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Biomedical subjects

H Branch Coslett

Publications and source records attributed to H Branch Coslett.

At least 19 recordsLinked to original sources

Impairment in writing, but not reading, morphologically complex words.

We report a patient, FP, with phonological dyslexia who is impaired in writing affixed words to dictation, but demonstrates no such deficit when reading affixed words. Moreover, she was much more impaired in the writing of regularly inflected words (e.g., "walked") as compared to irregularly inflected words (e.g., "ran") and derived words (e.g., "walker"). These findings indicate that FP's deficit was morphologically based and are consistent with accounts that assume that morphologically complex words are decomposed during lexical processing. The data also suggest that the lexical representations mediating reading and writing are, at least in part, dissociable.

Adult↗

Illusory conjunctions in simultanagnosia: coarse coding of visual feature location?

Simultanagnosia is a disorder characterized by an inability to see more than one object at a time. We report a simultanagnosic patient (ED) with bilateral posterior infarctions who produced frequent illusory conjunctions on tasks involving form and surface features (e.g., a red T) and form alone. ED also produced "blend" errors in which features of one familiar perceptual unit appeared to migrate to another familiar perceptual unit (e.g., "RO" read as "PQ"). ED often misread scrambled letter strings as a familiar word (e.g., "hmoe" read as "home"). Finally, ED's success in reporting two letters in an array was inversely related to the distance between the letters. These findings are consistent with the hypothesis that ED's illusory reflect coarse coding of visual feature location that is ameliorated in part by top-down information from object and word recognition systems; the findings are also consistent, however, with Treisman's Feature Integration Theory. Finally, the data provide additional support for the claim that the dorsal parieto-occipital cortex is implicated in the binding of visual feature information.

Aged↗

An acquired deficit of audiovisual speech processing.

We report a 53-year-old patient (AWF) who has an acquired deficit of audiovisual speech integration, characterized by a perceived temporal mismatch between speech sounds and the sight of moving lips. AWF was less accurate on an auditory digit span task with vision of a speaker's face as compared to a condition in which no visual information from the lower face was available. He was slower in matching words to pictures when he saw congruent lip movements compared to no lip movements or non-speech lip movements. Unlike normal controls, he showed no McGurk effect. We propose that multisensory binding of audiovisual language cues can be selectively disrupted.

Acoustic Stimulation↗

Frontotemporal dementia: clinicopathological correlations.

OBJECTIVE: Frontotemporal lobar degeneration (FTLD) is characterized by impairments in social, behavioral, and/or language function, but postmortem studies indicate that multiple neuropathological entities lead to FTLD. This study assessed whether specific clinical features predict the underlying pathology. METHODS: A clinicopathological correlation was performed on 90 consecutive patients with a pathological diagnosis of frontotemporal dementia and was compared with an additional 24 cases accrued during the same time period with a clinical diagnosis of FTLD, but with pathology not typically associated with frontotemporal dementia. RESULTS: Postmortem examination showed multiple pathologies including tauopathies (46%), FTLD with ubiquitin-positive inclusions (29%), and Alzheimer's disease (17%). The pathological groups manifested some distinct demographic, clinical, and neuropsychological features, although these attributes showed only a statistical association with the underlying pathology. FTLD with ubiquitin-positive inclusions was more likely to present with both social and language dysfunction, and motor neuron disease was more likely to emerge in these patients. Tauopathies were more commonly associated with an extrapyramidal disorder. Alzheimer's disease was associated with relatively greater deficits in memory and executive function. INTERPRETATION: Clinical and neuropsychological features contribute to delineating the spectrum of pathology underlying a patient diagnosed with FTLD, but biomarkers are needed that, together with the clinical phenotype, can predict the underlying neuropathology.

Adult↗

Cognitive rehabilitation interventions for neglect and related disorders: moving from bench to bedside in stroke patients.

The spatial neglect syndrome, defined by asymmetric attention and action not attributed to primary motor or sensory dysfunction and accompanied by functional disability, is a major cause of post-stroke morbidity. In this review, we consider the challenges and obstacles facing scientific researches wishing to evaluate the mechanisms and effectiveness of rehabilitation interventions. Spatial neglect is a heterogeneous disorder, for which consensus research definitions are not currently available, and it is unclear which of the deficits associated with the syndrome causes subsequent disability. We review current opinion about methods of assessment, suggest a rational approach to selecting therapies which requires further study, and make systems-level and theoretical recommendations for building theory. We lastly review some creative questions for consideration in future research.

Animals↗

The effect of gaze direction on sound localization in brain-injured and normal adults.

This study examined the effects of eye position on sound localization in normal and brain lesion subjects. On the assumption that cerebral lesions may disrupt the representation of or attention to auditory space in the contralesional hemispace, we predicted that subjects with brain lesions would be less accurate in localizing sounds in the contralesional hemispace. In Experiment 1 we showed that gazing to the midline subjects with brain lesions were indeed impaired in localizing sounds in the contralesional hemispace. On the assumption that spatial attention is deployed at the site to which gaze is directed, we predicted that sound localization would be better on the side to which subjects directed their gaze. In Experiment 2, brain lesion subjects performed significantly better in the contralesional hemispace when they directed gaze to that hemispace. This improvement was accompanied by deterioration of performance in the ipsilesional hemispace. When subjects directed gaze to the ipsilesional hemispace, performance in the contralesional hemispace was further impaired. The effect of gaze was also observed in normal subjects in Experiments 2 and 3, independently of response mode (verbal versus pointing responses). These findings are consistent with the hypothesis that sound location may be mapped in eye-centered coordinates and that directing gaze to one hemispace reduces attentional allocation to the other hemispace.

Acoustic Stimulation↗

Distinctions between manipulation and function knowledge of objects: evidence from functional magnetic resonance imaging.

A prominent account of conceptual knowledge proposes that information is distributed over visual, tactile, auditory, motor and verbal-declarative attribute domains to the degree to which these features were activated when the knowledge was acquired [D.A. Allport, Distributed memory, modular subsystems and dysphagia, In: S.K. Newman, R. Epstein (Eds.), Current perspectives in dysphagia, Churchill Livingstone, Edinburgh, 1985, pp. 32-60]. A corollary is that when drawing upon this knowledge (e.g., to answer questions), particular aspects of this distributed information is re-activated as a function of the requirements of the task at hand [L.J. Buxbaum, E.M. Saffran, Knowledge of object manipulation and object function: dissociations in apraxic and non-apraxic subjects. Brain and Language, 82 (2002) 179-199; L.J. Buxbaum, T. Veramonti, M.F. Schwartz, Function and manipulation tool knowledge in apraxia: knowing 'what for' but not 'how', Neurocase, 6 (2000) 83-97; W. Simmons, L. Barsalou, The similarity-in-topography principle: Reconciling theories of conceptual deficits, Cognitive Neuropsychology, 20 (2003) 451-486]. This account predicts that answering questions about object manipulation should activate brain regions previously identified as components of the distributed sensory-motor system involved in object use, whereas answering questions about object function (that is, the purpose that it serves) should activate regions identified as components of the systems supporting verbal-declarative features. These predictions were tested in a functional magnetic resonance imaging (fMRI) study in which 15 participants viewed picture or word pairs denoting manipulable objects and determined whether the objects are manipulated similarly (M condition) or serve the same function (F condition). Significantly greater and more extensive activations in the left inferior parietal lobe bordering the intraparietal sulcus were seen in the M condition with pictures and, to a lesser degree, words. These findings are consistent with the known role of this region in skilled object use [K.M. Heilman, L.J. Gonzalez Rothi, Apraxia, In: K.M. Heilman, E. Valenstein (Eds.), Clinical Neuropsychology, Oxford University Press, New York, 1993, pp. 141-150] as well as previous fMRI results [M. Kellenbach, M. Brett, K. Patterson, Actions speak louder than functions: the importance of manipulability and action in tool representation, Journal of Cognitive Neuroscience, 15 (2003) 30-46] and behavioral findings in brain-lesion patients [L.J. Buxbaum, E.M. Saffran, Knowledge of object manipulation and object function: dissociations in apraxic and non-apraxic subjects, Brain and Language, 82 (2002) 179-199]. No brain regions were significantly more activated in the F than M condition. These data suggest that brain regions specialized for sensory-motor function are a critical component of distributed representations of manipulable objects.

Adult↗

Cerebrospinal fluid profile in frontotemporal dementia and Alzheimer's disease.

We assessed cerebrospinal fluid (CSF) levels of tau and other biomarkers of neurodegenerative disease. CSF tau levels vary widely in reports of frontotemporal dementia (FTD). CSF samples were assayed for tau, amyloid beta1-42 (A1-42), and the isoprostane 8,12-iso-iPF2a-VI (iP) prospectively in 64 patients with FTD, retrospectively in 26 autopsied cases with FTD or Alzheimer's disease (AD), and in 13 healthy seniors. To validate our observations in vivo, we correlated CSF tau levels with cortical atrophy in 17 FTD patients using voxel-based morphometry analyses of high-resolution magnetic resonance imaging. CSF levels of tau, Abeta1-42, and iP differed significantly in FTD compared with AD. Individual patient analyses showed that 34% of FD patients had significantly low levels of CSF tau, although this was never seen in AD. A discriminant analysis based on CSF levels of tau, Abeta1-42, and iP was able to classify 88.5% of these patients in a manner that corresponds to their clinical or autopsy diagnosis. Magnetic resonance imaging studies showed that CSF tau levels correlate significantly with right frontal and left temporal cortical atrophy, brain regions known to be atrophic in patients with autopsy-proved FTD. We conclude that CSF tau levels are significantly reduced in many patients with FTD.

Age of Onset↗

The role of sensory-motor information in object recognition: evidence from category-specific visual agnosia.

The role of sensory-motor representations in object recognition was investigated in experiments involving AD, a patient with mild visual agnosia who was impaired in the recognition of visually presented living as compared to non-living entities. AD named visually presented items for which sensory-motor information was available significantly more reliably than items for which such information was not available; this was true when all items were non-living. Naming of objects from their associated sound was normal. These data suggest that both information about object form computed in the ventral visual system as well as sensory-motor information specifying the manner of manipulation contribute to object recognition.

Acoustic Stimulation↗

Evidence for multiple, distinct representations of the human body.

Previous data from single-case and small group studies have suggested distinctions among structural, conceptual, and online sensorimotor representations of the human body. We developed a battery of tasks to further examine the prevalence and anatomic substrates of these body representations. The battery was administered to 70 stroke patients. Fifty-one percent of the patients were impaired relative to controls on at least one body representation measure. Further, principal components analysis of the patient data as well as direct comparisons of patient and control performance suggested a triple dissociation between measures of the 3 putative body representations. Consistent with previous distinctions between the "what" and "how" pathways, lesions of the left temporal lobe were most consistently associated with impaired performance on tasks assessing knowledge of the shape or lexical-semantic information about the body, whereas lesions of the dorsolateral frontal and parietal regions resulted in impaired performance on tasks requiring on-line coding of body posture.

Adult↗

Executive function as a predictor of inattentive behavior after traumatic brain injury.

Emerging evidence from recent studies using laboratory and naturalistic attention tasks suggests that individuals with traumatic brain injury (TBI) may have a deficit mainly in strategic control of attention. In the present study, we tested the hypothesis that inattentive behavior after TBI could be predicted by performance on psychometric measures of executive function. A group of 37 individuals with moderate to severe TBI were assessed with previously validated naturalistic measures of attention. A battery of neuropsychological tests was also administered to assess various aspects of executive function. Seven measures of executive function and 10 variables reflecting inattentive behavior were combined to form 1 executive and 3 inattentive behavior (IB) composite scores. Three predictors (executive composite, current disability scores, and age) were associated, at the univariate level, with one of the IB composites reflecting frequency and duration of off-task episodes. A stepwise multiple regression procedure indicated that the executive composite was the only significant predictor of the IB composite. Additional post-hoc regression analyses suggested that the relationship was not likely to be mediated by processing speed. The current study supports the hypothesis that executive function, measured by commonly used neuropsychological tests, significantly predicts certain aspects of inattentive behavior in real-world tasks after TBI.

Adolescent↗

Mental motor imagery and the body schema: evidence for proprioceptive dominance.

Previous studies have demonstrated that both visual and proprioceptive feedback influence motor control. The relative contributions of these sensory modalities to the on-line computation of body position--that is, the body schema--remain unclear. We report a study designed to explore the roles of vision and proprioception in motor planning. The task required subjects to judge if a pictured stimulus was a right or left hand; stimuli included pictures of a right or left hand in a palm up or palm down position and in six different angular rotations (0 degrees , 60 degrees , 120 degrees , 180 degrees , 240 degrees , 300 degrees ). Each subject was tested with his/her right hand palm down and palm up. There were three conditions: a "control" condition (real hand in view), a "fake hand" condition (fake hand in view, real hand out of view), and a "proprioception" condition (no fake hand, real hand out of view). We found that proprioceptive input (that is, the subject's "felt position") had a significant influence on mental rotation whereas the visually perceived posture of the hand did not. We suggest that, at least under some circumstances, proprioceptive inflow may represent the dominant sensory input to the on-line representation of the body in space.

Analysis of Variance↗

Hemispheric mediation of spatial attention: pseudoneglect after callosal stroke.

Study of patients with callosal lesions can provide insight into the mediation of spatial attention-intention by each hemisphere. Two patients with anterior callosal strokes bisected lines to the left of midline with the left hand and to the right of midline with the right in both a visual and tactile bisection task. The patients demonstrated a similar pattern of performance on pointing to body-midline in space. These results are consistent with the notion that each hemisphere supports spatial attention-intention toward contralateral space and that the corpus callosum is critical in the integration of such information.

Aged↗

Bare hands and attention: evidence for a tactile representation of the human body.

If brain lesions impair the allocation of attention to a representation of the body surface and the hand may serve as an attentional focus or "wand", one might expect that somatosensory deficits caused by cerebral lesions would be ameliorated by contact with the ipsilesional hand. To test this prediction, tactile detection tasks were administered to two subjects with right hemisphere lesions. Subject CB's left tactile extinction was investigated in conditions in which the degree of contact between the right and left hands and the spatial relationship between his hands was systematically varied. His left tactile extinction was significantly reduced by touch of the right hand. Similarly, extinction at the left knee was ameliorated by touch of the knee by the right hand; touch of the right foot had no effect. Subject NC's ability to detect a tactile stimulus delivered to the left side was systematically assessed in conditions in which the hands touched and the spatial relationship between the hands was varied. His ability to detect a touch on the left hand improved in conditions in which the left hand was touched by the right hand. This effect was not observed if direct contact between the two hands was prevented by inserting a thin cloth between the hands. For both subjects, placing the right hand in close proximity to the left hand or altering the spatial location of the hands relative to the body did not influence performance. These data demonstrate that the hand may serve as a conduit for attention and provide strong evidence for a distinct representation of the body surface that is at least in part independent of spatial representations.

Attention↗

Effects of methylphenidate on attention deficits after traumatic brain injury: a multidimensional, randomized, controlled trial.

OBJECTIVE: To evaluate the effects of methylphenidate on a variety of aspects of attention, ranging from laboratory-based impairment measures to caregiver ratings and work productivity, in individuals after traumatic brain injury. DESIGN: A total of 34 adults with moderate to severe traumatic brain injury and attention complaints in the postacute phase of recovery were enrolled in a 6-wk, double-blind, placebo-controlled, repeated crossover study of methylphenidate, administered in a dose of 0.3 mg/kg/dose, twice a day. A wide range of attentional measures was gathered weekly, including computerized and paper-and-pencil tests of attention, videotaped records of individual work in a distracting environment, real-time observational scoring of attentiveness in a classroom environment, and caregiver and clinician rating scales of attentiveness. Participants also attempted to guess their drug condition each week. Data from the first ten participants were used for pilot purposes, to develop attentional factors for composite scoring, and to identify attentional dimensions suggestive of a treatment effect for independent replication. The remaining 24 participants' results were used to confirm potential treatment effects seen in the pilot sample, using Wilcoxon's signed-ranks test on composite factor scores and individual variables. RESULTS: A total of 54 dependent variables were reduced to 13 composite factors and 13 remaining individual variables. Of the 13 attentional factors, five showed suggestive treatment effects in the pilot sample. Of these, three showed statistically significant treatment effects in the replication sample: speed of information processing (effect sizes, -0.06 to 0.48; P < 0.001), attentiveness during individual work tasks (effect sizes, 0.15-0.62; P = 0.01), and caregiver ratings of attention (effect sizes, 0.44-0.50; P = 0.01). Of the individual variables, four showed suggestive treatment effects in the pilot sample, but only one showed significant treatment effects in the replication sample: reaction time before errors in the Sustained Attention to Response Task (effect size, 0.20; P = 0.03). No treatment-related improvement was seen in divided attention, sustained attention, or susceptibility to distraction. None of the variables showed suggestive or definite negative treatment effects. Effect sizes for those performance measures positively affected by methylphenidate were in the small to medium range and included both impairment and activity level measures. Improvements in processing speed did not seem to come at the expense of accuracy. CONCLUSIONS: Methylphenidate, at 0.3 mg/kg/dose, given twice a day to individuals with attentional complaints after traumatic brain injury, seems to have clinically significant positive effects on speed of processing, caregiver ratings of attention, and some aspects of on-task behavior in naturalistic tasks. Further research is needed to identify the optimal dose and to extend these findings to less carefully selected individuals.

Adult↗

Differences in word associations to pictures and words.

Normal subjects were asked to produce the "first word that comes to mind" in response to pictures or words that differed with respect to manipulability and animacy. In separate analyses across subjects and items, normal subjects produced a significantly higher proportion of action words (that is, verbs) to pictures as compared to words, to manipulable as compared to non-manipulable stimuli and to inanimate as compared to animate stimuli. The largest proportion of action words was elicited by pictures of non-living, manipulable objects. Furthermore, associates to words matched standard word associates significantly more often than those elicited by pictures. These data suggest that pictures and words initially contact different forms of conceptual information and are consistent with an account of semantic organization that assumes that information is distributed across different domains reflecting the mode of acquisition of that knowledge.

Adult↗

Knowledge of the human body: a distinct semantic domain.

BACKGROUND: Patients with selective deficits in the naming and comprehension of animals, plants, and artifacts have been reported. These descriptions of specific semantic category deficits have contributed substantially to the understanding of the architecture of semantic representations. OBJECTIVE: This study sought to further understanding of the organization of the semantic system by demonstrating that another semantic category, knowledge of the human body, may be selectively preserved. METHODS: The performance of a patient with semantic dementia was compared with the performance of healthy controls on a variety of tasks assessing distinct types of body representations, including the body schema, body image, and body structural description. RESULTS: Despite substantial deficits on tasks involving language and knowledge of the world generally, the patient performed normally on all tests of body knowledge except body part naming; even in this naming task, however, her performance with body parts was significantly better than on artifacts. CONCLUSIONS: The demonstration that body knowledge may be preserved despite substantial semantic deficits involving other types of semantic information argues that body knowledge is a distinct and dissociable semantic category. These data are interpreted as support for a model of semantics that proposes that knowledge is distributed across different cortical regions reflecting the manner in which the information was acquired.

Atrophy↗