[논문]Triangulation of language-cognitive impairments, naming errors and their neural bases post-stroke

Halai, Ajay D.; Woollams, Anna M.; Lambon Ralph, Matthew A.

doi:10.1016/j.nicl.2017.10.037

Triangulation of language-cognitive impairments, naming errors and their neural bases post-stroke 원문보기

NeuroImage : Clinical, v.17, 2018년, pp.465 - 473

Halai, Ajay D. (Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester) , Woollams, Anna M. (Corresponding author.) , Lambon Ralph, Matthew A.

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Abstract In order to gain a better understanding of aphasia one must consider the complex combinations of language impairments along with the pattern of paraphasias. Despite the fact that both deficits and paraphasias feature in diagnostic criteria, most research has focused only on the lesion correlates of language deficits, with minimal attention on the pattern of patients' paraphasias. In this study, we used a data-driven approach (principal component analysis - PCA) to fuse patient impairments and their pattern of errors into one unified model of chronic post-stroke aphasia. This model was subsequently mapped onto the patients' lesion profiles to generate the triangulation of language-cognitive impairments, naming errors and their neural correlates. Specifically, we established the pattern of co-occurrence between fifteen error types, which avoids focussing on a subset of errors or the use of experimenter-derived methods to combine across error types. We obtained five principal components underlying the patients' errors: omission errors; semantically-related responses; phonologically-related responses; dysfluent responses; and a combination of circumlocutions with mixed errors. In the second step, we aligned these paraphasia-related principal components with the patients' performance on a detailed language and cognitive assessment battery, utilising an additional PCA. This omnibus PCA revealed seven unique fused impairment-paraphasia factors: output phonology; semantics; phonological working memory; speech quanta; executive-cognitive skill; phonological (input) discrimination; and the production of circumlocution errors. In doing so we were able to resolve the complex relationships between error types and impairments. Some are relatively straightforward: circumlocution errors formed their own independent factor; there was a one-to-one mapping for phonological errors with expressive phonological abilities and for dysfluent errors with speech fluency. In contrast, omission-type errors loaded across both semantic and phonological working memory factors, whilst semantically-related errors had the most complex relationship by loading across four factors (phonological ability, speech quanta, executive-cognitive skills and circumlocution-type errors). Three components had unique lesion correlates: phonological working memory with the primary auditory region; semantics with the anterior temporal region; and fluency with the pre-central gyrus, converging with existing literature. In conclusion, the data-driven approach allowed derivation of the triangulation of deficits, error types and lesion correlates in post-stroke aphasia. Highlights Using principal component analysis to identify structure in naming errors. Determining the relationship between language impairments and naming errors. Identifying neural correlates of behavioural deficits in performance and errors. Seven independent factors identified to describe performance and error pattern. Phonological working memory, semantic skill and speech quanta had lesion correlates.

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Triangulation of language-cognitive impairments, naming errors and their neural bases post-stroke 원문보기

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