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Kinahan SP, Saidi P, Daliri A, Liss J, Berisha V. Electroencephalographic Classification Reveals Atypical Speech Motor Planning in Stuttering Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2053-2076. [PMID: 38924389 PMCID: PMC11253807 DOI: 10.1044/2024_jslhr-23-00635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/23/2024] [Accepted: 04/09/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE This study explores speech motor planning in adults who stutter (AWS) and adults who do not stutter (ANS) by applying machine learning algorithms to electroencephalographic (EEG) signals. In this study, we developed a technique to holistically examine neural activity differences in speaking and silent reading conditions across the entire cortical surface. This approach allows us to test the hypothesis that AWS will exhibit lower separability of the speech motor planning condition. METHOD We used the silent reading condition as a control condition to isolate speech motor planning activity. We classified EEG signals from AWS and ANS individuals into speaking and silent reading categories using kernel support vector machines. We used relative complexities of the learned classifiers to compare speech motor planning discernibility for both classes. RESULTS AWS group classifiers require a more complex decision boundary to separate speech motor planning and silent reading classes. CONCLUSIONS These findings indicate that the EEG signals associated with speech motor planning are less discernible in AWS, which may result from altered neuronal dynamics in AWS. Our results support the hypothesis that AWS exhibit lower inherent separability of the silent reading and speech motor planning conditions. Further investigation may identify and compare the features leveraged for speech motor classification in AWS and ANS. These observations may have clinical value for developing novel speech therapies or assistive devices for AWS.
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Affiliation(s)
- Sean P. Kinahan
- College of Health Solutions, Arizona State University, Tempe
- School of Computing and Augmented Intelligence, Arizona State University, Tempe
| | - Pouria Saidi
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe
| | - Ayoub Daliri
- College of Health Solutions, Arizona State University, Tempe
| | - Julie Liss
- Department of Speech and Hearing Science, Arizona State University, Tempe
| | - Visar Berisha
- College of Health Solutions, Arizona State University, Tempe
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe
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Pasculli G, Busan P, Jackson ES, Alm PA, De Gregorio D, Maguire GA, Goodwin GM, Gobbi G, Erritzoe D, Carhart-Harris RL. Psychedelics in developmental stuttering to modulate brain functioning: a new therapeutic perspective? Front Hum Neurosci 2024; 18:1402549. [PMID: 38962146 PMCID: PMC11221540 DOI: 10.3389/fnhum.2024.1402549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Developmental stuttering (DS) is a neurodevelopmental speech-motor disorder characterized by symptoms such as blocks, repetitions, and prolongations. Persistent DS often has a significant negative impact on quality of life, and interventions for it have limited efficacy. Herein, we briefly review existing research on the neurophysiological underpinnings of DS -specifically, brain metabolic and default mode/social-cognitive networks (DMN/SCN) anomalies- arguing that psychedelic compounds might be considered and investigated (e.g., in randomized clinical trials) for treatment of DS. The neural background of DS is likely to be heterogeneous, and some contribution from genetically determinants of metabolic deficiencies in the basal ganglia and speech-motor cortical regions are thought to play a role in appearance of DS symptoms, which possibly results in a cascade of events contributing to impairments in speech-motor execution. In persistent DS, the difficulties of speech are often linked to a series of associated aspects such as social anxiety and social avoidance. In this context, the SCN and DMN (also influencing a series of fronto-parietal, somato-motor, and attentional networks) may have a role in worsening dysfluencies. Interestingly, brain metabolism and SCN/DMN connectivity can be modified by psychedelics, which have been shown to improve clinical evidence of some psychiatric conditions (e.g., depression, post-traumatic stress disorder, etc.) associated with psychological constructs such as rumination and social anxiety, which also tend to be present in persistent DS. To date, while there have been no controlled trials on the effects of psychedelics in DS, anecdotal evidence suggests that these agents may have beneficial effects on stuttering and its associated characteristics. We suggest that psychedelics warrant investigation in DS.
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Affiliation(s)
- Giuseppe Pasculli
- Department of Computer, Control, and Management Engineering (DIAG), La Sapienza University, Rome, Italy
- Italian Society of Psychedelic Medicine (Società Italiana di Medicina Psichedelica–SIMePsi), Bari, Italy
| | | | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
| | - Per A. Alm
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Danilo De Gregorio
- IRCCS, San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Gerald A. Maguire
- School of Medicine, American University of Health Sciences, Signal Hill, CA, United States
- CenExel CIT Research, Riverside, CA, United States
| | - Guy M. Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - David Erritzoe
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, University of California, San Francisco, CA, United States
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Orpella J, Flick G, Assaneo MF, Shroff R, Pylkkänen L, Poeppel D, Jackson ES. Reactive Inhibitory Control Precedes Overt Stuttering Events. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2024; 5:432-453. [PMID: 38911458 PMCID: PMC11192511 DOI: 10.1162/nol_a_00138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/06/2024] [Indexed: 06/25/2024]
Abstract
Research points to neurofunctional differences underlying fluent speech between stutterers and non-stutterers. Considerably less work has focused on processes that underlie stuttered vs. fluent speech. Additionally, most of this research has focused on speech motor processes despite contributions from cognitive processes prior to the onset of stuttered speech. We used MEG to test the hypothesis that reactive inhibitory control is triggered prior to stuttered speech. Twenty-nine stutterers completed a delayed-response task that featured a cue (prior to a go cue) signaling the imminent requirement to produce a word that was either stuttered or fluent. Consistent with our hypothesis, we observed increased beta power likely emanating from the right pre-supplementary motor area (R-preSMA)-an area implicated in reactive inhibitory control-in response to the cue preceding stuttered vs. fluent productions. Beta power differences between stuttered and fluent trials correlated with stuttering severity and participants' percentage of trials stuttered increased exponentially with beta power in the R-preSMA. Trial-by-trial beta power modulations in the R-preSMA following the cue predicted whether a trial would be stuttered or fluent. Stuttered trials were also associated with delayed speech onset suggesting an overall slowing or freezing of the speech motor system that may be a consequence of inhibitory control. Post-hoc analyses revealed that independently generated anticipated words were associated with greater beta power and more stuttering than researcher-assisted anticipated words, pointing to a relationship between self-perceived likelihood of stuttering (i.e., anticipation) and inhibitory control. This work offers a neurocognitive account of stuttering by characterizing cognitive processes that precede overt stuttering events.
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Affiliation(s)
- Joan Orpella
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA
- Department of Psychology, New York University, New York, NY, USA
- Department of Communicative Sciences and Disorders, New York University, New York, NY, USA
| | - Graham Flick
- Department of Psychology, New York University, New York, NY, USA
| | - M. Florencia Assaneo
- Institute of Neurobiology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Ravi Shroff
- Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, USA
| | - Liina Pylkkänen
- Department of Psychology, New York University, New York, NY, USA
- Department of Linguistics, New York University, New York, NY, USA
- NYUAD Institute, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - David Poeppel
- Department of Psychology, New York University, New York, NY, USA
- Center for Language, Music and Emotion (CLaME), New York University, New York, NY, USA
- Ernst Strüngmann Institute (ESI) for Neuroscience, Frankfurt, Germany
| | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, USA
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Bayat M, Boostani R, Sabeti M, Yadegari F, Pirmoradi M, Rao KS, Nami M. Source Localization and Spectrum Analyzing of EEG in Stuttering State upon Dysfluent Utterances. Clin EEG Neurosci 2024; 55:371-383. [PMID: 36627837 DOI: 10.1177/15500594221150638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Purpose: The present study which addressed adults who stutter (AWS) attempted to investigate power spectral dynamics in the stuttering state by answering the questions using quantitative electroencephalography (qEEG). Method: A 64-channel electroencephalography (EEG) setup was used for data acquisition at 20 AWS. Since the speech, especially stuttering, causes significant noise in the EEG, 2 conditions of speech preparation (SP) and imagined speech (IS) were considered. EEG signals were decomposed into 6 bands. The corresponding sources were localized using the standard low-resolution electromagnetic tomography (sLORETA) tool in both fluent and dysfluent states. Results: Significant differences were noted after analyzing the time-locked EEG signals in fluent and dysfluent utterances. Consistent with previous studies, poor alpha and beta suppression in SP and IS conditions were localized in the left frontotemporal areas in a dysfluent state. This was partly true for the right frontal regions. In the theta range, disfluency was concurrence with increased activation in the left and right motor areas. Increased delta power in the left and right motor areas as well as increased beta2 power over left parietal regions was notable EEG features upon fluent speech. Conclusion: Based on the present findings and those of earlier studies, explaining the neural circuitries involved in stuttering probably requires an examination of the entire frequency spectrum involved in speech.
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Affiliation(s)
- Masoumeh Bayat
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Boostani
- Department of Computer Sciences and Engineering, School of Engineering, Shiraz University, Shiraz, Iran
| | - Malihe Sabeti
- Department of Computer Engineering, Islamic Azad University, North Tehran Branch, Tehran, Iran
| | - Fariba Yadegari
- Department of Speech and Language Pathology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadreza Pirmoradi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - K S Rao
- Neuroscience Center, INDICASAT-AIP, Panama City, Republic of Panama
| | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Center, INDICASAT-AIP, Panama City, Republic of Panama
- Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
- Academy of Health, Senses Cultural Foundation, Sacramento, CA, USA
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Marin E, Unsihuay N, Abarca VE, Elias DA. Identification of the Biomechanical Response of the Muscles That Contract the Most during Disfluencies in Stuttered Speech. SENSORS (BASEL, SWITZERLAND) 2024; 24:2629. [PMID: 38676246 PMCID: PMC11053464 DOI: 10.3390/s24082629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/04/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
Stuttering, affecting approximately 1% of the global population, is a complex speech disorder significantly impacting individuals' quality of life. Prior studies using electromyography (EMG) to examine orofacial muscle activity in stuttering have presented mixed results, highlighting the variability in neuromuscular responses during stuttering episodes. Fifty-five participants with stuttering and 30 individuals without stuttering, aged between 18 and 40, participated in the study. EMG signals from five facial and cervical muscles were recorded during speech tasks and analyzed for mean amplitude and frequency activity in the 5-15 Hz range to identify significant differences. Upon analysis of the 5-15 Hz frequency range, a higher average amplitude was observed in the zygomaticus major muscle for participants while stuttering (p < 0.05). Additionally, when assessing the overall EMG signal amplitude, a higher average amplitude was observed in samples obtained from disfluencies in participants who did not stutter, particularly in the depressor anguli oris muscle (p < 0.05). Significant differences in muscle activity were observed between the two groups, particularly in the depressor anguli oris and zygomaticus major muscles. These results suggest that the underlying neuromuscular mechanisms of stuttering might involve subtle aspects of timing and coordination in muscle activation. Therefore, these findings may contribute to the field of biosensors by providing valuable perspectives on neuromuscular mechanisms and the relevance of electromyography in stuttering research. Further research in this area has the potential to advance the development of biosensor technology for language-related applications and therapeutic interventions in stuttering.
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Affiliation(s)
| | | | - Victoria E. Abarca
- Biomechanics and Applied Robotics Research Laboratory, Pontificia Universidad Católica del Perú, Lima 15088, Peru; (E.M.); (N.U.); (D.A.E.)
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Busan P, Moret B, Formaggio E, Riavis L, Pisciotta C, Masina F, Manganotti P, Campana G. High definition-transcranial random noise stimulation to improve speech fluency in persistent developmental stuttering: A case study. Clin Neurophysiol 2023; 152:71-74. [PMID: 37343446 DOI: 10.1016/j.clinph.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/24/2023] [Accepted: 06/01/2023] [Indexed: 06/23/2023]
Affiliation(s)
| | - Beatrice Moret
- IRCCS Ospedale San Camillo, Venice, Italy; Department of General Psychology, University of Padua, Padua, Italy
| | - Emanuela Formaggio
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padua, Italy
| | | | | | | | - Paolo Manganotti
- Department of Medicine, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padua, Padua, Italy
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Furlanis G, Busan P, Formaggio E, Menichelli A, Lunardelli A, Ajcevic M, Pesavento V, Manganotti P. Stuttering-Like Dysfluencies as a Consequence of Long COVID-19. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:415-430. [PMID: 36749838 DOI: 10.1044/2022_jslhr-22-00381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE We present two patients who developed neurogenic stuttering after long COVID-19 related to SARS-CoV-2 infection. METHODS AND RESULTS Both patients experienced both physical (e.g., fatigue) and cognitive difficulties, which led to impaired function of attention, lexical retrieval, and memory consolidation. Both patients had new-onset stuttering-like speech dysfluencies: Blocks and repetitions were especially evident at the initial part of words and sentences, sometimes accompanied by effortful and associated movements (e.g., facial grimaces and oro-facial movements). Neuropsychological evaluations confirmed the presence of difficulties in cognitive tasks, while neurophysiological evaluations (i.e., electroencephalography) suggested the presence of "slowed" patterns of brain activity. Neurogenic stuttering and cognitive difficulties were evident for 4-5 months after negativization of SARS-CoV-2 nasopharyngeal swab, with gradual improvement and near-to-complete recovery. CONCLUSIONS It is now evident that SARS-CoV-2 infection may significantly involve the central nervous system, also resulting in severe and long-term consequences, even if the precise mechanisms are still unknown. In the present report, long COVID-19 resulted in neurogenic stuttering, as the likely consequence of a "slowed" metabolism of (pre)frontal and sensorimotor brain regions (as suggested by the present and previous clinical evidence). As a consequence, the pathophysiological mechanisms related to the appearance of neurogenic stuttering have been hypothesized, which help to better understand the broader and possible neurological consequences of COVID-19.
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Affiliation(s)
- Giovanni Furlanis
- Clinical Unit of Neurology, University Hospital and Health Services of Trieste, ASUGI, Italy
- Department of Medicine, Surgical and Health Sciences, University of Trieste, Italy
| | | | - Emanuela Formaggio
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Italy
| | - Alina Menichelli
- Neuropsychological Service, Clinical Unit of Rehabilitation, University Hospital and Health Services of Trieste, ASUGI, Italy
| | - Alberta Lunardelli
- Neuropsychological Service, Clinical Unit of Rehabilitation, University Hospital and Health Services of Trieste, ASUGI, Italy
| | - Milos Ajcevic
- Department of Engineering and Architecture, University of Trieste, Italy
| | - Valentina Pesavento
- Neuropsychological Service, Clinical Unit of Rehabilitation, University Hospital and Health Services of Trieste, ASUGI, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, University Hospital and Health Services of Trieste, ASUGI, Italy
- Department of Medicine, Surgical and Health Sciences, University of Trieste, Italy
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Effects of Binaural Beat Stimulation in Adults with Stuttering. Brain Sci 2023; 13:brainsci13020309. [PMID: 36831852 PMCID: PMC9954735 DOI: 10.3390/brainsci13020309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
In recent decades, several studies have demonstrated a link between stuttering and abnormal electroencephalographic (EEG) β-power in cortex. Effects of exposure to binaural stimuli were studied in adults with stuttering (AWS, n = 6) and fluent participants (n = 6) using EEG, ECG, and speech analysis. During standard reading tasks without stimulation, in controls but not in the AWS group, EEG β-power was significantly higher in the left hemisphere than in the right hemisphere. After stimulation, the power of the β-band in AWS participants in the left hemisphere increased 1.54-fold. The average β-band power within the left frontotemporal area and temporoparietal junction of the cortex after stimulation in AWS participants shows an increase by 1.65-fold and 1.72-fold, respectively. The rate of disfluency dropped significantly immediately after stimulation (median 74.70% of the baseline). Similarly, the speech rate significantly increased immediately after stimulation (median 133.15%). We show for the first time that auditory binaural beat stimulation can improve speech fluency in AWS, and its effect is proportional to boost in EEG β-band power in left frontotemporal and temporoparietal junction of cortex. Changes in β-power were detected immediately after exposure and persisted for 10 min. Additionally, these effects were accompanied by a reduction in stress levels.
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Gastaldon S, Busan P, Arcara G, Peressotti F. Inefficient speech-motor control affects predictive speech comprehension: atypical electrophysiological correlates in stuttering. Cereb Cortex 2023:6995383. [PMID: 36682885 DOI: 10.1093/cercor/bhad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023] Open
Abstract
Listeners predict upcoming information during language comprehension. However, how this ability is implemented is still largely unknown. Here, we tested the hypothesis proposing that language production mechanisms have a role in prediction. We studied 2 electroencephalographic correlates of predictability during speech comprehension-pre-target alpha-beta (8-30 Hz) power decrease and the post-target N400 event-related potential effect-in a population with impaired speech-motor control, i.e. adults who stutter (AWS), compared to typically fluent adults (TFA). Participants listened to sentences that could either constrain towards a target word or not, modulating its predictability. As a complementary task, participants also performed context-driven word production. Compared to TFA, AWS not only displayed atypical neural responses in production, but, critically, they showed a different pattern also in comprehension. Specifically, while TFA showed the expected pre-target power decrease, AWS showed a power increase in frontal regions, associated with speech-motor control. In addition, the post-target N400 effect was reduced for AWS with respect to TFA. Finally, we found that production and comprehension power changes were positively correlated in TFA, but not in AWS. Overall, the results support the idea that processes and neural structures prominently devoted to speech planning also support prediction during speech comprehension.
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Affiliation(s)
- Simone Gastaldon
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione (DPSS), University of Padova, Via Venezia 8, Padova (PD) 35131, Italy.,Padova Neuroscience Center (PNC), University of Padova, Via Giuseppe Orus 2/B, Padova (PD) 35131, Italy
| | - Pierpaolo Busan
- IRCCS Ospedale San Camillo, Via Alberoni 70, Lido (VE) 30126, Italy
| | - Giorgio Arcara
- IRCCS Ospedale San Camillo, Via Alberoni 70, Lido (VE) 30126, Italy
| | - Francesca Peressotti
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione (DPSS), University of Padova, Via Venezia 8, Padova (PD) 35131, Italy.,Padova Neuroscience Center (PNC), University of Padova, Via Giuseppe Orus 2/B, Padova (PD) 35131, Italy.,Centro Interdipartimentale di Ricerca "I-APPROVE-International Auditory Processing Project in Venice", University of Padova, Via Belzoni 160, Padova (PD) 35121, Italy
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