Social Listening in Gout: Impact of Proactive vs. Reactive Management on Self-Reported Emotional States.

INTRODUCTION: This study aimed to characterize patient-reported outcomes from social media conversations in the gout community. The impact of management strategy differences on the community's emotional states was explored. METHODS: We analyzed two social media sources using a variety of natural language processing techniques. We isolated conversations with a high probability of discussing disease management (score > 0.99). These conversations were stratified by management type: proactive or reactive. The polarity (positivity/negativity) of language and emotions conveyed in statements shared by community members was assessed by management type. RESULTS: Among the statements related to management, reactive management (e.g., urgent care) was mentioned in 0.5% of statements, and proactive management (e.g., primary care) was mentioned in 0.6% of statements. Reactive management statements had a significantly larger proportion of negative words (59%) than did proactive management statements (44%); "fear" occurred more frequently with reactive statements, whereas "trust" predominated in proactive statements. Allopurinol was the most common medication in proactive management statements, whereas reactive management had significantly higher counts of prednisone/steroid mentions. CONCLUSIONS: A unique aspect of examining gout-related social media conversations is the ability to better understand the intersection of clinical management and emotional impacts in the gout community. The effect of social media statements was significantly stratified by management type for gout community members, where proactive management statements were characterized by more positive language than reactive management statements. These results suggest that proactive disease management may result in more positive mental and emotional experiences in patients with gout.

SymCog: An open-source toolkit for assessing human symbolic cognition.

Symbol systems have a profound influence on human behavior, spanning countless modalities such as natural language, clothing styles, monetary systems, and gestural conventions (e.g., handshaking). Selective impairments in understanding and manipulating symbols are collectively known as asymbolia. Here we address open questions about the nature of asymbolia in the context of both historical and contemporary approaches to human symbolic cognition. We describe a tripartite perspective on symbolic cognition premised upon (1) mental representation of a concept, (2) a stored pool of symbols segregated from their respective referents, and (3) fast and accurate mapping between concepts and symbols. We present an open-source toolkit for assessing symbolic knowledge premised upon matching animated video depictions of abstract concepts to their corresponding verbal and nonverbal symbols. Animations include simple geometric shapes (e.g., filled circles, squares) moving in semantically meaningful ways. For example, a rectangle bending under the implied weight of a large square denotes "heaviness." We report normative data for matching words and images to these target animations. In a second norming study, participants rated target animations across a range of semantic dimensions (e.g., valence, dominance). In a third study, we normed a set of concepts familiar to American English speakers but lacking verbal labels (e.g., the feeling of a Sunday evening). We describe how these tools may be used to assess human symbolic processing and identify asymbolic deficits across the span of human development.

Eyetracking during picture naming predicts future vocabulary dropout in progressive anomia.

The dynamic and unpredictable nature of expressive vocabulary dropout in progressive anomia presents a challenge for language intervention. We evaluated whether eye gaze patterns during naming could predict anomia for the same items in the near future. We tracked naming accuracy and gaze patterns as patients with semantic (n = 7) or logopenic (n = 2) variants of Primary Progressive Aphasia or amnestic Alzheimer's Disease (n = 1), named photographs of people and objects. Patients were tested three or more times spaced roughly evenly over an average duration of 19.1 months. Target words named accurately at baseline were retrospectively coded as either known (i.e., consistently named) or vulnerable (i.e., inaccurately or inconsistently named) based on naming accuracy over the study interval. We extracted gaze data corresponding to successful naming attempts and implemented logistic mixed effects models to determine whether common gaze measures could predict each word's naming status as known or vulnerable. More visual fixations and greater visual fixation dispersion predicted later anomia. These findings suggest that eye tracking may yield a biomarker of the robustness of particular target words to future expressive vocabulary dropout. We discuss the potential utility of this finding for optimizing treatment for progressive anomia.

Olfactory language and semantic processing in anosmia: a neuropsychological case control study.

A longstanding debate within philosophy and neuroscience involves the extent to which sensory information is a necessary condition for conceptual knowledge. Much of our understanding of this relationship has been informed by examining the impact of congenital blindness and deafness on language and cognitive development. Relatively little is known about the "lesser" senses of smell and taste. Here we report a neuropsychological case-control study contrasting a young adult male (P01) diagnosed with anosmia (i.e. no olfaction) during early childhood relative to an age- and sex-matched control group. A structural MRI of P01's brain revealed profoundly atrophic/aplastic olfactory bulbs, and standardized smell testing confirmed his prior pediatric diagnosis of anosmia. Participants completed three language experiments examining comprehension, production, and subjective experiential ratings of odor salient words (e.g. sewer) and scenarios (e.g. fish market). P01's ratings of odor salience of single words were lower than all control participants, whereas his ratings on five other perceptual and affective dimensions were similar to controls. P01 produced unusual associations when cued to generate words that smelled similar to odor-neutral target words (e.g. ink → plant). In narrative picture description for odor salient scenes (e.g. bakery), P01 was indistinguishable from controls. These results suggest that odor deprivation does not overtly impair functional language use. However, subtle lexical-semantic effects of anosmia may be revealed using sensitive linguistic measures.

Evaluating a Maintenance-Based Treatment Approach to Preventing Lexical Dropout in Progressive Anomia.

Purpose Primary progressive aphasia (PPA) and the amnestic variant of Alzheimer's disease (AD) are neurodegenerative conditions characterized by a profound loss of functional communication abilities. Communicative impairment in AD and PPA is especially apparent in the domain of naming common objects and familiar faces. We evaluated the effectiveness of a language intervention targeting maintenance of an individualized core vocabulary in a longitudinal cohort of older adults experiencing either PPA or AD. Method PPA (n = 9) and AD (n = 1) patients were administered a semantically based language treatment for up to 2 years. Patients repeatedly named and generated semantic features for a personalized lexicon consisting of 100 words. We evaluated naming accuracy and off-line neuropsychological measures at four successive timepoints. Naming accuracy was assessed in patients (n = 7) who completed at least three recurrent evaluations. Off-line neuropsychological performance was assessed across timepoints in all patients. Results Patients demonstrated relative preservation of naming trained words relative to a steep decline for untrained (control) words. The greatest decrements were observed for naming people relative to objects. Conclusion These results suggest that consistent training of a finite set of words can protect a core lexicon composed of crucial target concepts (e.g., a spouse's name). We discuss potential benefits and clinical implications of maintenance-based approaches to promoting language functioning in the context of neurodegeneration.

The English Lexicon Mirrors Functional Brain Activation for a Sensory Hierarchy Dominated by Vision and Audition: Point-Counterpoint.

The meanings of most open class words are suffused with sensory and affective features. A word such as beach, for example, evokes polymodal associations ranging from gritty sand (tactile) and crashing waves (auditory) to the distinctive smell of sunscreen (olfactory). Aristotle argued for a hierarchy of the senses where vision and audition eclipse the lesser modalities of odor, taste, and touch. A direct test of Aristotle's premise was recently made possible with the establishment of the Lancaster Sensorimotor Norms (2019), a crowdsourced database cataloging sensorimotor salience for nearly 40,000 English words. Neurosynth, a metanalytic database of functional magnetic resonance imaging studies, can potentially confirm if Aristotle's sensory hierarchy is reflected in functional activation within the human brain. We correlated sensory salience of English words as assessed by subjective ratings of vision, audition, olfaction, touch, and gustation (Lancaster Ratings) with volumes of cortical activation for each of these respective sensory modalities (Neurosynth). English word ratings reflected the following sensory hierarchy: vision > audition > haptic > olfaction ≈ gustation. This linguistic hierarchy nearly perfectly correlated with voxel counts of functional activation maps by each sensory modality (Pearson r=.99). These findings are grossly consistent with Aristotle's hierarchy of the senses. We discuss implications and counterevidence from other natural languages.

Neuromodulation of cursing in American English: A combined tDCS and pupillometry study.

Many neurological disorders are associated with excessive and/or uncontrolled cursing. The right prefrontal cortex has long been implicated in a diverse range of cognitive processes that underlie the propensity for cursing, including non-propositional language representation, emotion regulation, theory of mind, and affective arousal. Neurogenic cursing often poses significant negative social consequences, and there is no known behavioral intervention for this communicative disorder. We examined whether right vs. left lateralized prefrontal neurostimultion via tDCS could modulate taboo word production in neurotypical adults. We employed a pre/post design with a bilateral frontal electrode montage. Half the participants received left anodal and right cathodal stimulation; the remainder received the opposite polarity stimulation at the same anatomical loci. We employed physiological (pupillometry) and behavioral (reaction time) dependent measures as participants read aloud taboo and non-taboo words. Pupillary responses demonstrated a crossover reaction, suggestive of modulation of phasic arousal during cursing. Participants in the right anodal condition showed elevated pupil responses for taboo words post stimulation. In contrast, participants in the right cathodal condition showed relative dampening of pupil responses for taboo words post stimulation. We observed no effects of stimulation on response times. We interpret these findings as supporting modulation of right hemisphere affective arousal that disproportionately impacts taboo word processing. We discuss alternate accounts of the data and future applications to neurological disorders.

Building the perfect curse word: A psycholinguistic investigation of the form and meaning of taboo words.

Taboo words represent a potent subset of natural language. It has been hypothesized that "tabooness" reflects an emergent property of negative valence and high physiological arousal of word referents. Many taboo words (e.g., dick, shit) are indeed consistent with this claim. Nevertheless, American English is also rife with negatively valenced, highly arousing words the usage of which is not socially condemned (e.g., cancer, abortion, welfare). We evaluated prediction of tabooness of single words and novel taboo compound words from a combination of phonological, lexical, and semantic variables (e.g., semantic category, word length). For single words, physiological arousal and emotional valence strongly predicted tabooness with additional moderating contributions from form (phonology) and meaning (semantic category). In Experiment 2, raters judged plausibility for combinations of common nouns with taboo words to form novel taboo compounds (e.g., shitgibbon). A mixture of formal (e.g., ratio of stop consonants, length) and semantic variables (e.g., ± receptacle, ± profession) predicted the quality of novel taboo compounding. Together, these studies provide complementary evidence for interactions between word form and meaning and an algorithmic prediction of tabooness in American English. We discuss applications for models of taboo word representation.

Naming and Knowing Revisited: Eyetracking Correlates of Anomia in Progressive Aphasia.

Progressive naming impairment (i.e., anomia) is a core diagnostic symptom of numerous pathologies that impact anterior and inferior portions of the temporal lobe. For patients who experience such regional temporal lobe degeneration, patterns of language loss often parallel the degradation of semantic memory, an etiology of naming impairment known as semantic anomia. Previous studies of semantic anomia have focused extensively on the output of naming attempts by contrasting errors, omissions, and distortions as a function of item-level characteristics (e.g., prototypicality, semantic category). An alternative approach involves evaluating visual confrontation naming as the naming process unfolds. Techniques with high temporal resolution (e.g., eyetracking) offer a potentially sensitive mode of delineating the locus of impairment during naming. For example, a lexical retrieval disorder would hypothetically elicit normal gaze patterns associated with successful visual object recognition regardless of naming accuracy. In contrast, we hypothesize that semantic anomia would be distinguished by aberrant gaze patterns as a function of reduced top-down conceptually guided search. Here we examined visual object recognition during picture confrontation naming by contrasting gaze patterns time locked to stimulus onset. Patients included a cohort of patients with anomia associated with either primary progressive aphasia (N = 9) or Alzheimer's disease (N = 1) who attempted to name 200 pictures over the course of 18-24 months. We retrospectively isolated correct and incorrect naming attempts and contrasted gaze patterns for accurate vs. inaccurate attempts to discern whether gaze patterns are predictive of language forgetting. Patients tended to show a lower fixation count, higher saccade count, and slower saccade velocity for items that were named incorrectly. These results hold promise for the utility of eyetracking as a diagnostic and therapeutic index of language functioning.