Social Isolation of Older Adults Living in a Neighbourhood of Montreal: A Qualitative Descriptive Study of the Perspectives of Older Adults and Community Stakeholders.

The purpose of this study was to describe the social isolation of older adults in the Côte-des-Neiges neighbourhood (Montreal, Canada) from the perspectives of older adults and community stakeholders. To do so, a descriptive qualitative study was conducted, involving community-dwelling older adults and a variety of key stakeholders from the neighbourhood. Seven focus groups were held, with a total of 37 participants. Focus group transcripts were analyzed using the approach of Miles, Huberman, and Saldaña. Participants reported that social isolation of older adults is characterized by gaps in social interactions (scarcity of social interactions, lack of social support, and unsatisfying relationships) as well as by low social participation that can be depicted in three ways: (1) exclusion by society, (2) self-restriction of participation, and (3) low eagerness to socialize. This study highlights that there is a diversity in how social isolation of older adults manifests itself. It can be the result of a deliberate choice (or not), as well as being desired (or not). These aspects of the phenomenon of social isolation of older adults are still not well described. However, they offer relevant avenues for rethinking approaches to intervention development.

Communication during the COVID-19 pandemic: the hearing-impaired perspective.

OBJECTIVE: To understand the communicational and psychosocial effects of COVID-19 protective measures in real-life everyday communication settings. DESIGN: An online survey consisting of close-set and open-ended questions aimed to describe the communication difficulties experienced in different communication activities (in-person and telecommunication) during the COVID-19 pandemic. STUDY SAMPLE: 172 individuals with hearing loss and 130 who reported not having a hearing loss completed the study. They were recruited through social media, private audiology clinics, hospitals and monthly newsletters sent by the non-profit organisation "Audition Quebec." RESULTS: Face masks were the most problematic protective measure for communication in 75-90% of participants. For all in-person communication activities, participants with hearing loss reported significantly more impact on communication than participants with normal hearing. They also exhibited more activity limitations and negative emotions associated with communication difficulties. CONCLUSION: These results suggest that, in times of pandemic, individuals with hearing loss are more likely to exhibit communication breakdowns in their everyday activities. This may lead to social isolation and have a deleterious effect on their mental health. When interacting with individuals with hearing loss, communication strategies to optimise speech understanding should be used.

French Phonological Component Analysis and aphasia recovery: A bilingual perspective on behavioral and structural data.

Studies show bilingualism entails an advantage in cognitive control tasks. There is evidence of a bilingual advantage in the context of aphasia, resulting in better cognitive outcomes and recovery in bilingual persons with aphasia compared to monolingual peers. This bilingual advantage also results in structural changes in the right hemisphere gray matter. Very few studies have examined the so-called bilingual advantage by reference to specific anomia therapy efficacy. This study aims to compare the effect of French-Phonological Component Analysis (Fr-PCA) in monolinguals and bilingual persons with aphasia, both at the linguistic and cognitive control level, and to examine the structural impact of left hemisphere lesion location and right hemisphere structural data. Eight participants with chronic aphasia received Fr-PCA for a total of 15 h over 5 weeks. The results showed improved accuracy for treated words and generalization to untreated items and discourse in both groups, and improved Flanker task performance for some participants. Bilingual participants improved more than monolinguals for picture-naming tasks and narrative discourse. Damage to the left postcentral gyrus and the middle frontal gyrus was associated with less therapy-induced improvement. Additionally, left hemisphere damage to the inferior parietal gyrus and postcentral gyrus was associated with reduced cognitive control pre-therapy. Undamaged right hemisphere cortical thicknesses were significantly different between groups; the inferior frontal gyrus and the middle frontal gyrus were greater for the bilingual participants and correlated with cognitive control skills. These results suggest a bilingual advantage in anomia recovery following Fr-PCA, potentially resulting from enhanced cognitive control abilities that could be supported by right hemisphere neural reserve.

Multifactorial approaches to study bilingualism in the aging population: Past, present, future.

A better understanding and more reliable classification of bilinguals has been progressively achieved through the fine-tuning methodology and simultaneously optimizing the measurement tools. However, the current understanding is far from generalization to a larger population varying in different measures of bilingualism-L2 Age of acquisition (L2 AOA), L2 usage and exposure, and L2 proficiency. More recent studies have highlighted the importance of modeling bilingualism as a continuous variable. An in-depth look at the role of bilingualism, comparing groups, may be considered a reductionist approach, i.e., grouping based on one measure of bilingualism (e.g., L2 AOA) may not account for variability in other measures of bilingualism (L2 exposure, L2 use or L2 proficiency, amongst others) within and between groups. Similarly, a multifactorial dimension is associated with cognitive performance, where not all domains of cognition and subcomponents are equally influenced by bilingualism. In addition, socio-cultural and demographical factors may add another dimension to the impact of bilingualism on cognitive performance, especially in older adults. Nevertheless, not many studies have controlled or used the multiple socio-cultural and demographical factors as a covariate to understand the role of different aspects of bilingualism that may influence cognitive performance differently. Such an approach would fail to generalize the research findings to a larger group of bilinguals. In the present review paper, we illustrate that considering a multifactorial approach to different dimensions of bilingual study may lead to a better understanding of the role of bilingualism on cognitive performance. With the evolution of various fine-tuned methodological approaches, there is a greater need to study variability in bilingual profiles that can help generalize the result universally.

Exploring attention in the bilingualism continuum: A resting-state functional connectivity study.

This study explores the effects of bilingualism on the subcomponents of attention using resting state functional connectivity analysis (rsFC). Unlike previous studies, measures of bilingualism - L2 Age of Acquisition (AOA), L2 exposure, and L2 proficiency - were examined along a continuum to study attentional mechanisms using rsFC instead of dichotomizing them. 20 seed regions were pre-selected for the three subcomponents of attention. The results showed a positive association between behavioral performance and rsFC for the seeds in alerting and orienting network; this was not true for the seeds in the executive control network. Secondly, rsFC for attention networks varied with different levels of bilingualism. The objective measures of bilingualism modulate all three attention networks. While the subjective measures such as L2 AOA modulates specific attention network. Thus, language performance in contrast to self-reported information, as a measure of bilingualism, has a greater potential to tap into the role of bilingualism in attentional processes.

Resting-State Functional Connectivity following Phonological Component Analysis: The Combined Action of Phonology and Visual Orthographic Cues.

Anomia is the most frequent and pervasive symptom for people with aphasia (PWA). Phonological component analysis (PCA) is a therapy incorporating phonological cues to treat anomia. Investigations of neural correlates supporting improvements following PCA remain scarce. Resting-state functional connectivity (rsFC) as a marker of therapy-induced neuroplasticity has been reported by our team. The present study explores the efficacy of PCA in French and associated therapy-induced neuroplasticity using whole-brain rsFC analysis. Ten PWA participated in a pre-/post-PCA fMRI study with cognitive linguistic assessments. PCA was delivered in French following the standard procedure. PCA led to significant improvement with trained and untrained items. PCA also led to changes in rsFC between distributed ROIs in the semantic network, visual network, and sub-cortical areas. Changes in rsFC can be interpreted within the frame of the visual and phonological nature of PCA. Behavioral and rsFC data changes associated with PCA in French highlight its efficacy and point to the importance of phonological and orthographic cues to consolidate the word-retrieval strategy, contributing to generalization to untrained words.

Increased links between language and motor areas: A proof-of-concept study on resting-state functional connectivity following Personalized Observation, Execution and Mental imagery therapy in chronic aphasia.

A tight coupling of language and motor processes has been established, which is consistent with embodied cognition theory. However, very few therapies have been designed to exploit the synergy between motor and language processes to help rehabilitate people with aphasia (PWA). Moreover, the underlying mechanisms supporting the efficacy of such approaches remain unknown. Previous work in our laboratory has demonstrated that personalized observation, execution, and mental imagery therapy (POEM)-a new therapy using three sensorimotor strategies to trigger action verb naming-leads to significant improvements in verb retrieval in PWA. Moreover, these improvements were supported by significant activations in language and sensorimotor processing areas, which further reinforce the role of both processes in language recovery (Durand et al., 2018). The present study investigates resting state functional connectivity (rsFC) changes following POEM in a pre-/post-POEM therapy design. A whole brain network functional connectivity approach was used to assess and describe changes in rsFC in a group of four PWA, who were matched and compared with four healthy controls (HC). Results showed increased rsFC in PWA within and between visuo-motor and language areas (right cuneal cortex-left supracalcarin (SCC) cortex/right precentral gyrus (PreCG)-left lingual gyrus (LG)) and between areas involved in action processing (right anterior parahippocampal gyrus (aPaHC)-left superior parietal lobule (SPL). In comparison to HC, the PWA group showed increased rsFC between the right inferior frontal gyrus (IFG) and left thalamus, which are areas involved in lexico-semantic processing. This proof-of-concept study suggests that the sensorimotor and language strategies used in POEM may induce modifications in large-scale networks, probably derived from the integration of visual and sensorimotor systems to sustain action naming, which is consistent with the embodied cognition theory.

Alerting, Orienting, and Executive Control: The Effect of Bilingualism and Age on the Subcomponents of Attention.

Life-long experience of using two or more languages has been shown to enhance cognitive control abilities in young and elderly bilinguals in comparison to their monolingual peers. This advantage has been found to be larger in older adults in comparison to younger adults, suggesting that bilingualism provides advantages in cognitive control abilities. However, studies showing this effect have used a variety of tasks (Simon Task, Stroop task, Flanker Task), each measuring different subcomponents of attention and raising mixed results. At the same time, attention is not a unitary function but comprises of subcomponents which can be distinctively addressed within the Attention Network Test (ANT) (1, 2). The purpose of this work was to examine the neurofunctional correlates of the subcomponents of attention in healthy young and elderly bilinguals taking into account the L2 age of acquisition, language usage, and proficiency. Participants performed an fMRI version of the ANT task, and speed, accuracy, and BOLD data were collected. As expected, results show slower overall response times with increasing age. The ability to take advantage of the warning cues also decreased with age, resulting in reduced alerting and orienting abilities in older adults. fMRI results showed an increase in neurofunctional activity in the frontal and parietal areas in elderly bilinguals when compared to young bilinguals. Furthermore, higher L2 proficiency correlated negatively with activation in frontal area, and that faster RTs correlated negatively with activation in frontal and parietal areas. Such a correlation, especially with L2 proficiency was not present in young bilinguals and provides evidence for a bilingual advantage in the alerting subcomponent of attention that characterizes elderly bilinguals' performance. This study thus provides extra details about the bilingual advantage in the subcomponent of attention, in older bilinguals. Consequently, speaking more than one language impacts cognition and the brain later in life.

The Neural and Behavioral Correlates of Anomia Recovery following Personalized Observation, Execution, and Mental Imagery Therapy: A Proof of Concept.

The impact of sensorimotor strategies on aphasia recovery has rarely been explored. This paper reports on the efficacy of personalized observation, execution, and mental imagery (POEM) therapy, a new approach designed to integrate sensorimotor and language-based strategies to treat verb anomia, a frequent aphasia sign. Two participants with verb anomia were followed up in a pre-/posttherapy fMRI study. POEM was administered in a massed stimulation schedule, with personalized stimuli, resulting in significant improvement in both participants, with both trained and untrained items. Given that the latter finding is rarely reported in the literature, the evidence suggests that POEM favors the implementation of a word retrieval strategy that can be integrated and generalized. Changes in fMRI patterns following POEM reflect a reduction in the number of recruited areas supporting naming and the recruitment of brain areas that belong to the language and mirror neuron systems. The data provide evidence on the efficacy of POEM for verb anomia, while pointing to the added value of combined language and sensorimotor strategies for recovery from verb anomia, contributing to the consolidation of a word retrieval strategy that can be better generalized to untrained words. Future studies with a larger sample of participants are required to further explore this avenue.

Lateralized Affective Word Priming and Gender Effect.

Affective priming research suggests that processing of affective words is a quick and short lived process. Using the divided visual field (DVF) paradigm, investigations of the lateralization of affective word processing have yielded inconsistent results. However, research on semantic processing of words generally suggests that the left hemisphere (LH) is the location where rapid processing occurs. We investigated the processing of affective (emotional) words using a combination of the DVF and affective priming paradigms, and four stimulus onset asynchronies (SOAs)-0, 150, 300, and 750 ms. The priming pattern yielded by males (n = 32) showed quick priming (at 0-ms SOA) of affective words in the LH; there was slower right hemisphere (RH) priming of affective words (at 750-ms SOA). In females (n = 28), both hemispheres were associated with quick priming of affective words (at 300-ms SOA in the LH and at 150-ms SOA in the RH). Results demonstrate the capability of both cerebral hemispheres in the processing of words with affective meaning, along with leading role of the left hemisphere in this process. This is similar to the results of semantic research that suggest access to word meanings occurs in both hemispheres, but different mechanisms might be involved. While the LH seems to prime affective words quickly regardless of gender, gender differences are likely in the RH in that affective word processing probably occurs slowly in males but rapidly in females. This gender difference may result from increased sensitivity to the emotional feature of affective words in females.

Second Language Word Learning through Repetition and Imitation: Functional Networks as a Function of Learning Phase and Language Distance.

Introduction and Aim: Repetition and imitation are among the oldest second language (L2) teaching approaches and are frequently used in the context of L2 learning and language therapy, despite some heavy criticism. Current neuroimaging techniques allow the neural mechanisms underlying repetition and imitation to be examined. This fMRI study examines the influence of verbal repetition and imitation on network configuration. Integration changes within and between the cognitive control and language networks were studied, in a pair of linguistically close languages (Spanish and French), and compared to our previous work on a distant language pair (Ghazi-Saidi et al., 2013). Methods: Twelve healthy native Spanish-speaking (L1) adults, and 12 healthy native Persian-speaking adults learned 130 new French (L2) words, through a computerized audiovisual repetition and imitation program. The program presented colored photos of objects. Participants were instructed to look at each photo and pronounce its name as closely as possible to the native template (imitate). Repetition was encouraged as many times as necessary to learn the object's name; phonological cues were provided if necessary. Participants practiced for 15 min, over 30 days, and were tested while naming the same items during fMRI scanning, at week 1 (shallow learning phase) and week 4 (consolidation phase) of training. To compare this set of data with our previous work on Persian speakers, a similar data analysis plan including accuracy rates (AR), response times (RT), and functional integration values for the language and cognitive control network at each measure point was included, with further L1-L2 direct comparisons across the two populations. Results and Discussion: The evidence shows that learning L2 words through repetition induces neuroplasticity at the network level. Specifically, L2 word learners showed increased network integration after 3 weeks of training, with both close and distant language pairs. Moreover, higher network integration was observed in the learners with the close language pair, suggesting that repetition effects on network configuration vary as a function of task complexity.

Maladaptive Plasticity in Aphasia: Brain Activation Maps Underlying Verb Retrieval Errors.

Anomia, or impaired word retrieval, is the most widespread symptom of aphasia, an acquired language impairment secondary to brain damage. In the last decades, functional neuroimaging techniques have enabled studying the neural basis underlying anomia and its recovery. The present study aimed to explore maladaptive plasticity in persistent verb anomia, in three male participants with chronic nonfluent aphasia. Brain activation maps associated with semantic verb paraphasia occurring within an oral picture-naming task were identified with an event-related fMRI paradigm. These maps were compared with those obtained in our previous study examining adaptive plasticity (i.e., successful verb naming) in the same participants. The results show that activation patterns related to semantic verb paraphasia and successful verb naming comprise a number of common areas, contributing to both maladaptive and adaptive neuroplasticity mechanisms. This finding suggests that the segregation of brain areas provides only a partial view of the neural basis of verb anomia and successful verb naming. Therefore, it indicates the importance of network approaches which may better capture the complexity of maladaptive and adaptive neuroplasticity mechanisms in anomia recovery.

X-linked focal epilepsy with reflex bathing seizures: Characterization of a distinct epileptic syndrome.

OBJECTIVE: We recently reported a Q555X mutation of synapsin 1 (SYN1) on chromosome Xp11-q21 in a family segregating partial epilepsy and autistic spectrum disorder. Herein, we provide a detailed description of the epileptic syndrome in the original family. METHODS: A total of 34 members from a large French-Canadian family were evaluated. Family members with seizures or epilepsy underwent (when possible) clinical, neuropsychological, electrophysiologic, and neuroimaging assessments. RESULTS: Epilepsy was diagnosed in 10 family members (4 deceased, 6 living). In addition to occasional spontaneous complex partial seizures, seven family members clearly had reflex seizures triggered by bathing or showering. Hippocampal atrophy was found in two of five epileptic family members family members who underwent magnetic resonance (MR) imaging. Video-electroencephalography (EEG) recordings of three triggered seizures in two affected members showed rhythmic theta activity over temporal head regions. Ictal single-photon emission computed tomography (SPECT) showed temporoinsular perfusion changes. Detailed neuropsychological assessments revealed that SYN1 Q555X male mutation carriers showed specific language impairment and mild autistic spectrum disorder. Female carriers also exhibited reading impairments and febrile seizures but no chronic epilepsy. SIGNIFICANCE: Available evidence suggests that impaired SYN1 function is associated with hyperexcitability of the temporoinsular network and disturbance of high mental functions such as language and social interaction. The presence of reflex bathing seizures, a most peculiar clinical feature, could be helpful in identifying other patients with this syndrome.

Interference Control In Elderly Bilinguals: Appearances Can Be Misleading.

Bilingualism has been associated with successful aging. In particular, research on the cognitive advantages of bilingualism suggests that it can enhance control over interference and help delay the onset of dementia signs. However, the evidence on the so-called cognitive advantage is not unanimous; furthermore, little is known about the neural basis of this supposed cognitive advantage in bilingual as opposed to monolingual elderly populations. In this study, elderly bilingual and monolingual participants performed a visuospatial interference control task during functional magnetic resonance imaging (fMRI) scanning. Response times and accuracy rates were calculated for congruent and incongruent conditions of the Simon task, and the neurofunctional correlates of performance on the Simon task were examined. The results showed equivalent performance on the Simon task across groups but different underlying neural substrates in the two groups. With incongruent trials, monolinguals activated the right middle frontal gyrus, whereas bilinguals relied upon the left inferior parietal lobule. These results show that elderly bilinguals and monolinguals have equivalent interference control abilities, but relay on different neural substrates. Thus, while monolinguals show a classical PASA (posterior-anterior shift in aging) effect, recruiting frontal areas, bilinguals activate visuospatial processing alone and thus do not show this posterior-anterior shift. Moreover, a modulation of frontal activity with task-dynamic control of interference, observed in the elderly bilingual group alone, suggests that elderly bilinguals deal with interference control without recruiting a circuit that is particularly vulnerable to aging.

Age-related behavioural and neurofunctional patterns of second language word learning: different ways of being successful.

This study aimed at investigating the neural basis of word learning as a function of age and word type. Ten young and ten elderly French-speaking participants were trained by means of a computerized Spanish word program. Both age groups reached a similar naming accuracy, but the elderly required significantly more time. Despite equivalent performance, distinct neural networks characterized the ceiling. While the young cohort showed subcortical activations, the elderly recruited the left inferior frontal gyrus, the left lingual gyrus and the precuneus. The learning trajectory of the elderly, the neuroimaging findings together with their performance on the Stroop suggest that the young adults relied on control processing areas whereas the elderly relied on episodic memory circuits, which may reflect resorting to better preserved cognitive resources. Finally, the recruitment of visual processing areas by the elderly may reflect the impact of the language training method used.

Aphasia therapy in the age of globalization: cross-linguistic therapy effects in bilingual aphasia.

INTRODUCTION: Globalization imposes challenges to the field of behavioural neurology, among which is an increase in the prevalence of bilingual aphasia. Thus, aphasiologists have increasingly focused on bilingual aphasia therapy and, more recently, on the identification of the most efficient procedures for triggering language recovery in bilinguals with aphasia. Therapy in both languages is often not available, and, thus, researchers have focused on the transfer of therapy effects from the treated language to the untreated one. AIM: This paper discusses the literature on bilingual aphasia therapy, with a focus on cross-linguistic therapy effects from the language in which therapy is provided to the untreated language. METHODS: Fifteen articles including two systematic reviews, providing details on pre- and posttherapy in the adult bilingual population with poststroke aphasia and anomia are discussed with regard to variables that can influence the presence or absence of cross-linguistic transfer of therapy effects. RESULTS AND DISCUSSION: . The potential for CLT of therapy effects from the treated to the untreated language depends on the word type, the degree of structural overlap between languages, the type of therapy approach, the pre- and postmorbid language proficiency profiles, and the status of the cognitive control circuit.

The complementary role of the cerebral hemispheres in recovery from aphasia after stroke: a critical review of literature.

OBJECTIVES: To review the literature on the specific role of the right cerebral hemisphere during recovery from aphasia in order to address the lack of consensus among authors. To derive a theoretical model reconciling the controversial findings in the literature. METHODS: Initial PubMed, MEDLINE (1946 to 5 May 2012) and PsycINFO (1806 to first week June 2012) searches on recovery mechanisms from aphasia, whether treatment-related or not, retrieved a total of 35 English language articles. Articles, cross-referenced in this initial set were also reviewed if they met the inclusion criteria, thus resulting in a total of 42 articles included in this review. MAIN OUTCOMES: Recruitment of the right hemisphere during recovery from aphasia can be effective if it occurs during a critical time window post-stroke. The recruitment's effectiveness will depend on the lesion's location, extent and permanence. Preservation of core language processing areas will generate minimal right hemisphere recruitment and vice versa. Some experimental studies seem to suggest that the improvement linked to a particular hemisphere can be modulated by specific therapy methods. CONCLUSION: The specific conditions in which effective right recruitment takes place may have important implications for rehabilitation treatment. These findings could lead to improved recovery in people suffering from aphasia. However, more research with non-invasive brain stimulation is needed.

Default-mode network functional connectivity in aphasia: therapy-induced neuroplasticity.

Previous research on participants with aphasia has mainly been based on standard functional neuroimaging analysis. Recent studies have shown that functional connectivity analysis can detect compensatory activity, not revealed by standard analysis. Little is known, however, about the default-mode network in aphasia. In the current study, we studied changes in the default-mode network in subjects with aphasia who underwent semantic feature analysis therapy. We studied nine participants with chronic aphasia and compared them to 10 control participants. For the first time, we identified the default-mode network using spatial independent component analysis, in participants with aphasia. Intensive therapy improved integration in the posterior areas of the default-mode network concurrent with language improvement. Correlations between integration and improvement did not reach significance, but the trend suggests that pre-therapy integration of the default-mode network may predict therapy outcomes. Functional connectivity allows a better understanding of the impact of semantic feature analysis in aphasia.