Regional homogeneity of intrinsic brain activity correlates with auditory-motor processing of vocal pitch errors

Right, but not left, posterior superior temporal gyrus is causally involved in vocal feedback control

The posterior superior temporal gyrus (pSTG) has been implicated in the integration of auditory feedback and motor system for controlling vocal production. However, the question as to whether and how the pSTG is causally involved in vocal feedback control is currently unclear. To this end, the present study selectively stimulated the left or right pSTG with continuous theta burst stimulation (c-TBS) in healthy participants, then used event-related potentials to investigate neurobehavioral changes in response to altered auditory feedback during vocal pitch regulation. The results showed that, compared to control (vertex) stimulation, c-TBS over the right pSTG led to smaller vocal compensations for pitch perturbations accompanied by smaller cortical N1 and larger P2 responses. Enhanced P2 responses received contributions from the right-lateralized temporal and parietal regions as well as the insula, and were significantly correlated with suppressed vocal compensations. Surprisingly, these effects were not found when comparing c-TBS over the left pSTG with control stimulation. Our findings provide evidence, for the first time, that supports a causal relationship between right, but not left, pSTG and auditory-motor integration for vocal pitch regulation. This lends support to a right-lateralized contribution of the pSTG in not only the bottom-up detection of vocal feedback errors but also the involvement of driving motor commands for error correction in a top-down manner.

Continuous theta burst stimulation over left and right supramarginal gyri demonstrates their involvement in auditory feedback control of vocal production

The supramarginal gyrus (SMG) has been implicated in auditory-motor integration for vocal production. However, whether the SMG is bilaterally or unilaterally involved in auditory feedback control of vocal production in a causal manner remains unclear. The present event-related potential (ERP) study investigated the causal roles of the left and right SMG to auditory-vocal integration using neuronavigated continuous theta burst stimulation (c-TBS). Twenty-four young adults produced sustained vowel phonations and heard their voice unexpectedly pitch-shifted by ±200 cents after receiving active or sham c-TBS over the left or right SMG. As compared to sham stimulation, c-TBS over the left or right SMG led to significantly smaller vocal compensations for pitch perturbations that were accompanied by smaller cortical P2 responses. Moreover, no significant differences were found in the vocal and ERP responses when comparing active c-TBS over the left vs. right SMG. These findings provide neurobehavioral evidence for a causal influence of both the left and right SMG on auditory feedback control of vocal production. Decreased vocal compensations paralleled by reduced P2 responses following c-TBS over the bilateral SMG support their roles for auditory-motor transformation in a bottom-up manner: receiving auditory feedback information and mediating vocal compensations for feedback errors.

The left inferior frontal gyrus is causally linked to vocal feedback control: evidence from high-definition transcranial alternating current stimulation

Current models of speech motor control propose a role for the left inferior frontal gyrus (IFG) in feedforward control of speech production. There is evidence, however, that has implicated the functional relevance of the left IFG for the neuromotor processing of vocal feedback errors. The present event-related potential (ERP) study examined whether the left IFG is causally linked to auditory feedback control of vocal production with high-definition transcranial alternating current stimulation (HD-tACS). After receiving active or sham HD-tACS over the left IFG at 6 or 70 Hz, 20 healthy adults vocalized the vowel sounds while hearing their voice unexpectedly pitch-shifted by ±200 cents. The results showed that 6 or 70 Hz HD-tACS over the left IFG led to larger magnitudes and longer latencies of vocal compensations for pitch perturbations paralleled by larger ERP P2 responses than sham HD-tACS. Moreover, there was a lack of frequency specificity that showed no significant differences between 6 and 70 Hz HD-tACS. These findings provide first causal evidence linking the left IFG to vocal pitch regulation, suggesting that the left IFG is an important part of the feedback control network that mediates vocal compensations for auditory feedback errors.

Changes of Regional Neural Activity Homogeneity in Preclinical Alzheimer's Disease: Compensation and Dysfunction

INTRODUCTION

Subjective cognitive decline (SCD) is the preclinical stage of Alzheimer's disease and may develop into amnestic mild cognitive impairment (aMCI). Finding suitable biomarkers is the key to accurately identifying SCD. Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies on SCD patients showed functional connectivity disorders. Our goal was to explore whether local neurological homogeneity changes in SCD patients, the relationship between these changes and cognitive function, and similarities of neurological homogeneity changes between SCD and aMCI patients.

MATERIALS AND METHODS

37 cases of the healthy control (HC) group, 39 cases of the SCD group, and 28 cases of the aMCI group were included. Participants underwent rs-fMRI examination and a set of neuropsychological test batteries. Regional homogeneity (ReHo) was calculated and compared between groups. ReHo values were extracted from meaningful regions in the SCD group, and the correlation between ReHo values with the performance of neuropsychological tests was analyzed.

RESULTS

Our results showed significant changes in the ReHo among groups. In the SCD group compared with the HC group, part of the parietal lobe, frontal lobe, and occipital lobe showed decreased ReHo, and the temporal lobe, part of the parietal lobe and the frontal lobe showed increased ReHo. The increased area of ReHo was negatively correlated with the decreased area, and was related to decrease on multiple neuropsychological tests performance. Simultaneously, the changed areas of ReHo in SCD patients are similar to aMCI patients, while aMCI group's neuropsychological test performance was significantly lower than that of the SCD group.

CONCLUSION

There are significant changes in local neurological homogeneity in SCD patients, and related to the decline of cognitive function. The increase of neurological homogeneity in the temporal lobe and adjacent area is negatively correlated with cognitive function, reflecting compensation for local neural damage. These changes in local neurological homogeneity in SCD patients are similar to aMCI patients, suggesting similar neuropathy in these two stages. However, the aMCI group's cognitive function was significantly worse than that of the SCD group, suggesting that this compensation is limited. In summary, regional neural activity homogeneity may be a potential biomarker for identifying SCD and measuring the disease severity.

Linking Cortical Morphology to Interindividual Variability in Auditory Feedback Control of Vocal Production

Speakers regulate vocal motor behaviors in a compensatory manner when perceiving errors in auditory feedback. Little is known, however, about the source of interindividual variability that exists in the degree to which speakers compensate for perceived errors. The present study included 40 young adults to investigate whether individual differences in auditory integration for vocal pitch regulation, as indexed by vocal compensations for pitch perturbations in auditory feedback, can be predicted by cortical morphology as assessed by gray-matter volume, cortical thickness, and surface area in a whole-brain manner. The results showed that greater gray-matter volume in the left inferior parietal lobule and greater cortical thickness and surface area in the left superior/middle temporal gyrus, temporal pole, inferior/superior parietal lobule, and precuneus predicted larger vocal responses. Greater cortical thickness in the right inferior frontal gyrus and superior parietal lobule and surface area in the left precuneus and cuneus were significantly correlated with smaller magnitudes of vocal responses. These findings provide the first evidence that vocal compensations for feedback errors are predicted by the structural morphology of the frontal and tempo-parietal regions, and further our understanding of the neural basis that underlies interindividual variability in auditory-motor control of vocal production.

Non-invasive brain stimulation for speech in Parkinson's disease: A randomized controlled trial

BACKGROUND

Hypokinetic dysarthria is a common but difficult-to-treat symptom of Parkinson's disease (PD).

OBJECTIVES

We evaluated the long-term effects of multiple-session repetitive transcranial magnetic stimulation on hypokinetic dysarthria in PD. Neural mechanisms of stimulation were assessed by functional MRI.

METHODS

A randomized parallel-group sham stimulation-controlled design was used. Patients were randomly assigned to ten sessions (2 weeks) of real (1 Hz) or sham stimulation over the right superior temporal gyrus. Stimulation effects were evaluated at weeks 2, 6, and 10 after the baseline assessment. Articulation, prosody, and speech intelligibility were quantified by speech therapist using a validated tool (Phonetics score of the Dysarthric Profile). Activations of the speech network regions and intrinsic connectivity were assessed using 3T MRI. Linear mixed models and post-hoc tests were utilized for data analyses.

RESULTS

Altogether 33 PD patients completed the study (20 in the real stimulation group and 13 in the sham stimulation group). Linear mixed models revealed significant effects of time (F(3, 88.1) = 22.7, p < 0.001) and time-by-group interactions: F(3, 88.0) = 2.8, p = 0.040) for the Phonetics score. Real as compared to sham stimulation led to activation increases in the orofacial sensorimotor cortex and caudate nucleus and to increased intrinsic connectivity of these regions with the stimulated area.

CONCLUSIONS

This is the first study to show the long-term treatment effects of non-invasive brain stimulation for hypokinetic dysarthria in PD. Neural mechanisms of the changes are discussed.

Expectancy changes the self-monitoring of voice identity

Self‐voice attribution can become difficult when voice characteristics are ambiguous, but functional magnetic resonance imaging (fMRI) investigations of such ambiguity are sparse. We utilized voice‐morphing (self‐other) to manipulate (un‐)certainty in self‐voice attribution in a button‐press paradigm. This allowed investigating how levels of self‐voice certainty alter brain activation in brain regions monitoring voice identity and unexpected changes in voice playback quality. FMRI results confirmed a self‐voice suppression effect in the right anterior superior temporal gyrus (aSTG) when self‐voice attribution was unambiguous. Although the right inferior frontal gyrus (IFG) was more active during a self‐generated compared to a passively heard voice, the putative role of this region in detecting unexpected self‐voice changes during the action was demonstrated only when hearing the voice of another speaker and not when attribution was uncertain. Further research on the link between right aSTG and IFG is required and may establish a threshold monitoring voice identity in action. The current results have implications for a better understanding of the altered experience of self‐voice feedback in auditory verbal hallucinations.

Top–Down Inhibitory Mechanisms Underlying Auditory–Motor Integration for Voice Control: Evidence by TMS

The dorsolateral prefrontal cortex (DLPFC) has been implicated in auditory–motor integration for accurate control of vocal production, but its precise role in this feedback-based process remains largely unknown. To this end, the present event-related potential study applied a transcranial magnetic stimulation (TMS) protocol, continuous theta-burst stimulation (c-TBS), to disrupt cortical activity in the left DLPFC as young adults vocalized vowel sounds while hearing their voice unexpectedly shifted upwards in pitch. The results showed that, as compared to the sham condition, c-TBS over left DLPFC led to significantly larger vocal compensations for pitch perturbations that were accompanied by significantly smaller cortical P2 responses. Source localization analyses revealed that this brain activity pattern was the result of reduced activation in the left superior frontal gyrus and right inferior parietal lobule (supramarginal gyrus). These findings demonstrate c-TBS-induced modulatory effects of DLPFC on the neurobehavioral processing of vocal pitch regulation, suggesting that disrupting prefrontal function may impair top–down inhibitory control mechanisms that prevent speech production from being excessively influenced by auditory feedback, resulting in enhanced vocal compensations for feedback perturbations. This is the first study that provides direct evidence for a causal role of the left DLPFC in auditory feedback control of vocal production.

Decreased Gray-Matter Volume in Insular Cortex as a Correlate of Singers' Enhanced Sensorimotor Control of Vocal Production

Accumulating evidence has shown enhanced sensorimotor control of vocal production as a consequence of extensive singing experience. The neural basis of this ability, however, is poorly understood. Given that the insula mediates motor aspects of vocal production, the present study investigated structural plasticity in insula induced by singing experience and its link to auditory feedback control of vocal production. Voxel-based morphometry (VBM) was used to examine the differences in gray matter (GM) volume in the insula of 21 singers and 21 non-singers. An auditory feedback perturbation paradigm was used to examine the differences in auditory-motor control of vocal production between singers and non-singers. Both groups vocalized sustained vowels while hearing their voice unexpectedly pitch-shifted −50 or −200 cents (200 ms duration). VBM analyses showed that singers exhibited significantly lower GM volumes in the bilateral insula than non-singers. When exposed to pitch perturbations in voice auditory feedback, singers involuntarily compensated for pitch perturbations in voice auditory feedback to a significantly lesser degree than non-singers. Moreover, across the two sizes of pitch perturbations, the magnitudes of vocal compensations were positively correlated with the total regional GM volumes in the bilateral insula. These results indicate that extensive singing training leads to decreased GM volumes in insula and suggest that morphometric plasticity in insula contributes to the enhanced sensorimotor control of vocal production observed in singers.

Aging and Sex Influence Cortical Auditory-Motor Integration for Speech Control

It is well known that acoustic change in speech production is subject to age-related declines. How aging alters cortical sensorimotor integration in speech control, however, remains poorly understood. The present event-related potential study examined the behavioral and neural effects of aging and sex on the auditory-motor processing of voice pitch errors. Behaviorally, older adults produced significantly larger vocal compensations for pitch perturbations than young adults across the sexes, while the effects of sex on vocal compensation did not exist for both young and older adults. At the cortical level, there was a significant interaction between aging and sex on the N1-P2 complex. Older males produced significantly smaller P2 amplitudes than young males, while young males produced significantly larger N1 and P2 amplitudes than young females. In addition, females produced faster N1 responses than males regardless of age, while young adults produced faster P2 responses than older adults across the sexes. These findings provide the first neurobehavioral evidence that demonstrates the aging influence on auditory feedback control of speech production, and highlight the importance of sex in understanding the aging of the neuromotor control of speech production.

The Association Between Genetic Variation in FOXP2 and Sensorimotor Control of Speech Production

Significant advances have been made in understanding the role of auditory feedback in sensorimotor integration for speech production. The neurogenetic basis of this feedback-based control process, however, remains largely unknown. Mutations of FOXP2 gene in humans are associated with severe deficits in speech motor behavior. The present study examined the associations between a FOXP2 common variant, rs6980093 (A/G), and the behavioral and event-related potential (ERP) responses to -50 and -200 cents pitch perturbations during vocal production in a sample of 133 Chinese adults. Behaviorally, the GG genotype was associated with significantly smaller vocal compensations for -200 cents perturbations relative to the AA and AG genotypes. Furthermore, both the AA and AG genotypes exhibited significant positive correlations between the degree of vocal compensation for -50 and -200 cents perturbations and the variability of normal voice fundamental frequency, whereas no such correlation existed for the GG genotype. At the cortical level, significantly larger P2 responses to -200 cents perturbations were associated with the GG genotype as compared to the AA and AG genotypes due to increased left-lateralized activity in the superior, middle, and inferior frontal gyrus, precentral gyrus, anterior cingulate cortex, middle temporal gyrus, and insula. The neurobehavioral responses to -50 cents perturbations, however, did not vary as a function of genotype. These findings present the first neurobehavioral evidence for an association between FOXP2 genetic variant and auditory-motor integration for vocal pitch regulation. The differential effects of FOXP2 genotypes at rs6980093 may reflect their influences on the weighting of feedback and feedforward control of speech production.

Auditory-Motor Control of Vocal Production during Divided Attention: Behavioral and ERP Correlates

When people hear unexpected perturbations in auditory feedback, they produce rapid compensatory adjustments of their vocal behavior. Recent evidence has shown enhanced vocal compensations and cortical event-related potentials (ERPs) in response to attended pitch feedback perturbations, suggesting that this reflex-like behavior is influenced by selective attention. Less is known, however, about auditory-motor integration for voice control during divided attention. The present cross-modal study investigated the behavioral and ERP correlates of auditory feedback control of vocal pitch production during divided attention. During the production of sustained vowels, 32 young adults were instructed to simultaneously attend to both pitch feedback perturbations they heard and flashing red lights they saw. The presentation rate of the visual stimuli was varied to produce a low, intermediate, and high attentional load. The behavioral results showed that the low-load condition elicited significantly smaller vocal compensations for pitch perturbations than the intermediate-load and high-load conditions. As well, the cortical processing of vocal pitch feedback was also modulated as a function of divided attention. When compared to the low-load and intermediate-load conditions, the high-load condition elicited significantly larger N1 responses and smaller P2 responses to pitch perturbations. These findings provide the first neurobehavioral evidence that divided attention can modulate auditory feedback control of vocal pitch production.

Predicting auditory feedback control of speech production from subregional shape of subcortical structures

Although a growing body of research has focused on the cortical sensorimotor mechanisms that support auditory feedback control of speech production, much less is known about the subcortical contributions to this control process. This study examined whether subregional anatomy of subcortical structures assessed by statistical shape analysis is associated with vocal compensations and cortical event-related potentials in response to pitch feedback errors. The results revealed significant negative correlations between the magnitudes of vocal compensations and subregional shape of the right thalamus, between the latencies of vocal compensations and subregional shape of the left caudate and pallidum, and between the latencies of cortical N1 responses and subregional shape of the left putamen. These associations indicate that smaller local volumes of the basal ganglia and thalamus are predictive of slower and larger neurobehavioral responses to vocal pitch errors. Furthermore, increased local volumes of the left hippocampus and right amygdala were predictive of larger vocal compensations, suggesting that there is an interplay between the memory-related subcortical structures and auditory-vocal integration. These results, for the first time, provide evidence for differential associations of subregional morphology of the basal ganglia, thalamus, hippocampus, and amygdala with neurobehavioral processing of vocal pitch errors, suggesting that subregional shape measures of subcortical structures can predict behavioral outcome of auditory-vocal integration and associated neural features. Hum Brain Mapp 39:459-471, 2018. © 2017 Wiley Periodicals, Inc.

Top-Down Modulation of Auditory-Motor Integration during Speech Production: The Role of Working Memory

Although working memory (WM) is considered as an emergent property of the speech perception and production systems, the role of WM in sensorimotor integration during speech processing is largely unknown. We conducted two event-related potential experiments with female and male young adults to investigate the contribution of WM to the neurobehavioural processing of altered auditory feedback during vocal production. A delayed match-to-sample task that required participants to indicate whether the pitch feedback perturbations they heard during vocalizations in test and sample sequences matched, elicited significantly larger vocal compensations, larger N1 responses in the left middle and superior temporal gyrus, and smaller P2 responses in the left middle and superior temporal gyrus, inferior parietal lobule, somatosensory cortex, right inferior frontal gyrus, and insula compared with a control task that did not require memory retention of the sequence of pitch perturbations. On the other hand, participants who underwent extensive auditory WM training produced suppressed vocal compensations that were correlated with improved auditory WM capacity, and enhanced P2 responses in the left middle frontal gyrus, inferior parietal lobule, right inferior frontal gyrus, and insula that were predicted by pretraining auditory WM capacity. These findings indicate that WM can enhance the perception of voice auditory feedback errors while inhibiting compensatory vocal behavior to prevent voice control from being excessively influenced by auditory feedback. This study provides the first evidence that auditory-motor integration for voice control can be modulated by top-down influences arising from WM, rather than modulated exclusively by bottom-up and automatic processes.SIGNIFICANCE STATEMENT One outstanding question that remains unsolved in speech motor control is how the mismatch between predicted and actual voice auditory feedback is detected and corrected. The present study provides two lines of converging evidence, for the first time, that working memory cannot only enhance the perception of vocal feedback errors but also exert inhibitory control over vocal motor behavior. These findings represent a major advance in our understanding of the top-down modulatory mechanisms that support the detection and correction of prediction-feedback mismatches during sensorimotor control of speech production driven by working memory. Rather than being an exclusively bottom-up and automatic process, auditory-motor integration for voice control can be modulated by top-down influences arising from working memory.

Menstrual Cycle Phase Modulates Auditory-Motor Integration for Vocal Pitch Regulation

In adult females, previous work has demonstrated that changes in auditory function and vocal motor behaviors may accompany changes in gonadal steroids. Less is known, however, about the influence of gonadal steroids on auditory-motor integration for voice control in humans. The present event-related potential (ERP) study sought to examine the interaction between gonadal steroids and auditory feedback-based vocal pitch regulation across the menstrual cycle. Participants produced sustained vowels while hearing their voice unexpectedly pitch-shifted during the menstrual, follicular, and luteal phases of the menstrual cycle. Measurement of vocal and cortical responses to pitch feedback perturbations and assessment of estradiol and progesterone levels were performed in all three phases. The behavioral results showed that the menstrual phase (when estradiol levels are low) as associated with larger magnitudes of vocal responses than the follicular and luteal phases (when estradiol levels are high). Furthermore, there was a significant negative correlation between the magnitudes of vocal responses and estradiol levels. At the cortical level, ERP P2 responses were smaller during the luteal phase (when progesterone levels were high) than the menstrual and follicular phases (when progesterone levels were low). These findings show neurobehavioral evidence for the modulation of auditory-motor integration for vocal pitch regulation across the menstrual cycle, and provide important insights into the neural mechanisms and functional outcomes of gonadal steroids' influence on speech motor control in adult women.