Visual Confrontation Naming Research Articles

Influence of Infarct Morphology and Patterns on Cognitive Outcomes After Endovascular Thrombectomy.

To assess the association of qualitative and quantitative infarct characteristics and 3 cognitive outcome tests, namely the Montreal Cognitive Assessment (MOCA) for mild cognitive impairment, the Boston Naming Test for visual confrontation naming, and the Sunnybrook Neglect Assessment Procedure for neglect, in large vessel occlusion stroke. Secondary observational cohort study using data from the randomized-controlled ESCAPE-NA1 trial (Safety and Efficacy of Nerinetide in Subjects Undergoing Endovascular Thrombectomy for Stroke), in which patients with large vessel occlusion undergoing endovascular treatment were randomized to receive either intravenous Nerinetide or placebo. MOCA, Sunnybrook Neglect Assessment Procedure, and 15-item Boston Naming Test were obtained at 90 days. Total infarct volume, gray matter, and white matter infarct volumes were manually measured on 24-hour follow-up imaging. Infarcts were also visually classified as either involving the gray matter only or both the gray and white matter and scattered versus territorial. Associations of infarct variables and cognitive outcomes were analyzed using multivariable ordinal or binary logistic regression models. Of 1105 patients enrolled in ESCAPE-NA1, 1026 patients with visible infarcts on 24-hour follow-up imaging were included. MOCA and Sunnybrook Neglect Assessment Procedure were available for 706 (68.8%) patients and the 15-item Boston Naming Test was available for 682 (66.5%) patients. Total infarct volume was associated with worse MOCA scores (adjusted common odds ratio per 10 mL increase, 1.05 [95% CI, 1.04-1.06]). After adjusting for baseline variables and total infarct volume, mixed gray and white matter involvement (versus gray matter-only adjusted common odds ratio, 1.92 [95% CI, 1.37-2.69]), white matter infarct volume (adjusted common odds ratio per 10 mL increase 1.36 [95% CI, 1.18-1.58]) and territorial (versus scattered) infarct pattern (adjusted common odds ratio, 1.65 [95% CI, 1.15-2.38]) were associated with worse MOCA scores. Results for Sunnybrook Neglect Assessment Procedure and 15-item Boston Naming Test were similar, except for the territorial infarct pattern, which did not reach statistical significance in multivariable analysis. Besides total infarct volume, infarcts that involve the white matter and that show a territorial distribution were associated with worse cognitive outcomes, even after adjusting for total infarct volume.

Language impairments in seropositive and seronegative autoimmune encephalitis

Background and objectiveAutoimmune encephalitis (AE) is a rare neuroinflammatory disease affecting the central nervous system. To examine language functions in patients with different subsets of AE consisting of seropositive and seronegative groups.MethodsFifty-two patients were recruited from neurology departments in Melbourne, Australia, who met clinical criteria for possible AE. Language tests include the Naming Test from the Sydney Language Battery (SydBat), the semantic fluency trial from the Controlled Oral Word Association Test (COWAT), and the Vocabulary and Similarities subtests of the Weschler Abbreviated Scale of Intelligence–Second Edition. The results were standardised with normative data.ResultsThe mean age of our cohort was 52.5 years old, with the average time from hospital admission to recruitment being 38.41 months. At an aggregate level, none of the mean language test z-scores were below normative data. At the patient level, impairment rates were 18.37% for COWAT (animals), 28.57% for SydBat (naming), 4.65% for Similarities, and 4.55% for Vocabulary. Chi-squared goodness of fit tests indicated that observed performances were significantly below expected performances for the SydBat (naming) test (p < 0.0001) and COWAT (animals) (p = 0.004).DiscussionWhile, on average, language functions were within normal limits in patients with AE, but a subgroup exhibited lower performance in semantic fluency and visual confrontation naming, with impairment rates below expected norms. To advance understanding of language in chronic AE patients, exploring the impact of seizure burden, antiseizure medication use, and the relationship of language functions with other cognitive functions is crucial.

Evaluation of reliability and validity of the Serbian Aphasia Screening Test.

A rise in strokes worldwide means that the number of people affected by aphasia is increasing. Early and accurate diagnosis of aphasia is crucial for recovery. Presently, there are no dedicated screening tests tailored for evaluating aphasia in Serbian-speaking individuals. This paper presents and describes the psychometric properties of the Serbian Aphasia Screening Test (SAST), a novel aphasia screening tool designed specifically for Serbian speakers. This initiative fills the gap in aphasia assessment tools for the Serbian population, providing a comprehensive and culturally sensitive approach to the evaluation of language disorders. Data using the SAST were collected from 240 participants: 120 Serbian speakers with aphasia after stroke compared to 120 neurotypical individuals. The assessment included the following subtests: conversation, verbal automatized sequences, auditory comprehension, visual confrontation naming, responsive naming, repetition of words, repetition of sentences, oral word reading, oral sentence reading, reading comprehension, and writing. The main objectives were to ascertain the psychometric qualities of the SAST, including inter-rater reliability of scoring, test-retest reliability, reliability of the individual subtests, overall test reliability, and inter-correlations among subtests. Additionally, the study evaluated the discriminatory capability of the SAST in distinguishing between individuals with aphasia and neurotypical controls, as well as between individuals with different types of aphasia. The findings revealed that the SAST has excellent inter-rater reliability, test-retest reliability, and internal consistency. There were statistically significant differences between individuals with aphasia and neurotypical controls on all SAST subtests. Furthermore, the study identified significant differences in language profiles among participants with different types of aphasia. The significant correlations between scores on the SAST and on the Boston Diagnostic Aphasia Examination (BDAE) suggest good convergent validity of the SAST. The results underscore the robust psychometric properties of this novel screening assessment (SAST) and its ability to effectively discriminate between diverse linguistic abilities within different aphasia syndromes in Serbian speaking individuals.

A - 11 Cognitive and Clinical Correlates of Olfactory Function in Adults with Epilepsy.

Olfactory dysfunction is well-documented in epilepsy. We recently found that olfactory assessment may have clinical utility in identifying surgical candidates with intractable epilepsy who benefit from magnetic resonance-guided laser interstitial thermal therapy (MRgLiTT). However, the demographic, clinical, and cognitive correlates of olfaction in epilepsy remain unclear and could aid in understanding its potential utility in clinical examinations. We identified 60 outpatients with epilepsy (mean age = 38.22 ± 13.84years; 50% male; 89.3% right-handed; seizure location: 45.0% left, 33.3% right, 13.3% bilateral, 8.3% unspecified) referred for neuropsychological evaluation in the Johns Hopkins Division of Medical Psychology Clinic. Neuropsychological evaluation included the 16-item Sniffin' Sticks Odor Identification Test. Linear regression models were used to examine associations between 1) olfaction and demographic/clinical characteristics (age, sex, education, duration of illness, seizure laterality) and 2) olfaction and cognition (processing speed, language, auditory-verbal and visuospatial memory, executive functioning; adjusted for demographic/clinical characteristics). Olfactory performance was not significantly associated with demographic or clinical characteristics. Across all participants, better olfactory performance was associated with better auditory-verbal memory (B = 5.04, t(46) = 4.16, p < 0.001) and visual confrontation naming (B = 1.53, t(45) = 4.11, p < 0.001) with correction for multiple comparisons. In a subset with lateralizing epilepsy (n = 47), better odor identification performance remained a significant predictor of the aforementioned cognitive measures with adjustment for demographic and clinical characteristics. Consistent with work in other neurologic conditions, our preliminary findings indicate that olfactory function is associated with verbally-mediated neuropsychological measures in epilepsy. Future studies utilizing pre-surgical neuroimaging will examine the association between olfaction, cognition, and radiographic markers of tissue integrity in epilepsy.

B - 42 The Effects of Bilingualism on a Visual Confrontational Naming Task.

This preliminary study examines the effects of bilingualism on a modified confrontational naming task (CNT) in native and non-native English speakers. The broad objective was to explore specific aspects of bilingualism that affected performance, to better inform good clinical practice in neuropsychology for linguistically diverse populations. A-priori hypotheses included: 1) Age of English acquisition (AOA) predicts CNT performance; 2) There would be a significant group diff between native and non-native English speakers; and 3) There would be significant group differences between multilingual and bilinguals on CNT performance. The Boston Naming Test (BNT) and the Language Experience and Proficiency Questionnaire (LEAP-Q) were modified and administered via Qualtrix. A total of 30 adults participated in the study, including 15 men and 15 women (Mage = 28.83, SDage = 1.71), 17 Asian Americans/Asians, 5 White/Caucasian Americans, 4 Black or African Americans, 2 Latino/a/x, and 2 Native Americans, 13 participants who were native English-speakers, and 17 who were non-native English-speakers. All participants were bilingual and denied any history of neurological conditions. Regression analysis and Analysis of Variance were conducted to test a-priori hypotheses. Findings supported H1, as AOA significantly predicted confrontational naming performance on the modified version of BNT, b = -0.480, t = -3.097, p = 0.005. H2 and H3 were not supported as there were no significant group differences. This suggests that AOA should be considered when administering and interpreting CNT performance in bilinguals. Given the small sample size, bigger-scale replication might be beneficial to examine specific aspects of bilingualism affecting CNT performance.

Stress phenotypes in epilepsy: impact on cognitive functioning and quality of life.

Drug-resistant epilepsy has been proposed as a chronic stress model. Stress can be measured in terms of chronicity (epilepsy duration) and intensity (comorbidities), with depression and anxiety among the most important comorbidities in epilepsy due to its prevalence and its relationship with cognitive functioning and quality of life. This study aims to establish phenotypes according to how patients face a stressful condition (epilepsy) and examine differences in cognition and quality of life depending on these phenotypes. We hypothesize that there will be an interrelationship between epilepsy duration and negative affectivity, and these variables will influence cognition and quality of life. 170 patients (82 men and 88 women) underwent a neuropsychological evaluation in which trait anxiety, depression, attention and executive function, verbal and visual memory, language, emotional recognition, and quality of life were assessed. Hierarchical clustering was performed using z-scores for three variables: trait anxiety; depression; and epilepsy duration. Three clusters were found: vulnerable (high negative affectivity and short duration); resilient (moderate negative affectivity and long duration); and low-impact group (low negative affectivity and short duration). Results show that the vulnerable group had poorer cognitive functioning and quality of life than the other groups. Specifically, the vulnerable group had poorer scores than the low-impact group on verbal memory, visual confrontation naming, and quality of life (except seizure worry). Furthermore, resilient patients had better scores than the low-impact group on cognitive flexibility variables, but lower scores on some quality-of-life subscales (i.e., overall quality of life, emotional well-being, and energy). Finally, the vulnerable group had poorer scores than the resilient group in executive functioning, naming, and quality of life. These results suggest that dealing with stress in patients with epilepsy is related to cognitive performance and quality of life. These findings underline the relevance of considering comorbidities in epilepsy and may be useful for detecting vulnerable or resilient profiles as risk or protective factors for cognitive and quality of life decline.

The Greek Australian neuropsychological normative study: tests & norms for Greek Australians aged 70-85 years

ABSTRACT Objective Access to valid and reliable neuropsychological measures for use with culturally diverse groups in Australia is limited. The aim of this study was to adapt and translate a selection of English language neuropsychological tests, employ several existing standardised Greek language tests, and provide specific reference group normative data for Greek Australian older adults. Method A convenience sample of 90 healthy older Greek Australians (M = 77.14 ± 4.46; range = 70–85), with a primary school level of education (M = 5.60 ± 0.68; Range = 4–6), was recruited throughout the Melbourne metropolitan area. Several neuropsychological measures were administered which assessed domains such as verbal and visual memory, confrontational naming, and executive functions. Results Regression modelling revealed that age, education and sex predicted between 5% and 35% of the variance of test scores, with age being the most significant predictor of performance across a majority of measures. Therefore, the normative data for all tests were stratified according to three age bands (70–74, 75–79, 80–85). Conclusions The use of culture-specific tests and norms for assessment of older Greek-Australians with limited education may facilitate accuracy of assessment findings, improve diagnostic outcomes, and reduce misclassification.

Arithmetic Word-Problem Solving as Cognitive Marker of Progression in Pre-Manifest and Manifest Huntington's Disease.

Arithmetic word-problem solving depends on the interaction of several cognitive processes that may be affected early in the disease in gene-mutation carriers for Huntington's disease (HD). Our goal was to examine the pattern of performance of arithmetic tasks in premanifest and manifest HD, and to examine correlations between arithmetic task performance and other neuropsychological tasks. We collected data from a multicenter cohort of 165 HD gene-mutation carriers. The sample consisted of 31 premanifest participants: 16 far-from (>12 years estimated time to diagnosis; preHD-A) and 15 close-to (≤12 years estimated time to diagnosis; preHD-B), 134 symptomatic patients (early-mild HD), and 37 healthy controls (HC). We compared performance between groups and explored the associations between arithmetic word-problem solving and neuropsychological and clinical variables. Total arithmetic word-problem solving scores were lower in preHD-B patients than in preHD-A (p < 0.05) patients and HC (p < 0.01). Early-mild HD patients had lower scores than preHD patients (p < 0.001) and HC (p < 0.001). Compared to HC, preHD and early-mild HD participants made more errors as trial complexity increased. Moreover, arithmetic word-problem solving scores were significantly associated with measures of global cognition (p < 0.001), frontal-executive functions (p < 0.001), attention (p < 0.001) visual working memory (p < 0.001), mental rotation (p < 0.001), and confrontation naming (p < 0.05). Arithmetic word-problem solving is affected early in the course of HD and is related to deficient processes in frontal-executive and mentalizing-related processes.

The 30-item and 15-item Boston naming test Czech version: Item response analysis and normative values for healthy older adults

ABSTRACT Objective The Boston Naming Test (BNT) is the most widely used test to assess visual confrontation naming in both research and clinical settings. Recently, an abbreviated Czech version of the BNT was described. The purpose of this study is to assess the validity of this new test at the item level with advanced psychometric methods to assess its equivalence with the original test. The rationale was to help busy clinicians in the differential diagnosis of language disorders. Method We administered the BNT-30 (odd item form of BNT-60) (N = 535; 75.61 ± 9.11; 60–96 years) and shortened the BNT-15 (N = 754; 71.94 ± 7.88; 60–96 years) to a large sample of healthy older adults. Results Significant but low associations between BNT performance and age, education, and sex were found. We found strong evidence for the unidimensionality of both BNT-15/BNT-30 versions in healthy adults (p’s < .001). Conclusion In-depth psychometric analysis of the BNT-15 and BNT-30 Czech versions show that test stimuli function in a similar fashion as the original BNT. Normative values adjusting for the influence of age, education, and sex are provided for use in clinical settings and future cross-cultural comparisons.

Expanded Exploration of the Auditory Naming Test in Patients with Dementia.

Auditory naming tests are superior to visual confrontation naming tests in revealing word-finding difficulties in many neuropathological conditions. To delineate characteristics of auditory naming most likely to reveal anomia in patients with dementia, and possibly improve diagnostic utility, we evaluated a large sample of patients referred with memory impairment complaints. Patients with dementia (N = 733) or other cognitive impairments and normal individuals (N = 69) were evaluated for frequency of impairment on variables of the Auditory Naming Test (ANT) of Hamberger & Seidel versus the Boston Naming Test (BNT). Naming impairment occurred more frequently using the ANT total score (φ= 0.41) or ANT tip-of-the tongue score (TOT; φ= 0.19) but not ANT mean response time compared to the BNT in patients with dementia (p < 0.001). Significantly more patients were impaired on ANT variables than on the BNT in Alzheimer's disease (AD), vascular dementia (VaD), mixed AD/VaD, and multiple domain mild cognitive impairment (mMCI) but not in other dementias or amnestic MCI (aMCI). This differential performance of patients on auditory versus visual naming tasks was most pronounced in older, well-educated, male patients with the least cognitive impairment. Impaired verbal comprehension was not contributory. Inclusion of an ANT index score increased sensitivity in the dementia sample (92%). Poor specificity (41%) may be secondary to the inherent limitation of using the BNT as a control variable. The ANT index score adds diagnostic utility to the assessment of naming difficulties in patients with suspected dementia.

The Rapid Naming Test: Development and initial validation in typically aging adults

Objective Progressive word-finding difficulty is a primary cognitive complaint among healthy older adults and a symptom of pathological aging. Classic measures of visual confrontation naming, however, show ceiling effects among healthy older adults. To address the need for a naming test that is sensitive to subtle, age-related word-finding decline, we developed the Rapid Naming Test (RNT), a computerized, one-minute, speeded visual naming test. Method Functionally intact older (n = 145) and younger (n = 69) adults completed the RNT. Subsets of older adults also completed neuropsychological tests, a self-report scale of functional decline, amyloid-β PET imaging, and repeat RNT administration to determine test-retest reliability. Results RNT scores were normally distributed and exhibited good test-retest reliability. Younger adults performed better than older adults. Within older adults, lower scores were associated with older age. Higher scores correlated with measures of language, processing speed, and episodic learning and memory. Scores were not correlated with visuospatial or working memory tests. Worse performance was related to subjective language decline, even after controlling for a classic naming test and speed. The RNT was also negatively associated with amyloid-β burden. Conclusions The RNT appears to be a reliable test that is sensitive to subtle, age-related word-finding decline. Convergent and divergent validity are supported by its specific associations with measures relying on visual naming processes. Ecological validity is supported by its relationship with subjective real-world language difficulties. Lastly, worse performance was related to amyloid-β deposition, an Alzheimer’s disease biomarker. This study represents a key step toward validating a novel, sensitive naming test in typically aging adults.

Word retrieval across the biomarker-confirmed Alzheimer's disease syndromic spectrum

Alzheimer's disease (AD) is now conceptualized as a biological entity defined by amyloid and tau deposition and neurodegeneration, with heterogeneous clinical presentations. With the aid of in vivo biomarkers, clinicians are better poised to examine clinical syndromic variability arising from a common pathology. Word retrieval deficits, measured using verbal fluency and confrontation naming tests, are hallmark features of the early clinical stages of the amnestic presentations of AD, specifically in category fluency and naming with relatively spared letter fluency. As yet, there is no consensus regarding performance on these tests in atypical clinical phenotypes of AD, including posterior cortical atrophy (PCA) and logopenic primary progressive aphasia (lvPPA), in individuals who are amyloid-positive (Aβ+) but present with different clinical profiles and patterns of neurodegeneration compared to amnestic AD. The goal of the current study is to determine how Aβ+ individuals across the syndromic spectrum of AD perform on three different word retrieval tasks. A secondary goal is to determine the neuroanatomical substrates underlying word retrieval performance in these Aβ+ individuals. Thirty-two Aβ+ participants with the amnestic presentation, 16 with Aβ+ PCA, 22 with Aβ+ lvPPA, and 99 amyloid-negative (Aβ-) control participants were evaluated with verbal fluency and visual confrontation naming tests as well as high-resolution MRI. The Aβ+ patient groups were rated at very mild or mild levels of severity (CDR 0.5 or 1) and had comparable levels of global cognitive impairment (average MMSE = 23.7 ± 3.9). Behaviorally, we found that the word retrieval profile of PCA patients is comparable to that of amnestic patients, characterized by intact letter fluency but impaired category fluency and visual confrontation naming, while lvPPA patients demonstrated impairment across all tests of word retrieval. Across all AD variants, we observed that letter fluency was associated with cortical thickness in prefrontal, central precuneus, lateral parietal and temporal cortex, while category fluency and naming were associated with cortical thickness in left middle frontal gyrus, posterior middle temporal gyrus, and lateral parietal cortex. Visual confrontation naming was uniquely associated with atrophy in inferior temporal and visual association cortex. We conclude that a better understanding of the word retrieval profiles and underlying neurodegeneration across the AD syndromic spectrum will help improve interpretation of neuropsychological profiles with regard to the localization of neurodegeneration, particularly in the atypical AD variants.

Naming and Knowing Revisited: Eyetracking Correlates of Anomia in Progressive Aphasia.

Progressive naming impairment (i.e., anomia) is a core diagnostic symptom of numerous pathologies that impact anterior and inferior portions of the temporal lobe. For patients who experience such regional temporal lobe degeneration, patterns of language loss often parallel the degradation of semantic memory, an etiology of naming impairment known as semantic anomia. Previous studies of semantic anomia have focused extensively on the output of naming attempts by contrasting errors, omissions, and distortions as a function of item-level characteristics (e.g., prototypicality, semantic category). An alternative approach involves evaluating visual confrontation naming as the naming process unfolds. Techniques with high temporal resolution (e.g., eyetracking) offer a potentially sensitive mode of delineating the locus of impairment during naming. For example, a lexical retrieval disorder would hypothetically elicit normal gaze patterns associated with successful visual object recognition regardless of naming accuracy. In contrast, we hypothesize that semantic anomia would be distinguished by aberrant gaze patterns as a function of reduced top-down conceptually guided search. Here we examined visual object recognition during picture confrontation naming by contrasting gaze patterns time locked to stimulus onset. Patients included a cohort of patients with anomia associated with either primary progressive aphasia (N = 9) or Alzheimer’s disease (N = 1) who attempted to name 200 pictures over the course of 18–24 months. We retrospectively isolated correct and incorrect naming attempts and contrasted gaze patterns for accurate vs. inaccurate attempts to discern whether gaze patterns are predictive of language forgetting. Patients tended to show a lower fixation count, higher saccade count, and slower saccade velocity for items that were named incorrectly. These results hold promise for the utility of eyetracking as a diagnostic and therapeutic index of language functioning.

A-46 Impairments in Memory for “Who”, “When”, and “Where” are Detectable in Middle-Aged Adults

Abstract Objective We conducted a cross-sectional study to examine age-¬related differences in performance on a new test assessing memory for “who, when, and where” and associations among these elements. The test was designed to assess aspects of episodic memory by simulating an everyday experience of meeting a series of different people in different places across time. Method Healthy young (ages 18¬-25), middle-aged (ages 40-55), and older adults (ages 60+) were asked to remember a sequence of pictures of different faces paired with different places. After viewing the sequence, the participants were asked to pair each face with the correct place and put the face-place pairs in the correct sequence. Participants also completed a battery of standardized neuropsychological tests. Results Young adults remembered significantly more face-place pairs in the correct sequence than middle-aged (p &lt; .05) and older adults (p &lt; .05). There were no significant differences between middle-aged and older adults in the number of face-place pairs in correct sequence. Furthermore, young adults remembered significantly more face-place pairs irrespective of sequence than older adults (p &lt; .05). There were no significant differences between young and middle-aged adults or between middle-aged and older adults in the number of correct face-place pairs irrespective of sequence. Conclusions Using a new test that incorporates aspects of episodic memory, we found evidence for age-related differences in test performance beginning in middle age. We found that performance on the test correlated with performance on standardized measures of verbal memory and executive functioning but not visual confrontation naming.

Examination of the reliability and validity of the NAB Naming Test in a diverse clinical sample

Objective: The Boston Naming Test, Second Edition (BNT-2) and the Neuropsychological Assessment Battery (NAB) Naming Test are common measures to assess visual confrontation naming ability. The comparably newer NAB Naming Test is a potential alternative to the BNT-2, given the latter’s history of criticism. A recent psychometric investigation of the NAB Naming Test demonstrated sufficient reliability and validity in a large clinical sample; however, their study was limited by a lack of ethnic, racial, and language diversity, all of which can impact scores on naming tests.Method: The present study examined convergent and discriminant validity and internal consistency of the NAB Naming Test in a diverse clinical sample comprised of 225 veterans (87.6% men, 51.1% White/Caucasian, 29.3% bilingual, 64.0% with cognitive impairment). All but three participants identified as White/Caucasian, Hispanic/Latino or Black/African American. These psychometric properties were examined for the overall sample and for monolingual (English) and bilingual (English/Spanish) participants separately.Results: As expected, the NAB Naming Test demonstrated sufficient internal consistency and a negatively skewed distribution for the overall sample and monolingual and bilingual participants. Evidence for adequate convergent and discriminative validity was also established for monolingual and bilingual participants separately.Conclusion: In a diverse clinical sample with differing levels of self-reported language status, the NAB Naming Test demonstrated adequate psychometric properties. Although it represents a viable option in neuropsychological practice, continued awareness of patient-specific factors that could impact performance is recommended.

Audiovisual Lexical Retrieval Deficits Following Left Hemisphere Stroke.

Binding sensory features of multiple modalities of what we hear and see allows formation of a coherent percept to access semantics. Previous work on object naming has focused on visual confrontation naming with limited research in nonverbal auditory or multisensory processing. To investigate neural substrates and sensory effects of lexical retrieval, we evaluated healthy adults (n = 118) and left hemisphere stroke patients (LHD, n = 42) in naming manipulable objects across auditory (sound), visual (picture), and multisensory (audiovisual) conditions. LHD patients were divided into cortical, cortical–subcortical, or subcortical lesions (CO, CO–SC, SC), and specific lesion location investigated in a predictive model. Subjects produced lower accuracy in auditory naming relative to other conditions. Controls demonstrated greater naming accuracy and faster reaction times across all conditions compared to LHD patients. Naming across conditions was most severely impaired in CO patients. Both auditory and visual naming accuracy were impacted by temporal lobe involvement, although auditory naming was sensitive to lesions extending subcortically. Only controls demonstrated significant improvement over visual naming with the addition of auditory cues (i.e., multisensory condition). Results support overlapping neural networks for visual and auditory modalities related to semantic integration in lexical retrieval and temporal lobe involvement, while multisensory integration was impacted by both occipital and temporal lobe lesion involvement. The findings support modality specificity in naming and suggest that auditory naming is mediated by a distributed cortical–subcortical network overlapping with networks mediating spatiotemporal aspects of skilled movements producing sound.

Factors Explaining Language Performance After Training in Elders With and Without Subjective Cognitive Decline.

The present study explores if cognitive reserve, executive functions, and working memory capacity are predictive of performance in the language domain (specifically in sentence comprehension and naming) after a cognitive training intervention. Sixty-six Spanish older adults voluntarily participated in the study, classified either as older adults with subjective cognitive decline according to Jessen et al.’s (2014) criteria (n = 35; 70.94 ± 4.16 years old) or cognitively intact (n = 31; 71.34 ± 4.96 years old). Written sentence comprehension and visual confrontation naming were assessed both immediately after recruitment (at the baseline), and then 6 months later, once each participant had completed his/her cognitive training (a well-known program in Spain, called UMAM; English translation: Madrid City Council Memory Unit Program). Cognitive reserve, executive functions (cognitive flexibility and controlled interference efficiency), and working memory capacity were measured for all participants at the baseline. Results pointed out that the subjective cognitive decline group presented greater benefits in the language domain than cognitively intact participants. We also observed that lower executive functioning and working memory capacity at the baseline predicted larger benefits in language performance after training, but only in the group of cognitively intact older adults. However, selected predictors hardly explained subjective cognitive decline participants’ results in language performance after training.

Neuropsychological performance in patients with asymptomatic HIV-1 infection

ABSTRACTHuman immunodeficiency virus (HIV-1) infection and acquired immunodeficiency syndrome (AIDS) lead to neurocognitive disorders; however, there is still much knowledge to be gained regarding HIV-associated neurocognitive disorders. The purpose of this study was to assess the cognitive performance, instrumental activities of daily living, depression, and anxiety in patients with asymptomatic HIV-1 infections compared with seronegative participants without neurocognitive impairment. We studied a sample consisted of 60 patients with asymptomatic HIV-1 infections and 60 seronegative participants without neurocognitive impairment from the city of Barranquilla, Colombia, with a mean age of 36.07 years. A protocol of neuropsychological and psychopathological tests was applied to the participants. The group of patients with asymptomatic HIV infections significantly underperformed on tasks that assessed global cognitive screening, attention span, learning, phonemic verbal fluency, auditory-verbal comprehension, information processing speed, cognitive flexibility, and motor skills compared to the group of seronegative participants. No significant differences were found in memory, visual confrontation naming, vocabulary, inhibition, and instrumental activities of daily living. Additionally, the patients with asymptomatic HIV-1 infection had a higher anxiety index than the seronegative participants, but no significant difference was found in depression. A correlation was found between depression and anxiety. In conclusion, the patients with asymptomatic HIV-1 infection had lower cognitive performances than the seronegative participants in the cognitive functions mentioned above and more anxiety but still performed the instrumental activities of daily living.

Neural Correlates of Visual Confrontation Naming in Persian-Speaking Individuals: An fMRI Study

Background: Neural correlates of visual confrontation naming (VCN) have received considerable attention in previous literature. Recently, there have been a few studies that have reported the activation of the hippocampus during VCN tasks. Whether or not the hippocampus is directly involved in picture naming has clinical importance for patients with refractory mesial temporal lobe epilepsy (MTLE) who should undergo anterior temporal lobe resection (ATLR). Objectives: In this study, we investigated the neural network of VCN and the role of the hippocampus in Persian-speaking individuals by functional magnetic resonance imaging (fMRI) VCN paradigm. Subjects and Methods: Twenty right-handed, healthy, Persian-speaking adults underwent fMRI while performing VCN task. Pictures were selected from a Snodgrass and Vanderwart dataset that was normed for Persian speakers. VCN performance was assessed and entered as a covariate in whole-brain analysis. Region of interest (ROI)-based analysis was also used to obtain more accurate results. Results: Activation in the left hippocampus was significantly correlated with VCN performance. Participants with higher scores showed greater fMRI activation in their left hippocampus. Activation in left occipitotemporal regions, such as the left occipital fusiform gyrus, left temporal occipital fusiform gyrus, left temporal pole, left middle temporal gyrus, and left superior temporal gyrus also showed significant correlation with VCN performance. The main effects of VCN were also found in frontal and occipital regions, such as the left inferior frontal gyrus, right inferior frontal gyrus, right orbital frontal gyrus, right lateral occipital gyrus, right occipital fusiform gyrus, and right occipital pole. Activation in the inferior frontal gyrus was significantly left lateralized among all of the subjects. Conclusion: These findings suggest that good naming ability depends on fMRI activation in the speech-dominant hippocampus. We also found that a left-dominant network of occipitotemporal regions plays a dominant role in VCN performance in healthy Persian-speaking individuals.

Investigating the Anterior Temporal Lobe With Direct Intracranial Recordings.

Anterior temporal lobectomy, also known as cortico-amygdalohippocampectomy (CAH), is one of the most effective operations for medically intractable (“pharmacoresistant”) epilepsy and can be associated with a greater than 70% chance of seizure freedom in patients with temporal lobe epilepsy1-3. Despite the potential for an excellent seizure outcome after CAH, resection of language dominant anterior temporal lobe (ATL) is frequently associated with a pronounced and specific deficit in naming4. Neuropsychologically, deficits can be seen as a decline in visual confrontation naming (e.g., naming concrete entities as on the Boston Naming Test4), but the most striking deficits (and those that are most troubling to patients) are in proper naming of unique entities (e.g., famous faces as on the Iowa Famous Faces test5) and in learning new proper names. Lesion studies have provided consistent evidence that proper naming (e.g. of famous faces, landmarks) is dependent on the language dominant ATL6, 7. Interestingly, studies comparing CAH to selective amygdalohippocampectomy (where the ATL is partially disconnected, but spared) report no significant difference in cognitive decline between the two techniques8. In contrast, recent reports examining naming outcomes following selective laser ablation of the amygdala and hippocampus (a technique that spares ATL connectivity) report better postoperative naming outcomes9. Together, these findings suggest that language dominant CAH-associated naming impairment is a result of ATL resection or disconnection. Although the nature of CAH-associated naming impairment is well-studied, the physiologic mechanisms of naming in the ATL are poorly understood and are difficult to study using noninvasive techniques. One reason for this is the variation in ATL response patterns in functional magnetic resonance imaging 10, which may be attributed at least in part to signal dropout caused by susceptibility artifact that is particularly prominent around the ATL11, 12. Positron emission tomography has also been used7, 13, but is limited by low temporal resolution that cannot resolve the exquisite timing of language processes. Therefore, studying the physiologic correlates of cognition in the ATL is technically challenging, and noninvasive techniques to map ATL language cortex with high spatial and temporal resolution are not yet available. Recently, there has been increasing use of intracranial electrodes, which are implanted in patients with medically intractable epilepsy for localization of epileptic foci, to directly study the physiology of the ATL with excellent spatial and temporal resolution. An emerging body of literature14-17 demonstrates the utility of intracranial recordings for studying ATL physiology and has yielded important results that have increased knowledge about ATL function. Traditionally, coverage of the ATL has been achieved with an anteromedial strip electrode that provides sparse coverage of ATL cortex18. Recently, we developed a specialized electrode array that fits within the middle cranial fossa to provide dense and consistent coverage of ATL cortex for localization of both epileptogenic and eloquent cortex14. In this manuscript, we describe our preliminary work studying physiologic responses of the ATL during proper naming.