Task-related differences in temporo-parietal cortical activation during human phonatory behaviors

Fluency shaping increases integration of the command-to-execution and the auditory-to-motor pathways in persistent developmental stuttering

Fluency-shaping enhances the speech fluency of persons who stutter, yet underlying conditions and neuroplasticity-related mechanisms are largely unknown. While speech production-related brain activity in stuttering is well studied, it is unclear whether therapy repairs networks of altered sensorimotor integration, imprecise neural timing and sequencing, faulty error monitoring, or insufficient speech planning. Here, we tested the impact of one-year fluency-shaping therapy on resting-state fMRI connectivity within sets of brain regions subserving these speech functions. We analyzed resting-state data of 22 patients who participated in a fluency-shaping program, 18 patients not participating in therapy, and 28 fluent control participants, measured one year apart. Improved fluency was accompanied by an increased connectivity within the sensorimotor integration network. Specifically, two connections were strengthened; the left inferior frontal gyrus showed increased connectivity with the precentral gyrus at the representation of the left laryngeal motor cortex, and the left inferior frontal gyrus showed increased connectivity with the right superior temporal gyrus. Thus, therapy-associated neural remediation was based on a strengthened integration of the command-to-execution pathway together with an increased auditory-to-motor coupling. Since we investigated task-free brain activity, we assume that our findings are not biased to network activity involved in compensation but represent long-term focal neuroplasticity effects.

Limbic and cortical control of phonation for speech in response to a public speech preparation stressor

Knowledge on brain networks subserving vocalization in vocally healthy individuals under various task conditions is scarce but paramount to understand voice disorders. The aims of our study were to determine (1) the effect of social-evaluative stress on the central neural control of phonation underlying speech production; and (2) the neural signature, personality profile, and aerodynamic vocal function in relation to salivary cortisol responses. Thirteen vocally healthy females underwent an event-related sparse-sampling fMRI protocol consisting of voiced and whispered sentence productions with and without exposure to the social-evaluative stressor public speaking anticipation. Participants completed a personality questionnaire, rating scales of negative emotional state, and provided salivary cortisol samples. In the total sample, the task contrast of voiced productions revealed that stressor exposure resulted in a peak activation in the right caudate with concomitant deactivations in the bilateral pgACC and aMCC, and right IFG, BA 9, BA 10, insula, putamen, and thalamus. There were individual differences in stressor-induced brain activations as a function of stress reactivity with greater cortisol reactivity linked with lower laryngeal motor cortex activity and lower scores on aspects of extraversion. Our data confirm that stress alters the phonatory control for speech production through limbic-motor interactions. The findings support the Trait Theory of Voice Disorders (Roy and Bless 2000) and help provide critical insights to the study of voice disorders such as primary muscle tension dysphonia.

Inner Speech: Development, Cognitive Functions, Phenomenology, and Neurobiology

Inner speech-also known as covert speech or verbal thinking-has been implicated in theories of cognitive development, speech monitoring, executive function, and psychopathology. Despite a growing body of knowledge on its phenomenology, development, and function, approaches to the scientific study of inner speech have remained diffuse and largely unintegrated. This review examines prominent theoretical approaches to inner speech and methodological challenges in its study, before reviewing current evidence on inner speech in children and adults from both typical and atypical populations. We conclude by considering prospects for an integrated cognitive science of inner speech, and present a multicomponent model of the phenomenon informed by developmental, cognitive, and psycholinguistic considerations. Despite its variability among individuals and across the life span, inner speech appears to perform significant functions in human cognition, which in some cases reflect its developmental origins and its sharing of resources with other cognitive processes.

Preliminary findings on the relation between the personality trait of stress reaction and the central neural control of human vocalization

The objectives of this study were to examine whether the personality trait of stress reaction (SR), as assessed with the Multidimensional Personality Questionnaire-Brief Form (MPQ-BF), (1) influences prefrontal and limbic area activity during overt sentence reading and if (2) SR and associated individual differences in prefrontal and limbic activations correlate with sensorimotor cortical activity during overt sentence reading. Ten vocally healthy adults (22-57 years) participated in a functional MRI study using an event-related sparse sampling design to acquire brain activation data during sentence production tasks (covert, whispered, overt). The outcome measure was the blood oxygenation level-dependent signal change in prefrontal, limbic, and primary somatosensory (S1) and motor cortices (M1). Significant positive correlations were found between SR scores and S1, dorsolateral prefrontal cortex (both r =.73, p <.05), and periaqueductal gray (r =.88, p <.01) activity. M1 activity was positively correlated with SR (r =.64, p <.05) and negatively with social potency (r = -.70, p <.05). Our findings suggest that motor cortical control subserving voice and speech production varies with expression of selected personality traits. Future studies should investigate the functional significance of personality differences in the central neural control of vocalization.

A review and synthesis of the first 20 years of PET and fMRI studies of heard speech, spoken language and reading

The anatomy of language has been investigated with PET or fMRI for more than 20 years. Here I attempt to provide an overview of the brain areas associated with heard speech, speech production and reading. The conclusions of many hundreds of studies were considered, grouped according to the type of processing, and reported in the order that they were published. Many findings have been replicated time and time again leading to some consistent and undisputable conclusions. These are summarised in an anatomical model that indicates the location of the language areas and the most consistent functions that have been assigned to them. The implications for cognitive models of language processing are also considered. In particular, a distinction can be made between processes that are localized to specific structures (e.g. sensory and motor processing) and processes where specialisation arises in the distributed pattern of activation over many different areas that each participate in multiple functions. For example, phonological processing of heard speech is supported by the functional integration of auditory processing and articulation; and orthographic processing is supported by the functional integration of visual processing, articulation and semantics. Future studies will undoubtedly be able to improve the spatial precision with which functional regions can be dissociated but the greatest challenge will be to understand how different brain regions interact with one another in their attempts to comprehend and produce language.

Otolaryngology head and neck surgery: an integrative view of the larynx

The glottis is composed of muscular, cartilaginous, and other viscoelastic tissues which perform some of our most important, complex, coordinated, and life-sustaining functions. Dominated by the thyroarytenoid muscles and associated glottic closure muscles, the larynx is involved in respiration, swallowing, voicing, coughing, valsalva, vomiting, laughing, and crying. With respiration continuing in the background, all other "secondary" laryngeal events seamlessly occur. When the delicate balance of coordinating these events is disrupted by disease or disorder, many of these tasks are compromised. Due to the complex innervation of these volitional and reflexive tasks with brainstem central pattern generators, primary sensorimotor areas and importantly, limbic areas, failure can occur due to disease, anatomic compromise, and even emotional state. Understanding the level of sensorimotor control and interaction among systems that share these laryngeal neuromuscular substrates will improve the diagnostic and therapeutic skill of the clinician when treating compromise of laryngeal function.