Neural & Behavioral Correlates of Speech and Melody Repetition in Aphasia

171661-Thumbnail Image.png
Description
Speech and music are traditionally thought to be primarily supported by different hemispheres. A growing body of evidence suggests that speech and music often rely on shared resources in bilateral brain networks, though the right and left hemispheres exhibit some…

Speech and music are traditionally thought to be primarily supported by different hemispheres. A growing body of evidence suggests that speech and music often rely on shared resources in bilateral brain networks, though the right and left hemispheres exhibit some domain-specific specialization. While there is ample research investigating speech deficits in individuals with right hemisphere lesions and amusia, fewer investigate amusia in individuals with left hemisphere lesions and aphasia. Many of the fronto-temporal-parietal regions in the left hemisphere commonly associated with speech processing and production are also implicated in bilateral music processing networks. The current study investigates the relationship between damage to specific regions of interest within these networks, and an individual’s ability to successfully match the pitch and rhythm of a presented melody. Twenty-seven participants with chronic-stroke lesions were given a melody repetition task to hum short novel piano melodies. Participants underwent structural MRI acquisition and were administered an extensive speech and cognitive battery. Pitch and rhythm scores were calculated by correlating participant responses and target piano notes. Production errors were calculated by counting trials with responses that don’t match the target melody’s note count. Overall, performance varied widely, and rhythm scores were significantly correlated. Working memory scores were significantly correlated with rhythm scores and production errors, but not pitch scores. Broca’s area lesions were not associated with significant differences in any of the melody repetition measures, while left Heschl’s gyrus lesions were associated with worse performance on pitch, rhythm, and production errors. Lower rhythm scores were associated with lesions including both the left anterior and posterior superior temporal gyrus, and in participants with damage to the left planum temporale. The other regions of interest were not consistently associated with poorer pitch scores or production errors. Although the present study does have limitations, the current study suggests lesions to left hemisphere regions thought to only affect speech also affect musical pitch and rhythm processing. Therefore, amusia should not be characterized solely as a right hemisphere disorder. Instead, musical abilities of individuals with left hemisphere stroke and aphasia should be characterized to better understand their deficits and mechanisms of impairment.
Date Created
2022
Agent

She Said I Love You: The Effect of StartReact and Startle Adjuvant Rehabilitation Therapy in Post-Stroke Aphasia, Apraxia, and Dysarthria of Speech

171445-Thumbnail Image.png
Description
Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost…

Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost and low success rates. Therefore, the ability to make functionally significant changes in individuals with severe post- stroke aphasia remains a key challenge for the rehabilitation community. This dissertation aimed to evaluate the efficacy of Startle Adjuvant Rehabilitation Therapy (START), a tele-enabled, low- cost treatment, to improve quality of life and speech in individuals with severe-to-moderate stroke. START is the exposure to startling acoustic stimuli during practice of motor tasks in individuals with stroke. START increases the speed and intensity of practice in severely impaired post-stroke reaching, with START eliciting muscle activity 2-3 times higher than maximum voluntary contraction. Voluntary reaching distance, onset, and final accuracy increased after a session of START, suggesting a rehabilitative effect. However, START has not been evaluated during impaired speech. The objective of this study is to determine if impaired speech can be elicited by startling acoustic stimuli, and if three days of START training can enhance clinical measures of moderate to severe post-stroke aphasia and apraxia of speech. This dissertation evaluates START in 42 individuals with post-stroke speech impairment via telehealth in a Phase 0 clinical trial. Results suggest that impaired speech can be elicited by startling acoustic stimuli and that START benefits individuals with severe-to-moderate post-stroke impairments in both linguistic and motor speech domains. This fills an important gap in aphasia care, as many speech therapies remain ineffective and financially inaccessible for patients with severe deficits. START is effective, remotely delivered, and may likely serve as an affordable adjuvant to traditional therapy for those that have poor access to quality care.
Date Created
2022
Agent

Using Diffusion Tensor Imaging to Identify the White Matter Correlates of Motor Skill Learning and Visuospatial Processes in Older Adults

168329-Thumbnail Image.png
Description
Repetitive practice of functional movement patterns during motor rehabilitation are known to drive learning (or relearning) of novel motor skills, but the learning process is highly variable between individuals such that responsiveness to task-specific training is often patient-specific. A number…

Repetitive practice of functional movement patterns during motor rehabilitation are known to drive learning (or relearning) of novel motor skills, but the learning process is highly variable between individuals such that responsiveness to task-specific training is often patient-specific. A number of neuroimaging and neurophysiological methods have been proposed to better predict a patient’s responsiveness to a given type or dose of motor therapy. However, these methods are often time- and resource-intensive, and yield results that are not readily interpretable by clinicians. In contrast, standardized visuospatial tests may offer a more feasible solution. The work presented in this dissertation demonstrate that a clinical paper-and-pencil test of visuospatial function may improve predictive models of motor skill learning in older adults and individuals with stroke pathology. To further our understanding of the neuroanatomical correlates underlying this behavioral relationship, I collected diffusion-weighted magnetic resonance images from 19 nondemented older adults to determine if diffusion characteristics of white matter tracts explain shared variance in delayed visuospatial memory test scores and motor skill learning. Consistent with previous work, results indicated that the structural integrity of regions with the bilateral anterior thalamic radiations, corticospinal tracts, and superior longitudinal fasciculi are related to delayed visuospatial memory performance and one-week skill retention. Overall, results of this dissertation suggest that incorporating a clinical paper-and-pencil test of delayed visuospatial memory may prognose motor rehabilitation outcomes and support that personalized variables should be considered in standards of care. Moreover, regions within specific white matter tracts may underlie this behavioral relationship and future work should investigate these regions as potential targets for therapeutic intervention.
Date Created
2021
Agent

Investigation of Sensorimotor Abilities in Stroke Survivors With Aphasia: A Delayed Auditory Feedback Study

165768-Thumbnail Image.png
Description

Aphasia is an acquired speech-language disorder that is brought upon because of post-stroke damage to the left hemisphere of the brain. Treatment for individuals with these speech production impairments can be challenging for clinicians because there is high variability in…

Aphasia is an acquired speech-language disorder that is brought upon because of post-stroke damage to the left hemisphere of the brain. Treatment for individuals with these speech production impairments can be challenging for clinicians because there is high variability in language recovery after stroke and lesion size does not predict language outcome (Lazar et al, 2008). It is also important to note that adequate integration between the sensory and motor systems is critical for many aspects of fluent speech and correcting speech errors. The present study seeks to investigate how delayed auditory-feedback paradigms, which alter the time scale of sensorimotor interactions in speech, might be useful in characterizing the speech production impairments in individuals with aphasia. To this end, six individuals with aphasia and nine age-matched control subjects were introduced to delayed auditory feedback at 4 different intervals during a sentence reading task. Our study found that the aphasia group generated more errors in 3 out of the 4 linguistic categories measured across all delay lengths, but that there was no significant main effect delay or interaction between group and delay. Acoustic analyses revealed variability among scores within the control and aphasia groups on all phoneme types. For example, acoustic analyses highlighted how the individual with conduction aphasia showed significantly longer amplitudes at all delays, and significantly larger duration at no delay, but that significance diminished as delay periods increased. Overall, this study suggests that delayed auditory feedback’s effects vary across individuals with aphasia and provides a base of research to be further built on by future testing of individuals with varying aphasia types and levels of severity.

Date Created
2022-05
Agent

The Effects of Mindfulness Meditation on Resting-State Functional Connectivity and Executive Function in Adults with Autism Spectrum Disorder

161713-Thumbnail Image.png
Description
Individuals with autism spectrum disorder (ASD) are known to show impairments in various domains of executive function (EF) such as behavioral flexibility or inhibitory control. Research suggests that EF impairment in adults with ASD may relate to ASD core…

Individuals with autism spectrum disorder (ASD) are known to show impairments in various domains of executive function (EF) such as behavioral flexibility or inhibitory control. Research suggests that EF impairment in adults with ASD may relate to ASD core symptoms, restrictive behaviors and social communication deficits. Mindfulness-based stress reduction (MBSR) has shown promise for improving EF abilities in neurotypical adults, but research has not explored its efficacy or neural mechanisms in adults with ASD. This pilot study examines the effects of an 8-week MBSR intervention on self-report measures of EF and resting-state functional connectivity in a sample of adults with ASD. Fifty-four participants were assigned either to an MBSR group (n = 29) or a social support group (n = 25). Executive function was measured using the BRIEF-2 before and after the intervention for the twenty-seven participants in the second cohort. MBSR-specific improvements in EF were found for BRIEF measures of initiation, inhibition, and working-memory. Resting-state fMRI data was analyzed using independent component analysis (ICA), and group by time resting-state functional connectivity differences were observed between the cerebellar network and frontal regions including the right frontal pole (rFP), medial frontal cortex (MFC) and left and right superior frontal gyri (SFG). The MBSR group showed increases in functional connectivity between the cerebellum and EF regions which correlated with improvements in BRIEF-2 measures. These findings suggest that MBSR may improve EF domains in adults with ASD, and that increases in functional connectivity between the cerebellum and frontal regions while at rest may be a mechanism for such improvements.
Date Created
2021
Agent

The effect of corpus callosum agenesis on the communication between cerebral hemispheres

148374-Thumbnail Image.png
Description

Agenesis of the corpus callosum is the lack of the development of the corpus callosum. This condition can lead to impairments in language processing, epilepsy, and emotion and social functioning, but many individuals with this condition do not show any…

Agenesis of the corpus callosum is the lack of the development of the corpus callosum. This condition can lead to impairments in language processing, epilepsy, and emotion and social functioning, but many individuals with this condition do not show any of these impairments. The present study investigated the connectivity of language and sensorimotor networks within an individual with agenesis of the corpus callosum using resting-state fMRI. The individual’s results were compared to those of neurotypical control subjects. It was hypothesized that the overall interhemispheric functional connectivity would be less than that of a control group in bilateral language networks, but the intrahemispheric connectivity, particularly within the sensorimotor network, would show greater functional connectivity. The results revealed significantly weaker functional connectivity in the individual with agenesis of the corpus callosum within the right ventral stream compared to the control group. There were no other significant inter or intrahemispheric differences in the functional connectivity of the language and sensorimotor networks. These findings lead us to conclude that the right hemisphere’s ventral stream perhaps relies upon connections with the left hemisphere’s language networks to maintain its typical functionality. The results of this study support the idea that, in the case of corpus callosum agenesis, the right language network may contribute differently to language processes than in neurotypical controls.

Date Created
2021-05
Agent

Utilizing functional MRI to Analyze Differences in the Brain in Response to Speech and Music Stimuli in Persons with Aphasia

148383-Thumbnail Image.png
Description

The distinctions between the neural resources supporting speech and music comprehension have long been studied using contexts like aphasia and amusia, and neuroimaging in control subjects. While many models have emerged to describe the different networks uniquely recruited in response…

The distinctions between the neural resources supporting speech and music comprehension have long been studied using contexts like aphasia and amusia, and neuroimaging in control subjects. While many models have emerged to describe the different networks uniquely recruited in response to speech and music stimuli, there are still many questions, especially regarding left-hemispheric strokes that disrupt typical speech-processing brain networks, and how musical training might affect the brain networks recruited for speech after a stroke. Thus, our study aims to explore some questions related to the above topics. We collected task-based functional MRI data from 12 subjects who previously experienced a left-hemispheric stroke. Subjects listened to blocks of spoken sentences and novel piano melodies during scanning to examine the differences in brain activations in response to speech and music. We hypothesized that speech stimuli would activate right frontal regions, and music stimuli would activate the right superior temporal regions more than speech (both findings not seen in previous studies of control subjects), as a result of functional changes in the brain, following the left-hemispheric stroke and particularly the loss of functionality in the left temporal lobe. We also hypothesized that the music stimuli would cause a stronger activation in right temporal cortex for participants who have had musical training than those who have not. Our results indicate that speech stimuli compared to rest activated the anterior superior temporal gyrus bilaterally and activated the right inferior frontal lobe. Music stimuli compared to rest did not activate the brain bilaterally, but rather only activated the right middle temporal gyrus. When the group analysis was performed with music experience as a covariate, we found that musical training did not affect activations to music stimuli specifically, but there was greater right hemisphere activation in several regions in response to speech stimuli as a function of more years of musical training. The results of the study agree with our hypotheses regarding the functional changes in the brain, but they conflict with our hypothesis about musical expertise. Overall, the study has generated interesting starting points for further explorations of how musical neural resources may be recruited for speech processing after damage to typical language networks.

Date Created
2021-05
Agent

The Post Stroke Journey: A Survey Study of the Effects of Family Support and Psychological Factors on Rehabilitation Goals

131230-Thumbnail Image.png
Description
Stroke is the fifth most common cause of death in America and a leading cause of long-term adult disability, affecting more than 795,000 people a year ("American Stroke Association: A Division of the American Heart Association"). Many of these individuals…

Stroke is the fifth most common cause of death in America and a leading cause of long-term adult disability, affecting more than 795,000 people a year ("American Stroke Association: A Division of the American Heart Association"). Many of these individuals experience persistent difficulty with the execution of daily tasks as a direct consequence of a stroke. A key factor in the successful recovery of a stroke survivor is rehabilitation. Rehabilitation sessions can start within two days of the stroke if the patient is in stable condition, and often continues long after their release from the hospital ("American Stroke Association: A Division of the American Heart Association"). The rehabilitation sessions are driven by a team of rehabilitation care professionals which includes, but is not limited to a physical therapist, occupational therapist, and speech-language pathologist. These professionals are available to the stroke survivor as resources to assist in developing and organizing ways to achieve independence as opposed to dependence. Ultimately, a stroke survivor’s family typically provides the most important long-term support during recovery and rehabilitation ("American Stroke Association: A Division of the American Heart Association"). However, there is very little research that focuses on the impact that local family can have on the stroke survivor’s establishment and achievement of goals throughout their recovery and rehabilitation. This study examines this gap in knowledge.
Date Created
2020-05
Agent

Dyslexia, Creativity, and Neural Adaptation

131285-Thumbnail Image.png
Description
Objective: A recent electroencephalogram (EEG) study of adults with dyslexia showed that individuals with dyslexia have diminished auditory sensory gating compared to typical controls. Previous studies done involving intoxication and its effect on sensory gating and creativity have shown that…

Objective: A recent electroencephalogram (EEG) study of adults with dyslexia showed that individuals with dyslexia have diminished auditory sensory gating compared to typical controls. Previous studies done involving intoxication and its effect on sensory gating and creativity have shown that there is a positive correlation between creativity (divergent thinking problem solving) and sensory gating deficiency. With previous study findings, the link between dyslexia and sensory gating deficiency and the link between sensory gating deficiency and creativity have been shown, but not the link between dyslexia and creativity. This pilot study aims to address this knowledge gap using event-related potentials.

Methods: Two adults with dyslexia and 4 control adults participated in an auditory gating test using tone pairs. Latencies and Amplitudes for the N100 and P200 responses were recorded and analyzed. Participants were also administered the Abbreviated Torrance Test for Adults (ATTA), a test of creative ability designed to evaluate divergent thinking in individuals. Results were averaged and compared.

Results: The averaged difference in measured N100 amplitudes between tone 1 and tone 2 was significantly larger in the control group compared to the difference observed in the dyslexia group. In particular, one participant with dyslexia who had low scores on a task of rapid word recognition also showed no evidence of gating at the N100 component, whereas the other participant with dyslexia with good word recognition scores showed evidence of intact gating. The averaged difference in measured P200 amplitude between tone 1 and tone 2 was larger in the dyslexia group compared to the control group; however, the difference was small enough to be considered insignificant. The total average ATTA score for the control group was higher than the average of the dyslexia group. This difference in total average was less than one point on a 106-point scale.

Conclusions: Neural sensory gating occurs approximately 100 ms after the onset of a stimulus and is diminished in adults with dyslexia who also have deficits in rapid word recognition. There is a difference in creativity, in terms of divergent thinking, between those with dyslexia and those without (controls scored higher on average); however, the difference is not significant (less than one point). Dyslexia scores were more consistent than controls.
Date Created
2020-05
Agent

Speech Motor Learning Depends on Relevant Auditory Errors

131919-Thumbnail Image.png
Description
In the past, researchers have studied the elements of speech and how they work together in the human brain. Auditory feedback, an important aid in speech production, provides information to speakers and allows them to gain an understanding if the…

In the past, researchers have studied the elements of speech and how they work together in the human brain. Auditory feedback, an important aid in speech production, provides information to speakers and allows them to gain an understanding if the prediction of their speech matches their production. The speech motor system uses auditory goals to determine errors in its auditory output during vowel production. We learn from discrepancies between our prediction and auditory feedback. In this study, we examined error assessment processes by systematically manipulating the correspondence between speech motor outputs and their auditory consequences while producing speech. We conducted a study (n = 14 adults) in which participants’ auditory feedback was perturbed to test their learning rate in two conditions. During the trials, participants repeated CVC words and were instructed to prolong the vowel each time. The adaptation trials were used to examine the reliance of auditory feedback and speech prediction by systematically changing the weight of auditory feedback. Participants heard their perturbed feedback through insert earphones in real time. Each speaker’s auditory feedback was perturbed according to task-relevant and task-irrelevant errors. Then, these perturbations were presented to subjects gradually and suddenly in the study. We found that adaptation was less extensive with task-irrelevant errors, adaptation did not saturate significantly in the sudden condition, and adaptation, which was expected to be extensive and faster in the task-relevant condition, was closer to the rate of adaptation in the task-irrelevant perturbation. Though adjustments are necessary, we found an efficient way for speakers to rely on auditory feedback more than their prediction. Furthermore, this research opens the door to future investigations in adaptation in speech and presents implications for clinical purposes (e.g. speech therapy).
Date Created
2020-05
Agent
Subscribe to Rogalsky, Corianne