Dynamics of White Matter Architecture in Lexical Production among Middle-Aged Adults

Abstract This study aimed to elucidate the white matter changes associated with lexical production (LP) difficulties that typically emerge in middle age, resulting in increased naming latencies. To delay the onset of LP decline, middle-aged adults may rely on domain-general (DG) and language-specific (LS) compensatory mechanisms as proposed by the LARA model (Lexical Access and Retrieval in Aging). However, our knowledge of the white matter changes supporting these mechanisms remains incomplete. Based on a sample of 155 middle-aged adults from the CAMCAN cohort, we combined dimensionality reduction techniques with multivariate statistical methods to jointly examine the relationships between diffusion-weighted imaging and LP-related neuropsychological data. Our findings (i) show that midlife constitutes a pivotal period marked by a discontinuity in brain structure within distributed networks within dorsal, ventral, and anterior cortico-subcortical pathways, and (ii) reveal that this discontinuity signals a neurocognitive transition around age 53-54, marking the onset of LP decline. Indeed, our results propose that middle-aged adults may initially adopt a “semantic strategy” to compensate for initial LP challenges. Still, this strategy may be compromised when late middle-aged adults (age 55-60) lose the ability to exert cognitive control over semantic representations (i.e., reduced semantic control). In summary, our study advances our comprehension of brain structure changes that underpin the neurocognitive profile of LP in middle age. Specifically, we underscore the importance of considering the interplay between DG and LS processes when studying the trajectory of LP performance in healthy aging. Furthermore, these findings offer valuable insights into identifying predictive biomarkers related to the compensatory dynamics observed in midlife, which can help understand language-related neurodegenerative pathologies. Highlights Midlife constitutes a pivotal period characterized by a discontinuity in brain structure. Early middle-aged adults (age 45-55) adopt a “semantic strategy” to facilitate semantic access and sustain lexical production (LP) performances. Late middle-aged adults (age 55-60) gradually lose the ability to exert cognitive control over semantic representations, marking the onset of LP decline.