The impact of vascular factors on language localization in the superior temporal sulcus

Situating word deafness within aphasia recovery: A case report

Word deafness is a rare neurological disorder often observed following bilateral damage to superior temporal cortex and canonically defined as an auditory modality-specific deficit in word comprehension. The extent to which word deafness is dissociable from aphasia remains unclear given its heterogeneous presentation, and some have consequently posited that word deafness instead represents a stage in recovery from aphasia, where auditory and linguistic processing are affected to varying degrees and improve at differing rates. Here, we report a case of an individual (Mr. C) with bilateral temporal lobe lesions whose presentation evolved from a severe aphasia to an atypical form of word deafness, where auditory linguistic processing was impaired at the sentence level and beyond. We first reconstructed in detail Mr. C's stroke recovery through medical record review and supplemental interviewing. Then, using behavioral testing and multimodal neuroimaging, we documented a predominant auditory linguistic deficit in sentence and narrative comprehension-with markedly reduced behavioral performance and absent brain activation in the language network in the spoken modality exclusively. In contrast, Mr. C displayed near-unimpaired behavioral performance and robust brain activations in the language network for the linguistic processing of words, irrespective of modality. We argue that these findings not only support the view of word deafness as a stage in aphasia recovery but also further instantiate the important role of left superior temporal cortex in auditory linguistic processing.

Functional Parcellation of the Speech Production Cortex

Neuroimaging has revealed a core network of cortical regions that contribute to speech production, but the functional organization of this network remains poorly understood. Purpose We describe efforts to identify reliable boundaries around functionally homogenous regions within the cortical speech motor control network in order to improve the sensitivity of functional magnetic resonance imaging (fMRI) analyses of speech production and thus improve our understanding of the functional organization of speech production in the brain. Method We used a bottom-up, data-driven approach by pooling data from 12 previously conducted fMRI studies of speech production involving the production of monosyllabic and bisyllabic words and pseudowords that ranged from single vowels and consonant-vowel pairs to short sentences (163 scanning sessions, 136 unique participants, 39 different speech conditions). After preprocessing all data through the same pipeline and registering individual contrast maps to a common surface space, hierarchical clustering was applied to contrast maps randomly sampled from the pooled data set in order to identify consistent functional boundaries across subjects and tasks. Boundary completion was achieved by applying adaptive smoothing and watershed segmentation to the thresholded population-level boundary map. Hierarchical clustering was applied to the mean within-functional region of interest (fROI) response to identify networks of fROIs that respond similarly during speech. Results We identified highly reliable functional boundaries across the cortical areas involved in speech production. Boundary completion resulted in 117 fROIs in the left hemisphere and 109 in the right hemisphere. Clustering of the mean within-fROI response revealed a core sensorimotor network flanked by a speech motor planning network. The majority of the left inferior frontal gyrus clustered with the visual word form area and brain regions (e.g., anterior insula, dorsal anterior cingulate) associated with detecting salient sensory inputs and choosing the appropriate action. Conclusion The fROIs provide insight into the organization of the speech production network and a valuable tool for studying speech production in the brain by improving within-group and between-groups comparisons of speech-related brain activity. Supplemental Material https://doi.org/10.23641/asha.9402674.

Convergence of spoken and written language processing in the superior temporal sulcus

Spoken and written language processing streams converge in the superior temporal sulcus (STS), but the functional and anatomical nature of this convergence is not clear. We used functional MRI to quantify neural responses to spoken and written language, along with unintelligible stimuli in each modality, and employed several strategies to segregate activations on the dorsal and ventral banks of the STS. We found that intelligible and unintelligible inputs in both modalities activated the dorsal bank of the STS. The posterior dorsal bank was able to discriminate between modalities based on distributed patterns of activity, pointing to a role in encoding of phonological and orthographic word forms. The anterior dorsal bank was agnostic to input modality, suggesting that this region represents abstract lexical nodes. In the ventral bank of the STS, responses to unintelligible inputs in both modalities were attenuated, while intelligible inputs continued to drive activation, indicative of higher level semantic and syntactic processing. Our results suggest that the processing of spoken and written language converges on the posterior dorsal bank of the STS, which is the first of a heterogeneous set of language regions within the STS, with distinct functions spanning a broad range of linguistic processes.

Syntactic processing is distributed across the language system

Language comprehension recruits an extended set of regions in the human brain. Is syntactic processing localized to a particular region or regions within this system, or is it distributed across the entire ensemble of brain regions that support high-level linguistic processing? Evidence from aphasic patients is more consistent with the latter possibility: damage to many different language regions and to white-matter tracts connecting them has been shown to lead to similar syntactic comprehension deficits. However, brain imaging investigations of syntactic processing continue to focus on particular regions within the language system, often parts of Broca's area and regions in the posterior temporal cortex. We hypothesized that, whereas the entire language system is in fact sensitive to syntactic complexity, the effects in some regions may be difficult to detect because of the overall lower response to language stimuli. Using an individual-subjects approach to localizing the language system, shown in prior work to be more sensitive than traditional group analyses, we indeed find responses to syntactic complexity throughout this system, consistent with the findings from the neuropsychological patient literature. We speculate that such distributed nature of syntactic processing could perhaps imply that syntax is inseparable from other aspects of language comprehension (e.g., lexico-semantic processing), in line with current linguistic and psycholinguistic theories and evidence. Neuroimaging investigations of syntactic processing thus need to expand their scope to include the entire system of high-level language processing regions in order to fully understand how syntax is instantiated in the human brain.