Effect of Healthy Aging and Gender on Syntactic Input Processing: A P600 Event-Related Potential Study.

PURPOSE: This study aimed to investigate the effect of healthy aging and gender, as well as the interaction, thereof, on syntactic input processing during sentence comprehension. This was achieved through the recording of the P600 event-related potential. METHOD: Sixty Flemish (native speakers of Dutch) participants (30 men and 30 women), equally distributed into three age groups (young, middle-aged, and older adults), were subjected to a visually presented word order violation task under simultaneous electro-encephalography recording. The task contained 60 sentences, of which half were grammatical and half contained a word order violation. P600 responses were analyzed for amplitude, latency, topographical distribution, and source localization. RESULTS: Regarding the effect of healthy aging, no age-related differences were found for the amplitude, onset latency, and topographical distribution of the P600 effect (difference wave). Although aging effects on the P600 effect amplitude were absent, a reduced P600 amplitude in response to both the grammatical and ungrammatical sentences was found, next to a reduced overall degree of source activation in linguistic regions of interest. Also, a reduced behavioral accuracy in response to the word order violation was observed in the older adults group. Regarding the effect of gender, females exhibited a larger P600 effect amplitude and a reduced behavioral accuracy compared to males. No gender-related differences were found for P600 effect onset latency, topographical distribution, and source activation. CONCLUSIONS: While this study demonstrates no effect of aging on the P600 effect, the lower behavioral response and absence of any activation shift argues against functional compensation. Moreover, although increased neural activation in women combined with their reduced behavioral accuracy may indicate the use of different cognitive strategies in men and women, source localization analysis could not objectify this hypothesis.

Aging and sex effects on phoneme perception: An exploratory mismatch negativity and P300 investigation.

BACKGROUND & AIMS: The mismatch negativity (MMN) and P300 event-related potentials (ERPs) have been studied in relation to phoneme discrimination and categorization, respectively. Although the effects of aging and sex on pure-tone perception have been widely investigated using these ERPs, evidence relating to phoneme perception is scarce. The current study aimed to provide insight into the effects of aging and sex on phoneme discrimination and categorization, as measured through the MMN and P300. METHOD: An inattentive and attentive oddball paradigm containing a phonemic articulation place contrast were administered during EEG registration in sixty healthy individuals (thirty males and females), of which an equal number of young (20-39 years), middle-aged (40-59 years) and elderly (60+ years) subjects were included. The amplitude, onset latency and topographical distribution of the MMN and P300 effect, as well as the amplitude of the P1-N1-P2 complex, were analyzed for age group and sex differences. RESULTS: With respect to aging, elderly subjects demonstrated a reduced MMN and P300 amplitude compared to the young group, whereas the scalp distribution of both components was unaffected. No aging effects on the P1-N1-P2 complex were found. In elderly individuals, the P300 was found to be delayed compared to the young group, while no such effect on MMN latency could be observed. No differences in MMN and P300 measures could be identified between males and females. CONCLUSION: Differential effects of aging were found on the MMN and P300, specifically in terms of latency, in relation to phoneme perception. In contrast, sex was found to scarcely affect both processes.

Therapy-Induced Electrophysiological Changes in Primary Progressive Aphasia: A Preliminary Study.

Aims: This preliminary study aimed to investigate therapy-induced electrophysiological changes in persons with primary progressive aphasia (PPA). The investigated event-related potential (ERP) components associated with language processing were the mismatch negativity, P300, N400, and P600. Methods: A linguistic ERP test battery and standardized language assessment were administered in four patients with PPA of which two received speech-language therapy (SLT) and two did not receive therapy. The battery was administered twice with approximately 6 months in between in each patient. The results of the follow-up assessments were compared to the results of the initial assessments. Results: Although the results of the behavioral language assessment remained relatively stable between the initial and follow-up assessments, changes in the mean amplitudes, onset latencies, and duration of the ERP components were found in the four patients. In the two patients that did not receive SLT, an increased delay in 50% and a decreased mean amplitude in 25% of the measured ERP components were found. The electrophysiological changes found in the patients that received SLT were variable. Interestingly, the mismatch negativity and the N400 effect elicited by the categorical priming paradigm were less delayed and had an increased mean amplitude at the follow-up assessment in the patient with the non-fluent variant who received SLT. In this patient, the P600 component was absent at the initial assessment but present at the follow-up assessment. Conclusion: Although no clear patterns in electrophysiological changes between patients who received SLT and patients who did not receive SLT were found by our preliminary study, it seems like the SLT induced improvements or compensation mechanisms in some specific language comprehension processes in the patient with the NFV. The results of this study are still preliminary because only four heterogeneous patients were included. Future studies should include larger patient groups of the three clinical variants because the therapy-induced electrophysiological changes might differ depending on the clinical variant and the underlying pathology.

A case series of verbal semantic processing in primary progressive aphasia: Evidence from the N400 effect.

BACKGROUND: The semantic variant of primary progressive aphasia (PPA) is typically associated with a loss of semantic knowledge. Research on the semantic processing in the other clinical variants of PPA is, however, rather sparse and limited to off-line behavioural studies. AIMS: This study aimed to investigate verbal semantic processing in patients with the three variants of PPA by the event-related potential technique. The presence, latency, amplitude and/or topographic distribution of the N400 effect may be helpful in the diagnosis of PPA and its clinical variants and it provides temporal information about semantic processing (disturbances) in the three variants of PPA. METHODS & PROCEDURES: The N400 effect was studied by a categorical word-priming paradigm and a semantic-anomaly paradigm at sentence level in eight persons with PPA(-plus) and 30 age-matched healthy controls. The mean amplitudes and onset latencies of the N400 effect were compared between each patient and the control group by two methods that are applicable in clinical practice, namely visual inspection and Z-scores. OUTCOMES & RESULTS: The N400 effect elicited by the categorical-priming paradigm was only present in the two patients with the non-fluent variant of PPA. This effect was absent in the two patients with the semantic variant(-plus), two patients with the logopenic variant(-plus), one patient with the non-fluent variant-plus, and the patient with PPA not otherwise specified. The results of the N400 effect elicited by the semantic-anomaly task at the sentence level were variable, but differences in the presence, mean amplitudes, onset latencies and/or topographic distributions of the effect were found in all patients with PPA(-plus) in comparison with the control group. CONCLUSIONS & IMPLICATIONS: The results of our study showed that the evaluation of the N400 effect might have an added value in the diagnostic process of PPA in general and in the differentiation of patients with the non-fluent variant from patients with the logopenic and semantic variants. Furthermore, our results indicate the presence of difficulties with retrieving stored semantic knowledge or semantic integration of a word in the preceding context in patients with the three variants of PPA. These findings might help the speech-language pathologist in determining individualized therapy goals and indicate that it might be helpful to focus on verbal semantic processing in language therapy in patients with the three variants of PPA and not only in patients with the semantic variant. WHAT THIS PAPER ADDS: What is already known on the subject The semantic variant of PPA is characterized by an impaired object knowledge and single-word comprehension and these functions are relatively spared in the non-fluent and logopenic variants following the guidelines of Gorno-Tempini et al. (2011). Research on the semantic processing in patients with the non-fluent and logopenic variant is, however, rather sparse and limited to off-line behavioural studies. Only four group studies investigated verbal semantic processing by the N400 effect, and these studies indicate disturbances in the three variants of PPA. What this paper adds to existing knowledge Our results indicate the presence of difficulties with retrieving stored semantic knowledge or semantic integration of a word in the preceding context during a semantic-priming paradigm in patients with the semantic and logopenic variants of PPA and during a semantic-anomaly task at the sentence level in patients with the three variants of PPA. What are the potential or actual clinical implications of this work? The results of our study showed that the evaluation of the N400 effect might have an added value in the diagnostic process of PPA in general and in the differentiation of patients with the non-fluent variant from patients with the logopenic and semantic variants. The evaluation of the N400 effect might also help the speech-language pathologist in determining individualized therapy goals and indicate that it might be helpful to focus on verbal semantic processing in language therapy in patients with the three variants of PPA and not only in patients with the semantic variant.

The Electrophysiological Correlates of Phoneme Perception in Primary Progressive Aphasia: A Preliminary Case Series.

Aims: This study aimed to investigate phoneme perception in patients with primary progressive aphasia (PPA) by using the event-related potential (ERP) technique. These ERP components might contribute to the diagnostic process of PPA and its clinical variants (NFV: nonfluent variant, SV: semantic variant, LV: logopenic variant) and reveal insights about phoneme perception processes in these patients. Method: Phoneme discrimination and categorization processes were investigated by the mismatch negativity (MMN) and P300 in eight persons with early- and late-stage PPA (3 NFV, 2 LV, 2 SV, and 1 PPA-NOS; not otherwise specified) and 30 age-matched healthy adults. The mean amplitude, the onset latency, and the topographic distribution of both components in each patient were compared to the results of the control group. Results: The MMN was absent or the onset latency of the MMN was delayed in the patients with the NFV, LV, and PPA-NOS in comparison to the control group. In contrast, no differences in mean amplitudes and onset latencies of the MMN were found between the patients with the SV and the control group. Concerning the P300, variable results were found in the patients with the NFV, SV, and PPA-NOS, but the P300 of both patients with the LV was delayed and prolonged with increased mean amplitude in comparison to the control group. Conclusion: In this preliminary study, phoneme discrimination deficits were found in the patients with the NFV and LV, and variable deficits in phoneme categorization processes were found in all patients with PPA. In clinical practice, the MMN might be valuable to differentiate the SV from the NFV and the LV and the P300 to differentiate the LV from the NFV and the SV. Further research in larger and independent patient groups is required to investigate the applicability of these components in the diagnostic process and to determine the nature of these speech perception deficits in the clinical variants of PPA.

Language and Speech Markers of Primary Progressive Aphasia: A Systematic Review.

Purpose This systematic review aimed to establish language and speech markers to support the clinical diagnosis of primary progressive aphasia (PPA) and its clinical phenotypes. Our first objective was to identify behavioral language and speech markers of early-stage PPA. Our second objective was to identify the electrophysiological correlates of the language and speech characteristics in PPA. Method The databases MEDLINE, Web of Science, and Embase were searched for relevant articles. To identify behavioral markers, the initial subjective complaints and the language and speech deficits detected during the initial diagnostic evaluation were summarized for PPA in general and each clinical variant according to the 2011 consensus diagnostic criteria (nonfluent variant [NFV], semantic variant, and logopenic variant [LV]). To identify electrophysiological markers, the studies in which event-related potentials (ERPs) were elicited by a language or speech paradigm in patients with PPA were included. Results In total, 114 relevant studies were identified, including 110 behavioral studies and only four electrophysiological studies. This review suggests that patients with the semantic variant could be accurately differentiated from the NFV and LV in the initial stages based on the consensus criteria. Nonetheless, the early differentiation between the NFV and LV is not straightforward. In the four electrophysiological studies, differences in the latency, amplitude, and topographical distribution of the semantic N400 component were found between patients with PPA and healthy controls. Conclusions To accurately differentiate the NFV from the LV, it could be important to assess the language and speech degeneration by more specific assessments and by more objective diagnostic methods that offer insights into the language-related processes. Electrophysiological markers of PPA were not identified in this review due to the low number of studies that investigated language-related ERPs. More controlled ERP studies in larger patient cohorts are needed to investigate the diagnostic applicability of language-related ERPs in PPA. Supplemental Material https://doi.org/10.23641/asha.12798080.