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

Background: Implicit-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. Aims: We 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. Methods: We 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 Discussion: We 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

THE AFTERCARE SURVEY:Assessment and intervention practices after brain tumour surgery in Europe

Introduction People with gliomas need specialized neurosurgical, neuro-oncological, psycho-oncological, and neuropsychological care. The role of language and cognitive recovery and rehabilitation in patients’ well-being and resumption of work is crucial, but there are no clear guidelines for the ideal timing and character of assessments and interventions. The goal of the present work was to describe representative (neuro)psychological practices implemented after brain surgery in Europe. Methods An online survey was addressed to professionals working with individuals after brain surgery. We inquired about the assessments and interventions and the involvement of caregivers. Additionally, we asked about recommendations for an ideal assessment and intervention plan. Results Thirty-eight European centres completed the survey. Thirty of them offered at least one post-surgical (neuro)psychological assessment, mainly for language and cognition, especially during the early recovery stage and at long-term. Twenty-eight of the participating centres offered post-surgical therapies. Patients who stand the highest chances of being included in evaluation and therapy post-surgically are those who underwent awake brain surgery, harboured a low-grade glioma, or showed poor recovery. Nearly half of the respondents offer support programs to caregivers, and all teams recommend them. Treatments differed between these offered to individuals with low-grade glioma versus those with high-grade glioma. The figure of caregiver is not yet fully recognized in the recovery phase. Conclusion We stress the need for more complete rehabilitation plans, including the emotional and health-related aspects of recovery. In respondents´ opinions, assessment and rehabilitation plans should also be individually tailored and goal-directed (e.g., professional reinsertion)

Understanding discourse-linked elements in aphasia: a threefold study in Russian

Background: Agrammatic speakershaveproblemswithgrammaticalencodinganddecoding.However, not allsyntacticprocessesareequallyproblematic:presenttimereference, who questions,andreflexives can beprocessedbynarrowsyntaxaloneandarerelativelysparedcomparedtopasttimereference, which questions,andpersonalpronouns,respectively.Thelatterneedadditionalaccesstodiscourseand information structurestolinktotheirreferentoutsidetheclause(Avrutin,2006).Linguisticprocessing that requiresdiscourse-linkingisdifficult foragrammaticindividuals:verbmorphologywithreferenceto the pastismoredifficult thanwithreferencetothepresent(Bastiaanseetal.,2011).Thesameholdsfor which questionscomparedto who questionsandforpronounscomparedtoreflexives(Avrutin,2006). These resultshavebeenreportedindependentlyfordifferentpopulationsindifferentlanguages. The currentstudy,forthe first time,testedallconditionswithinthesamepopulation. Aims: Wehadtwoaimswiththecurrentstudy.First,wewantedtoinvestigatewhetherdiscourse- linking isthecommondenominatorofthedeficits intimereference, wh questions,andobjectpronouns. Second, weaimedtocomparethecomprehensionofdiscourse-linkedelementsinpeoplewith agrammatic and fluent aphasia. Methods andprocedures: Threesentence-picture-matchingtaskswereadministeredto10agrammatic, 10 fluent aphasic,and10non-brain-damagedRussianspeakers(NBDs):(1)theTestforAssessing ReferenceofTime(TART)forpresentimperfective(referencetopresent)andpastperfective(referenceto past), (2)theWhExtractionAssessmentTool(WHEAT)for which and who subject questions,and(3)the Reflexive-PronounTest(RePro)forreflexiveandpronominalreference. Outcomes andresults: NBDs scoredatceilingandsignificantly higherthantheaphasicparticipants.We found anoveralleffectofdiscourse-linkingintheTARTandWHEATfortheagrammaticspeakers,andin all threetestsforthe fluent speakers.ScoresontheReProwereatceiling. Conclusions: The resultsareinlinewiththepredictionthatproblemsthatindividualswithagrammatic and fluent aphasiaexperiencewhencomprehendingsentencesthatcontainverbswithpasttime reference, which questionwordsandpronounsarecausedbythefactthattheseelementsinvolve discourse linking.Theeffectisnotspecific toagrammatism,althoughitmayresultfromdifferent underlyingdisordersinagrammaticand fluent aphasia