Chapter 13 Apraxia of speech. Neuropsychology and Behavioral Neurology. Elsevier; 2008. pp. 269-85. [DOI: 10.1016/s0072-9752(07)88013-4]

Pars Opercularis Underlies Efferent Predictions and Successful Auditory Feedback Processing in Speech: Evidence From Left-Hemisphere Stroke

Hearing one's own speech allows for acoustic self-monitoring in real time. Left-hemisphere motor planning regions are thought to give rise to efferent predictions that can be compared to true feedback in sensory cortices, resulting in neural suppression commensurate with the degree of overlap between predicted and actual sensations. Sensory prediction errors thus serve as a possible mechanism of detection of deviant speech sounds, which can then feed back into corrective action, allowing for online control of speech acoustics. The goal of this study was to assess the integrity of this detection-correction circuit in persons with aphasia (PWA) whose left-hemisphere lesions may limit their ability to control variability in speech output. We recorded magnetoencephalography (MEG) while 15 PWA and age-matched controls spoke monosyllabic words and listened to playback of their utterances. From this, we measured speaking-induced suppression of the M100 neural response and related it to lesion profiles and speech behavior. Both speaking-induced suppression and cortical sensitivity to deviance were preserved at the group level in PWA. PWA with more spared tissue in pars opercularis had greater left-hemisphere neural suppression and greater behavioral correction of acoustically deviant pronunciations, whereas sparing of superior temporal gyrus was not related to neural suppression or acoustic behavior. In turn, PWA who made greater corrections had fewer overt speech errors in the MEG task. Thus, the motor planning regions that generate the efferent prediction are integral to performing corrections when that prediction is violated.

Sensitivity and specificity of an acoustic- and perceptual-based tool for assessing motor speech disorders in French: the MonPaGe-screening protocol

To respond to the need of objective screening tools for motor speech disorders (MSD), we present the screening version of a speech assessment protocol (MonPaGe-2.0.s), which is based on semi-automated acoustic and perceptual measures on several speech dimensions in French. We validate the screening tool by testing its sensitivity and specificity and comparing its outcome with external standard assessment tools. The data from 80 patients diagnosed with different types of mild to moderate MSD and 62 healthy test controls were assessed against the normative data obtained on 404 neurotypical speakers, with Deviance Scores computed on seven speech dimensions (voice, speech rate, articulation, prosody, pneumophonatory control, diadochokinetic rate, intelligibility) based on acoustic and perceptual measures. A cut-off of the MonPaGe total deviance score (TotDevS) >2 allowed MSD to be diagnosed with specificity of 95% and an overall sensitivity of 83.8% on all patients pulled, reaching 91% when very mildly impaired patients were excluded. A strong correlation was found between the MonPaGe TotDevS and an external composite perceptual score of MSD provided by six experts. The MonPaGe screening protocol has proven its sensitivity and specificity for diagnosing presence and severity of MSD. Further implementations are needed to complement the characterization of impaired dimensions in order to distinguish subtypes of MSD.

Contribution of acoustic analysis to the detection of vocoid epenthesis in apraxia of speech and other motor speech disorders

BACKGROUND

Vocoid epenthesis within consonant clusters has been claimed to contribute to the diagnosis of apraxia of speech. In clinical practice, the clinicians often doubt about the correct production of clusters as the C-C transition may be minimally disrupted.

AIMS

To demonstrate the value of acoustic analysis in clinical practice as a reliable complement to perceptive judgment.

METHODS & PROCEDURES

We compared the acoustic signature and the perceptive detection of vocoid epentheses in unvoiced consonant clusters within pseudo-words produced by 40 participants presenting different subtypes of motor speech disorders (including apraxia of speech (AoS) and dysarthria) and matched neurotypical controls.

OUTCOMES & RESULTS

The results indicate that vocoid epenthesis was acoustically visible in 3 out of 10 participants with AoS, and in one out of 30 participants with dysarthria. One-quarter of these vocoid epentheses was not detected via auditory perception by expert listeners (speech and language therapists) who also made false detections.

CONCLUSIONS

The current results indicate that vocoid epenthesis is not systematic at least in mild AoS. Moreover, an important proportion is misdetected by ear, even by expert clinicians, meaning that visualisation of the acoustic signal can be of precious help.

On the Neurocircuitry of Grasping: The influence of action intent on kinematic asymmetries in reach-to-grasp actions

Evidence from electrophysiology suggests that nonhuman primates produce reach-to-grasp movements based on their functional end goal rather than on the biomechanical requirements of the movement. However, the invasiveness of direct-electrical stimulation and single-neuron recording largely precludes analogous investigations in humans. In this review, we present behavioural evidence in the form of kinematic analyses suggesting that the cortical circuits responsible for reach-to-grasp actions in humans are organized in a similar fashion. Grasp-to-eat movements are produced with significantly smaller and more precise maximum grip apertures (MGAs) than are grasp-to-place movements directed toward the same objects, despite near identical mechanical requirements of the two subsequent (i.e., grasp-to-eat and grasp-to-place) movements. Furthermore, the fact that this distinction is limited to right-handed movements suggests that the system governing reach-to-grasp movements is asymmetric. We contend that this asymmetry may be responsible, at least in part, for the preponderance of right-hand dominance among the global population.

Use of diverse diagnostic criteria for acquired apraxia of speech: a scoping review

BACKGROUND

There is a growing body of evidence that speech and language therapy (SLT) intervention is effective in improving communication ability for individuals with non-progressive acquired apraxia of speech (AOS). However, there is no universally agreed diagnostic standard for AOS, and diverging opinions on its diagnostic features. This has led to claims that diverse diagnostic criteria may be used to select participants for AOS research studies. These claims raise concerns for evidence-based practice in AOS but have yet to be systematically investigated.

AIMS

To determine the presence, nature and extent of diversity in the diagnostic criteria for non-progressive AOS used in both published studies and clinical practice internationally.

METHODS & PROCEDURES

The study used a scoping review methodology that followed the 2005 framework of Arksey and O'Malley and included a consultation exercise in the form of an online survey of international SLTs. The scoping review included 157 studies involving participants with acquired AOS, published between 1997 and 2017. There were 264 respondents to the online survey of SLTs, with a completion rate of 72%. Respondents came from 15 countries and had varying levels of clinical experience.

MAIN CONTRIBUTION

This study found that no common set of diagnostic criteria for AOS was used universally across research and practice. Although the diagnostic criteria used to select participants with AOS were reported explicitly in most studies, they varied from study to study. Some studies used directly conflicting criteria. Use of specific diagnostic criteria in studies was influenced by year of publication but not by location. There was a trend towards increasing consistency in diagnostic criteria in recent years. Compared with the research, the survey revealed relatively greater consistency among SLTs on the speech features considered indicative of AOS, although the SLTs who responded to the survey showed variation in how diagnostic criteria were combined into sets. Use of specific diagnostic criteria was not associated with SLTs' location or experience. There were differences between the diagnostic criteria for AOS used most commonly in research studies and those selected most commonly by SLTs in the survey. These findings have implications for the generalizability of AOS research to clinical practice, as well as implications for effective research synthesis.

CONCLUSIONS & IMPLICATIONS

The claim that research and practice in the field of AOS is characterized by the use of diverse diagnostic criteria is supported by this scoping review. The findings support the need to develop a universal consensus standard for AOS diagnosis to ensure consistency across research and clinical practice.

Speech motor planning in the context of phonetically similar words: Evidence from apraxia of speech and aphasia

The purpose of this study was to test two competing hypotheses about the nature of the impairment in apraxia of speech (AOS). The Reduced Buffer Capacity Hypothesis argues that people with AOS can hold only one syllable at a time in the speech motor planning buffer. The Program Retrieval Deficit Hypothesis, states that people with AOS have difficulty accessing the intended motor program in the context where several motor programs are activated simultaneously. The participants included eight speakers with AOS, most of whom also had aphasia, nine speakers with aphasia without AOS, and 25 age-matched control speakers. The experimental paradigm prompted single word production following three types of primes. In most trials, prime and target were the same (e.g., bill-bill). On some trials, the initial consonant differed in one phonetic feature (e.g., bill-dill; Similar) or in all phonetic features (fill-bill; Different). The dependent measures were accuracy and reaction time. The results revealed a switch cost - longer reaction times in trials where the prime and target differed compared to trials where they were the same words - in all groups; however, the switch cost was significantly larger in the AOS group compared to the other two groups. These findings are in line with the prediction of the Program Retrieval Deficit Hypothesis and suggest that speakers with AOS have difficulty with selecting one program over another when several programs compete for selection.

Disfluency clusters in speakers with and without neurogenic stuttering following traumatic brain injury

PURPOSE

Analyze the characteristics and rate of disfluency clusters in adults with and without neurogenic stuttering after traumatic brain injury (TBI).

METHOD

Twenty adults with TBI participated in this study, including 10 with neurogenic stuttering (Group B) and 10 without -stuttering (Group A). Disfluency clusters in speech samples were classified into three types: Stuttering-like (SLD), other (OD), and mixed (MIX).

RESULTS

Speakers with and without neurogenic stuttering produced the same mean number of disfluency clusters. In addition, the mean length of clusters did not differ between these speaker groups although the longest clusters did. The most frequently occurring cluster type for people with neurogenic stuttering was MIX and OD for people without stuttering. Although the speakers in Group A produced stuttering-like disfluencies, these never occurred together to form a SLD type cluster. For Group B, the starter units of the clusters were usually stuttering-like disfluencies, while for Group A, the starter units were mostly interruptions.

CONCLUSIONS

Compared to non-stuttering speakers, stuttering after TBI did not increase the number of clusters, but rather lengthened them. In speakers with neurogenic stuttering, the number and length of clusters were related to the manifestation of other communication deficits, not to the frequency of stuttering-like disfluencies. Still, SLD clusters occurred only in those people with neurogenic stuttering. These findings raise questions about the nature of both neurogenic stuttering and the dynamics of disfluency clustering.

An Investigation of Compensation and Adaptation to Auditory Perturbations in Individuals With Acquired Apraxia of Speech

Two auditory perturbation experiments were used to investigate the integrity of neural circuits responsible for speech sensorimotor adaptation in acquired apraxia of speech (AOS). This has implications for understanding the nature of AOS as well as normal speech motor control. Two experiments were conducted. In Experiment 1, compensatory responses to unpredictable fundamental frequency (F0) perturbations during vocalization were investigated in healthy older adults and adults with acquired AOS plus aphasia. F0 perturbation involved upward and downward 100-cent shifts versus no shift, in equal proportion, during 2 s vocalizations of the vowel /a/. In Experiment 2, adaptive responses to sustained first formant (F1) perturbations during speech were investigated in healthy older adults, adults with AOS and adults with aphasia only (APH). The F1 protocol involved production of the vowel /ε/ in four consonant-vowel words of Australian English (pear, bear, care, dare), and one control word with a different vowel (paw). An unperturbed Baseline phase was followed by a gradual Ramp to a 30% upward F1 shift stimulating a compensatory response, a Hold phase where the perturbation was repeatedly presented with alternating blocks of masking trials to probe adaptation, and an End phase with masking trials only to measure persistence of any adaptation. AOS participants showed normal compensation to unexpected F0 perturbations, indicating that auditory feedback control of low-level, non-segmental parameters is intact. Furthermore, individuals with AOS displayed an adaptive response to sustained F1 perturbations, but age-matched controls and APH participants did not. These findings suggest that older healthy adults may have less plastic motor programs that resist modification based on sensory feedback, whereas individuals with AOS have less well-established and more malleable motor programs due to damage from stroke.

Stochastic time models of syllable structure

Drawing on phonology research within the generative linguistics tradition, stochastic methods, and notions from complex systems, we develop a modelling paradigm linking phonological structure, expressed in terms of syllables, to speech movement data acquired with 3D electromagnetic articulography and X-ray microbeam methods. The essential variable in the models is syllable structure. When mapped to discrete coordination topologies, syllabic organization imposes systematic patterns of variability on the temporal dynamics of speech articulation. We simulated these dynamics under different syllabic parses and evaluated simulations against experimental data from Arabic and English, two languages claimed to parse similar strings of segments into different syllabic structures. Model simulations replicated several key experimental results, including the fallibility of past phonetic heuristics for syllable structure, and exposed the range of conditions under which such heuristics remain valid. More importantly, the modelling approach consistently diagnosed syllable structure proving resilient to multiple sources of variability in experimental data including measurement variability, speaker variability, and contextual variability. Prospects for extensions of our modelling paradigm to acoustic data are also discussed.

Impaired laryngeal voice production in a patient with foreign accent syndrome

We report a Japanese-speaking monolingual woman who developed foreign accent syndrome (FAS) following an infarction in the precentral and premotor cortices (Brodmann Area 6) at and around the inferior frontal sulcus. Her speech sounded Chinese or Korean to our bilingual coauthor who speaks Chinese and Japanese. Quantitative acoustic analyses of words and sentences showed that pitch (fundamental frequency variation) and intensity variances appeared lowered and fully voiced glottal pulses were reduced. These findings suggest laryngeal dysfunction that contributes to the unusual speech production in a case of FAS. This may be caused by damage to a restricted area of the motor and premotor cortices that controls laryngeal function.

Behavioral, computational, and neuroimaging studies of acquired apraxia of speech

A critical examination of speech motor control depends on an in-depth understanding of network connectivity associated with Brodmann areas 44 and 45 and surrounding cortices. Damage to these areas has been associated with two conditions-the speech motor programming disorder apraxia of speech (AOS) and the linguistic/grammatical disorder of Broca's aphasia. Here we focus on AOS, which is most commonly associated with damage to posterior Broca's area (BA) and adjacent cortex. We provide an overview of our own studies into the nature of AOS, including behavioral and neuroimaging methods, to explore components of the speech motor network that are associated with normal and disordered speech motor programming in AOS. Behavioral, neuroimaging, and computational modeling studies are indicating that AOS is associated with impairment in learning feedforward models and/or implementing feedback mechanisms and with the functional contribution of BA6. While functional connectivity methods are not yet routinely applied to the study of AOS, we highlight the need for focusing on the functional impact of localized lesions throughout the speech network, as well as larger scale comparative studies to distinguish the unique behavioral and neurological signature of AOS. By coupling these methods with neural network models, we have a powerful set of tools to improve our understanding of the neural mechanisms that underlie AOS, and speech production generally.

Consensus paper: Language and the cerebellum: an ongoing enigma

In less than three decades, the concept "cerebellar neurocognition" has evolved from a mere afterthought to an entirely new and multifaceted area of neuroscientific research. A close interplay between three main strands of contemporary neuroscience induced a substantial modification of the traditional view of the cerebellum as a mere coordinator of autonomic and somatic motor functions. Indeed, the wealth of current evidence derived from detailed neuroanatomical investigations, functional neuroimaging studies with healthy subjects and patients and in-depth neuropsychological assessment of patients with cerebellar disorders shows that the cerebellum has a cardinal role to play in affective regulation, cognitive processing, and linguistic function. Although considerable progress has been made in models of cerebellar function, controversy remains regarding the exact role of the "linguistic cerebellum" in a broad variety of nonmotor language processes. This consensus paper brings together a range of different viewpoints and opinions regarding the contribution of the cerebellum to language function. Recent developments and insights in the nonmotor modulatory role of the cerebellum in language and some related disorders will be discussed. The role of the cerebellum in speech and language perception, in motor speech planning including apraxia of speech, in verbal working memory, in phonological and semantic verbal fluency, in syntax processing, in the dynamics of language production, in reading and in writing will be addressed. In addition, the functional topography of the linguistic cerebellum and the contribution of the deep nuclei to linguistic function will be briefly discussed. As such, a framework for debate and discussion will be offered in this consensus paper.

Brain mechanisms of acoustic communication in humans and nonhuman primates: An evolutionary perspective

Any account of “what is special about the human brain” (Passingham 2008) must specify the neural basis of our unique ability to produce speech and delineate how these remarkable motor capabilities could have emerged in our hominin ancestors. Clinical data suggest that the basal ganglia provide a platform for the integration of primate-general mechanisms of acoustic communication with the faculty of articulate speech in humans. Furthermore, neurobiological and paleoanthropological data point at a two-stage model of the phylogenetic evolution of this crucial prerequisite of spoken language: (i) monosynaptic refinement of the projections of motor cortex to the brainstem nuclei that steer laryngeal muscles, presumably, as part of a “phylogenetic trend” associated with increasing brain size during hominin evolution; (ii) subsequent vocal-laryngeal elaboration of cortico-basal ganglia circuitries, driven by human-specificFOXP2mutations.;>This concept implies vocal continuity of spoken language evolution at the motor level, elucidating the deep entrenchment of articulate speech into a “nonverbal matrix” (Ingold 1994), which is not accounted for by gestural-origin theories. Moreover, it provides a solution to the question for the adaptive value of the “first word” (Bickerton 2009) since even the earliest and most simple verbal utterances must have increased the versatility of vocal displays afforded by the preceding elaboration of monosynaptic corticobulbar tracts, giving rise to enhanced social cooperation and prestige. At the ontogenetic level, the proposed model assumes age-dependent interactions between the basal ganglia and their cortical targets, similar to vocal learning in some songbirds. In this view, the emergence of articulate speech builds on the “renaissance” of an ancient organizational principle and, hence, may represent an example of “evolutionary tinkering” (Jacob 1977).

You don't say: dynamic aphasia, another variant of primary progressive aphasia?

Primary progressive aphasia (PPA) is a language predominant neurodegenerative disorder that has three recognized variants: nonfluent/agrammatic, semantic, and logopenic. This report describes a 60-year-old man who presented with a progressive decline in verbal output that does not fit the currently accepted PPA subtypes. The patient exhibited a paucity of verbal output and impaired phonemic fluency with minimal associated language, cognitive, or behavioral deficits. Focal cortical thinning/hypometabolism of the left superior frontal region and a cerebrospinal fluid profile not consistent with Alzheimer's disease pathology were identified. This case of isolated progressive dynamic aphasia extends the current boundaries of PPA diagnostic variants.

Distinguishable neurofunctional effects of task practice and item practice in picture naming: a BOLD fMRI study in healthy subjects

Practice of language tasks results in improved performance and BOLD signal changes. We distinguish changes correlated with repeated exposure to a picture naming task, from changes associated with naming specific items trained during practice. Task practice affected trained and untrained items, yielding left-sided BOLD deactivations in extrastriate, prefrontal and superior temporal areas (consistent with their putative role in perceptual priming, articulatory planning and phonological lexical retrieval, respectively). Item practice effects were restricted to trained words. There was deactivation in left posterior fusiform (supporting its role in accessing structural object representations), anterior cingulate and left insular/inferior frontal cortices (consistent with their role in processing low-frequency words). Central precuneus and posterior cingulate were hyperactivated (consistent with their putative role in episodic memory for trained items, probably due to functional connections with language areas). In healthy subjects, naming practice modifies stored linguistic representations, but mostly affects ease of access to trained words.

Neurophonetics

Neurophonetics aims at the elucidation of the brain mechanisms underlying speech communication in our species. Clinical observations in patients with speech impairments following cerebral disorders provided the initial vantage point of this research area and indicated distinct functional-neuroanatomic systems to support human speaking and listening. Subsequent approaches-considering speech production a motor skill-investigated vocal tract movements associated with spoken language by means of kinematic and electromyographic techniques-allowing, among other things, for the evaluation of computational models suggesting elementary phonological gestures or a mental syllabary as basic units of speech motor control. As concerns speech perception, the working characteristics of auditory processing were first investigated based upon psychoacoustic techniques such as dichotic listening and categorical perception designs. More recently, functional hemodynamic neuroimaging and electrophysiological methods opened the door to the delineation of multiple stages of central auditory processing related to signal detection, classification, sensory memory processes, and, finally, lexical access. Beyond the control mechanisms in a stricter sense, both speech articulation and auditory processing represent examples of 'grounded cognition'. For example, both domains cannot be restricted to text-to-speech translation processes, but are intimately interwoven with neuropsychological aspects of speech prosody, including the vocal expression of affects and the actual performance of speech acts, transforming propositional messages to 'real' utterances. Furthermore, during language acquisition, the periphery of language-i.e., hearing and speaking behavior-plays a dominant role for the construction of a language-specific mental lexicon as well as language-specific action plans for the production of a speech message. WIREs Cogn Sci 2013, 4:191-200. doi: 10.1002/wcs.1211 For further resources related to this article, please visit the WIREs website.

Patterns of impairments in AOS and mechanisms of interaction between phonological and phonetic encoding

PURPOSE

One reason why the diagnosis of apraxia of speech (AOS) and its underlying impairment are often debated may lie in the fact that most patients do not display pure patterns of AOS. Mixed patterns are clearly acknowledged at other levels of impairment (e.g., lexical-semantic and lexical-phonological), and they have contributed to debate about the degree of interaction between encoding levels; by contrast, mixed impairments and mechanisms of interaction are less acknowledged at the levels of phonological and phonetic processes. Here, the author aims at bringing together empirical evidence in favor of an interaction between phonological and phonetic encoding and of the predominance of mixed patterns of impairment over pure phonetic impairment.

METHOD

The author reviews empirical results from acoustic and psycholinguistic studies, both with healthy speakers and speakers with brain damage, favoring independent phonological and phonetic encoding and separable impairments as well as recent research pointing to an interaction between phonological and phonetic encoding processes and overlapping patterns of impairments.

CONCLUSIONS

Acknowledging interaction between phonological and phonetic processing has clear consequences on the definition of patterns of impairment. In particular, phonetic errors have not necessarily a phonetic origin, and most patterns of impairment are bound to display both phonological and phonetic features.

Apraxia of speech and phonological errors in the diagnosis of nonfluent/agrammatic and logopenic variants of primary progressive aphasia

PURPOSE

The International Consensus Criteria for the diagnosis of primary progressive aphasia (PPA; Gorno-Tempini et al., 2011) propose apraxia of speech (AOS) as 1 of 2 core features of nonfluent/agrammatic PPA and propose phonological errors or absence of motor speech disorder as features of logopenic PPA. We investigated the sensitivity and specificity of AOS and phonological errors as markers for these variants and also investigated the relationship between AOS, phonological errors, and findings on C-labeled Pittsburgh Compound B (PiB)-positron emission tomography (PET) imaging associated with putative Alzheimer-type pathology.

METHOD

Connected speech and word repetition in 23 people with PPA who underwent PiB-PET imaging were rated for apraxic versus phonological disruption by 1 rater who was blind to diagnosis and by 2 raters who were blind to PiB-PET results.

RESULTS

Apraxic characteristics had high sensitivity for nonfluent/agrammatic PPA, and phonological errors had high sensitivity for logopenic PPA; however, phonological errors showed lower specificity for logopenic PPA. On PiB imaging, 8 of 9 people with predominant AOS returned negative results, whereas participants with no or questionable AOS with and without phonological errors returned positive results.

CONCLUSIONS

Attention to AOS and phonological errors may help counter some of the inherent limitations of diagnosis-by-exclusion in the current International Consensus Criteria for diagnosing PPA.

The hypothesis of apraxia of speech in children with autism spectrum disorder

In a sample of 46 children aged 4-7 years with Autism Spectrum Disorder (ASD) and intelligible speech, there was no statistical support for the hypothesis of concomitant Childhood Apraxia of Speech (CAS). Perceptual and acoustic measures of participants' speech, prosody, and voice were compared with data from 40 typically-developing children, 13 preschool children with Speech Delay, and 15 participants aged 5-49 years with CAS in neurogenetic disorders. Speech Delay and Speech Errors, respectively, were modestly and substantially more prevalent in participants with ASD than reported population estimates. Double dissociations in speech, prosody, and voice impairments in ASD were interpreted as consistent with a speech attunement framework, rather than with the motor speech impairments that define CAS.

The contribution of mesiofrontal cortex to the preparation and execution of repetitive syllable productions: an fMRI study

Clinical data indicate that the brain network of speech motor control can be subdivided into at least three functional-neuroanatomical subsystems: (i) planning of movement sequences (premotor ventrolateral-frontal cortex and/or anterior insula), (ii) preparedness for/initiation of upcoming verbal utterances (supplementary motor area, SMA), and (iii) on-line innervation of vocal tract muscles, i.e., motor execution (corticobulbar system, basal ganglia, cerebellum). Using an event-related design, this functional magnetic resonance imaging (fMRI) study sought to further delineate the contribution of SMA to pre-articulatory processes of speech production (preceding the innervation of vocal tract muscles) during an acoustically paced syllable repetition task forewarned by a tone signal. Hemodynamic activation across the whole brain and the time courses of the responses in five regions of interest (ROIs) were computed. First, motor preparation was associated with a widespread bilateral activation pattern, encompassing brainstem structures, SMA, insula, premotor ventrolateral-frontal areas, primary sensorimotor cortex (SMC), basal ganglia, and the superior cerebellum. Second, calculation of the time courses of BOLD ("blood oxygenation level-dependent") signal changes revealed the warning stimulus to elicit synchronous onset of hemodynamic activation in these areas. However, during 4-s intervals of syllable repetitions SMA and cerebellum showed opposite temporal activation patterns in terms of a shorter (SMA) and longer (cerebellum) latency of the entire BOLD response-as compared to SMC, indicating different pacing mechanisms during the initial and the ongoing phase of the task. Nevertheless, the contribution of SMA was not exclusively restricted to the preparation/initiation of verbal responses since the extension of mesiofrontal activation varied with task duration.

The influence of syllable onset complexity and syllable frequency on speech motor control

Functional imaging studies have delineated a "minimal network for overt speech production", encompassing mesiofrontal structures (supplementary motor area, anterior cingulate gyrus), bilateral pre- and postcentral convolutions, extending rostrally into posterior parts of the inferior frontal gyrus (IFG) of the language-dominant hemisphere, left anterior insula as well as bilateral components of the basal ganglia, the cerebellum, and the thalamus. In order to further elucidate the specific contribution of these cerebral regions to speech motor planning, subjects were asked to read aloud visually presented bisyllabic pseudowords during functional magnetic resonance imaging (fMRI). The test stimuli systematically varied in onset complexity (CCV versus CV) and frequency of occurrence (high-frequency, HF versus low-frequency, LF) of the initial syllable. A cognitive subtraction approach revealed a significant main effect of syllable onset complexity (CCV versus CV) at the level of left posterior IFG, left anterior insula, and both cerebellar hemispheres. Conceivably, these areas closely cooperate in the sequencing of subsyllabic aspects of the sound structure of verbal utterances. A significant main effect of syllable frequency (LF versus HF), by contrast, did not emerge. However, calculation of the time series of hemodynamic activation within the various cerebral structures engaged in speech motor control revealed this factor to enhance functional connectivity between Broca's area and ipsilateral anterior insula.

Cerebellar contributions to speech production and speech perception: psycholinguistic and neurobiological perspectives

Articulate speech represents a unique trait of our species. Besides other structures, the cerebellum pertains to the brain network engaged in spoken language production. Data from different sources point at a dual role of this organ within the verbal domain: (i) the cerebellum appears to subserve the online sequencing of syllables into fast, smooth and rhythmically organized larger utterances, and (ii) furthermore, the cerebellum seems to participate in the temporal organization of internal speech, that is, a prearticulatory verbal code. Impaired prearticulatory verbal coding mechanisms could explain at least some of the perceptual and cognitive deficits observed in cerebellar disorders. Recent genetic studies indicate that distinct mutations of a specific regulatory gene (FOXP2) promoted the emergence of articulate speech during the course of hominid evolution. Conceivably, structural changes of the expressed FOXP2 protein supported the 'vocal elaboration' of phylogenetically older brain networks engaged in upper limb motor control, such as the cerebro-cerebellar loops.