The organization of narrative discourse in Lewy body spectrum disorder

Ash, Sharon; McMillan, Corey T.; Gross, Rachel G.; Cook, Philip A.; Morgan, Brianna; Boller, Ashley; Dreyfuss, Michael; Siderowf, Andrew; Grossman, Murray

doi:10.1016/j.bandl.2011.05.006

Cited by 76 publications

(92 citation statements)

References 71 publications

(100 reference statements)

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“…In Parkinson's disease (PD) and early Alzheimer's disease, researchers have found that individual word comprehension is relatively intact, yet the ability to infer the meaning of the text is impaired (44). In PD, this deficit in the organization and interpretation of narrative discourse was associated with reduced cortical volume in several brain regions, including the superior part of the left STS and the anterior cingulate (45). Our finding that these regions demonstrated large differences between the stories (Fig.…”

Section: Discussionmentioning

confidence: 99%

Amplification of local changes along the timescale processing hierarchy

Yeshurun

Nguyen

Hasson

2017

Proc. Natl. Acad. Sci. U.S.A.

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Small changes in word choice can lead to dramatically different interpretations of narratives. How does the brain accumulate and integrate such local changes to construct unique neural representations for different stories? In this study, we created two distinct narratives by changing only a few words in each sentence (e.g., "he" to "she" or "sobbing" to "laughing") while preserving the grammatical structure across stories. We then measured changes in neural responses between the two stories. We found that differences in neural responses between the two stories gradually increased along the hierarchy of processing timescales. For areas with short integration windows, such as early auditory cortex, the differences in neural responses between the two stories were relatively small. In contrast, in areas with the longest integration windows at the top of the hierarchy, such as the precuneus, temporal parietal junction, and medial frontal cortices, there were large differences in neural responses between stories. Furthermore, this gradual increase in neural differences between the stories was highly correlated with an area's ability to integrate information over time. Amplification of neural differences did not occur when changes in words did not alter the interpretation of the story (e.g., sobbing to "crying"). Our results demonstrate how subtle differences in words are gradually accumulated and amplified along the cortical hierarchy as the brain constructs a narrative over time.timescale | amplification | fMRI | narrative | hierarchy S tories unfold over many minutes and are organized into temporarily nested structures: Paragraphs are made of sentences, which are made of words, which are made of phonemes. Understanding a story therefore requires processing the story at multiple timescales, starting with the integration of phonemes to words within a relatively short temporal window, to the integration of words to sentences across a longer temporal window of a few seconds, and up to the integration of sentences and paragraphs into a coherent narrative over many minutes. It was recently suggested that the temporally nested structure of language is processed hierarchically along the cortical surface (1-4). A consequence of the hierarchical structure of language is that small changes in word choice can give rise to large differences in sentence and overall narrative interpretation. Here, we propose that local momentary changes in linguistic input in the context of a narrative (e.g., "he" to "she" or "sobbing" to "laughing") are accumulated and amplified during the processing of linguistic content across the cortex. Specifically, we hypothesize that as areas in the brain increase in their ability to integrate information over time (e.g., processing "word" level content vs. "sentence" or "narrative" level content), the neural response to small word changes will become increasingly divergent.Previously, we defined a temporal receptive window (TRW) as the length of time during which prior information from an ongoing stimulu...

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Section: Discussionmentioning

confidence: 99%

Amplification of local changes along the timescale processing hierarchy

Yeshurun

Nguyen

Hasson

2017

Proc. Natl. Acad. Sci. U.S.A.

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“…The narrative abilities of focal neurodegenerative disease patients have previously been compared in controlled, experimental studies (Ash et al, 2011; Ash et al, 2006; Chapman et al, 2005; Farag et al, 2010); however, this is the first study to quantify narrative production of neurodegenerative disease groups in the form of storytelling in a naturalistic social interaction and to compare patterns of neurodegeneration with specific narrative devices such as narrative evaluations, oft-cited as the most important aspect of storytelling and which reflect key inferential and valuation processes inherent to personal narratives.…”

Section: Discussionmentioning

confidence: 99%

Neural substrates of spontaneous narrative production in focal neurodegenerative disease

et al. 2015

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Conversational storytelling integrates diverse cognitive and socio-emotional abilities that critically differ across neurodegenerative disease groups and may have diagnostic relevance and predict anatomic changes. The present study employed mixed methods discourse and quantitative analyses to delineate patterns of storytelling across focal neurodegenerative disease groups, and to clarify the neuroanatomical contributions to common storytelling characteristics in these patients. Transcripts of spontaneous social interactions of 46 participants (15 behavioral variant frontotemporal dementia (bvFTD), 7 semantic variant primary progressive aphasia (svPPA), 12 Alzheimer's disease (AD), and 12 healthy older normal controls) were analysed for storytelling characteristics and frequency, and videos of the interactions were rated for patients' social attentiveness. Compared to controls, svPPAs also told more stories and autobiographical stories, and perseverated on aspects of self during storytelling. ADs told fewer autobiographical stories than NCs, and svPPAs and bvFTDs failed to attend to social cues. Storytelling characteristics were associated with a processing speed and mental flexibility, and voxel-based anatomic analysis of structural magnetic resonance imaging revealed that temporal organization, evaluations, and social attention correlated with atrophy corresponding to known intrinsic connectivity networks, including the default mode, limbic, salience, and stable task control networks. Differences in spontaneous storytelling among neurodegenerative groups elucidated diverse cognitive, socio-emotional, and neural contributions to narrative production, with implications for diagnostic screening and therapeutic intervention.

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“…The few discourse studies to date report a trend toward decreased informational content as well as decreased complexity of syntax [4][5][6]. Others report no abnormalities with narrative production in non-demented individuals with PD [7]. These observations are difficult to interpret due to the limited and variable nature of studies to date.…”

Section: Introductionmentioning

confidence: 61%

“…The exception is a study by Ash and colleagues [7] which found no significant impairments of narrative discourse in a group of 18 nondemented, individuals with PD; however, all participants were medicated when providing their narrative discourse sample. Other investigators [4,5] did not examine cohesion/coherence, but did find deficits in discourse-level information content in individuals with PD.…”

Section: Discussionmentioning

confidence: 92%

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Preliminary evidence of discourse improvement with dopaminergic medication

Sanchez¹,

Spencer²

2013

APD

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Dopaminergic therapy can improve motor functioning in Parkinson's Disease (PD), but its effect on spoken discourse is poorly understood. This study addressed whether discourse produced during a one-minute monologue would be affected by medication withdrawal. We performed a detailed analysis of semistructured speech samples in 38 patients with PD, including measures of efficiency, syntactic complexity, cohesion (i.e., lexical and grammatical ties between sentences), and coherence (i.e., semantic relationship between the utterances and the topic, or between utterances). We found that patients produced more efficient and coherent monlogues when on versus off medication. As discourse relies heavily on cognitive processes such as working memory, these findings are consistent with research showing improved working memory and executive processes with dopaminegic medication.

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The organization of narrative discourse in Lewy body spectrum disorder

Cited by 76 publications

References 71 publications

Amplification of local changes along the timescale processing hierarchy

Amplification of local changes along the timescale processing hierarchy

Neural substrates of spontaneous narrative production in focal neurodegenerative disease

Preliminary evidence of discourse improvement with dopaminergic medication

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