The Wernicke conundrum revisited: evidence from connectome-based lesion-symptom mapping in post-stroke aphasia

The classical assumption that word and sentence comprehension deficits in stroke aphasia follow from damage to Wernicke's area has been questioned following discrepant results in primary progressive aphasia. We tested the hypothesis of Mesulam et al. (2015; 2019) that word and sentence comprehension deficits in stroke aphasia result from 'double disconnection' due to white matter damage: word comprehension deficits resulting from disconnection of the anterior temporal lobe and sentence comprehension deficits resulting from disconnection of the frontal lobe. We performed lesion-deficit correlations, including connectome-based lesion-symptom mapping, in four large, partially overlapping groups of English-speaking chronic left hemisphere stroke survivors. After removing variance due to object recognition and associative semantic processing, the same middle and posterior temporal lobe regions were implicated both in word comprehension deficits (N = 180) and complex noncanonical sentence comprehension deficits (N = 131). Repetition deficits (N = 218) were associated with damage to the posterior temporal lobe and superior longitudinal fasciculus, and agrammatic production (N = 92) was associated with damage to the posterior middle frontal gyrus. Connectome lesion-symptom mapping revealed similar temporal-occipital white matter disconnections for impaired word and noncanonical sentence comprehension, including the temporal pole. We found additional significant temporal-parietal disconnections for noncanonical sentence comprehension deficits, which may indicate a role for phonological working memory in processing complex syntax, but no significant frontal-temporal or frontal-parietal disconnections. By contrast, repetition deficits were associated with a very large set of significant disconnections, including frontal-temporal disconnections, and agrammatic production was associated primarily with significant disconnections within the frontal lobe. Our results largely agree with the classical notion that damage to Wernicke's area causes both word and sentence comprehension deficits in stroke-based aphasia, suggest a supporting role for temporal pole in both word and sentence comprehension, and speak against the hypothesis that sentence comprehension deficits in Wernicke's aphasia result from frontal-temporal or frontal-parietal disconnections.

Contextual Acquisition of Concrete and Abstract Words: Behavioural and Electrophysiological Evidence

and concrete words differ in their cognitive and neuronal underpinnings, but the exact mechanisms underlying these distinctions are unclear. We investigated differences between these two semantic types by analysing brain responses to newly learnt words with fully controlled psycholinguistic properties. Experimental participants learned 20 novel abstract and concrete words in the context of short stories. After the learning session, event-related potentials (ERPs) to newly learned items were recorded, and acquisition outcomes were assessed behaviourally in a range of lexical and semantic tasks. Behavioural results showed better performance on newly learnt abstract words in lexical tasks, whereas semantic assessments showed a tendency for higher accuracy for concrete words. ERPs to novel abstract and concrete concepts differed early on, ~150 ms after the word onset. Moreover, differences between novel words and control untrained pseudowords were observed earlier for concrete (~150 ms) than for abstract (~200 ms) words. Distributed source analysis indicated bilateral temporo-parietal activation underpinning newly established memory traces, suggesting a crucial role of Wernicke’s area and its right-hemispheric homologue in word acquisition. In sum, we report behavioural and neurophysiological processing differences between concrete and abstract words evident immediately after their controlled acquisition, confirming distinct neurocognitive mechanisms underpinning these types of semantics.

Gross anatomy of the longitudinal fascicle of Sapajus sp.

Opposing genetic and cultural-social explanations for the origin of language are currently the focus of much discussion. One of the functions linked to the longitudinal fascicle is language, which links Wernicke’s area and Broca’s area in the brain, and its size should indicate the brain increase in the evolution. Sapajus is a New World primate genus with high cognition and advanced tool use similar to that of chimpanzees. A study of the gross anatomy of the longitudinal fascicle of Sapajus using Kingler’s method found it to differ from other studied primates, such as macaques and chimpanzees, mainly because its fibers join the cingulate fascicle. As in other non-human primates, the longitudinal fascicle of Sapajus does not reach the temporal lobe, which could indicate a way of separating these fascicles to increase white matter in relation to individual function. The study of anatomical structures seems very promising for understanding the basis of the origin of language. Indeed, socio-historical-cultural philosophy affirms the socio-cultural origin of speech, although considering the anatomical structures behind it working as a functional system.

Monolingual and bilingual language networks in healthy subjects using functional MRI and graph theory

Bilingualism requires control of multiple language systems, and may lead to architectural differences in language networks obtained from clinical fMRI tasks. Emerging connectivity metrics such as k-core may capture these differences, highlighting crucial network components based on resiliency. We investigated the influence of bilingualism on clinical fMRI language tasks and characterized bilingual networks using connectivity metrics to provide a patient care benchmark. Sixteen right-handed subjects (mean age 42-years; nine males) without neurological history were included: eight native English-speaking monolinguals and eight native Spanish-speaking (L1) bilinguals with acquired English (L2). All subjects underwent fMRI with gold-standard clinical language tasks. Starting from active clusters on fMRI, we inferred the persistent functional network across subjects and ran centrality measures to characterize differences. Our results demonstrated a persistent network “core” consisting of Broca’s area, the pre-supplementary motor area, and the premotor area. K-core analysis showed that Wernicke’s area was engaged by the “core” with weaker connection in L2 than L1.

Prior Neurosurgery Decreases fMRI Estimates of Language Laterality in Patients with Gliomas within Anterior Language Sites

The impact of previous surgery on the assessment of language dominance with preoperative fMRI remains inconclusive in patients with recurrent brain tumors. Samples in this retrospective study included 17 patients with prior brain surgery and 21 patients without prior surgery (38 patients total; mean age 43.2, SD = 11.9; 18 females; seven left-handed). All the patients were left language dominant, as determined clinically. The two samples were matched on 10 known confounds, including, for example, tumor laterality and location (all tumors affected Brodmann areas 44/45/47). We calculated fMRI language dominance with laterality indices using a whole-brain and region of interest approach (ROI; Broca’s and Wernicke’s area). Patients with prior surgery had decreased fMRI language dominance (p = 0.03) with more activity in the right hemisphere (p = 0.03) than patients without surgery. Patients with prior brain surgery did not display less language activity in the left hemisphere than patients without surgery. These results were replicated using an ROI approach in the affected Broca’s area. Further, we observed no differences between our samples in the unaffected Wernicke’s area. In sum, prior brain surgery affecting Broca’s area could be a confounding factor that needs to be considered when evaluating fMRI language dominance.

Acquisition of concrete and abstract words is modulated by tDCS of Wernicke’s area

Previous behavioural and neuroimaging research suggested distinct cortical systems involved in processing abstract and concrete semantics; however, there is a dearth of causal evidence to support this. To address this, we applied anodal, cathodal, or sham (placebo) tDCS over Wernicke’s area before a session of contextual learning of novel concrete and abstract words (n = 10 each), presented five times in short stories. Learning effects were assessed at lexical and semantic levels immediately after the training and, to attest any consolidation effects of overnight sleep, on the next day. We observed successful learning of all items immediately after the session, with decreased performance in Day 2 assessment. Importantly, the results differed between stimulation conditions and tasks. Whereas the accuracy of semantic judgement for abstract words was significantly lower in the sham and anodal groups on Day 2 vs. Day 1, no significant performance drop was observed in the cathodal group. Similarly, the cathodal group showed no significant overnight performance reduction in the free recall task for either of the stimuli, unlike the other two groups. Furthermore, between-group analysis showed an overall better performance of both tDCS groups over the sham group, particularly expressed for abstract semantics and cathodal stimulation. In sum, the results suggest overlapping but diverging brain mechanisms for concrete and abstract semantics and indicate a larger degree of involvement of core language areas in storing abstract knowledge. Furthermore, they demonstrate a possiblity to improve learning outcomes using neuromodulatory techniques.