Steven Z Rapcsak

Interests

Research

Cognitive neuroscience, behavioral neurology, Alzheimer's disease and related disorders, spoken and written language impairment

Courses

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Scholarly Contributions

Chapters

• Beeson, P. M., Rising, K., & Rapcsak, S. Z. (2017). Acquired Impairments of Reading and Writing. In In Lapointe, LL & Stierwalt JAG (Eds). Handbook of Aphasia and Brain-Based Cognitive-Language Disorders.. New York: Thieme Publishers.
• Hishaw, G. A., Rapcsak, S. Z., & Lin, T. P. (2017). Visual Hallucinations. In In Kreutzer, JS, DeLuca, J & Kaplan, B (Eds). Encyclopedia of Clinical Neuropsychology. New York: Springer-Verlag, under review.
• Rapcsak, S. Z. (2017). Cortical Blindness. In In Kreutzer, JS, DeLuca, J & Kaplan, B (Eds). Encyclopedia of Clinical Neuropsychology. 2nd Edition. New York: Springer-Verlag in press.
• Rapcsak, S. Z. (2017). Prosopagnosia. In Wenzel, AE (Ed.), The SAGE Encyclopedia of Abnormal and Clinical Psychology.
• Beeson, P. M., & Rapcsak, S. Z. (2015). Clinical Diagnosis and treatment of spelling disorders. In A.E. Hillis (Ed.). In Handbook of Adult Language Disorders: Integrating Cognitive Neuropsychology, Neurology and Rehabilitation (2nd Edition)(pp 117-138). Philadelphia: Psychology Press.
• Rapcsak, S. Z., & Beeson, P. (2015). Neuroanatomical correlates of spelling and writing. In A.E. Hillis (Ed.). In Handbook of Adult Language Disorders: Integrating Cognitive Neuropsychology, Neurology and Rehabilitation (2nd Edition)(pp 87-116). Philadelphia: Psychology Press.

Journals/Publications

• Bartoň, M., Fňašková, M., Rektorová, I., Mikl, M., Mareček, R., Rapcsak, S. Z., & Rektor, I. (2020). The role of the striatum in visuomotor integration during handwriting: an fMRI study. Journal of neural transmission (Vienna, Austria : 1996), 127(3), 331-337.
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  This study investigates the role of the dorsal/sensorimotor striatum in visuomotor integration (i.e., the transformation of internal visual information about letter shapes into motor output) during handwriting. Twenty healthy participants underwent fMRI scanning with tasks consisting of self-paced handwriting of alphabetically ordered single letters and simple dots, with both tasks performed without visual feedback. Functional connectivity (FC) from these two tasks was compared to demonstrate the difference between coordinated activity arising during handwriting and the activity during a simpler motor condition. Our study focused upon the writing-specific cortico-striatal network of preselected regions of interest consisting of the visual word form area (VWFA), anterior intraparietal sulcus/superior parietal lobule, striatum, premotor cortex/Exner's area, and primary and supplementary motor regions. We observed systematically increased task-induced cortico-striatal and cortico-cortical FC. This increased synchronization of neural activity between the VWFA, i.e., the visual cortical area containing information about letter shapes, and the frontoparietal motor regions is mediated by the striatum. These findings suggest the involvement of the striatum in integrating stored letter-shape information with motor planning and execution during handwriting.
• Sundman, M. H., Lim, K., Ton That, V., Mizell, J. M., Ugonna, C., Rodriguez, R., Chen, N. K., Fuglevand, A. J., Liu, Y., Wilson, R. C., Fellous, J. M., Rapcsak, S., & Chou, Y. H. (2020). Transcranial magnetic stimulation reveals diminished homoeostatic metaplasticity in cognitively impaired adults. Brain communications, 2(2), fcaa203.
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  Homoeostatic metaplasticity is a neuroprotective physiological feature that counterbalances Hebbian forms of plasticity to prevent network destabilization and hyperexcitability. Recent animal models highlight dysfunctional homoeostatic metaplasticity in the pathogenesis of Alzheimer's disease. However, the association between homoeostatic metaplasticity and cognitive status has not been systematically characterized in either demented or non-demented human populations, and the potential value of homoeostatic metaplasticity as an early biomarker of cognitive impairment has not been explored in humans. Here, we report that, through pre-conditioning the synaptic activity prior to non-invasive brain stimulation, the association between homoeostatic metaplasticity and cognitive status could be established in a population of non-demented human subjects (older adults across cognitive spectrums; all within the non-demented range). All participants ( = 40; age range, 65-74, 47.5% female) underwent a standardized neuropsychological battery, magnetic resonance imaging and a transcranial magnetic stimulation protocol. Specifically, we sampled motor-evoked potentials with an input/output curve immediately before and after repetitive transcranial magnetic stimulation to assess neural plasticity with two experimental paradigms: one with voluntary muscle contraction (i.e. modulated synaptic activity history) to deliberately introduce homoeostatic interference, and one without to serve as a control condition. From comparing neuroplastic responses across these experimental paradigms and across cohorts grouped by cognitive status, we found that (i) homoeostatic metaplasticity is diminished in our cohort of cognitively impaired older adults and (ii) this neuroprotective feature remains intact in cognitively normal participants. This novel finding suggests that (i) future studies should expand their scope beyond just Hebbian forms of plasticity that are traditionally assessed when using non-invasive brain stimulation to investigate cognitive ageing and (ii) the potential value of homoeostatic metaplasticity in serving as a biomarker for cognitive impairment should be further explored.
• Rapcsak, S. Z. (2019). Face Recognition. Current neurology and neuroscience reports, 19(7), 41.
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  Functional imaging studies, intracranial recordings, and lesion-deficit correlations in neurological patients have produced unique insights into the cognitive mechanisms and neural substrates of face recognition. In this review, we highlight recent advances in the field and integrate data from these complementary lines of research to propose a functional neuroanatomical model of face identity recognition.
• Rapcsak, S. Z. (2019). Faster cognitive decline in dementia due to Alzheimer’s disease with clinically undiagnosed Lewy Body Disease.. PLOS ONE.
• Rapcsak, S. Z. (2018). Reductions in white matter integrity in brain regions involved in early stages of Parkinson’s disease. Brain Connectivity.
• Rapcsak, S. Z. (2018). The Contribution of the Left Anterior Ventrolateral Temporal Lobe to Personal Semantics:. Neuropsychologia.
• Rapcsak, S. Z., DeMarco, A., & Beeson, P. M. (2018). The neural substrates of improved phonological processing following successful treatment in a case of phonological alexia. Neurocase.
• DeMarco, A. T., Wilson, S. M., Rising, K., Rapcsak, S. Z., & Beeson, P. M. (2017). Neural substrates of sublexical processing for spelling. Brain and language, 164, 118-128.
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  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 production of both irregular words and nonwords engaged a left-hemisphere perisylvian network associated with reading/spelling and phonological processing skills. Effects of lexicality, manifested by increased activation during nonword relative to irregular word spelling, were noted in anterior perisylvian regions (posterior inferior frontal gyrus/operculum/precentral gyrus/insula), and in left ventral occipito-temporal cortex. In addition to enhanced neural responses within domain-specific components of the language network, the increased cognitive demands associated with spelling nonwords engaged domain-general frontoparietal cortical networks involved in selective attention and executive control. These results elucidate the neural substrates of sublexical processing during written language production and complement lesion-deficit correlation studies of phonological agraphia.
• Elfmarkova, N. N., Gajdos, M., Rektorova, I., Markecek, R., & Rapcsak, S. Z. (2017). Neural Evidence for defective top-down control of visual processing in Parkinson's and Alzheimer's disease. Neuropsychologia.
• Rapcsak, S. Z. (2017). Oscillatory reactivity to effortful cognitive processing in the subthalamic nucleus and internal pallidum: a depth electrode EEG study. Journal of Neural Transmission, 841-852.
• Beeson, P. M., Rising, K., DeMarco, A. T., Foley, T. H., & Rapcsak, S. Z. (2016). The nature and treatment of phonological text agraphia. Neuropsychological rehabilitation, 1-21.
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  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, some individuals demonstrate difficulty reading functors and affixes in sentences, a profile referred to as phonological text alexia. In this paper, we demonstrate an analogous manifestation of the phonological impairment on text-level writing and suggest the term "phonological text agraphia". We examined four individuals with phonological alexia/agraphia who also showed disproportionate difficulty writing well-formed sentences in comparison to their grammatical competence in spoken utterances. Implementation of a phonological treatment protocol resulted in significantly improved sublexical phonology skills as well as improvements in grammatical accuracy of written narratives. These findings support the notion of a common phonological impairment underlying nonword reading/spelling deficits and sentence-level difficulties.
• Filon, J. R., Introcia, A. J., Sue, L. I., Arreola, E. V., Wilson, J. D., Davis, K. J., & Rapcsak, S. Z. (2016). Gender Differences in Alzheimer's Disease: brain atrophy, histopathological burden and cognition.. Journal of Neuropathology and Experimental Neurology, 75:748-754.
• Marquine, M. J., Grilli, M. D., Rapcsak, S. Z., Kaszniak, A. W., Ryan, L., Walther, K., & Glisky, E. L. (2016). Impaired personal trait knowledge, but spared other-person trait knowledge, in an individual with bilateral damage to the medial prefrontal cortex. Neuropsychologia, 89, 245-53.
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  Functional neuroimaging has revealed that in healthy adults retrieval of personal trait knowledge is associated with increased activation in the medial prefrontal cortex (mPFC). Separately, neuropsychology has shown that the self-referential nature of memory can be disrupted in individuals with mPFC lesions. However, it remains unclear whether damage to the mPFC impairs retrieval of personal trait knowledge. Therefore, in this neuropsychological case study we investigated the integrity of personal trait knowledge in J.S., an individual who sustained bilateral damage to the mPFC as a result of an anterior communicating artery aneurysm. We measured both accuracy and consistency of J.S.'s personal trait knowledge as well as his trait knowledge of another, frequently seen person, and compared his performance to a group of healthy adults. Findings revealed that J.S. had severely impaired accuracy and consistency of his personal trait knowledge relative to control participants. In contrast, J.S.'s accuracy and consistency of other-person trait knowledge was intact in comparison to control participants. Moreover, J.S. showed a normal positivity bias in his trait ratings. These results, albeit based on a single case, implicate the mPFC as critical for retrieval of personal trait knowledge. Findings also cast doubt on the likelihood that the mPFC, in particular the ventral mPFC, is necessary for storage and retrieval of trait knowledge of other people. Therefore, this case study adds to a growing body of evidence that mPFC damage can disrupt the link between self and memory.
• Beach, T. G., Adler, C. H., Sue, L. I., Serrano, G., Shill, H. A., Walker, D. G., & Rapcsak, S. Z. (2015). Arizona Study of Aging and Neurodegenerative Disorders and Brain and Body Donation Program. Neuropathology, 35: 354-389.
• Bonakdarpour, B., Beeson, P. M., DeMarco, A. T., & Rapcsak, S. Z. (2015). Variability in blood oxygen level dependent (BOLD) signal in patients with stroke-induced and primary progressive aphasia. NeuroImage. Clinical, 8, 87-94.
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  Although fMRI is increasingly used to assess language-related brain activation in patients with aphasia, few studies have examined the hemodynamic response function (HRF) in perilesional, and contralesional areas of the brain. In addition, the relationship between HRF abnormalities and other variables such as lesion size and severity of aphasia has not been explored. The objective of this study was to investigate changes in HRF signal during language-related neural activation in patients with stroke-induced aphasia (SA). We also examined the status of the HRF in patients with aphasia due to nonvascular etiology, namely, primary progressive aphasia (PPA). Five right handed SA patients, three PPA patients, and five healthy individuals participated in the study. Structural damage was quantified with T1-weighted MR images. Functional MR imaging was performed with long trial event-related design and an overt naming task to measure BOLD signal time to peak (TTP) and percent signal change (ΔS). In SA patients, the average HRF TTP was significantly delayed in the left hemisphere regions involved in naming compared to healthy participants and PPA patients. However, ΔS was not different in SA patients compared to the other two groups. Delay in HRF TTP in the left hemisphere naming network of SA patients was correlated with lesion size and showed a negative correlation with global language function. There were no significant differences in the HRF TTP and ΔS in the right hemisphere homologues of the naming network or in the left and the right occipital control regions across the three groups. In PPA patients, HRF had a normal pattern. Our results indicate that abnormal task-related HRF is primarily found in the left hemisphere language network of SA patients and raise the possibility that abnormal physiology superimposed on structural damage may contribute to the clinical deficit. Follow-up investigations in a larger sample of age-matched healthy individuals, SA, and PPA patients will be needed to further confirm and extend our findings.
• Kim, E. S., Rising, K., Rapcsak, S. Z., & Beeson, P. M. (2015). Concurrent Treatment for the Combined Syndrome of letter-by-letter reading and surface agraphia.. Journal of Speech, Language & Hearing Research, 58:1521-1537.
• Roberts, D. J., Lambon Ralph, M. A., Kim, E., Tainturier, M. J., Beeson, P. M., Rapcsak, S. Z., & Woollams, A. M. (2015). Processing deficits for familiar and novel faces in patients with left posterior fusiform lesions. Cortex; a journal devoted to the study of the nervous system and behavior, 72, 79-96.
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  Pure alexia (PA) arises from damage to the left posterior fusiform gyrus (pFG) and the striking reading disorder that defines this condition has meant that such patients are often cited as evidence for the specialisation of this region to processing of written words. There is, however, an alternative view that suggests this region is devoted to processing of high acuity foveal input, which is particularly salient for complex visual stimuli like letter strings. Previous reports have highlighted disrupted processing of non-linguistic visual stimuli after damage to the left pFG, both for familiar and unfamiliar objects and also for novel faces. This study explored the nature of face processing deficits in patients with left pFG damage. Identification of famous faces was found to be compromised in both expressive and receptive tasks. Discrimination of novel faces was also impaired, particularly for those that varied in terms of second-order spacing information, and this deficit was most apparent for the patients with the more severe reading deficits. Interestingly, discrimination of faces that varied in terms of feature identity was considerably better in these patients and it was performance in this condition that was related to the size of the length effects shown in reading. This finding complements functional imaging studies showing left pFG activation for faces varying only in spacing and frontal activation for faces varying only on features. These results suggest that the sequential part-based processing strategy that promotes the length effect in the reading of these patients also allows them to discriminate between faces on the basis of feature identity, but processing of second-order configural information is most compromised due to their left pFG lesion. This study supports a view in which the left pFG is specialised for processing of high acuity foveal visual information that supports processing of both words and faces.