Andrew T. DeMarco's research while affiliated with Georgetown University and other places
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Publications (43)
Background
Discourse analyses yield quantitative measures of functional communication in aphasia. However, they are historically underutilized in clinical settings. Confrontation naming assessments are used widely clinically and have been used to estimate discourse-level production. Such work shows that naming accuracy explains moderately high prop...
Introduction
In stroke survivors with aphasia (SWA), differences in behavioral language performance have been observed between Black and White Americans. These racial differences in aphasia outcomes may reflect biological stroke severity, disparities in access to care, potential assessment bias, or interactions between these factors and race. Under...
Language function in the brain, once thought to be highly localized, is now appreciated as relying on a connected but distributed network. The semantic system is of particular interest in the language domain because of its hypothesized integration of information across multiple cortical regions. Previous work in healthy individuals has focused on g...
The severity of post-stroke aphasia is related to damage to white matter connections. However, neural signaling can route not only through direct connections, but also along multi-step network paths. When brain networks are damaged by stroke, paths can bypass around the damage to restore communication. The shortest network paths between regions cou...
The success of a lesion-symptom mapping (LSM) study in answering a specific research question critically depends on how behavioral variables are selected and handled in the analysis. In this chapter, we discuss the theoretical and practical considerations regarding the use of behavioral measures in LSM studies. We begin by addressing theoretical co...
People use cognitive control across many contexts in daily life, yet it remains unclear how cognitive control is used in contexts involving language. Distinguishing language-specific cognitive control components may be critical to understanding aphasia, which can co-occur with cognitive control deficits. For example, deficits in control of semantic...
Aphasia is a prevalent cognitive syndrome caused by stroke. The rarity of premorbid imaging and heterogeneity of lesion obscures the links between the local effects of the lesion, global anatomical network organization, and aphasia symptoms. We applied a simulated attack approach in humans to examine the effects of 39 stroke lesions (16 females) on...
Background and Objectives
A prominent theory proposes that neuroplastic recruitment of perilesional tissue supports aphasia recovery, especially when language-capable cortex is spared by smaller lesions. This theory has rarely been tested directly, and findings have been inconclusive. Here, we test the perilesional plasticity hypothesis using two f...
Optimal performance in any task relies on the ability to detect and correct errors. The anterior cingulate cortex and the broader posterior medial frontal cortex (pMFC) are active during error processing. However, it is unclear whether damage to the pMFC impairs error monitoring. We hypothesized that successful error monitoring critically relies on...
Non-negative matrix factorization is a relatively new method of matrix decomposition which factors an m × n data matrix X into an m × k matrix W and a k × n matrix H, so that X ≈ W × H. Importantly, all values in X, W, and H are constrained to be non-negative. NMF can be used for dimensionality reduction, since the k columns of W can be considered...
Aphasia is one of the most prevalent cognitive syndromes caused by stroke. The rarity of premorbid imaging and heterogeneity of lesion size and extent obfuscates the links between the local effects of the lesion, global anatomical network organization, and aphasia symptoms. We applied a simulated attack approach to examine the effects of 39 stroke...
Language function in the brain, once thought to be highly localized, is now appreciated as relying on a connected but distributed network. The semantic system is of particular interest in the language domain because of its hypothesized integration of information across multiple cortical regions. Previous work in healthy individuals has focused on g...
Optimal performance in any task relies on the ability to detect and repair errors. The anterior cingulate cortex and the broader posterior medial frontal cortex (pMFC) are active during error processing. However, it is unclear whether damage to the pMFC impairs error monitoring. We hypothesized that successful error monitoring critically relies on...
People use cognitive control across many contexts in daily life, yet it remains unclear how cognitive control is used in contexts involving language. Distinguishing language-specific cognitive control components may be critical to understanding aphasia, which can co-occur with cognitive control deficits. For example, deficits in control of semantic...
The severity of post-stroke aphasia is related to damage to white matter connections. However, neural signaling can route not only through direct connections, but also along multi-step network paths. When brain networks are damaged by stroke, paths can bypass around the damage to restore communication. The shortest network paths between regions cou...
Alexia is common in the context of aphasia. It is widely agreed that damage to phonological and semantic systems not specific to reading causes co-morbid alexia and aphasia. Studies of alexia to date have only examined phonology and semantics as singular processes or axes of impairment, typically in the context of stereotyped alexia syndromes. Howe...
Objective
A prominent theory proposes that neuroplastic recruitment of perilesional tissue supports aphasia recovery, especially when language-capable cortex is spared by smaller lesions. This theory has rarely been tested directly, and findings have been inconclusive. Here, we test the perilesional plasticity hypothesis using two fMRI tasks in two...
Stroke has a deleterious impact on quality of life. However, it is less well known if stroke lesions in different brain regions are associated with reduced quality of life (QoL). We therefore investigated this association by multivariate lesion-symptom mapping. We analyzed magnetic resonance imaging and clinical data from the WAKE-UP trial. Europea...
Background:
Aphasia is a common, debilitating consequence of stroke, and speech therapy is often inadequate to achieve a satisfactory outcome. Neuromodulation techniques have emerged as a potential augmentative treatment for improving aphasia outcomes. Most studies have targeted the cerebrum, but there are theoretical and practical reasons that st...
Background:
Health-related quality of life (HRQL) in stroke survivors is related to numerous factors, but more research is needed to delineate factors related to HRQL in people with aphasia.
Objective:
To examine the relationship between HRQL and demographic factors, impairment-based measures, and lesion characteristics in chronic aphasia.
Meth...
The brain structures and cognitive abilities necessary for successful monitoring of one’s own speech errors remain unknown. We aimed to inform self-monitoring models by examining the neural and behavioral correlates of phonological and semantic error detection in individuals with post-stroke aphasia. First, we determined whether detection related t...
OBJECTIVES/GOALS: A particularly debilitating consequence of stroke is alexia, an acquired impairment in reading. Cognitive models aim to characterize how information is processed based on behavioral data. If we can concurrently characterize how neural networks process that information, we can enhance the models to reflect the neuronal interactions...
The lesion method has been important for understanding brain-behavior relationships in humans, but has previously used maps based on structural damage. Lesion measurement based on structural damage may label partly damaged but functional tissue as abnormal, and moreover, ignores distant dysfunction in structurally intact tissue caused by deafferent...
Purpose
Recovery from aphasia is thought to depend on neural plasticity, that is, functional reorganization of surviving brain regions such that they take on new or expanded roles in language processing. To make progress in characterizing the nature of this process, we need feasible, reliable, and valid methods for identifying language regions of t...
Two maintenance mechanisms with separate neural systems have been suggested for verbal working memory: articulatory-rehearsal and non-articulatory maintenance. Although lesion data would be key to understanding the essential neural substrates of these systems, there is little evidence from lesion studies that the two proposed mechanisms crucially r...
Reading involves the rapid extraction of sound and meaning from print through a cooperative division of labor between phonological and lexical-semantic processes. Whereas lesion studies of patients with stereotyped acquired reading deficits contributed to the notion of a dissociation between phonological and lexical-semantic reading, the neuroanato...
Phonological encoding depends on left-lateralized regions in the supramarginal gyrus and the ventral precentral gyrus. Localization of these phonological regions in individual participants—including individuals with language impairments—is important in several research and clinical contexts. To localize these regions, we developed two paradigms tha...
The lesion method has been a cornerstone in the endeavor to understand brain-behavior relationships in humans, but has relied on the flawed assumption that anatomically abnormal tissue functions abnormally and anatomically normal tissue functions normally. To address this longstanding problem, we introduce an approach to directly map the degree of...
Lesion‐symptom mapping has become a cornerstone of neuroscience research seeking to localize cognitive function in the brain by examining the sequelae of brain lesions. Recently, multivariate lesion‐symptom mapping methods have emerged, such as support vector regression, which simultaneously consider many voxels at once when determining whether dam...
OBJECTIVES/SPECIFIC AIMS: To develop a robust spatial normalization pipeline for brains of individuals with focal cortical lesions. METHODS/STUDY POPULATION: Individuals with chronic focal cortical lesions from stroke. RESULTS/ANTICIPATED RESULTS: We have developed a robust spatial normalization pipeline for brains of individuals with focal cortica...
Phonological deficits are common in aphasia after left-hemisphere stroke, and can have significant functional consequences for spoken and written language. While many individuals improve through treatment, the neural substrates supporting improvements are poorly understood. We measured brain activation during pseudoword reading in an individual thr...
We used fMRI to examine the neural substrates of sublexical phoneme-grapheme conversion during spelling in a group of healthy young adults. Participants performed a writing-to-dictation task involving irregular words (e.g., choir), plausible nonwords (e.g., kroid), and a control task of drawing familiar geometric shapes (e.g., squares). Written pro...
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Patients with primary progressive aphasia (PPA) present with varying degrees of impaired syntactic processing. Using functional and structural MRI, Wilson et al . report that syntactic deficits in PPA are associated not only with left inferior frontal atrophy as previously shown, but with functional disruption of a wider s...
Phonological alexia and agraphia are written language disorders characterised by disproportionate difficulty reading and spelling nonwords in comparison to real words. In phonological alexia, it has been shown that, despite relatively accurate reading of words in isolation, text-level reading deficits are often marked and persistent. Specifically,...
Ovarian cancer is particularly deadly because it is usually diagnosed after it has metastasized. We have previously identified features of ovarian cancer using optical coherence tomography (OCT) and second-harmonic generation (SHG) microscopy (targeting collagen). OCT provides an image of the ovarian microstructure, while SHG provides a high-resolu...
Ovarian cancer is particularly deadly because it is usually diagnosed after it has begun to spread. Transvaginal sonography (TVS) is the most common imaging screening technique. However, routine use of TVS has not reduced ovarian cancer mortality. The superior resolution of optical imaging techniques may make them attractive alternatives to TVS. We...
Neuroimaging and neuropsychological studies have implicated the anterior temporal lobe (ATL) in sentence-level processing, with syntactic structure-building and/or combinatorial semantic processing suggested as possible roles. A potential challenge to the view that the ATL is involved in syntactic aspects of sentence processing comes from the clini...
Citations
... Several methods have been developed for clustering, including spectral clustering and k-means [5][6][7], which rely on the metric of data similarity [8][9][10]. Due to the potential clustering representation, nonnegative matrix factorization, which is an effective method for data dimensionality reduction and feature extraction, has been widely used in clustering tasks [11,12]. NMF expresses part-based data by finding two nonnegative matrices whose product is close to the raw data and only allows additive combinations of data. ...
... Structural connectomes were constructed from the HARDI data through the MRtrix 3.0 software (Tournier et al. 2019) as described in full by Dickens et al. 2021. Briefly, preprocessing followed the standard stepwise application of gaussian noise removal, gibbs ringing artifact removal, correction of distortions induced by motion, eddy currents, and magnetic susceptibility, and correction of B0 field inhomogeneity. ...
... After a left hemisphere stroke in adulthood, language impairments tend to be chronic. In patients who have spared language areas in the left hemisphere, language processing continues to recruit these regions (however, see DeMarco et al., 2021), and in some cases also homotopic right hemisphere regions (Turkeltaub et al., 2011). Some studies have argued that better language outcomes after adult stroke depend on reengaging the intact left hemisphere tissue (see Anglade et al., 2014, andTurkeltaub, 2015, for a review of language recovery in the left versus right hemisphere after adult stroke). ...
... It is generally recognized that ischemic strokes affecting the dominant hemisphere, which in the majority of the population is the left-as opposed to the non-dominant or right hemisphere, can result in unique clinical syndromes and deficits depending on the regions affected. Multiple studies [74][75][76][77][78][79][80][81][82] have also shown that the right hemisphere's involvement is predictive of inferior functional outcomes in patients with AIS. Given that the connection between lesion location, clinical impairments, recovery and functional outcome, as measured by mRS, is expected to be altered by the site of the lesion, differentiation is crucial [82][83][84][85][86][87]. ...
... Whether due to the subtlety of de cits caused by cerebellar lesions or because of heterogeneity of cerebellar circuitry between individuals, various models and theories of cerebellar function with regards to cognition and speech have been proposed, but there is lack of conformity between experts on the localization of various nonmotor cerebellar functions 2,4 . This becomes increasingly important in an era when post-stroke management is introducing modalities such as transcranial direct current stimulation (tDCS) that can be targeted to certain areas of the brain to potentially improve recovery [5][6][7] . Formal correlation of cerebellar regions to elements of speech and neurocognition could have an exponential impact on the future management of stroke and other cerebellar lesions. ...
... The anterior and the dorsomedial prefrontal cortices exhibited a more robust response in value-based decisionmaking and profitable actions (45)(46)(47)(48). Moreover, the DLPFC activation was also observed during demanding problem-solving tasks, conscious self-monitoring, and focused attention (49)(50)(51). Given the association between DLPFC activity with the inhibition of pre-potent impulses (52) and the discouragement of declaration of individual thoughts (53), these two facts conform to the truthsuppression context. ...
... The result is a group or individual functional anomaly map (FAM). The method has been validated for studying cerebrovascular lesions and their effects on distant brain function, [23] and showed correlation with clinical symptoms and cognitive profiles. [24] For generating an individual FAM, time-varying rsfMRI signal aberrations are estimated by contrasting individual patient data to a group of controls in a support vector regression model ( Figure 1). ...
... Further, the language network is sensitive to linguistic regularities at all levels: from phonological/sub-lexical, to word level, to phrase/sentence level [Bautista and Wilson, 2016, Blank et al., 2016, Fedorenko et al., 2011 and supports linguistic operations that are related to both the processing of word meanings and those related to combinatorial semantic and syntactic processing , Hu et al., 2022b. This consistent recruitment for language across a broad range of conditions, as well as the fact that damage to the language network leads to linguistic deficits [e.g., Bates et al., 2003, Broca, 1865, Damasio, 1992, Mesulam, 2001, Mesulam et al., 2014, Saffran, 2000, Wernicke, 1874, Wilson et al., 2019, indicates that this set of regions stores our linguistic knowledge representations-a set of mappings between linguistic forms and meanings. ...
... In verbal working memory studies, it has been found that Broca's area, premotor areas (PMC), the STG, the inferior parietal lobule (IPL), the superior parietal lobule (SPL), insula, and the cerebellum are involved in the processing of verbal working memory (Paulesu et al., 1993;Awh et al., 1996;Fiez et al., 1996;Bamiou et al., 2003;Gruber and von Cramon, 2003;Crottaz-Herbette et al., 2004;Ravizza et al., 2004;Chen and Desmond, 2005;Kirschen et al., 2005;Koelsch et al., 2009;Cowan et al., 2011;Huang et al., 2013;Li et al., 2014;Fegen et al., 2015;Majerus et al., 2016;Emch et al., 2019;Ghaleh et al., 2020;Hoddinott et al., 2021). In the tonal working memory domain, relevant activations were found in the intra parietal sulcus (IPS), inferior frontal gyrus (IFG), cerebellum, dorsal lateral prefrontal cortex (DLPFC), supramarginal gyrus (SMG), STG, insula, and hippocampus (Zatorre et al., 1994;Holcomb et al., 1998;Griffiths et al., 1999;Gaab et al., 2003;Foster and Zatorre, 2010;Linke et al., 2011;Schulze et al., 2011;Albouy et al., 2013Albouy et al., , 2015Albouy et al., , 2017Foster et al., 2013;Kumar et al., 2016;Czoschke et al., 2021;Erhart et al., 2021). ...
... Given that emergent factors reflect the specific dataset, it is useful to review the range of tasks entered into PCA as well as how they load on particular factors. This is relevant to the refinement of language models and the study of neural substrates of language processing that use derived factors from PCA in conjunction with voxel-based lesion correlation maps (e.g., Mirman et al., 2015a,b;Woollams et al., 2018;Dickens et al., 2019;Ingram et al., 2020). ...