory processing is a shared mechanism underlying both LD and DLD.

Longitudinal changes in connected speech over a one-year span in the nonfluent/agrammatic variant of Primary Progressive Aphasia

ABSTRACT Background Connected speech assessment is essential to characterize the language features in primary progressive aphasia (PPA). This is especially true for the non-fluent/agrammatic variant (nfvPPA) in which one of the core features is agrammatism. Identification of agrammatism typically involves the analysis of sentence production, as in connected speech, in order to detect syntactic deficits. However, little is known about the longitudinal changes occurring in connected speech of individuals with non-fluent PPA. Aim The aim of this study was to assess changes in connected speech over a one-year span in participants with nfvPPA using semi-structured interviews. Methods and procedures We conducted a prospective group study including participants with nfvPPA (n=9) and age- and education-matched healthy controls (n=9). For each individual, connected speech was obtained using topic-directed interviews at two testing rounds, each approximately one year apart. Production on each task was recorded, transcribed and analyzed according to the Quantitative Production Analysis (QPA) protocol, a tool developed by Berndt and colleagues (2000) for the analysis of sentence production in aphasia. For each group, the probability of deterioration between the two testing rounds was estimated using Bayesian analysis. Results and outcomes For individuals with nfvPPA, statistical evidence of deterioration from the first testing round to the second was found for five variables, namely the proportion of pronouns, the proportion of verbs, the proportion of closed class words, the inflection index and the proportion of well-formed sentences. Conclusions Results from the present study suggest that variables relating to word-finding and morphology are more vulnerable to time and therefore may be relevant potential targets for intervention.

Morphosyntactic Skills Influence the Written Decoding Accuracy of Italian Children With and Without Developmental Dyslexia.

Some types of developmental dyslexia (DD) are associated with morphology. Deep DD leads to morphological and semantic errors, and possible comorbidity with syntactic deficits; phonological-output-buffer DD causes problems in decoding longer morphologically complex words. In addition, cross-linguistic studies highlight the effects of morphological awareness on reading accuracy and fluency. The role of morphosyntactic abilities on reading is, however, not clear. This study explores the influence of morphosyntactic competence on reading in Italian children with and without DD. A total of 14 children with DD and 28 with Typical Development (TD) attending the Italian primary school were tested on written decoding, syntactic comprehension of different grammatical structures, and syntactic production of direct object clitic pronouns. DD children were significantly less accurate and slower in reading than TD children. Syntactic skills of the two groups did not differ significantly, but some differences in their acquisitional pace emerged. Syntactic comprehension and production of direct-object-clitic pronouns predicted reading accuracy standard scores, thus suggesting that morphosyntactic abilities, beyond clitics’ weak phonological status, affect decoding accuracy. Decoding accuracy was influenced by reading errors related to morphology (morphological, semantic, and phonological-output-buffer errors). Decoding speed was a specific weakness of DD children and was rather affected by multi-letter combinations. Consistent with a dual-route approach to orthographic processing, we argue that accuracy depends on fine-grained decoding strategies maximizing the precise ordering of letters, thus it is more sensitive to morphosyntactic skills. Morphological reading errors were associated with phonologically weak (determiners, clitic pronouns, and prepositions) and salient words (verbs). This suggests that the decoding of function words and morphologically complex words is particularly demanding and related to both phonological and morphosyntactic skills. Age had a negative predictive effect on semantic errors, compatible with the gradual acquisition of lexical decoding strategies, which seemed to be slowed down by DD. We conclude that oral morphosyntactic skills play a role in reading accuracy in the Italian shallow orthography for both DD and TD children. It is then advisable to assess children’s linguistic profile during DD diagnoses to establish whether some reading errors are related to morphosyntactic weakness. In this case, ad hoc morphosyntactic training might support reading accuracy.

Processing Argument Structure and Syntactic Complexity in People with Schizophrenia Spectrum Disorders

IntroductionDeficits in language comprehension and production have been repeatedly observed in Schizophrenia Spectrum Disorders (SSD). However, the characterization of the language profile of this population is far from complete, and the relationship between language deficits, impaired thinking and cognitive functions is widely debated. ObjectiveThe aims of the present study were to assess production and comprehension of verbs with different argument structures, as well as production and comprehension of sentences with canonical and non-canonical word order in people with SSD. In addition, the study investigated the relationship between language deficits and cognitive functions. MethodsThirty-four participants with a diagnosis of SSD and a group of healthy control participants (HC) were recruited and evaluated using the Italian version of the Northwestern Assessment of Verbs and Sentences (NAVS, Cho-Reyes & Thompson, 2012; Barbieri et al., 2019). ResultsResults showed that participants with SSD were impaired – compared to HC – on both verb and sentence production, as well as on comprehension of syntactically complex (but not simple) sentences. While verb production was equally affected by verb-argument structure complexity in both SSD and HC, sentence comprehension was disproportionately more affected by syntactic complexity in SSD than in HC. In addition, in the SSD group, verb production deficits were predicted by performance on a measure of visual attention, while sentence production and comprehension deficits were explained by performance on measures of executive functions and working memory, respectively. DiscussionOur findings support the hypothesis that language deficits in SSD may be one aspect of a more generalized, multi-domain, cognitive impairment, and are consistent with previous findings pointing to reduced inter- and intra-hemispheric connectivity as a possible substrate for such deficits. The study provides a systematic characterization of lexical and syntactic deficits in SSD and demonstrates that psycholinguistically-based assessment tools may be able to capture language deficits in this population.

Description of connected speech across different elicitation tasks in the logopenic variant of primary progressive aphasia.

Despite its importance, in-depth analysis of connected speech is often neglected in the diagnosis of primary progressive aphasia (PPA) - especially for the logopenic variant (lvPPA) for which unreliable differential diagnosis has been documented. Only a few studies have been conducted on this topic in lvPPA. The aim of this study was to describe and compare lexico-semantic and morphosyntactic features of connected speech in participants with lvPPA, in comparison with healthy controls, using three different elicitation tasks (i.e., picture description, story narration and semi-structured interviews). In addition to a number of discourse features, we were particularly interested in the presence or absence of syntactic deficits in this PPA variant in line with recent findings. A prospective group study was conducted to compare lvPPA participants (n = 13) to age- and education-matched healthy controls (n = 13). For each individual, connected speech was obtained using three tasks: (1) The Cookie Theft picture description; (2) Cinderella Story; (3) Topic-directed interview. Production on each task was recorded, transcribed and analysed according to the Quantitative Production Analysis (QPA) protocol, a tool developed by Berndt etal. (2000) for the analysis of sentence production in aphasia. Differences between lvPPA and healthy controls and among elicitation tasks were analysed using repeated measures multilevel mixed-effects regression, separately for each outcome. Four measures were significantly different between lvPPA participants and healthy controls across all elicitation tasks. Specifically, lvPPA participants produced a reduced proportion of open-class words, a higher proportion of verbs, a higher proportion of pronouns and fewer well-formed sentences. For these measures, the difference between lvPPA and healthy controls was consistent among elicitation tasks, except for the proportion of well-formed sentences, where the difference between the two groups was significantly greater in the story narration task than in the other tasks. Across elicitation tasks that used the same analysis protocol (i.e., QPA), a similar pattern of deficits in connected speech emerged in lvPPA patients. Importantly, the findings replicate previous studies, which used different elicitation tasks and analysis protocols. Especially in relation to the documented syntactic deficits, these findings provide implications for differential diagnosis in PPA. What is already known on the subject Connected speech analysis can provide an important contribution to the language assessment for the logopenic variant of primary progressive aphasia (lvPPA). However, only a few studies have been conducted with this population. What this paper adds to existing knowledge This study highlights differences between patients with lvPPA and healthy controls regarding the proportion of open-class words, nouns, verbs and well-formed sentences. What are the potential or actual clinical implications of this work? Importantly, our results highlight syntactic deficits in the same group of individuals with lvPPA, using the same analysis protocol and across various elicitation tasks, which has implications for differential diagnosis.

Aphasia associated with lacunar infarctions

HintergrundAphasien gehören nicht zu den typischen klinischen Manifestationen lakunärer Hirninfarkte, sind jedoch im Rahmen seltener atypischer lakunärer Syndrome beschrieben.Ziel der ArbeitBeschreibung von Aphasiemustern und betroffener Fasertrakte bei lakunären Infarkten.Material und MethodenFallserie von drei Patienten mit in der Magnetresonanztomographie nachgewiesenen lakunären Hirninfarkten und Aphasie. Identifikation betroffener Faserbahnen mittels Fasertraktographie der koregistrierten Schädigungsorte in Gehirnen zweier gesunder Probanden.ErgebnisseRadiologisch waren die Lakunen, die Aphasien hervorriefen, weit lateral im Marklager der linken Hemisphäre gelegen und befanden sich im Vergleich zu der Lakune eines nichtaphasischen Kontrollpatienten weiter rostrodorsal. Klinisch fand sich trotz Aussparung des Kortex, Thalamus und weiter Teile der Basalganglien eine leichte bis moderate nichtflüssige Aphasie mit syntaktischen Defiziten. In der Fasertraktographie zeigten die aphasischen im Vergleich zum nichtaphasischen Patienten eine stärkere Affektion der Fasern des linken Fasciculus arcuatus sowie eine Beteiligung des frontostriatalen und frontalen Aslant-Trakts.DiskussionLinks lateral gelegene lakunäre Infarkte können durch Beteiligung sprachrelevanter Fasertrakte eine klinisch relevante Aphasie hervorrufen.

Relative Clause Sentence Processing in Korean-Speaking School-Aged Children With and Without Specific Language Impairment.

Purpose The goal of this study was to examine online and off-line sentence processing using Korean language relative clause sentences between children with specific language impairment (SLI) and children with typical development (TD). Method Twenty-four children with TD and 19 children with SLI participated in this study. Children completed online and off-line sentence-processing tasks using relative clause sentences. The response time (RT) data obtained from the online processing task were analyzed at each word position and between adjacent words for items answered both correctly and incorrectly on the off-line comprehension task. A linear mixed-effects model and a generalized linear mixed-effects model were used to analyze the performances on the online/off-line sentence-processing task between the two groups. Results The results revealed that the processing pattern of RTs on the online processing task differed between the two groups, such that the SLI group did not show the predicted RT increase while the TD group did. Also, the SLI group processed each word with comparable or faster reading rates than the TD group. On the off-line comprehension task, the SLI group performed poorly compared to the TD group. Conclusions Processing of syntactically complex sentences differed between the TD and SLI groups, such that the SLI group had lower accuracy on the off-line comprehension task and was less efficient on the online processing task as compared to the TD group. These results mainly support the syntactic deficit account in children with SLI.

Gender agreement in SLI: A study on production and inflection of articles in German

ABSTRACT This study addresses the question of whether gender agreement is impaired in SLI German. Article production and gender marking on articles were examined in three groups of German-speaking children: 10 children with Specific Language Impairment (SLI), 10 age-matched typically developing (TD) children, and 10 TD children who were on average two years younger. Gender marking on articles did not reveal any evidence of an agreement deficit in the SLI group. Nevertheless, the children of the SLI group had a selective deficit in assigning the correct gender to neuter nouns. Regarding article production, it was found that article omissions were more frequent in the SLI group than in the age-matched TD group. However, these omissions cannot be clearly attributed to a deficit in gender agreement. The data indicate that article omissions may also reflect an avoidance strategy due to a lack of gender information. These results provide evidence for the ability of SLI children to acquire and use rule-governed syntactic computations. This is incompatible with accounts of SLI that posit a broad syntactic deficit in these children.

The Effect of Syntactic Impairment on Errors in Reading Aloud: Text Reading and Comprehension of Deaf and Hard of Hearing Children.

Deaf and Hard of Hearing (DHH) children show difficulties in reading aloud and comprehension of texts. Here, we examined the hypothesis that these reading difficulties are tightly related to the syntactic deficit displayed by DHH children. We first assessed the syntactic abilities of 32 DHH children communicating in spoken language (Hebrew) aged 9;1–12;2. We classified them into two groups of DHH children—with and without a syntactic deficit according to their performance in six syntactic tests assessing their comprehension and production of sentences with syntactic movement. We also assessed their reading at the single word level using a reading aloud test of words, nonwords, and word pairs, designed to detect the various types of dyslexia, and established, for each participant, whether they had dyslexia and of what type. Following this procedure, 14 of the children were identified with a syntactic deficit, and 15 with typical syntax (3 marginally impaired); 22 of the children had typical reading at the word level, and 4 had dyslexia (3 demonstrated sublexical reading). The main experiment examined reading aloud and comprehension of 6 texts with syntactic movement (which contained, e.g., relative clauses and topicalized sentences), in comparison to 6 parallel texts without movement. The results indicated a close connection between syntactic difficulties and errors in reading aloud and in comprehension of texts. The DHH children with syntactic deficit made significantly more errors in reading aloud and more comprehension errors than the DHH children with intact syntax (and than the hearing controls), even though most of them did not have dyslexia at the word level. The DHH children with syntactic deficit made significantly more reading errors when they read texts with syntactic movement than on matched texts without movement. These results indicate that difficulties in text reading, manifesting both in errors in reading aloud and in impaired comprehension, may stem from a syntactic deficit and may occur even when reading at the word level is completely intact.

Implicit-statistical learning in aphasia and its relation to lesion location

BackgroundImplicit-statistical learning (ISL) research investigates whether domain-general mechanisms are recruited in the linguistic processes that require manipulation of patterned regularities (e.g. syntax). Aphasia is a language disorder caused by focal brain damage in the left fronto-temporal-parietal network. Research shows that people with aphasia (PWA) with frontal lobe lesions manifest convergent deficits in syntax and ISL mechanisms. So far, ISL mechanisms in PWA with temporal or parietal lobe lesions have not been systematically investigated. AimsWe investigated two complementary hypotheses: 1) the anatomical hypothesis, that PWA with frontal lesions display more severely impaired ISL abilities than PWA with posterior lesions and 2) the behavioural hypothesis, that the magnitude of impairment in ISL mechanisms correlates to syntactic deficits in aphasia. MethodsWe tested 13 PWA, 5 with frontal lesions and 8 with posterior lesions, and 11 non-brain-damaged controls on a visual statistical learning (VSL) task. In addition, all PWA completed several linguistic tasks. Reaction times, obtained in the VSL task, were analyzed using linear mixed-effects model. Correlational statistics were used to assess the relationship between VSL task performance and linguistic measures. Results and DiscussionWe did not find support for the anatomical hypothesis as patients with spared frontal regions also manifested impaired ISL mechanisms. This is attributed to a) ISL mechanisms being vulnerable to other cognitive dysfunctions and/or b) ISL mechanisms anatomically extending to the posterior brain regions. Notably, ISL mechanisms were impaired, but not absent in aphasia. With regards to the behavioural hypothesis, we provide empirical evidence of correlation between ISL mechanisms and syntactic, but not lexical impairment in aphasia. We discuss both the theoretical contributions to the debate of domain-independence of ISL mechanisms and clinical implications for implicit language therapy.