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Biomedical subjects

Laurent Cohen

Publications and source records attributed to Laurent Cohen.

At least 19 recordsLinked to original sources

Nonconscious semantic processing of emotional words modulates conscious access.

Whether masked words can be processed at a semantic level remains a controversial issue in cognitive psychology. Although recent behavioral studies have demonstrated masked semantic priming for number words, attempts to generalize this finding to other categories of words have failed. Here, as an alternative to subliminal priming, we introduce a sensitive behavioral method to detect nonconscious semantic processing of words. The logic of this method consists of presenting words close to the threshold for conscious perception and examining whether their semantic content modulates performance in objective and subjective tasks. Our results disclose two independent sources of modulation of the threshold for access to consciousness. First, prior conscious perception of words increases the detection rate of the same words when they are subsequently presented with stronger masking. Second, the threshold for conscious access is lower for emotional words than for neutral ones, even for words that have not been previously consciously perceived, thus implying that written words can receive nonconscious semantic processing.

Consciousness↗

Direct intracranial, FMRI, and lesion evidence for the causal role of left inferotemporal cortex in reading.

Models of the "visual word form system" postulate that a left occipitotemporal region implements the automatic visual word recognition required for efficient reading. This theory was assessed in a patient in whom reading was explored with behavioral measures, fMRI, and intracranial local field potentials. Prior to surgery, when reading was normal, fMRI revealed a normal mosaic of ventral visual selectivity for words, faces, houses, and tools. Intracranial recordings demonstrated that the left occipitotemporal cortex responded with a short latency to conscious but also to subliminal words. Surgery removed a small portion of word-responsive occipitotemporal cortex overlapping with the word-specific fMRI activation. The patient developed a marked reading deficit, while recognition of other visual categories remained intact. Furthermore, in the post-surgery fMRI map of visual cortex, only word-specific activations disappeared. Altogether, these results provide direct evidence for the causal role of the left occipitotemporal cortex in the recognition of visual words.

Brain Mapping↗

The role of the supplementary motor area (SMA) in word production.

The supplementary motor area (SMA) is a key structure for behavioral planning and execution. Recent research on motor control conducted with monkeys and humans has put to light an anatomical and functional distinction between pre-SMA and SMA-proper. According to this view, the pre-SMA would be involved in higher level processes while the SMA-proper would be more closely tied to motor output. We extended this general framework to the verbal domain, in order to investigate the role of the SMA in speech production. We conducted two speech production experiments with fMRI where we manipulated parameters such as familiarity, complexity or constraints on word selection. The results reveal a parcellation of the SMA into three distinct regions, according to their involvement in different aspects of word production. More specifically, following a rostrocaudal gradient, we observed differential activations related to lexical selection, linear sequence encoding and control of motor output. A parallel organization was observed in the dorsolateral frontal cortex. By refining its anatomical and functional parcellation, these results clarify the roles of the SMA in speech production.

Adult↗

A direct intracranial record of emotions evoked by subliminal words.

A classical but still open issue in cognitive psychology concerns the depth of subliminal processing. Can the meaning of undetected words be accessed in the absence of consciousness? Subliminal priming experiments in normal subjects have revealed only small effects whose interpretation remains controversial. Here, we provide a direct demonstration of semantic access for unseen masked words. In three epileptic patients with intracranial electrodes, we recorded brain potentials from the amygdala, a neural structure that responds to fearful or threatening stimuli presented in various modalities, including written words. We show that the subliminal presentation of emotional words modulates the activity of the amygdala at a long latency (>800 ms). Our result indicates that subliminal words can trigger long-lasting cerebral processes, including semantic access to emotional valence.

Adult↗

Effortless control: executive attention and conscious feeling of mental effort are dissociable.

Recruitment of executive attention is normally associated to a subjective feeling of mental effort. Here we investigate the nature of this coupling in a patient with a left mesio-frontal cortex lesion including the anterior cingulate cortex (ACC), and in a group of comparison subjects using a Stroop paradigm. We show that in normal subjects, subjective increases in effort associated with executive control correlate with higher skin-conductance responses (SCRs). However, our patient experienced no conscious feeling of mental effort and showed no SCR, in spite of exhibiting normal executive control, and residual right anterior cingulate activity measured with event-related potentials (ERPs). Finally, this patient demonstrated a pattern of impaired behavior and SCRs in the Iowa gambling task-elaborated by Damasio, Bechara and colleagues-replicating the findings reported by these authors for other patients with mesio-frontal lesions. Taken together, these results call for a theoretical refinement by revealing a decoupling between conscious cognitive control and consciously reportable feelings. Moreover, they reveal a fundamental distinction, observed here within the same patient, between the cognitive operations which are depending on normal somatic marker processing, and those which are withstanding to impairments of this system.

Adult↗

Detection of prominent left anterior descending coronary artery stenosis for patients with stable angina using Doppler tissue echocardiography.

The midseptum has an elective left anterior descending coronary artery (LAD) supply. Septal peak velocity (PkV) and myocardial velocity gradient (MVG) were studied at rest with M-mode Doppler tissue echocardiography during the cardiac cycle including the septal active relaxation (SAR) outward wall motion preceding isovolumic relaxation. In all, 33 patients had significant multivessel coronary artery disease. Group A (15 patients) had prominent LAD stenosis. Group B (18 patients) had prominent circumflex (15) or right (3) coronary artery stenoses. The goal was to detect a prominent LAD stenosis. During SAR, sensitivity to detect a prominent LAD stenosis was 86% for PkV < 20 mm/s and 80% for MVG < 1.1 s(-1); specificity was 83% for both variables. During systole, sensitivity was 86% with a 55% specificity for MVG < 2.0 s(-1), whereas sensitivity was 73% and specificity 66% for PkV < 30 mm/s. Areas under receiver operating characteristic curves were over 0.90 during SAR and only 0.70 for PkV and 0.80 for MVG during systole. In multivessel coronary artery disease, SAR variables better identified a prominent LAD stenosis than systolic variables. Moreover, SAR PkVs were informative per se, whereas systole required MVG calculation.

Aged↗

Brain activations during letter-by-letter reading: a follow-up study.

Lesions affecting the ventral cortex of the left temporal lobe commonly yield a selective reading impairment known as pure alexia. It is thought to result from the disruption or deafferentation of the Visual Word Form Area (VWFA), a region in the left lateral occipitotemporal sulcus activated whenever normal subjects are viewing alphabetic strings. Most pure alexic patients retain the ability to identify single letters, and develop a strategy of letter-by-letter (LBL) reading. We recently studied fMRI activations in LBL readers and clarified the underlying mechanisms. However, LBL reading is a dynamic process which may improve over months or years of practice, although the cerebral bases of this continuing improvement are currently unknown. We had the opportunity to run the same behavioural testing and fMRI experiment a second time in an alexic patient, 8 months after collecting the data reported by Cohen et al. [Cohen, L., Henry, C., Dehaene, S., Molko, N., Lehéricy, S., Martinaud, O., Lemer, C., and Ferrieux, S. (2004). The pathophysiology of letter-by-letter reading. Neuropsychologia, 42, 1768-1780]. We analyze the changes that occurred over this period in the pattern of reading-related activations, while the patient's LBL reading improved. The activation level decreased in most of the overall network between the two sessions. This general trend contrasted with a focal increase restricted to specific left frontal and parietal areas. When studying the contrast between words and consonant strings, which may be taken as a correlate of LBL reading, we also found a general decrease, except for similar left frontal and parietal regions, which showed a significant increase. We suggest that the pattern of evolution fits with the minimal hypothesis of normal strategic abilities and skill learning, associated with perceptual tuning in right-hemispheric structures able to substitute the disrupted VWFA.

Adult↗

The neural code for written words: a proposal.

How is reading, a cultural invention, coded by neural populations in the human brain? The neural code for written words must be abstract, because we can recognize words regardless of their location, font and size. Yet it must also be exquisitely sensitive to letter identity and letter order. Most existing coding schemes are insufficiently invariant or incompatible with the constraints of the visual system. We propose a tentative neuronal model according to which part of the occipito-temporal 'what' pathway is tuned to writing and forms a hierarchy of local combination detectors sensitive to increasingly larger fragments of words. Our proposal can explain why the detection of 'open bigrams' (ordered pairs of letters) constitutes an important stage in visual word recognition.

Age Factors↗

Productive and perceptive language reorganization in temporal lobe epilepsy.

The aim of this work was to determine whether productive and perceptive language functions are differentially affected in homogeneous groups of epilepsy patients with right and left temporal lobe epilepsy (TLE). Eighteen patients with left TLE, 18 with right TLE, and 17 healthy volunteers were studied using fMRI during performance of three tasks assessing the productive and perceptive aspects of language (covert semantic verbal fluency, covert sentence repetition, and story listening). Hemispheric dominance for language was calculated in the frontal and temporal regions using laterality indices (LI). Atypical lateralization was defined as a right-sided LI (LI<-0.20) in the frontal lobes during the verbal fluency task or in the temporal lobes during the story listening task. Control subjects and right TLE patients demonstrated a strong left lateralization for language in the frontal lobes during the fluency task, whereas activation was less lateralized to the left hemisphere in left TLE patients, although the difference did not reach significance. In the story listening and the repetition tasks, activation was significantly more right sided in the temporal lobes of patients with left TLE. Atypical language representation was found in 19% of TLE patients (five left and two right TLE). The shift toward the right hemisphere was significantly larger in the temporal than the frontal lobes in patients with atypical language lateralization compared to TLE patients with a typical language lateralization. Neuropsychological performances of patients with atypical language patterns were better than those of patients with typical patterns, suggesting that this reorganization may represent a compensatory mechanism.

Adolescent↗

Learning to read without a left occipital lobe: right-hemispheric shift of visual word form area.

Using anatomical and functional magnetic resonance imaging, we studied the pattern of brain lateralization during spoken and written language tasks, in an 11-year-old girl who underwent a left occipitotemporal resection for a Sturge-Weber angioma at the age of 4 years, that is, after the development of speech but before the acquisition of reading. We observed a selective and successful shift to the right hemisphere of the visual component of reading, particularly the Visual Word Form Area, whereas the verbal components remained strongly left-lateralized. This emphasizes the potential utility of a precise functional and developmental cartography of language for the surgical treatment of focal brain lesions in children.

Child↗

Arithmetic and the brain.

Recent studies in human neuroimaging, primate neurophysiology, and developmental neuropsychology indicate that the human ability for arithmetic has a tangible cerebral substrate. The human intraparietal sulcus is systematically activated in all number tasks and could host a central amodal representation of quantity. Areas of the precentral and inferior prefrontal cortex also activate when subjects engage in mental calculation. A monkey analogue of these parieto-frontal regions has recently been identified, and a neuronal population code for number has been characterized. Finally, pathologies of this system, leading to acalculia in adults or to developmental dyscalculia in children, are beginning to be understood, thus paving the way for brain-oriented intervention studies.

Animals↗

A new Doppler tissue ratio to revisit systole: the pre-ejectional isovolumic to ejectional velocity ratio-application to aging.

Most diagnostic applications of Doppler tissue echocardiography rely on peak (Pk) velocity (V) values of single variables or myocardial V gradient. Whereas age-related changes in diastolic V are well-known, previous Doppler tissue echocardiography studies of systolic function showed no age effect for pre-ejectional (Ej) isovolumic (PEI) and Ej inward wall motion Pk V. In addition to myocardial V gradient, ratios were calculated between PEI and Ej Pk V, and mean V averaged over systole (PEI/Ej V ratios) at each layer of the posterior wall using M-mode color on two control groups: A (27 +/- 5 years) and B (54 +/- 10 years). The only changes were for PEI/Ej V ratios (mean V endocardial 21 +/- 7% vs 34 +/- 20%, P = .01; mean V epicardial 27 +/- 8% vs 40 +/- 18%, P = .006; Pk epicardial V 21 +/- 10% vs 30 +/- 16%, P = .04 for groups A and B, respectively). Correlation versus age were r = 0.52 and P = .005 (mean V endocardial), r = 0.50 and P = .007 (mean V epicardial), and r = 0.32 and P = .03 (Pk epicardial V). PEI/Ej V ratios and mean V studied in separate layers showed that the new systolic approach had advantages over single variable or Pk V to study age-related changes.

Adult↗

Specialization within the ventral stream: the case for the visual word form area.

Is there specialization for visual word recognition within the visual ventral stream of literate human adults? We review the evidence for a specialized "visual word form area" and critically examine some of the arguments recently placed against this hypothesis. Three distinct forms of specialization must be distinguished: functional specialization, reproducible localization, and regional selectivity. Examination of the literature with this theoretical division in mind indicates that reading activates a precise subpart of the left ventral occipitotemporal sulcus, and that patients with pure alexia consistently exhibit lesions of this region (reproducible localization). Second, this region implements processes adequate for reading in a specific script, such as invariance across upper- and lower-case letters, and its lesion results in the selective loss of reading-specific processes (functional specialization). Third, the issue of regional selectivity, namely, the existence of putative cortical patches dedicated to letter and word recognition, cannot be resolved by positron emission tomography or lesion data, but requires high-resolution neuroimaging techniques. The available evidence from single-subject fMRI and intracranial recordings suggests that some cortical sites respond preferentially to letter strings than to other categories of visual stimuli such as faces or objects, though the preference is often relative rather than absolute. We conclude that learning to read results in the progressive development of an inferotemporal region increasingly responsive to visual words, which is aptly named the visual word form area (VWFA).

Dyslexia↗

Distinct unimodal and multimodal regions for word processing in the left temporal cortex.

How are word recognition circuits organized in the left temporal lobe? We used functional magnetic resonance imaging (fMRI) to dissect cortical word-processing circuits using three diagnostic criteria: the capacity of an area (1) to respond to words in a single modality (visual or auditory) or in both modalities, (2) to modulate its response in a top-down manner as a function of the graphemic or phonemic emphasis of the task, and (3) to show repetition suppression in response to the conscious repetition of the target word within the same sensory modality or across different modalities. The results clarify the organization of visual and auditory word-processing streams. In particular, the visual word form area (VWFA) in the left occipitotemporal sulcus appears strictly as a visual unimodal area. It is, however, bordered by a second lateral inferotemporal area which is multimodal [lateral inferotemporal multimodal area (LIMA)]. Both areas might have been confounded in past work. Our results also suggest a possible homolog of the VWFA in the auditory stream, the auditory word form area, located in the left anterior superior temporal sulcus.

Adult↗

A cognitive characterization of dyscalculia in Turner syndrome.

Current theories of number processing postulate that the human abilities for arithmetic are based on cerebral circuits that are partially laid down under genetic control and later modified by schooling and education. This view predicts the existence of genetic diseases that interfere specifically with components of the number system. Here, we investigate whether Turner syndrome (TS) corresponds to this definition. TS is a genetic disorder which affects one woman in 2500 and is characterized by partial or complete absence of one X chromosome. In addition to well-characterized physical and hormonal dysfunction, TS patients exhibit cognitive deficits including dyscalculia. We tested 12 women with Turner syndrome and 13 control subjects on a cognitive battery including arithmetical tests (addition, subtraction, multiplication, division) as well as tests of the understanding of numerosity and quantity (cognitive estimation, estimation, comparison, bisection, subitizing/counting). Impairments were observed in cognitive estimation, subitizing, and calculation. We examine whether these deficits can be attributed to a single source, and discuss the possible implications of hormonal and genetic factors in the neuropsychological profile of TS patients.

Adolescent↗

The pathophysiology of letter-by-letter reading.

Pure alexia is a frequent and incapacitating consequence of left occipitotemporal lesions. It is thought to result from the disruption or the disconnection of the visual word form area (VWFA), a region reproducibly located within the left occipito-temporal sulcus, and encoding the abstract identity of strings of visual letters. Alexic patients often retain effective single letter recognition abilities, and develop an effortful letter-by-letter reading strategy which is the basis of most rehabilitation techniques. We study a patient who developed letter-by-letter reading following the surgical removal of left occipito-temporal regions. Using anatomical and functional MRI in the patient and in normal controls, we show that alexia resulted from the deafferentation of left fusiform cortex, and we analyze the network of brain regions subtending letter-by-letter reading. We propose that during letter-by-letter reading (1) letters are identified in the intact right-hemispheric visual system, with a central role for the region symetrical to the VWFA; (2) letters are serially transferred to the left hemisphere through the intact segment of the corpus callosum; (3) word identity is eventually recovered in the left hemisphere through verbal working memory processes involving inferior frontal and supramarginal cortex.

Adult↗