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Biomedical subjects

Laurent Cohen

Publications and source records attributed to Laurent Cohen.

At least 19 recordsLinked to original sources
PubMed2006

Brief report: visual-spatial deficit in a 16-year-old girl with maternally derived duplication of proximal 15q.

Duplications of chromosome 15 may be one of the most common single genetic causes of autism spectrum disorders (ASD), aside from fragile X. Most of the cases are associated with maternally derived interstitial duplication involving 15q11-13. This case report describes a female proband with a maternally derived interstitial duplication of proximal 15q. She did not exhibit any symptoms of ASD apart from some developmental delay. By adolescence, she showed mild dysmorphism, a discrepant profile on the Wechsler Intelligence Scale for Children (Verbal IQ = 87; Performance IQ = 65) and a major deficit in visual-spatial abilities affecting fine motor skills, mathematical reasoning, visual memory and some global reading tasks. This is one of the first reports of a child with a maternal duplication who exhibits a visual-spatial deficit without ASD.

Abnormalities, Multiple↗
PubMed2006

Principles underlying the design of "The Number Race", an adaptive computer game for remediation of dyscalculia.

BACKGROUND: Adaptive game software has been successful in remediation of dyslexia. Here we describe the cognitive and algorithmic principles underlying the development of similar software for dyscalculia. Our software is based on current understanding of the cerebral representation of number and the hypotheses that dyscalculia is due to a "core deficit" in number sense or in the link between number sense and symbolic number representations. METHODS: "The Number Race" software trains children on an entertaining numerical comparison task, by presenting problems adapted to the performance level of the individual child. We report full mathematical specifications of the algorithm used, which relies on an internal model of the child's knowledge in a multidimensional "learning space" consisting of three difficulty dimensions: numerical distance, response deadline, and conceptual complexity (from non-symbolic numerosity processing to increasingly complex symbolic operations). RESULTS: The performance of the software was evaluated both by mathematical simulations and by five weeks of use by nine children with mathematical learning difficulties. The results indicate that the software adapts well to varying levels of initial knowledge and learning speeds. Feedback from children, parents and teachers was positive. A companion article describes the evolution of number sense and arithmetic scores before and after training. CONCLUSION: The software, open-source and freely available online, is designed for learning disabled children aged 5-8, and may also be useful for general instruction of normal preschool children. The learning algorithm reported is highly general, and may be applied in other domains.

Journal Article↗
PubMed2006

An open trial assessment of "The Number Race", an adaptive computer game for remediation of dyscalculia.

BACKGROUND: In a companion article, we described the development and evaluation of software designed to remediate dyscalculia. This software is based on the hypothesis that dyscalculia is due to a "core deficit" in number sense or in its access via symbolic information. Here we review the evidence for this hypothesis, and present results from an initial open-trial test of the software in a sample of nine 7-9 year old children with mathematical difficulties. METHODS: Children completed adaptive training on numerical comparison for half an hour a day, four days a week over a period of five-weeks. They were tested before and after intervention on their performance in core numerical tasks: counting, transcoding, base-10 comprehension, enumeration, addition, subtraction, and symbolic and non-symbolic numerical comparison. RESULTS: Children showed specific increases in performance on core number sense tasks. Speed of subitizing and numerical comparison increased by several hundred msec. Subtraction accuracy increased by an average of 23%. Performance on addition and base-10 comprehension tasks did not improve over the period of the study. CONCLUSION: Initial open-trial testing showed promising results, and suggested that the software was successful in increasing number sense over the short period of the study. However these results need to be followed up with larger, controlled studies. The issues of transfer to higher-level tasks, and of the best developmental time window for intervention also need to be addressed.

Journal Article↗
PubMed2006

Nonconscious semantic processing of emotional words modulates conscious access.

Whether masked words can be processed at a semantic level remains a controversial issue in cognitive psychology. Although recent behavioral studies have demonstrated masked semantic priming for number words, attempts to generalize this finding to other categories of words have failed. Here, as an alternative to subliminal priming, we introduce a sensitive behavioral method to detect nonconscious semantic processing of words. The logic of this method consists of presenting words close to the threshold for conscious perception and examining whether their semantic content modulates performance in objective and subjective tasks. Our results disclose two independent sources of modulation of the threshold for access to consciousness. First, prior conscious perception of words increases the detection rate of the same words when they are subsequently presented with stronger masking. Second, the threshold for conscious access is lower for emotional words than for neutral ones, even for words that have not been previously consciously perceived, thus implying that written words can receive nonconscious semantic processing.

Consciousness↗
PubMed2006

Direct intracranial, FMRI, and lesion evidence for the causal role of left inferotemporal cortex in reading.

Models of the "visual word form system" postulate that a left occipitotemporal region implements the automatic visual word recognition required for efficient reading. This theory was assessed in a patient in whom reading was explored with behavioral measures, fMRI, and intracranial local field potentials. Prior to surgery, when reading was normal, fMRI revealed a normal mosaic of ventral visual selectivity for words, faces, houses, and tools. Intracranial recordings demonstrated that the left occipitotemporal cortex responded with a short latency to conscious but also to subliminal words. Surgery removed a small portion of word-responsive occipitotemporal cortex overlapping with the word-specific fMRI activation. The patient developed a marked reading deficit, while recognition of other visual categories remained intact. Furthermore, in the post-surgery fMRI map of visual cortex, only word-specific activations disappeared. Altogether, these results provide direct evidence for the causal role of the left occipitotemporal cortex in the recognition of visual words.

Brain Mapping↗
PubMed2006

The role of the supplementary motor area (SMA) in word production.

The supplementary motor area (SMA) is a key structure for behavioral planning and execution. Recent research on motor control conducted with monkeys and humans has put to light an anatomical and functional distinction between pre-SMA and SMA-proper. According to this view, the pre-SMA would be involved in higher level processes while the SMA-proper would be more closely tied to motor output. We extended this general framework to the verbal domain, in order to investigate the role of the SMA in speech production. We conducted two speech production experiments with fMRI where we manipulated parameters such as familiarity, complexity or constraints on word selection. The results reveal a parcellation of the SMA into three distinct regions, according to their involvement in different aspects of word production. More specifically, following a rostrocaudal gradient, we observed differential activations related to lexical selection, linear sequence encoding and control of motor output. A parallel organization was observed in the dorsolateral frontal cortex. By refining its anatomical and functional parcellation, these results clarify the roles of the SMA in speech production.

Adult↗
PubMed2006

The neural bases of prosopagnosia and pure alexia: recent insights from functional neuroimaging.

PURPOSE OF REVIEW: To discuss whether recent functional neuroimaging results can account for clinical phenomenology in visual associative agnosias. RECENT FINDINGS: Functional neuroimaging studies in healthy human subjects have identified only two regions of ventral occipitotemporal cortex that invariantly respond to individual faces and visual words, respectively. The signature of face identity coding in the fusiform neural response was shown to be missing in a patient with prosopagnosia. Another case study established that a surgical lesion close to the region sensitive to visual words can result in pure alexia. SUMMARY: Evidence is increasing that functional specialization for processing face identity and visual word forms is restricted to two specialized sensory modules in the occipitotemporal cortex. A structural or functional lesion to face-sensitive and word-sensitive regions in the ventral occipitotemporal cortex can provide the most parsimonious account for the clinical syndromes of prosopagnosia and agnosic alexia. This review suggests that functional specialization should be considered in terms of whether exclusively one brain region (instead of many) underpins a defined function and not as whether this brain region underpins exclusively one cognitive function. Such functional specialization seems to exist for at least two higher-order visual perceptual functions, face and word identification.

Dyslexia↗
PubMed2006

"What" and "where" in word reading: ventral coding of written words revealed by parietal atrophy.

The visual system of literate adults develops a remarkable perceptual expertise for printed words. To delineate the aspects of this competence intrinsic to the occipitotemporal "what" pathway, we studied a patient with bilateral lesions of the occipitoparietal "where" pathway. Depending on critical geometric features of the display (rotation angle, letter spacing, mirror reversal, etc.), she switched from a good performance, when her intact ventral pathway was sufficient to encode words, to severely impaired reading, when her parietal lesions prevented the use of alternative reading strategies as a result of spatial and attentional impairments. In particular, reading was disrupted (a) by rotating word by more than 50 degrees , providing an approximation of the invariance range for words encoding in the ventral pathway; (b) by separating letters with double spaces, revealing the limits of letter grouping into perceptual wholes; (c) by mirror-reversing words, showing that words escape the default mirror-invariant representation of visual objects in the ventral pathway. Moreover, because of her parietal lesions, she was unable to discriminate mirror images of common objects, although she was excellent with reversible pseudowords, confirming that the breaking of mirror symmetry was intrinsic to the occipitotemporal cortex. Thus, charting the display conditions associated with preserved or impaired performance allowed us to infer properties of word coding in the normal ventral pathway and to delineate the roles of the parietal lobes in single-word recognition.

Cerebral Cortex↗
PubMed2005

A direct intracranial record of emotions evoked by subliminal words.

A classical but still open issue in cognitive psychology concerns the depth of subliminal processing. Can the meaning of undetected words be accessed in the absence of consciousness? Subliminal priming experiments in normal subjects have revealed only small effects whose interpretation remains controversial. Here, we provide a direct demonstration of semantic access for unseen masked words. In three epileptic patients with intracranial electrodes, we recorded brain potentials from the amygdala, a neural structure that responds to fearful or threatening stimuli presented in various modalities, including written words. We show that the subliminal presentation of emotional words modulates the activity of the amygdala at a long latency (>800 ms). Our result indicates that subliminal words can trigger long-lasting cerebral processes, including semantic access to emotional valence.

Adult↗
PubMed2005

Effortless control: executive attention and conscious feeling of mental effort are dissociable.

Recruitment of executive attention is normally associated to a subjective feeling of mental effort. Here we investigate the nature of this coupling in a patient with a left mesio-frontal cortex lesion including the anterior cingulate cortex (ACC), and in a group of comparison subjects using a Stroop paradigm. We show that in normal subjects, subjective increases in effort associated with executive control correlate with higher skin-conductance responses (SCRs). However, our patient experienced no conscious feeling of mental effort and showed no SCR, in spite of exhibiting normal executive control, and residual right anterior cingulate activity measured with event-related potentials (ERPs). Finally, this patient demonstrated a pattern of impaired behavior and SCRs in the Iowa gambling task-elaborated by Damasio, Bechara and colleagues-replicating the findings reported by these authors for other patients with mesio-frontal lesions. Taken together, these results call for a theoretical refinement by revealing a decoupling between conscious cognitive control and consciously reportable feelings. Moreover, they reveal a fundamental distinction, observed here within the same patient, between the cognitive operations which are depending on normal somatic marker processing, and those which are withstanding to impairments of this system.

Adult↗
PubMed2005

Detection of prominent left anterior descending coronary artery stenosis for patients with stable angina using Doppler tissue echocardiography.

The midseptum has an elective left anterior descending coronary artery (LAD) supply. Septal peak velocity (PkV) and myocardial velocity gradient (MVG) were studied at rest with M-mode Doppler tissue echocardiography during the cardiac cycle including the septal active relaxation (SAR) outward wall motion preceding isovolumic relaxation. In all, 33 patients had significant multivessel coronary artery disease. Group A (15 patients) had prominent LAD stenosis. Group B (18 patients) had prominent circumflex (15) or right (3) coronary artery stenoses. The goal was to detect a prominent LAD stenosis. During SAR, sensitivity to detect a prominent LAD stenosis was 86% for PkV < 20 mm/s and 80% for MVG < 1.1 s(-1); specificity was 83% for both variables. During systole, sensitivity was 86% with a 55% specificity for MVG < 2.0 s(-1), whereas sensitivity was 73% and specificity 66% for PkV < 30 mm/s. Areas under receiver operating characteristic curves were over 0.90 during SAR and only 0.70 for PkV and 0.80 for MVG during systole. In multivessel coronary artery disease, SAR variables better identified a prominent LAD stenosis than systolic variables. Moreover, SAR PkVs were informative per se, whereas systole required MVG calculation.

Aged↗
PubMed2005

Brain activations during letter-by-letter reading: a follow-up study.

Lesions affecting the ventral cortex of the left temporal lobe commonly yield a selective reading impairment known as pure alexia. It is thought to result from the disruption or deafferentation of the Visual Word Form Area (VWFA), a region in the left lateral occipitotemporal sulcus activated whenever normal subjects are viewing alphabetic strings. Most pure alexic patients retain the ability to identify single letters, and develop a strategy of letter-by-letter (LBL) reading. We recently studied fMRI activations in LBL readers and clarified the underlying mechanisms. However, LBL reading is a dynamic process which may improve over months or years of practice, although the cerebral bases of this continuing improvement are currently unknown. We had the opportunity to run the same behavioural testing and fMRI experiment a second time in an alexic patient, 8 months after collecting the data reported by Cohen et al. [Cohen, L., Henry, C., Dehaene, S., Molko, N., Lehéricy, S., Martinaud, O., Lemer, C., and Ferrieux, S. (2004). The pathophysiology of letter-by-letter reading. Neuropsychologia, 42, 1768-1780]. We analyze the changes that occurred over this period in the pattern of reading-related activations, while the patient's LBL reading improved. The activation level decreased in most of the overall network between the two sessions. This general trend contrasted with a focal increase restricted to specific left frontal and parietal areas. When studying the contrast between words and consonant strings, which may be taken as a correlate of LBL reading, we also found a general decrease, except for similar left frontal and parietal regions, which showed a significant increase. We suggest that the pattern of evolution fits with the minimal hypothesis of normal strategic abilities and skill learning, associated with perceptual tuning in right-hemispheric structures able to substitute the disrupted VWFA.

Adult↗
PubMed2005

The neural code for written words: a proposal.

How is reading, a cultural invention, coded by neural populations in the human brain? The neural code for written words must be abstract, because we can recognize words regardless of their location, font and size. Yet it must also be exquisitely sensitive to letter identity and letter order. Most existing coding schemes are insufficiently invariant or incompatible with the constraints of the visual system. We propose a tentative neuronal model according to which part of the occipito-temporal 'what' pathway is tuned to writing and forms a hierarchy of local combination detectors sensitive to increasingly larger fragments of words. Our proposal can explain why the detection of 'open bigrams' (ordered pairs of letters) constitutes an important stage in visual word recognition.

Age Factors↗
PubMed2004

Productive and perceptive language reorganization in temporal lobe epilepsy.

The aim of this work was to determine whether productive and perceptive language functions are differentially affected in homogeneous groups of epilepsy patients with right and left temporal lobe epilepsy (TLE). Eighteen patients with left TLE, 18 with right TLE, and 17 healthy volunteers were studied using fMRI during performance of three tasks assessing the productive and perceptive aspects of language (covert semantic verbal fluency, covert sentence repetition, and story listening). Hemispheric dominance for language was calculated in the frontal and temporal regions using laterality indices (LI). Atypical lateralization was defined as a right-sided LI (LI<-0.20) in the frontal lobes during the verbal fluency task or in the temporal lobes during the story listening task. Control subjects and right TLE patients demonstrated a strong left lateralization for language in the frontal lobes during the fluency task, whereas activation was less lateralized to the left hemisphere in left TLE patients, although the difference did not reach significance. In the story listening and the repetition tasks, activation was significantly more right sided in the temporal lobes of patients with left TLE. Atypical language representation was found in 19% of TLE patients (five left and two right TLE). The shift toward the right hemisphere was significantly larger in the temporal than the frontal lobes in patients with atypical language lateralization compared to TLE patients with a typical language lateralization. Neuropsychological performances of patients with atypical language patterns were better than those of patients with typical patterns, suggesting that this reorganization may represent a compensatory mechanism.

Adolescent↗
PubMed2004

Learning to read without a left occipital lobe: right-hemispheric shift of visual word form area.

Using anatomical and functional magnetic resonance imaging, we studied the pattern of brain lateralization during spoken and written language tasks, in an 11-year-old girl who underwent a left occipitotemporal resection for a Sturge-Weber angioma at the age of 4 years, that is, after the development of speech but before the acquisition of reading. We observed a selective and successful shift to the right hemisphere of the visual component of reading, particularly the Visual Word Form Area, whereas the verbal components remained strongly left-lateralized. This emphasizes the potential utility of a precise functional and developmental cartography of language for the surgical treatment of focal brain lesions in children.

Child↗
PubMed2004

Arithmetic and the brain.

Recent studies in human neuroimaging, primate neurophysiology, and developmental neuropsychology indicate that the human ability for arithmetic has a tangible cerebral substrate. The human intraparietal sulcus is systematically activated in all number tasks and could host a central amodal representation of quantity. Areas of the precentral and inferior prefrontal cortex also activate when subjects engage in mental calculation. A monkey analogue of these parieto-frontal regions has recently been identified, and a neuronal population code for number has been characterized. Finally, pathologies of this system, leading to acalculia in adults or to developmental dyscalculia in children, are beginning to be understood, thus paving the way for brain-oriented intervention studies.

Animals↗