Week 2- Progressive Aphasias & MEG

Question 1

What is primary progressive aphasia? (According to Mesulam)

Answer 1

-dominant symptom declining language for at least two years (before other symptoms set in)

Question 2

Discuss progressive non-fluent / agrammatical aphasia (PNFA) in terms of production, comprehension, repetition atrophy and non-verbal deficits.

Answer 2

Production: Non-fluent, hesitant, agrammatic, often phonological errors, often apraxia of speech
Comprehension: Often intact for single words, simple sentences. Impaired for complex sentences.
Repetition: Impaired
Atrophy: Left posterior inferior frontal gyrus (Broca’s area)
Non-verbal deficits: working memory, executive functions

Question 3

Discuss progressive semantic dementia in terms of production, comprehension, repetition, atrophy and non-verbal deficits.

Answer 3

Production: Fluent but with semantic errors
Comprehension: Impaired
Repetition: Intact
Atrophy: Anterior temporal lobes
Non-verbal deficits: Non-verbal deficits
Object recognition, social cognition, emotional regulation

Question 4

Discuss progressive logopenic progressive aphasia (LPA) in terms of production, comprehension, repetition, atrophy and non-verbal deficits.

Answer 4

Production: Severe word-finding difficulties, some phonemic paraphasias
Comprehension: Mostly intact for single words and simple sentences, impaired for complex sentences.
Repetition: Usually intact for single words but impaired for sentences and sequences
Atrophy: Left posterior superior temporal gyrus (Wernicke’s area)
Non-verbal deficits: Ideomotor apraxia, calculation difficulties

Question 5

In logopenic progressive aphasia (LPA), there is ___ in Wernicke’s area but it is not similar to Wernicke’s aphasia in what ways:

Answer 5

atrophy

- patients do not produce many phonological paraphasias and no jargon as in Wernicke’s aphasia

Question 6

In logopenic progressive aphasia (LPA), there is ___ in Wernicke’s area but it is not similar to Wernicke’s aphasia in what ways:

Answer 6

atrophy

- patients do not produce many phonological paraphasias and no jargon as in Wernicke’s aphasia

Question 7

SD symptoms do not occur in what type of aphasias?

Answer 7

classic aphasias

Question 8

Discuss progressive logopenic progressive aphasia (LPA) in terms of production, comprehension, repetition, atrophy and non-verbal deficits.

Answer 8

Production: Severe word-finding difficulties, some phonemic paraphasias
Comprehension: Mostly intact for single words and simple sentences, impaired for complex sentences.
Repetition: Usually intact for single words but impaired for sentences and sequences
Atrophy: Left posterior superior temporal gyrus (Wernicke’s area)
Non-verbal deficits: Ideomotor apraxia, calculation difficulties

Question 9

Name the three main types of primary progressive aphasia:

Answer 9

• progressive non-fluent / agrammatical aphasia (PNFA)
• semantic dementia (SD)
• logopenic progressive aphasia (LPA)
• ->logos = word, speech (from lego = say), penia = lack of, poverty

Question 10

Another MEG study: separating semantic and syntactic processing in reading. Are semantic and syntactic processing of sentences carried out by different areas in the brain?

Answer 10

• bilateral, pre-dominantly left, activation in the superior and middle temporal gyri, peaking at 400 ms, was sensitive to semantic anomaly: N400m
• the left dipoles also reacted (somewhat less strongly) to word- class errors and to morpho-syntactic errors ≈ LANm?
• more posterior bilateral, pre-dominantly right, dipoles in the temporal lobe were sensitive to syntactic but not semantic violations
• the syntactic dipoles showed an activation pattern peaking late, between 600 and 800 ms after word presentation: P600m
• as we read at 200–300 ms/word the P600 cannot be a response to single words
• could it be a learning/memory response (~ LAD kicking in)?

Question 11

Name the three main types of primary progressive aphasia:

Answer 11

• progressive non-fluent / agrammatical aphasia (PNFA)
• semantic dementia (SD)
• logopenic progressive aphasia (LPA)
• ->logos = word, speech (from lego = say), penia = lack of, poverty

Question 12

Discuss progressive non-fluent / agrammatical aphasia (PNFA) in terms of production, comprehension, repetition and non-verbal deficits.

Answer 12

Production: Non-fluent, hesitant, agrammatic, often phonological errors, often apraxia of speech
Comprehension: Often intact for single words, simple sentences. Impaired for complex sentences.
Repetition: Impaired
Non-verbal deficits: working memory, executive functions

Question 13

Discuss progressive semantic dementia in terms of production, comprehension, repetition and non-verbal deficits.

Answer 13

Production: Fluent but with semantic errors
Comprehension: Impaired
Repetition: Intact
Non-verbal deficits: Non-verbal deficits
Object recognition, social cognition, emotional regulation

Question 14

Discuss progressive logopenic progressive aphasia (LPA) in terms of production, comprehension, repetition and non-verbal deficits.

Answer 14

Production: Severe word-finding difficulties, some phonemic paraphasias
Comprehension: Mostly intact for single words and simple sentences, impaired for complex sentences.
Repetition: Usually intact for single words but impaired for sentences and sequences
Non-verbal deficits: Ideomotor apraxia, calculation difficulties

Question 15

LPA: ____ in Wernicke’s area but patients do not produce many phonological paraphasias and no jargon as in Wernicke’s aphasia

Answer 15

atrophy

Question 16

SD symptoms do not occur in ___ aphasias

Answer 16

classic

Question 17

What is an MEG?

Answer 17

Magnetoencephalography (MEG) is a functional neuroimaging technique for mapping brain activity by recording magnetic fields produced by electrical currents occurring naturally in the brain, using very sensitive magnetometers.

Question 18

In event-related potentials, different responses have been found to be sensitive to different types of
sentence anomalies: the ___ to semantic anomalies, the____ to major syntactic anomalies, and the ____ to local (morpho-)syntactic anomalies

Answer 18

N400, P600, (E)LAN

Question 19

Another MEG study: separating semantic and syntactic processing in reading. Are semantic and syntactic processing of sentences carried out by different areas in the brain?

Answer 19

-bilateral, pre-dominantly left, activation in the superior and middle temporal gyri, peaking at 400 ms, was sensitive to semantic anomaly: N400m
-the left dipoles also reacted (somewhat less strongly) to word- class errors and to morpho-syntactic errors ≈ LANm?
more posterior bilateral, pre-dominantly right, dipoles in the temporal lobe were sensitive to syntactic but not semantic violations

Question 20

Another MEG study: separating semantic and syntactic processing in reading. Are different areas responsible for sentence-level syntax based on phrase structure on the one hand and finer tuned syntax based on morpho-syntax on the other?

Answer 20

• the syntactic dipoles showed an activation pattern peaking late, between 600 and 800 ms after word presentation: P600m
• as we read at 200–300 ms/word the P600 cannot be a response to single words
• could it be a learning/memory response (~ LAD kicking in)?

Question 21

What is apraxia?

Answer 21

inability to perform particular purposive actions, as a result of brain damage.

Question 22

What is brain atrophy?

Answer 22

a loss of neurons and the connections between them

Question 23

What is cortical atrophy?

Answer 23

gradual and progressive degeneration of the outer layer of the brain (the cortex) in the part of the brain located in the back of the head (posterior)

Question 24

First reports of primary progressive aphasia:
Arnold Pick (1892):

Answer 24

-a man with progressive aphasia and amnesia, who became mute (Pick’s disease)

Question 25

First reports of primary progressive aphasia:

Paul Sérieux (1893):

Answer 25

• woman with slow deterioration of word comprehension but without loss of memory or intelligence – first pure case of progressive aphasia
• cortical atrophy in both temporal lobes

Question 26

First reports of primary progressive aphasia:

Warrington (1975):

Answer 26

-three patients with progressive word- finding difficulties, declining understanding of words and pictures

Question 27

Pathophysiological processes target ___, cerebro-vascular accidents target areas affected by ____

Answer 27

networks, arteries

Question 28

MEG version of PMN/N400 study in dyslexia. What was the stimuli?

Answer 28

• auditory sentences presented one word at a time four
• types of ending words:
  
  • correct: When the power went out the room became dark.
  • anomalous: When the power went out the room became herrings.
  • phonologically similar beginning: When the power went out the room became darling.
  • improbable: When the power went out the room became quiet.

Question 29

MEG version of PMN/N400 study in dyslexia. What was the stimuli?

Answer 29

• auditory sentences presented one word at a time four
• types of ending words:
  
  • correct: When the power went out the room became dark.
  • anomalous: When the power went out the room became herrings.
  • phonologically similar beginning: When the power went out the room became darling.
  • improbable: When the power went out the room became quiet.

Question 30

MEG version of PMN/N400 study in dyslexia. What were the results?

Answer 30

• dyslexics show abnormal neural responses related to both integration of similarities between the consecutive stimuli and the ability to detect incongruent stimuli
• Semantic priming seems relatively intact in dyslexics, however neural responses to contextual incongruency are delayed