Energization and spoken language production: Evidence from progressive supranuclear palsy

Abstract

Energization is the process of initiating and sustaining a response over time. It has been described as one of three key "supervisory" attentional control processes associated with the frontal lobes. Attentional mechanisms, such as energization, are critical for a range of cognitive functions, such as spontaneous speech and other higher-order tasks. We aimed to investigate the process of energization in a case series of patients with progressive supranuclear palsy (PSP). Patients with a diagnosis of PSP (N = 5), patient controls with a neurodegenerative condition (Alzheimer's disease N = 3, frontotemporal dementia N = 2) and healthy older adult controls (N = 30) were assessed on a standard neuropsychological battery, including executive tasks and standard attention and language tests. Energization was investigated using word fluency tasks, samples of spontaneous speech and an experimental button-pressing concentration task. Response rates for the word fluency, spontaneous speech and concentration tasks were separated into time periods, in order to compare response rates at different points across the tasks (e.g., first 15 s vs. last 45 s in a 60 s task). Four PSP patients showed a clear response pattern indicative of a decrease in energization. Healthy and patient controls remained consistent in their responding over time. Understanding how these underlying processes are impaired in PSP can ultimately inform intervention and management strategies, and has theoretical implications for models of spoken language production.

Idea Formulation for Spoken Language Production: The Interface of Cognition and Language

“…However, given the complexity of propositional language and executive attentional processes, fine-grained and theoretically driven analyses are critical. For example, we have presented some evidence that the Stuss and Alexander (2007) model of frontal executive attention provides a framework for identifying, defining and testing potential mechanisms of idea formulation (e.g., energization and idea generation; Barker et al, 2018;. Many neuropsychological tests thought to tap attention are influenced by multiple cognitive processes (e.g., Trail Making, Stroop; see Aron, Robbins, & Poldrack, 2014), so future work should focus on isolating specific processes based on theoretical models.…”

“…This will allow frameworks to be more comprehensive and precise in their predictions. For example, preliminary results from Barker et al (2018) suggest that in Sherratt's (2007) model of discourse production, the 'input trigger' does not necessarily take the form of an external stimulus (as Sherratt posits); rather, it may be internally generated via the process of energization.…”

“…This form is domain-general, encompassing both verbal and non-verbal functions. It is generally observed in patients with diffuse bilateral frontal and subcortical damage, and may be linked to disrupted frontostriatal circuits or superior medial frontal damage (Barker, Nelson, O'Sullivan, Adam, & Robinson, 2018). Several case studies have documented this form of dynamic aphasia, and, although single cases have limited generalisability, they comprise detailed behavioural experiments that spark hypotheses to be tested in larger-scale research.…”

Case Report: Barely Able to Speak, Can’t Stop Echoing: Echolalic Dynamic Aphasia in Progressive Supranuclear Palsy

“…Further support for the diagnosis of DA comes from the impaired performance of both patients on experimental DA tests, which disclosed widespread verbal generation deficits in response to verbal and non-verbal stimuli in comparison with healthy controls ( Robinson et al, 1998 , 2006 , 2015 ). Such alterations may reflect the combination of the inability to generate verbal responses, impairments in energization (idea generation) ( Barker et al, 2018 ), and in the generation of a fluent sequence of novel thoughts filled with perseverations ( Robinson et al, 2006 ).…”

A Goal Intervention Improves Language Fluency: Evidence from Parkinson’s Disease and Healthy Aging

“…PD is marked by deposition of alpha-synuclein and Lewy bodies with associated loss of dopaminergic neurons in the substantia nigra pars compacta and degradation of the frontostriatal pathways [3][4][5]. Disruption to frontostriatal circuits has been implicated in cognitive impairment affecting executive functions and initiation of spoken language [6][7][8][9], and can result in behavioral disorders such as apathy [10][11][12]. The current study aimed to investigate the initiation of spoken language and apathy in patients with PD, and the effectiveness of a novel goal intervention for improving language generation.…”