Language performance as a prognostic factor for developing Alzheimer's clinical syndrome and mild cognitive impairment: Results from the population-based HELIAD cohort.

OBJECTIVES: There is limited research on the prognostic value of language tasks regarding mild cognitive impairment (MCI) and Alzheimer's clinical syndrome (ACS) development in the cognitively normal (CN) elderly, as well as MCI to ACS conversion. METHODS: Participants were drawn from the population-based Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort. Language performance was evaluated via verbal fluency [semantic (SVF) and phonemic (PVF)], confrontation naming [Boston Naming Test short form (BNTsf)], verbal comprehension, and repetition tasks. An additional language index was estimated using both verbal fluency tasks: SVF-PVF discrepancy. Cox proportional hazards analyses adjusted for important sociodemographic parameters (age, sex, education, main occupation, and socioeconomic status) and global cognitive status [Mini Mental State Examination score (MMSE)] were performed. RESULTS: A total of 959 CN and 118 MCI older (>64 years) individuals had follow-up investigations after a mean of ∼3 years. Regarding the CN group, each standard deviation increase in the composite language score reduced the risk of ACS and MCI by 49% (8-72%) and 32% (8-50%), respectively; better SVF and BNTsf performance were also independently associated with reduced risk of ACS and MCI. On the other hand, using the smaller MCI participant set, no language measurement was related to the risk of MCI to ACS conversion. CONCLUSIONS: Impaired language performance is associated with elevated risk of ACS and MCI development. Better SVF and BNTsf performance are associated with reduced risk of ACS and MCI in CN individuals, independent of age, sex, education, main occupation, socioeconomic status, and MMSE scores at baseline.

Exploring Verbal Fluency Strategies among Individuals with Normal Cognition, Amnestic and Non-Amnestic Mild Cognitive Impairment, and Alzheimer's Disease.

Background and Objectives: The present study explored the utilization of verbal fluency (VF) cognitive strategies, including clustering, switching, intrusions, and perseverations, within both semantic (SVF) and phonemic (PVF) conditions, across a continuum of neurocognitive decline, spanning from normal cognitive ageing (NC) to mild cognitive impairment (MCI) and its subtypes, amnestic (aMCI) and non-amnestic (naMCI), as well as AD. Materials and Methods: The study sample was derived from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort. The sample included 1607 NC individuals, 146 with aMCI (46 single-domain and 100 multi-domain), 92 with naMCI (41 single-domain and 51 multi-domain), and 79 with AD. Statistical analyses, adjusting for sex, age, and education, employed multivariate general linear models to probe differences among these groups. Results: Results showed that AD patients exhibited poorer performance in switching in both VF tasks and SVF clustering compared to NC. Similarly, the aMCI group performed worse than the NC in switching and clustering in both tasks, with aMCI performing similarly to AD, except for SVF switching. In contrast, the naMCI subgroup performed similarly to those with NC across most strategies, surpassing AD patients. Notably, the aMCI subgroup's poor performance in SVF switching was mainly due to the subpar performance of the multi-domain aMCI subgroup. This subgroup was outperformed in switching in both VF tasks by the single-domain naMCI, who also performed better than the multi-domain naMCI in SVF switching. No significant differences emerged in terms of perseverations and intrusions. Conclusions: Overall, these findings suggest a continuum of declining switching ability in the SVF task, with NC surpassing both aMCI and AD, and aMCI outperforming those with AD. The challenges in SVF switching suggest executive function impairment associated with multi-domain MCI, particularly driven by the multi-domain aMCI.

Analysis of ADORA2A rs5760423 and CYP1A2 rs762551 Genetic Variants in Patients with Alzheimer's Disease.

Various studies have been conducted, exploring the genetic susceptibility of Alzheimer's disease (AD). Adenosine receptor subtype A2a (ADORA2A) and cytochrome P450 1A2 (CYP1A2) are implicated in pathways such as oxidative stress and caffeine metabolism, which are associated with AD. The aim of this study was to explore for any potential association between the ADORA2A rs5760423 and the CYP1A2 rs762551 genetic variants and AD. A case-control study was performed with a total of 654 subjects (327 healthy controls and 327 patients with AD). Five genetic models were assumed. We also examined the allele-allele combination of both variants. The value of 0.05 was considered as the statistical significance threshold. A statistically significant association was found between ADORA2A rs5760423 and AD, as the "T" allele was associated with increased AD risk in recessive (OR = 1.51 (1.03-2.21)) and log-additive (OR = 1.30 (1.04-1.62)) genetic modes. In the codominant model, the TT genotype was more prevalent compared to the GG genotype (OR = 1.71 (1.09-2.66)). The statistical significance was maintained after adjustment for sex. No association between CYP1A2 rs762551 or allele-allele combination and AD was detected. We provide preliminary indication for a possible association between the ADORA2A rs5760423 genetic polymorphism and AD.

Qualitative Verbal Fluency Components as Prognostic Factors for Developing Alzheimer's Dementia and Mild Cognitive Impairment: Results from the Population-Based HELIAD Cohort.

Background and Objectives: The aim of the present study was to investigate the prognostic value of the qualitative components of verbal fluency (clustering, switching, intrusions, and perseverations) on the development of mild cognitive impairment (MCI) and dementia. Materials and Methods: Participants were drawn from the multidisciplinary, population-based, prospective HELIAD (Hellenic Longitudinal Investigation of Aging and Diet) cohort. Two participant sets were separately analysed: those with normal cognition and MCI at baseline. Verbal fluency was assessed via one category and one letter fluency task. Separate Cox proportional hazards regressions adjusted for important sociodemographic parameters were performed for each qualitative semantic and phonemic verbal fluency component. Results: There were 955 cognitively normal (CN), older (72.9 years ±4.9), predominantly female (~60%) individuals with available follow-up assessments after a mean of 3.09 years (±0.83). Among them, 34 developed dementia at follow-up (29 of whom progressed to Alzheimer's dementia (AD)), 160 developed MCI, and 761 remained CN. Each additional perseveration on the semantic condition increased the risk of developing all-cause dementia and AD by 52% and 55%, respectively. Of note, participants with two or more perseverations on the semantic task presented a much more prominent risk for incident dementia compared to those with one or no perseverations. Among the remaining qualitative indices, none were associated with the hazard of developing all-cause dementia, AD, and MCI at follow-up. Conclusions: Perseverations on the semantic fluency condition were related to an increased risk of incident all-cause dementia or AD in older, CN individuals.

Duration Perception and Reading in Typically Developing Adults and Adults with Developmental Dyslexia: Implications for Assessment and Intervention.

While the link between beat perception and reading skills is attributed to a general improvement in neural entrainment to speech units, duration perception (DP) is primarily linked to a specific aspect of speech perception, specifially discriminating phonemes of varying lengths. Our previous study found a significant correlation between DP and pseudoword reading in both typically developing (TD) individuals and adults with dyslexia (DD). This suggests that, like beat, DP may also enhance overall speech perception. However, our previous study employed a composite measure that did not discriminate speed from accuracy. In this study, we sought to replicate the link between DP and pseudoword reading in a new sample and explore how it might vary depending on the reading parameter being measured. We analyzed the performance of 60 TD vs. 20 DD adults in DP, word reading and pseudoword reading tasks, analyzing the latter for both speed and accuracy. Indeed, duration skills correlated positively with pseudoword reading accuracy. In TD adults, there was no association between DP and reading speed, whereas DD individuals exhibited slower reading speed alongside improved duration skills. We emphasize the potential usefulness of DP tasks in assessment and early intervention and raise new questions about compensatory strategies adopted by DD adults.

Increased Pre-Boundary Lengthening Does Not Enhance Implicit Intonational Phrase Perception in European Portuguese: An EEG Study.

Prosodic phrasing is the segmentation of utterances into prosodic words, phonological phrases (smaller units) and intonational phrases (larger units) based on acoustic cues-pauses, pitch changes and pre-boundary lengthening. The perception of prosodic boundaries is characterized by a positive event-related potential (ERP) component, temporally aligned with phrase boundaries-the Closure Positive Shift (CPS). The role of pre-boundary lengthening in boundary perception is still a matter of debate: while studies on phonological phrase boundaries indicate that all three cues contribute equally, approaches to intonational phrase boundaries highlight the pause as the most powerful cue. Moreover, all studies used explicit boundary recognition tasks, and it is unknown how pre-boundary lengthening works in implicit prosodic processing tasks, characteristic of real-life contexts. In this study, we examined the effects of pre-boundary lengthening (original, short, and long) on the EEG responses to intonational phrase boundaries (CPS effect) in European Portuguese, using an implicit task. Both original and short versions showed equivalent CPS effects, while the long set did not elicit the effect. This suggests that pre-boundary lengthening does not contribute to improved perception of boundaries in intonational phrases (longer units), possibly due to memory and attention-related constraints.

Duration perception for visual stimuli is impaired in dyslexia but deficits in visual processing may not be the culprits.

Dyslexics underperform controls in estimating and comparing time intervals defined by visual stimuli. Accuracy in vision-based duration perception requires efficient processing of visual events because these will define the onset and offset of time intervals. Since dyslexics have difficulties processing dimensions of visual stimuli like luminance contrasts and motion, we do not know the extent to which these visual deficits are responsible for their difficulties in judging time intervals. To address this gap, we asked adults with dyslexia and matched controls to perform an interval comparison task involving five different types of visual stimuli with different levels of challenge regarding luminance contrasts and motion. If the expected disadvantage of dyslexics in visual duration perception increased for stimuli requiring increased luminance or motion processing, this would indicate that visual processing plays a role. Results showed poorer time discrimination in dyslexics, but this disadvantage did not change according to stimulus type. Complementary analyses of oculomotor behavior during the task suggested that the poorer timing performance of dyslexics may relate instead to attention and/or engagement with the task. Our findings strengthen the evidence in favor of visual duration perception deficits in dyslexia, but not the hypothesis that these result from purely visual problems.

Formal language hierarchy reflects different levels of cognitive complexity.

Formal language hierarchy describes levels of increasing syntactic complexity (adjacent dependencies, nonadjacent nested, nonadjacent crossed) of which the transcription into a hierarchy of cognitive complexity remains under debate. The cognitive foundations of formal language hierarchy have been contradicted by two types of evidence: First, adjacent dependencies are not easier to learn compared to nonadjacent; second, crossed nonadjacent dependencies may be easier than nested. However, studies providing these findings may have engaged confounds: Repetition monitoring strategies may have accounted for participants' high performance in nonadjacent dependencies, and linguistic experience may have accounted for the advantage of crossed dependencies. We conducted two artificial grammar learning experiments where we addressed these confounds by manipulating reliance on repetition monitoring and by testing participants inexperienced with crossed dependencies. Results showed relevant differences in learning adjacent versus nonadjacent dependencies and advantages of nested over crossed, suggesting that formal language hierarchy may indeed translate into a hierarchy of cognitive complexity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Domain-general but not speech-specific auditory duration perception predicts pseudoword reading in adults.

Associations between reading performance and duration perception have been found both for domain-general and speech-specific duration perception. However, research seems limited to children and, critically, the predictive value of the two duration perception modalities has not been compared so far. In the present study we compared the weight of domain-general (comparison of time intervals defined by beeps) vs. speech-specific duration perception (pre-attentive EEG responses to consonants with different durations) as statistical predictors of reading in a sample of 46 neurotypical adults (18-43 years old) with 13 years of schooling on average. Reading included word and pseudoword decoding, as well as reading comprehension. We ran one regression model with domain-general and speech-specific duration perception as predictors for each of the three reading skills. Pseudoword decoding was the only reading skill that was significantly predicted by duration perception, and this happened for domain-general duration perception only. A complementary analysis adding 26 typically developing and 24 dyslexic adults to the main sample (n = 96 in total) showed the same pattern of results in dyslexics, but not in added controls. Our findings strengthen the idea that duration perception is important to phonological encoding and its use in grapheme-to-phoneme conversion, given that only pseudoword decoding was predicted by the interval comparison task. The irrelevance of speech-specific duration perception tones down the possibility that accurately perceiving the length of speech sounds is crucial to skilled reading.

Longitudinal episodic memory trajectories in older adults with normal cognition.

OBJECTIVE: To determine the longitudinal trajectories and normative standards of episodic memory in older adults. METHODS: Participants were drawn from the cognitively normal(CN) subgroup of the population-based HELIAD cohort, a fairly representative cohort of the older Greek population. Verbal and non-verbal memory were assessed using the Greek Verbal Learning Test and Medical College of Georgia-Complex Figure Test. Baseline and longitudinal associations of memory performance with age, sex and formal education were explored with linear regression analysis and generalized estimated equations. RESULTS: A total of 1607 predominantly female (60%) individuals (73.82 ± 5.43 years), with a mean educational attainment of 8.17(±4.86) years were CN at baseline. Baseline analysis revealed a continuum of memory decline with aging and lower educational attainment. Women performed better in composite and verbal memory measures, while men performed better in non-verbal memory tasks. A subgroup of 761 participants with available assessments after 3.07(±0.82) years remained CN at follow-up. Composite memory scores yearly diminished by an additional 0.007 of a SD for each additional year of age at baseline. Regarding verbal learning, immediate free verbal recall, delayed free verbal recall and delayed cued verbal recall, an additional yearly decrease of 0.107, 0.043, 0.036 and 0.026 words were respectively recorded at follow-up, for each additional year of age at baseline. Women underwent steeper yearly decreases of 0.227 words in delayed cued verbal recall. No significant longitudinal associations emerged for immediate non-verbal memory, delayed non-verbal memory and immediate cued verbal recall. CONCLUSIONS: In the present study, aging (but not educational attainment) was consistently associated with steeper verbal memory decline.Supplemental data for this article is available online at https://doi.org/10.1080/13854046.2022.2059011 .

Epilepsy and the "dark" literature of the Greek novelist Demosthenes Voutyras: an outstanding epileptic personality.

BACKGROUND: The role of temporal lobe epilepsy (TLE) in determining personality traits and neurobehavioral symptoms, collectively known as the interictal behavioral syndrome (also known as Geschwind syndrome or "Gastaut-Geschwind syndrome"), as well as the syndrome's association with the particular artistic expression of many epileptic litterateurs are well known in neurology and psychiatry. A deepening of emotionality along with a serious, highly ethical, and spiritual behavior have been described as positive personality changes among patients with chronic mesial-TLE. OBJECTIVES: Our narrative-based clinical hypothesis aims at contributing to the ongoing debate on the association between TLE and artistic expression, as well as the latter's supposed implication for epileptology in general and the neuropsychology of epilepsy in particular. METHODS: Through an analysis of the biography, language, and literary work of Greek novelist Demosthenes Voutyras, we hypothesize that his mystical and dark writing style could be attributed to medial temporal interictal dynamics. CONCLUSIONS: We suggest that the psycholiterary profile of Voutyras is consistent with the idiosyncratic characteristics of the temporal lobe personality, while a non-dominant temporal lobe contribution has been proposed.

ANTECEDENTES: O papel da epilepsia do lobo temporal (ELT) na determinação de traços de personalidade e sintomas neurocomportamentais, coletivamente conhecidos como síndrome comportamental interictal (também conhecida como síndrome de Geschwind ou "síndrome de Gastaut-Geschwind"), bem como a associação da síndrome com o expressão de muitos literatos epilépticos são bem conhecidos em neurologia e psiquiatria. Um aprofundamento da emotividade juntamente com um comportamento sério, altamente ético e espiritual tem sido descrito como mudanças positivas de personalidade em pacientes com ELT mesial crônica. OBJETIVOS: A nossa hipótese clínica narrativa visa contribuir para o debate em curso sobre a associação entre ELT e a expressão artística, bem como a suposta implicação desta última para a epilepsia em geral e a neuropsicologia da epilepsia em particular. MéTODOS: Através de uma análise da biografia, linguagem e obra literária do romancista grego Demóstenes Voutyras, levantamos a hipótese de que seu estilo de escrita místico e sombrio poderia ser atribuído à dinâmica interictal temporal medial. CONCLUSõES: Sugerimos que o perfil psicoliterário de Voutyras é consistente com as características idiossincráticas da personalidade do lobo temporal, enquanto uma contribuição do lobo temporal não dominante foi proposta.

Language Differences Among Individuals with Normal Cognition, Amnestic and Non-Amnestic MCI, and Alzheimer's Disease.

OBJECTIVE: To investigate differences in language performance among older adults with normal cognition (CN), mild cognitive impairment (MCI), and Alzheimer's disease (ad). Owing to the conflicting literature concerning MCI, discrepancies between amnestic (aMCI) and non-amnestic MCI (naMCI) were explored in greater detail. METHOD: The study sample was drawn from the older (>64 years) HELIAD cohort. Language performance was assessed via semantic and phonemic fluency, confrontation naming, verbal comprehension, verbal repetition as well as a composite language index. Age, sex, and education adjusted general linear models were used to quantify potential pairwise differences in language performance. RESULTS: The present analysis involved 1607 participants with CN, 146 with aMCI [46 single and 100 multi-domain aMCI], 92 with naMCI [41 single and 51 multi-domain naMCI], and 79 with ad. The mean age and education of our predominantly female (60%) participants were 73.82 (±5.43) and 7.98 (±4.93) years, respectively. MCI individuals performed between those with CN and ad, whereas participants with aMCI performed worse compared to those with naMCI, especially in the semantic fluency and verbal comprehension tasks. Discrepancies between the aMCI and naMCI groups were driven by the exquisitely poor performance of multi-domain aMCI subgroup. CONCLUSIONS: Overall, individuals could be hierarchically arranged in a continuum of language impairment with the CN individuals constituting the healthy reference and naMCI, aMCI, ad patients representing gradually declining classes in terms of language performance. Exploration of language performance via separation of single from multi-domain naMCI provided a potential explanation for the conflicting evidence of previous research.

Longitudinal trajectories and normative language standards in older adults with normal cognitive status.

OBJECTIVE: To determine the longitudinal trajectories and normative standards of language in older adults. METHOD: Participants were drawn from the cognitively normal (CN) subgroup of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort, a fairly representative cohort of the older Greek population. Language was assessed via semantic (SVF) and phonemic verbal fluency (PVF), Boston Naming Test-short form (BNT-sf), verbal comprehension and repetition, and a composite language z-score. Both baseline and longitudinal associations of language performance with age, sex, and education were explored with linear regression and generalized estimated equations. RESULTS: A total of 1,607 individuals (73.82 years ± 5.43, 60% women), with a mean educational attainment of 8.17 years (± 4.86) were CN at baseline. Baseline analysis revealed a continuum of language decline with higher age and lower educational attainment. Women performed better in composite and SVF tasks. A subgroup of 761 participants with available assessments after 3.07 years remained CN at follow-up. Each additional year of education mitigated composite language decline by .004 of a SD per year. Education additionally mitigated yearly reductions in SVF (by .049) and repetition (by .018) totals. Intriguingly, educational attainment was inversely related to the rate of PVF decline over time (ß = -.063). Women exhibited a more precipitous course of decline in SVF totals (.355 per year). Age was not related to differential rates of language decline in any measure. No significant longitudinal associations emerged for comprehension and BNT-sf. CONCLUSIONS: Lower educational attainment (but not aging) was associated with steeper language decline, mainly driven by SVF and verbal repetition. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Therapeutic application of rTMS in neurodegenerative and movement disorders: A review.

Transcranial magnetic stimulation (TMS) is a non-invasive form of brain stimulation that makes use of the magnetic field generated when an electric current passes through a magnetic coil placed over the scalp. It can be applied as a single stimulus at a time, in pairs of stimuli, or repetitively in trains of stimuli (repetitive TMS, rTMS). RTMS can induce changes in brain activity, whose after-effects reflect the processes of long-term potentiation and long-term depression, as certain protocols, namely those using low frequencies (≤1 Hz) seem to suppress cortical excitability, while those using high frequencies (>1 Hz) seem to enhance it. It is a technique with very few and mostly mild side-effects, whose effects can persist for long time periods, and as such, it has been studied as a potential treatment option in a multitude of neurodegenerative diseases, including those affecting movement. Although rTMS has received approval as a treatment strategy of only a few aspects in movement disorders in the latest guidelines, its further use seems to also be promising in their context. In this review, we gathered the available literature on the therapeutic application of rTMS in movement disorders, namely Parkinson's disease, Amyotrophic Lateral Sclerosis, Huntington's disease, Dystonia, Tic disorders and Essential Tremor.

Beneficial effect of computer-based multidomain cognitive training in patients with mild cognitive impairment.

The purpose of the present study was to explore the effects of computer-based multidomain cognitive training program on Greek patients with Mild Cognitive Impairment (MCI). Forty-six patients with MCI were randomly divided into two groups; (a) the training group, which received a computer-based multidomain cognitive training program with the use of the RehaCom software and (b) the control group, which underwent standard-clinical care. The duration of the computer-based training program was 15 weeks, administered twice a week for approximately one hour per session. Analysis of the baseline versus endpoint performance of each group demonstrated that in the control group delayed memory and executive function had deteriorated over the observation period of 15 weeks, while improvement was observed in the training group's performance on delayed memory, word recognition, Boston Naming Test (BNT), Clock Drawing Test (CDT), Semantic Fluency (SF), Trail Making Test-A (TMT-A) and Trail Making Test-B (TMT-B). Comparison between the two groups presented asignificant effect of the intervention for most cognitive domains. These findings are promising for the development of training methods designed to delay cognitive decline in patients with MCI, which is considered to be the prodromal stage of Alzheimer's Disease (AD).

Pesticides, cognitive functions and dementia: A review.

Pesticides are widely-used chemicals commonly applied in agriculture for the protection of crops from pests. Depending on the class of pesticides, the specific substances may have a specific set of adverse effects on humans, especially in cases of acute poisoning. In past years, evidence regarding sequelae of chronic, low-level exposure has been accumulating. Cognitive impairment and dementia heavily affect a person's quality of life and scientific data has been hinting towards an association between them and antecedent chronic pesticide exposure. Here, we reviewed animal and human studies exploring the association between pesticide exposure, cognition and dementia. Additionally, we present potential mechanisms through which pesticides may act neurotoxically and lead to neurodegeneration. Study designs rarely presented homogeneity and the estimation of the exposure to pesticides has been most frequently performed without measuring the synergic effects and the possible interactions between the toxicants within mixtures, and also overlooking low exposures to environmental toxicants. It is possible that a Real-Life Risk Simulation approach would represent a robust alternative for future studies, so that the safe exposure limits and the net risk that pesticides confer to impaired cognitive function can be examined. Previous studies that evaluated the effect of low dose chronic exposure to mixtures of pesticides and other chemicals intending to simulate real life exposure scenarios showed that hormetic neurobehavioral effects can appear after mixture exposure at doses considered safe for individual compounds and these effects can be exacerbated by a coexistence with specific conditions such as vitamin deficiency. However, there is an overall indication, derived from both epidemiologic and laboratory evidence, supporting an association between exposure to neurotoxic pesticides and cognitive dysfunction, dementia and Alzheimer's disease.

The inferior frontal cortex in artificial syntax processing: an rTMS study.

The human capacity to implicitly acquire knowledge of structured sequences has recently been investigated in artificial grammar learning using functional magnetic resonance imaging. It was found that the left inferior frontal cortex (IFC; Brodmann's area (BA) 44/45) was related to classification performance. The objective of this study was to investigate whether the IFC (BA 44/45) is causally related to classification of artificial syntactic structures by means of an off-line repetitive transcranial magnetic stimulation (rTMS) paradigm. We manipulated the stimulus material in a 2 x 2 factorial design with grammaticality status and local substring familiarity as factors. The participants showed a reliable effect of grammaticality on classification of novel items after 5 days of exposure to grammatical exemplars without performance feedback in an implicit acquisition task. The results show that rTMS of BA 44/45 improves syntactic classification performance by increasing the rejection rate of non-grammatical items and by shortening reaction times of correct rejections specifically after left-sided stimulation. A similar pattern of results is observed in FMRI experiments on artificial syntactic classification. These results suggest that activity in the inferior frontal region is causally related to artificial syntax processing.

Modality effects in implicit artificial grammar learning: An EEG study.

Recently, it has been proposed that sequence learning engages a combination of modality-specific operating networks and modality-independent computational principles. In the present study, we compared the behavioural and EEG outcomes of implicit artificial grammar learning in the visual vs. auditory modality. We controlled for the influence of surface characteristics of sequences (Associative Chunk Strength), thus focusing on the strictly structural aspects of sequence learning, and we adapted the paradigms to compensate for known frailties of the visual modality compared to audition (temporal presentation, fast presentation rate). The behavioural outcomes were similar across modalities. Favouring the idea of modality-specificity, ERPs in response to grammar violations differed in topography and latency (earlier and more anterior component in the visual modality), and ERPs in response to surface features emerged only in the auditory modality. In favour of modality-independence, we observed three common functional properties in the late ERPs of the two grammars: both were free of interactions between structural and surface influences, both were more extended in a grammaticality classification test than in a preference classification test, and both correlated positively and strongly with theta event-related-synchronization during baseline testing. Our findings support the idea of modality-specificity combined with modality-independence, and suggest that memory for visual vs. auditory sequences may largely contribute to cross-modal differences.

Epilepsy and the "dark" literature of the Greek novelist Demosthenes Voutyras: an outstanding epileptic personality / Epilepsia e a literatura "sombria" do romancista grego Demosthenes Voutyras: uma personalidade epilética notável

Abstract Background The role of temporal lobe epilepsy (TLE) in determining personality traits and neurobehavioral symptoms, collectively known as the interictal behavioral syndrome (also known as Geschwind syndrome or "Gastaut-Geschwind syndrome"), as well as the syndrome's association with the particular artistic expression of many epileptic litterateurs are well known in neurology and psychiatry. A deepening of emotionality along with a serious, highly ethical, and spiritual behavior have been described as positive personality changes among patients with chronic mesial-TLE. Objectives Our narrative-based clinical hypothesis aims at contributing to the ongoing debate on the association between TLE and artistic expression, as well as the latter's supposed implication for epileptology in general and the neuropsychology of epilepsy in particular. Methods Through an analysis of the biography, language, and literary work of Greek novelist Demosthenes Voutyras, we hypothesize that his mystical and dark writing style could be attributed to medial temporal interictal dynamics. Conclusions We suggest that the psycholiterary profile of Voutyras is consistent with the idiosyncratic characteristics of the temporal lobe personality, while a non-dominant temporal lobe contribution has been proposed.

Resumo Antecedentes O papel da epilepsia do lobo temporal (ELT) na determinação de traços de personalidade e sintomas neurocomportamentais, coletivamente conhecidos como síndrome comportamental interictal (também conhecida como síndrome de Geschwind ou "síndrome de Gastaut-Geschwind"), bem como a associação da síndrome com o expressão de muitos literatos epilépticos são bem conhecidos em neurologia e psiquiatria. Um aprofundamento da emotividade juntamente com um comportamento sério, altamente ético e espiritual tem sido descrito como mudanças positivas de personalidade em pacientes com ELT mesial crônica. Objetivos A nossa hipótese clínica narrativa visa contribuir para o debate em curso sobre a associação entre ELT e a expressão artística, bem como a suposta implicação desta última para a epilepsia em geral e a neuropsicologia da epilepsia em particular. Métodos Através de uma análise da biografia, linguagem e obra literária do romancista grego Demóstenes Voutyras, levantamos a hipótese de que seu estilo de escrita místico e sombrio poderia ser atribuído à dinâmica interictal temporal medial. Conclusões Sugerimos que o perfil psicoliterário de Voutyras é consistente com as características idiossincráticas da personalidade do lobo temporal, enquanto uma contribuição do lobo temporal não dominante foi proposta.