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Kenyon KH, Boonstra F, Noffs G, Morgan AT, Vogel AP, Kolbe S, Van Der Walt A. The characteristics and reproducibility of motor speech functional neuroimaging in healthy controls. Front Hum Neurosci 2024; 18:1382102. [PMID: 39171097 PMCID: PMC11335534 DOI: 10.3389/fnhum.2024.1382102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 07/22/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction Functional magnetic resonance imaging (fMRI) can improve our understanding of neural processes subserving motor speech function. Yet its reproducibility remains unclear. This study aimed to evaluate the reproducibility of fMRI using a word repetition task across two time points. Methods Imaging data from 14 healthy controls were analysed using a multi-level general linear model. Results Significant activation was observed during the task in the right hemispheric cerebellar lobules IV-V, right putamen, and bilateral sensorimotor cortices. Activation between timepoints was found to be moderately reproducible across time in the cerebellum but not in other brain regions. Discussion Preliminary findings highlight the involvement of the cerebellum and connected cerebral regions during a motor speech task. More work is needed to determine the degree of reproducibility of speech fMRI before this could be used as a reliable marker of changes in brain activity.
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Affiliation(s)
- Katherine H. Kenyon
- Department of Neuroscience, School of Translational Medicine, Melbourne, VIC, Australia
| | - Frederique Boonstra
- Department of Neuroscience, School of Translational Medicine, Melbourne, VIC, Australia
| | - Gustavo Noffs
- Department of Neuroscience, School of Translational Medicine, Melbourne, VIC, Australia
- Redenlab Inc., Melbourne, VIC, Australia
| | - Angela T. Morgan
- Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Audiology and Speech Pathology, Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, University of Melbourne, Carlton, VIC, Australia
| | - Adam P. Vogel
- Redenlab Inc., Melbourne, VIC, Australia
- Department of Audiology and Speech Pathology, Parkville, VIC, Australia
| | - Scott Kolbe
- Department of Neuroscience, School of Translational Medicine, Melbourne, VIC, Australia
| | - Anneke Van Der Walt
- Department of Neuroscience, School of Translational Medicine, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
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Cai H, Dong J, Mei L, Feng G, Li L, Wang G, Yan H. Functional and structural abnormalities of the speech disorders: a multimodal activation likelihood estimation meta-analysis. Cereb Cortex 2024; 34:bhae075. [PMID: 38466117 DOI: 10.1093/cercor/bhae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Speech disorders are associated with different degrees of functional and structural abnormalities. However, the abnormalities associated with specific disorders, and the common abnormalities shown by all disorders, remain unclear. Herein, a meta-analysis was conducted to integrate the results of 70 studies that compared 1843 speech disorder patients (dysarthria, dysphonia, stuttering, and aphasia) to 1950 healthy controls in terms of brain activity, functional connectivity, gray matter, and white matter fractional anisotropy. The analysis revealed that compared to controls, the dysarthria group showed higher activity in the left superior temporal gyrus and lower activity in the left postcentral gyrus. The dysphonia group had higher activity in the right precentral and postcentral gyrus. The stuttering group had higher activity in the right inferior frontal gyrus and lower activity in the left inferior frontal gyrus. The aphasia group showed lower activity in the bilateral anterior cingulate gyrus and left superior frontal gyrus. Across the four disorders, there were concurrent lower activity, gray matter, and fractional anisotropy in motor and auditory cortices, and stronger connectivity between the default mode network and frontoparietal network. These findings enhance our understanding of the neural basis of speech disorders, potentially aiding clinical diagnosis and intervention.
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Affiliation(s)
- Hao Cai
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
| | - Jie Dong
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
| | - Leilei Mei
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University); School of Psychology; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Genyi Feng
- Imaging Department, Xi'an GEM Flower Changqing Hospital, Xi'an 710201, China
| | - Lili Li
- Speech Language Therapy Department, Shaanxi Provincial Rehabilitation Hospital, Xi'an 710065, China
| | - Gang Wang
- Imaging Department, Xi'an GEM Flower Changqing Hospital, Xi'an 710201, China
| | - Hao Yan
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
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Morison LD, Braden RO, Amor DJ, Brignell A, van Bon BWM, Morgan AT. Social motivation a relative strength in DYRK1A syndrome on a background of significant speech and language impairments. Eur J Hum Genet 2022; 30:800-811. [PMID: 35437318 PMCID: PMC9259653 DOI: 10.1038/s41431-022-01079-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/10/2022] [Accepted: 02/24/2022] [Indexed: 11/09/2022] Open
Abstract
Speech and language impairments are commonly reported in DYRK1A syndrome. Yet, speech and language abilities have not been systematically examined in a prospective cohort study. Speech, language, social behaviour, feeding, and non-verbal communication skills were assessed using standardised tools. The broader health and medical phenotype was documented using caregiver questionnaires, interviews and confirmation with medical records. 38 individuals with DYRK1A syndrome (23 male, median age 8 years 3 months, range 1 year 7 months to 25 years) were recruited. Moderate to severe intellectual disability (ID), autism spectrum disorder (ASD), vision, motor and feeding impairments were common, alongside epilepsy in a third of cases. Speech and language was disordered in all participants. Many acquired some degree of verbal communication, yet few (8/38) developed sufficient oral language skills to rely solely on verbal communication. Speech was characterised by severe apraxia and dysarthria in verbal participants, resulting in markedly poor intelligibility. Those with limited verbal language (30/38) used a combination of sign and graphic augmentative and alternative communication (AAC) systems. Language skills were low across expressive, receptive, and written domains. Most had impaired social behaviours (25/29). Restricted and repetitive interests were most impaired, whilst social motivation was a relative strength. Few individuals with DYRK1A syndrome use verbal speech as their sole means of communication, and hence, all individuals need early access to tailored, graphic AAC systems to support their communication. For those who develop verbal speech, targeted therapy for apraxia and dysarthria should be considered to improve intelligibility and, consequently, communication autonomy.
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Affiliation(s)
- Lottie D Morison
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Ruth O Braden
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - David J Amor
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- The University of Melbourne, Melbourne, VIC, Australia
- Royal Children's Hospital, Melbourne, VIC, Australia
| | - Amanda Brignell
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Monash University, Melbourne, VIC, Australia
- Australian Catholic University, Melbourne, VIC, Australia
| | | | - Angela T Morgan
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.
- The University of Melbourne, Melbourne, VIC, Australia.
- Royal Children's Hospital, Melbourne, VIC, Australia.
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Braden RO, Amor DJ, Fisher SE, Mei C, Myers CT, Mefford H, Gill D, Srivastava S, Swanson LC, Goel H, Scheffer IE, Morgan AT. Severe speech impairment is a distinguishing feature of FOXP1-related disorder. Dev Med Child Neurol 2021; 63:1417-1426. [PMID: 34109629 DOI: 10.1111/dmcn.14955] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/21/2022]
Abstract
AIM To delineate the speech and language phenotype of a cohort of individuals with FOXP1-related disorder. METHOD We administered a standardized test battery to examine speech and oral motor function, receptive and expressive language, non-verbal cognition, and adaptive behaviour. Clinical history and cognitive assessments were analysed together with speech and language findings. RESULTS Twenty-nine patients (17 females, 12 males; mean age 9y 6mo; median age 8y [range 2y 7mo-33y]; SD 6y 5mo) with pathogenic FOXP1 variants (14 truncating, three missense, three splice site, one in-frame deletion, eight cytogenic deletions; 28 out of 29 were de novo variants) were studied. All had atypical speech, with 21 being verbal and eight minimally verbal. All verbal patients had dysarthric and apraxic features, with phonological deficits in most (14 out of 16). Language scores were low overall. In the 21 individuals who carried truncating or splice site variants and small deletions, expressive abilities were relatively preserved compared with comprehension. INTERPRETATION FOXP1-related disorder is characterized by a complex speech and language phenotype with prominent dysarthria, broader motor planning and programming deficits, and linguistic-based phonological errors. Diagnosis of the speech phenotype associated with FOXP1-related dysfunction will inform early targeted therapy. What this paper adds Individuals with FOXP1-related disorder have a complex speech and language phenotype. Dysarthria, which impairs intelligibility, is the dominant feature of the speech profile. No participants were receiving speech therapy for dysarthria, but were good candidates for therapy Features of speech apraxia occur alongside persistent phonological errors. Language abilities are low overall; however, expressive language is a relative strength.
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Affiliation(s)
- Ruth O Braden
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Audiology and Speech Pathology and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - David J Amor
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Audiology and Speech Pathology and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Victorian Clinical Genetics Service, Parkville, VIC, Australia
| | - Simon E Fisher
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Cristina Mei
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Orygen and Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Candace T Myers
- Department of Pediatrics, Division of Genetic Medicine, University of Washington, Seattle, WA, USA
| | - Heather Mefford
- Department of Pediatrics, Division of Genetic Medicine, University of Washington, Seattle, WA, USA
| | - Deepak Gill
- TY Nelson Department of Neurology, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Lindsay C Swanson
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Himanshu Goel
- Hunter Genetics, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Ingrid E Scheffer
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Audiology and Speech Pathology and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Austin Health, Heidelberg, Melbourne, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Audiology and Speech Pathology and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.,The Royal Children's Hospital, Parkville, VIC, Australia.,Victorian Clinical Genetics Service, Parkville, VIC, Australia
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Speech and language deficits are central to SETBP1 haploinsufficiency disorder. Eur J Hum Genet 2021; 29:1216-1225. [PMID: 33907317 PMCID: PMC8384874 DOI: 10.1038/s41431-021-00894-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 02/02/2023] Open
Abstract
Expressive communication impairment is associated with haploinsufficiency of SETBP1, as reported in small case series. Heterozygous pathogenic loss-of-function (LoF) variants in SETBP1 have also been identified in independent cohorts ascertained for childhood apraxia of speech (CAS), warranting further investigation of the roles of this gene in speech development. Thirty-one participants (12 males, aged 0; 8-23; 2 years, 28 with pathogenic SETBP1 LoF variants, 3 with 18q12.3 deletions) were assessed for speech, language and literacy abilities. Broader development was examined with standardised motor, social and daily life skills assessments. Gross and fine motor deficits (94%) and intellectual impairments (68%) were common. Protracted and aberrant speech development was consistently seen, regardless of motor or intellectual ability. We expand the linguistic phenotype associated with SETBP1 LoF syndrome (SETBP1 haploinsufficiency disorder), revealing a striking speech presentation that implicates both motor (CAS, dysarthria) and language (phonological errors) systems, with CAS (80%) being the most common diagnosis. In contrast to past reports, the understanding of language was rarely better preserved than language expression (29%). Language was typically low, to moderately impaired, with commensurate expression and comprehension ability. Children were sociable with a strong desire to communicate. Minimally verbal children (32%) augmented speech with sign language, gestures or digital devices. Overall, relative to general development, spoken language and literacy were poorer than social, daily living, motor and adaptive behaviour skills. Our findings show that poor communication is a central feature of SETBP1 haploinsufficiency disorder, confirming this gene as a strong candidate for speech and language disorders.
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Schölderle T, Haas E, Ziegler W. Dysarthria syndromes in children with cerebral palsy. Dev Med Child Neurol 2021; 63:444-449. [PMID: 32970343 DOI: 10.1111/dmcn.14679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2020] [Indexed: 11/28/2022]
Abstract
AIM To investigate whether dysarthria syndromes acquired in adulthood can also be observed in children with cerebral palsy (CP) and, if so, whether they align with children's CP subtypes. METHOD Twenty-six children with CP participated (mean age 7y 8mo [SD 1y 2mo], 5y 1mo-9y 10mo; 16 males and 10 females). Speech samples were elicited in a computer-based game and were analysed using the auditory perceptual criteria of the Bogenhausen Dysarthria Scales (BoDyS). For statistical classification, three comparison groups of adults with standard dysarthria syndromes (i.e. spastic, hyperkinetic, and ataxic) were used. Their BoDyS data were entered into a mixture discriminant analysis, with data from the comparison groups as the training sample and those from the children with CP as the test sample. Results were related to findings in a group of adults with CP. RESULTS Among the children with CP, most had spastic (n=14), while fewer had ataxic (n=9) or hyperkinetic (n=3), dysarthria. However, syndrome allocations were significantly more ambiguous than in adults with CP. For 11 children, their dysarthria syndromes did not align with their CP subtype. INTERPRETATION Dysarthria syndromes are less clear cut in children than in adults with CP because of a number of developmental factors. WHAT THIS PAPER ADDS Children with cerebral palsy (CP) show diverse patterns of dysarthric symptoms. Dysarthria syndromes do not seem to manifest fully during childhood. Dysarthria syndrome and CP subtype may not align in children with CP.
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Affiliation(s)
- Theresa Schölderle
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
| | - Elisabet Haas
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
| | - Wolfram Ziegler
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
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Braden RO, Boyce JO, Stutterd CA, Pope K, Goel H, Leventer RJ, Scheffer IE, Morgan AT. Speech, Language, and Oromotor Skills in Patients With Polymicrogyria. Neurology 2021; 96:e1898-e1912. [PMID: 33589534 DOI: 10.1212/wnl.0000000000011698] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/06/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether specific speech, language, and oromotor profiles are associated with different patterns of polymicrogyria, we assessed 52 patients with polymicrogyria using a battery of standardized tests and correlated findings with topography and severity of polymicrogyria. METHODS Patients were identified via clinical research databases and invited to participate, irrespective of cognitive and verbal language abilities. We conducted standardized assessments of speech, oromotor structure and function, language, and nonverbal IQ. Data were analyzed according to normative assessment data and descriptive statistics. We conducted a correlation analysis between topographic pattern and speech and language findings. RESULTS Fifty-two patients (33 male, 63%) were studied at an average age of 12.7 years (range 2.5-36 years). All patients had dysarthria, which ranged from mild impairment to anarthria. Developmental speech errors (articulation and phonology), oral motor structure and function deficits, and language disorder were frequent. A total of 23/29 (79%) had cognitive abilities in the low average to extremely low range. In the perisylvian polymicrogyria group (36/52), speech, everyday language, and oral motor impairments were more severe, compared to generalized (1 patient), frontal (3), polymicrogyria with periventricular nodular heterotopia (3), parasagittal parieto-occipital (1), mesial occipital (1), and other (7) patterns. CONCLUSIONS Dysarthria is a core feature of polymicrogyria, often accompanied by receptive and expressive language impairments. These features are associated with all polymicrogyria distribution patterns and more severe in individuals with bilateral polymicrogyria, particularly in the perisylvian region.
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Affiliation(s)
- Ruth O Braden
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Jessica O Boyce
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Chloe A Stutterd
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Kate Pope
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Himanshu Goel
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Richard J Leventer
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Ingrid E Scheffer
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia
| | - Angela T Morgan
- From Murdoch Children's Research Institute (R.O.B., J.O.B., C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Departments of Audiology and Speech Pathology (R.O.B., J.O.B., A.T.M.) and Paediatrics (C.A.S., R.J.L., I.E.S.), University of Melbourne; The Royal Children's Hospital (C.A.S., K.P., R.J.L., I.E.S., A.T.M.); Victorian Clinical Genetics Service (C.A.S., K.P.), Parkville, Victoria; Hunter Genetics (H.G.), John Hunter Hospital, New Lambton Heights, New South Wales; Austin Health (I.E.S.), Heidelberg, Victoria; and Florey Institute of Neuroscience and Mental Health (I.E.S.), Parkville, Victoria, Australia.
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Brignell A, Gu C, Holm A, Carrigg B, Sheppard DA, Amor DJ, Morgan AT. Speech and language phenotype in Phelan-McDermid (22q13.3) syndrome. Eur J Hum Genet 2020; 29:564-574. [PMID: 33293697 DOI: 10.1038/s41431-020-00761-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/23/2020] [Indexed: 11/09/2022] Open
Abstract
Communication difficulties are a core feature of Phelan-McDermid syndrome (PMS). However, a specific speech and language phenotype has not been delineated, preventing prognostic counselling and development of targeted therapies. We examined speech, language, social and functional communication abilities in 21 individuals with PMS (with SHANK3 involvement), using standardised assessments. Mean age was 9.7 years (SD 4.1) and 57% were female. Deletion size ranged from 41 kb to 8.3 Mb. Nine participants (45%) were non-verbal. Four (19%) had greater verbal ability, speaking in at least 4-5 word sentences, but with speech sound errors. Standard scores for receptive and expressive language were low (typically >3 SD below the mean). Language age equivalency was 13-16 months on average (range 2-53 months). There was a significant association between deletion size and the ability to use phrases. Participants with smaller deletion sizes were more likely to be able to use phrases (odds ratio: 0.36, 95% CI: 0.14-0.95, p = 0.040). Adaptive behaviour (life skills) was low in all areas (>2 SD below mean). Scores in communication were markedly lower than for daily living (p = 0.008) and socialisation (p < 0.001). A common linguistic profile was characterised by severe impairment across receptive, expressive and social language domains. Yet data indicated greater communicative intent than appeared to be capitalised by current therapies. Early implementation of augmentative (e.g. computer-assisted) modes of communication, alongside promotion of oral language, is essential to harness this intent, accelerate language development and reduce frustration. Future trials should examine the added benefit of targeted speech motor interventions in those with greater verbal capacity.
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Affiliation(s)
- Amanda Brignell
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Conway Gu
- University of Melbourne, Melbourne, Australia
| | | | | | - Daisy A Sheppard
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - David J Amor
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Melbourne, Australia. .,University of Melbourne, Melbourne, Australia.
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Mei C, Reilly S, Bickerton M, Mensah F, Turner S, Kumaranayagam D, Pennington L, Reddihough D, Morgan AT. Speech in children with cerebral palsy. Dev Med Child Neurol 2020; 62:1374-1382. [PMID: 32588921 DOI: 10.1111/dmcn.14592] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 12/01/2022]
Abstract
AIM To examine the frequency, characteristics, and factors associated with speech delay and disorder in a community sample of children with cerebral palsy (CP). METHOD Participants were 84 children (37 females, 47 males; aged between 4y 11mo-6y 6mo) with CP identified through a population-based registry. Speech and oromotor function were systematically evaluated to provide a differential diagnosis of articulation, phonological, and motor speech disorders. RESULTS In total, 82% (69/84) of participants had delayed or disordered speech production, including minimally verbal presentations (n=20). Verbal participants (n=64) presented with dysarthria (78%), articulation delay or disorder (54%), phonological delay or disorder (43%), features of childhood apraxia of speech (CAS) (17%), or mixed presentations across these conditions. Speech intelligibility was poorest in those with dysarthria and features of CAS. Speech delay or disorder in verbal participants was associated with language impairment (p=0.002) and reduced health-related quality of life (p=0.04) (Fisher's exact test). Poorer speech accuracy (i.e. lower percentage consonants correct) correlated with greater impairments in both language (p<0.001) and oromotor function (p<0.001) (Spearman's test). INTERPRETATION The speech profile of children with CP is characterized by impairment at multiple levels of speech production (phonetic, cognitive-linguistic, neuromuscular execution, and high-level planning/programming), highlighting the importance of a personalized differential diagnosis informing targeted treatment.
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Affiliation(s)
- Cristina Mei
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | | | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia.,Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Samantha Turner
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | | | - Lindsay Pennington
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dinah Reddihough
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia.,Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
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10
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Zhavoronkova LA, Maksakova OA, Shevtsova TP, Moraresku SI, Kuptsova SV, Kushnir EM, Iksanova EM. [Dual-tasks is an indicator of cognitive deficit specificity in patients after traumatic brain injury]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:46-52. [PMID: 31626170 DOI: 10.17116/jnevro201911908146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To investigate the brain activity impairment in patients after traumatic brain injury (TBI) during dual-tasks in comparison with the normal ranges. MATERIAL AND METHODS Electroencephalographic (EEG), stabilographic and clinical study was performed in 9 patients (mean age 25±1.2 years) for up to 3 months after a mild traumatic brain injury (TBI) in comparison with 18 healthy subjects (mean age 26.6±0.07 years). All participants of the study performed two motor tasks and two cognitive tasks that were carried out in isolation, and simultaneously (dual-tasks). RESULTS Clinical examination revealed cognitive deficit in TBI patients with safety of postural control. The EEG data demonstrated a pronounced decrease in the coherence for slow rhythms in the left hemisphere and frontal areas during cognitive tasks performance. In healthy subjects, an increase in EEG coherence for slow spectral bands was observed in these brain areas. CONCLUSION Dual-tasks are an informative method for estimation of predominant cognitive deficit after mild TBI and the use of this approach for rehabilitation contributes to positive clinical dynamics.
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Affiliation(s)
- L A Zhavoronkova
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - O A Maksakova
- Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | | | | | - S V Kuptsova
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia; Center of Speech Pathology and Neurorehabilitation, Moscow, Russia
| | - E M Kushnir
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - E M Iksanova
- Lomonosov Moscow State University, Moscow, Russia
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11
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Rusz J, Vaneckova M, Benova B, Tykalova T, Novotny M, Ruzickova H, Uher T, Andelova M, Novotna K, Friedova L, Motyl J, Kucerova K, Krasensky J, Horakova D. Brain volumetric correlates of dysarthria in multiple sclerosis. BRAIN AND LANGUAGE 2019; 194:58-64. [PMID: 31102976 DOI: 10.1016/j.bandl.2019.04.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 04/23/2019] [Accepted: 04/30/2019] [Indexed: 06/09/2023]
Abstract
Although dysarthria is a common pattern in multiple sclerosis (MS), the contribution of specific brain areas to key factors of dysarthria remains unknown. Speech data were acquired from 123 MS patients with Expanded Disability Status Scale (EDSS) ranging from 1 to 6.5 and 60 matched healthy controls. Results of computerized acoustic analyses of subtests on spastic and ataxic aspects of dysarthria were correlated with MRI-based brain volume measurements. Slow articulation rate during reading was associated with bilateral white and grey matter loss whereas reduced maximum speed during oral diadochokinesis was related to greater cerebellar involvement. Articulation rate showed similar correlation to whole brain atrophy (r = 0.46, p < 0.001) as the standard clinical scales such as EDSS (r = -0.45, p < 0.001). Our results support the critical role of the pyramidal tract and cerebellum in the modification of motor speech timing in MS.
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Affiliation(s)
- Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic; Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
| | - Manuela Vaneckova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Barbora Benova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tereza Tykalova
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Michal Novotny
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Hana Ruzickova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomas Uher
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Michaela Andelova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Klara Novotna
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Lucie Friedova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jiri Motyl
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Karolina Kucerova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jan Krasensky
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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12
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Liégeois FJ, Turner SJ, Mayes A, Bonthrone AF, Boys A, Smith L, Parry-Fielder B, Mandelstam S, Spencer-Smith M, Bahlo M, Scerri TS, Hildebrand MS, Scheffer IE, Connelly A, Morgan AT. Dorsal language stream anomalies in an inherited speech disorder. Brain 2019; 142:966-977. [DOI: 10.1093/brain/awz018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Samantha J Turner
- The University of Melbourne, Parkville VIC, Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville VIC, Australia
| | - Angela Mayes
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville VIC, Australia
| | | | - Amber Boys
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville VIC, Australia
- Victorian Clinical Genetics Services, 50 Flemington Rd, Parkville VIC, Australia
| | - Libby Smith
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville VIC, Australia
| | | | - Simone Mandelstam
- The University of Melbourne, Parkville VIC, Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville VIC, Australia
- Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville VIC, Australia
| | - Megan Spencer-Smith
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville VIC, Australia
- Monash University, Scenic Blvd, Clayton, VIC, Australia
| | - Melanie Bahlo
- The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville VIC, Australia
| | - Tom S Scerri
- The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville VIC, Australia
| | | | - Ingrid E Scheffer
- The University of Melbourne, Parkville VIC, Australia
- Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville VIC, Australia
| | - Alan Connelly
- The University of Melbourne, Parkville VIC, Australia
- Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville VIC, Australia
| | - Angela T Morgan
- The University of Melbourne, Parkville VIC, Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville VIC, Australia
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13
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Northam GB, Morgan AT, Fitzsimmons S, Baldeweg T, Liégeois FJ. Corticobulbar Tract Injury, Oromotor Impairment and Language Plasticity in Adolescents Born Preterm. Front Hum Neurosci 2019; 13:45. [PMID: 30837853 PMCID: PMC6389783 DOI: 10.3389/fnhum.2019.00045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/28/2019] [Indexed: 12/20/2022] Open
Abstract
Children born preterm are at risk of impairments in oromotor control, with implications for early feeding and speech development. In this study, we aimed to identify (a) neuroanatomical markers of persistent oromotor deficits using diffusion-weighted imaging (DWI) tractography and (b) evidence of compensatory neuroplasticity using functional MRI (fMRI) during a language production task. In a cross-sectional study of 36 adolescents born very preterm (<33 weeks' gestation) we identified persistent difficulties in oromotor control in 31% of cases, but no clinical diagnoses of speech-sound disorder (e.g., dysarthria, dyspraxia). We used DWI-tractography to examine the microstructure (fractional anisotropy, FA) of the corticospinal and corticobulbar tracts. Compared to the unimpaired group, the oromotor-impaired group showed (i) reduced FA within the dorsal portion of the left corticobulbar tract (containing fibres associated with movements of the lips, tongue, and larynx) and (ii) greater recruitment of right hemisphere language regions on fMRI. We conclude that, despite the development of apparently normal everyday speech, early injury to the corticobulbar tract leads to persistent subclinical problems with voluntary control of the face, lips, jaw, and tongue. Furthermore, we speculate that early speech problems may be ameliorated by cerebral plasticity - in particular, recruitment of right hemisphere language areas.
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Affiliation(s)
- Gemma B. Northam
- Great Ormond Street Hospital for Children NHS Trust, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Angela T. Morgan
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - Sophie Fitzsimmons
- Great Ormond Street Hospital for Children NHS Trust, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Torsten Baldeweg
- Great Ormond Street Hospital for Children NHS Trust, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Frédérique J. Liégeois
- Great Ormond Street Hospital for Children NHS Trust, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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14
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Wearne T, Anderson V, Catroppa C, Morgan A, Ponsford J, Tate R, Ownsworth T, Togher L, Fleming J, Douglas J, Docking K, Sigmundsdottir L, Francis H, Honan C, McDonald S. Psychosocial functioning following moderate-to-severe pediatric traumatic brain injury: recommended outcome instruments for research and remediation studies. Neuropsychol Rehabil 2018; 30:973-987. [DOI: 10.1080/09602011.2018.1531768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Travis Wearne
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
| | - Vicki Anderson
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Clinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Psychological Service, The Royal Children’s Hospital, Parkville, Australia
| | - Cathy Catroppa
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Clinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Psychological Sciences & Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Angela Morgan
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Clinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Psychological Sciences & Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Jennie Ponsford
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Psychological Sciences, Monash University Monash-Epworth Rehabilitation Centre, Melbourne, VIC, Australia
- Monash-Epworth rehabilitation Research Centre, Melbourne, Australia
| | - Robyn Tate
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, the University of Sydney, Sydney, NSW, Australia
| | - Tamara Ownsworth
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Leanne Togher
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Fleming
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Science, University of Queensland, St Lucia, QLD, Australia
| | - Jacinta Douglas
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Allied Health, Department of Community and Clinical Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Kimberley Docking
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Linda Sigmundsdottir
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, the University of Sydney, Sydney, NSW, Australia
| | - Heather Francis
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Cynthia Honan
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Department of Psychology, School of Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
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15
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Morgan AT, Webster R. Aetiology of childhood apraxia of speech: A clinical practice update for paediatricians. J Paediatr Child Health 2018; 54:1090-1095. [PMID: 30294994 DOI: 10.1111/jpc.14150] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 02/03/2023]
Abstract
Childhood apraxia of speech (CAS) is a rare disorder of childhood that can leave a watermark of the impacts throughout the lifetime. Since being first described in the 1950s, aetiological insights have been limited. At a neurobiological level, clinical MRI scans fail to reveal overt neural anomalies in individual cases with CAS, although quantitative MRI methods have revealed subtle brain anomalies at a group level. Dramatic insights, however, occurred in the past decade from the discovery of genetic pathways underlying the phenotype. Several single genes and copy number-variant conditions are now associated with CAS either in relative isolation, as in the case of FOXP2 variants, or most typically in association with other neurodevelopmental conditions, such as epilepsy, intellectual disability, motor impairment and autism. CAS requires careful differential diagnosis from other childhood speech disorders, but when a severe and persistent diagnosis is confirmed, a genetic aetiology should increasingly be pursued.
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Affiliation(s)
- Angela T Morgan
- Speech and Language, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Audiology and Speech Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Richard Webster
- Department of Neurology and Neurosurgery, Children's Hospital, Sydney, New South Wales, Australia
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16
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Evidence- and Consensus-Based Guidelines for the Management of Communication and Swallowing Disorders Following Pediatric Traumatic Brain Injury. J Head Trauma Rehabil 2018; 33:326-341. [DOI: 10.1097/htr.0000000000000366] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Luders E, Kurth F, Pigdon L, Conti-Ramsden G, Reilly S, Morgan AT. Atypical Callosal Morphology in Children with Speech Sound Disorder. Neuroscience 2017; 367:211-218. [PMID: 29102664 DOI: 10.1016/j.neuroscience.2017.10.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/16/2022]
Abstract
Speech sound disorder (SSD) is common, yet its neurobiology is poorly understood. Recent studies indicate atypical structural and functional anomalies either in one hemisphere or both hemispheres, which might be accompanied by alterations in inter-hemispheric connectivity. Indeed, abnormalities of the corpus callosum - the main fiber tract connecting the two hemispheres - have been linked to speech and language deficits in associated disorders, such as stuttering, dyslexia, aphasia, etc. However, there is a dearth of studies examining the corpus callosum in SSD. Here, we investigated whether a sample of 18 children with SSD differed in callosal morphology from 18 typically developing children carefully matched for age. Significantly reduced dimensions of the corpus callosum, particularly in the callosal anterior third, were observed in children with SSD. These findings indicating pronounced callosal aberrations in SSD make an important contribution to an understudied field of research and may suggest that SSD is accompanied by atypical lateralization of speech and language function.
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Affiliation(s)
- Eileen Luders
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, USA; Murdoch Childrens Research Institute, Melbourne, Australia.
| | - Florian Kurth
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, USA
| | - Lauren Pigdon
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Gina Conti-Ramsden
- Murdoch Childrens Research Institute, Melbourne, Australia; The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
| | - Sheena Reilly
- Murdoch Childrens Research Institute, Melbourne, Australia; Menzies Health Institute at Griffith University, Gold Coast, Queensland, Australia
| | - Angela T Morgan
- Murdoch Childrens Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia.
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18
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Chouinard B, Boliek C, Cummine J. How to Interpret and Critique Neuroimaging Research: A Tutorial on Use of Functional Magnetic Resonance Imaging in Clinical Populations. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 25:269-289. [PMID: 27537490 DOI: 10.1044/2016_ajslp-15-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 12/30/2015] [Indexed: 06/06/2023]
Abstract
PURPOSE Magnetic resonance imaging (MRI), an influential experimental approach, provides valuable information about clinical disorders that can be used to select and/or refine speech and language interventions. Functional MRI (fMRI) in particular is becoming a widespread methodological tool for investigating speech and language. However, because MRI is relatively new and complex, potential consumers need to be able to critically assess the methods used in order to appraise results and conclusions. The authors offer a tutorial that (a) relays foundational knowledge related to the collection and analysis of MRI data in general and fMRI data specifically and (b) presents strategies for evaluating studies that utilize fMRI methods. METHOD This tutorial outlines methodological considerations that should be addressed by fMRI researchers and noted by consumers of the research, including clinicians and behavioral researchers who work with neurogenic communication disorders. RESULTS Readers will be able to evaluate a neuroimaging publication and identify the methodological strengths and weaknesses that potentially influence the integrity of reported findings and interpretations. CONCLUSION This tutorial provides information and strategies that can be used to critically evaluate studies that collect, analyze, and interpret fMRI data. The tutorial concludes with a summary checklist to guide critical appraisal.
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19
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Connectome-scale assessment of structural and functional connectivity in mild traumatic brain injury at the acute stage. NEUROIMAGE-CLINICAL 2016; 12:100-115. [PMID: 27408795 PMCID: PMC4932612 DOI: 10.1016/j.nicl.2016.06.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/08/2016] [Accepted: 06/14/2016] [Indexed: 01/16/2023]
Abstract
Mild traumatic brain injury (mTBI) accounts for over one million emergency visits each year in the United States. The large-scale structural and functional network connectivity changes of mTBI are still unknown. This study was designed to determine the connectome-scale brain network connectivity changes in mTBI at both structural and functional levels. 40 mTBI patients at the acute stage and 50 healthy controls were recruited. A novel approach called Dense Individualized and Common Connectivity-based Cortical Landmarks (DICCCOLs) was applied for connectome-scale analysis of both diffusion tensor imaging and resting state functional MRI data. Among 358 networks identified on DICCCOL analysis, 41 networks were identified as structurally discrepant between patient and control groups. The involved major white matter tracts include the corpus callosum, and superior and inferior longitudinal fasciculi. Functional connectivity analysis identified 60 connectomic signatures that differentiate patients from controls with 93.75% sensitivity and 100% specificity. Analysis of functional domains showed decreased intra-network connectivity within the emotion network and among emotion-cognition interactions, and increased interactions among action-emotion and action-cognition as well as within perception networks. This work suggests that mTBI may result in changes of structural and functional connectivity on a connectome scale at the acute stage.
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20
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O'Hare A. Management of developmental speech and language disorders. Part 2: acquired conditions. Arch Dis Child 2016; 101:278-83. [PMID: 25990500 DOI: 10.1136/archdischild-2014-306153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/01/2015] [Indexed: 11/03/2022]
Abstract
Many children who present with these acquired impairments of communication have a clear preceding event such as an acquired brain injury from a road traffic accident. Children often respond differently in this situation to adult presentations. They may have a period of mutism when the prognosis might look poor and yet they subsequently make rapid progress and recover speech. They have greater potential for neural plasticity and language recovery, although they often have persisting difficulties in oral and written language. Alternatively, there may be a presentation with a paroxysmal event such as a seizure or a period of depressed consciousness, and the unusual behaviour that may accompany dysphasia and dysarthria may be misinterpreted in the child, whereas for the adult with the more common 'stroke-like' presentation, it would be immediately considered. Rarely the aphasia/dysphasia may itself be the paroxysmal event where actually recognising that the child's disrupted communication is the basis of any observed behaviours can be the greater challenge.
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21
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Xiao FL, Gao PY, Sui BB, Wan H, Lin Y, Xue J, Zhou J, Qian TY, Wang S, Li D, Liu S. Time-course of Changes in Activation Among Facial Nerve Injury: A Functional Imaging Study. Medicine (Baltimore) 2015; 94:e1582. [PMID: 26512554 PMCID: PMC4985368 DOI: 10.1097/md.0000000000001582] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Patients suffering different intervals of facial nerve injury were investigated by functional magnetic resonance imaging to study changes in activation within cortex.Forty-five patients were divided into 3 groups based on intervals of facial nerve injury. Another 16 age and sex-matched healthy participants were included as a control group. Patients and healthy participants underwent task functional magnetic resonance imaging (eye blinking and lip pursing) examination.Functional reorganization after facial nerve injury is dynamic and time-dependent. Correlation between activation in sensorimotor area and intervals of facial nerve injury was significant, with a Pearson correlation coefficient of -0.951 (P < 0.001) in the left sensorimotor area and a Pearson correlation coefficient of 0.333 (P = 0.025) in the right sensorimotor area.Increased activation in integration areas, such as supramarginal gyrus and precunes lobe, could be detected in the early-middle stage of facial dysfunction compared with normal individuals. Decreased activation in sensorimotor area contralateral to facial nerve injury could be found in late stage of facial dysfunction compared with normal individuals. Dysfunction in the facial nerve has devastating effects on the activity of sensorimotor areas, whereas enhanced intensity in the sensorimotor area ipsilateral to the facial nerve injury in middle stage of facial dysfunction suggests the possible involvement of interhemispheric reorganization. Behavioral or brain stimulation technique treatment in this stage could be applied to alter reorganization within sensorimotor area in the rehabilitation of facial function, monitoring of therapeutic efficacy, and improvement in therapeutic intervention along the course of recovery.
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Affiliation(s)
- Fu-Long Xiao
- From the Department of Radiology, Beijing Tian Tan Hospital, Capital Medical University (F-LX, P-YG, B-BS, JZ); Beijing Neurosurgical Institute (P-YG, HW, YL, JX, SW, SL); Beijing Key Laboratory of Central Nervous System Injury (HW); Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics (JZ); Siemens Healthcare, MR Collaboration NE Asia (T-YQ); China National Clinical Research Center for Neurological Diseases (SW); Center of Brain Tumor, Beijing Institute for Brain Disorders and Beijing Key Laboratory of Brian Tumor (DL); Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (DL, SL); and UMR 788, INSERM et Université Paris-Sud, 80 rue du Général Leclerc, Le Kremlin-Bicêtre Cedex, Paris, France (SL)
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22
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Morgan AT, Mei C, Da Costa A, Fifer J, Lederer D, Benoit V, McMillin MJ, Buckingham KJ, Bamshad MJ, Pope K, White SM. Speech and language in a genotyped cohort of individuals with Kabuki syndrome. Am J Med Genet A 2015; 167:1483-92. [DOI: 10.1002/ajmg.a.37026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/08/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Angela T. Morgan
- Murdoch Childrens Research Institute; Melbourne; Australia
- Department of Paediatrics; University of Melbourne; Melbourne Australia
- Royal Children's Hospital; Melbourne; Australia
| | - Cristina Mei
- Murdoch Childrens Research Institute; Melbourne; Australia
- Department of Paediatrics; University of Melbourne; Melbourne Australia
| | - Annette Da Costa
- Murdoch Childrens Research Institute; Melbourne; Australia
- Department of Paediatrics; University of Melbourne; Melbourne Australia
- Royal Children's Hospital; Melbourne; Australia
| | - Joanne Fifer
- Murdoch Childrens Research Institute; Melbourne; Australia
| | - Damien Lederer
- Centre for Human Genetics; Institute of Pathology and Genetics; Gosselies Belgium
| | - Valérie Benoit
- Centre for Human Genetics; Institute of Pathology and Genetics; Gosselies Belgium
| | | | | | - Michael J. Bamshad
- Department of Pediatrics; University of Washington; Seattle Washington
- Department of Genome Sciences; University of Washington; Seattle Washington
| | - Kate Pope
- Victorian Clinical Genetics Services; Murdoch Childrens Research Institute; Melbourne Australia
| | - Susan M. White
- Department of Paediatrics; University of Melbourne; Melbourne Australia
- Royal Children's Hospital; Melbourne; Australia
- Victorian Clinical Genetics Services; Murdoch Childrens Research Institute; Melbourne Australia
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Mercadillo RE, Galvez V, Díaz R, Paredes L, Velázquez-Moctezuma J, Hernandez-Castillo CR, Fernandez-Ruiz J. Social and Cultural Elements Associated with Neurocognitive Dysfunctions in Spinocerebellar Ataxia Type 2 Patients. Front Psychiatry 2015; 6:90. [PMID: 26113822 PMCID: PMC4462049 DOI: 10.3389/fpsyt.2015.00090] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/27/2015] [Indexed: 11/30/2022] Open
Abstract
Spinocerebellar Ataxia Type 2 (SCA2) is a rare genetic disorder producing cerebellar degeneration and affecting motor abilities. Neuroimaging studies also show neurodegeneration in subcortical and cortical regions related to emotional and social processes. From social neuroscience, it is suggested that motor and social abilities can be influenced by particular cultural dynamics so, culture is fundamental to understand the effect of brain-related alterations. Here, we present the first analysis about the cultural elements related to the SCA2 disorder in 15 patients previously evaluated with neuroimaging and psychometric instruments, and their nuclear relationships distributed in six geographical and cultural regions in Mexico. Ethnographic records and photographic and video archives about the quotidian participant's routine were obtained from the patients, their relatives and their caregivers. The information was categorized and interpreted taking into consideration cultural issues and patients' medical files. Our analyses suggest that most of the participants do not understand the nature of the disease and this misunderstanding favors magic and non-medical explanations. Patients' testimonies suggest a decrease in pain perception as well as motor alterations that may be related to interoceptive dysfunctions. Relatives' testimonies indicate patients' lack of social and emotional interests that may be related to frontal, temporal, and cerebellar degeneration. In general, participants use their religious beliefs to deal with the disease and only a few of them trust the health system. Patients and their families are either openly rejected and ignored, tolerated or even helped by their community accordingly to different regional traits. We propose that ethnography can provide social representations to understand the patients' alterations, to formulate neurobiological hypotheses, to develop neurocognitive interventions, and to improve the medical approach to the disease.
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Affiliation(s)
- Roberto Emmanuele Mercadillo
- Laboratorio de Neuropsicología, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México , Mexico City , Mexico ; Consejo Nacional de Ciencia y Tecnología-Cátedras , Mexico City , Mexico ; Área de Neurociencias, Departamento de Biología de la Reproducción, Universidad Autónoma Metropolitana, Unidad Iztapalapa , Mexico City , Mexico
| | - Víctor Galvez
- Posgrado en Neuroetología, Universidad Veracruzana , Xalapa , Mexico
| | - Rosalinda Díaz
- Laboratorio de Neuropsicología, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México , Mexico City , Mexico
| | - Lorena Paredes
- Facultad de Psicología, Universidad Nacional Autónoma de México , Mexico City , Mexico
| | - Javier Velázquez-Moctezuma
- Área de Neurociencias, Departamento de Biología de la Reproducción, Universidad Autónoma Metropolitana, Unidad Iztapalapa , Mexico City , Mexico
| | - Carlos R Hernandez-Castillo
- Consejo Nacional de Ciencia y Tecnología-Cátedras , Mexico City , Mexico ; Instituto de Neuroetología, Universidad Veracruzana , Xalapa , Mexico
| | - Juan Fernandez-Ruiz
- Laboratorio de Neuropsicología, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México , Mexico City , Mexico ; Posgrado en Neuroetología, Universidad Veracruzana , Xalapa , Mexico ; Facultad de Psicología, Universidad Veracruzana , Xalapa , Mexico
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Mercadillo RE, Galvez V, Díaz R, Hernández-Castillo CR, Campos-Romo A, Boll MC, Pasaye EH, Fernandez-Ruiz J. Parahippocampal gray matter alterations in Spinocerebellar Ataxia Type 2 identified by voxel based morphometry. J Neurol Sci 2014; 347:50-8. [DOI: 10.1016/j.jns.2014.09.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 08/20/2014] [Accepted: 09/12/2014] [Indexed: 11/26/2022]
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25
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Abstract
The brain is highly plastic after stroke or epilepsy; however, there is a paucity of brain plasticity investigation after traumatic brain injury (TBI). This mini review summarizes the most recent evidence of brain plasticity in human TBI patients from the perspective of advanced magnetic resonance imaging. Similar to other forms of acquired brain injury, TBI patients also demonstrated both structural reorganization as well as functional compensation by the recruitment of other brain regions. However, the large scale brain network alterations after TBI are still unknown, and the field is still short of proper means on how to guide the choice of TBI rehabilitation or treatment plan to promote brain plasticity. The authors also point out the new direction of brain plasticity investigation.
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Affiliation(s)
- Zhifeng Kou
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA ; Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Armin Iraji
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA
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26
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Liégeois FJ, Mahony K, Connelly A, Pigdon L, Tournier JD, Morgan AT. Pediatric traumatic brain injury: language outcomes and their relationship to the arcuate fasciculus. BRAIN AND LANGUAGE 2013; 127:388-98. [PMID: 23756046 PMCID: PMC3988975 DOI: 10.1016/j.bandl.2013.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 04/15/2013] [Accepted: 05/07/2013] [Indexed: 05/12/2023]
Abstract
Pediatric traumatic brain injury (TBI) may result in long-lasting language impairments alongside dysarthria, a motor-speech disorder. Whether this co-morbidity is due to the functional links between speech and language networks, or to widespread damage affecting both motor and language tracts, remains unknown. Here we investigated language function and diffusion metrics (using diffusion-weighted tractography) within the arcuate fasciculus, the uncinate fasciculus, and the corpus callosum in 32 young people after TBI (approximately half with dysarthria) and age-matched healthy controls (n=17). Only participants with dysarthria showed impairments in language, affecting sentence formulation and semantic association. In the whole TBI group, sentence formulation was best predicted by combined corpus callosum and left arcuate volumes, suggesting this "dual blow" seriously reduces the potential for functional reorganisation. Word comprehension was predicted by fractional anisotropy in the right arcuate. The co-morbidity between dysarthria and language deficits therefore seems to be the consequence of multiple tract damage.
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Affiliation(s)
- Frédérique J Liégeois
- Developmental Cognitive Neuroscience Unit, University College London, Institute of Child Health, London, United Kingdom.
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