Case report: the effects of cerebellar tDCS in bilingual post-stroke aphasia.

Transcranial Direct Current Stimulation may be a useful neuromodulation tool for enhancing the effects of speech and language therapy in people with aphasia, but research so far has focused on monolinguals. We present the effects of 9 sessions of anodal cerebellar tDCS (ctDCS) coupled with language therapy in a bilingual patient with chronic post-stroke aphasia caused by left frontal ischemia, in a double-blind, sham-controlled within-subject design. Language therapy was provided in his second language (L2). Both sham and anodal treatment improved trained picture naming in the treated language (L2), while anodal ctDCS in addition improved picture naming of untrained items in L2 and his first language, L1. Picture description improved in L2 and L1 after anodal ctDCS, but not after sham.

Executive functions in primary progressive aphasia: A meta-analysis.

Executive functions (EFs) refer to a set of cognitive processes, specifically shifting, inhibition, updating of working memory, and are involved in the cognitive control of behavior. Conflicting results have been reported regarding impairments of EFs in Primary Progressive Aphasia (PPA). We performed a multi-level meta-analysis to confirm whether deficits of EFs exist in this population, focusing on a common EFs composite, and the components shifting, inhibition and updating separately. We included 141 studies that report on 294 EFs tasks. The overall mean weighted effect size was large (d = -1,28), indicating poorer EFs in PPA as compared to age-matched cognitively healthy controls. Differences between effect sizes of the EFs components were not significant, indicating all components are affected similarly. Overall, moderator analysis revealed that PPA variant and disease duration were significant moderators of performance, while task modality and years of education were not. The non-fluent/agrammatic PPA and the logopenic PPA variants were similarly affected, but the semantic variant was affected to a lesser extent. We discuss implications for clinical and research settings, and future research.

A Domain-General Monitoring Account of Bilingual Language Control in Recognition: The Role of Language Dominance and Bilingual Experience.

The ability of bilingual individuals to manage two competing languages is assumed to rely on both domain-specific language control and domain-general control mechanisms. However, previous studies have reported mixed findings about the extent and nature of cross-domain generality. The present study examined the role of language dominance, along with bilingual language experience, in the relationship between word recognition and domain-general cognitive control. Two single-language lexical decision tasks (one in L1 and another in L2) and a domain-general flanker task were administered to bilinguals who live in the sociolinguistic context of a minority and a majority language, namely, Uyghur (L1) and Chinese (L2), respectively. The results showed a diversity in language dominance patterns with better performance in L2 than L1 in the recognition modality, even for participants who self-identified as globally being dominant in L1. This finding reflected all bilinguals' self-evaluation that their preferred language for reading was L2, suggesting that language dominance is dynamic, depending on what language modality is measured. Furthermore, it was found that an earlier onset age of L2 acquisition (but not recent exposure) and a higher across-modality dominance in L2 were related to faster L2 word recognition. When self-reported language dominance was operationalised as a grouping variable, it was further found that both across-modality L1- and L2-dominant bilingual participants demonstrated a significant relationship between L2 word recognition and domain-general monitoring control, while only L1-dominant bilinguals additionally tapped into inhibitory control, indexed by the flanker effect during L2 word recognition. These findings suggest that language dominance has an impact on the extent and nature of the overlap in control mechanisms across specific linguistic and domain-general cognitive domains and add evidence to a domain-general monitoring account of bilingual word recognition.

A Systematic Review of Transcranial Direct Current Stimulation in Primary Progressive Aphasia: Methodological Considerations.

A variety of tDCS approaches has been used to investigate the potential of tDCS to improve language outcomes, or slow down the decay of language competences caused by Primary Progressive Aphasia (PPA). The employed stimulation protocols and study designs in PPA are generally speaking similar to those deployed in post-stroke aphasic populations. These two etiologies of aphasia however differ substantially in their pathophysiology, and for both conditions the optimal stimulation paradigm still needs to be established. A systematic review was done and after applying inclusion and exclusion criteria, 15 articles were analyzed focusing on differences and similarities across studies especially focusing on PPA patient characteristics (age, PPA variant, language background), tDCS stimulation protocols (intensity, frequency, combined therapy, electrode configuration) and study design as recent reviews and group outcomes for individual studies suggest tDCS is an effective tool to improve language outcomes, while methodological approach and patient characteristics are mentioned as moderators that may influence treatment effects. We found that studies of tDCS in PPA have clinical and methodological and heterogeneity regarding patient populations, stimulation protocols and study design. While positive group results are usually found irrespective of these differences, the magnitude, duration and generalization of these outcomes differ when comparing stimulation locations, and when results are stratified according to the clinical variant of PPA. We interpret the results of included studies in light of patient characteristics and methodological decisions. Further, we highlight the role neuroimaging can play in study protocols and interpreting results and make recommendations for future work.

Language Dominance and Sociolinguistic Experience Are Related to Language Control and Domain-General Monitoring Control: An Investigation in Bilinguals Who Live in a Minority/Majority Sociolinguistic Setting.

Bilingual language control in production tasks with language switches is supposed to be linked to domain-general cognitive control. In the present study, we investigated the role of language dominance, measured on a continuous scale, in the relationship between measures of language control elicited through language switching in a picture naming task and non-linguistic cognitive control induced by stimulus-response interference in a Simon task. In our sample of bilinguals who speak both a minority and majority language (language pair of Uyghur-Chinese), the results showed that as bilinguals were more L2-dominant, a pattern of reversed asymmetry switch costs in language control, i.e., larger L2 than L1 switch costs, was observed. Furthermore, the findings showed that recent exposure to the L1 minority language was associated with the change in language switch costs in terms of both response latencies and accuracy rates. This suggests a role for sociolinguistic context in bilingual language control. Concerning cross-domain generality, globally sustained language control was found to be correlated with domain-general monitoring control in response latencies for all bilingual participants. It lends support to the idea that bilinguals tap into monitoring control in the context of language switching. Additionally, the cross-domain overlap was found between two non-equivalent measures (global language control vs. cognitive inhibitory control) in response latencies, specifically for L1-dominant bilinguals. This suggests that language dominance may have an impact on cross-domain generality in language-switching processes.

Individual Variation and the Bilingual Advantage-Factors that Modulate the Effect of Bilingualism on Cognitive Control and Cognitive Reserve.

This editorial is an introduction to the special issue 'Individual variation and the bilingual advantage-factors that modulate the effect of bilingualism on cognitive control'[...].

Shifting Gear in the Study of the Bilingual Advantage: Language Switching Examined as a Possible Moderator.

The bilingual advantage is a heavily debated topic in research on bilingualism. The current study further investigated one specific aspect of bilingualism proposed to be a determining factor for the bilingual advantage, namely language switching behaviour. We investigated whether a bilingual advantage can be detected in the executive functions of inhibition and shifting by comparing monolingual and bilingual participants on a Simon task and a colour-shape switching task. Furthermore, we examined the relation between these executive functions and language switching proficiency, as measured by a semantic verbal fluency task. In addition, the current study set out to investigate the convergence of self-reported language switching estimates and actual language switching proficiency. Results revealed a bilingual advantage for shifting, but not for inhibition. However, this bilingual advantage for shifting was not related to language switching behaviour. Additionally, we were unable to identify a relation between objective and subjective measures of switching abilities. These findings seem to confirm the existence of a bilingual advantage, but also once again validate its elusiveness, as demonstrated by the absence of bilingual benefits on our measure of inhibition. It furthermore questions the validity of switching measures employed in previous studies.

A Systematic Review on the Possible Relationship Between Bilingualism, Cognitive Decline, and the Onset of Dementia.

A systematic review was conducted to investigate whether bilingualism has a protective effect against cognitive decline in aging and can protect against dementia. We searched the Medline, ScienceDirect, Scopus, and ERIC databases with a cut-off date of 31 March, 2019, thereby following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. Our search resulted in 34 eligible studies. Mixed results were found with respect to the protective effect of bilingualism against cognitive decline. Several studies showed a protective effect whereas other studies failed to find it. Moreover, evidence for a delay of the onset of dementia of between 4 and 5.5 years in bilingual individuals compared to monolinguals was found in several studies, but not in all. Methodological differences in the set-up of the studies seem to explain these mixed results. Lifelong bilingualism is a complex individual process, and many factors seem to influence this and need to be further investigated. This can be best achieved through large longitudinal studies with objective behavioral and neuroimaging measurements. In conclusion, although some evidence was found for a cognitive reserve-enhancing effect of lifelong bilingualism and protection against dementia, to date, no firm conclusions can be drawn.

Attention Network in Interpreters: The Role of Training and Experience.

The purpose of this study is to explore the relationship found between interpreting training and experience and the attentional network components: Alerting, orienting, and executive attention using the Attention Network Test (ANT). In the current study we tested three groups of interpreting students, translation students, and professional interpreters as specific forms of multilingual expertise. The student groups were tested longitudinally at the beginning and the end of their Master's programme. The professional interpreters were tested only one point in time. The results showed different attention network dynamics for the interpreting students compared to the translation students regarding alertness and executive network. First, the interpreting students showed a higher conflict effect when the alert cue was presented as well as a reduced accuracy compared to translation students. Second, the interpreting training had less effect on alerting than the translation training. Finally, two student groups showed a faster response time in conflict effect than the professional interpreters. In contrast, the professional interpreters scored a higher accuracy than two-student groups specifically in an incongruent alert condition, which confirms that they used a different responding strategy.

Relationship Between Language Dominance and Stimulus-Stimulus or Stimulus-Response Inhibition in Uyghur-Chinese Bilinguals with an Investigation of Speed-Accuracy Trade-Offs.

The effect of bilingualism on inhibition control is increasingly under ongoing exploration. The present study primarily investigated the effect of within bilingual factors (i.e., dominance types of Uyghur-Chinese bilinguals) on a Stimulus-Stimulus task (Flanker) and a Stimulus-Response task (Simon). We also compared the bilinguals' performance on each type of cognitive control task in respect to a possible trade-off between speed and accuracy. The findings showed no explicit differences on performance in response time or accuracy among balanced, L1-dominant and L2-dominant bilinguals but balanced bilinguals demonstrated a significant speed-accuracy trade-off in the overall context switching between non-conflict and conflict trials in both cognitive control tasks where monitoring process is highly demanded. Additionally, all bilinguals across all language dominance types showed a trade-off strategy in inhibition during a Stimulus-Stimulus conflict (flanker task). This evidence indicates that the differences of within bilinguals in cognitive control could lie in the monitoring process, while for all bilinguals, inhibition during a Stimulus-Stimulus conflict could be a major component in the mechanism of bilingual language processing.

Does the Bilingual Advantage in Cognitive Control Exist and If So, What Are Its Modulating Factors? A Systematic Review.

Recently, doubts were raised about the existence of the bilingual advantage in cognitive control. The aim of the present review was to investigate the bilingual advantage and its modulating factors. We searched the Medline, ScienceDirect, Scopus, and ERIC databases for all original data and reviewed studies on bilingualism and cognitive control, with a cut-off date of 31 October 2018, thereby following the guidelines of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol. The results of the 46 original studies show that indeed, the majority, 54.3%, reported beneficial effects of bilingualism on cognitive control tasks; however, 28.3% found mixed results and 17.4% found evidence against its existence. Methodological differences seem to explain these mixed results: Particularly, the varying selection of the bilingual participants, the use of nonstandardized tests, and the fact that individual differences were often neglected and that longitudinal designs were rare. Therefore, a serious risk for bias exists in both directions (i.e., in favor of and against the bilingual advantage). To conclude, we found some evidence for a bilingual advantage in cognitive control; however, if significant progress is to be made, better study designs, bigger data, and more longitudinal studies are needed.

The Role of Cognitive Development and Strategic Task Tendencies in the Bilingual Advantage Controversy.

Recent meta-analyses have indicated that the bilingual advantage in cognitive control is not clear-cut. So far, the literature has mainly focussed on behavioral differences and potential differences in strategic task tendencies between monolinguals and bilinguals have been left unexplored. In the present study, two groups of younger and older bilingual Dutch-French children were compared to monolingual controls on a Simon and flanker task. Beside the classical between-group comparison, we also investigated potential differences in strategy choices as indexed by the speed-accuracy trade-off. Whereas we did not find any evidence for an advantage for bilingual over monolingual children, only the bilinguals showed a significant speed-accuracy trade-off across tasks and age groups. Furthermore, in the younger bilingual group, the trade-off effect was only found in the Simon and not the flanker task. These findings suggest that differences in strategy choices can mask variations in performance between bilinguals and monolinguals, and therefore also provide inconsistent findings on the bilingual cognitive control advantage.

Schizophrenia and depression: The relation between sleep quality and working memory.

Sleep is known to be markedly disturbed in patients with depression, but in patients with schizophrenia these problems are underestimated. This research aimed to determine if a relationship existed between sleep problems in patients with schizophrenia and with depression and their reduced working memory (WM) performance. Thirty outpatients with schizophrenia, 30 outpatients with depression, and 30 healthy control participants were enrolled in this study. All participants completed a sleep questionnaire (i.e., Pittsburgh Sleep Quality Index (PSQI)), two simple WM tasks tapping only its storage component (i.e., digit span forward and backward task), and two complex WM tasks tapping both its storage and processing components (i.e., letter-number sequencing and reading span task). The results showed that neither psychiatric group differed from the healthy controls on simple WM tasks. Patients with schizophrenia did not differ from those with depression in the performance of simple or complex WM tasks. However, patients with schizophrenia, and, to a lesser degree, patients with depression performed significantly worse than the healthy control participants on complex WM tasks, which was visible in lower WM scores for patients with depression and in slower information processing, as well, for patients with schizophrenia. Finally, a significant negative relationship was found between the PSQI score and the reading span task scores; thus, participants with worse performance tended to report more sleep problems. To conclude, sleep needs to receive more priority when treating patients with depression and especially patients with schizophrenia because better sleep improves (working) memory performance and daily functioning.

Age of second language acquisition affects nonverbal conflict processing in children: an fMRI study.

BACKGROUND: In their daily communication, bilinguals switch between two languages, a process that involves the selection of a target language and minimization of interference from a nontarget language. Previous studies have uncovered the neural structure in bilinguals and the activation patterns associated with performing verbal conflict tasks. One question that remains, however is whether this extra verbal switching affects brain function during nonverbal conflict tasks. METHODS: In this study, we have used fMRI to investigate the impact of bilingualism in children performing two nonverbal tasks involving stimulus-stimulus and stimulus-response conflicts. Three groups of 8-11-year-old children--bilinguals from birth (2L1), second language learners (L2L), and a control group of monolinguals (1L1)--were scanned while performing a color Simon and a numerical Stroop task. Reaction times and accuracy were logged. RESULTS: Compared to monolingual controls, bilingual children showed higher behavioral congruency effect of these tasks, which is matched by the recruitment of brain regions that are generally used in general cognitive control, language processing or to solve language conflict situations in bilinguals (caudate nucleus, posterior cingulate gyrus, STG, precuneus). Further, the activation of these areas was found to be higher in 2L1 compared to L2L. CONCLUSION: The coupling of longer reaction times to the recruitment of extra language-related brain areas supports the hypothesis that when dealing with language conflicts the specialization of bilinguals hampers the way they can process with nonverbal conflicts, at least at early stages in life.

DTI reveals structural differences in white matter tracts between bilingual and monolingual children.

The impact of bilingualism on the microstructure of the white matter pathways related to language processing is assessed in elementary school children by magnetic resonance diffusion tensor imaging (MR-DTI). Forty children, 8-11 years old, subdivided into 3 different groups (15 simultaneous bilinguals, 15 sequential bilinguals and 10 monolinguals), were scanned. The hypothesis was that the starting age and the manner of second language acquisition would affect the characteristics of language circuitry. In each subject the mean fractional anisotropy (FA) was obtained for four major white matter pathways: 1 - the left arcuate fasciculus/superior longitudinal fasciculus (lAF/lSLF) that connects Broca's area in the opercular and triangular regions of the left inferior frontal gyrus to the posterior language zone, 2 - the left inferior occipitofrontal fasciculus (lIFOF), connecting anterior regions in the frontal lobe with posterior regions in the temporal occipital lobes, 3 - the bundle arising from the anterior part of the corpus callosum projecting to the orbital lobe (AC-OL) and 4 - the fibers emerging from the anterior midbody (AMB) of the corpus callosum that associate with the premotor and supplementary motor cortices (AMB-PMC). The three groups did not show significant differences in mean FA over the lAF/lSLF or AMB-PMC tracts. In simultaneous bilingual subjects the lIFOF tracts had higher mean FA value compared to monolinguals and also sequential bilinguals, whereas the comparison for the AC-OL fibers yielded a significantly lower mean FA value in simultaneous bilingual subjects compared to monolinguals. In both cases the FA value for sequential bilinguals was intermediate to that of the other two groups. To our knowledge, this study provides the first evidence of bilingualism related adaptation of white matter microstructure in the human brain.