Role of medial premotor areas in action language processing in relation to motor skills

The literature reports that the supplementary motor area (SMA) and pre-supplementary motor area (pre-SMA) are involved in motor planning and execution, and in motor-related cognitive functions such as motor imagery. However, their specific role in action language processing remains unclear. In the present study, we investigated the impact of repetitive transcranial magnetic stimulation (rTMS) over SMA and pre-SMA during an action semantic analogy task (SAT) in relation with fine motor skills (i.e., manual dexterity) and motor imagery abilities in healthy non-expert adults. The impact of rTMS over SMA (but not pre-SMA) on reaction times (RT) during SAT was correlated with manual dexterity. Specifically, results show that rTMS over SMA modulated RT for those with lower dexterity skills. Our results therefore demonstrate a causal involvement of SMA in action language processing, as well as the existence of inter-individual differences in this involvement. We discuss these findings in light of neurolinguistic theories of language processing

The use of executive fluency tasks to detect cognitive impairment in individuals with subjective cognitive decline

Objective: Although evidence has indicated that subjective cognitive decline (SCD) may be an early sign of Alzheimer’s disease (AD), the objectification of cognitive impairment in SCD is challenging, mainly due to the lack of sensitivity in assessment tools. The present study investigated the potential contribution of two verbal fluency tasks with high executive processing loads to the identification of cognitive impairment in SCD. Methods: A total of 60 adults with SCD and 60 healthy controls (HCs) performed one free action (verb) fluency task and two fluency tasks with more executive processing load—an alternating fluency task and an orthographic constraint fluency task—and the results were compared. Result: In the free action fluency task, the performance of the participants with SCD and the HCs was similar. However, HCs performed significantly better than SCD in the alternating fluency task, which required mental flexibility, and the orthographic constraint fluency task, which required inhibition. Discussion: The study findings suggest that verbal fluency tasks with high executive processing load could be useful in detecting cognitive deficits at the preclinical stage of AD. The inclusion of such tests in assessment batteries should be considered in order to improve the detection of subtle cognitive impairment in preclinical major neurocognitive disorder populations

Normative data for phonemic and semantic verbal fluency test in the adult french-Quebec population and validation study in Alzheimer's disease and depression

Objective: Verbal fluency tasks are principally used to assess lexical access and have shown usefulness for differential diagnosis. The purpose of Study 1 was to provide normative data in the adult French–Quebec population (Canada) for semantic verbal fluency (animals), for two sets of phonemic verbal fluency (TNP and PFL), and for letter P alone (60 seconds per category/letter). The objectives of Study 2 were to establish the diagnostic and predictive validity of the present tasks and normative data in Alzheimer’s disease (AD) and major depressive episode (MDE). Method: The normative sample consisted of 932 participants aged 19–91 years. Based on multiple linear regressions, equations to calculate Z-scores were provided. To assess validity, performance of 62 healthy participants was compared to 62 participants with AD and 41 with MDE aged over 50. Results: Age and education, but not gender, predicted performance on each verbal fluency task. Healthy adults aged 50 and younger had a better performance on semantic than phonemic verbal fluency. In comparison to MDE, AD participants had lower performance on animals and TNP, but not on letter P. Ninety percent of people with a Z-score ≤ −1.50 on semantic verbal fluency had AD and the global accuracy was 76.6%. Test–retest reliability over one year was high for both animals (r = .711) and TNP (r = .790) in healthy older participants, but dropped for animals in people with AD (r = .493). Conclusions: These data will strengthen accurate detection of verbal fluency deficits in French–Quebec adults

Are Verbal Fluency and Nonliteral Language Comprehension Deficits Related to Depressive Symptoms in Parkinson's Disease?

Depression in Parkinson's disease (PD) is frequently associated with executive deficits, which can influence nonliteral comprehension and lexical access. This study explores whether depressive symptoms in PD modulate verbal fluency and nonliteral language comprehension. Twelve individuals with PD without depressive symptoms, 13 with PD and depressive symptoms (PDDSs), and 13 healthy controls completed a semantic and phonemic verbal fluency task and an indirect speech acts comprehension task. All groups had the same performance in the phonemic fluency task while the PDDS group was impaired in the semantic task. For the indirect speech act comprehension task, no difference was observed between the groups. However, the PDDS group had difficulty answering direct speech act questions. As some language impairments in PD become apparent when depressive symptoms are associated with the disease, it would appear to be important to take the presence of depressive symptoms into account when evaluating language abilities in PD

Psychogenic or neurogenic origin of agrammatism and foreign accent syndrome in a bipolar patient: a case report

BACKGROUND: Foreign accent syndrome (FAS) is a rare speech disorder characterized by the appearance of a new accent, different from the speaker's native language and perceived as foreign by the speaker and the listener. In most of the reported cases, FAS follows stroke but has also been found following traumatic brain injury, cerebral haemorrhage and multiple sclerosis. In very few cases, FAS was reported in patients presenting with psychiatric disorders but the link between this condition and FAS was confirmed in only one case. CASE PRESENTATION: In this report, we present the case of FG, a bipolar patient presenting with language disorders characterized by a foreign accent and agrammatism, initially categorized as being of psychogenic origin. The patient had an extensive neuropsychological and language evaluation as well as brain imaging exams. In addition to FAS and agrammatism, FG also showed a working memory deficit and executive dysfunction. Moreover, these clinical signs were related to altered cerebral activity on an FDG-PET scan that showed diffuse hypometabolism in the frontal, parietal and temporal lobes bilaterally as well as a focal deficit in the area of the anterior left temporal lobe. When compared to the MRI, these deficits were related to asymmetric atrophy, which was retrospectively seen in the left temporal and frontal opercular/insular region without a focal lesion. DISCUSSION: To our knowledge, FG is the first case of FAS imaged with an (18)F-FDG-PET scan. The nature and type of neuropsychological and linguistic deficits, supported by neuroimaging data, exclude a neurotoxic or neurodegenerative origin for this patient's clinical manifestations. For similar reasons, a psychogenic etiology is also highly improbable. CONCLUSION: To account for the FAS and agrammatism in FG, various explanations have been ruled out. Because of the focal deficit seen on the brain imaging, involving the left insular and anterior temporal cortex, two brain regions frequently involved in aphasic syndrome but also in FAS, a cerebrovascular origin must be considered the best explanation to account for FG's language deficits