Combined anodal transcranial direct current stimulation and behavioural naming treatment improves language performance in patients with post-stroke aphasia.

PRIMARY OBJECTIVE: During the last decade, studies using anodal transcranial Direct Current Stimulation (atDCS) have yielded promising results in patients with aphasia. The main aim of the present pilot study was to assess the effects of combined atDCS over the left posterior perisylvian region and behavioral naming training on the behavioral outcomes of language comprehension and production of patients with post-stroke aphasia. RESEARCH DESIGN: A 2 × 2 quasi-experimental design was conducted, optimal to compare changes after treatment in experimental versus control group. METHODS AND PROCEDURES: Ten patients with post-stroke aphasia were enrolled in this study: half received atDCS on the left posterior perisylvian region while they underwent a 2-week behavioral naming training. The other half received sham stimulation. The outcomes were measured using the abbreviated form of the Boston Diagnostic Aphasia Examination and analyzed using ANOVAs. MAIN OUTCOMES AND RESULTS: Both groups improved their performance in Oral comprehension, Narrative writing and Language Competence Index, but only those that received anodal tDCS presented better results in the Naming category after the treatment. CONCLUSIONS: AtDCS on the left posterior perisylvian area seems to be a promising tool for boosting the outcomes of behavioral naming therapy in patients with post-stroke aphasia.

Spatiotemporal pattern of brain electrical activity related to immediate and delayed episodic memory retrieval.

In the present study we used the event-related brain potentials (ERP) technique and eLORETA (exact low-resolution electromagnetic tomography) method in order to characterize and compare the performance and the spatiotemporal pattern of the brain electrical activity related to the immediate episodic retrieval of information (words) that is being learned relative to delayed episodic retrieval twenty-minutes later. For this purpose, 16 young participants carried out an old/new word recognition task with source memory (word colour). The task included an immediate memory phase (with three study-test blocks) followed (20 min later) by a delayed memory phase with one test block. The behavioural data showed progressive learning and consolidation of the information (old words) during the immediate memory phase. The ERP data to correctly identified old words for which the colour was subsequently recollected (H/H) compared to the correctly rejected new words (CR) showed: (1) a significant more positive-going potential in the 500-675 ms post-stimulus interval (parietal old/new effect, related to recollection), and (2) a more negative-going potential in the 950-1850 ms interval (LPN effect, related to retrieval and post-retrieval processes). The eLORETA data also revealed that the successful recognition of old words (and probably retrieval of their colour) was accompanied by activation of (1) left medial temporal (parahippocampal gyrus) and parietal regions involved in the recollection in both memory phases, and (2) prefrontal regions and the superior temporal gyrus (in the immediate and delayed memory phases respectively) involved in monitoring, evaluating and maintaining the retrieval products. These findings indicate that episodic memory retrieval depends on a network involving medial temporal lobe and frontal, parietal and temporal neocortical structures. That network was involved in immediate and delayed memory retrieval and during the course of memory consolidation, with greater activation of some nodes (mobilization of more processing resources) for the delayed respect to the immediate retrieval condition.

Neuroanatomical and neurocognitive changes associated with subjective cognitive decline.

Introduction: Subjective Cognitive Decline (SCD) can progress to mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia and thus may represent a preclinical stage of the AD continuum. However, evidence about structural changes observed in the brain during SCD remains inconsistent. Materials and methods: This cross-sectional study aimed to evaluate, in subjects recruited from the CompAS project, neurocognitive and neurostructural differences between a group of forty-nine control subjects and forty-nine individuals who met the diagnostic criteria for SCD and exhibited high levels of subjective cognitive complaints (SCCs). Structural magnetic resonance imaging was used to compare neuroanatomical differences in brain volume and cortical thickness between both groups. Results: Relative to the control group, the SCD group displayed structural changes involving frontal, parietal, and medial temporal lobe regions of critical importance in AD etiology and functionally related to several cognitive domains, including executive control, attention, memory, and language. Conclusion: Despite the absence of clinical deficits, SCD may constitute a preclinical entity with a similar (although subtle) pattern of neuroanatomical changes to that observed in individuals with amnestic MCI or AD dementia.

Brain Atrophy and Clinical Characterization of Adults With Mild Cognitive Impairment and Different Cerebrospinal Fluid Biomarker Profiles According to the AT(N) Research Framework of Alzheimer's Disease.

Introduction: This study aimed to evaluate, in adults with mild cognitive impairment (MCI), the brain atrophy that may distinguish between three AT(N) biomarker-based profiles, and to determine its clinical value. Methods: Structural MRI (sMRI) was employed to evaluate the volume and cortical thickness differences in MCI patients with different AT(N) profiles, namely, A-T-(N)-: normal AD biomarkers; A+T-(N)-: AD pathologic change; and A+T+(N)+: prodromal AD. Sensitivity and specificity of these changes were also estimated. Results: An initial atrophy in medial temporal lobe (MTL) areas was found in the A+T-(N)- and A+T+(N)+ groups, spreading toward the parietal and frontal regions in A+T+(N)+ patients. These structural changes allowed distinguishing AT(N) profiles within the AD continuum; however, the profiles and their pattern of neurodegeneration were unsuccessful to determine the current clinical status. Conclusion: sMRI is useful in the determination of the specific brain structural changes of AT(N) profiles along the AD continuum, allowing differentiation between MCI adults with or without pathological AD biomarkers.

Changes in brain activity related to episodic memory retrieval in adults with single domain amnestic mild cognitive impairment.

The present fMRI study aimed to characterize the performance and the brain activity changes related to episodic memory retrieval in adults with single domain aMCI (sdaMCI), relative to cognitively unimpaired adults. Participants performed an old/new recognition memory task with words while BOLD signal was acquired. The sdaMCI group showed lower hits (correct recognition of old words), lower ability to discriminate old and new words, higher errors and longer reaction times for hits. This group also displayed brain hypoactivation in left precuneus and the left midcingulate cortex during the successful recognition of old words. These changes in brain activity suggest the presence of neural dysregulations in brain regions involved during successful episodic memory retrieval. Moreover, hypoactivation in these brain areas discriminated both groups with moderate sensitivity and specificity values, suggesting that it might constitute a potential neurocognitive biomarker of sdaMCI.