Phonetic basis of phonemic paraphasias in aphasia: Evidence for cascading activation

Inhibitory modulation of speech trajectories: Evidence from a vowel-modified Stroop task

How does cognitive inhibition influence speaking? The Stroop effect is a classic demonstration of the interference between reading and color naming. We used a novel variant of the Stroop task to measure whether this interference impacts not only the response speed, but also the acoustic properties of speech. Speakers named the color of words in three categories: congruent (e.g., red written in red), color-incongruent (e.g., green written in red), and vowel-incongruent - those with partial phonological overlap with their color (e.g., rid written in red, grain in green, and blow in blue). Our primary aim was to identify any effect of the distractor vowel on the acoustics of the target vowel. Participants were no slower to respond on vowel-incongruent trials, but formant trajectories tended to show a bias away from the distractor vowel, consistent with a phenomenon of acoustic inhibition that increases contrast between confusable alternatives.

Three-Dimensional Speech Profiles in Stroke Aphasia and Apraxia of Speech

PURPOSE

Behaviorally, acquired apraxia of speech (AOS) is a multidimensional syndrome that the experienced clinician recognizes based on impaired articulation and abnormal temporal prosody. We conducted this study to determine the extent to which three core features of AOS-when defined quantitatively-distinguish categorically among aphasia with no or minimal speech sound involvement, aphasia with AOS, and aphasia with phonemic paraphasia (APP).

METHOD

The study involved retrospective analysis of 195 participants with stroke-induced aphasia. We used three quantitative measures (phonemic error frequency, distortion error frequency, and word syllable duration [WSD]) to divide the sample into four participant groups according to the most likely speech diagnosis: aphasia with minimal speech sound errors, AOS, APP, and a borderline group with mixed profiles. We then conducted nonparametric comparisons across groups for which the measures were not defined and visualized all three measures in a three-dimensional graph.

RESULTS

The measures distributed as multidimensional spectra rather than discrete diagnostic entities, and there was considerable behavioral overlap among participant groups. Thirty percent of participants presented with aphasia with minimal sound production difficulties, and they were statistically indistinguishable from the APP group on distortion frequency and WSD. Distortion frequency and WSD were in a borderline region between AOS and APP for 29% of participants. Compared to all other groups, participants with AOS produced significantly more errors that affected listeners' phonemic perception.

CONCLUSIONS

The results suggest that the current AOS-APP dichotomy has limited validity. We conclude that a continuous multidimensional view of speech variation would be a constructive perspective from which to understand how the left cerebral hemisphere produces speech and that quantitative and normed speech measures should be used to inform differential diagnosis in clinical settings.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21807609.

Precision of phonological errors in aphasia supports resource models of phonological working memory in language production

Working memory (WM) is critical for many cognitive functions including language production. A key feature of WM is its capacity limitation. Two models have been proposed to account for such capacity limitation: slot models and resource models. In recent years, resource models have found support in both visual and auditory perception, but do they also extend to production? We investigate this by analyzing sublexical errors from four individuals with aphasia. Using tools from computational linguistics, we first define the concept of "precision" of sublexical errors. We then demonstrate that such precision decreases with increased working memory load, i.e., word length, as predicted by resource models. Finally, we rule out alternative accounts of this effect, such as articulatory simplification. These data provide the first evidence for the applicability of the resource model to production and further point to the generalizability of this account as a model of resource division in WM.

Speech Metrics and Samples That Differentiate Between Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia

Purpose Of the three currently recognized variants of primary progressive aphasia, behavioral differentiation between the nonfluent/agrammatic (nfvPPA) and logopenic (lvPPA) variants is particularly difficult. The challenge includes uncertainty regarding diagnosis of apraxia of speech, which is subsumed within criteria for variant classification. The purpose of this study was to determine the extent to which a variety of speech articulation and prosody metrics for apraxia of speech differentiate between nfvPPA and lvPPA across diverse speech samples. Method The study involved 25 participants with progressive aphasia (10 with nfvPPA, 10 with lvPPA, and five with the semantic variant). Speech samples included a word repetition task, a picture description task, and a story narrative task. We completed acoustic analyses of temporal prosody and quantitative perceptual analyses based on narrow phonetic transcription and then evaluated the degree of differentiation between nfvPPA and lvPPA participants (with the semantic variant serving as a reference point for minimal speech production impairment). Results Most, but not all, articulatory and prosodic metrics differentiated statistically between the nfvPPA and lvPPA groups. Measures of distortion frequency, syllable duration, syllable scanning, and-to a limited extent-syllable stress and phonemic accuracy showed greater impairment in the nfvPPA group. Contrary to expectations, classification was most accurate in connected speech samples. A customized connected speech metric-the narrative syllable duration-yielded excellent to perfect classification accuracy. Discussion Measures of average syllable duration in multisyllabic utterances are useful diagnostic tools for differentiating between nfvPPA and lvPPA, particularly when based on connected speech samples. As such, they are suitable candidates for automatization, large-scale study, and application to clinical practice. The observation that both speech rate and distortion frequency differentiated more effectively in connected speech than on a motor speech examination suggests that it will be important to evaluate interactions between speech and discourse production in future research.

Slowed Compensation Responses to Altered Auditory Feedback in Post-Stroke Aphasia: Implications for Speech Sensorimotor Integration

Developing a clearer understanding of impairments that underlie the behavioral characteristics of aphasia is essential for the development of targeted treatments and will help inform theories of speech motor control. Impairments in sensorimotor integration of speech in individuals with conduction aphasia have previously been implicated in their repetition deficits. However, much less is known about the extent to which these integrative deficits occur outside of conduction aphasia and how this manifests behaviorally in areas other than speech repetition. In this study, we aimed to address these issues by examining the behavioral correlates of speech sensorimotor impairment under altered auditory feedback (AAF) and their relationship with the impaired ability to independently correct for online errors during picture naming in people with aphasia. We found that people with aphasia generate slower vocal compensation response to pitch-shift AAF stimuli compared with controls. However, when the timing of responses was controlled for, no significant difference in the magnitude of vocal pitch compensation was observed between aphasia and control groups. Moreover, no relationship was found between self-correction of naming errors and the timing and magnitude of vocal compensation responses to AAF. These findings suggest that slowed compensation is a potential behavioral marker of impaired sensorimotor integration in aphasia.

Orthographic Visualisation Induced Brain Activations in a Chronic Poststroke Global Aphasia with Dissociation between Oral and Written Expression

We propose a method of orthographic visualisation strategy in a poststroke severe aphasia person with dissociation between oral and written expression. fMRI results suggest that such strategy may induce the engagement of alternative nonlanguage networks and visual representations may help improving oral output. This choice of rehabilitation method can be based on the remaining capacities and, therefore, on written language. Most notably, no study so far addressed how orthographic visualisation strategy during speech rehabilitation might influence clinical outcomes in nonfluent aphasia and apraxia patients.

Phonological and phonetic impairment in aphasic speech: an acoustic study of the voice onset time of six French-speaking aphasic patients

The aim of the present study is to contribute to the description of the speech production deficits in French-speaking aphasic patients, so as to shed light on their potential phonetic and/or phonological disorders. Acoustic studies of aphasics' speech productions remain relatively infrequent, especially in French, and when entering into the specifics, often lead to inconsistent results. We conducted a multiple-case study on six aphasic patients, four with non-fluent aphasia and two with fluent aphasia. They were administered a variety of language and neuropsychological tasks, then they participated in a customized non-word repetition task. Acoustic analyses of their speech productions were performed, focussing on VOT as the main acoustic correlate of the voicing contrast for oral stops. Other atypicalities in their productions were also classified. Results showed variable and mainly "mixed" phonetic-phonological impairment profiles that differed from the traditional hypotheses made in the literature about the speech deficits to be expected as a function of type of aphasia. Our results support the use of acoustic analyses in order to complete language examination in aphasic patients but also suggest that the frontier between phonological and phonetic impairment is not clear-cut. These outcomes are better accounted for by theories and models postulating close relationships between the phonological and phonetic levels of processing.

Assessing speech correction abilities with acoustic analyses: Evidence of preserved online correction in persons with aphasia

Purpose: Disorders of speech production may be accompanied by abnormal processing of speech sensory feedback. Here, we introduce a semi-automated analysis designed to assess the degree to which speakers use natural online feedback to decrease acoustic variability in spoken words. Because production deficits in aphasia have been hypothesised to stem from problems with sensorimotor integration, we investigated whether persons with aphasia (PWA) can correct their speech acoustics online. Method: Eight PWA in the chronic stage produced 200 repetitions each of three monosyllabic words. Formant variability was measured for each vowel in multiple time windows within the syllable, and the reduction in formant variability from vowel onset to midpoint was quantified. Result: PWA significantly decreased acoustic variability over the course of the syllable, providing evidence of online feedback correction mechanisms. The magnitude of this corrective formant movement exceeded past measurements in control participants. Conclusion: Vowel centreing behaviour suggests that error correction abilities are at least partially spared in speakers with aphasia, and may be relied upon to compensate for feedforward deficits by bringing utterances back on track. These proof of concept data show the potential of this analysis technique to elucidate the mechanisms underlying disorders of speech production.

Temporal control in the voicing contrast: Evidence from surgery-related apraxia of speech

The goal of this study was to investigate the phonetic realisation of the voicing feature in two tumour resection-related Spanish speakers with apraxia of speech. Temporal parameters related to the phonological contrast of voicing in Spanish have been analysed for intervocalic voiced and voiceless obstruents embedded in isolated words and nonwords, and compared with data collected from healthy speakers. Results indicate that in devoiced productions, where VOT values fitted the 'voiceless stops' category, vowel duration values matched those of voiced stops and suggested the preservation of contextual voicing cues. An attempt at preserving a consonant/vowel duration ratio consistent with aerodynamic predictions for voicing contrast has been observed in apraxic correct production as well as in devoicing errors, but not in the control group, which could be interpreted as a compensatory mechanism.

Identification and Remediation of Phonological and Motor Errors in Acquired Sound Production Impairment

Purpose

This study aimed to test whether an approach to distinguishing errors arising in phonological processing from those arising in motor planning also predicts the extent to which repetition-based training can lead to improved production of difficult sound sequences.

Method

Four individuals with acquired speech production impairment who produced consonant cluster errors involving deletion were examined using a repetition task. We compared the acoustic details of productions with deletion errors in target consonant clusters to singleton consonants. Changes in accuracy over the course of the study were also compared.

Results

Two individuals produced deletion errors consistent with a phonological locus of the errors, and 2 individuals produced errors consistent with a motoric locus of the errors. The 2 individuals who made phonologically driven errors showed no change in performance on a repetition training task, whereas the 2 individuals with motoric errors improved in their production of both trained and untrained items.

Conclusions

The results extend previous findings about a metric for identifying the source of sound production errors in individuals with both apraxia of speech and aphasia. In particular, this work may provide a tool for identifying predominant error types in individuals with complex deficits.