Periodic Reporting for period 1 - ProResA (The time course of pronoun resolution in post-stroke and progressive aphasia)
Periodo di rendicontazione: 2020-02-01 al 2022-01-31
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.
Within the initial 24 project months of ProResA, a global fellowship action, a significant amount of work has been completed despite the severe impact of the COVID pandemic and affiliated measures taken against the pandemic.
Within the framework of this action, four full journal articles in international high-impact journals and eight conference dissemination and/or proceeding papers were published. Four journal articles are underway. These project outcomes have been significantly limited by travel restrictions, and closure of lab infrastructures for months, and by an overload in health care sectors which made it difficult to collect data in clinics and hospitals.
These (prospective) publications report on the following work completed so far:
An important objective of this action was to investigate cross-linguistic data on pronoun processing in aphasia. Solid work has been done with regard to this objective. Pronoun processing outcomes in Turkish post-stroke aphasia, a typologically distant language on which little research has been conducted, has been empirically investigated using eye-movement monitoring experiments. Results from this study point to differential patterns of impairments when compared to well-studied languages. Aphasiological and theoretical considerations are addressed in conference presentations, and a publication is underway.
Another study has been conducted on French individuals with PPA, showing that they have cognitive capacity shortages during sentence repetition. Following this study, a conference presentation was done, and publication is underway. In 2022, an investigation using eye-movement monitoring to examine the resolution of pronouns in real-time is planned with this population.
Another aim of this action was to examine whether individuals with primary progressive aphasia maintain their pronoun resolution ability. Work addressing this objective has been quite slow border closures and curfews. With regard to this strand, three experiments have been programmed, stimulus materials have been normed with control subjects. These experiments investigate pronoun impairment during (i) comprehending complex sentence structures, (ii) simple sentence structures and (iii) during production of pronouns in sentence contexts in English. Recruitment of individuals with primary progressive aphasia is yet pending and will commence in the first quarter of 2022.
In respect to another objective of this action, involving machine learning techniques to uncover determiners of pronoun outcomes in aphasia, initial work has already begun. Utilising a three-based random forest machine learning algorithm, our systematic review from 474 PWA speaking 16 different languages has identified important linguistic variables that largely predict pronoun impairments. Our models have shown pronoun impairment is consistently present in aphasia regardless of the type of aphasia or language spoken but there are important cross-linguistic differences. A full-length journal publication is already out.
Within the framework of this action, four full journal articles in international high-impact journals and eight conference dissemination and/or proceeding papers were published. Four journal articles are underway. These project outcomes have been significantly limited by travel restrictions, and closure of lab infrastructures for months, and by an overload in health care sectors which made it difficult to collect data in clinics and hospitals.
These (prospective) publications report on the following work completed so far:
An important objective of this action was to investigate cross-linguistic data on pronoun processing in aphasia. Solid work has been done with regard to this objective. Pronoun processing outcomes in Turkish post-stroke aphasia, a typologically distant language on which little research has been conducted, has been empirically investigated using eye-movement monitoring experiments. Results from this study point to differential patterns of impairments when compared to well-studied languages. Aphasiological and theoretical considerations are addressed in conference presentations, and a publication is underway.
Another study has been conducted on French individuals with PPA, showing that they have cognitive capacity shortages during sentence repetition. Following this study, a conference presentation was done, and publication is underway. In 2022, an investigation using eye-movement monitoring to examine the resolution of pronouns in real-time is planned with this population.
Another aim of this action was to examine whether individuals with primary progressive aphasia maintain their pronoun resolution ability. Work addressing this objective has been quite slow border closures and curfews. With regard to this strand, three experiments have been programmed, stimulus materials have been normed with control subjects. These experiments investigate pronoun impairment during (i) comprehending complex sentence structures, (ii) simple sentence structures and (iii) during production of pronouns in sentence contexts in English. Recruitment of individuals with primary progressive aphasia is yet pending and will commence in the first quarter of 2022.
In respect to another objective of this action, involving machine learning techniques to uncover determiners of pronoun outcomes in aphasia, initial work has already begun. Utilising a three-based random forest machine learning algorithm, our systematic review from 474 PWA speaking 16 different languages has identified important linguistic variables that largely predict pronoun impairments. Our models have shown pronoun impairment is consistently present in aphasia regardless of the type of aphasia or language spoken but there are important cross-linguistic differences. A full-length journal publication is already out.
There is a line of important wider societal implications from this project. Dr. Arslan has accepted to the working group lead position for the Aphasia Assessment and Outcomes Working Group of the Collaborators of Aphasia Trialists network (see https://www.aphasiatrials.org/). This Working Group has 84 active members (60 full and 24 collaborators) organized in 32 language teams. It aims to facilitate access to common comprehensive, normed and validated tests for their use across international aphasia trials in monolingual and multilingual contexts. As an executive member of this network, outcomes from ProResA reach a much larger global group of scientists and clinicians working with people with aphasia. This position has roles for Dr. Arslan to organise seminars for early career researchers within this network and organise scientific symposiums, prepare joint networking grant applications. This network has an important mission for global engagement for aphasia research, profiling aphasia research at international conferences, provide support to individuals with aphasia by generating aphasia friendly materials. ProResA has created a well-blended synergy with the CATs network. Dr. Arslan and Prof. Maviş (both members of CATs) adapted the Aphasia United Best Practice Recommendations for aphasia to Turkish, providing important input to both clinicians and families of individuals with aphasia (https://www.aphasiaunited.org/best-practice-recommendations/).
Within the framework of ProResA knowledge transfer activities have been taking place. Most importantly, supervision of two PhD students is going with similar themes to ProResA action, intensifying efforts into knowledge and skill transfer. The outcomes from these doctoral studies will significantly complement outcomes from this action.
Within the framework of ProResA knowledge transfer activities have been taking place. Most importantly, supervision of two PhD students is going with similar themes to ProResA action, intensifying efforts into knowledge and skill transfer. The outcomes from these doctoral studies will significantly complement outcomes from this action.