Browsing by Author "Méndez Orellana, Carolina Patricia"

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    Beyond the left cerebral hemisphere: bilateral language lateralization in healthy aging and its clinical implications
    (2025) Toloza Ramírez, David Isaias; Santibáñez Ávila, Rodrigo Andrés; Arrano Carrasco, Leonardo Marcelo; Zunino Pesce, Romina Francesca; Julio-Ramos, Teresa; Copland, David A.; Quezada, Camilo; Méndez Orellana, Carolina Patricia
    Background Functional MRI (fMRI) studies conducted on young adults reveal a predominantly left-lateralized cortical language network during semantic and phonological processing (SP and PP, respectively). Both linguistic dimensions have been advanced as potential cognitive markers of pathological aging. However, the neural mechanisms underlying SP and PP among healthy older adults remain poorly understood.AimThis study aimed to investigate the dynamics of language lateralization among native Spanish-speaking older adults in relation to their behavioral performance in specific semantic and phonological tasks.MethodologyTwenty-eight healthy, right-handed older Chilean adults (mean age: 67.7, SD±: 7.44, range: 60–87) took part in an fMRI session during which they performed semantic and phonological tasks. They were also evaluated for overall language performance using the Spanish version of ScreeLing and verbal fluency tasks. A fixed-effect analysis was performed to explore group-level differences. Standard regression analyses were also used to assess the association between brain activation and language performance.ResultsBoth SP and PP elicited bilateral activation in the pars triangularis and opercularis of the inferior frontal gyrus (IFG) and the superior temporal gyrus. Activation was also observed in the left inferior parietal gyrus. Semantic fluency performance was significantly associated with activation in the right angular gyrus and the pars opercularis of the IFG. In contrast, phonological fluency was associated with bilateral activation in the IFG pars orbitalis.ConclusionAmong healthy older adults, SP and PP recruit bilateral language-related brain regions, potentially reflecting compensatory mechanisms associated with normal aging. Notably, the IFG pars orbitalis may play a distinct role in supporting phonological fluency, despite not being a region traditionally linked to PP. Further research is needed to clarify the contribution of this region to phonological performance among aging adults.
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    Neuropsychological differential diagnosis of Alzheimer's disease and Lewy body dementia: A systematic reviewDiagnóstico neuropsicológico diferencial en enfermedad de Alzheimer y demencia por cuerpos de Lewy: una revisión sistemática
    (2024) Julio-Ramos. T.; Mora-Castelleto, V.; Foncea González, Camila Paz; Adames-Valencia, C.; Cigarroa, I.; Méndez Orellana, Carolina Patricia; Toloza-Ramírez, D.
    Introduction: Alzheimer's disease (AD) reports heterogeneity of neuropsychological symptoms misleading the differential diagnosis with other forms of dementia, such as dementia with Lewy bodies (DLB). About 50% of DLB patients are misdiagnosed as AD cases. Likewise, the diagnosis of both diseases is mainly based on clinical characteristics. However, differentiating AD of those with DLB based on neuropsychological symptoms and anatomical and functional brain changes remains challenging. Aim: To establish the main neuropsychological, anatomical, and functional similarities and differences in patients with AD and DLB. Methods: The present study followed the PRISMA guidelines and included studies from the PubMed, Scopus, and Web of Sciences databases, published between January 2000 and July 2022. Results: Forty-one articles were included in this systematic review for critical analysis. Our results suggest that the cognitive key domains to consider in the differential diagnosis are memory, executive function, attention, visuospatial/visuoconstructive skills, and verbal fluency (both semantic and phonological). The stage and severity of both diseases would be essential for differential diagnosis. On the other hand, the anatomical and functional changes suggest a similar atrophy pattern between AD and DLB in the frontal, parietal, temporal, hippocampal, and precuneus regions. Conclusion: The differential diagnosis between AD and DLB is challenging in clinical practice. Therefore, our results suggest exploring cognitive linguistic markers along with correlating these markers with anatomical and functional brain changes.© 2024 Sociedad Española de NeurologíaIntroducción: La enfermedad de Alzheimer (EA) reporta heterogeneidad de síntomas neuropsicológicos. Esto conduce a errores diagnósticos con otras formas de demencia, como la demencia por cuerpos de Lewy (DPCL). De hecho, alrededor del 50% de los pacientes con DPCL son confundidos como casos de EA. Si bien el diagnóstico de ambos cuadros se basa principalmente en aspectos clínicos, continúa siendo un desafío su diferenciación en base a los síntomas neuropsicológicos y los patrones de atrofia cortical. Objetivo: Establecer las principales similitudes y diferencias neuropsicológicas y de atrofia cortical en pacientes con EA y DPCL. Metodología: La presente revisión sistemática siguió los lineamientos establecidos en la declaración PRISMA, utilizando las bases de datos PubMed, Scopus y Web of Science. La búsqueda estuvo limitada a estudios observacionales analíticos de pruebas diagnósticas, publicados en idioma inglés entre enero de 2000 y julio de 2022. Resultados: La búsqueda dio como resultado 41 artículos finales. Del total de los artículos identificados se sugiere que los elementos neuropsicológicos clave para el diagnóstico diferencial entre EA y DPCL son la memoria, la función ejecutiva, la atención, las habilidades visuoespaciales/visuoconstructivas y la fluidez verbal (semántica y fonológica), siendo el estadio y el grado de severidad de cada cuadro críticos en el proceso diagnóstico. Los resultados además sugieren un patrón de cambios anatomofuncionales similar entre EA y DPCL en las áreas frontal, parietal, temporal, hipocampal y precuneus. Conclusión: El diagnóstico diferencial entre EA y DPCL es un desafío en la práctica clínica, por lo que esta revisión se propone explorar marcadores cognitivos con énfasis en los indicadores lingüísticos además de los cambios anatómicos y funcionales de las áreas cerebrales.
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    Neuropsychological differential diagnosis of Alzheimer's disease and Lewy body dementia: A systematic reviewDiagnóstico neuropsicológico diferencial en enfermedad de Alzheimer y demencia por cuerpos de Lewy: una revisión sistemática
    (2024) Julio-Ramos. T.; Mora-Castelleto, V.; Foncea González, Camila Paz; Adames-Valencia, C.; Cigarroa, I.; Méndez Orellana, Carolina Patricia; Toloza-Ramírez, D.
    Introduction: Alzheimer's disease (AD) reports heterogeneity of neuropsychological symptoms misleading the differential diagnosis with other forms of dementia, such as dementia with Lewy bodies (DLB). About 50% of DLB patients are misdiagnosed as AD cases. Likewise, the diagnosis of both diseases is mainly based on clinical characteristics. However, differentiating AD of those with DLB based on neuropsychological symptoms and anatomical and functional brain changes remains challenging. Aim: To establish the main neuropsychological, anatomical, and functional similarities and differences in patients with AD and DLB. Methods: The present study followed the PRISMA guidelines and included studies from the PubMed, Scopus, and Web of Sciences databases, published between January 2000 and July 2022. Results: Forty-one articles were included in this systematic review for critical analysis. Our results suggest that the cognitive key domains to consider in the differential diagnosis are memory, executive function, attention, visuospatial/visuoconstructive skills, and verbal fluency (both semantic and phonological). The stage and severity of both diseases would be essential for differential diagnosis. On the other hand, the anatomical and functional changes suggest a similar atrophy pattern between AD and DLB in the frontal, parietal, temporal, hippocampal, and precuneus regions. Conclusion: The differential diagnosis between AD and DLB is challenging in clinical practice. Therefore, our results suggest exploring cognitive linguistic markers along with correlating these markers with anatomical and functional brain changes.© 2024 Sociedad Española de NeurologíaIntroducción: La enfermedad de Alzheimer (EA) reporta heterogeneidad de síntomas neuropsicológicos. Esto conduce a errores diagnósticos con otras formas de demencia, como la demencia por cuerpos de Lewy (DPCL). De hecho, alrededor del 50% de los pacientes con DPCL son confundidos como casos de EA. Si bien el diagnóstico de ambos cuadros se basa principalmente en aspectos clínicos, continúa siendo un desafío su diferenciación en base a los síntomas neuropsicológicos y los patrones de atrofia cortical. Objetivo: Establecer las principales similitudes y diferencias neuropsicológicas y de atrofia cortical en pacientes con EA y DPCL. Metodología: La presente revisión sistemática siguió los lineamientos establecidos en la declaración PRISMA, utilizando las bases de datos PubMed, Scopus y Web of Science. La búsqueda estuvo limitada a estudios observacionales analíticos de pruebas diagnósticas, publicados en idioma inglés entre enero de 2000 y julio de 2022. Resultados: La búsqueda dio como resultado 41 artículos finales. Del total de los artículos identificados se sugiere que los elementos neuropsicológicos clave para el diagnóstico diferencial entre EA y DPCL son la memoria, la función ejecutiva, la atención, las habilidades visuoespaciales/visuoconstructivas y la fluidez verbal (semántica y fonológica), siendo el estadio y el grado de severidad de cada cuadro críticos en el proceso diagnóstico. Los resultados además sugieren un patrón de cambios anatomofuncionales similar entre EA y DPCL en las áreas frontal, parietal, temporal, hipocampal y precuneus. Conclusión: El diagnóstico diferencial entre EA y DPCL es un desafío en la práctica clínica, por lo que esta revisión se propone explorar marcadores cognitivos con énfasis en los indicadores lingüísticos además de los cambios anatómicos y funcionales de las áreas cerebrales.
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    Right hemisphere engagement in language abilities in older adults: indication of compensation rather than decline
    (2025) Solomons, Daniel; Rodríguez Fernández, María; Mery Muñoz, Francisco Javier; Arraño Carrasco, Leonardo Marcelo; Toloza Ramírez, David Isaias; Sahli Costabal, Francisco; Méndez Orellana, Carolina Patricia
    Introduction: Structural brain changes during aging have been used as specific markers to distinguish normal aging from dementia. Changes in specific cognitive abilities such as episodic memory, processing speed, and executive functions, are observed in healthy aging. Limited evidence reports changes in linguistic functions alongside structural and functional brain changes. This study investigates correlations between language performance, gray matter volume (GMV), and neural activity in language regions, adjusted for demographic factors, in healthy older adults. Methods: Twenty-seven right-handed participants aged 60–87 were evaluated for overall linguistic performance using the Spanish version of ScreeLing (SCL) test and phonemic fluency and semantic verbal fluency tasks (PF and SF). Participants also underwent an MRI session during which they performed a functional MRI language task. T1-weighted MRI scans were used to measure GMV in specific language-related regions and assess language lateralization. Correlational analyses were conducted between language scores, GMV, years of education, age, sex, and fMRI lateralization. Results: In the right hemisphere (RH), significant positive correlations were found between SCL scores and GMV in the orbital inferior frontal gyrus (r = 0.5402; p = 0.0044) and the superior temporal gyrus (r = 0.516; p = 0.007). Furthermore, SCL and Phonemic fluency positively correlated with years of education, indicating that higher education enhances speech performance. No significant correlations were found in the left hemisphere (LH). Age, sex, and fMRI lateralization did not significantly correlate with specific linguistic scores. Discussion: These results challenge the current view of the role of the right hemisphere in language performance as increased GMV in specific right hemisphere language regions is associated with better language performance, highlighting the role of the right hemisphere in supporting language skills during healthy aging.