Contributions of volumetrics of the hippocampus and thalamus to verbal memory in temporal lobe epilepsy patients

Recent theories have posited that the hippocampus and thalamus serve distinct, yet related, roles in episodic memory. Whereas the hippocampus has been implicated in long-term memory encoding and storage, the thalamus, as a whole, has been implicated in the selection of items for subsequent encoding and the use of retrieval strategies. However, dissociating the memory impairment that occurs following thalamic injury as distinguished from that following hippocampal injury has proven difficult. This study examined relationships between MRI volumetric measures of the hippocampus and thalamus and their contributions to prose and rote verbal memory functioning in 18 patients with intractable temporal lobe epilepsy (TLE). Results revealed that bilateral hippocampal and thalamic volume independently predicted delayed prose verbal memory functioning. However, bilateral hippocampal, but not thalamic, volume predicted delayed rote verbal memory functioning. Follow-up analyses indicated that bilateral thalamic volume independently predicted immediate prose, but not immediate rote, verbal recall, whereas bilateral hippocampal volume was not associated with any of these immediate memory measures. These findings underscore the cognitive significance of thalamic atrophy in chronic TLE, demonstrating that hippocampal and thalamic volume make quantitatively, and perhaps qualitatively, distinct contributions to episodic memory functioning in TLE patients. They are also consistent with theories proposing that the hippocampus supports long-term memory encoding and storage, whereas the thalamus is implicated in the executive aspects of episodic memory.     

Dichotic listening and otoacoustic emissions: shared variance between cochlear function and dichotic listening performance in adults with normal hearing

The present study investigated a possible connection between speech processing and cochlear function. Twenty-two subjects with age range from 18 to 39, balanced for gender with normal hearing and without any known neurological condition, were tested with the dichotic listening (DL) test, in which listeners were asked to identify CV-syllables in a nonforced, and also attention-right, and attention-left condition. Transient evoked otoacoustic emissions (TEOAEs) were recorded for both ears, with and without the presentation of contralateral broadband noise. The main finding was a strong negative correlation between language laterality as measured with the dichotic listening task and of the TEOAE responses. The findings support a hypothesis of shared variance between central and peripheral auditory lateralities, and contribute to the attentional theory of auditory lateralization. The results have implications for the understanding of the cortico-fugal efferent control of cochlear activity.     

Dichotic listening,executive functions and grey matter cortical volume in patients with schizophrenia and healthy controls

Schizophrenia is characterized by cognitive impairment, especially in relation to executive functions. Brain structural abnormalities are also often seen in schizophrenia although little is known of the relationship between cognitive impairment and structural brain changes. Our aim was therefore to investigate this relationship further using MRI and a dichotic listening (DL) task with simple speech sounds and with instructions to focus attention and report only from the left or right ear stimulus. When instructed to focus attention on the left ear syllable a cognitive conflict is induced requiring the allocation of executive resources to be resolved. Grey matter (GM) volume was measured with MRI from four volumes of interests (VOIs), left and right frontal and temporal cortex, respectively, and correlated with DL performance. The results showed significant differences between the groups in their ability to focus attention on and report the left ear stimulus, which was accompanied by reduced GM volume in the left frontal and right temporal lobe VOIs. There was also a significant positive correlation between left frontal GM volume and performance on the DL task, for the groups combined. The results did not support a conclusion that an impairment in cognitive function in schizophrenia was driven by an corresponding impairment in brain structure, since there were no significant correlations when the groups were analyzed separately. It is however concluded that patients with schizophrenia are impaired in executive functions and that they also show reduced GM volumes in left frontal and right temporal lobe areas, compared to healthy controls.     

A dichotic listening study of attention control in older adults

The influence of age on attentional control of bottom-up processing was investigated with a dichotic-listening paradigm. The typical right-ear-advantage (REA) without specific attentional instructions was used as a measure of bottom-up processing (non-forced condition). Top-down attentional control was evaluated by instructing subjects to report only the right or left ear stimulus of the dichotic pair (forced-right, forced-left conditions). Both young and old participants showed a REA in the non-forced condition and an increased REA in the forced-right condition. The old group failed, however, to use attention to modulate the REA to the same degree as the younger participants in the forced-left condition. Only the young group showed a significant left ear advantage (LEA). The results are discussed in relation to cognitive decline in normal aging and in early stages of dementia.     

Selective attention to emotional prosody in social anxiety: a dichotic listening study

The majority of evidence on social anxiety (SA)-linked attentional biases to threat comes from research using facial expressions. Emotions are, however, communicated through other channels, such as voice. Despite its importance in the interpretation of social cues, emotional prosody processing in SA has been barely explored. This study investigated whether SA is associated with enhanced processing of task-irrelevant angry prosody. Fifty-three participants with high and low SA performed a dichotic listening task in which pairs of male/female voices were presented, one to each ear, with either the same or different prosody (neutral or angry). Participants were instructed to focus on either the left or right ear and to identify the speaker’s gender in the attended side. Our main results show that, once attended, task-irrelevant angry prosody elicits greater interference than does neutral prosody. Surprisingly, high socially anxious participants were less prone to distraction from attended-angry (compared to attended-neutral) prosody than were low socially anxious individuals. These findings emphasise the importance of examining SA-related biases across modalities.     

Dichotic listening performance in subtypes of developmental dyslexia and a left temporal lobe brain tumor contrast group.

This study examined dichotic listening performance in three subtypes of developmental dyslexia and in children with left temporal lobe brain tumors (clinical contrast group). Each child was administered a free-recall CV syllable dichotic paradigm (30 pairs). Analysis of variance and Tukey-HSD pairwise follow-up comparison indicated that the dichotic listening performance of the left temporal lobe brain tumor contrast group (strong LEA/right ear suppression) was significantly different from those of the visual-spatial/dyseidetic (strong REA/left ear depression) and mixed (moderate REA/bilateral ear suppression) dyslexic subtypes. The language disorder/dysphonetic dyslexic subtype demonstrated a REA with right ear depression. Closer inspection of the individual performances of the language disorder/dysphonetic dyslexic subtype revealed a bimodal distribution with 12 subjects demonstrating a strong LEA/right ear suppression and 8 subjects exhibiting a strong REA/left ear depression. These results lend support for the contention that the dyslexic population is heterogeneous in nature with each subgroup exhibiting (1) a distinct neuropsychological test profile and reading pattern and (2) a pattern of performance on the dichotic listening task which is consistent with what would be expected based upon the pattern of dysfunction exhibited on neuropsychological evaluation.     

Smoking reduces language lateralization: a dichotic listening study with control participants and schizophrenia patients

Schizophrenia has been associated with deficits in functional brain lateralization. According to some authors, the reduction of asymmetry could even promote this psychosis. At the same time, schizophrenia is accompanied by a high prevalence of nicotine dependency compared to any other population. This association is very interesting, because sex-dependent effects of smoking in auditory language asymmetries have been reported recently, and the verbal domain is also one major focus in cognitive deficit studies of schizophrenia. Thus, the altered laterality pattern in schizophrenia could, at least in part, result from secondary artefacts due to smoking rather than being a pure cause of the disease itself. To test this hypothesis, the present study examined auditory language lateralization in 67 schizophrenia patients and in 72 healthy controls in a phonemic and an emotional dichotic listening task. Our findings replicate previous research, in that smoking reduces language lateralization in men in phonemic dichotic listening. In addition, we show that smoking also reduces laterality in women in the emotional dichotic listening task. Thus, smoking alters phonemic and emotional language asymmetries differentially for men and women, with a stronger effect for men in the left hemisphere phonemic task, and a stronger effect for women in the right hemisphere emotional task. Together, these findings point towards an effect of smoking which is possibly independent of sex and hemisphere. Importantly, by testing equal numbers of smoking and non-smoking patients and controls, we found no schizophrenia-associated asymmetry effect. Possible neurobiological mechanisms with which smoking may alter auditory microcircuits and thereby diminish left-right differences are discussed.     

Dreaming and cognition in patients with frontotemporal dysfunction

Individuals with Parkinson’s disease (PD) and temporal lobe epilepsy (TLE) have hallucinations and mild cognitive dysfunction. The objective of this work was to study dreams in PD and TLE patients using a common functional model of dream production involving the limbic and paralimbic structures.Dreams were characterised in early-stage PD (19 males) and TLE patients (52) with dream diaries classified by the Hall van de Castle system and were compared with matched controls.In PD, there were significant differences between patients’ dreams and those of controls: animals, physical aggression, and a befriender were more common in patients, and aggressor and bodily misfortunes were less common. The dreams of patients with frontal dysfunction showed more aggressive features.TLE patients had lower recall than PD patients and a higher proportion of dreams involving family and familiar settings, lower proportions involving success, and a higher incidence of frontal dysfunction.The dreams of PD and TLE patients share important features.     

Memory for between‐list and within‐list information in amnesic patients with temporal lobe and diencephalic lesions

Patients with medial temporal lobe damage and diencephalic damage were compared on two tests of verbal temporal order memory: between‐list discrimination and within‐list discrimination. Both patient groups were impaired relative to a group of healthy control participants. In addition, despite comparable levels of item recognition, the diencephalic group was impaired relative to the medial temporal lobe group on both within‐list and between‐list discrimination. Temporal order memory for between‐list information showed a significant correlation with a composite measure of recognition memory, and the results are discussed in terms of the patients' reliance on familiarity and distance‐based processes to make temporal order judgments.     

Intelligence profiles in children and adolescents with left temporal lobe epilepsy: relationship to language laterality

Pre- and postoperative IQ profiles were examined in children and adolescents with left temporal-lobe epilepsy. Participants were grouped according to their pattern of speech dominance, as indicated by the intracarotid sodium amobarbital procedure. Seven participants with typical (left hemisphere) speech representation were matched for age and sex to seven participants with atypical (bilateral or right hemisphere) speech representation. The group with atypical speech representation tended to perform worse pre- and postoperatively on several verbal and nonverbal subtests. Unlike Strauss et al.'s (1990) sample, however, the groups did not differ significantly on pre- or postoperative Performance IQ. The results suggest that when individuals are matched closely for age and sex, there may only be limited support for a nonverbal "crowding" hypothesis. Atypical speech representation in children and adolescents with early temporal-lobe epilepsy appears to be associated with lowered performance on both verbal and nonverbal IQ subtests.     

Confirmatory factor analysis of the WMS-III in patients with temporal lobe epilepsy

Five competing models specifying the factor structure underlying the Wechsler Memory Scale-Third Edition (D. Wechsler, 1997b) primary subtest scores were evaluated in a sample of patients with intractable temporal lobe epilepsy (N = 254). Models specifying separate immediate and delayed constructs resulted in inadmissible parameter estimates and model specification error. There were negligible goodness-of-fit differences between a 3-factor model of working memory, auditory memory, and visual memory and a nested--more parsimonious--2-factor model of working memory and general memory. The results suggest that specifying a separate visual memory factor provides little advantage for this sample--an unexpected finding in a population with lateralized dysfunction, for which one might have predicted separate auditory and visual memory dimensions.     

Cognitive control deficits in adolescents born with very low birth weight (≤ 1500 g): Evidence from dichotic listening

The objective of the paper is to explore bottom‐up auditory and top‐down cognitive processing abilities as part of long‐term outcome assessment of preterm birth. Fifty‐five adolescents (age 13–15) born with very low birth weight (VLBW) were compared to 80 matched controls born to term, using three consonant‐vowel dichotic listening (DL) instruction conditions (non‐forced, forced‐right and forced‐left). DL scores were correlated with cortical gray matter thickness derived from T1‐weighted structural MRI volumes using FreeSurfer to examine group differences also in the neural correlates of higher cognitive processes. While showing normal bottom‐up processing, VLBW adolescents displayed impaired top‐down controlled conflict processing related to significant cortical thickness differences in left superior temporal gryus and anterior cingulate cortex. Preterm birth with VLBW induces fundamental changes in brain function and structure posing a risk for long‐term neurocognitive impairments. Deficits emerge in situations of increasing cognitive conflict and can be related to measures of executive functions as well as morphology.     

Language localization in cases of left temporal lobe arachnoid cyst: evidence against interhemispheric reorganization

We investigated whether left-hemisphere arachnoid cysts lead to reorganization of the language function using PET. A group analysis demonstrated that patients showed no more right-hemisphere activation than a matched control group. Several patients had clear language localizations in the left hemisphere during language comprehension; none of the patients showed right-hemisphere activation. We conclude that left-hemisphere tissue must suffer considerable compromise before reorganization of language into the right hemisphere becomes necessary. Language activations within the left hemisphere are clearly displaced. This is consistent with mere physical displacement in some patients rather than reorganization within the left hemisphere; in others intrahemispheric reorganization cannot be excluded.     

Relationship of temporal lobe volumes to neuropsychological test performance in healthy children

Ecological validity of neuropsychological assessment includes the ability of tests to predict real-world functioning and/or covary with brain structures. Studies have examined the relationship between adaptive skills and test performance, with less focus on the association between regional brain volumes and neurobehavioral function in healthy children. The present study examined the relationship between temporal lobe gray matter volumes and performance on two neuropsychological tests hypothesized to measure temporal lobe functioning (visual perception-VP; peabody picture vocabulary test, third edition-PPVT-III) in 48 healthy children ages 5-18 years. After controlling for age and gender, left and right temporal and left occipital volumes were significant predictors of VP. Left and right frontal and temporal volumes were significant predictors of PPVT-III. Temporal volume emerged as the strongest lobar correlate with both tests. These results provide convergent and discriminant validity supporting VP as a measure of the "what" system; but suggest the PPVT-III as a complex measure of receptive vocabulary, potentially involving executive function demands.     

Role of left posterior superior temporal gyrus in phonological processing for speech perception and production

Models of both speech perception and speech production typically postulate a processing level that involves some form of phonological processing. There is disagreement, however, on the question of whether there are separate phonological systems for speech input versus speech output. We review a range of neuroscientific data that indicate that input and output phonological systems partially overlap. An important anatomical site of overlap appears to be the left posterior superior temporal gyrus. We then present the results of a new event-related functional magnetic resonance imaging (fMRI) experiment in which participants were asked to listen to and then (covertly) produce speech. In each participant, we found two regions in the left posterior superior temporal gyrus that responded both to the perception and production components of the task, suggesting that there is overlap in the neural systems that participate in phonological aspects of speech perception and speech production. The implications for neural models of verbal working memory are also discussed in connection with our findings.     

Different types of working memory binding in epilepsy patients with unilateral anterior temporal lobectomy

The medial temporal lobe is an important structure for long-term memory formation, but its role in working memory is less clear. Recent studies have shown hippocampal involvement during working memory tasks requiring binding of information. It is yet unclear whether this is limited to tasks containing spatial features. The present study contrasted three binding conditions and one single-item condition in patients with unilateral anterior temporal lobectomy.A group of 43 patients with temporal lobectomy (23 left; 20 right) and 20 matched controls were examined with a working memory task assessing spatial relational binding (object–location), non-spatial relational binding (object–object), conjunctive binding (object–colour) and working memory for single items. We varied the delay period (3 or 6 s), as there is evidence showing that delay length may modulate working memory performance.The results indicate that performance was worse for patients than for controls in both relational binding conditions, whereas patients were unimpaired in conjunctive binding. Single-item memory was found to be marginally impaired, due to a deficit on long-delay trials only.In conclusion, working memory binding deficits are found in patients with unilateral anterior temporal lobectomy. The role of the medial temporal lobe in working memory is not limited to tasks containing spatial features. Rather, it seems to be involved in relational binding, but not in conjunctive binding. The medial temporal lobe gets involved when working memory capacity does not suffice, for example when relations have to be maintained or when the delay period is long.     

Disruption of spelling-to-sound correspondence mapping during single-word reading in patients with temporal lobe epilepsy

Processing and/or hemispheric differences in the neural bases of word recognition were examined in patients with long-standing, medically-intractable epilepsy localized to the left (N=18) or right (N=7) temporal lobe. Participants were asked to read words that varied in the frequency of their spelling-to-sound correspondences. For the right temporal lobe group, reaction times (RTs) showed the same pattern across spelling-to-sound correspondence conditions as previously reported for normal participants. For the left temporal lobe group, however, the pattern of RTs suggested a greater relative influence of orthographic frequency than rime frequency, such that performance was worse on words whose orthographic body was less frequent in the language. We discuss these results in terms of differences in processing between the two cerebral hemispheres: the results for the right-temporal lobe patients are taken to support connectionist models of reading as described for the dominant (left) hemisphere, while results for the left-temporal lobe patients support a view of the right hemisphere as relatively less sensitive to phonology and relatively more sensitive to orthography.     

Effects of attention on dichotic listening in elderly and patients with dementia of the Alzheimer type

This article presents an overview of our studies in elderly and Alzheimer patients employing Kimura's dichotic digits paradigm as a measure for left hemispheric predominance for processing language stimuli. In addition to structural brain mechanisms, we demonstrated that attention modulates the direction and degree of ear asymmetry in dichotic listening. Elderly showed increasingly more difficulties focusing attention on the left ear (LE) with advancing age. Alzheimer patients showed severe deficits to allocate attention to the LE, which could result in a right ear advantage. These results may be attributed to a breakdown of the cortical attentional network which is mediated by frontal (inhibitory control of attention) and parietal regions (spatial attention and 'disengagement processes'). Both interhemispheric disconnectivity (callosal atrophy) and intrahemispheric disconnectivity (subcortical white matter lesions) appear to be important factors contributing to these findings.     

Visual implicit memory in the left hemisphere: evidence from patients with callosotomies and right occipital lobe lesions

Identification of visually presented objects and words is facilitated by implicit memory for past visual experiences with those items. Several behavioral and neuroimaging studies suggest that this form of memory is dependent on perceptual processes localized in the right occipital lobe. We tested this claim by examining implicit memory in patients with extensive right occipital lobe lesions, using lexical-decision, mirror-reading, picture-fragment, and word-fragment-completion tests, and found that these patients exhibited normal levels of priming. We also examined implicit memory in patients with complete callosotomies, using standard and divided-visual-field word-fragment-completion procedures, and found that the isolated left hemisphere exhibited normal priming effects. The results indicate that the right occipital lobe does not play a necessary role in visual implicit memory, and that the isolated left hemisphere can support normal levels of visual priming in a variety of tasks.