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Yuanjun X, Guan M, Zhang T, Ma C, Wang L, Lin X, Li C, Wang Z, Zhujing M, Wang H, Peng F. Targeting auditory verbal hallucinations in schizophrenia: effective connectivity changes induced by low-frequency rTMS. Transl Psychiatry 2024; 14:393. [PMID: 39341819 PMCID: PMC11438995 DOI: 10.1038/s41398-024-03106-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 09/19/2024] [Accepted: 09/20/2024] [Indexed: 10/01/2024] Open
Abstract
Low-frequency repetitive transcranial magnetic stimulation (rTMS) has emerged as an effective intervention for alleviating symptoms of psychiatric disorders, particularly schizophrenia characterized by persistent auditory verbal hallucinations (AVH). However, the underlying mechanism of its action remain elusive. This study employed a randomized controlled design to investigate the impact of low-frequency rTMS on the neural connectivity at the stimulate site, specifically left temporoparietal junction (TPJ), in schizophrenia patients with suffering from AVH. Using Dynamic Causal Modeling (DCM), this study assessed changes in directed connectivity patterns and their correlations with clinical symptomatology. The results demonstrated significant improvements in AVH. Notably, significant changes in connectivity were observed, including both abnormal functional connectivity and effective connectivity among multiple brain regions. Particularly, the inhibition effects from the left precentral gyrus and left medial superior frontal gyrus to the left TPJ were closely associated with improvements in AVH. These findings underscore the potential of rTMS to effectively modulate neural pathways implicated in hallucinations in schizophrenia, thereby providing a neurobiological foundation for its therapeutic effects.
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Affiliation(s)
- Xie Yuanjun
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China.
- Department of Radiology, Fourth Military Medical University, Xi'an, China.
| | - Muzhen Guan
- Deparment of Mental Health, Xi'an Medical College, Xi'an, China
| | - Tian Zhang
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Chaozong Ma
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Lingling Wang
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Xinxin Lin
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Chenxi Li
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Zhongheng Wang
- Department of Psychiatry, Fourth Military Medical University, Xi'an, China
| | - Ma Zhujing
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Huaning Wang
- Department of Psychiatry, Fourth Military Medical University, Xi'an, China.
| | - Fang Peng
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China.
- Shaanxi Provincial Key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Xi'an, China.
- Military Medical Innovation Center, Fourth Military Medical University, Xi'an, China.
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2
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Silva AB, Littlejohn KT, Liu JR, Moses DA, Chang EF. The speech neuroprosthesis. Nat Rev Neurosci 2024; 25:473-492. [PMID: 38745103 DOI: 10.1038/s41583-024-00819-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/16/2024]
Abstract
Loss of speech after paralysis is devastating, but circumventing motor-pathway injury by directly decoding speech from intact cortical activity has the potential to restore natural communication and self-expression. Recent discoveries have defined how key features of speech production are facilitated by the coordinated activity of vocal-tract articulatory and motor-planning cortical representations. In this Review, we highlight such progress and how it has led to successful speech decoding, first in individuals implanted with intracranial electrodes for clinical epilepsy monitoring and subsequently in individuals with paralysis as part of early feasibility clinical trials to restore speech. We discuss high-spatiotemporal-resolution neural interfaces and the adaptation of state-of-the-art speech computational algorithms that have driven rapid and substantial progress in decoding neural activity into text, audible speech, and facial movements. Although restoring natural speech is a long-term goal, speech neuroprostheses already have performance levels that surpass communication rates offered by current assistive-communication technology. Given this accelerated rate of progress in the field, we propose key evaluation metrics for speed and accuracy, among others, to help standardize across studies. We finish by highlighting several directions to more fully explore the multidimensional feature space of speech and language, which will continue to accelerate progress towards a clinically viable speech neuroprosthesis.
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Affiliation(s)
- Alexander B Silva
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA, USA
| | - Kaylo T Littlejohn
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA, USA
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - Jessie R Liu
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA, USA
| | - David A Moses
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA, USA
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
- Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA, USA.
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3
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Chen Y, Zekelman LR, Zhang C, Xue T, Song Y, Makris N, Rathi Y, Golby AJ, Cai W, Zhang F, O'Donnell LJ. TractGeoNet: A geometric deep learning framework for pointwise analysis of tract microstructure to predict language assessment performance. Med Image Anal 2024; 94:103120. [PMID: 38458095 PMCID: PMC11016451 DOI: 10.1016/j.media.2024.103120] [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: 07/09/2023] [Revised: 11/30/2023] [Accepted: 02/21/2024] [Indexed: 03/10/2024]
Abstract
We propose a geometric deep-learning-based framework, TractGeoNet, for performing regression using diffusion magnetic resonance imaging (dMRI) tractography and associated pointwise tissue microstructure measurements. By employing a point cloud representation, TractGeoNet can directly utilize tissue microstructure and positional information from all points within a fiber tract without the need to average or bin data along the streamline as traditionally required by dMRI tractometry methods. To improve regression performance, we propose a novel loss function, the Paired-Siamese Regression loss, which encourages the model to focus on accurately predicting the relative differences between regression label scores rather than just their absolute values. In addition, to gain insight into the brain regions that contribute most strongly to the prediction results, we propose a Critical Region Localization algorithm. This algorithm identifies highly predictive anatomical regions within the white matter fiber tracts for the regression task. We evaluate the effectiveness of the proposed method by predicting individual performance on two neuropsychological assessments of language using a dataset of 20 association white matter fiber tracts from 806 subjects from the Human Connectome Project Young Adult dataset. The results demonstrate superior prediction performance of TractGeoNet compared to several popular regression models that have been applied to predict individual cognitive performance based on neuroimaging features. Of the twenty tracts studied, we find that the left arcuate fasciculus tract is the most highly predictive of the two studied language performance assessments. Within each tract, we localize critical regions whose microstructure and point information are highly and consistently predictive of language performance across different subjects and across multiple independently trained models. These critical regions are widespread and distributed across both hemispheres and all cerebral lobes, including areas of the brain considered important for language function such as superior and anterior temporal regions, pars opercularis, and precentral gyrus. Overall, TractGeoNet demonstrates the potential of geometric deep learning to enhance the study of the brain's white matter fiber tracts and to relate their structure to human traits such as language performance.
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Affiliation(s)
- Yuqian Chen
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Leo R Zekelman
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, MA, USA
| | - Chaoyi Zhang
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Tengfei Xue
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Yang Song
- School of Computer Science and Engineering, University of New South Wales, Sydney, NSW, Australia
| | - Nikos Makris
- Departments of Psychiatry and Neurology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexandra J Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Weidong Cai
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
| | - Lauren J O'Donnell
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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4
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Dagnino PC, Escrichs A, López-González A, Gosseries O, Annen J, Sanz Perl Y, Kringelbach ML, Laureys S, Deco G. Re-awakening the brain: Forcing transitions in disorders of consciousness by external in silico perturbation. PLoS Comput Biol 2024; 20:e1011350. [PMID: 38701063 PMCID: PMC11068192 DOI: 10.1371/journal.pcbi.1011350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 03/31/2024] [Indexed: 05/05/2024] Open
Abstract
A fundamental challenge in neuroscience is accurately defining brain states and predicting how and where to perturb the brain to force a transition. Here, we investigated resting-state fMRI data of patients suffering from disorders of consciousness (DoC) after coma (minimally conscious and unresponsive wakefulness states) and healthy controls. We applied model-free and model-based approaches to help elucidate the underlying brain mechanisms of patients with DoC. The model-free approach allowed us to characterize brain states in DoC and healthy controls as a probabilistic metastable substate (PMS) space. The PMS of each group was defined by a repertoire of unique patterns (i.e., metastable substates) with different probabilities of occurrence. In the model-based approach, we adjusted the PMS of each DoC group to a causal whole-brain model. This allowed us to explore optimal strategies for promoting transitions by applying off-line in silico probing. Furthermore, this approach enabled us to evaluate the impact of local perturbations in terms of their global effects and sensitivity to stimulation, which is a model-based biomarker providing a deeper understanding of the mechanisms underlying DoC. Our results show that transitions were obtained in a synchronous protocol, in which the somatomotor network, thalamus, precuneus and insula were the most sensitive areas to perturbation. This motivates further work to continue understanding brain function and treatments of disorders of consciousness.
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Affiliation(s)
- Paulina Clara Dagnino
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Anira Escrichs
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Ane López-González
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau 2, University Hospital of Liège, Liège, Belgium
| | - Jitka Annen
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau 2, University Hospital of Liège, Liège, Belgium
| | - Yonatan Sanz Perl
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Morten L. Kringelbach
- Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steven Laureys
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, University of Laval, Québec, Québec, Canada
| | - Gustavo Deco
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- Institució Catalana de la Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain
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5
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Sun C, Zhang J, Bu L, Lu J, Yao Y, Wu J. A speech fluency brain network derived from gliomas. Brain Commun 2024; 6:fcae153. [PMID: 38756538 PMCID: PMC11098038 DOI: 10.1093/braincomms/fcae153] [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: 01/12/2023] [Revised: 02/21/2024] [Accepted: 04/28/2024] [Indexed: 05/18/2024] Open
Abstract
The brain network of speech fluency has not yet been investigated via a study with a large and homogenous sample. This study analysed multimodal imaging data from 115 patients with low-grade glioma to explore the brain network of speech fluency. We applied voxel-based lesion-symptom mapping to identify domain-specific regions and white matter pathways associated with speech fluency. Direct cortical stimulation validated the domain-specific regions intra-operatively. We then performed connectivity-behaviour analysis with the aim of identifying connections that significantly correlated with speech fluency. Voxel-based lesion-symptom mapping analysis showed that damage to domain-specific regions (the middle frontal gyrus, the precentral gyrus, the orbital part of inferior frontal gyrus and the insula) and white matter pathways (corticospinal fasciculus, internal capsule, arcuate fasciculus, uncinate fasciculus, frontal aslant tract) are associated with reduced speech fluency. Furthermore, we identified connections emanating from these domain-specific regions that exhibited significant correlations with speech fluency. These findings illuminate the interaction between domain-specific regions and 17 domain-general regions-encompassing the superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus and rolandic operculum, superior temporal gyrus, temporal pole, inferior temporal pole, middle cingulate gyrus, supramarginal gyrus, fusiform gyrus, inferior parietal lobe, as well as subcortical structures such as thalamus-implicating their collective role in supporting fluent speech. Our detailed mapping of the speech fluency network offers a strategic foundation for clinicians to safeguard language function during the surgical intervention for brain tumours.
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Affiliation(s)
- Cechen Sun
- Department of Biostatistics, School of Public Health & National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jie Zhang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Shanghai 201107, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, China
- Neurosurgical Institute of Fudan University, Shanghai 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, China
| | - Linghao Bu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Shanghai 201107, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, China
- Neurosurgical Institute of Fudan University, Shanghai 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, China
| | - Junfeng Lu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Shanghai 201107, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, China
- Neurosurgical Institute of Fudan University, Shanghai 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, China
| | - Ye Yao
- Department of Biostatistics, School of Public Health & National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Jinsong Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Shanghai 201107, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai 200040, China
- Neurosurgical Institute of Fudan University, Shanghai 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, China
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6
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Bunker LD, Bailey DJ, Poss E, Mauszycki S, Wambaugh JL. Stability Over Time of Word Syllable Duration for Speakers With Acquired Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-15. [PMID: 38527280 DOI: 10.1044/2024_jslhr-23-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE Neurogenic speech and language disorders-such as acquired apraxia of speech (AOS) and aphasia with phonemic paraphasia (APP)-are often misdiagnosed due to similarities in clinical presentation. Word syllable duration (WSD)-a measure of average syllable length in multisyllabic words-serves as a proxy for speech rate, which is an important and arguably more objective clinical characteristic of AOS and APP. This study reports stability of WSD over time for speakers with AOS (and aphasia). METHOD Twenty-nine participants with AOS and aphasia (11 women and 18 men, Mage = 53.5 years, SD = 13.3) repeated 30 multisyllabic words (of three-, four-, and five-syllable lengths) on three occasions across 4 weeks. WSDs were calculated for each word and then averaged across each list (i.e., word length), as well as across combined lists (i.e., all 30 words) to yield four WSDs for each participant at each time point. Stability over time was calculated using Friedman's test for the group and using Spearman's rho for the individual level. Effects of time and word length were examined using robust mixed-effects linear regression. RESULTS Friedman's tests and correlations indicated no significant difference in WSDs across sampling occasions for each word length separately or combined. WSD correlated positively with AOS severity and negatively with intelligibility but was not correlated with aphasia severity. Regression analyses confirmed WSD to be stable over time, while WSD calculated from only five tokens (i.e., WSD-5) was less stable over time. CONCLUSIONS Results indicate that WSD can be a stable measure over time, at the individual and group level, providing support for its use in diagnosis and/or as an outcome measure, both clinically and for research. In general, WSD outperformed WSD-5, suggesting that it may be better to calculate WSD from more than five tokens. Stability of WSD in other populations and suitability for differential diagnosis need to be determined. Currently, differentiating disorders by speaking rate, alone, is not recommended. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25438735.
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Affiliation(s)
| | | | - Elaine Poss
- VA Sierra Nevada Health Care System, Reno, NV
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7
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Esmailzade Moghimi S, Mohammadi F, Yadegari F, Dehghan M, Hojjati SMM, Saadat P, Geraili Z, Alizadeh M. Verbal and oral apraxia in patients with acute stroke: Frequency, relationship, and some risk factors. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:97-108. [PMID: 34726969 DOI: 10.1080/23279095.2021.1993225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Verbal and oral apraxia are two possible consequences of stroke. It seems that there are not sufficient studies regarding the frequency of these disorders. This study aimed to evaluate the frequency of Verbal and oral apraxia. In addition, the relationship between apraxia and some variables such as age, gender, and education, as well as the relationship between types of apraxia with each other, and damaged areas of the brain in apraxia of the oral system in Persian-speaking patients with stroke were studied. In this descriptive-analytical study, 42 patients participated using the convenient sampling method. Verbal and oral apraxia were assessed using the oral and verbal apraxia tasks for adults test. Data were analyzed using independent t-test, Chi-square, and Fisher's exact test. The frequency of patients with oral apraxia was 35.7%, those with verbal apraxia was 2.3%, and the combination of both verbal and oral apraxia was 4.7%. People with apraxia were significantly older than those without apraxia. There was not any significant relationship between apraxia and gender, apraxia and education, and oral apraxia with verbal apraxia (p < 0.05). The present study's findings showed the high frequency of post-stroke apraxia and the high rate of its incidence with age.
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Affiliation(s)
| | - Fatemeh Mohammadi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Fariba Yadegari
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Dehghan
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
| | | | - Payam Saadat
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Neurology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Geraili
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Alizadeh
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
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8
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Shekari E, Seyfi M, Modarres Zadeh A, Batouli SA, Valinejad V, Goudarzi S, Joghataei MT. Mechanisms of brain activation following naming therapy in aphasia: A systematic review on task-based fMRI studies. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:780-801. [PMID: 35666667 DOI: 10.1080/23279095.2022.2074849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The pattern of brain neuroplasticity after naming therapies in patients with aphasia can be evaluated using task-based fMRI. This article aims to review studies investigating brain reorganization after semantic and phonological-based anomia therapy that used picture-naming fMRI tasks. We searched for those articles that compared the activation of brain areas before and after aphasia therapies in the PubMed and the EMBASE databases from 1993 up to April 2020. All studies (single-cases or group designs) on anomia treatment in individuals with acquired aphasia were reviewed. Data were synthesized descriptively through tables to allow the facilitated comparison of the studies. A total of 14 studies were selected and reviewed. The results of the reviewed studies demonstrated that the naming improvement is associated with changes in the activation of cortical and subcortical brain areas. This review highlights the need for a more systematic investigation of the association between decreased and increased activation of brain areas related to anomia therapy. Also, more detailed information about factors influencing brain reorganization is required to elucidate the neural mechanisms of anomia therapy. Overall, regarding the theoretical and clinical aspects, the number of studies that used intensive protocol is growing, and based on the positive potential of these treatments, they could be suitable for the rehabilitation of people with aphasia.
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Affiliation(s)
- Ehsan Shekari
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Seyfi
- Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Modarres Zadeh
- Department of Speech Therapy, Faculty of Rehabilitation, Tehran University of Medical science, Tehran, Iran
| | - Seyed Amirhossein Batouli
- Neuroimaging and Analysis Group, Tehran University of Medical Sciences, Tehran, Iran
- School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Valinejad
- Department of Speech Therapy, Faculty of Rehabilitation, Tehran University of Medical science, Tehran, Iran
| | - Sepideh Goudarzi
- Department of Pharmacology and Toxicology, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Taghi Joghataei
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
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9
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Tsukada T, Kubo M, Okamoto S, Hirao M, Horie Y. Intravenous Thrombolysis Improved Aphemia and Confirmed the Dominant Precentral Gyrus as the Responsible Lesion. Cureus 2023; 15:e46964. [PMID: 38021911 PMCID: PMC10640781 DOI: 10.7759/cureus.46964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Aphemia is now considered an impairment of speech production. We present a case of an 89-year-old right-handed woman who received intravenous thrombolysis with a recombinant tissue plasminogen activator for the ischemic symptom "loss of speech" and recovered with an ischemic lesion of the left precentral gyrus. The patient had untreated atrial fibrillation. Neurological examination showed that her level of consciousness was alert, with normal comprehension and mild lower facial droop. Head computed tomography (CT) did not reveal a hemorrhagic lesion. To treat the acute ischemic stroke, she received a recombinant tissue plasminogen activator. Just after thrombolysis, she started to speak. Then, magnetic resonance imaging (MRI) revealed an acute ischemic infarction in the dominant precentral gyrus. Follow-up MRI revealed the peripheral middle cerebral artery territory infarction in the left precentral gyrus, but she still could speak. The symptom of "loss of speech" was considered aphemia. By intravenous thrombolysis, impaired speech production in our patient was believed to be caused by an infarction in the dominant precentral gyrus. This case also demonstrated that the rare clinical symptom was due to an ischemic stroke in the territory of the distal middle cerebral artery. Clinicians who engage in stroke care need to know the rare symptoms of aphemia in the era when mechanical thrombectomy could be considered a promising treatment option for distal medium vessel occlusion.
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Affiliation(s)
| | - Michiya Kubo
- Neurological Surgery, Saiseikai Toyama Hospital, Toyama, JPN
| | - Soshi Okamoto
- Neurological Surgery, Saiseikai Toyama Hospital, Toyama, JPN
| | - Masato Hirao
- Neurology, Saiseikai Toyama Hospital, Toyama, JPN
| | - Yukio Horie
- Neurological Surgery, Saiseikai Toyama Hospital, Toyama, JPN
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10
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Pracar AL, Ivanova MV, Richardson A, Dronkers NF. A case of pure apraxia of speech after left hemisphere stroke: behavioral findings and neural correlates. Front Neurol 2023; 14:1187399. [PMID: 37576017 PMCID: PMC10421996 DOI: 10.3389/fneur.2023.1187399] [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: 03/16/2023] [Accepted: 06/29/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Apraxia of speech (AOS) is a motor speech disorder impairing the coordination of complex articulatory movements needed to produce speech. AOS typically co-occurs with a non-fluent aphasia, or language disorder, making it challenging to determine the specific brain structures that cause AOS. Cases of pure AOS without aphasia are rare but offer the best window into the neural correlates that support articulatory planning. The goal of the current study was to explore patterns of apraxic speech errors and their underlying neural correlates in a case of pure AOS. Methods A 67-year-old right-handed man presented with severe AOS resulting from a fronto-insular lesion caused by an ischemic stroke. The participant's speech and language were evaluated at 1-, 3- and 12-months post-onset. High resolution structural MRI, including diffusion weighted imaging, was acquired at 12 months post-onset. Results At the first assessment, the participant made minor errors on the Comprehensive Aphasia Test, demonstrating mild deficits in writing, auditory comprehension, and repetition. By the second assessment, he no longer had aphasia. On the Motor Speech Evaluation, the severity of his AOS was initially rated as 5 (out of 7) and improved to a score of 4 by the second visit, likely due to training by his SLP at the time to slow his speech. Structural MRI data showed a fronto-insular lesion encompassing the superior precentral gyrus of the insula and portions of the inferior and middle frontal gyri and precentral gyrus. Tractography derived from diffusion MRI showed partial damage to the frontal aslant tract and arcuate fasciculus along the white matter projections to the insula. Discussion This pure case of severe AOS without aphasia affords a unique window into the behavioral and neural mechanisms of this motor speech disorder. The current findings support previous observations that AOS and aphasia are dissociable and confirm a role for the precentral gyrus of the insula and BA44, as well as underlying white matter in supporting the coordination of complex articulatory movements. Additionally, other regions including the precentral gyrus, Broca's area, and Area 55b are discussed regarding their potential role in successful speech production.
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Affiliation(s)
- Alexis L. Pracar
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Maria V. Ivanova
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Amber Richardson
- VA Northern California Health Care System, Martinez, CA, United States
| | - Nina F. Dronkers
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
- Department of Neurology, University of California, Davis, Davis, CA, United States
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11
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Hickok G, Venezia J, Teghipco A. Beyond Broca: neural architecture and evolution of a dual motor speech coordination system. Brain 2023; 146:1775-1790. [PMID: 36746488 PMCID: PMC10411947 DOI: 10.1093/brain/awac454] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/04/2022] [Accepted: 11/19/2022] [Indexed: 02/08/2023] Open
Abstract
Classical neural architecture models of speech production propose a single system centred on Broca's area coordinating all the vocal articulators from lips to larynx. Modern evidence has challenged both the idea that Broca's area is involved in motor speech coordination and that there is only one coordination network. Drawing on a wide range of evidence, here we propose a dual speech coordination model in which laryngeal control of pitch-related aspects of prosody and song are coordinated by a hierarchically organized dorsolateral system while supralaryngeal articulation at the phonetic/syllabic level is coordinated by a more ventral system posterior to Broca's area. We argue further that these two speech production subsystems have distinguishable evolutionary histories and discuss the implications for models of language evolution.
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Affiliation(s)
- Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA 92697, USA
- Department of Language Science, University of California, Irvine, CA 92697, USA
| | - Jonathan Venezia
- Auditory Research Laboratory, VA Loma Linda Healthcare System, Loma Linda, CA 92357, USA
- Department of Otolaryngology—Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Alex Teghipco
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
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12
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Wang L, Ma Q, Sun X, Xu Z, Zhang J, Liao X, Wang X, Wei D, Chen Y, Liu B, Huang CC, Zheng Y, Wu Y, Chen T, Cheng Y, Xu X, Gong Q, Si T, Qiu S, Lin CP, Cheng J, Tang Y, Wang F, Qiu J, Xie P, Li L, He Y, Xia M, Zhang Y, Li L, Cheng J, Gong Q, Li L, Lin CP, Qiu J, Qiu S, Si T, Tang Y, Wang F, Xie P, Xu X, Xia M. Frequency-resolved connectome alterations in major depressive disorder: A multisite resting fMRI study. J Affect Disord 2023; 328:47-57. [PMID: 36781144 DOI: 10.1016/j.jad.2023.01.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND Functional connectome studies have revealed widespread connectivity alterations in major depressive disorder (MDD). However, the low frequency bandpass filtering (0.01-0.08 Hz or 0.01-0.1 Hz) in most studies have impeded our understanding on whether and how these alterations are affected by frequency of interest. METHODS Here, we performed frequency-resolved (0.01-0.06 Hz, 0.06-0.16 Hz and 0.16-0.24 Hz) connectome analyses using a large-sample resting-state functional MRI dataset of 1002 MDD patients and 924 healthy controls from seven independent centers. RESULTS We reported significant frequency-dependent connectome alterations in MDD in left inferior parietal, inferior temporal, precentral, and fusiform cortices and bilateral precuneus. These frequency-dependent connectome alterations are mainly derived by abnormalities of medium- and long-distance connections and are brain network-dependent. Moreover, the connectome alteration of left precuneus in high frequency band (0.16-0.24 Hz) is significantly associated with illness duration. LIMITATIONS Multisite harmonization model only removed linear site effects. Neurobiological underpinning of alterations in higher frequency (0.16-0.24 Hz) should be further examined by combining fMRI data with respiration, heartbeat and blood flow recordings in future studies. CONCLUSIONS These results highlight the frequency-dependency of connectome alterations in MDD and the benefit of examining connectome alteration in MDD under a wider frequency band.
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Affiliation(s)
- Lei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Qing Ma
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Xiaoyi Sun
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; School of Systems Science, Beijing Normal University, Beijing, China
| | - Zhilei Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jiaying Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xuhong Liao
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Xiaoqin Wang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Chu-Chung Huang
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yanting Zheng
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yankun Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ching-Po Lin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK; Institute of Neuroscience, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Peng Xie
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingjiang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Chinese Institute for Brain Research, Beijing, China
| | | | - Mingrui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| | - Yihe Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
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13
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Pace B, Holtzer R, Wagshul ME. Gray matter volume and within-task verbal fluency performance among older adults. Brain Cogn 2023; 166:105960. [PMID: 36868129 PMCID: PMC10257804 DOI: 10.1016/j.bandc.2023.105960] [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: 09/06/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 03/05/2023]
Abstract
The current study examined the relationship between gray matter volume (GMV) and rate of word generation over the course of three consecutive 20-sec intervals in 60-sec letter and category verbal fluency (VF) tasks. Attenuated rate of within-person word generation in VF provides incremental information beyond total scores and predicts increased risk of incident Mild Cognitive Impairment (MCI). No studies to date, however, have determined the structural neural substrates underlying word generation rate in VF. Participants were 70 community-residing adults ≥ 65 years, who completed the letter and category VF tasks and a 3 T structural MRI scan. Linear mixed effects models (LMEMs) were used to determine the moderating effect of GMV on word generation rate. Whole brain voxel-wise LMEMs, adjusted for age, gender, education, Wide-Range Achievement Test - reading subtest score (WRAT3), and global health score, were run using permutation methods to correct for multiple comparisons. Lower GMV, primarily in frontal regions (superior frontal, rostral middle frontal, frontal pole, medial orbitofrontal, and pars orbitalis), were related to attenuated word generation rate, especially for letter VF. We propose that lower frontal GMV underlies inefficient executive word search processes reflected by attenuated word generation slope in letter VF amongst older adults.
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Affiliation(s)
- Brigitte Pace
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, The Bronx, NY 10461, United States.
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, The Bronx, NY 10461, United States; Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Ave, The Bronx, NY 10416, United States.
| | - Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, 1250 Morris Park Ave, The Bronx, NY 10461, United States; Physiology and Biophysics, Albert Einstein College of Medicine, 1300 Morris Park Ave, The Bronx, NY 10416, United States.
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14
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Ishihara K, Fukui T, Kawamura M, Shiota JI, Nakano I. Symptomatology and Neuropathology of patients presenting with focal cortical signs. Neuropathology 2023; 43:27-43. [PMID: 36328774 DOI: 10.1111/neup.12854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/05/2022] [Accepted: 07/10/2022] [Indexed: 11/06/2022]
Abstract
Here, we describe two patients who presented with focal cortical signs and underwent neuropathological examination. Case 1 was a 73-year-old woman with progressive speech disorder and abnormal behavior. She showed agraphia of the frontal lobe type, featured by the omission of kana letters when writing, other than pyramidal tract signs, pseudobulbar palsy, and frontal lobe dementia. Neuropathological examination, including TAR DNA-binding protein 43 (TDP-43) immunohistochemistry, revealed bilateral frontal and anterior temporal lobe lesions accentuated in the precentral gyrus and posterior part of the middle frontal gyrus. Both upper and lower motor neurons showed pathological changes compatible with amyotrophic lateral sclerosis. Case 2 was a 62-year-old man with progressive speech disorder and hand clumsiness. He had a motor speech disorder, compatible with apraxia of speech, and limb apraxia of the limb-kinetic and ideomotor type. Neuropathological examination revealed degeneration in the left frontal lobe, including the precentral gyrus, anterior temporal, and parietal lobe cortices. Moreover, numerous argyrophilic neuronal intracytoplasmic inclusions (Pick body) and ballooned neurons were observed in these lesions and the limbic system. The pathological diagnosis was Pick disease involving the peri-Rolandic area and parietal lobe. In these two cases, the distribution of neuropathological changes in the cerebral cortices correlated with the clinical symptoms observed.
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Affiliation(s)
- Kenji Ishihara
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Asahi Hospital of Neurology and Rehabilitation, Chiba, Japan
| | - Toshiya Fukui
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Mitsuru Kawamura
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Okusawa Hospital, Tokyo, Japan
| | - Jun-Ichi Shiota
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Ushioda Home Clinic, Yokohama, Japan
| | - Imaharu Nakano
- Department of Neurology, Jichi Medical University, Tochigi, Japan
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15
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Morihara K, Ota S, Kakinuma K, Kawakami N, Higashiyama Y, Kanno S, Tanaka F, Suzuki K. Buccofacial apraxia in primary progressive aphasia. Cortex 2023; 158:61-70. [PMID: 36462386 DOI: 10.1016/j.cortex.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/23/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022]
Abstract
Buccofacial apraxia (BFA) is associated with nonfluent/agrammatic variant primary progressive aphasia (nfvPPA) as well as with the severity of apraxia of speech (AOS), a core symptom of nfvPPA. However, an association with agrammatism has not been established. The aim of this study was to examine the association between BFA and agrammatism in nfvPPA and to determine differences in atrophic regions in primary progressive aphasia (PPA) with and without BFA. Seventy-four patients with PPA were recruited, including 34, 15, 10, and 15 patients with nfvPPA, semantic variant PPA, logopenic variant PPA, and unclassified PPA, respectively. All patients underwent language examination and BFA evaluations. Voxel-based morphometry (VBM) was performed to determine whether atrophy of a specific lesion correlated with the presence of BFA. BFA was observed in 20 and 3 patients with nfvPPA and unclassified PPA, respectively. In a comparison of patients with nfvPPA with and without BFA, the BFA group showed significantly worse spontaneous speech and writing in the Western Aphasia Battery. The agrammatism ratio or the ratio of agrammatic errors to the total number of particles was higher in the BFA group; however, the severity of prosodic and phonetic components of AOS did not differ between the two groups. VBM showed that the severity of BFA correlated with atrophy of the opercular and triangular areas of the inferior frontal gyrus to a part of the left middle frontal gyrus. BFA has a different anatomical basis from AOS in patients with nfvPPA and that BFA is characterized by more anterior degeneration compared to that of AOS.
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Affiliation(s)
- Keisuke Morihara
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
| | - Shoko Ota
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kazuo Kakinuma
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nobuko Kawakami
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yuichi Higashiyama
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Shigenori Kanno
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kyoko Suzuki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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16
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Sintini I, Duffy JR, Clark HM, Utianski RL, Botha H, Machulda MM, Senjem ML, Strand EA, Schwarz CG, Lowe VJ, Jack CR, Josephs KA, Whitwell JL. Functional connectivity to the premotor cortex maps onto longitudinal brain neurodegeneration in progressive apraxia of speech. Neurobiol Aging 2022; 120:105-116. [PMID: 36166918 PMCID: PMC9613616 DOI: 10.1016/j.neurobiolaging.2022.08.013] [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: 03/25/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 11/26/2022]
Abstract
Primary progressive apraxia of speech (PPAOS) is a neurodegenerative motor speech disorder affecting the ability to produce speech. If agrammatic aphasia is present, it can be referred to as the non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA). We investigated whether resting-state functional MRI (rs-fMRI) connectivity from disease "epicenters" correlated with longitudinal gray matter atrophy and hypometabolism in nfvPPA and PPAOS. Eighteen nfvPPA and 23 PPAOS patients underwent clinical assessment, structural MRI, rs-fMRI, and [18F] fluorodeoxyglucose (FDG)-PET at baseline and ∼2 years follow-up. Rates of neurodegeneration in nfvPPA and PPAOS correlated with functional connectivity to the premotor, motor, and frontal cortex. Connectivity to the caudate and thalamus was more strongly associated with rates of hypometabolism than atrophy. Connectivity to the left Broca's area was more strongly associated with rates of atrophy and hypometabolism in nfvPPA. Finally, functional connectivity to a network of regions, and not to a single epicenter, correlated with rates of neurodegeneration in PPAOS and nfvPPA, suggesting similar biological mechanisms driving disease progression, with regional differences related to language.
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Affiliation(s)
- Irene Sintini
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
| | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Matthew L Senjem
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Edythe A Strand
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Speech & Hearing Sciences, University of Washington, Seattle, WA, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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17
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Silva AB, Liu JR, Zhao L, Levy DF, Scott TL, Chang EF. A Neurosurgical Functional Dissection of the Middle Precentral Gyrus during Speech Production. J Neurosci 2022; 42:8416-8426. [PMID: 36351829 PMCID: PMC9665919 DOI: 10.1523/jneurosci.1614-22.2022] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Classical models have traditionally focused on the left posterior inferior frontal gyrus (Broca's area) as a key region for motor planning of speech production. However, converging evidence suggests that it is not critical for either speech motor planning or execution. Alternative cortical areas supporting high-level speech motor planning have yet to be defined. In this review, we focus on the precentral gyrus, whose role in speech production is often thought to be limited to lower-level articulatory muscle control. In particular, we highlight neurosurgical investigations that have shed light on a cortical region anatomically located near the midpoint of the precentral gyrus, hence called the middle precentral gyrus (midPrCG). The midPrCG is functionally located between dorsal hand and ventral orofacial cortical representations and exhibits unique sensorimotor and multisensory functions relevant for speech processing. This includes motor control of the larynx, auditory processing, as well as a role in reading and writing. Furthermore, direct electrical stimulation of midPrCG can evoke complex movements, such as vocalization, and selective injury can cause deficits in verbal fluency, such as pure apraxia of speech. Based on these findings, we propose that midPrCG is essential to phonological-motoric aspects of speech production, especially syllabic-level speech sequencing, a role traditionally ascribed to Broca's area. The midPrCG is a cortical brain area that should be included in contemporary models of speech production with a unique role in speech motor planning and execution.
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Affiliation(s)
- Alexander B Silva
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Medical Scientist Training Program, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
| | - Jessie R Liu
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
| | - Lingyun Zhao
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Deborah F Levy
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Terri L Scott
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
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18
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Zhao J, Li Y, Zhang X, Yuan Y, Cheng Y, Hou J, Duan G, Liu B, Wang J, Wu D. Alteration of network connectivity in stroke patients with apraxia of speech after tDCS: A randomized controlled study. Front Neurol 2022; 13:969786. [PMID: 36188376 PMCID: PMC9521848 DOI: 10.3389/fneur.2022.969786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to examine the changes in the functional connectivity of the cortical speech articulation network after anodal transcranial direct current stimulation (A-tDCS) over the left lip region of the primary motor cortex (M1) in subacute post-stroke patients with apraxia of speech (AoS), and the effect of A-tDCS on AoS. Methods A total of 24 patients with post-stroke AoS were randomized into two groups and received A-tDCS over the left lip region of M1 (tDCS group)/ sham tDCS (control group) as well as speech and language therapy two times per day for 5 days. Before and after the treatment, the AoS assessments and electroencephalogram (EEG) were evaluated. The cortical interconnections were measured using the EEG non-linear index of cross approximate entropy (C-ApEn). Results The analysis of EEG showed that, after the treatment, the activated connectivity was all in the left hemisphere, and not only regions in the speech articulation network but also in the dorsal lateral prefrontal cortex (DLPFC) in the domain-general network were activated in the tDCS group. In contrast, the connectivity was confined to the right hemisphere and between bilateral DLPFC and bilateral inferior frontal gyrus (IFG) in the control group. In AoS assessments, the tDCS group improved significantly more than the control group in four of the five subtests. The results of multivariate linear regression analyses showed that only the group was significantly associated with the improvement of word repetition (P = 0.002). Conclusion A-tDCS over the left lip region of M1 coupled with speech therapy could upregulate the connectivity of both speech-specific and domain-general networks in the left hemisphere. The improved articulation performance in patients with post-stroke AoS might be related to the enhanced connectivity of networks in the left hemisphere induced by tDCS. Clinical trial registration ChiCTR-TRC-14005072.
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Affiliation(s)
- Jiayi Zhao
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Yuanyuan Li
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Xu Zhang
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Ying Yuan
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Yinan Cheng
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Jun Hou
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Guoping Duan
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Baohu Liu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Jie Wang
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
- Jie Wang
| | - Dongyu Wu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Science, Beijing, China
- *Correspondence: Dongyu Wu
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19
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Cassidy JM, Mark JI, Cramer SC. Functional connectivity drives stroke recovery: shifting the paradigm from correlation to causation. Brain 2022; 145:1211-1228. [PMID: 34932786 PMCID: PMC9630718 DOI: 10.1093/brain/awab469] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/20/2021] [Accepted: 11/26/2021] [Indexed: 11/14/2022] Open
Abstract
Stroke is a leading cause of disability, with deficits encompassing multiple functional domains. The heterogeneity underlying stroke poses significant challenges in the prediction of post-stroke recovery, prompting the development of neuroimaging-based biomarkers. Structural neuroimaging measurements, particularly those reflecting corticospinal tract injury, are well-documented in the literature as potential biomarker candidates of post-stroke motor recovery. Consistent with the view of stroke as a 'circuitopathy', functional neuroimaging measures probing functional connectivity may also prove informative in post-stroke recovery. An important step in the development of biomarkers based on functional neural network connectivity is the establishment of causality between connectivity and post-stroke recovery. Current evidence predominantly involves statistical correlations between connectivity measures and post-stroke behavioural status, either cross-sectionally or serially over time. However, the advancement of functional connectivity application in stroke depends on devising experiments that infer causality. In 1965, Sir Austin Bradford Hill introduced nine viewpoints to consider when determining the causality of an association: (i) strength; (ii) consistency; (iii) specificity; (iv) temporality; (v) biological gradient; (vi) plausibility; (vii) coherence; (viii) experiment; and (ix) analogy. Collectively referred to as the Bradford Hill Criteria, these points have been widely adopted in epidemiology. In this review, we assert the value of implementing Bradford Hill's framework to stroke rehabilitation and neuroimaging. We focus on the role of neural network connectivity measurements acquired from task-oriented and resting-state functional MRI, EEG, magnetoencephalography and functional near-infrared spectroscopy in describing and predicting post-stroke behavioural status and recovery. We also identify research opportunities within each Bradford Hill tenet to shift the experimental paradigm from correlation to causation.
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Affiliation(s)
- Jessica M Cassidy
- Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jasper I Mark
- Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Steven C Cramer
- Department of Neurology, University of California, Los Angeles; and California Rehabilitation Institute, Los Angeles, CA, USA
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20
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Shah-Basak P, Sivaratnam G, Teti S, Deschamps T, Kielar A, Jokel R, Meltzer JA. Electrophysiological connectivity markers of preserved language functions in post-stroke aphasia. Neuroimage Clin 2022; 34:103036. [PMID: 35561556 PMCID: PMC9111985 DOI: 10.1016/j.nicl.2022.103036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/19/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022]
Abstract
Post-stroke aphasia is a consequence of localized stroke-related damage as well as global disturbances in a highly interactive and bilaterally-distributed language network. Aphasia is increasingly accepted as a network disorder and it should be treated as such when examining the reorganization and recovery mechanisms after stroke. In the current study, we sought to investigate reorganized patterns of electrophysiological connectivity, derived from resting-state magnetoencephalography (rsMEG), in post-stroke chronic (>6 months after onset) aphasia. We implemented amplitude envelope correlations (AEC), a metric of connectivity commonly used to describe slower aspects of interregional communication in resting-state electrophysiological data. The main focus was on identifying the oscillatory frequency bands and frequency-specific spatial topology of connections associated with preserved language abilities after stroke. RsMEG was recorded for 5 min in 21 chronic stroke survivors with aphasia and in 20 matched healthy controls. Source-level MEG activity was reconstructed and summarized within 72 atlas-defined brain regions (or nodes). A 72 × 72 leakage-corrected connectivity (of AEC) matrix was obtained for frequencies from theta to low-gamma (4–50 Hz). Connectivity was compared between groups, and, the correlations between connectivity and subscale scores from the Western Aphasia Battery (WAB) were evaluated in the stroke group, using partial least squares analyses. Posthoc multiple regression analyses were also conducted on a graph theory measure of node strengths, derived from significant connectivity results, to control for node-wise properties (local spectral power and lesion sizes) and demographic and stroke-related variables. Connectivity among the left hemisphere regions, i.e. those ipsilateral to the stroke lesion, was greatly reduced in stroke survivors with aphasia compared to matched healthy controls in the alpha (8–13 Hz; p = 0.011) and beta (15–30 Hz; p = 0.001) bands. The spatial topology of hypoconnectivity in the alpha vs. beta bands was distinct, revealing a greater involvement of ventral frontal, temporal and parietal areas in alpha, and dorsal frontal and parietal areas in beta. The node strengths from alpha and beta group differences remained significant after controlling for nodal spectral power. AEC correlations with WAB subscales of object naming and fluency were significant. Greater alpha connectivity was associated with better naming performance (p = 0.045), and greater connectivity in both the alpha (p = 0.033) and beta (p = 0.007) bands was associated with better speech fluency performance. The spatial topology was distinct between these frequency bands. The node strengths remained significant after controlling for age, time post stroke onset, nodal spectral power and nodal lesion sizes. Our findings provide important insights into the electrophysiological connectivity profiles (frequency and spatial topology) potentially underpinning preserved language abilities in stroke survivors with aphasia.
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Affiliation(s)
- Priyanka Shah-Basak
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.
| | - Gayatri Sivaratnam
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Selina Teti
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Tiffany Deschamps
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Aneta Kielar
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, AZ, USA
| | - Regina Jokel
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada; Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Jed A Meltzer
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada; Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada; Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada; Department of Psychology, University of Toronto, Toronto, ON, Canada
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21
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Kenney JPM, Milena Rueda-Delgado L, Hanlon EO, Jollans L, Kelleher I, Healy C, Dooley N, McCandless C, Frodl T, Leemans A, Lebel C, Whelan R, Cannon M. Neuroanatomical markers of psychotic experiences in adolescents: A machine-learning approach in a longitudinal population-based sample. Neuroimage Clin 2022; 34:102983. [PMID: 35287090 PMCID: PMC8920932 DOI: 10.1016/j.nicl.2022.102983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/25/2022]
Abstract
It is important to identify accurate markers of psychiatric illness to aid early prediction of disease course. Subclinical psychotic experiences (PEs) are important risk factors for later mental ill-health and suicidal behaviour. This study used machine learning to investigate neuroanatomical markers of PEs in early and later stages of adolescence. Machine learning using logistic regression using Elastic Net regularization was applied to T1-weighted and diffusion MRI data to classify adolescents with subclinical psychotic experiences vs. controls across 3 timepoints (Time 1:11-13 years, n = 77; Time 2:14-16 years, n = 56; Time 3:18-20 years, n = 40). Neuroimaging data classified adolescents aged 11-13 years with current PEs vs. controls returning an AROC of 0.62, significantly better than a null model, p = 1.73e-29. Neuroimaging data also classified those with PEs at 18-20 years (AROC = 0.59;P = 7.19e-10) but performance was at chance level at 14-16 years (AROC = 0.50). Left hemisphere frontal regions were top discriminant classifiers for 11-13 years-old adolescents with PEs, particularly pars opercularis. Those with future PEs at 18-20 years-old were best distinguished from controls based on left frontal regions, right-hemisphere medial lemniscus, cingulum bundle, precuneus and genu of the corpus callosum (CC). Deviations from normal adolescent brain development in young people with PEs included an acceleration in the typical pattern of reduction in left frontal thickness and right parietal curvature, and accelerated progression of microstructural changes in right white matter and corpus callosum. These results emphasise the importance of multi-modal analysis for understanding adolescent PEs and provide important new insights into early phenotypes for psychotic experiences.
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Affiliation(s)
- Joanne P M Kenney
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; School of Psychology, Dublin City University, Dublin, Ireland
| | - Laura Milena Rueda-Delgado
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Erik O Hanlon
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Lee Jollans
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Niamh Dooley
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Conor McCandless
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Thomas Frodl
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Alexander Leemans
- Images Sciences Institute, University Medical Center Utrecht, The Netherlands
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute and the Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Robert Whelan
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Mary Cannon
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 2, Ireland
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22
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Ziegler W, Aichert I, Staiger A, Willmes K, Baumgaertner A, Grewe T, Flöel A, Huber W, Rocker R, Korsukewitz C, Breitenstein C. The prevalence of apraxia of speech in chronic aphasia after stroke: A Bayesian hierarchical analysis. Cortex 2022; 151:15-29. [DOI: 10.1016/j.cortex.2022.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 01/24/2023]
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23
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Neuronavigated repetitive transcranial magnetic stimulation as novel mapping technique provides insights into language function in primary progressive aphasia. Brain Imaging Behav 2021; 16:1208-1216. [PMID: 34964088 PMCID: PMC9107445 DOI: 10.1007/s11682-021-00605-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/13/2022]
Abstract
Navigated repetitive transcranial magnetic stimulation (nrTMS) is an innovative technique that provides insight into language function with high accuracy in time and space. So far, nrTMS has mainly been applied in presurgical language mapping of patients with intracranial neoplasms. For the present study, nrTMS was used for language mapping in primary progressive aphasia (PPA). Seven patients (median age: 70 years, 4 males) with the non-fluent variant of PPA (nfvPPA) were included in this pilot study. Trains of nrTMS (5 Hz, 100% resting motor threshold) caused virtual lesions at 46 standardized cortical stimulation targets per hemisphere. Patients’ errors in a naming task during stimulation were counted. The majority of errors induced occurred during frontal lobe stimulation (34.3%). Timing errors and non-responses were most frequent. More errors were induced in the right hemisphere (58%) than in the left hemisphere (42%). Mapping was tolerated by all patients, however, discomfort or pain was reported for stimulation of frontal areas. The elevated right-hemispheric error rate in our study could be due to a partial shift of language function to the right hemisphere in neurodegenerative aphasia during the course of disease and therefore points to the existence of neuronal plasticity in nfvPPA. While this is an interesting finding for neurodegenerative disorders per se, its promotion might also harbor future therapeutic targets.
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24
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Conterno M, Kümmerer D, Dressing A, Glauche V, Urbach H, Weiller C, Rijntjes M. Speech apraxia and oral apraxia: association or dissociation? A multivariate lesion-symptom mapping study in acute stroke patients. Exp Brain Res 2021; 240:39-51. [PMID: 34652492 PMCID: PMC8803819 DOI: 10.1007/s00221-021-06224-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 09/11/2021] [Indexed: 11/28/2022]
Abstract
The anatomical relationship between speech apraxia (SA) and oral apraxia (OA) is still unclear. To shed light on this matter we studied 137 patients with acute ischaemic left-hemisphere stroke and performed support vector regression-based, multivariate lesion–symptom mapping. Thirty-three patients presented with either SA or OA. These two symptoms mostly co-occurred (n = 28), except for few patients with isolated SA (n = 2) or OA (n = 3). All patient with either SA or OA presented with aphasia (p < 0.001) and these symptoms were highly associated with apraxia (p < 0.001). Co-occurring SA and OA were predominantly associated with insular lesions, while the insula was completely spared in the five patients with isolated SA or OA. Isolated SA occurred in case of frontal lesions (prefrontal gyrus and superior longitudinal fasciculus), while isolated OA occurred in case of either temporoparietal or striatocapsular lesions. Our study supports the notion of a predominant, but not exclusive, role of the insula in verbal and non-verbal oral praxis, and indicates that frontal regions may contribute exclusively to verbal oral praxis, while temporoparietal and striatocapsular regions contribute to non-verbal oral praxis. However, since tests for SA and OA so far intrinsically also investigate aphasia and apraxia, refined tests are warranted.
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Affiliation(s)
- Martina Conterno
- Clinic of Neurology and Neurophysiology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg im Breisgau, Germany. .,Freiburg Brain Imaging Centre, University of Freiburg, 79106, Freiburg im Breisgau, Germany.
| | - Dorothee Kümmerer
- Clinic of Neurology and Neurophysiology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg im Breisgau, Germany.,Freiburg Brain Imaging Centre, University of Freiburg, 79106, Freiburg im Breisgau, Germany
| | - Andrea Dressing
- Clinic of Neurology and Neurophysiology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg im Breisgau, Germany.,Freiburg Brain Imaging Centre, University of Freiburg, 79106, Freiburg im Breisgau, Germany.,BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, 79110, Freiburg im Breisgau, Germany
| | - Volkmar Glauche
- Clinic of Neurology and Neurophysiology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg im Breisgau, Germany.,Freiburg Brain Imaging Centre, University of Freiburg, 79106, Freiburg im Breisgau, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Cornelius Weiller
- Clinic of Neurology and Neurophysiology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg im Breisgau, Germany.,Freiburg Brain Imaging Centre, University of Freiburg, 79106, Freiburg im Breisgau, Germany.,BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, 79110, Freiburg im Breisgau, Germany
| | - Michel Rijntjes
- Clinic of Neurology and Neurophysiology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106, Freiburg im Breisgau, Germany.,Freiburg Brain Imaging Centre, University of Freiburg, 79106, Freiburg im Breisgau, Germany
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25
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Dickens JV, DeMarco AT, van der Stelt CM, Snider SF, Lacey EH, Medaglia JD, Friedman RB, Turkeltaub PE. Two types of phonological reading impairment in stroke aphasia. Brain Commun 2021; 3:fcab194. [PMID: 34522884 PMCID: PMC8432944 DOI: 10.1093/braincomms/fcab194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 07/18/2021] [Accepted: 07/26/2021] [Indexed: 11/12/2022] Open
Abstract
Alexia is common in the context of aphasia. It is widely agreed that damage to phonological and semantic systems not specific to reading causes co-morbid alexia and aphasia. Studies of alexia to date have only examined phonology and semantics as singular processes or axes of impairment, typically in the context of stereotyped alexia syndromes. However, phonology, in particular, is known to rely on subprocesses, including sensory-phonological processing, motor-phonological processing, and sensory-motor integration. Moreover, many people with stroke aphasia demonstrate mild or mixed patterns of reading impairment that do not fit neatly with one syndrome. This cross-sectional study tested whether the hallmark symptom of phonological reading impairment, the lexicality effect, emerges from damage to a specific subprocess of phonology in stroke patients not selected for alexia syndromes. Participants were 30 subjects with left-hemispheric stroke and 37 age- and education-matched controls. A logistic mixed-effects model tested whether post-stroke impairments in sensory phonology, motor phonology, or sensory-motor integration modulated the effect of item lexicality on patient accuracy in reading aloud. Support vector regression voxel-based lesion-symptom mapping localized brain regions necessary for reading and non-orthographic phonological processing. Additionally, a novel support vector regression structural connectome-symptom mapping method identified the contribution of both lesioned and spared but disconnected, brain regions to reading accuracy and non-orthographic phonological processing. Specifically, we derived whole-brain structural connectomes using constrained spherical deconvolution-based probabilistic tractography and identified lesioned connections based on comparisons between patients and controls. Logistic mixed-effects regression revealed that only greater motor-phonological impairment related to lower accuracy reading aloud pseudowords versus words. Impaired sensory-motor integration was related to lower overall accuracy in reading aloud. No relationship was identified between sensory-phonological impairment and reading accuracy. Voxel-based and structural connectome lesion-symptom mapping revealed that lesioned and disconnected left ventral precentral gyrus related to both greater motor-phonological impairment and lower sublexical reading accuracy. In contrast, lesioned and disconnected left temporoparietal cortex is related to both impaired sensory-motor integration and reduced overall reading accuracy. These results clarify that at least two dissociable phonological processes contribute to the pattern of reading impairment in aphasia. First, impaired sensory-motor integration, caused by lesions disrupting the left temporoparietal cortex and its structural connections, non-selectively reduces accuracy in reading aloud. Second, impaired motor-phonological processing, caused at least partially by lesions disrupting left ventral premotor cortex and structural connections, selectively reduces sublexical reading accuracy. These results motivate a revised cognitive model of reading aloud that incorporates a sensory-motor phonological circuit.
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Affiliation(s)
- Jonathan Vivian Dickens
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Andrew T DeMarco
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA.,Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Candace M van der Stelt
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Sarah F Snider
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Elizabeth H Lacey
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA
| | - John D Medaglia
- Drexel University, Philadelphia, PA 19104, USA.,University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rhonda B Friedman
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA
| | - Peter E Turkeltaub
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC 20007, USA.,Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC 20007, USA.,Department of Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.,Research Division, MedStar National Rehabilitation Hospital, Washington, DC 20001, USA
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26
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Gajardo-Vidal A, Lorca-Puls DL, Team P, Warner H, Pshdary B, Crinion JT, Leff AP, Hope TMH, Geva S, Seghier ML, Green DW, Bowman H, Price CJ. Damage to Broca's area does not contribute to long-term speech production outcome after stroke. Brain 2021; 144:817-832. [PMID: 33517378 PMCID: PMC8041045 DOI: 10.1093/brain/awaa460] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/12/2020] [Accepted: 10/22/2020] [Indexed: 02/03/2023] Open
Abstract
Broca's area in the posterior half of the left inferior frontal gyrus has long been thought to be critical for speech production. The current view is that long-term speech production outcome in patients with Broca's area damage is best explained by the combination of damage to Broca's area and neighbouring regions including the underlying white matter, which was also damaged in Paul Broca's two historic cases. Here, we dissociate the effect of damage to Broca's area from the effect of damage to surrounding areas by studying long-term speech production outcome in 134 stroke survivors with relatively circumscribed left frontal lobe lesions that spared posterior speech production areas in lateral inferior parietal and superior temporal association cortices. Collectively, these patients had varying degrees of damage to one or more of nine atlas-based grey or white matter regions: Brodmann areas 44 and 45 (together known as Broca's area), ventral premotor cortex, primary motor cortex, insula, putamen, the anterior segment of the arcuate fasciculus, uncinate fasciculus and frontal aslant tract. Spoken picture description scores from the Comprehensive Aphasia Test were used as the outcome measure. Multiple regression analyses allowed us to tease apart the contribution of other variables influencing speech production abilities such as total lesion volume and time post-stroke. We found that, in our sample of patients with left frontal damage, long-term speech production impairments (lasting beyond 3 months post-stroke) were solely predicted by the degree of damage to white matter, directly above the insula, in the vicinity of the anterior part of the arcuate fasciculus, with no contribution from the degree of damage to Broca's area (as confirmed with Bayesian statistics). The effect of white matter damage cannot be explained by a disconnection of Broca's area, because speech production scores were worse after damage to the anterior arcuate fasciculus with relative sparing of Broca's area than after damage to Broca's area with relative sparing of the anterior arcuate fasciculus. Our findings provide evidence for three novel conclusions: (i) Broca's area damage does not contribute to long-term speech production outcome after left frontal lobe strokes; (ii) persistent speech production impairments after damage to the anterior arcuate fasciculus cannot be explained by a disconnection of Broca's area; and (iii) the prior association between persistent speech production impairments and Broca's area damage can be explained by co-occurring white matter damage, above the insula, in the vicinity of the anterior part of the arcuate fasciculus.
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Affiliation(s)
- Andrea Gajardo-Vidal
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Faculty of Health Sciences, Universidad del Desarrollo, Concepcion, Chile
| | - Diego L Lorca-Puls
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.,Department of Speech, Language and Hearing Sciences, Faculty of Medicine, Universidad de Concepcion, Concepcion, Chile
| | - Ploras Team
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Holly Warner
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Bawan Pshdary
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Jennifer T Crinion
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Alexander P Leff
- Institute of Cognitive Neuroscience, University College London, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Thomas M H Hope
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Sharon Geva
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Mohamed L Seghier
- Cognitive Neuroimaging Unit, Emirates College for Advanced Education, Abu Dhabi, UAE.,Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, UAE
| | - David W Green
- Department of Experimental Psychology, University College London, London, UK
| | - Howard Bowman
- Centre for Cognitive Neuroscience and Cognitive Systems and the School of Computing, University of Kent, Canterbury, UK.,School of Psychology, University of Birmingham, Birmingham, UK
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
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27
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Gao J, Yang C, Li Q, Chen L, Jiang Y, Liu S, Zhang J, Liu G, Chen J. Hemispheric Difference of Regional Brain Function Exists in Patients With Acute Stroke in Different Cerebral Hemispheres: A Resting-State fMRI Study. Front Aging Neurosci 2021; 13:691518. [PMID: 34305571 PMCID: PMC8299339 DOI: 10.3389/fnagi.2021.691518] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/14/2021] [Indexed: 12/26/2022] Open
Abstract
Objective To explore the different compensatory mechanisms of brain function between the patients with brain dysfunction after acute ischemic stroke (AIS) in the dominant hemisphere and the non-dominant hemisphere based on Resting-state Functional Magnetic Resonance Imaging (Rs-fMRI). Methods In this trial, 15 healthy subjects (HS) were used as blank controls. In total, 30 hemiplegic patients with middle cerebral artery acute infarction of different dominant hemispheres were divided into the dominant hemisphere group (DH) and the non-dominant hemisphere group (NDH), scanned by a 3.0 T MRI scanner, to obtain the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) and compare the differences. Results Compared with the HS, increased ALFF values in the brain areas, such as the bilateral midbrain, were observed in DH. Meanwhile decreased ReHo values in the brain areas, such as the right postcentral gyrus (BA3), were also observed. Enhanced ALFF values in the brain areas, such as the left BA6, and enhanced ReHo values in the brain areas, such as the left precuneus, were observed in the NDH. The ALFF and ReHo values of the right BA9 and precentral gyrus were both increased. Compared with DH, the NDH group showed lower ALFF values in the left supplementary motor area and lower ReHo values in the right BA10. Conclusion After acute infarction in the middle cerebral artery of the dominant hemisphere, a compensation mechanism is triggered in brain areas of the ipsilateral cortex regulating motor-related pathways, while some brain areas related to cognition, sensation, and motor in the contralateral cortex are suppressed, and the connection with the peripheral brain regions is weakened. After acute infarction in the middle cerebral artery of the non-dominant hemisphere, compensatory activation appears in motor control-related brain areas of the dominant hemisphere. After acute middle cerebral artery infarction in the dominant hemisphere, compared with the non-dominant hemisphere, functional specificity in the bilateral supplementary motor area weakens. After acute middle cerebral artery infarction in different hemispheres, there are hemispheric differences in the compensatory mechanism of brain function.
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Affiliation(s)
- Jingchun Gao
- Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University, Guangzhou, China.,Department of Rehabilitation Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Canhong Yang
- Department of Neurology, Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Qixiong Li
- Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Lanpin Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yijing Jiang
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Songyan Liu
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jing Zhang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Gang Liu
- Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junqi Chen
- Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University, Guangzhou, China
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Tomaiuolo F, Campana S, Voci L, Lasaponara S, Doricchi F, Petrides M. The Precentral Insular Cortical Network for Speech Articulation. Cereb Cortex 2021; 31:3723-3731. [PMID: 33825880 DOI: 10.1093/cercor/bhab043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/30/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Apraxia of speech is a motor disorder characterized by the impaired ability to coordinate the sequential articulatory movements necessary to produce speech. The critical cortical area(s) involved in speech apraxia remain controversial because many of the previously reported cases had additional aphasic impairments, preventing localization of the specific cortical circuit necessary for the somatomotor execution of speech. Four patients with "pure speech apraxia" (i.e., who had no aphasic and orofacial motor impairments) are reported here. The critical lesion in all four patients involved, in the left hemisphere, the precentral gyrus of the insula (gyrus brevis III) and, to a lesser extent, the nearby areas with which it is strongly connected: the adjacent subcentral opercular cortex (part of secondary somatosensory cortex) and the most inferior part of the central sulcus where the orofacial musculature is represented. There was no damage to rostrally adjacent Broca's area in the inferior frontal gyrus. The present study demonstrates the critical circuit for the coordination of complex articulatory movements prior to and during the execution of the motor speech plans. Importantly, this specific cortical circuit is different from those that relate to the cognitive aspects of language production (e.g., Broca's area on the inferior frontal gyrus).
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Affiliation(s)
- Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, Messina University, Piazza Pugliatti, 1 Messina, Italy 98122
| | - Serena Campana
- Neurorehabilitation Unit, Auxilium Vitae Volterra, Volterra, Italy 56048
| | - Loredana Voci
- Neurorehabilitation Unit, Auxilium Vitae Volterra, Volterra, Italy 56048
| | - Stefano Lasaponara
- Dipartimento di Scienze Umane, Libera Università Maria Santissima Assunta LUMSA, Rome, Italy 00193.,Laboratorio di Neuropsicologia dell'attenzione, Fondazione Santa Lucia IRCCS, Rome, Italy 00179
| | - Fabrizio Doricchi
- La Sapienza University, Rome, Italy 00185.,Laboratorio di Neuropsicologia dell'attenzione, Fondazione Santa Lucia IRCCS, Rome, Italy 00179
| | - Michael Petrides
- Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec, Canada, H3A 2B4
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Briggs RG, Lin YH, Dadario NB, Kim SJ, Young IM, Bai MY, Dhanaraj V, Fonseka RD, Hormovas J, Tanglay O, Chakraborty AR, Milligan TM, Abraham CJ, Anderson CD, Palejwala AH, Conner AK, O'Donoghue DL, Sughrue ME. Anatomy and White Matter Connections of the Middle Frontal Gyrus. World Neurosurg 2021; 150:e520-e529. [PMID: 33744423 DOI: 10.1016/j.wneu.2021.03.045] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The middle frontal gyrus (MFG) is involved in attention, working memory, and language-related processing. A detailed understanding of the subcortical white matter tracts connected within the MFG can facilitate improved navigation of white matter lesions in and around this gyrus and explain the postoperative morbidity after surgery. We aimed to characterize the fiber tracts within the MFG according to their connection to neuroanatomic structures through the use of diffusion spectrum imaging-based fiber tractography and validate the findings by gross anatomic dissection for qualitative visual agreement. METHODS Tractography analysis was completed using diffusion imaging data from 10 healthy, adult subjects enrolled in the Human Connectome Project. We assessed the MFG as a whole component according to its fiber connectivity with other neural regions. Mapping was completed on all tracts within both hemispheres, with the resultant tract volumes used to calculate a lateralization index. A modified Klingler technique was used on 10 postmortem dissections to demonstrate the location and orientation of the major tracts. RESULTS Two major connections of the MFG were identified: the superior longitudinal fasciculus, which connects the MFG to parts of the inferior parietal lobule, posterior temporal lobe, and lateral occipital cortex; and the inferior fronto-occipital fasciculus, which connected the MFG to the lingual gyrus and cuneus. Intra- and intergyral short association, U-shaped fibers were also identified. CONCLUSIONS Subcortical white matter pathways integrated within the MFG include the superior longitudinal fasciculus and inferior fronto-occipital fasciculus. The MFG is implicated in a variety of tasks involving attention and memory, making it an important cortical region. The postoperative neurologic outcomes related to surgery in and around the MFG could be clarified in the context of the anatomy of the fiber bundles highlighted in the present study.
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Affiliation(s)
- Robert G Briggs
- Department of Neurosurgery, University of Southern California, Los Angeles, California, USA
| | - Yueh-Hsin Lin
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Nicholas B Dadario
- Rutgers Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, New Jersey, USA
| | - Sihyong J Kim
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Isabella M Young
- Cingulum Research, Cingulum Health, Sydney, New South Wales, Australia
| | - Michael Y Bai
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Vukshitha Dhanaraj
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - R Dineth Fonseka
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Jorge Hormovas
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Onur Tanglay
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Arpan R Chakraborty
- Department of Neurosurgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Ty M Milligan
- Department of Neurosurgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Carol J Abraham
- Department of Neurosurgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Christopher D Anderson
- Department of Neurosurgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Ali H Palejwala
- Department of Neurosurgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Andrew K Conner
- Department of Neurosurgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Daniel L O'Donoghue
- Department of Cell Biology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Michael E Sughrue
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
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30
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Pisano F, Caltagirone C, Incoccia C, Marangolo P. Spinal or cortical direct current stimulation: Which is the best? Evidence from apraxia of speech in post-stroke aphasia. Behav Brain Res 2020; 399:113019. [PMID: 33207242 DOI: 10.1016/j.bbr.2020.113019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 09/04/2020] [Accepted: 11/11/2020] [Indexed: 10/23/2022]
Abstract
To date, new advances in technology have already shown the effectiveness of non-invasive brain stimulation and, in particular, of transcranial direct current stimulation (tDCS), in enhancing language recovery in post-stroke aphasia. More recently, it has been suggested that the stimulation over the spinal cord improves the production of words associated to sensorimotor schemata, such as action verbs. Here, for the first time, we present evidence that transpinal direct current stimulation (tsDCS) combined with a language training is efficacious for the recovery from speech apraxia, a motor speech disorder which might co-occur with aphasia. In a randomized-double blind experiment, ten aphasics underwent five days of tsDCS with concomitant treatment for their articulatory deficits in two different conditions: anodal and sham. In all patients, language measures were collected before (T0), at the end (T5) and one week after the end of treatment (F/U). Results showed that only after anodal tsDCS patients exhibited a better accuracy in repeating the treated items. Moreover, these effects persisted at F/U and generalized to other oral language tasks (i.e. picture description, noun and verb naming, word repetition and reading). A further analysis, which compared the tsDCS results with those collected in a matched group of patients who underwent the same language treatment but combined with tDCS, revealed no differences between the two groups. Given the persistency and severity of articulatory deficits in aphasia and the ease of use of tsDCS, we believe that spinal stimulation might result a new innovative approach for language rehabilitation.
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Affiliation(s)
- Francesca Pisano
- Department of Humanities studies - University Federico II, Naples, Italy
| | | | | | - Paola Marangolo
- Department of Humanities studies - University Federico II, Naples, Italy; IRCCS Santa Lucia Foundation, Rome, Italy.
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31
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Allison KM, Cordella C, Iuzzini-Seigel J, Green JR. Differential Diagnosis of Apraxia of Speech in Children and Adults: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2952-2994. [PMID: 32783767 PMCID: PMC7890226 DOI: 10.1044/2020_jslhr-20-00061] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Purpose Despite having distinct etiologies, acquired apraxia of speech (AOS) and childhood apraxia of speech (CAS) share the same central diagnostic challenge (i.e., isolating markers specific to an impairment in speech motor planning/programming). The purpose of this review was to evaluate and compare the state of the evidence on approaches to differential diagnosis for AOS and CAS and to identify gaps in each literature that could provide directions for future research aimed to improve clinical diagnosis of these disorders. Method We conducted a scoping review of literature published between 1997 and 2019, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. For both AOS and CAS, literature was charted and summarized around four main methodological approaches to diagnosis: speech symptoms, quantitative speech measures, impaired linguistic-motor processes, and neuroimaging. Results Results showed that similar methodological approaches have been used to study differential diagnosis of apraxia of speech in adults and children; however, the specific measures that have received the most research attention differ between AOS and CAS. Several promising candidate markers for AOS and CAS have been identified; however, few studies report metrics that can be used to assess their diagnostic accuracy. Conclusions Over the past two decades, there has been a proliferation of research identifying potential diagnostic markers of AOS and CAS. In order to improve clinical diagnosis of AOS and CAS, there is a need for studies testing the diagnostic accuracy of multiple candidate markers, better control over language impairment comorbidity, more inclusion of speech-disordered control groups, and an increased focus on translational work moving toward clinical implementation of promising measures.
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Affiliation(s)
- Kristen M. Allison
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Claire Cordella
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Boston
| | - Jenya Iuzzini-Seigel
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI
| | - Jordan R. Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
- Program in Speech and Hearing Bioscience and Technology, Harvard University, Boston, MA
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32
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Mapping articulatory and grammatical subcomponents of fluency deficits in post-stroke aphasia. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 19:1286-1298. [PMID: 31240565 PMCID: PMC6786948 DOI: 10.3758/s13415-019-00729-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fluent speech production is a critical aspect of language processing and is central to aphasia diagnosis and treatment. Multiple cognitive processes and neural subsystems must be coordinated to produce fluent narrative speech. To refine the understanding of these systems, measures that minimize the influence of other cognitive processes were defined for articulatory deficits and grammatical deficits. Articulatory deficits were measured by the proportion of phonetic errors (articulatory and prosodic) in a word repetition task in 115 participants with aphasia following left hemisphere stroke. Grammatical deficits were assessed in 46 participants based on two measures-proportion of closed class words and proportion of words in sentences-generated during semistructured narrative speech production (telling the Cinderella story). These measures were used to identify brain regions critical for articulatory and grammatical aspects of speech production using a multivariate lesion-symptom mapping approach based on support vector regression. Phonetic error proportion was associated with damage to the postcentral gyrus and the inferior parietal lobule (particularly the supramarginal gyrus). Proportion of closed class words in narrative speech did not have consistent lesion correlates. Proportion of words in sentences was strongly associated with frontal lobe damage, particularly the inferior and middle frontal gyri. Grammatical sentence structuring relies on frontal regions, particularly the inferior and middle frontal gyri, whereas phonetic-articulatory planning and execution relies on parietal regions, particularly the postcentral and supramarginal gyri. These results clarify and extend current understanding of the functional components of the frontoparietal speech production system.
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Altschuler EL. Commentary: Pure Apraxia of Speech After Resection Based in the Posterior Middle Frontal Gyrus. Neurosurgery 2020; 87:E390-E391. [PMID: 32097474 DOI: 10.1093/neuros/nyaa036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/11/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eric L Altschuler
- Department of Physical Medicine and Rehabilitation, Metropolitan Hospital Center, New York, New York
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Chang EF, Kurteff G, Andrews JP, Briggs RG, Conner AK, Battiste JD, Sughrue ME. Pure Apraxia of Speech After Resection Based in the Posterior Middle Frontal Gyrus. Neurosurgery 2020; 87:E383-E389. [PMID: 32097489 PMCID: PMC7690655 DOI: 10.1093/neuros/nyaa002] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 12/01/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND IMPORTANCE Apraxia of speech is a disorder of articulatory coordination and planning in speech sound production. Its diagnosis is based on deficits in articulation, prosody, and fluency. It is often described concurrent with aphasia or dysarthria, while pure apraxia of speech is a rare entity. CLINICAL PRESENTATION A right-handed man underwent focal surgical resection of a recurrent grade III astrocytoma in the left hemisphere dorsal premotor cortex located in the posterior middle frontal gyrus. After the procedure, he experienced significant long-term speech production difficulties. A battery of standard and custom language and articulatory assessments were administered, revealing intact comprehension and naming abilities, and preserved strength in orofacial articulators, but considerable deficits in articulatory coordination, fluency, and prosody-consistent with diagnosis of pure apraxia of speech. Tractography and resection volumes compared with publicly available imaging data from the Human Connectome Project suggest possible overlap with area 55b, an under-recognized language area in the dorsal premotor cortex and has white matter connectivity with the superior longitudinal fasciculus. CONCLUSION The case reported here details a rare clinical entity, pure apraxia of speech resulting from resection of posterior middle frontal gyrus. While not a classical language area, emerging literature supports the role of this area in the production of fluent speech, and has implications for surgical planning and the general neurobiology of language.
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Affiliation(s)
- Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - Garret Kurteff
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - John P Andrews
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - Robert G Briggs
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Andrew K Conner
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - James D Battiste
- Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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35
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Sotelo MR, Kalinosky BT, Goodfriend K, Hyngstrom AS, Schmit BD. Indirect Structural Connectivity Identifies Changes in Brain Networks After Stroke. Brain Connect 2020; 10:399-410. [PMID: 32731752 DOI: 10.1089/brain.2019.0725] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Background/Purpose: The purpose of this study was (1) to identify changes in structural connectivity after stroke and (2) to relate changes in indirect connectivity to post-stroke impairment. Methods: A novel measure of indirect connectivity was implemented to assess the impact of stroke on brain connectivity. Probabilistic tractography was performed on 13 chronic stroke and 16 control participants to estimate connectivity between gray matter (GM) regions. The Fugl-Meyer assessment of motor impairment was measured for stroke participants. Network measures of direct and indirect connectivity were calculated, and these measures were linearly combined with measures of white matter integrity to predict motor impairment. Results: We found significantly reduced indirect connectivity in the frontal and parietal lobes, ipsilesional subcortical regions, and bilateral cerebellum after stroke. When added to the regression analysis, the volume of GM with reduced indirect connectivity significantly improved the correlation between image parameters and upper extremity motor impairment (R2 = 0.71, p < 0.05). Conclusion: This study provides evidence of changes in indirect connectivity in regions remote from the lesion, particularly in the cerebellum and regions in the fronto-parietal cortices, and these changes correlate with upper extremity motor impairment. These results highlight the value of using measures of indirect connectivity to identify the effect of stroke on brain networks. Impact statement Changes in indirect structural connectivity occur in regions distant from a lesion after stroke, highlighting the impact that stroke has on brain functional networks. Specifically, losses in indirect structural connectivity occur in hubs with high centrality, including the fronto-parietal cortices and cerebellum. These losses in indirect connectivity more accurately reflect motor impairments than measures of direct structural connectivity. As a consequence, indirect structural connectivity appears to be important to recovery after stroke and imaging biomarkers that incorporate indirect structural connectivity might improve prognostication of stroke outcomes.
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Affiliation(s)
- Miguel R Sotelo
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Benjamin T Kalinosky
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Karin Goodfriend
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Allison S Hyngstrom
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USA
| | - Brian D Schmit
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Terband H, Rodd J, Maas E. Testing hypotheses about the underlying deficit of apraxia of speech through computational neural modelling with the DIVA model. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:475-486. [PMID: 31630555 DOI: 10.1080/17549507.2019.1669711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: A recent behavioural experiment featuring a noise masking paradigm suggests that Apraxia of Speech (AOS) reflects a disruption of feedforward control, whereas feedback control is spared and plays a more prominent role in achieving and maintaining segmental contrasts. The present study set out to validate the interpretation of AOS as a possible feedforward impairment using computational neural modelling with the DIVA (Directions Into Velocities of Articulators) model.Method: In a series of computational simulations with the DIVA model featuring a noise-masking paradigm mimicking the behavioural experiment, we investigated the effect of a feedforward, feedback, feedforward + feedback, and an upper motor neuron dysarthria impairment on average vowel spacing and dispersion in the production of six/bVt/speech targets.Result: The simulation results indicate that the output of the model with the simulated feedforward deficit resembled the group findings for the human speakers with AOS best.Conclusion: These results provide support to the interpretation of the human observations, corroborating the notion that AOS can be conceptualised as a deficit in feedforward control.
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Affiliation(s)
- Hayo Terband
- Utrecht Institute of Linguistics-OTS, Utrecht University, Utrecht, The Netherlands
| | - Joe Rodd
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Edwin Maas
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
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Li Z, Zhang W, Li C, Wang M, Wang S, Chen R, Zhang X. Articulation rehabilitation induces cortical plasticity in adults with non-syndromic cleft lip and palate. Aging (Albany NY) 2020; 12:13147-13159. [PMID: 32619200 PMCID: PMC7377881 DOI: 10.18632/aging.103402] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/25/2020] [Indexed: 11/25/2022]
Abstract
In this study, we investigated brain morphological changes in adults with non-syndromic cleft lip and palate (NSCLP) after articulation rehabilitation (AR). High-resolution T1 weighted brain magnetic resonance imaging data were analyzed from 45 adults with NSCLP after palatoplasty: 24 subjects were assessed before AR (bNSCLP) and 21 subjects were assessed after AR (aNSCLP). In addition, there were 24 age and sex matched controls. Intergroup differences of grey matter volume were evaluated as a comprehensive measure of the cortex; cortical thickness and cortical complexity (gyrification and fractal dimensions) were also analyzed. As compared to controls, the bNSCLP subjects exhibited altered indexes in frontal, temporal, and parietal lobes; these morphological changes are characteristic for adults with NSCLP. Importantly, as compared to the bNSCLP and control subjects, the aNSCLP subjects exhibited cortical plasticity in the regions involved in language, auditory, pronunciation planning, and execution functions. The AR-mediated cortical plasticity in aNSCLP subjects may be caused by AR-induced cortical neurogenesis, which might reflect the underlying neural mechanism during AR.
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Affiliation(s)
- Zhen Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Wenjing Zhang
- Department of Oral and Maxillofacial Plastic and Trauma Surgery, Center of Cleft Lip and Palate Treatment, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Chunlin Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Mengyue Wang
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Songjian Wang
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Renji Chen
- Department of Oral and Maxillofacial Plastic and Trauma Surgery, Center of Cleft Lip and Palate Treatment, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Xu Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
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Miller HE, Guenther FH. Modelling speech motor programming and apraxia of speech in the DIVA/GODIVA neurocomputational framework. APHASIOLOGY 2020; 35:424-441. [PMID: 34108793 PMCID: PMC8183977 DOI: 10.1080/02687038.2020.1765307] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND The Directions Into Velocities of Articulators (DIVA) model and its partner, the Gradient Order DIVA (GODIVA) model, provide neurobiologically grounded, computational accounts of speech motor control and motor sequencing, with applications for the study and treatment of neurological motor speech disorders. AIMS In this review, we provide an overview of the DIVA and GODIVA models and how they explain the interface between phonological and motor planning systems to build on previous models and provide a mechanistic accounting of apraxia of speech (AOS), a disorder of speech motor programming. MAIN CONTRIBUTION Combined, the DIVA and GODIVA models account for both the segmental and suprasegmental features that define AOS via damage to (i) a speech sound map, hypothesized to reside in left ventral premotor cortex, (ii) a phonological content buffer hypothesized to reside in left posterior inferior frontal sulcus, and/or (iii) the axonal projections between these regions. This account is in line with a large body of behavioural work, and it unifies several prior theoretical accounts of AOS. CONCLUSIONS The DIVA and GODIVA models provide an integrated framework for the generation and testing of both behavioural and neuroimaging hypotheses about the underlying neural mechanisms responsible for motor programming in typical speakers and in speakers with AOS.
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Affiliation(s)
- Hilary E. Miller
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA
| | - Frank H. Guenther
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA
- Department of Biomedical Engineering, Boston University, Boston, MA
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA
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Hirano T, Enatsu R, Sasagawa A, Arihara M, Kuribara T, Yokoyama R, Suzuki H, Ochi S, Mikuni N. Anatomical and functional distribution of functional MRI language mapping. J Clin Neurosci 2020; 77:116-122. [PMID: 32439278 DOI: 10.1016/j.jocn.2020.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of the present study was to compare localization of the language cortex using electrical cortical stimulation (ECS) and functional magnetic resonance imaging (fMRI) to establish the relevance of fMRI language mapping. METHODS Language mapping with fMRI and functional ECS mapping were retrospectively compared in ten patients with refractory epilepsy who underwent fMRI language mapping and functional ECS mapping between June 2012 and April 2019. A shiritori task, a popular Japanese word chain game, was used for fMRI language mapping. RESULTS BOLD signal activation was observed in the left inferior frontal gyrus (including the pars opecularis and the pars triangularis), and superior temporal gyrus, which is a language-related area, as well as in the left superior and middle frontal gyri, the intraparietal sulcus, and fusiform gyrus. These results were compared with ECS to elucidate the functional role of the activated areas during fMRI language tasks. These activated areas included language areas, negative motor areas, supplementary motor areas (SMAs), and non-functional areas. CONCLUSION The activated areas of fMRI language mapping include language-related areas, the negative motor area, and SMAs. These findings suggest the involvement of language and higher order motor networks in verbal expression.
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Affiliation(s)
- Tsukasa Hirano
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Ayaka Sasagawa
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Masayasu Arihara
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | | | - Rintaro Yokoyama
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Hime Suzuki
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Satoko Ochi
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
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40
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DeMarco AT, Turkeltaub PE. Functional anomaly mapping reveals local and distant dysfunction caused by brain lesions. Neuroimage 2020; 215:116806. [PMID: 32278896 DOI: 10.1016/j.neuroimage.2020.116806] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/16/2020] [Accepted: 03/21/2020] [Indexed: 01/28/2023] Open
Abstract
The lesion method has been important for understanding brain-behavior relationships in humans, but has previously used maps based on structural damage. Lesion measurement based on structural damage may label partly damaged but functional tissue as abnormal, and moreover, ignores distant dysfunction in structurally intact tissue caused by deafferentation, diaschisis, and other processes. A reliable method to map functional integrity of tissue throughout the brain would provide a valuable new approach to measuring lesions. Here, we use machine learning on four dimensional resting state fMRI data obtained from left-hemisphere stroke survivors in the chronic period of recovery and control subjects to generate graded maps of functional anomaly throughout the brain in individual patients. These functional anomaly maps identify areas of obvious structural lesions and are stable across multiple measurements taken months and even years apart. Moreover, the maps identify functionally anomalous regions in structurally intact tissue, providing a direct measure of remote effects of lesions on the function of distant brain structures. Multivariate lesion-behavior mapping using functional anomaly maps replicates classic behavioral localization, identifying inferior frontal regions related to speech fluency, lateral temporal regions related to auditory comprehension, parietal regions related to phonology, and the hand area of motor cortex and descending corticospinal pathways for hand motor function. Further, this approach identifies relationships between tissue function and behavior distant from the structural lesions, including right premotor dysfunction related to ipsilateral hand movement, and right cerebellar regions known to contribute to speech fluency. Brain-wide maps of the functional effects of focal lesions could have wide implications for lesion-behavior association studies and studies of recovery after brain injury.
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Affiliation(s)
- Andrew T DeMarco
- Department of Neurology, Georgetown University, Washington, DC, 20057, United States.
| | - Peter E Turkeltaub
- Department of Neurology, Georgetown University, Washington, DC, 20057, United States; MedStar National Rehabilitation Hospital, Washington, DC, 20010, United States
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41
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Yao S, Liebenthal E, Juvekar P, Bunevicius A, Vera M, Rigolo L, Golby AJ, Tie Y. Sex Effect on Presurgical Language Mapping in Patients With a Brain Tumor. Front Neurosci 2020; 14:4. [PMID: 32038154 PMCID: PMC6992642 DOI: 10.3389/fnins.2020.00004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/06/2020] [Indexed: 12/12/2022] Open
Abstract
Differences between males and females in brain development and in the organization and hemispheric lateralization of brain functions have been described, including in language. Sex differences in language organization may have important implications for language mapping performed to assess, and minimize neurosurgical risk to, language function. This study examined the effect of sex on the activation and functional connectivity of the brain, measured with presurgical functional magnetic resonance imaging (fMRI) language mapping in patients with a brain tumor. We carried out a retrospective analysis of data from neurosurgical patients treated at our institution who met the criteria of pathological diagnosis (malignant brain tumor), tumor location (left hemisphere), and fMRI paradigms [sentence completion (SC); antonym generation (AG); and resting-state fMRI (rs-fMRI)]. Forty-seven patients (22 females, mean age = 56.0 years) were included in the study. Across the SC and AG tasks, females relative to males showed greater activation in limited areas, including the left inferior frontal gyrus classically associated with language. In contrast, males relative to females showed greater activation in extended areas beyond the classic language network, including the supplementary motor area (SMA) and precentral gyrus. The rs-fMRI functional connectivity of the left SMA in the females was stronger with inferior temporal pole (TP) areas, and in the males with several midline areas. The findings are overall consistent with theories of greater reliance on specialized language areas in females relative to males, and generalized brain areas in males relative to females, for language function. Importantly, the findings suggest that sex could affect fMRI language mapping. Thus, considering sex as a variable in presurgical language mapping merits further investigation.
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Affiliation(s)
- Shun Yao
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Center for Pituitary Tumor Surgery, Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Wuhan School of Clinical Medicine, Southern Medical University, Wuhan, China
| | - Einat Liebenthal
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Institute for Technology in Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, United States
| | - Parikshit Juvekar
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Adomas Bunevicius
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Matthew Vera
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Laura Rigolo
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexandra J. Golby
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Yanmei Tie
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
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Faulkner JW, Wilshire CE. Mapping eloquent cortex: A voxel-based lesion-symptom mapping study of core speech production capacities in brain tumour patients. BRAIN AND LANGUAGE 2020; 200:104710. [PMID: 31739187 DOI: 10.1016/j.bandl.2019.104710] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/21/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
This study used voxel-based lesion-symptom mapping to examine the cortical and white matter regions associated with language production impairments in a sample of 63 preoperative tumour patients. We identified four cognitive functions considered crucial for spoken language production: semantic-to-lexical mapping (selecting the appropriate lexical label for the intended concept); phonological encoding (retrieving the word's phonological form); articulatory-motor planning (programming the articulatory motor movements); and goal-driven language selection (exerting top-down control over the words selected for production). Each participant received a score estimating their competence on each function. We then mapped the region(s) where pathology was significantly associated with low scores. For semantic-to-lexical mapping, the critical map encompassed portions of the left posterior middle and inferior temporal gyri, extending into posterior fusiform gyrus, overlapping substantially with the territory of the inferior longitudinal fasciculus. For phonological encoding, the map encompassed the left inferior parietal lobe and posterior middle temporal gyrus, overlapping with the territory of the inferior longitudinal and posterior arcuate fasciculi. For articulatory-motor planning, the map encompassed parts of the left frontal pole, frontal operculum, and inferior frontal gyrus, and overlapped with the territory of the frontal aslant tract. Finally, the map for goal-driven language selection encompassed the left frontal pole and the anterior cingulate cortex. We compare our findings with those from other neuropsychological samples, and conclude that the study of tumour patients offers evidence that complements that available from other populations.
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Affiliation(s)
- Josh W Faulkner
- School of Psychology, Victoria University of Wellington, New Zealand
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Woolnough O, Forseth KJ, Rollo PS, Tandon N. Uncovering the functional anatomy of the human insula during speech. eLife 2019; 8:53086. [PMID: 31852580 PMCID: PMC6941893 DOI: 10.7554/elife.53086] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 12/12/2019] [Indexed: 12/11/2022] Open
Abstract
The contribution of insular cortex to speech production remains unclear and controversial given diverse findings from functional neuroimaging and lesional data. To create a precise spatiotemporal map of insular activity, we performed a series of experiments: single-word articulations of varying complexity, non-speech orofacial movements and speech listening, in a cohort of 27 patients implanted with penetrating intracranial electrodes. The posterior insula was robustly active bilaterally, but after the onset of articulation, during listening to speech and during production of non-speech mouth movements. Preceding articulation there was very sparse activity, localized primarily to the frontal operculum rather than the insula. Posterior insular was active coincident with superior temporal gyrus but was more active for self-generated speech than external speech, the opposite of the superior temporal gyrus. These findings support the conclusion that the insula does not serve pre-articulatory preparatory roles.
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Affiliation(s)
- Oscar Woolnough
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, United States.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, United States
| | - Kiefer James Forseth
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, United States.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, United States
| | - Patrick Sarahan Rollo
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, United States.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, United States
| | - Nitin Tandon
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, United States.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, United States.,Memorial Hermann Hospital, Texas Medical Center, Houston, United States
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44
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Wang J, Wu D, Cheng Y, Song W, Yuan Y, Zhang X, Zhang D, Zhang T, Wang Z, Tang J, Yin L. Effects of Transcranial Direct Current Stimulation on Apraxia of Speech and Cortical Activation in Patients With Stroke: A Randomized Sham-Controlled Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1625-1637. [PMID: 31618056 DOI: 10.1044/2019_ajslp-19-0069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The study aims to investigate, using anodal transcranial direct current stimulation (A-tDCS), over which site, the left lip region of primary motor cortex (M1) or the Broca's area, there would be better recovery from apraxia of speech (AoS) in patients with poststroke aphasia and to examine for altered activation in speech-related areas after tDCS with nonlinear electroencephalography (EEG). Method Fifty-two patients with AoS were randomized into A-tDCS over the left M1 (A-tDCS-M1), Broca's area, and sham tDCS groups who underwent 10 sessions of tDCS and speech treatment for 5 days. The EEG nonlinear index of approximate entropy was calculated for 6 subjects in each group before and after treatment. Results After treatment, the change in speech-language performance improved more significantly in the A-tDCS-M1 group than the other 2 groups (p < .05). EEG approximate entropy indicated that both A-tDCS groups could activate the stimulated sites; the improvement in the A-tDCS-M1 group was correlated with high activation in the dorsal lateral prefrontal cortex and Broca's areas of the left hemisphere in addition to the stimulated site. Conclusion A-tDCS over the left M1 can improve the speech function in patients with poststroke aphasia and severe AoS and excite and recruit more areas in the motor speech network.
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Affiliation(s)
- Jie Wang
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing, China
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Dongyu Wu
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing, China
| | - Yinan Cheng
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Weiqun Song
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Ying Yuan
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xu Zhang
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing, China
| | - Dahua Zhang
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Tiantian Zhang
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Zhuo Wang
- Department of Rehabilitation, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Jingwen Tang
- Department of Integrated Traditional Chinese and Western Medicine Oncology, Affiliated Tumor Hospital of Zhengzhou University, China
| | - Ling Yin
- Department of Health Care, Zunyi Academician Center, China
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45
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Basilakos A, Smith KG, Fillmore P, Fridriksson J, Fedorenko E. Functional Characterization of the Human Speech Articulation Network. Cereb Cortex 2019; 28:1816-1830. [PMID: 28453613 DOI: 10.1093/cercor/bhx100] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 04/05/2017] [Indexed: 12/14/2022] Open
Abstract
A number of brain regions have been implicated in articulation, but their precise computations remain debated. Using functional magnetic resonance imaging, we examine the degree of functional specificity of articulation-responsive brain regions to constrain hypotheses about their contributions to speech production. We find that articulation-responsive regions (1) are sensitive to articulatory complexity, but (2) are largely nonoverlapping with nearby domain-general regions that support diverse goal-directed behaviors. Furthermore, premotor articulation regions show selectivity for speech production over some related tasks (respiration control), but not others (nonspeech oral-motor [NSO] movements). This overlap between speech and nonspeech movements concords with electrocorticographic evidence that these regions encode articulators and their states, and with patient evidence whereby articulatory deficits are often accompanied by oral-motor deficits. In contrast, the superior temporal regions show strong selectivity for articulation relative to nonspeech movements, suggesting that these regions play a specific role in speech planning/production. Finally, articulation-responsive portions of posterior inferior frontal gyrus show some selectivity for articulation, in line with the hypothesis that this region prepares an articulatory code that is passed to the premotor cortex. Taken together, these results inform the architecture of the human articulation system.
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Affiliation(s)
- Alexandra Basilakos
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Kimberly G Smith
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA.,Department of Speech Pathology and Audiology, University of South Alabama, Mobile, AL 36688, USA
| | - Paul Fillmore
- Department of Communication Sciences and Disorders, Baylor University, Waco, TX 76798, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Evelina Fedorenko
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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46
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Orthographic Visualisation Induced Brain Activations in a Chronic Poststroke Global Aphasia with Dissociation between Oral and Written Expression. Case Rep Neurol Med 2019; 2019:8425914. [PMID: 31355031 PMCID: PMC6632504 DOI: 10.1155/2019/8425914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 06/03/2019] [Indexed: 11/17/2022] Open
Abstract
We propose a method of orthographic visualisation strategy in a poststroke severe aphasia person with dissociation between oral and written expression. fMRI results suggest that such strategy may induce the engagement of alternative nonlanguage networks and visual representations may help improving oral output. This choice of rehabilitation method can be based on the remaining capacities and, therefore, on written language. Most notably, no study so far addressed how orthographic visualisation strategy during speech rehabilitation might influence clinical outcomes in nonfluent aphasia and apraxia patients.
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47
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Chenausky K, Paquette S, Norton A, Schlaug G. Apraxia of speech involves lesions of dorsal arcuate fasciculus and insula in patients with aphasia. Neurol Clin Pract 2019; 10:162-169. [PMID: 32309035 DOI: 10.1212/cpj.0000000000000699] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/29/2019] [Indexed: 11/15/2022]
Abstract
Objective To determine the contributions of apraxia of speech (AOS) and anomia to conversational dysfluency. Methods In this observational study of 52 patients with chronic aphasia, 47 with concomitant AOS, fluency was quantified using correct information units per minute (CIUs/min) from propositional speech tasks. Videos of patients performing conversational, how-to and picture-description tasks, word and sentence repetition, and diadochokinetic tasks were used to diagnose AOS using the Apraxia of Speech Rating Scale (ASRS). Anomia was quantified by patients' scores on the 30 even-numbered items from the Boston Naming Test (BNT). Results Together, ASRS and BNT scores accounted for 51.4% of the total variance in CIUs/min; the ASRS score accounted for the majority of that variance. The BNT score was associated with lesions in the left superior temporal gyrus, left inferior frontal gyrus, and large parts of the insula. The global ASRS score was associated with lesions in the left dorsal arcuate fasciculus (AF), pre- and post-central gyri, and both banks of the central sulcus of the insula. The ASRS score for the primary distinguishing features of AOS (no overlap with features of aphasia) was associated with less AF and more insular involvement. Only ∼27% of this apraxia-specific lesion overlapped with lesions associated with the BNT score. Lesions associated with AOS had minimal overlap with the frontal aslant tract (FAT) (<1%) or the extreme capsule fiber tract (1.4%). Finally, ASRS scores correlated significantly with damage to the insula but not to the AF, extreme capsule, or FAT. Conclusions Results are consistent with previous findings identifying lesions of the insula and AF in patients with AOS, damage to both of which may create dysfluency in patients with aphasia.
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Affiliation(s)
- Karen Chenausky
- Sargent College (KC), Boston University; Department of Neurology (KC, SP, GS), Harvard Medical School; and Music, Neuroimaging, and Stroke Recovery Laboratory (KC, SP, AN, GS), Beth Israel Deaconess Medical Center, Boston
| | - Sébastien Paquette
- Sargent College (KC), Boston University; Department of Neurology (KC, SP, GS), Harvard Medical School; and Music, Neuroimaging, and Stroke Recovery Laboratory (KC, SP, AN, GS), Beth Israel Deaconess Medical Center, Boston
| | - Andrea Norton
- Sargent College (KC), Boston University; Department of Neurology (KC, SP, GS), Harvard Medical School; and Music, Neuroimaging, and Stroke Recovery Laboratory (KC, SP, AN, GS), Beth Israel Deaconess Medical Center, Boston
| | - Gottfried Schlaug
- Sargent College (KC), Boston University; Department of Neurology (KC, SP, GS), Harvard Medical School; and Music, Neuroimaging, and Stroke Recovery Laboratory (KC, SP, AN, GS), Beth Israel Deaconess Medical Center, Boston
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48
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Kaufmann BC, Pastore-Wapp M, Lübeck M, Koenig M, Bohlhalter S, Vanbellingen T, Cazzoli D, Nyffeler T. cTBS over contralesional homologue areas deteriorates speech output in isolated apraxia of speech after stroke. Brain Stimul 2019; 12:1069-1071. [PMID: 30914261 DOI: 10.1016/j.brs.2019.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/16/2022] Open
Affiliation(s)
- Brigitte C Kaufmann
- Perception and Eye Movement Laboratory, Department of Neurology, University of Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Switzerland
| | - Manuela Pastore-Wapp
- Neurocenter, Luzerner Kantonsspital, Switzerland; Support Center for Advanced Neuroimaging (SCAN), Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital, University of Bern, Switzerland
| | - Maria Lübeck
- Neurocenter, Luzerner Kantonsspital, Switzerland
| | | | | | - Tim Vanbellingen
- Neurocenter, Luzerner Kantonsspital, Switzerland; Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research University of Bern, Switzerland
| | - Dario Cazzoli
- Perception and Eye Movement Laboratory, Department of Neurology, University of Bern, Switzerland; Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research University of Bern, Switzerland
| | - Thomas Nyffeler
- Perception and Eye Movement Laboratory, Department of Neurology, University of Bern, Switzerland; Neurocenter, Luzerner Kantonsspital, Switzerland; Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research University of Bern, Switzerland.
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49
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Haley KL, Smith M, Wambaugh JL. Sound Distortion Errors in Aphasia With Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:121-135. [PMID: 31072155 DOI: 10.1044/2018_ajslp-17-0186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Loosely defined diagnostic criteria for acquired apraxia of speech (AOS) limit clinicians' ability to diagnose the disorder validly and reliably. The purpose of this study was to contribute to the development of more precise diagnostic guidelines by characterizing the frequency and quality of sound distortion errors in speakers with clinically diagnosed AOS. Method Audio-recorded motor speech evaluations from 24 speakers with AOS and aphasia were analyzed by trained listeners using a narrow phonetic transcription protocol that included 12 distortion categories. We calculated percentage of segments transcribed with phonemic error, distortion error, and a combination of phonemic and distortion error. Results Distortion frequency varied substantially across participants, distributing on a continuum from 5% to 22% of segments. The frequency of phonemic errors was significantly greater than the frequency of distortion errors, which, in turn, was greater than the frequency of distorted substitution errors. The most common distortion qualities were voicing ambiguity and segment lengthening, but over 40% of distortion errors were distributed across an assortment of tongue modifications. Conclusions The results replicated observations from previous studies of speakers with quantitatively defined AOS in a new sample of participants with clinically diagnosed AOS. Similar distortion qualities were observed across studies, offering focus for diagnosticians and guidance for operationalizing future measures. The broad performance continua we observed help explain why binary classification of the presence/absence of AOS can be challenging and indicate a need to develop quantitative norms.
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Affiliation(s)
- Katarina L Haley
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina, Chapel Hill
| | - Michael Smith
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina, Chapel Hill
| | - Julie L Wambaugh
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
- VA Salt Lake City Health Care System, UT
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50
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Takakura Y, Otsuki M, Sakai S, Tajima Y, Mito Y, Ogata A, Koshimizu S, Yoshino M, Uemori G, Takakura S, Nakagawa Y. Sub-classification of apraxia of speech in patients with cerebrovascular and neurodegenerative diseases. Brain Cogn 2019; 130:1-10. [PMID: 30622034 DOI: 10.1016/j.bandc.2018.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 12/14/2022]
Abstract
Some studies have hypothesized that primary progressive apraxia of speech (ppAOS) consists of heterogeneous symptoms that can be sub-classified; however, no study has classified stroke-induced AOS (sAOS) and ppAOS according to common criteria. The purpose of this study was to elucidate the symptoms and relevant brain regions associated with sAOS and ppAOS for sub-classification. Participants included 8 patients with sAOS following lesions in the left precentral gyrus and/or underlying white matter, and 3 patients with ppAOS. All patients with sAOS could be classified into three subtypes: type I, with prominent distorted articulation; type II, with prominent prosodic abnormalities or type III, with similarly distorted articulation and prosodic abnormalities. This sub-classification was consistent with the subtypes of ppAOS proposed in previous reports. All patients with ppAOS were classified as type III, and exhibited three characteristics distinguishable from those of sAOS. First, they showed prominent lengthened syllables compared with the segmentation of syllables. Second, they could not always complete the production of multi-syllabic single words in one breath. Finally, they showed dysfunctional lesions in the bilateral supplementary motor area. We conclude that sAOS and ppAOS can be sub-classified and are universal symptoms that are common between the English and Japanese populations.
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Affiliation(s)
- Yuki Takakura
- Department of Communication Disorders, School of Rehabilitation Science, Health Sciences University of Hokkaido, 1757 Kanazawa, Tobetsu-cho, Ishikari-gun, Hokkaido 061-0293, Japan; Graduate School of Health Sciences, Hokkaido University, N12-W5, Kita-ku, Sapporo, Hokkaido 060-0812, Japan
| | - Mika Otsuki
- Faculty of Health Sciences, Hokkaido University, N12-W5, Kita-ku, Sapporo, Hokkaido 060-0812, Japan.
| | - Shinya Sakai
- Faculty of Health Sciences, Hokkaido University, N12-W5, Kita-ku, Sapporo, Hokkaido 060-0812, Japan
| | - Yasutaka Tajima
- Sapporo City General Hospital, Division of Neurology, 1-1, N11-W13, Chuo-ku, Sapporo, Hokkaido 060-8604, Japan
| | - Yasunori Mito
- Sapporo City General Hospital, Division of Neurology, 1-1, N11-W13, Chuo-ku, Sapporo, Hokkaido 060-8604, Japan
| | - Akihiko Ogata
- Hokkaido Neurosurgical Memorial Hospital, Department of Neurology, 1-20, Higashi-5, Hachiken-9, Nishi-ku, Sapporo, Hokkaido 063-0869, Japan
| | - Shuichi Koshimizu
- Hokkaido Neurosurgical Memorial Hospital, Department of Neurology, 1-20, Higashi-5, Hachiken-9, Nishi-ku, Sapporo, Hokkaido 063-0869, Japan
| | - Masami Yoshino
- Hokkaido Neurosurgical Memorial Hospital, Department of Neurosurgery, 1-20, Higashi-5, Hachiken-9, Nishi-ku, Sapporo, Hokkaido 063-0869, Japan
| | - Genki Uemori
- Hokkaido Neurosurgical Memorial Hospital, Department of Neurosurgery, 1-20, Higashi-5, Hachiken-9, Nishi-ku, Sapporo, Hokkaido 063-0869, Japan
| | - Satoko Takakura
- Aizen Hospital, Department of Rehabilitation, 2-1-38, Kawazoe-13, Minami-ku, Sapproro, Hokkaido 005-0813, Japan
| | - Yoshitsugu Nakagawa
- Department of Communication Disorders, School of Rehabilitation Science, Health Sciences University of Hokkaido, 1757 Kanazawa, Tobetsu-cho, Ishikari-gun, Hokkaido 061-0293, Japan
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