Speech and song: the role of the cerebellum

The Cerebellum in Musicology: a Narrative Review

The cerebellum is involved in cognitive procressing including music perception and music production. This narrative review aims to summarize the current knowledge on the activation of the cerebellum by different musical stimuli, on the involvement of the cerebellum in cognitive loops underlying the analysis of music, and on the role of the cerebellum in the motor network underlying music production. A possible role of the cerebellum in therapeutic settings is also briefly discussed. In a second part, the cerebellum as object of musicology (i.e., in classical music, in contemporary music, cerebellar disorders of musicians) is described.

Differential effects of ageing on the neural processing of speech and singing production

Background

Understanding healthy brain ageing has become vital as populations are ageing rapidly and age-related brain diseases are becoming more common. In normal brain ageing, speech processing undergoes functional reorganisation involving reductions of hemispheric asymmetry and overactivation in the prefrontal regions. However, little is known about how these changes generalise to other vocal production, such as singing, and how they are affected by associated cognitive demands.

Methods

The present cross-sectional fMRI study systematically maps the neural correlates of vocal production across adulthood (N=100, age 21-88 years) using a balanced 2x3 design where tasks varied in modality (speech: proverbs / singing: song phrases) and cognitive demand (repetition / completion from memory / improvisation).

Results

In speech production, ageing was associated with decreased left pre- and postcentral activation across tasks and increased bilateral angular and right inferior temporal and fusiform activation in the improvisation task. In singing production, ageing was associated with increased activation in medial and bilateral prefrontal and parietal regions in the completion task, whereas other tasks showed no ageing effects. Direct comparisons between the modalities showed larger age-related activation changes in speech than singing across tasks, including a larger left-to-right shift in lateral prefrontal regions in the improvisation task.

Conclusion

The present results suggest that the brains' singing network undergoes differential functional reorganisation in normal ageing compared to the speech network, particularly during a task with high executive demand. These findings are relevant for understanding the effects of ageing on vocal production as well as how singing can support communication in healthy ageing and neurological rehabilitation.

Translation into Brazilian Portuguese and transcultural adaptation of the Apraxia of Speech Rating Scale 3.5

PURPOSE

To present the translation into Brazilian Portuguese and cross-cultural adaptation of the Apraxia of Speech Rating Scale (ASRS) version 3.5.

METHODS

Validation study restricted to translation and cross-cultural adaptation. The following steps were carried out: translation and synthesis of translations; verification of applicability of the scale synthesis by judges recruited for this purpose; analysis of the relevance and feasibility of the scale calculated by the Content Validity Index (CVI), individual (CVI-I) and total (CVI-T). Eighteen speech therapists were selected. Their answers were used for the analysis of agreement (intraclass correlation coefficients - ICC) and for the calculation of the Content Validity Index (CVI). Finally, the synthesis of the translation was matched in terms of semantic, idiomatic, experiential, conceptual, syntactic, grammatical, and operational equivalence.

RESULTS

The ICC ranged between 0.83 and 0.94. Six items obtained values higher than 0.9. The other items presented values between 0.8 and 0.9. The CVI-I and CVI-T had excellent values (CVI ≥ 0.78) for relevance and feasibility.

CONCLUSION

The Brazilian version of the ASRS 3.5 presents semantic, idiomatic, experiential, conceptual, and syntactic/grammatical equivalence to the original document. Thus, it is ready for the next validation steps.

Singing training predicts increased insula connectivity with speech and respiratory sensorimotor areas at rest

The insula contributes to the detection of salient events during goal-directed behavior and participates in the coordination of motor, multisensory, and cognitive systems. Recent task-fMRI studies with trained singers suggest that singing experience can enhance the access to these resources. However, the long-term effects of vocal training on insula-based networks are still unknown. In this study, we employed resting-state fMRI to assess experience-dependent differences in insula co-activation patterns between conservatory-trained singers and non-singers. Results indicate enhanced bilateral anterior insula connectivity in singers relative to non-singers with constituents of the speech sensorimotor network. Specifically, with the cerebellum (lobule V-VI) and the superior parietal lobes. The reversed comparison showed no effects. The amount of accumulated singing training predicted enhanced bilateral insula co-activation with primary sensorimotor areas representing the diaphragm and the larynx/phonation area-crucial regions for cortico-motor control of complex vocalizations-as well as the bilateral thalamus and the left putamen. Together, these findings highlight the neuroplastic effect of expert singing training on insula-based networks, as evidenced by the association between enhanced insula co-activation profiles in singers and the brain's speech motor system components.

Singing and Speaking Ability in Parkinson's Disease and Spinocerebellar Ataxia

PURPOSE

This study examined spontaneous, spoken-to-a-model, and two sung modes in speakers with Parkinson's disease (PD), speakers with cerebellar disease (CD), and healthy controls. Vocal performance was measured by intelligibility scores and listeners' perceptual ratings.

METHOD

Participants included speakers with hypokinetic dysarthria secondary to PD, those with ataxic dysarthria secondary to CD, and healthy speakers. Participants produced utterances in four vocal modes: spontaneous speech, spoken-to-a-model, sung-to-a-model, and spontaneous singing. For spoken-to-a-model and sung-to-a-model modes, written material was provided the model. For spontaneous singing, participants sang songs that they endorsed as familiar.

DEPENDENT VARIABLES

In Experiment I, listeners orthographically transcribed the audio samples of the first three vocal modes. In Experiment IIa, raters evaluated the accuracy of the pitch and rhythm of the spontaneous singing of familiar songs. Finally, familiar songs and sung-to-a-model utterances were rated on a competency scale by a second group of raters (Experiment IIb).

RESULTS

Results showed increases in intelligibility during the spoken-to-a-model mode compared with the spontaneous mode in both PD and CD groups. Singing enhanced the vocal output of speakers with PD more than in speakers with CD, as measured by percent intelligibility. PD participants' pitch and rhythm accuracy and competency in singing familiar songs was rated more favorably than those produced by CD participants.

CONCLUSIONS

The findings reveal a vocal task effect for spoken utterances in both groups. Sung exemplars, more impaired in CD, suggest a significant involvement of the cerebellum in singing.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809544.

Reading-related Brain Function Restored to Normal After Articulation Training in Patients with Cleft Lip and Palate: An fMRI Study

Cleft lip and/or palate (CLP) are the most common craniofacial malformations in humans. Speech problems often persist even after cleft repair, such that follow-up articulation training is usually required. However, the neural mechanism behind effective articulation training remains largely unknown. We used fMRI to investigate the differences in brain activation, functional connectivity, and effective connectivity across CLP patients with and without articulation training and matched normal participants. We found that training promoted task-related brain activation among the articulation-related brain networks, as well as the global attributes and nodal efficiency in the functional-connectivity-based graph of the network. Our results reveal the neural correlates of effective articulation training in CLP patients, and this could contribute to the future improvement of the post-repair articulation training program.

Musical abilities in children with developmental cerebellar anomalies

Developmental Cerebellar Anomalies (DCA) are rare diseases (e.g., Joubert syndrome) that affect various motor and non-motor functions during childhood. The present study examined whether music perception and production are affected in children with DCA. Sixteen children with DCA and 37 healthy matched control children were tested with the Montreal Battery for Evaluation of Musical Abilities (MBEMA) to assess musical perception. Musical production was assessed using two singing tasks: a pitch-matching task and a melodic reproduction task. Mixed model analyses showed that children with DCA were impaired on the MBEMA rhythm perception subtest, whereas there was no difference between the two groups on the melodic perception subtest. Children with DCA were also impaired in the melodic reproduction task. In both groups, singing performance was positively correlated with rhythmic and melodic perception scores, and a strong correlation was found between singing ability and oro-bucco-facial praxis in children with DCA. Overall, children with DCA showed impairments in both music perception and production, although heterogeneity in cerebellar patient’s profiles was highlighted by individual analyses. These results confirm the role of the cerebellum in rhythm processing as well as in the vocal sensorimotor loop in a developmental perspective. Rhythmic deficits in cerebellar patients are discussed in light of recent work on predictive timing networks including the cerebellum. Our results open innovative remediation perspectives aiming at improving perceptual and/or production musical abilities while considering the heterogeneity of patients’ clinical profiles to design music-based therapies.

Right cerebral motor areas that support accurate speech production following damage to cerebellar speech areas

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Participants with damage to cerebellar speech regions were studied with fMRI.

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At the time of test, their speech production was accurate and precise.

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Their speech production activation was enhanced in right hemisphere motor regions.

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We provide hypotheses for targeting future fMRI and brain stimulation studies.

Specific regions of the cerebellum are activated when neurologically intact adults speak, and cerebellar damage can impair speech production early after stroke, but how the brain supports accurate speech production years after cerebellar damage remains unknown. We investigated this in patients with cerebellar lesions affecting regions that are normally recruited during speech production. Functional MRI activation in these patients, measured during various single word production tasks, was compared to that of neurologically intact controls, and patient controls with lesions that spared the cerebellar speech production regions. Our analyses revealed that, during a range of speech production tasks, patients with damage to cerebellar speech production regions had greater activation in the right dorsal premotor cortex (r-PMd) and right supplementary motor area (r-SMA) compared to neurologically intact controls.

The loci of increased activation in cerebral motor speech areas motivate future studies to delineate the functional contributions of different parts of the speech production network, and test whether non-invasive stimulation to r-PMd and r-SMA facilitates speech recovery after cerebellar stroke.

Temporo-cerebellar connectivity underlies timing constraints in audition

The flexible and efficient adaptation to dynamic, rapid changes in the auditory environment likely involves generating and updating of internal models. Such models arguably exploit connections between the neocortex and the cerebellum, supporting proactive adaptation. Here, we tested whether temporo-cerebellar disconnection is associated with the processing of sound at short timescales. First, we identify lesion-specific deficits for the encoding of short timescale spectro-temporal non-speech and speech properties in patients with left posterior temporal cortex stroke. Second, using lesion-guided probabilistic tractography in healthy participants, we revealed bidirectional temporo-cerebellar connectivity with cerebellar dentate nuclei and crura I/II. These findings support the view that the encoding and modeling of rapidly modulated auditory spectro-temporal properties can rely on a temporo-cerebellar interface. We discuss these findings in view of the conjecture that proactive adaptation to a dynamic environment via internal models is a generalizable principle.

Neural mechanisms of foreign accent syndrome: Lesion and network analysis

BACKGROUND

Foreign accent syndrome (FAS) is a rare acquired speech disorder wherein an individual's spoken accent is perceived as "foreign." Most reported cases involve left frontal brain lesions, but it is known that various other lesions can also cause FAS. To determine whether heterogeneous FAS-causing lesions are localized to a common functional speech network rather than to a single anatomical site, we employed a recently validated image analysis technique known as "lesion network mapping."

METHODS

We identified 25 published cases of acquired neurogenic FAS without aphasia, and mapped each lesion volume onto a reference brain. We next identified the network of brain regions functionally connected to each FAS lesion using a connectome dataset from normative participants. Network maps were then overlapped to identify common network sites across the lesions.

RESULTS

Classical lesion overlap analysis showed heterogeneity in lesion anatomical location, consistent with prior reports. However, at least 80% of lesions showed network overlap in the bilateral lower and middle portions of the precentral gyrus and in the medial frontal cortex. The left lower portion of the precentral gyrus is suggested to be the location of lesions causing apraxia of speech (AOS), and the middle portion is considered to be a larynx-specific motor area associated with the production of vowels and stop/nasal consonants and with the determination of pitch accent.

CONCLUSIONS

The lesions that cause FAS are anatomically heterogeneous, but they share a common functional network located in the bilateral posterior region of the frontal lobe. This network specifically includes not only the lower portion of the central gyrus, but also its middle region, which is referred to as the larynx motor cortex and is known to be associated with phonation. Our findings suggest that disrupted networks in FAS might be anatomically different from those in AOS.

Speech Perception under the Tent: A Domain-general Predictive Role for the Cerebellum

The role of the cerebellum in speech perception remains a mystery. Given its uniform architecture, we tested the hypothesis that it implements a domain-general predictive mechanism whose role in speech is determined by connectivity. We collated all neuroimaging studies reporting cerebellar activity in the Neurosynth database (n = 8206). From this set, we found all studies involving passive speech and sound perception (n = 72, 64% speech, 12.5% sounds, 12.5% music, and 11% tones) and speech production and articulation (n = 175). Standard and coactivation neuroimaging meta-analyses were used to compare cerebellar and associated cortical activations between passive perception and production. We found distinct regions of perception- and production-related activity in the cerebellum and regions of perception-production overlap. Each of these regions had distinct patterns of cortico-cerebellar connectivity. To test for domain-generality versus specificity, we identified all psychological and task-related terms in the Neurosynth database that predicted activity in cerebellar regions associated with passive perception and production. Regions in the cerebellum activated by speech perception were associated with domain-general terms related to prediction. One hallmark of predictive processing is metabolic savings (i.e., decreases in neural activity when events are predicted). To test the hypothesis that the cerebellum plays a predictive role in speech perception, we examined cortical activation between studies reporting cerebellar activation and those without cerebellar activation during speech perception. When the cerebellum was active during speech perception, there was far less cortical activation than when it was inactive. The results suggest that the cerebellum implements a domain-general mechanism related to prediction during speech perception.

Dissociable Auditory Cortico-Cerebellar Pathways in the Human Brain Estimated by Intrinsic Functional Connectivity

The cerebellum, a structure historically associated with motor control, has more recently been implicated in several higher-order auditory-cognitive functions. However, the exact functional pathways that mediate cerebellar influences on auditory cortex (AC) remain unclear. Here, we sought to identify auditory cortico-cerebellar pathways based on intrinsic functional connectivity magnetic resonance imaging. In contrast to previous connectivity studies that principally consider the AC as a single functionally homogenous unit, we mapped the cerebellar connectivity across different parts of the AC. Our results reveal that auditory subareas demonstrating different levels of interindividual functional variability are functionally coupled with distinct cerebellar regions. Moreover, auditory and sensorimotor areas show divergent cortico-cerebellar connectivity patterns, although sensorimotor areas proximal to the AC are often functionally grouped with the AC in previous connectivity-based network analyses. Lastly, we found that the AC can be functionally segmented into highly similar subareas based on either cortico-cerebellar or cortico-cortical functional connectivity, suggesting the existence of multiple parallel auditory cortico-cerebellar circuits that involve different subareas of the AC. Overall, the present study revealed multiple auditory cortico-cerebellar pathways and provided a fine-grained map of AC subareas, indicative of the critical role of the cerebellum in auditory processing and multisensory integration.

Sensory contribution to vocal emotion deficit in patients with cerebellar stroke

In recent years, there has been increasing evidence of cerebellar involvement in emotion processing. Difficulties in the recognition of emotion from voices (i.e., emotional prosody) have been observed following cerebellar stroke. However, the interplay between sensory and higher-order cognitive dysfunction in these deficits, as well as possible hemispheric specialization for emotional prosody processing, has yet to be elucidated. We investigated the emotional prosody recognition performances of patients with right versus left cerebellar lesions, as well as of matched controls, entering the acoustic features of the stimuli in our statistical model. We also explored the cerebellar lesion-behavior relationship, using voxel-based lesion-symptom mapping. Results revealed impairment of vocal emotion recognition in both patient subgroups, particularly for neutral or negative prosody, with a higher number of misattributions in patients with right-hemispheric stroke. Voxel-based lesion-symptom mapping showed that some emotional misattributions correlated with lesions in the right Lobules VIIb and VIII and right Crus I and II. Furthermore, a significant proportion of the variance in this misattribution was explained by acoustic features such as pitch, loudness, and spectral aspects. These results point to bilateral posterior cerebellar involvement in both the sensory and cognitive processing of emotions.

The internal time keeper: Causal evidence for the role of the cerebellum in anticipating regular acoustic events

Most acoustic events in our environment do not appear randomly but are rather predictable due to the temporal regularity in that they occur. Besides sensory-related cortical areas, the cerebellum has been suggested as a key structure in temporal processing and in the anticipation of future events. Hence, patients with cerebellum lesions show impaired precision in temporal processing as reflected in the reduced ability to exploit temporal regularity. Using transcranial direct current stimulation (tDCS), we here aimed to draw further causal conclusions on the human cerebellum as functionally relevant in temporal processing of acoustic events. We focused on the electrophysiologic P3b, a large positive wave apparent in the electroencephalography (EEG), that represents encoding of task-relevant events and that has been demonstrated as sensitive to the exploitation of temporal regularities. Participants received 30 min of anodal, cathodal or sham tDCS over the cerebellum while they performed two oddball paradigms with different temporal regularities in that the acoustic stimuli were presented. Following clinical observations, we hypothesized that tDCS-effects will be present in the regular oddball paradigm only, thus, in the condition that allows anticipating the occurrence of subsequent stimuli. In result, we found that cathodal tDCS over the cerebellum reduced the P3b-amplitude specifically in response to target stimuli in the regular paradigm. Thereby, tDCS-induced changes mirror the effects of cerebellar lesions in clinical samples. Our data provides direct evidence for a causal link between the human cerebellum and auditory processing of temporal regularity and emphasize future work on a potential benefit of cerebellar-tDCS in clinical samples.

Dynamic Language Network in Early and Late Cantonese-Mandarin Bilinguals

The brain representation of language in bilinguals is sculptured by several factors, such as age of acquisition (AoA) and proficiency level (PL) in second language. Although the effect of AoA-L2 on brain function and structure has been studied, little attention is devoted to dynamic properties of the language network and their differences between early and late bilinguals. In this study, we acquired resting-state fMRI data from early and late Cantonese (L1)–Mandarin (L2) bilinguals with high PLs of verbal fluency in both languages. We then analyzed dynamic functional connectivity (dFC) by using the sliding-windows approach, estimated the dFC states by using the k-means clustering algorithm, and calculated the dynamic topological properties of the language network for the early and late bilinguals. We detected four dFC states, State 1, State 2, State 3, and State 4, which may be related to phonetic processing, semantic processing, language control, and syntactic processing, respectively. Compared to the late bilinguals, the early bilinguals showed higher dFC between the inferior frontal area and the temporal area in State 1 and State 2, while higher dFC between the cerebellum and other regions in State 3. The early bilinguals showed a higher clustering coefficient and local and global efficiency in State 1 and State 3, but lower characteristic path length in State 1, than the late bilinguals. Together, these results suggested that AoA-L2 affects temporal neural activation and dynamic topological properties of the language network. These findings provide new information to understand the effect of experience of L2 acquisition on language network in bilinguals.

Whole-body somatotopic maps in the cerebellum revealed with 7T fMRI

The cerebellum is known to contain a double somatotopic body representation. While the anterior lobe body map has shown a robust somatotopic organization in previous fMRI studies, the representations in the posterior lobe have been more difficult to observe and are less precisely characterized. In this study, participants went through a simple motor task asking them to move either the eyes (left-right guided saccades), tongue (left-right movement), thumbs, little fingers or toes (flexion). Using high spatial resolution fMRI data acquired at ultra-high field (7T), with special care taken to obtain sufficient B₁ over the entire cerebellum and a cerebellar surface reconstruction facilitating visual inspection of the results, we were able to precisely map the somatotopic representations of these five distal body parts on both subject- and group-specific cerebellar surfaces. The anterior lobe (including lobule VI) showed a consistent and robust somatotopic gradient. Although less robust, the presence of such a gradient in the posterior lobe, from Crus II to lobule VIIIb, was also observed. Additionally, the eyes were also strongly represented in Crus I and the oculomotor vermis. Overall, crosstalk between the different body part representations was negligible. Taken together, these results show that multiple representations of distal body parts are present in the cerebellum, across many lobules, and they are organized in an orderly manner.

Neural architectures of music - Insights from acquired amusia

The ability to perceive and produce music is a quintessential element of human life, present in all known cultures. Modern functional neuroimaging has revealed that music listening activates a large-scale bilateral network of cortical and subcortical regions in the healthy brain. Even the most accurate structural studies do not reveal which brain areas are critical and causally linked to music processing. Such questions may be answered by analysing the effects of focal brain lesions in patients´ ability to perceive music. In this sense, acquired amusia after stroke provides a unique opportunity to investigate the neural architectures crucial for normal music processing. Based on the first large-scale longitudinal studies on stroke-induced amusia using modern multi-modal magnetic resonance imaging (MRI) techniques, such as advanced lesion-symptom mapping, grey and white matter morphometry, tractography and functional connectivity, we discuss neural structures critical for music processing, consider music processing in light of the dual-stream model in the right hemisphere, and propose a neural model for acquired amusia.

Human GNPTAB stuttering mutations engineered into mice cause vocalization deficits and astrocyte pathology in the corpus callosum

Stuttering is a common neurodevelopmental disorder that has been associated with mutations in genes involved in intracellular trafficking. However, the cellular mechanisms leading to stuttering remain unknown. Engineering a mutation in N-acetylglucosamine-1-phosphate transferase subunits α and β (GNPTAB) found in humans who stutter into the mouse Gnptab gene resulted in deficits in the flow of ultrasonic vocalizations similar to speech deficits of humans who stutter. Here we show that other human stuttering mutations introduced into this mouse gene, Gnptab Ser321Gly and Ala455Ser, produce the same vocalization deficit in 8-day-old pup isolation calls and do not affect other nonvocal behaviors. Immunohistochemistry showed a marked decrease in staining of astrocytes, particularly in the corpus callosum of the Gnptab Ser321Gly homozygote mice compared to wild-type littermates, while the staining of cerebellar Purkinje cells, oligodendrocytes, microglial cells, and dopaminergic neurons was not significantly different. Diffusion tensor imaging also detected deficits in the corpus callosum of the Gnptab Ser321Gly mice. Using a range of cell type-specific Cre-drivers and a Gnptab conditional knockout line, we found that only astrocyte-specific Gnptab-deficient mice displayed a similar vocalization deficit. These data suggest that vocalization defects in mice carrying human stuttering mutations in Gnptab derive from abnormalities in astrocytes, particularly in the corpus callosum, and provide support for hypotheses that focus on deficits in interhemispheric communication in stuttering.

Cerebellar contribution to vocal emotion decoding: Insights from stroke and neuroimaging

While the role of the cerebellum in emotion recognition has been explored with facial expressions, its involvement in the auditory modality (i.e., emotional prosody) remains to be demonstrated. The present study investigated the recognition of emotional prosody in 15 patients with chronic cerebellar ischaemic stroke and 15 matched healthy controls, using a validated task, as well as clinical, motor, neuropsychological, and psychiatric assessments. We explored the cerebellar lesion-behaviour relationship using voxel-based lesion-symptom mapping. Results showed a significant difference between the stroke and healthy control groups, with patients giving erroneous ratings on the Surprise scale when they listened to fearful stimuli. Moreover, voxel-based lesion-symptom mapping revealed that these emotional misattributions correlated with lesions in right Lobules VIIb, VIIIa,b and IX. Interestingly, the posterior cerebellum has previously been found to be involved in affective processing, and Lobule VIIb in rhythm discrimination. These results point to the cerebellum's functional involvement in vocal emotion decoding.

Consequences of multilingualism for neural architecture

Language has the power to shape cognition, behavior, and even the form and function of the brain. Technological and scientific developments have recently yielded an increasingly diverse set of tools with which to study the way language changes neural structures and processes. Here, we review research investigating the consequences of multilingualism as revealed by brain imaging. A key feature of multilingual cognition is that two or more languages can become activated at the same time, requiring mechanisms to control interference. Consequently, extensive experience managing multiple languages can influence cognitive processes as well as their neural correlates. We begin with a brief discussion of how bilinguals activate language, and of the brain regions implicated in resolving language conflict. We then review evidence for the pervasive impact of bilingual experience on the function and structure of neural networks that support linguistic and non-linguistic cognitive control, speech processing and production, and language learning. We conclude that even seemingly distinct effects of language on cognitive operations likely arise from interdependent functions, and that future work directly exploring the interactions between multiple levels of processing could offer a more comprehensive view of how language molds the mind.

"Being a bully isn't very cool…": Rap & Sing Music Therapy for enhanced emotional self-regulation in an adolescent school setting - a randomized controlled trial

Music as an effective self-regulative tool for emotions and behavioural adaptation for adolescents might enhance emotion-related skills when applied as a therapeutic school intervention. This study investigated Rap & Sing Music Therapy in a school-based programme, to support self-regulative abilities for well-being. One-hundred-and-ninety adolescents in grade 8 of a public school in the Netherlands were randomly assigned to an experimental group involving Rap & Sing Music Therapy or a control group. Both interventions were applied to six classes once a week during four months. Measurements at baseline and again after four months provided outcome data of adolescents' psychological well-being, self-description, self-esteem and emotion regulation. Significant differences between groups on the SDQ teacher test indicated a stabilized Rap & Sing Music Therapy group, as opposed to increased problems in the control group (p = .001; η_p ² = .132). Total problem scores of all tests indicated significant improvements in the Rap & Sing Music Therapy group. The RCT results imply overall benefits of Rap & Sing Music Therapy in a school setting. There were improved effects on all measures - as they are in line with school interventions of motivational engagement in behavioural, emotional and social themes - a promising result.

The Contribution of Brainstem and Cerebellar Pathways to Auditory Recognition

The cerebellum has been known to play an important role in motor functions for many years. More recently its role has been expanded to include a range of cognitive and sensory-motor processes, and substantial neuroimaging and clinical evidence now points to cerebellar involvement in most auditory processing tasks. In particular, an increase in the size of the cerebellum over recent human evolution has been attributed in part to the development of speech. Despite this, the auditory cognition literature has largely overlooked afferent auditory connections to the cerebellum that have been implicated in acoustically conditioned reflexes in animals, and could subserve speech and other auditory processing in humans. This review expands our understanding of auditory processing by incorporating cerebellar pathways into the anatomy and functions of the human auditory system. We reason that plasticity in the cerebellar pathways underpins implicit learning of spectrotemporal information necessary for sound and speech recognition. Once learnt, this information automatically recognizes incoming auditory signals and predicts likely subsequent information based on previous experience. Since sound recognition processes involving the brainstem and cerebellum initiate early in auditory processing, learnt information stored in cerebellar memory templates could then support a range of auditory processing functions such as streaming, habituation, the integration of auditory feature information such as pitch, and the recognition of vocal communications.

Contributions of cerebellar event-based temporal processing and preparatory function to speech perception

The role of the cerebellum in the anatomical and functional architecture of the brain is a matter of ongoing debate. We propose that cerebellar temporal processing contributes to speech perception on a number of accounts: temporally precise cerebellar encoding and rapid transmission of an event-based representation of the temporal structure of the speech signal serves to prepare areas in the cerebral cortex for the subsequent perceptual integration of sensory information. As speech dynamically evolves in time this fundamental preparatory function may extend its scope to the predictive allocation of attention in time and supports the fine-tuning of temporally specific models of the environment. In this framework, an oscillatory account considering a range of frequencies may best serve the linking of the temporal and speech processing systems. Lastly, the concerted action of these processes may not only advance predictive adaptation to basic auditory dynamics but optimize the perceptual integration of speech.

The cerebellum, internal models and prediction in 'non-motor' aspects of language: A critical review

The emergence of studies on cerebellar contributions in 'non-motor' aspects of predictive language processing has long been awaited by researchers investigating the neural foundations of language and cognition. Despite (i) progress in research implicating the cerebellum in language processing, (ii) the widely-accepted nature of the uniform, multi-modal computation that the cerebellum implements in the form of internal models, as well as (iii) the long tradition of psycholinguistic studies addressing prediction mechanisms, research directly addressing cerebellar contributions to 'non-motor' predictive language processing has only surfaced in the last five years. This paper provides the first review of this novel field, along with a critical assessment of the studies conducted so far. While encouraging, the evidence for cerebellar involvement in 'non-motor' aspects of predictive language processing remains inconclusive under further scrutiny. Future directions are finally discussed with respect to outstanding questions in this novel field of research.

Effects of Early and Late Bilingualism on Resting-State Functional Connectivity

Of current interest is how variations in early language experience shape patterns of functional connectivity in the human brain. In the present study, we compared simultaneous (two languages from birth) and sequential (second language learned after age 5 years) bilinguals using a seed-based resting-state MRI approach. We focused on the inferior frontal gyrus (IFG) as our ROI, as recent studies have demonstrated both neurofunctional and neurostructural changes related to age of second language acquisition in bilinguals in this cortical area. Stronger functional connectivity was observed for simultaneous bilinguals between the left and right IFG, as well as between the inferior frontal gyrus and brain areas involved in language control, including the dorsolateral prefrontal cortex, inferior parietal lobule, and cerebellum. Functional connectivity between the left IFG and the right IFG and right inferior parietal lobule was also significantly correlated with age of acquisition for sequential bilinguals; the earlier the second language was acquired, the stronger was the functional connectivity. In addition, greater functional connectivity between homologous regions of the inferior frontal gyrus was associated with reduced neural activation in the left IFG during speech production. The increased connectivity at rest and reduced neural activation during task performance suggests enhanced neural efficiency in this important brain area involved in both speech production and domain-general cognitive processing. Together, our findings highlight how the brain's intrinsic functional patterns are influenced by the developmental timeline in which second language acquisition occurs.

SIGNIFICANCE STATEMENT

Of current interest is how early life experience leaves its footprint on brain structure and function. In this regard, bilingualism provides an optimal way to determine the effects of the timing of language learning because a second language can be learned from birth or later in life. We used resting-state fMRI to look at simultaneous and sequential bilinguals who differed only in age of acquisition, and found stronger connectivity between language and cognitive control regions in bilinguals who learned their two languages simultaneously, a pattern that was associated with more efficient brain activation during speech. Our findings highlight how functional connections in the brain differ depending upon when learning takes place.

Internal modeling of upcoming speech: A causal role of the right posterior cerebellum in non-motor aspects of language production

Some language processing theories propose that, just as for other somatic actions, self-monitoring of language production is achieved through internal modeling. The cerebellum is the proposed center of such internal modeling in motor control, and the right cerebellum has been linked to an increasing number of language functions, including predictive processing during comprehension. Relating these findings, we tested whether the right posterior cerebellum has a causal role for self-monitoring of speech errors. Participants received 1 Hz repetitive transcranial magnetic stimulation during 15 min to lobules Crus I and II in the right hemisphere, and, in counterbalanced orders, to the contralateral area in the left cerebellar hemisphere (control) in order to induce a temporary inactivation of one of these zones. Immediately afterwards, they engaged in a speech production task priming the production of speech errors. Language production was impaired after right compared to left hemisphere stimulation, a finding that provides evidence for a causal role of the cerebellum during language production. We interpreted this role in terms of internal modeling of upcoming speech through a verbal working memory process used to prevent errors.

Cerebellar contributions to motor control and language comprehension: searching for common computational principles

The past 25 years have seen the functional domain of the cerebellum extend beyond the realm of motor control, with considerable discussion of how this subcortical structure contributes to cognitive domains including attention, memory, and language. Drawing on evidence from neuroanatomy, physiology, neuropsychology, and computational work, sophisticated models have been developed to describe cerebellar function in sensorimotor control and learning. In contrast, mechanistic accounts of how the cerebellum contributes to cognition have remained elusive. Inspired by the homogeneous cerebellar microanatomy and a desire for parsimony, many researchers have sought to extend mechanistic ideas from motor control to cognition. One influential hypothesis centers on the idea that the cerebellum implements internal models, representations of the context-specific dynamics of an agent's interactions with the environment, enabling predictive control. We briefly review cerebellar anatomy and physiology, to review the internal model hypothesis as applied in the motor domain, before turning to extensions of these ideas in the linguistic domain, focusing on speech perception and semantic processing. While recent findings are consistent with this computational generalization, they also raise challenging questions regarding the nature of cerebellar learning, and may thus inspire revisions of our views on the role of the cerebellum in sensorimotor control.

A TMS investigation on the role of the cerebellum in pitch and timbre discrimination

Background

Growing neuroimaging and clinical evidence suggests that the cerebellum plays a critical role in perception. In the auditory domain, the cerebellum seems to be important in different aspects of music and sound processing. Here we investigated the possible causal role of the cerebellum in two auditory tasks, a pitch discrimination and a timbre discrimination task. Specifically, participants performed a pitch and a timbre discrimination task prior and after receiving offline low frequency transcranical magnetic stimulation (TMS) over their (right) cerebellum.

Results

Suppressing activity in the right cerebellum by means of inhibitory 1 Hz TMS affected participants’ ability to discriminate pitch but not timbre.

Conclusion

These findings point to a causal role of the cerebellum in at least certain aspects of sound processing and are important in a clinical perspective helping understanding the impact of cerebellar lesions on sensory functions.

Right hemisphere grey matter structure and language outcomes in chronic left hemisphere stroke

The neural mechanisms underlying recovery of language after left hemisphere stroke remain elusive. Although older evidence suggested that right hemisphere language homologues compensate for damage in left hemisphere language areas, the current prevailing theory suggests that right hemisphere engagement is ineffective or even maladaptive. Using a novel combination of support vector regression-based lesion-symptom mapping and voxel-based morphometry, we aimed to determine whether local grey matter volume in the right hemisphere independently contributes to aphasia outcomes after chronic left hemisphere stroke. Thirty-two left hemisphere stroke survivors with aphasia underwent language assessment with the Western Aphasia Battery-Revised and tests of other cognitive domains. High-resolution T1-weighted images were obtained in aphasia patients and 30 demographically matched healthy controls. Support vector regression-based multivariate lesion-symptom mapping was used to identify critical language areas in the left hemisphere and then to quantify each stroke survivor's lesion burden in these areas. After controlling for these direct effects of the stroke on language, voxel-based morphometry was then used to determine whether local grey matter volumes in the right hemisphere explained additional variance in language outcomes. In brain areas in which grey matter volumes related to language outcomes, we then compared grey matter volumes in patients and healthy controls to assess post-stroke plasticity. Lesion-symptom mapping showed that specific left hemisphere regions related to different language abilities. After controlling for lesion burden in these areas, lesion size, and demographic factors, grey matter volumes in parts of the right temporoparietal cortex positively related to spontaneous speech, naming, and repetition scores. Examining whether domain general cognitive functions might explain these relationships, partial correlations demonstrated that grey matter volumes in these clusters related to verbal working memory capacity, but not other cognitive functions. Further, grey matter volumes in these areas were greater in stroke survivors than healthy control subjects. To confirm this result, 10 chronic left hemisphere stroke survivors with no history of aphasia were identified. Grey matter volumes in right temporoparietal clusters were greater in stroke survivors with aphasia compared to those without history of aphasia. These findings suggest that the grey matter structure of right hemisphere posterior dorsal stream language homologues independently contributes to language production abilities in chronic left hemisphere stroke, and that these areas may undergo hypertrophy after a stroke causing aphasia.

Speech motor brain regions are differentially recruited during perception of native and foreign-accented phonemes for first and second language listeners

Brain imaging studies indicate that speech motor areas are recruited for auditory speech perception, especially when intelligibility is low due to environmental noise or when speech is accented. The purpose of the present study was to determine the relative contribution of brain regions to the processing of speech containing phonetic categories from one's own language, speech with accented samples of one's native phonetic categories, and speech with unfamiliar phonetic categories. To that end, native English and Japanese speakers identified the speech sounds /r/ and /l/ that were produced by native English speakers (unaccented) and Japanese speakers (foreign-accented) while functional magnetic resonance imaging measured their brain activity. For native English speakers, the Japanese accented speech was more difficult to categorize than the unaccented English speech. In contrast, Japanese speakers have difficulty distinguishing between /r/ and /l/, so both the Japanese accented and English unaccented speech were difficult to categorize. Brain regions involved with listening to foreign-accented productions of a first language included primarily the right cerebellum, left ventral inferior premotor cortex PMvi, and Broca's area. Brain regions most involved with listening to a second-language phonetic contrast (foreign-accented and unaccented productions) also included the left PMvi and the right cerebellum. Additionally, increased activity was observed in the right PMvi, the left and right ventral superior premotor cortex PMvs, and the left cerebellum. These results support a role for speech motor regions during the perception of foreign-accented native speech and for perception of difficult second-language phonetic contrasts.

Multisensory and modality specific processing of visual speech in different regions of the premotor cortex

Behavioral and neuroimaging studies have demonstrated that brain regions involved with speech production also support speech perception, especially under degraded conditions. The premotor cortex (PMC) has been shown to be active during both observation and execution of action (“Mirror System” properties), and may facilitate speech perception by mapping unimodal and multimodal sensory features onto articulatory speech gestures. For this functional magnetic resonance imaging (fMRI) study, participants identified vowels produced by a speaker in audio-visual (saw the speaker's articulating face and heard her voice), visual only (only saw the speaker's articulating face), and audio only (only heard the speaker's voice) conditions with varying audio signal-to-noise ratios in order to determine the regions of the PMC involved with multisensory and modality specific processing of visual speech gestures. The task was designed so that identification could be made with a high level of accuracy from visual only stimuli to control for task difficulty and differences in intelligibility. The results of the functional magnetic resonance imaging (fMRI) analysis for visual only and audio-visual conditions showed overlapping activity in inferior frontal gyrus and PMC. The left ventral inferior premotor cortex (PMvi) showed properties of multimodal (audio-visual) enhancement with a degraded auditory signal. The left inferior parietal lobule and right cerebellum also showed these properties. The left ventral superior and dorsal premotor cortex (PMvs/PMd) did not show this multisensory enhancement effect, but there was greater activity for the visual only over audio-visual conditions in these areas. The results suggest that the inferior regions of the ventral premotor cortex are involved with integrating multisensory information, whereas, more superior and dorsal regions of the PMC are involved with mapping unimodal (in this case visual) sensory features of the speech signal with articulatory speech gestures.

Hippocampal Sclerosis Affects fMR-Adaptation of Lyrics and Melodies in Songs

Songs constitute a natural combination of lyrics and melodies, but it is unclear whether and how these two song components are integrated during the emergence of a memory trace. Network theories of memory suggest a prominent role of the hippocampus, together with unimodal sensory areas, in the build-up of conjunctive representations. The present study tested the modulatory influence of the hippocampus on neural adaptation to songs in lateral temporal areas. Patients with unilateral hippocampal sclerosis and healthy matched controls were presented with blocks of short songs in which lyrics and/or melodies were varied or repeated in a crossed factorial design. Neural adaptation effects were taken as correlates of incidental emergent memory traces. We hypothesized that hippocampal lesions, particularly in the left hemisphere, would weaken adaptation effects, especially the integration of lyrics and melodies. Results revealed that lateral temporal lobe regions showed weaker adaptation to repeated lyrics as well as a reduced interaction of the adaptation effects for lyrics and melodies in patients with left hippocampal sclerosis. This suggests a deficient build-up of a sensory memory trace for lyrics and a reduced integration of lyrics with melodies, compared to healthy controls. Patients with right hippocampal sclerosis showed a similar profile of results although the effects did not reach significance in this population. We highlight the finding that the integrated representation of lyrics and melodies typically shown in healthy participants is likely tied to the integrity of the left medial temporal lobe. This novel finding provides the first neuroimaging evidence for the role of the hippocampus during repetitive exposure to lyrics and melodies and their integration into a song.

Multivoxel patterns reveal functionally differentiated networks underlying auditory feedback processing of speech

The everyday act of speaking involves the complex processes of speech motor control. An important component of control is monitoring, detection, and processing of errors when auditory feedback does not correspond to the intended motor gesture. Here we show, using fMRI and converging operations within a multivoxel pattern analysis framework, that this sensorimotor process is supported by functionally differentiated brain networks. During scanning, a real-time speech-tracking system was used to deliver two acoustically different types of distorted auditory feedback or unaltered feedback while human participants were vocalizing monosyllabic words, and to present the same auditory stimuli while participants were passively listening. Whole-brain analysis of neural-pattern similarity revealed three functional networks that were differentially sensitive to distorted auditory feedback during vocalization, compared with during passive listening. One network of regions appears to encode an "error signal" regardless of acoustic features of the error: this network, including right angular gyrus, right supplementary motor area, and bilateral cerebellum, yielded consistent neural patterns across acoustically different, distorted feedback types, only during articulation (not during passive listening). In contrast, a frontotemporal network appears sensitive to the speech features of auditory stimuli during passive listening; this preference for speech features was diminished when the same stimuli were presented as auditory concomitants of vocalization. A third network, showing a distinct functional pattern from the other two, appears to capture aspects of both neural response profiles. Together, our findings suggest that auditory feedback processing during speech motor control may rely on multiple, interactive, functionally differentiated neural systems.

Perception of words and pitch patterns in song and speech

This functional magnetic resonance imaging study examines shared and distinct cortical areas involved in the auditory perception of song and speech at the level of their underlying constituents: words and pitch patterns. Univariate and multivariate analyses were performed to isolate the neural correlates of the word- and pitch-based discrimination between song and speech, corrected for rhythmic differences in both. Therefore, six conditions, arranged in a subtractive hierarchy were created: sung sentences including words, pitch and rhythm; hummed speech prosody and song melody containing only pitch patterns and rhythm; and as a control the pure musical or speech rhythm. Systematic contrasts between these balanced conditions following their hierarchical organization showed a great overlap between song and speech at all levels in the bilateral temporal lobe, but suggested a differential role of the inferior frontal gyrus (IFG) and intraparietal sulcus (IPS) in processing song and speech. While the left IFG coded for spoken words and showed predominance over the right IFG in prosodic pitch processing, an opposite lateralization was found for pitch in song. The IPS showed sensitivity to discrete pitch relations in song as opposed to the gliding pitch in speech. Finally, the superior temporal gyrus and premotor cortex coded for general differences between words and pitch patterns, irrespective of whether they were sung or spoken. Thus, song and speech share many features which are reflected in a fundamental similarity of brain areas involved in their perception. However, fine-grained acoustic differences on word and pitch level are reflected in the IPS and the lateralized activity of the IFG.

The cerebellar cognitive profile

The cerebellar role in non-motor functions is supported by the clinical finding that lesions confined to cerebellum produce the cerebellar cognitive affective syndrome. Nevertheless, there is no consensus regarding the overall cerebellar contribution to cognition. Among other reasons, this deficiency might be attributed to the small sample sizes and narrow breadths of existing studies on lesions in cerebellar patients, which have focused primarily on a single cognitive domain. The aim of this study was to examine the expression of cerebellar cognitive affective syndrome with regard to lesion topography in a large group of subjects with cerebellar damage. We retrospectively analysed charts from patients in the Ataxia Lab of Santa Lucia Foundation between 1997 and 2007. Of 223 charts, 156 were included in the study, focusing on the importance of the cerebellum in cognition and the relevance of lesion topography in defining the cognitive domains that have been affected. Vascular topography and the involvement of deep cerebellar nuclei were the chief factors that determined the cognitive profile. Of the various cognitive domains, the ability to sequence was the most adversely affected in nearly all subjects, supporting the hypothesis that sequencing is a basic cerebellar operation.

Emotions and their cognitive control in children with cerebellar tumors

A constellation of deficits, termed the cerebellar cognitive affective syndrome (CCAS), has been reported following acquired cerebellar lesions. We studied emotion identification and the cognitive control of emotion in children treated for acquired tumors of the cerebellum. Participants were 37 children (7-16 years) treated for cerebellar tumors (19 benign astrocytomas (AST), 18 malignant medulloblastomas (MB), and 37 matched controls (CON). The Emotion Identification Task investigated recognition of happy and sad emotions in music. In two cognitive control tasks, we investigated whether children could identify emotion in situations in which the emotion in the music and the emotion in the lyrics was either congruent or incongruent. Children with cerebellar tumors identified emotion as accurately and quickly as controls (p > .05), although there was a significant interaction of emotions and group (p < .01), with the MB group performing less accurately identifying sad emotions, and both cerebellar tumor groups were impaired in the cognitive control of emotions (p < .01). The fact that childhood acquired cerebellar tumors disrupt cognitive control of emotion rather than emotion identification provides some support for a model of the CCAS as a disorder, not so much of emotion as of the regulation of emotion by cognition.

Cortical speech processing unplugged: a timely subcortico-cortical framework

Speech is inherently tied to time. This fundamental quality has long been deemed secondary, and has consequently not received appropriate recognition in speech processing models. We develop an integrative speech processing framework by synthesizing evolutionary, anatomical and neurofunctional concepts of auditory, temporal and speech processing. These processes converge in a network that extends cortical speech processing systems with cortical and subcortical systems associated with motor control. This subcortico-cortical multifunctional network is based on temporal processing and predictive coding of events to optimize interactions between the organism and the environment. The framework we outline provides a novel perspective on speech processing and has implications for future studies on learning, proficient use, and developmental and acquired disorders of speech production and perception.

The cerebellum in children with spina bifida and Chiari II malformation: Quantitative volumetrics by region

Few volumetric MRI studies of the entire cerebellum have been published; even less quantitative information is available in patients with hindbrain malformations, including the Chiari II malformation which is ubiquitous in patients with spina bifida meningomyelocele (SBM). In the present study, regional volumetric analyses of the cerebellum were conducted in children with SBM/Chiari II and typically developing (TD) children. Total cerebellar volume was significantly reduced in the SBM group relative to the TD group. After correcting for total cerebellum volume, and relative to the TD group, the posterior lobe was significantly reduced in SBM, the corpus medullare was not different, and the anterior lobe was significantly enlarged. Children with thoracic level lesions had smaller cerebellar volumes relative to those with lumbar/sacral lesions, who had smaller volumes compared to TD children. The reduction in cerebellar volume in the group with SBM represents not a change in linear scaling but rather a reconfiguration involving anterior lobe enlargement and posterior lobe reduction.

Brain activation during anticipation of sound sequences

Music consists of sound sequences that require integration over time. As we become familiar with music, associations between notes, melodies, and entire symphonic movements become stronger and more complex. These associations can become so tight that, for example, hearing the end of one album track can elicit a robust image of the upcoming track while anticipating it in total silence. Here, we study this predictive "anticipatory imagery" at various stages throughout learning and investigate activity changes in corresponding neural structures using functional magnetic resonance imaging. Anticipatory imagery (in silence) for highly familiar naturalistic music was accompanied by pronounced activity in rostral prefrontal cortex (PFC) and premotor areas. Examining changes in the neural bases of anticipatory imagery during two stages of learning conditional associations between simple melodies, however, demonstrates the importance of fronto-striatal connections, consistent with a role of the basal ganglia in "training" frontal cortex (Pasupathy and Miller, 2005). Another striking change in neural resources during learning was a shift between caudal PFC earlier to rostral PFC later in learning. Our findings regarding musical anticipation and sound sequence learning are highly compatible with studies of motor sequence learning, suggesting common predictive mechanisms in both domains.

Hemispheric Specialization for Linguistic Processing of Sung Speech

The two hemispheres of the brain play complementary roles in song perception, with the left hemisphere specialized for processing the linguistic aspects of song and the right hemisphere specialized for the processing of melody. However, very little is known about how language and melody interact. The present study tested the hypothesis that right hemisphere linguistic processing would be facilitated by the presence of melody. In a dichotic listening paradigm, participants (8 men, 43 women) performed a linguistic task while listening to spoken or sung speech. Contrary to the hypothesis, left hemisphere specialization for linguistic processing was identical whether the sentences were spoken or sung.