11/4/2015 1 Language systems in the brain across the life span Maria Luisa Gorno-Tempini, MD, PhD University of California, San Francisco Memory and Aging Center Language Neurobiology Laboratory Dyslexia Center In right-handed individuals language is a left brain function In 25% of left handers, language is bilateral In 5% of left handers, language is right-sided Different brain networks sustain specific language functions in healthy subjects Reading and writing Semantics and word comprehension Sounds and speech Aphasia is defined as an acquired language deficit due to brain lesion Lesion models to study Aphasia: Stroke Anatomy of lesion follows the vasculature
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Language systems in the brain across the life span
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11/4/2015
1
Language systems in the brain across the life span
Maria Luisa Gorno-Tempini, MD, PhD
University of California, San FranciscoMemory and Aging Center
Language Neurobiology LaboratoryDyslexia Center
In right-handed individuals language is a left brain function
In 25% of left handers, language is bilateralIn 5% of left handers, language is right-sided
Different brain networks sustain specific language functions in healthy subjects
Reading and writing
Semantics and word comprehension
Sounds and speech
Aphasia is defined as an acquired language deficit due to brain lesion
Lesion models to study Aphasia: Stroke Anatomy of lesion follows the vasculature
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Primary Progressive Aphasia (PPA): Selective degeneration of language systems
Logopenic PPA
Semantic PPA
Non-fluent PPA
Lesion models to study Aphasia: PPAAnatomy of lesion follows brain connections
Variants of PPA linked to underlying patterns of atrophy caused by different toxic proteins
Nonfluent variant = FTD-Tau
Semantic variant = FTD-TDP
Logopenic variant = AD-Amyloidtau
1. Comprehension and semantic network
Semantics and comprehension
Semantic PPA
What is semantic memory?
• Semantic:
• Episodic:
PHONE
JUSTICE
OBAMA
Tulving, 1972
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Pathways to “understanding”
INTEGRATION:SEMANTICS
OUTPUT
spoken word
written wordSound
VISUAL ANALYSIS
ACOUSTIC ANALYSIS
♪♪
MATERIAL SPECIFIC ENCODING
MATERIAL SPECIFIC ENCODING
Spoken words or written words?The contribution of functional neuroimaging
read vs. repeat
read repeat
repeat vs. read
Visual Temporal lobe: faces or written words
written word
What happens if these areas are lesioned?
“Auditory” Temporal Lobe: WORDS
• Lesion posterior portion of the superior temporal gyrus/sulcus results in language comprehension deficits and
Wernicke’s aphasia (1874)
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Viasual temporal lobe: prosopagnosia and visual dyslexia
R
Pathways to “understanding”Auditory stimuli Visual stimuli
Spoken name Bill Clinton
Integration ?
When the semantic network lesioned:Semantic PPA
• Progressive difficulty naming and recognizing objects and understanding words
buryyachtflanneltailwolf
snitehancehoachsmode
islandweddingchickencolonel
When semantic network is lesioned:Surface dyslexia
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Two interacting reading systems
• Phonological dyslexia: errors in “decoding non-words (words that do not exist) most common in developmental dyslexia
WHOLE-WORD PROCEDUREusing semantics:
Irregular LFSUBLEXICAL
PROCEDURE using phonic rules: regular
words, non-words
lexicalWritten word
sub-lexical
lexical
sounds
sub-lexical
Semantics“YACHT”“CHOIR”
“MUST”“tine”
2. Sounds (phonological) network
Logopenic PPA
Children use this network when they first learn to read, when they “sound out”, less after words are memorized
• Segments words and sentences into their phonological (sounds) components
• Translates letters/words into sounds and vice versa for reading and spelling
Vision to sounds and phonological “loop” network
Logopenic patients have Alzheimer’s disease.Why does it look different?
59 yo F
63 yo M
60 yo F
56 yo F
MRI PET-FDG
norm
0
2.0
PET-PIB
DVR
0
2.5
Rabinovici et al., Annals Neurol 2008
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Anatomical changes in lvPPA
Developmental dyslexia
Network covariance in fcMRI
Developmental vulnerability? Increased frequency of dyslexia in logopenic PPA patients
Miller Z et al., Brain 2014
3. Sounds to articulation and grammar networks
Highly connected system for fast feedback and adjustment
Non-fluent PPA
• Segment words into phonemes, holds them in a rehearsal system and then translates them into movements
• Speech is the most fine-tuned motor control system
Sounds to speech: articulation
Often the first symptom in diseases of the motor system
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•Speech hesitant, effortful, with sound distortions and substitutions (AOS)