Lexical prosodic representation and access in Japanese children with developmental dyslexia.

Recent research indicates that awareness of the prosodic information present in spoken language could be an important factor for literacy development, and that adults with developmental dyslexia show impaired awareness of lexical prosodic information, while the phonological representations remain intact. We investigated lexical prosodic representation and awareness in Japanese children with and without developmental dyslexia. Lexical prosodic representation was investigated using a cross-modal fragment priming task, and awareness was examined using a fragment identification task. The task was modified for children by selecting words with higher familiarity and fewer trials. As a result, the same pattern of prosodic priming effects was observed between groups; lexical decision time was faster in the prosodic congruent condition than in the incongruent condition. In addition, accuracy and reaction time did not show group differences in the fragment identification task. Relationship between prosody and literacy development may differ between languages but the sample size were small in both groups. Further investigation with larger sample size is required.

Syntactic Impairment Associated with Hypoperfusion in the Left Middle and Inferior Frontal Gyri after Right Cerebellar Hemorrhage.

Cerebellar injuries can cause syntax impairments. Cortical dysfunction due to cerebello-cerebral diaschisis is assumed to play a role in this phenomenon. Functional magnetic resonance imaging studies have repeatedly shown the activation of Broca's area in response to syntactic tasks. However, there have been no reports of selective syntax impairment and hypoperfusion restricted to this area after cerebellar injury. We herein report a patient with right cerebellar hemorrhage that led to marked syntax impairment along with severe hypoperfusion confined to the Brodmann area (BA) 45 (anterior part of Broca's area) and BA46.

Word recall process and physiological activation in the tip-of-the-tongue state: Comparison of young and middle-aged groups.

To clarify the feeling of knowing a name but not being able to recall it, known as having a "tip-of-the-tongue" (TOT) experience, we proposed a TOT model consisting of three stages combining a face recognition model and autonomic sympathetic nerve activity. Since TOT increases with age, we compared two age groups: young (N = 27, M = 20.4 ± 1.5 years) and middle-aged (N = 29, M = 58.5 ± 8.0 years). Experiment 1 showed that successfully naming low-frequency common names increased the skin conductance response (SCR) value, and the time to reach the maximum SCR value was longer. Experiment 2 was a naming task for face photographs. The younger group showed higher SCR values during successfully naming, while the middle-aged group showed similar SCR values for successfully naming and experiencing TOT. Both groups had the longest time to reach maximum SCR in TOT. In this study, physiological arousal of TOT was not affected by aging.

Convergent validity of the developmental coordination disorder checklist using soft neurological signs.

AIMS: To investigate the convergent validity of a new questionnaire, the Developmental Coordination Disorder Checklist (DCDC), we examined the relationship between the DCDC score and Soft Neurological Signs (SNS) which highly correlated with the Movement Assessment Battery for Children (MABC), which is widely applied to assess fine and gross motor skills. METHODS: The patients were 70 elementary school children without intellectual disabilities who were referred to our clinic, examined for SNS, and whose parents completed the DCDC. The DCDC consists of 16 items that focus on three factors: fine motor, gross motor, and catch and throw. We used a previously described method to assess SNS, which included five tasks: (1) standing on one leg with closed eyes, (2) finger opposition test, (3) diadochokinesis, (4) associated movements during diadochokinesis, and (5) motor persistence (laterally fixed gaze). RESULTS: DCDC scores and SNS were strongly and positively correlated, with higher DCDC scores (indicating greater coordination problems) associated with a higher number of positive SNS. CONCLUSIONS: DCDC scores have been proven to be strongly correlated with SNS, and these data suggest that DCDC has good convergent validity.

Development of a reading difficulty questionnaire for adolescents in Japanese.

BACKGROUND: Dyslexia is a neurodevelopmental disorder which occurs in childhood but continues to influence academic and occupational function in adulthood. Recently, a Japanese dyslexia questionnaire and diagnostic procedure was established for primary school children. However, there is currently no procedure for the diagnosis or screening of dyslexia in individuals at or above junior high school age; accordingly, we aimed to develop a questionnaire to screen for reading difficulties in those individuals. METHODS: A questionnaire with various candidate items was developed from two English questionnaires, one Japanese questionnaire, and newly devised items focusing on the Japanese writing system and the most appropriate 28 items were selected. In total, 462 adults and 127 junior high to high school students were enrolled. Of those, 191 participants also took part in reading tests. After the exploratory factor analysis, reliability and validity were evaluated using the above control participants and 12 adolescents with dyslexia. RESULTS: The questionnaire included three factors, i.e., silent reading sub-scale (four items), writing sub-scale (four items), and aloud reading sub-scale (three items). Five were newly devised items focusing on the Japanese writing system. Cronbach's alphas of the three factors were 0.706, 0.638, and 0.568, respectively, and the interclass correlation coefficients (2,1) were 0.743, 0.609, and 0.695, respectively. The silent reading and aloud reading sub-scales were positively correlated with word, non-word, and passage reading time. DISCUSSION: The newly developed questionnaire correlated well with actual reading performance and may be used to screen reading difficulty in Japanese individuals at or above junior high school age.

[A Study of Pronunciation Errors in the Reading of Kanji Words in Cases with Pure Apraxia of Speech].

In this study we investigated the pronunciation error patterns in Kanji words of two patients with pure apraxia of speech. We asked the patients to read aloud 80 visually presented Kanji words, half of which were homonymous and the rest non-homonymous. The words were presented at three different intervals (2, 1.5 and 1 sec.). Case A, a 68-year-old right-handed woman, produced a variety of sound errors - substitution, distortion and omission - and some errors of pitch position. Case B, a 73-year-old right-handed woman, omitted the prolonged vowels of each word, and produced many pitch errors, including pitch position errors and flattening of pitch. Each patient had different lesions in the left precentral gyrus - Case A from the posterior bank to the middle part of the left precentral gyrus, and Case B in the anterior bank and deep white matter of the left precentral gyrus. We speculated that Case A has difficulty mainly in the articulation process and vocalization, whereas Case B's deficit lies mainly in the phonation process, which relates to control of pitch and expiration.

Retrospective time estimation following damage to the prefrontal cortex.

Time estimation in patients with prefrontal cortex (PFC) damage is often inaccurate. The relationship between PFC and estimation of short time intervals has been examined. However, it remains unclear whether PFC damage affects estimation of longer time intervals. Here, we investigated the ability of patients and healthy subjects to verbally estimate a period of 30 min, using a method easily applied in clinical settings. In 99 patients with brain damage, we compared under and normal ranges of time in patients with PFC damage or damage to other brain areas with the chi-squared test. Subsequently, we conducted a discriminant analysis and a multiple linear regression analysis to identify specific brain areas affecting time estimation. We observed a significantly larger number of patients who overestimated 30 min in the group with bilateral PFC damage compared to patients with damage to other regions. Discriminant analysis revealed that damage of right lateral PFC and left medial PFC contributed to discrimination between the normal range and overestimation groups. Multiple linear regression analysis indicated that right lateral PFC damage strongly affected overestimation of a 30-min interval. Neuropsychological test results revealed lower general cognitive function scores and orientation scores in overestimation group. The length of estimated time and the score of delayed word recall were negatively correlated. We propose that these may require encoding, maintenance, and updating of memory and are indirectly related to contextual memory. We discuss hypotheses on contextual memory segmentation and reconstruction to clarify the mechanism of impaired time overestimation in PFC-damaged patients.

Development of a movement questionnaire adapted for Japanese culture for elementary school children.

AIMS: Current tools to evaluate Developmental Coordination Disorder (DCD) symptoms are not adapted to Japanese cultural and educational contexts. We aimed to develop a new tool, the Developmental Coordination Disorder Checklist (DCDC), that can be applied specifically to elementary school-aged children in Japan, by generating a list of culturally relevant items. METHODS: We designed an 18-item questionnaire that was distributed to parents and teachers of elementary school-aged children. The degree of negative influence on a child's life from their motor ability was estimated using a visual analogue scale (VAS). RESULTS: We analyzed the responses from parents/guardians (n = 1174) and teachers (n = 688) of elementary school children (age range: 75-147 months, 1st-6th grades). An exploratory analysis showed that the DCD items could be divided into three factors: fine motor, gross motor, and catch and throw. Internal consistency reliabilities of each factor and of total DCDC were sufficiently high (all coefficients of Cronbach's alpha: > 0.75). Inter-rater reliability between parent/guardian and teacher was moderate in each sub-score and total DCDC score. Parents/guardians evaluated the degree of difficulty in the fine motor factor more severely than teachers. Total DCDC score was correlated significantly with VAS value (r = 0.545), with each factor in DCDC proving useful in predicting negative impact on daily life. CONCLUSIONS: DCDC is an efficient and culturally relevant assessment tool for DCD symptoms within Japan, particularly for measuring any practical deficits in daily life activities.

Autonomic Nervous System Activity During a Speech Task.

Previous research has reported that different coping types (active or passive) are required depending on the stress-inducing task. The aim of this study was to examine the autonomic nervous response during speech tasks that require active coping, by using Lorenz plot analysis. Thirty-one university students participated in this study (M = 21.03 years, SD = 2.27). This study included 3 phases: (1) resting phase, (2) silent reading phase, and (3) reading aloud phase. Autonomic nervous system responses were recorded in each phase. We asked participants to evaluate their subjective states (arousal, valence, and mood) after the silent reading phase and the reading aloud phase. We observed that the cardiac sympathetic index (CSI) for the sympathetic nervous response was significantly higher during the reading aloud phase than during the silent reading phase. In contrast, the cardiac vagal index (CVI) for the parasympathetic nervous response was significantly higher during the reading aloud phase than during the resting phase. There were no significant differences between the resting phase and the silent reading phase in both cardiac sympathetic and CVIs. We also observed that the degree of arousal was significantly higher after the reading aloud phase than after the silent reading phase. Our findings indicate that the psychological load during silent reading is ineffective for activating the sympathetic nervous system. The sympathetic nervous response was activated in the reading aloud phase. Also, the parasympathetic nervous response in the reading aloud phase was activated compared with the resting phase. Reading aloud is necessary to adequately activate the parasympathetic nervous system by requiring participants to respire (i.e., expiration) more than during resting and silent reading tasks. The increase in the CVI likely stems from activating the parasympathetic nervous system during expiration. Although the speech task required participants to perform active coping, it was designed to activate both the sympathetic and parasympathetic nervous systems during expiration.

Reliability and Validity of Speech Evaluation in Adductor Spasmodic Dysphonia.

OBJECTIVES: The aim of this study was to evaluate speech in patients with adductor spasmodic dysphonia (ADSD) by perceptual evaluations and acoustic measures, and to examine the reliability and validity of these measures. METHODS: Twenty-four patients with ADSD and 24 healthy volunteers were included in the study. Speech materials consisted of three sentences constructed from serial voiced syllables to elicit abductor voice breaks. Three otolaryngologists rated the degree of voice symptoms using a visual analog scale (VAS). VAS sheets with five 100-mm horizontal lines were given to each rater. The ends of the lines were labeled normal vs severe, and the five lines were labeled as overall severity of each of the four speech symptoms (strangulation, interruption, tremor and strained speech). Nine words were selected for acoustic analysis, and abnormal acoustic events were classified into one of the three categories. To evaluate the intra- and inter-rater and intermeasurer reliabilities of the VAS scores or acoustic measures, Pearson r correlations were calculated. To examine the validity of perceptual evaluations and acoustic measures, the sensitivity and the specificity were calculated. RESULTS: Pearson r correlation coefficients for overall severity showed the highest intra- and inter-rater reliabilities. For acoustic events, the intrameasurer reliabilities were r = .645 (frequency shifts), r = .969 (aperiodic segments), and r = 1.0 (phonation breaks), and the intermeasurer reliability ranged from r = .102 to r = 1.0. Perceptual evaluation showed high sensitivity (91.7%) and specificity (100%), whereas acoustic analysis showed low sensitivity (70.8%) and high specificity (100%). CONCLUSION: Both perceptual evaluation and acoustic measures alone were found likely to overlook patients with true ADSD.

The effect of anxiety sensitivity on psychological and biological variables during the cold pressor test.

We examined the relationship between anxiety sensitivity (AS) and autonomic nervous system responses (ANS) during the cold pressor test (CPT). Seventy-four university students participated and were divided into low-AS (M=9.06, SD=3.97) and high-AS groups (M=28.68, SD=6.63) based on AS Index scores (n's=36 and 38, respectively). The study included three phases: Rest, CPT, and Recovery. We measured the psychological variables (fear of pain and subjective pain) at pre- and post-CPT. ANS response data were collected during each phase. Fear of pain was experienced more strongly in the high-AS group (M=4.74, SD=3.25) relative to the low-AS group (M=2.72, SD=2.31), and subjective pain was also stronger in the high-AS group (M=3.08, SD=1.91) relative to the low-AS group (M=2.47, SD=1.00) in post-CPT. While parasympathetic nervous system (PNS) responses did not differ between the two groups during the CPT, the high AS-group demonstrated lower PNS activity during the Recovery phase. The high-AS group reported significantly more anticipatory fear and pain prior to the CPT, which appeared to aggravate subjective pain experiences. Furthermore, for individuals with anxiety sensitivity, ANS reactivity may be the mechanism underlying the relationship between negative affect and subjective pain.

Pure agraphia after infarction in the superior and middle portions of the left precentral gyrus: Dissociation between Kanji and Kana.

The present study describes a Japanese patient with pure agraphia displaying differential disturbances in processing Kanji (morphogram) and Kana (syllabogram) letters after an infarction in the middle and superior portions of the left precentral gyrus. Kana errors reflected the patient's difficulty with retrieving both motor and visual letter images, whereas Kanji errors included partial letter stroke omissions or additions. This present case suggests that differences in writing disturbances between Kana and Kanji letters are caused by a differential dependency on letter motor images.

The neural basis of dishonest decisions that serve to harm or help the target.

We conducted a functional magnetic resonance imaging (fMRI) study to elucidate the neurocognitive mechanisms of harmful and helpful dishonest decisions. During scanning, the subjects read scenarios concerning events that could occur in real-life situations and were asked to decide whether to tell a lie as though they were experiencing those events. Half of the scenarios consisted of harmful stories in which the dishonest decisions could be regarded as bad lies, and the other half consisted of helpful stories in which the dishonest decisions could be regarded as good lies. In contrast to the control decision-making task, we found that the decision-making tasks that involved honesty or dishonesty recruited a network of brain regions that included the left dorsolateral prefrontal cortex. In the harmful stories, the right temporoparietal junction and the right medial frontal cortex were activated when the subjects made dishonest decisions compared with honest decisions. No region discriminated between the honest and dishonest decisions made in the helpful stories. These preliminary findings suggest that the neural basis of dishonest decisions is modulated by whether the lying serves to harm or help the target.

A Validation Study of the Japanese Version of the Addenbrooke's Cognitive Examination-Revised.

The aim of this study was to validate the Japanese version of the Addenbrooke's Cognitive Examination-Revised (ACE-R) [Mori: Japanese Edition of Hodges JR's Cognitive Assessment for Clinicians, 2010] designed to detect dementia, and to compare its diagnostic accuracy with that of the Mini-Mental State Examination. The ACE-R was administered to 85 healthy individuals and 126 patients with dementia. The reliability assessment revealed a strong correlation in both groups. The internal consistency was excellent (α-coefficient = 0.88). Correlation with the Clinical Dementia Rating sum of boxes score was significant (r(s) = -0.61, p < 0.001). The area under the curve was 0.98 for the ACE-R and 0.96 for the Mini-Mental State Examination. The cut-off score of 80 showed a sensitivity of 94% and a specificity of 94%. Like the original ACE-R and the versions designed for other languages, the Japanese version of the ACE-R is a reliable and valid test for the detection of dementia.

Changing the criteria for old/new recognition judgments can modulate activity in the anterior hippocampus.

Numerous functional magnetic resonance imaging (fMRI) studies have reported that the medial temporal lobe (MTL) is activated to a greater extent when subjects encounter novel items as compared with familiar ones. However, it remains unclear whether the novelty signals in the MTL are modulated by the criteria for old/new recognition judgments. In this study, we used fMRI to test our hypothesis that when subjects encounter items similar to previously encountered ones, the novelty signals in the MTL will differ depending on whether the subjects focus on the perceptual features or the semantic aspects of the items. The subjects studied a series of photographs and were later asked to make a recognition judgment of (a) Same items (items identical to those seen during encoding), (b) Similar items (items similar to but not identical to those seen during encoding), and (c) New items (unstudied items) in two types of tasks: Perceptual and Semantic. The subjects judged whether the items were perceptually identical to those seen during encoding in the Perceptual task and whether the items were semantically identical to those seen during encoding in the Semantic task. The left anterior hippocampus was activated when subjects were presented with New items relative to Same items in both tasks. In addition, the hippocampal activity in response to the Similar items was increased only in the Perceptual, but not the Semantic task. Our results indicate that the novelty signals in the hippocampus can be modulated by criteria for old/new recognition judgments.

The role of the dorsolateral prefrontal cortex in deception when remembering neutral and emotional events.

We used functional magnetic resonance imaging (fMRI) to investigate the neural correlates of deception while remembering neutral events and emotional events. Before fMRI, subjects were presented with a series of neutral and emotional pictures and were asked to rate each picture for arousal. During fMRI, subjects were presented with the studied and nonstudied pictures and were asked to make an honest recognition judgment in response to half of the pictures and a dishonest response to the remaining half. We found that deception pertaining to the memory of neutral pictures was associated with increased activity in the bilateral dorsolateral prefrontal cortex, the left ventrolateral prefrontal cortex, and the left orbitofrontal cortex. We also found that deception while remembering emotional pictures was associated with increased activity in the bilateral dorsolateral prefrontal cortex. An overlapping activation between the two types of deception was found in the bilateral dorsolateral prefrontal cortex. Our results indicate that the dorsolateral prefrontal cortex is associated with the executive aspects of deception, regardless of the emotional valence of memory content.

[Attempt for development of rapid word reading test for children--evaluation of reliability and validity].

We developed a rapid word reading test for examining the phonological processing ability of Japanese children. We prepared two versions of the test, version A and B. Each test has word and non-word tasks. Twenty-two healthy boys of third grade in primary schools participated in this validation study. For criterion related validity, we performed the serial Hiragana reading test, the sentence reading test, Raven's coloured progressive matrices (RCPM), the Token test for children, the Kana word dictation test, the standardized comprehension test of abstract words (SCTAW), and Trail Circle test. The reading times of the newly developed test correlated moderately or highly with those of the serial Hiragana reading test and the sentence reading test. However, the scores of the other tests (RCPM, Token test for children, Kana word dictation test, SCTAW, Trail Circle test) did not correlated with the reading time of the rapid word reading test. Test-retest reliabilities in the word tasks were more than moderate: 0.52 and 0.76 in versions A and B, while those in the non-word tasks were high: 0.91 and 0.88 in versions A and B. The correlation coefficient between versions A and B was 0.7 for the word tasks and 0.92 for the non-word tasks. This study showed that the rapid word reading test has substantial validity and reliability for testing the phonological processing ability of Japanese children. In addition, the non-word tasks were more suitable for selectively examining the speed of the grapheme to phoneme conversion process.

Incidence of dementia and associated risk factors in Japan: The Osaki-Tajiri Project.

The incidence of dementia and risk factors has not been fully investigated in Japan. Following a prevalence study in 1998, we investigated the incidence and associated factors in the same population in 2003 and 2005. Randomly selected 771 residents in Tajiri were targeted. The final participants included 204 (65.2%) healthy older adults (Clinical Dementia Rating, CDR 0) and 335 (73.1%) people with questionable dementia (CDR 0.5). We analyzed the incidence of dementia and dementing diseases, and possible risk factors. The risk factors included demographics, lifestyle-related factors, vascular risk factors, cognitive functions, and MRI findings. Overall, 3.9% of the CDR 0 and 37.0% of the CDR 0.5 participants developed dementia during the 5-year period, whereas 40.2% of the CDR 0.5 participants developed dementia during the 7-year period. Older adults had a higher incidence. Higher CDR Box scores had a higher incidence. Of the dementing diseases, 60.8% of participants developed Alzheimer' disease (AD), followed by vascular dementia (VaD), 17.9%. Logistic regression analyses showed that age, MMSE, cognitive functions such as recent memory, and generalized atrophy were significant predictors of progression to AD. Similarly, predictive factors for progression to VaD were age, MMSE, cognitive functions such as frontal function, and white matter lesions and cerebrovascular diseases. A comprehensive system including CDR, cognitive tests, and MRI, is recommended in community-based health policy planning.

Confabulations in episodic memory are associated with delusions in Alzheimer's disease.

Although confabulations and delusions are observed in Alzheimer's disease, the relationship between the 2 has not been fully investigated. This study involved 50 patients with Alzheimer's disease and 10 healthy participants. After the patients were divided into delusional and nondelusional groups, confabulations and cognitive function were assessed. No confabulations appeared in the healthy participants, and only patients with Alzheimer's disease showed confabulations. The delusional group produced more confabulations on episodic subjects than on semantic subjects. There was a correlation between cognitive impairment and confabulations in semantic memory. These findings suggest that different mechanisms are involved in confabulations between semantic and episodic memories.