Cognitive deficits often accompany language impairments post-stroke. Past research has focused on working memory in aphasia, but attention is largely underexplored. Therefore, this dissertation will first quantify attention deficits post-stroke before investigating whether preserved cognitive abilities, including attention, can improve auditory sentence comprehension post-stroke. In Experiment 1a, three components of attention (alerting, orienting, executive control) were measured in persons with aphasia and matched-controls using visual and auditory versions of the well-studied Attention Network Test. Experiment 1b then explored the neural resources supporting each component of attention in the visual and auditory modalities in chronic stroke participants. The results from Experiment 1a indicate that alerting, orienting, and executive control are uniquely affected by presentation modality. The lesion-symptom mapping results from Experiment 1b associated the left angular gyrus with visual executive control, the left supramarginal gyrus with auditory alerting, and Broca’s area (pars opercularis) with auditory orienting attention post-stroke. Overall, these findings indicate that perceptual modality may impact the lateralization of some aspects of attention, thus auditory attention may be more susceptible to impairment after a left hemisphere stroke.

Prosody, rhythm and pitch changes associated with spoken language may improve spoken language comprehension in persons with aphasia by recruiting intact cognitive abilities (e.g., attention and working memory) and their associated non-lesioned brain regions post-stroke. Therefore, Experiment 2 explored the relationship between cognition, two unique prosody manipulations, lesion location, and auditory sentence comprehension in persons with chronic stroke and matched-controls. The combined results from Experiment 2a and 2b indicate that stroke participants with better auditory orienting attention and a specific left fronto-parietal network intact had greater comprehension of sentences spoken with sentence prosody. For list prosody, participants with deficits in auditory executive control and/or short-term memory and the left angular gyrus and globus pallidus relatively intact, demonstrated better comprehension of sentences spoken with list prosody. Overall, the results from Experiment 2 indicate that following a left hemisphere stroke, individuals need good auditory attention and an intact left fronto-parietal network to benefit from typical sentence prosody, yet when cognitive deficits are present and this fronto-parietal network is damaged, list prosody may be more beneficial.

Language and music are fundamentally entwined within human culture. The two domains share similar properties including rhythm, acoustic complexity, and hierarchical structure. Although language and music have commonalities, abilities in these two domains have been found to dissociate after brain damage, leaving unanswered questions about their interconnectedness, including can one domain support the other when damage occurs? Evidence supporting this question exists for speech production. Musical pitch and rhythm are employed in Melodic Intonation Therapy to improve expressive language recovery, but little is known about the effects of music on the recovery of speech perception and receptive language. This research is one of the first to address the effects of music on speech perception. Two groups of participants, an older adult group (n=24; M = 71.63 yrs) and a younger adult group (n=50; M = 21.88 yrs) took part in the study. A native female speaker of Standard American English created four different types of stimuli including pseudoword sentences of normal speech, simultaneous music-speech, rhythmic speech, and music-primed speech. The stimuli were presented binaurally and participants were instructed to repeat what they heard following a 15 second time delay. Results were analyzed using standard parametric techniques. It was found that musical priming of speech, but not simultaneous synchronized music and speech, facilitated speech perception in both the younger adult and older adult groups. This effect may be driven by rhythmic information. The younger adults outperformed the older adults in all conditions. The speech perception task relied heavily on working memory, and there is a known working memory decline associated with aging. Thus, participants completed a working memory task to be used as a covariate in analyses of differences across stimulus types and age groups. Working memory ability was found to correlate with speech perception performance, but that the age-related performance differences are still significant once working memory differences are taken into account. These results provide new avenues for facilitating speech perception in stroke patients and sheds light upon the underlying mechanisms of Melodic Intonation Therapy for speech production.