The Semantic Association Test (SAT): normative data from healthy Italian participants and a validation study in aphasic patients.

The Semantic Association Test assesses several aspects of Semantic Memory (Categorical, Encyclopedic, Functional, and Visual Encyclopedic associations: CAs, EAs, FAs and VEAs), using a picture-to-picture matching paradigm. Normative data were collected from a group of 329 healthy participants (178 females) with mean 51.1 (range 20-90) years of age and mean 11.89 (range 5-19) years of education. Raw scores of healthy participants, pre-calculated correction factors for age and educational level, and Equivalent Scores are provided. The SAT was validated in a sample of 139 left brain-damaged persons with aphasia (PWA). Both groups (healthy participants and PWA) scored worse in the CA and EA conditions. The performance of the PWA group was overall defective, and global aphasics scored worse than persons with other types of aphasia. However, several PWA did not show impairments in the SAT. Dissociations were also found, with individual PWA showing defective performance confined to a single category. These results present the SAT as a tool that is useful to detect impairments of visual Semantic Memory, providing normative data from healthy participants and a validation study in PWA.

Agency of Subjects and Eye Movements in Schizophrenia Spectrum Disorders.

People with schizophrenia spectrum disorders (SSD) show anomalies in language processing with respect to "who is doing what" in an action. This linguistic behavior is suggestive of an atypical representation of the formal concepts of "Agent" in the lexical representation of a verb, i.e., its thematic grid. To test this hypothesis, we administered a silent-reading task with sentences including a semantic violation of the animacy trait of the grammatical subject to 30 people with SSD and 30 healthy control participants (HCs). When the anomalous grammatical subject was the Agent of the event, a significant increase of Gaze Duration was observed in HCs, but not in SSDs. Conversely, when the anomalous subject was a Theme, SSDs displayed an increased probability of go-back movements, unlike HCs. These results are suggestive of a higher tolerability for anomalous Agents in SSD compared to the normal population. The fact that SSD participants did not show a similar tolerability for anomalous Themes rules out the issue of an attention deficit. We suggest that general communication abilities in SSD might benefit from explicit training on deep linguistic structures.

Some evidence on Gerstmann's syndrome: A case study on a variant of the clinical disorder.

We describe the case of a bilingual patient with persistent symptoms largely, although not fully, consistent with those that are usually reported in Gerstmann's syndrome. Twenty months after a spontaneous primary intracranial hemorrhage, the patient was evaluated with a series of neuropsychological tasks and underwent an MRI investigation based on Diffusion Tensor Imaging probabilistic tractography. The patient suffered from dysgraphia (difficulty in the access to the graphemic representation of letter forms), autotopoagnosia (difficulties in locating body parts on verbal command), right-left confusion (difficulties in localizing right and left side of symmetrical body parts), and number processing/calculation impairments (predominant difficulties on transcoding tasks). Probabilistic tractography revealed a relatively spared superior longitudinal fasciculus and severe damage to the subcortical white matter connecting the angular gyrus with other parietal regions, such as the intraparietal sulcus and the supramarginal gyrus. Within the framework of the contemporary cognitive accounts of Gerstmann's syndrome, the case supports the assumption of an anatomical intraparietal disconnection more than a functional Grundstörung (core impairment).

Open-source open-access reaction time test (OORTT): an easy tool to assess reaction times.

The speed of information processing is one of the most reliable indices of cognitive efficiency. The most common way to evaluate this ability is to assess reaction times (RTs). The technical limitations of previous tasks, aimed at measuring RT, have motivated us to develop a new battery for their evaluation. The aim of this study is to build an open-source, open-access reaction time test (OORTT), which has the following characteristics: rapid and easy administration, robust Italian normative data based on a wide age range, a simple scoring system, compatibility with all operating systems, no license or activation costs, and based on an open-source software platform. The battery is composed of three tasks: simple reaction times (SRT), Go/No-Go (GNG) condition, and four-position reaction times (4PRT). The battery was administered to 300 healthy participants aged between 14 and 89, and 3 groups of patients: 24 right brain-damaged; 21 left brain-damaged, and 19 degenerative cognitively impaired. We have developed specific norms for each task of the test battery: SRT, GNG, and 4PRT. Compared with healthy individuals, all groups obtained lower scores. More specifically, cognitively impaired patients obtained significantly longer RTs than healthy participants as well as unilateral brain-damaged patients. In the 4PRT task, right brain-damaged patients obtained a significantly left > right difference in RTs. In conclusion, the OORTT test battery proved to be a valuable tool which can be used in the clinical environment for cases of different attentional deficits after focal or degenerative brain damage.

Diagnostic Accuracy of Noun- and Verb-Naming Tasks in Detecting Cognitive Impairment in Parkinson's Disease.

BACKGROUND: In Parkinson's disease (PD), verb-naming tasks (VNTs) have been proposed as superior to noun-naming ones in detecting language deficits, although such a hypothesis is not supported at a statistical level. OBJECTIVES: The main aim of this study was to provide diagnostic accuracy evidence for a VNT and noun-naming task (NNT) in detecting cognitive impairment (CI) in PD patients. METHOD: Thirty-three consecutive PD patients were subdivided into participants with (PD-CI; N = 12) or without CI (cognitively unimpaired, PD-CU; N = 21), based on a raw score ≤25 or >25 on the Mini-Mental State Examination, respectively. The NNT and VNT by Neuropsychologia [2006 Jan;44(1):73-89] were administered. Diagnostic accuracy of the NNT and VNT was assessed through receiver-operating characteristics analyses by comparing PD-CU to PD-CI patients. At the optimal cut-off, sensitivity, specificity, positive and negative predictive values (PPV, NPV), and likelihood ratios (LR+, LR-) were separately tested for the NNT and VNT against PD-CU versus PD-CI classification. RESULTS: Diagnostic accuracy was higher for the NNT (AUC = 0.85; p = 0.001) versus the VNT (AUC = 0.68; p = 0.092). Consistently, the NNT yielded higher sensitivity, specificity, and post-test features than the VNT (NNT: sensitivity = 0.75, specificity = 0.81, PPV = 0.69, NPV = 0.85, LR+ = 3.94, LR- = 0.31; VNT: sensitivity = 0.67, specificity = 0.67, PPV = 0.53, NPV = 0.78, LR+ = 2, LR- = 0.5). CONCLUSIONS: In accordance with the Movement Disorders Society guidelines, NNTs are diagnostically sound psychometric instruments to discriminate PD patients with versus without CI. However, these findings need replication by (1) employing a gold standard different from the Mini-Mental State Examination, which does not capture the full range of CI in this population and (2) subdividing PD patients into those with mild CI and dementia.

Phonological and surface dyslexia in individuals with brain tumors: Performance pre-, intra-, immediately post-surgery and at follow-up.

We address existing controversies regarding neuroanatomical substrates of reading-aloud processes according to the dual-route processing models, in this particular instance in a series of 49 individuals with brain tumors who performed several reading tasks of real-time neuropsychological testing during surgery (low- to high-grade cerebral neoplasms involving the left hemisphere). We explored how reading abilities in individuals with brain tumors evolve during and after surgery for a brain tumor, and we studied the reading performance in a sample of 33 individuals in a 4-month follow-up after surgery. Impaired reading performance was seen pre-surgery in 7 individuals with brain tumors, intra-surgery in 18 individuals, at immediate post-surgery testing in 26 individuals, and at follow-up in 5 individuals. We classified their reading disorders according to operational criteria for either phonological or surface dyslexia. Neuroimaging results are discussed within the theoretical framework of the dual-route model of reading. Lesion-mask subtraction analyses revealed that areas selectively related with phonological dyslexia were located-along with the left hemisphere dorsal stream-in the Rolandic operculum, the inferior frontal gyrus, the precentral gyrus, the supramarginal gyrus, the insula (and/or the underlying external capsule), and parts of the superior longitudinal fasciculus, whereas lesions related to surface dyslexia involved the ventral stream, that is, the left middle and inferior temporal gyrus and parts of the left inferior longitudinal fasciculus.

Can the right hemisphere read? A behavioral and disconnectome study on implicit reading in a patient with pure alexia.

Patients with pure alexia have major difficulties in reading aloud. However, they often perform above chance level in reading tasks that do not require overt articulation of the target word - like lexical decision or semantic judgment - a phenomenon usually known as "implicit reading." There is no agreement in the literature on whether implicit reading should be attributed to relative sparing of some left hemisphere (LH) reading centers or rather to signs of compensatory endeavors by the right hemisphere (RH). We report the case of an 81-year-old patient (AA) with pure alexia due to a lesion involving the left occipital lobe and the temporal infero-mesial areas, as well as the posterior callosal pathways. Although AA's reading was severely impaired and proceeded letter by letter, she showed an above-chance-level performance for frequent concrete words in a tachistoscopic lexical decision task. A structural disconnectome analysis revealed that AA's lesion not only affected the left occipital cortex and the splenium: it also disconnected white-matter tracts meant to connect the visual word-form system to decision-related frontal areas within the LH. We suggest that the RH, rather than the LH, may be responsible for patient AA's implicit reading.

Correction to: The assessment of severe lexical disorders in Italian individuals with aphasia.

This article was published with incomplete Table 4. The Equivalent scores were missing during the submission. The correct Table is presented here.

The assessment of severe lexical disorders in Italian individuals with aphasia.

Tests and batteries used in the evaluation of language impairments are overly complex and often ineffective (too difficult) in the assessment of post-stroke patients affected by severe aphasia (global aphasia). The present study reports details on the construction and standardization of a new Italian battery of tasks, specifically designed to assess severe lexical disorders in acquired aphasia (Battery for the Assessment of Severe Acquired Lexical Damage in Italian, BASALDI). The battery is composed of a common set of 64 stimuli (concrete nouns), belonging to both living and non-living categories, and consists of four lexical tasks assessing picture naming, repetition, reading aloud, and oral comprehension. The item selection was based on word frequency, word length, and phonological-articulatory complexity, namely the presence of continuant vs. plosive phones, a variable that may interact with word production in case of severe language damage. Standardization (naming agreement) of a new set of 64 colored images and normative data on Italian healthy subjects pooled across homogenous subgroups for age, gender, and education are reported. Finally, for the four tasks, percentile ranks and z-scores were calculated from a pool of 92 left brain-damaged patients affected by aphasia of different types and severity. The battery allows a fine investigation of lexical disorders, being suitable for diagnostic assessment of mild-to-moderate and severe aphasic lexical deficits, detection of changes over time, and possible dissociations between tasks.

VRT (verbal reasoning test): a new test for assessment of verbal reasoning. Test realization and Italian normative data from a multicentric study.

Verbal reasoning is a complex, multicomponent function, which involves activation of functional processes and neural circuits distributed in both brain hemispheres. Thus, this ability is often impaired after brain injury. The aim of the present study is to describe the construction of a new verbal reasoning test (VRT) for patients with brain injury and to provide normative values in a sample of healthy Italian participants. Three hundred and eighty healthy Italian subjects (193 women and 187 men) of different ages (range 16-75 years) and educational level (primary school to postgraduate degree) underwent the VRT. VRT is composed of seven subtests, investigating seven different domains. Multiple linear regression analysis revealed a significant effect of age and education on the participants' performance in terms of both VRT total score and all seven subtest scores. No gender effect was found. A correction grid for raw scores was built from the linear equation derived from the scores. Inferential cut-off scores were estimated using a non-parametric technique, and equivalent scores were computed. We also provided a grid for the correction of results by z scores.

The representation of compound headedness in the mental lexicon: a picture naming study in aphasia.

Most compound words are constituted of a head constituent (e.g., light in moonlight) and a modifier constituent (e.g., moon in moonlight); the information transmitted by these head-modifier roles is fundamental for defining the grammatical and semantic properties of the compound and for identifying a correct combination of the constituents at the conceptual level. The objective of this study is to assess how lexical processing in aphasia is influenced by the head-modifier structure of nominal compounds. A picture-naming task of 35 compounds with head-initial (pescespada, swordfish, literally fishsword) and head-final (autostrada, highway, literally carroad) forms was administered to 45 Italian aphasic patients, and their accuracy in retrieving constituents was analysed with a mixed-effects logistic regression. The interaction between headedness and constituent position was significant: The modifier emerged as being more difficult to retrieve than the head, but only for head-final compounds. The results are consistent with previous data from priming experiments on healthy subjects and provide convincing evidence that compound headedness is represented at central processing levels.

Clinical and structural disconnectome evaluation in a case of optic aphasia.

Optic Aphasia (OA) and Associative Visual Agnosia (AVA) are neuropsychological disorders characterized by impaired naming on visual presentation. From a cognitive point of view, while stimulus identification is largely unimpaired in OA (where access to semantic knowledge is still possible), in AVA it is not. OA has been linked with right hemianopia and disconnection of the occipital right-hemisphere (RH) visual processing from the left hemisphere (LH) language areas.In this paper, we describe the case of AA, an 81-year-old housewife suffering from a deficit in naming visually presented stimuli after left occipital lesion and damage to the interhemispheric splenial pathway. AA has been tested through a set of tasks assessing different levels of visual object processing. We discuss behavioral performance as well as the pattern of lesion and disconnection in relation to a neurocognitive model adapted from Luzzatti and colleagues (1998). Despite the complexity of the neuropsychological picture, behavioral data suggest that semantic access from visual input is possible, while a lesion-based structural disconnectome investigation demonstrated the splenial involvement.Altogether, neuropsychological and neuroanatomical findings support the assumption of visuo-verbal callosal disconnection compatible with a diagnosis of OA.

Assessment of verb and sentence processing deficits in stroke-induced aphasia: the Italian version of the Northwestern Assessment of Verbs and Sentences (NAVS-I).

Background: The Northwestern Assessment of Verbs and Sentences (NAVS) assesses verb and sentence production and comprehension in aphasia. Results from the original English version and from its adaptation to German have shown that the NAVS is able to capture effects of verb-argument structure (VAS) complexity (i.e., lower accuracy for two- and three-argument vs. one-argument verbs) and syntactic complexity (i.e., lower accuracy for non-canonical vs. canonical sentences) in both agrammatic participants and individuals with mild (residual) forms of aphasia. The NAVS has been recently adapted to Italian (NAVS-I) and tested on a group of healthy participants, with results showing longer reaction times to complex vs. simple verbs and sentences. Aims: The present study aimed to test the ability of NAVS-I to i) capture verb/sentence production and comprehension deficits in Italian-speaking individuals with agrammatism or with fluent aphasia, and ii) differentiate individuals with aphasia from healthy age-matched participants, with the overall goal to validate its use in clinical practice. Methods & Procedures: Forty-four healthy participants and 28 individuals with aphasia (10 with agrammatic speech production) were administered the NAVS-I, which includes tasks assessing production and comprehension of verbs requiring one, two or three arguments, as well as production and comprehension of canonical and non-canonical sentences. Outcomes & Results: On the Verb Naming Task (VNT), better production of one- (vs. two- and three-) argument verbs was found in the agrammatic group, whereas, verb production in the fluent group was solely predicted by word length and imageability. No effects of argument optionality (i.e., greater difficulty for optionally transitive verbs than for 1-argument verbs) were found. Sentence-level tasks found no differences between the agrammatic and the fluent group in production or comprehension of both canonical and non-canonical sentences; rather, sentence comprehension accuracy was predicted by demographic variables and by aphasia severity. At the individual level, performance on the NAVS-I was significantly different from that of healthy speakers in 26/28 patients. Conclusions: Data show that the NAVS-I is able to capture effects of argument structure complexity in verb production, and effects of syntactic complexity in sentence production and comprehension. In addition, our results point to verb production as the task with greater capability to differentiate agrammatism from other (fluent) forms of aphasia. The study provides support for the use of the NAVS-I in the diagnosis of aphasia, as it is able to detect language deficits at the individual level, even in participants with mild (residual) forms of aphasia.

Understanding the mental lexicon through neglect dyslexia: a study on compound noun reading.

The present study employs neglect dyslexia (ND) as an experimental model to study compound-word processing; in particular, it investigates whether compound constituents are hierarchically organized at mental level and addresses the possibility of whole-word representation. Seven Italian-speaking patients suffering from ND participated in a word naming task. Both left-headed (pescespada, swordfish) and right-headed (astronave, spaceship) Italian compound nouns were used as stimuli. Non-existent compounds, which were generated by substituting the leftmost constituent of a compound with an orthographically similar word (e.g., *pestespada, *plaguesword), were also employed. A significant headedness effect emerged in the group analysis: patients read left-headed compounds better than right-headed compounds. A significant lexicality effect was also found: the participants read real compounds better than their non-existent compound pairs. Moreover, logit mixed-effects analyses indicated a left-hand constituent frequency effect. Results are discussed in terms of hierarchical representation of compounds and direct access to compound lemma nodes.

Lateralized reading in the healthy brain: A behavioral and computational study on the nature of the visual field effect.

Despite its widespread use to measure functional lateralization of language in healthy subjects, the neurocognitive bases of the visual field effect in lateralized reading are still debated. Crucially, the lack of knowledge on the nature of the visual field effect is accompanied by a lack of knowledge on the relative impact of psycholinguistic factors on its measurement, thus potentially casting doubts on its validity as a functional laterality measure. In this study, an eye-tracking-controlled tachistoscopic lateralized lexical decision task (Experiment 1) was administered to 60 right-handed and 60 left-handed volunteers and word length, orthographic neighborhood, word frequency, and imageability were manipulated. The magnitude of visual field effect was bigger in right-handed than in left-handed participants. Across the whole sample, a visual field-by-frequency interaction was observed, whereby a comparatively smaller effect of word frequency was detected in the left visual field/right hemisphere (LVF/RH) than in the right visual field/left hemisphere (RVF/LH). In a subsequent computational study (Experiment 2), efficient (LH) and inefficient (RH) activation of lexical orthographic nodes was modelled by means of the Naïve Discriminative Learning approach. Computational data simulated the effect of visual field and its interaction with frequency observed in the Experiment 1. Data suggest that the visual field effect can be biased by word frequency. Less distinctive connections between orthographic cues and lexical/semantic output units in the RH than in the LH can account for the emergence of the visual field effect and its interaction with word frequency.

Delusion of inanimate doubles: description of a case of focal retrograde amnesia.

This paper reports the case of a patient, M.P., who developed delusion of inanimate doubles, without Capgras syndrome, after traumatic brain injury. His delusional symptoms were studied longitudinally and the cognitive impairments associated with delusion were investigated. Data suggest that M.P. did 'perceive' the actual differences between doubles and originals rather than 'confabulate' them. The cognitive profile, characterized by retrograde episodic amnesia, but neither object processing impairment nor confabulations, supports this hypothesis. The study examines the nature of object misidentification based on Ellis' and Staton's account and proposes a new account based on concurrent unbiased retrieval of semantic memory traces and biased recollection of episodic memory traces.

A verb-naming test accurately detects cognitive changes in ALS.

Verb-naming tests were proposed for detecting cognitive impairment in ALS, although statistical evidence on their clinical usefulness is still lacking. A total of 29 ALS patients and 29 demographic-matched healthy controls (HCs) were administered the Action-Verb-Naming Test (AVNT), a standardized picture-naming task of actions. Patients were also administered the Edinburgh Cognitive and Behavioral ALS Screen (ECAS), and classified according to Strong et al. (Amyotrophic lateral sclerosis-frontotemporal spectrum disorder (ALS-FTSD): revised diagnostic criteria. Amyotroph Lateral Scler Frontotemporal Degener. 2017;18:153-4) criteria. The AVNT discriminated ALS patients from HCs (p = 0.026) and yielded high accuracy in detecting cognitive impairments among ALS patients (88% of accuracy; sensitivity = 1; specificity = 0.84; PPV = 0.5; NPV = 1; LR+ = 3.83; LR- = 0), as well as a below-cutoff performance on the ECAS (AUC = 0.74). The AVNT was unrelated to other clinical variables, despite being strongly associated with ECAS total, ALS-specific, Language and Executive scores (rs = 0.65-0.75). These findings show that verb naming is an accurate test to detect domain-specific cognitive changes in ALS patients, regardless of their disease phenotype.

Processing Argument Structure and Syntactic Complexity in People with Schizophrenia Spectrum Disorders.

INTRODUCTION: Deficits in language comprehension and production have been repeatedly observed in Schizophrenia Spectrum Disorders (SSD). However, the characterization of the language profile of this population is far from complete, and the relationship between language deficits, impaired thinking and cognitive functions is widely debated. OBJECTIVE: The aims of the present study were to assess production and comprehension of verbs with different argument structures, as well as production and comprehension of sentences with canonical and non-canonical word order in people with SSD. In addition, the study investigated the relationship between language deficits and cognitive functions. METHODS: Thirty-four participants with a diagnosis of SSD and a group of healthy control participants (HC) were recruited and evaluated using the Italian version of the Northwestern Assessment of Verbs and Sentences (NAVS, Cho-Reyes & Thompson, 2012; Barbieri et al., 2019). RESULTS: Results showed that participants with SSD were impaired - compared to HC - on both verb and sentence production, as well as on comprehension of syntactically complex (but not simple) sentences. While verb production was equally affected by verb-argument structure complexity in both SSD and HC, sentence comprehension was disproportionately more affected by syntactic complexity in SSD than in HC. In addition, in the SSD group, verb production deficits were predicted by performance on a measure of visual attention, while sentence production and comprehension deficits were explained by performance on measures of executive functions and working memory, respectively. DISCUSSION: Our findings support the hypothesis that language deficits in SSD may be one aspect of a more generalized, multi-domain, cognitive impairment, and are consistent with previous findings pointing to reduced inter- and intra-hemispheric connectivity as a possible substrate for such deficits. The study provides a systematic characterization of lexical and syntactic deficits in SSD and demonstrates that psycholinguistically-based assessment tools may be able to capture language deficits in this population.

Implicit chord processing and motor representation in pianists.

The aim of this paper is to assess the relevance of pitch dimension in auditory-motor interaction. Several behavioural and brain imaging studies have shown that auditory processing of sounds can activate motor representations, an effect which is however elicited only by action-related sounds, i.e., sounds linked to a specific motor repertoire. Music provides an appropriate framework for further exploration of this issue. Three groups of participants (pianists, non-pianist musicians and non-musicians) were tested with a shape decision task where left-hand and right-hand responses were required; each visual stimulus was paired with an auditory task-irrelevant stimulus (high-pitched or low-pitched piano-timbre chords). Of the three groups, only pianists had longer reaction times for left-hand/high-pitched chords and right-hand/low-pitched chords associations. These findings are consistent with an auditory-motor effect elicited by pitch dimension, as only pianists show an interaction between motor responses and implicit pitch processing. This interaction is consistent with the canonical mapping of hand gestures and pitch dimension on the piano keyboard. The results are discussed within the ideo-motor theoretical framework offered by the Theory of Event Coding (Hommel et al. in Behav Brain Sci 24:849-937, 2001).

Johann Jakob Wepfer (1620-1695): A review of his contributions to neuropsychology on the quadricentennial of his birth.

The effects of brain damage on behavior have been reported by authors from the Greek, Roman, Medieval, Renaissance, and seventeenth-century medical traditions. However, few of the reported cases discussed mind-brain relationships, even fewer reported data that offered a description of cognitive functions, and none described a clear association of a functional mechanism of cognitive impairment with identifiable focal brain damage. An exception is found in the case studies by Johann Jakob Wepfer (1620-1695). After reviewing the pre-seventeenth-century background and Wepfer's milieu, we analyze his texts on neuroanatomy, apoplexy, and brain vascularization (Observationes anatomicae ex cadaveribus eorum, quos sustulit apoplexia cum exercitatione de ejus loco affecto) and his remarkable collection of 222 neurological cases (Observationes medico-practicae de affectibus capitis internis & externis), posthumously published in 1727. We focus on his reports concerning on the presence of aphasia, memory disorders, and unilateral neglect, correlated with focal brain damage, with particular emphasis on his examination of language impairments.