Periodic Reporting for period 2 - ProResA (The time course of pronoun resolution in post-stroke and progressive aphasia)
Période du rapport: 2022-02-01 au 2023-01-31
Aphasia is a communication disorder affecting language ability following brain damage or degeneration. These impairments render the skilled communication needed for successful everyday living impossible, with impact on mental health, quality of life and career burden. People with aphasia find processing sentences difficult and particularly struggle to understand and produce pronouns (e.g. she/him). Although language impairments in aphasia have been studied, aphasic individuals' sentence interpretation in time-sensitive measurements and the spatio-temporal dynamics of their brain responses have only scarcely been examined. We do not know why people with aphasia experience these problems. The existing theoretical and experimental investigations are limited. This project seeks to fill this gap in knowledge. It aims to determine how PWA work out who or what a pronoun refers to, by examining moment-by-moment sentence-comprehension and its associated brain activity in both post-stroke aphasia and primary progressive aphasia (a form of aphasia resulting from brain degeneration). More specifically, this action seeks to generate scientific knowledge on post-stroke aphasia and primary progressive aphasia by investigating the time course of how people with aphasia precisely work out to whom a pronoun (e.g. she/him/herself) refers during moment-by-moment on-line sentence processing. According to WHO estimates, aphasia affects 1.1 million individuals per year. Without understanding the nature of language breakdown in aphasia, we cannot develop effective treatments. This action aims to fill this important gap by answering the following research questions: (i) Do cross-linguistic data from Turkish, French and English individuals with stroke aphasia show similar levels of pronoun processing impairments? (ii)Which spatio-temporal components characterize the brain responses during pronoun resolution in stroke aphasia and normal controls? (iii) Do individuals with primary progressive aphasia maintain their pronoun resolution ability intact as the disease progresses? To what extent oculomotor and working memory impairments influence the maintenance of pronouns? (iv) Can an eye-movement database to be built from the studies proposed here be useful in machine learning to determine the likelihood of healthy aging individuals’ probability of acquiring adverse language-impairing symptoms? Findings of this action will inform both the theory and clinical assessment of sentence-level processing in the aphasia types with direct implications for the treatment of these debilitating disorders.
A significant amount of work has been completed under the ProResA within the last 12 project months of the action, significant progress has been taken underway. In the following details of the action’s progress are reported. As mentioned in our earlier periodic report, the outgoing phase of the action was severely impacted by the COVID pandemic. We covered most of the work of the action in the last 12 months and the most effort-intense work was conducted under WP1 and WP2.
Outcomes from the action can be summarised as the following:
Pronouns are selectively impaired in PPA. Results from WP1 indicate that pronouns is a vulnerable grammatical category that dissolves as primary progressive aphasia becomes worse over time. This is based on a case study on individuals with PPA suffering from logopenic and non-fluent variants. We observed that pronoun impairment is manifested in the non-fluent variant but less so in the logopenic variant. Therefore, it seems that pronoun impairment across PPA variants might be selective. Results from WP1 are being processed with promising outcomes, we have a poster accepted in the Nordic Aphasia Conference in Reykjavik, Iceland, in June 2023 reporting on this work, and are preparing for publication.
Although work in WP2 has not yet come to a point where we can make conclusions on the data, as analysis of the data is still ongoing, it is possible to draw some insights from the work conducted so far. In an earlier EEG study published under this action, we know that electrophysiological responses are modulated by working memory. Following this, we have run a MEG study with a total of 16 healthy participants. Data processing is in progress.
In WG3, Dr. Arslan worked on data analysis and publication of the Turkish eye-tracking study, which included groups of healthy controls and people with post-stroke aphasia recruited during the earlier phases of the action. Outcomes from this study were presented at the Science of Aphasia conference in Bordeaux, France, in September 2022. A publication is under review. A second publication reported experimental data on how Turkish PWA comprehend “quantifiers” while resolving pronouns is under review. Furthermore, two important publications appeared in 2022 reporting data on sentence repetition span in French PPA showing that sentence span might be an important factor in dissociating PPA from other neurıocognitive disorders.
Outcomes from the action can be summarised as the following:
Pronouns are selectively impaired in PPA. Results from WP1 indicate that pronouns is a vulnerable grammatical category that dissolves as primary progressive aphasia becomes worse over time. This is based on a case study on individuals with PPA suffering from logopenic and non-fluent variants. We observed that pronoun impairment is manifested in the non-fluent variant but less so in the logopenic variant. Therefore, it seems that pronoun impairment across PPA variants might be selective. Results from WP1 are being processed with promising outcomes, we have a poster accepted in the Nordic Aphasia Conference in Reykjavik, Iceland, in June 2023 reporting on this work, and are preparing for publication.
Although work in WP2 has not yet come to a point where we can make conclusions on the data, as analysis of the data is still ongoing, it is possible to draw some insights from the work conducted so far. In an earlier EEG study published under this action, we know that electrophysiological responses are modulated by working memory. Following this, we have run a MEG study with a total of 16 healthy participants. Data processing is in progress.
In WG3, Dr. Arslan worked on data analysis and publication of the Turkish eye-tracking study, which included groups of healthy controls and people with post-stroke aphasia recruited during the earlier phases of the action. Outcomes from this study were presented at the Science of Aphasia conference in Bordeaux, France, in September 2022. A publication is under review. A second publication reported experimental data on how Turkish PWA comprehend “quantifiers” while resolving pronouns is under review. Furthermore, two important publications appeared in 2022 reporting data on sentence repetition span in French PPA showing that sentence span might be an important factor in dissociating PPA from other neurıocognitive disorders.
One of the most important impacts of this action was to enhance the future career prospects of the researcher: Arslan has been a tenured associated researcher in CNRS, focused 100% on scientific research. Arslan has also submitted grants for future research and international collaborations. Regarding teaching, Dr. Arslan taught four national and international courses in neurolinguistics and research methods to research students. The highly international nature of these courses enhanced knowledge transfer effects to reach to a wider audience. Regarding student supervision, Dr. Arslan has been co-supervising four PhD students: Two of these PhDs ar working on directly relevant topics to this action (namely, pronouns in German aphasia and executive functions in PPA).
The action enhanced a strong leadership opportunity for Dr. Arslan, who has been appointed as the lead of the Aphasia Assessment and Outcomes Working Group of the Collaborators of Aphasia Trialists network (CATs, https://www.aphasiatrials.org/) in December 2021. This working group has 78 active members who are established researchers in aphasiology and neurolinguistics. seeks to capture and evaluate the linguistic and cognitive abilities of people with aphasia, their participation, the severity of their impairment as well as evaluate communication and quality of life improvements. Aphasia assessment practices vary across countries. We therefore aim to facilitate access to common comprehensive, normed, and validated tools. Our group has navigated efforts towards adapting aphasia tests into 16 under-resourced languages. Dr. Arslan has been involved in the Multilingual Aphasia Practice (MAP) consensus group that is currently conducting an international survey to assess multilingual management and practices around the world. A handful of regional and country-specific surveys on multilingual aphasia practices do exist; nonetheless, the MAP survey is the first one addressing a truly global consensus.
The action enhanced a strong leadership opportunity for Dr. Arslan, who has been appointed as the lead of the Aphasia Assessment and Outcomes Working Group of the Collaborators of Aphasia Trialists network (CATs, https://www.aphasiatrials.org/) in December 2021. This working group has 78 active members who are established researchers in aphasiology and neurolinguistics. seeks to capture and evaluate the linguistic and cognitive abilities of people with aphasia, their participation, the severity of their impairment as well as evaluate communication and quality of life improvements. Aphasia assessment practices vary across countries. We therefore aim to facilitate access to common comprehensive, normed, and validated tools. Our group has navigated efforts towards adapting aphasia tests into 16 under-resourced languages. Dr. Arslan has been involved in the Multilingual Aphasia Practice (MAP) consensus group that is currently conducting an international survey to assess multilingual management and practices around the world. A handful of regional and country-specific surveys on multilingual aphasia practices do exist; nonetheless, the MAP survey is the first one addressing a truly global consensus.