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Ross ED. Affective Prosody and Its Impact on the Neurology of Language, Depression, Memory and Emotions. Brain Sci 2023; 13:1572. [PMID: 38002532 PMCID: PMC10669595 DOI: 10.3390/brainsci13111572] [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: 10/02/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
Based on the seminal publications of Paul Broca and Carl Wernicke who established that aphasic syndromes (disorders of the verbal-linguistic aspects of communication) were predominantly the result of focal left-hemisphere lesions, "language" is traditionally viewed as a lateralized function of the left hemisphere. This, in turn, has diminished and delayed the acceptance that the right hemisphere also has a vital role in language, specifically in modulating affective prosody, which is essential for communication competency and psychosocial well-being. Focal lesions of the right hemisphere may result in disorders of affective prosody (aprosodic syndromes) that are functionally and anatomically analogous to the aphasic syndromes that occur following focal left-hemisphere lesions. This paper will review the deductive research published over the last four decades that has elucidated the neurology of affective prosody which, in turn, has led to a more complete and nuanced understanding of the neurology of language, depression, emotions and memory. In addition, the paper will also present the serendipitous clinical observations (inductive research) and fortuitous inter-disciplinary collaborations that were crucial in guiding and developing the deductive research processes that culminated in the concept that primary emotions and related display behaviors are a lateralized function of the right hemisphere and social emotions, and related display behaviors are a lateralized function of the left hemisphere.
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Affiliation(s)
- Elliott D. Ross
- Department of Neurology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA; or
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
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Coulombe V, Joyal M, Martel-Sauvageau V, Monetta L. Affective prosody disorders in adults with neurological conditions: A scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:1939-1954. [PMID: 37212522 DOI: 10.1111/1460-6984.12909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Individuals with affective-prosodic deficits have difficulty understanding or expressing emotions and attitudes through prosody. Affective prosody disorders can occur in multiple neurological conditions, but the limited knowledge about the clinical groups prone to deficits complicates their identification in clinical settings. Additionally, the nature of the disturbance underlying affective prosody disorder observed in different neurological conditions remains poorly understood. AIMS To bridge these knowledge gaps and provide relevant information to speech-language pathologists for the management of affective prosody disorders, this study provides an overview of research findings on affective-prosodic deficits in adults with neurological conditions by answering two questions: (1) Which clinical groups present with acquired affective prosodic impairments following brain damage? (2) Which aspects of affective prosody comprehension and production are negatively affected in these neurological conditions? METHODS & PROCEDURES We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A literature search was undertaken in five electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL and Linguistics, and Language Behavior Abstracts) to identify primary studies reporting affective prosody disorders in adults with neurological impairments. We extracted data on clinical groups and characterised their deficits based on the assessment task used. OUTCOMES & RESULTS The review of 98 studies identified affective-prosodic deficits in 17 neurological conditions. The task paradigms typically used in affective prosody research (discrimination, recognition, cross-modal integration, production on request, imitation and spontaneous production) do not target the processes underlying affective prosody comprehension and production. Therefore, based on the current state of knowledge, it is not possible to establish the level of processing at which impairment occurs in clinical groups. Nevertheless, deficits in the comprehension of affective prosody are observed in 14 clinical groups (mainly recognition deficits) and deficits in the production of affective prosody (either on request or spontaneously) in 10 clinical groups. Neurological conditions and types of deficits that have not been investigated in many studies are highlighted. CONCLUSIONS & IMPLICATIONS The aim of this scoping review was to provide an overview on acquired affective prosody disorders and to identify gaps in knowledge that warrant further investigation. Deficits in the comprehension or production of affective prosody are common to numerous clinical groups with various neurological conditions. However, the underlying cause of affective prosody disorders across them is still unknown. Future studies should implement standardised assessment methods with specific tasks based on a cognitive model to identify the underlying deficits of affective prosody disorders. WHAT THIS PAPER ADDS What is already known on the subject What is already known on the subjectAffective prosody is used to share emotions and attitudes through speech and plays a fundamental role in communication and social interactions. Affective prosody disorders can occur in various neurological conditions, but the limited knowledge about the clinical groups prone to affective-prosodic deficits and about the characteristics of different phenotypes of affective prosody disorders complicates their identification in clinical settings. Distinct abilities underlying the comprehension and production of affective prosody can be selectively impaired by brain damage, but the nature of the disturbance underlying affective prosody disorders in different neurological conditions remains unclear. What this study adds Affective-prosodic deficits are reported in 17 neurological conditions, despite being recognised as a core feature of the clinical profile in only a few of them. The assessment tasks typically used in affective prosody research do not provide accurate information about the specific neurocognitive processes impaired in the comprehension or production of affective prosody. Future studies should implement assessment methods based on a cognitive approach to identify underlying deficits. The assessment of cognitive/executive dysfunctions, motor speech impairment and aphasia might be important for distinguishing primary affective prosodic dysfunctions from those secondarily impacting affective prosody. What are the potential clinical implications of this study? Raising awareness about the possible presence of affective-prosodic disorders in numerous clinical groups will facilitate their recognition by speech-language pathologists and, consequently, their management in clinical settings. A comprehensive assessment covering multiple affective-prosodic skills could highlight specific aspects of affective prosody that warrant clinical intervention.
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Affiliation(s)
- Valérie Coulombe
- Faculty of Medicine, Université Laval, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
| | | | - Vincent Martel-Sauvageau
- Faculty of Medicine, Université Laval, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
| | - Laura Monetta
- Faculty of Medicine, Université Laval, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
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Baglione H, Coulombe V, Martel-Sauvageau V, Monetta L. The impacts of aging on the comprehension of affective prosody: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-16. [PMID: 37603689 DOI: 10.1080/23279095.2023.2245940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Recent clinical reports have suggested a possible decline in the ability to understand emotions in speech (affective prosody comprehension) with aging. The present study aims to further examine the differences in performance between older and younger adults in terms of affective prosody comprehension. Following a recent cognitive model dividing affective prosody comprehension into perceptual and lexico-semantic components, a cognitive approach targeting these components was adopted. The influence of emotions' valence and category on aging performance was also investigated. A systematic review of the literature was carried out using six databases. Twenty-one articles, presenting 25 experiments, were included. All experiments analyzed affective prosody comprehension performance of older versus younger adults. The results confirmed that older adults' performance in identifying emotions in speech was reduced compared to younger adults. The results also brought out the fact that affective prosody comprehension abilities could be modulated by the emotion category but not by the emotional valence. Various theories account for this difference in performance, namely auditory perception, brain aging, and socioemotional selectivity theory suggesting that older people tend to neglect negative emotions. However, the explanation of the underlying deficits of the affective prosody decline is still limited.
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Affiliation(s)
- Héloïse Baglione
- Département de réadaptation, Université Laval, Québec City, Quebec, Canada
- Département de readaptation, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec City, Quebec, Canada
| | - Valérie Coulombe
- Département de réadaptation, Université Laval, Québec City, Quebec, Canada
- Département de readaptation, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec City, Quebec, Canada
| | - Vincent Martel-Sauvageau
- Département de réadaptation, Université Laval, Québec City, Quebec, Canada
- Département de readaptation, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec City, Quebec, Canada
| | - Laura Monetta
- Département de réadaptation, Université Laval, Québec City, Quebec, Canada
- Département de readaptation, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec City, Quebec, Canada
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Gong B, Li N, Li Q, Yan X, Chen J, Li L, Wu X, Wu C. The Mandarin Chinese auditory emotions stimulus database: A validated set of Chinese pseudo-sentences. Behav Res Methods 2023; 55:1441-1459. [PMID: 35641682 DOI: 10.3758/s13428-022-01868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/08/2022]
Abstract
Emotional prosody is fully embedded in language and can be influenced by the linguistic properties of a specific language. Considering the limitations of existing Chinese auditory stimulus database studies, we developed and validated an emotional auditory stimuli database composed of Chinese pseudo-sentences, recorded by six professional actors in Mandarin Chinese. Emotional expressions included happiness, sadness, anger, fear, disgust, pleasant surprise, and neutrality. All emotional categories were vocalized into two types of sentence patterns, declarative and interrogative. In addition, all emotional pseudo-sentences, except for neutral, were vocalized at two levels of emotional intensity: normal and strong. Each recording was validated with 40 native Chinese listeners in terms of the recognition accuracy of the intended emotion portrayal; finally, 4361 pseudo-sentence stimuli were included in the database. Validation of the database using a forced-choice recognition paradigm revealed high rates of emotional recognition accuracy. The detailed acoustic attributes of vocalization were provided and connected to the emotion recognition rates. This corpus could be a valuable resource for researchers and clinicians to explore the behavioral and neural mechanisms underlying emotion processing of the general population and emotional disturbances in neurological, psychiatric, and developmental disorders. The Mandarin Chinese auditory emotion stimulus database is available at the Open Science Framework ( https://osf.io/sfbm6/?view_only=e22a521e2a7d44c6b3343e11b88f39e3 ).
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Affiliation(s)
- Bingyan Gong
- School of Nursing, Peking University Health Science Center, Room 510, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Na Li
- Theatre Pedagogy Department, Central Academy of Drama, Beijing, 100710, China
| | - Qiuhong Li
- School of Nursing, Peking University Health Science Center, Room 510, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xinyuan Yan
- School of Computing, University of Utah, Salt Lake City, UT, USA
| | - Jing Chen
- Department of Machine Intelligence, Peking University, 5 Yiheyuan Road, Haidian District, Beijing, 100871, China
- Speech and Hearing Research Center, Key Laboratory on Machine Perception (Ministry of Education), Peking University, Beijing, 100871, China
| | - Liang Li
- School of Psychological and Cognitive Sciences, Peking University, Beijing, 100871, China
| | - Xihong Wu
- Department of Machine Intelligence, Peking University, 5 Yiheyuan Road, Haidian District, Beijing, 100871, China.
- Speech and Hearing Research Center, Key Laboratory on Machine Perception (Ministry of Education), Peking University, Beijing, 100871, China.
| | - Chao Wu
- School of Nursing, Peking University Health Science Center, Room 510, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Karimi-Boroujeni M, Dajani HR, Giguère C. Perception of Prosody in Hearing-Impaired Individuals and Users of Hearing Assistive Devices: An Overview of Recent Advances. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:775-789. [PMID: 36652704 DOI: 10.1044/2022_jslhr-22-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Prosody perception is an essential component of speech communication and social interaction through which both linguistic and emotional information are conveyed. Considering the importance of the auditory system in processing prosody-related acoustic features, the aim of this review article is to review the effects of hearing impairment on prosody perception in children and adults. It also assesses the performance of hearing assistive devices in restoring prosodic perception. METHOD Following a comprehensive online database search, two lines of inquiry were targeted. The first summarizes recent attempts toward determining the effects of hearing loss and interacting factors such as age and cognitive resources on prosody perception. The second analyzes studies reporting beneficial or detrimental impacts of hearing aids, cochlear implants, and bimodal stimulation on prosodic abilities in people with hearing loss. RESULTS The reviewed studies indicate that hearing-impaired individuals vary widely in perceiving affective and linguistic prosody, depending on factors such as hearing loss severity, chronological age, and cognitive status. In addition, most of the emerging information points to limitations of hearing assistive devices in processing and transmitting the acoustic features of prosody. CONCLUSIONS The existing literature is incomplete in several respects, including the lack of a consensus on how and to what extent hearing prostheses affect prosody perception, especially the linguistic function of prosody, and a gap in assessing prosody under challenging listening situations such as noise. This review article proposes directions that future research could follow to provide a better understanding of prosody processing in those with hearing impairment, which may help health care professionals and designers of assistive technology to develop innovative diagnostic and rehabilitation tools. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21809772.
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Affiliation(s)
| | - Hilmi R Dajani
- School of Electrical Engineering and Computer Science, University of Ottawa, Ontario, Canada
| | - Christian Giguère
- School of Rehabilitation Sciences, University of Ottawa, Ontario, Canada
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Abstract
OBJECTIVES The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke. METHODS One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches. RESULTS Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments. CONCLUSIONS This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.
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Ukaegbe OC, Holt BE, Keator LM, Brownell H, Blake ML, Lundgren K. Aprosodia Following Focal Brain Damage: What's Right and What's Left? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2313-2328. [PMID: 35868292 DOI: 10.1044/2022_ajslp-21-00302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Hemispheric specialization for the comprehension and expression of linguistic and emotional prosody is typically attributed to the right hemisphere. This study used techniques adapted from meta-analysis to critically examine the strength of existing evidence for hemispheric lateralization of prosody following brain damage. METHOD Twenty-one databases were searched for articles published from 1970 to 2020 addressing differences in prosody performance between groups defined by right hemisphere damage and left hemisphere damage. Hedges's g effect sizes were calculated for all possible prosody comparisons. Primary analyses summarize effects for four types: linguistic production, linguistic comprehension, emotion comprehension, and emotion production. Within each primary analysis, Hedges's g values were averaged across comparisons (usually from a single article) based on the same sample of individuals. Secondary analyses explore more specific classifications of comparisons. RESULTS Out of the 113 articles investigating comprehension and production of emotional and linguistic prosody, 62 were deemed appropriate for data extraction, but only 21 met inclusion criteria, passed quality reviews, and provided sufficient information for analysis. Evidence from this review illustrates the heterogeneity of research methods and results from studies that have investigated aprosodia. This review provides inconsistent support for selective contribution of the two cerebral hemispheres to prosody comprehension and production; however, the strongest finding suggests that right hemisphere lesions disrupt emotional prosody comprehension more than left hemisphere lesions. CONCLUSION This review highlights the impoverished nature of the existing literature; offers suggestions for future research; and highlights relevant clinical implications for the prognostication, evaluation, and treatment of aprosodia. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20334987.
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Affiliation(s)
- Onyinyechi C Ukaegbe
- Department of Communication Sciences and Disorders, The University of North Carolina Greensboro
| | - Brooke E Holt
- Department of Communication Sciences and Disorders, The University of North Carolina Greensboro
| | - Lynsey M Keator
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Hiram Brownell
- Department of Psychology and Neuroscience, Boston College, MA
| | | | - Kristine Lundgren
- Department of Communication Sciences and Disorders, The University of North Carolina Greensboro
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Zhao X, Liu Y, Wang S, Chen J, Chen T, Liu G. Electrophysiological evidence for inhibition hypothesis of micro-expressions based on tensor component analysis and Physarum network algorithm. Neurosci Lett 2022; 790:136897. [PMID: 36195299 DOI: 10.1016/j.neulet.2022.136897] [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: 06/10/2022] [Revised: 09/01/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022]
Abstract
The inhibition hypothesis advocated by Ekman (1985) states when an emotion is concealed or masked, the true emotion is manifested as a micro-expression (ME) which is a fleeting expression lasting for 40 to 500 ms. However, research about the inhibition hypothesis of ME from the perspective of electrophysiology is lacking. Here, we report the electrophysiological evidence obtained from an electroencephalography (EEG) data analysis method. Specifically, we designed an ME elicitation paradigm to collect data of MEs of positive emotions and EEG from 70 subjects, and proposed a method based on tensor component analysis (TCA) combined with the Physarum network (PN) algorithm to characterize the spatial, temporal, and spectral signatures of dynamic EEG data of MEs. The proposed TCA-PN methods revealed two pathways involving dorsal and ventral streams in functional brain networks of MEs, which reflected the inhibition processing and emotion arousal of MEs. The results provide evidence for the inhibition hypothesis from an electrophysiological standpoint, which allows us to better understand the neural mechanism of MEs.
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Affiliation(s)
- Xingcong Zhao
- School of Electronic and Information Engineering, Southwest University, 400715, China
| | - Ying Liu
- School of Music, Southwest University, 400715, China
| | - Shiyuan Wang
- School of Electronic and Information Engineering, Southwest University, 400715, China
| | - Jiejia Chen
- School of Electronic and Information Engineering, Southwest University, 400715, China
| | - Tong Chen
- School of Electronic and Information Engineering, Southwest University, 400715, China
| | - Guangyuan Liu
- School of Electronic and Information Engineering, Southwest University, 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, 400715, China.
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Abstract
OBJECTIVE To identify which aspects of prosody are negatively affected subsequent to right hemisphere brain damage (RHD) and to evaluate the methodological quality of the constituent studies. METHOD Twenty-one electronic databases were searched to identify articles from 1970 to February 2020 by entering keywords. Eligibility criteria for articles included a focus on adults with acquired RHD, prosody as the primary research topic, and publication in a peer-reviewed journal. A quality appraisal was conducted using a rubric adapted from Downs and Black (1998). RESULTS Of the 113 articles appraised as eligible and appropriate for inclusion, 71 articles were selected to undergo data extraction for both meta-analyses of population effect size estimates and qualitative synthesis. Across all domains of prosody, the effect estimate was g = 2.51 [95% CI (1.94, 3.09), t = 8.66, p < 0.0001], based on 129 contrasts between RHD and non-brain-damaged healthy controls (NBD), indicating a significant random effects model. This effect size was driven by findings in emotional prosody, g = 2.48 [95% CI (1.76, 3.20), t = 6.88, p < 0.0001]. Overall, studies of higher quality (rpb = 0.18, p < 0.001) and higher sample size/contrast ratio (rpb = 0.25, p < 0.001) were more likely to report significant differences between RHD and NBD participants. CONCLUSIONS The results confirm consistent evidence for emotional prosody deficits in the RHD population. Inconsistent evidence was observed across linguistic prosody domains and pervasive methodological issues were identified across studies, regardless of their prosody focus. These findings highlight the need for more rigorous and sufficiently high-powered designs to examine prosody subsequent to RHD, particularly within the linguistic prosody domain.
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Qu JF, Zhou YQ, Liu JF, Hu HH, Cheng WY, Lu ZH, Shi L, Luo YS, Zhao L, Chen YK. Right Cortical Infarction and a Reduction in Putamen Volume May Be Correlated with Empathy in Patients after Subacute Ischemic Stroke—A Multimodal Magnetic Resonance Imaging Study. J Clin Med 2022; 11:jcm11154479. [PMID: 35956096 PMCID: PMC9369598 DOI: 10.3390/jcm11154479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/12/2022] [Accepted: 07/28/2022] [Indexed: 02/04/2023] Open
Abstract
Empathy has not been well studied in patients following ischemic stroke. We aimed to evaluate the relationships of multimodal neuroimaging parameters with the impairment of empathy in patients who had experienced subacute ischemic stroke. Patients who had experienced a first-event acute ischemic stroke were recruited, and we assessed their empathy using the Chinese version of the Empathy Quotient (EQ) 3 months after the index stroke. Multimodal magnetic resonance imaging (MRI) was conducted in all the participants to identify acute infarction and assess brain volumes, white matter integrity, and other preexisting abnormalities. We quantified the brain volumes of various subcortical structures, the ventricles, and cortical lobar atrophy. The microstructural integrity of the white matter was reflected in the mean fractional anisotropy (FA) and mean diffusivity (MD), and the regional mean values of FA and MD were quantified after mapping using the ICBM_DTI_81 Atlas. Twenty-three (56.1%) men and 18 (43.9%) women (mean age: 61.73 years, range: 41–77 years) were included. The median National Institutes of Health Stroke Scale (NIHSS) score at discharge was 1 (range: 0–4). On univariate analysis, the EQ was correlated with right cortical infarction (r = −0.39, p = 0.012), putamen volume (r = 0.382, p = 0.014), right putamen volume (r = 0.338, p = 0.031), and the FA value of the right sagittal stratum. EQ did not correlated with the MD value in any region of interest or pre-existing brain abnormalities. Multiple stepwise linear regression models were used to identify factors associated with EQ. After adjusting for age and the NIHSS score on admission, the frequency of right cortical infarcts negatively correlated with EQ (standardized β = −0.358, 95% confidence interval =−0.708 to −0.076, p = 0.016), and the putamen volume positively correlated with EQ (standardized β = 0.328, 95% confidence interval =0.044 to 0.676, p = 0.027). In conclusion, in patients who have experienced subacute ischemic stroke, right cortical infarction and a smaller putamen volume are associated with the impairment of empathy.
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Affiliation(s)
- Jian-Feng Qu
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan 523108, China; (J.-F.Q.); (Y.-Q.Z.); (J.-F.L.); (H.-H.H.); (W.-Y.C.); (Z.-H.L.)
| | - Yue-Qiong Zhou
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan 523108, China; (J.-F.Q.); (Y.-Q.Z.); (J.-F.L.); (H.-H.H.); (W.-Y.C.); (Z.-H.L.)
- Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang 524013, China
| | - Jian-Fei Liu
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan 523108, China; (J.-F.Q.); (Y.-Q.Z.); (J.-F.L.); (H.-H.H.); (W.-Y.C.); (Z.-H.L.)
- Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou 510505, China
| | - Hui-Hong Hu
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan 523108, China; (J.-F.Q.); (Y.-Q.Z.); (J.-F.L.); (H.-H.H.); (W.-Y.C.); (Z.-H.L.)
| | - Wei-Yang Cheng
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan 523108, China; (J.-F.Q.); (Y.-Q.Z.); (J.-F.L.); (H.-H.H.); (W.-Y.C.); (Z.-H.L.)
| | - Zhi-Hao Lu
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan 523108, China; (J.-F.Q.); (Y.-Q.Z.); (J.-F.L.); (H.-H.H.); (W.-Y.C.); (Z.-H.L.)
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong, China;
| | - Yi-Shan Luo
- BrainNow Research Institute, Shenzhen 518000, China; (Y.-S.L.); (L.Z.)
| | - Lei Zhao
- BrainNow Research Institute, Shenzhen 518000, China; (Y.-S.L.); (L.Z.)
| | - Yang-Kun Chen
- Department of Neurology, Dongguan People’s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan 523108, China; (J.-F.Q.); (Y.-Q.Z.); (J.-F.L.); (H.-H.H.); (W.-Y.C.); (Z.-H.L.)
- Correspondence: ; Tel.: +86-13713135765
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Minga J, Fromm D, Jacks A, Stockbridge MD, Nelthropp J, MacWhinney B. The Effects of Right Hemisphere Brain Damage on Question-Asking in Conversation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:727-737. [PMID: 35077648 PMCID: PMC9132138 DOI: 10.1044/2021_jslhr-21-00309] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Right hemisphere brain damage (RHD) can cause challenges with information gathering. Cognitive processes aid in implicit and explicit information gathering, yet the relationship between these processes and question-asking, the most explicit avenue of information gathering, has not been explored. The purpose of this exploratory descriptive study was to test the hypothesis that adults with RHD differ from controls in the types of questions produced during a conversational discourse task and whether observed differences are associated with cognitive limitations. METHOD Adults with RHD (n = 15) and controls (n = 15) participated in a 5-min "first-encounter conversation" and were assessed for attention, memory, executive functioning (EF), visuospatial skills, and language domains using the Cognitive Linguistic Quick Test (CLQT). Questions produced during the conversation were coded and tallied by type: polar (yes/no), content (wh-), or alternative (A or B) using Computerized Language Analysis programs. Groups were compared on total questions used, use of questions by type, and CLQT domain scores; associations were computed between cognitive domain scores and question types. RESULTS Compared with controls, adults with RHD used half as many questions overall and scored significantly lower on the attention, executive function, and visuospatial domains of the CLQT. For the RHD group, there was a significant correlation between EF scores and the production of content and polar questions. CONCLUSIONS The frequency of question-asking is important to understanding the communication profile in adults with RHD. Executive function, attention, and, to a lesser extent, visuospatial capabilities may contribute to question-asking behaviors in conversation in this population. The RHD Framework for Asking Questions is proposed to illustrate the potential areas of deficit in the question-asking process after RHD.
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Affiliation(s)
- Jamila Minga
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Davida Fromm
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Adam Jacks
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill
| | - Melissa D. Stockbridge
- Cerebrovascular Division, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer Nelthropp
- Department of Communication Sciences and Disorders, North Carolina Central University, Durham
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
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12
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Schelinski S, Tabas A, von Kriegstein K. Altered processing of communication signals in the subcortical auditory sensory pathway in autism. Hum Brain Mapp 2022; 43:1955-1972. [PMID: 35037743 PMCID: PMC8933247 DOI: 10.1002/hbm.25766] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 11/24/2021] [Accepted: 12/19/2021] [Indexed: 12/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterised by social communication difficulties. These difficulties have been mainly explained by cognitive, motivational, and emotional alterations in ASD. The communication difficulties could, however, also be associated with altered sensory processing of communication signals. Here, we assessed the functional integrity of auditory sensory pathway nuclei in ASD in three independent functional magnetic resonance imaging experiments. We focused on two aspects of auditory communication that are impaired in ASD: voice identity perception, and recognising speech‐in‐noise. We found reduced processing in adults with ASD as compared to typically developed control groups (pairwise matched on sex, age, and full‐scale IQ) in the central midbrain structure of the auditory pathway (inferior colliculus [IC]). The right IC responded less in the ASD as compared to the control group for voice identity, in contrast to speech recognition. The right IC also responded less in the ASD as compared to the control group when passively listening to vocal in contrast to non‐vocal sounds. Within the control group, the left and right IC responded more when recognising speech‐in‐noise as compared to when recognising speech without additional noise. In the ASD group, this was only the case in the left, but not the right IC. The results show that communication signal processing in ASD is associated with reduced subcortical sensory functioning in the midbrain. The results highlight the importance of considering sensory processing alterations in explaining communication difficulties, which are at the core of ASD.
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Affiliation(s)
- Stefanie Schelinski
- Faculty of Psychology, Chair of Cognitive and Clinical Neuroscience, Technische Universität Dresden, Dresden, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Alejandro Tabas
- Faculty of Psychology, Chair of Cognitive and Clinical Neuroscience, Technische Universität Dresden, Dresden, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Katharina von Kriegstein
- Faculty of Psychology, Chair of Cognitive and Clinical Neuroscience, Technische Universität Dresden, Dresden, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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13
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Murray EA, Fellows LK. Prefrontal cortex interactions with the amygdala in primates. Neuropsychopharmacology 2022; 47:163-179. [PMID: 34446829 PMCID: PMC8616954 DOI: 10.1038/s41386-021-01128-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 02/07/2023]
Abstract
This review addresses functional interactions between the primate prefrontal cortex (PFC) and the amygdala, with emphasis on their contributions to behavior and cognition. The interplay between these two telencephalic structures contributes to adaptive behavior and to the evolutionary success of all primate species. In our species, dysfunction in this circuitry creates vulnerabilities to psychopathologies. Here, we describe amygdala-PFC contributions to behaviors that have direct relevance to Darwinian fitness: learned approach and avoidance, foraging, predator defense, and social signaling, which have in common the need for flexibility and sensitivity to specific and rapidly changing contexts. Examples include the prediction of positive outcomes, such as food availability, food desirability, and various social rewards, or of negative outcomes, such as threats of harm from predators or conspecifics. To promote fitness optimally, these stimulus-outcome associations need to be rapidly updated when an associative contingency changes or when the value of a predicted outcome changes. We review evidence from nonhuman primates implicating the PFC, the amygdala, and their functional interactions in these processes, with links to experimental work and clinical findings in humans where possible.
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Affiliation(s)
| | - Lesley K Fellows
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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14
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Psychiatric sequelae of stroke affecting the non-dominant cerebral hemisphere. J Neurol Sci 2021; 430:120007. [PMID: 34624794 DOI: 10.1016/j.jns.2021.120007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/08/2023]
Abstract
There are a plethora of cognitive sequelae in addition to neglect and extinction that arise with unilateral right hemispheric stroke (RHS). Cognitive deficits following non-dominant (right) hemisphere stroke are common with unilateral neglect and extinction being the most recognized examples. The severity of RHS is usually underestimated by the National Institutes of Health Stroke Scale (NIHSS), which in terms of lateralized right hemisphere cognitive deficits, tests only for visual inattention/extinction. They account for 2 out of 42 total possible points. Additional neuropsychiatric sequelae include but are not limited to deficiencies in affective prosody comprehension and production (aprosodias), understanding and expressing facial emotions, empathy, recognition of familiar faces, anxiety, mania, apathy, and psychosis. These sequelae have a profound impact on patients' quality of life; affecting communication, interpersonal relationships, and the ability to fulfill social roles. They also pose additional challenges to recovery. There is presently a gap in the literature regarding a cohesive overview of the significant cognitive sequelae following RHS. This paper serves as a narrative survey of the current understanding of the subject, with particular emphasis on neuropsychiatric poststroke syndromes not predominantly associated with left hemisphere lesions (LHL), bilateral lesions, hemiplegia, or paralysis. A more comprehensive understanding of the neuropsychological consequences of RHS extending beyond the typical associations of unilateral neglect and extinction may have important implications for clinical practice, including the ways in which clinicians approach diagnostics, treatment, and rehabilitation.
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15
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Sihvonen AJ, Sammler D, Ripollés P, Leo V, Rodríguez-Fornells A, Soinila S, Särkämö T. Right ventral stream damage underlies both poststroke aprosodia and amusia. Eur J Neurol 2021; 29:873-882. [PMID: 34661326 DOI: 10.1111/ene.15148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE This study was undertaken to determine and compare lesion patterns and structural dysconnectivity underlying poststroke aprosodia and amusia, using a data-driven multimodal neuroimaging approach. METHODS Thirty-nine patients with right or left hemisphere stroke were enrolled in a cohort study and tested for linguistic and affective prosody perception and musical pitch and rhythm perception at subacute and 3-month poststroke stages. Participants listened to words spoken with different prosodic stress that changed their meaning, and to words spoken with six different emotions, and chose which meaning or emotion was expressed. In the music tasks, participants judged pairs of short melodies as the same or different in terms of pitch or rhythm. Structural magnetic resonance imaging data were acquired at both stages, and machine learning-based lesion-symptom mapping and deterministic tractography were used to identify lesion patterns and damaged white matter pathways giving rise to aprosodia and amusia. RESULTS Both aprosodia and amusia were behaviorally strongly correlated and associated with similar lesion patterns in right frontoinsular and striatal areas. In multiple regression models, reduced fractional anisotropy and lower tract volume of the right inferior fronto-occipital fasciculus were the strongest predictors for both disorders, over time. CONCLUSIONS These results highlight a common origin of aprosodia and amusia, both arising from damage and disconnection of the right ventral auditory stream integrating rhythmic-melodic acoustic information in prosody and music. Comorbidity of these disabilities may worsen the prognosis and affect rehabilitation success.
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Affiliation(s)
- Aleksi J Sihvonen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Daniela Sammler
- Research Group "Neurocognition of Music and Language, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Pablo Ripollés
- Department of Psychology, New York University, New York, New York, USA
| | - Vera Leo
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Antoni Rodríguez-Fornells
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain.,Department of Cognition, Development, and Education Psychology, University of Barcelona, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | - Seppo Soinila
- Neurocenter, Turku University Hospital and Division of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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16
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Durfee AZ, Sheppard SM, Blake ML, Hillis AE. Lesion loci of impaired affective prosody: A systematic review of evidence from stroke. Brain Cogn 2021; 152:105759. [PMID: 34118500 PMCID: PMC8324538 DOI: 10.1016/j.bandc.2021.105759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023]
Abstract
Affective prosody, or the changes in rate, rhythm, pitch, and loudness that convey emotion, has long been implicated as a function of the right hemisphere (RH), yet there is a dearth of literature identifying the specific neural regions associated with its processing. The current systematic review aimed to evaluate the evidence on affective prosody localization in the RH. One hundred and ninety articles from 1970 to February 2020 investigating affective prosody comprehension and production in patients with focal brain damage were identified via database searches. Eleven articles met inclusion criteria, passed quality reviews, and were analyzed for affective prosody localization. Acute, subacute, and chronic lesions demonstrated similar profile characteristics. Localized right antero-superior (i.e., dorsal stream) regions contributed to affective prosody production impairments, whereas damage to more postero-lateral (i.e., ventral stream) regions resulted in affective prosody comprehension deficits. This review provides support that distinct RH regions are vital for affective prosody comprehension and production, aligning with literature reporting RH activation for affective prosody processing in healthy adults as well. The impact of study design on resulting interpretations is discussed.
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Affiliation(s)
- Alexandra Zezinka Durfee
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
| | - Shannon M Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Communication Sciences and Disorders, Chapman University Crean College of Health and Behavioral Sciences, Irvine, CA 92618, United States
| | - Margaret L Blake
- Department of Communication Sciences and Disorders, University of Houston College of Liberal Arts and Social Sciences, Houston, TX 77204, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, United States
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17
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Lin RZ, Marsh EB. Abnormal singing can identify patients with right hemisphere cortical strokes at risk for impaired prosody. Medicine (Baltimore) 2021; 100:e26280. [PMID: 34115027 PMCID: PMC8202571 DOI: 10.1097/md.0000000000026280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/21/2021] [Indexed: 01/04/2023] Open
Abstract
Despite lacking aphasia seen with left hemisphere (LH) infarcts involving the middle cerebral artery territory, right hemisphere (RH) strokes can result in significant difficulties in affective prosody. These impairments may be more difficult to identify but lead to significant communication problems.We determine if evaluation of singing can accurately identify stroke patients with cortical RH infarcts at risk for prosodic impairment who may benefit from rehabilitation.A prospective cohort of 36 patients evaluated with acute ischemic stroke was recruited. Participants underwent an experimental battery evaluating their singing, prosody comprehension, and prosody production. Singing samples were rated by 2 independent reviewers as subjectively "normal" or "abnormal," and analyzed for properties of the fundamental frequency. Relationships between infarct location, singing, and prosody performance were evaluated using t tests and chi-squared analysis.Eighty percent of participants with LH cortical strokes were unable to successfully complete any of the tasks due to severe aphasia. For the remainder, singing ratings corresponded to stroke location for 68% of patients. RH cortical strokes demonstrated a lower mean fundamental frequency while singing than those with subcortical infarcts (176.8 vs 130.4, P = 0.02). They also made more errors on tasks of prosody comprehension (28.6 vs 16.0, P < 0.001) and production (40.4 vs 18.4, P < 0.001).Patients with RH cortical infarcts are more likely to exhibit impaired prosody comprehension and production and demonstrate the poor variation of tone when singing compared to patients with subcortical infarcts. A simple singing screen is able to successfully identify patients with cortical lesions and potential prosodic deficits.
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Affiliation(s)
- Rebecca Z. Lin
- Department of Cognitive Science, Johns Hopkins University
| | - Elisabeth B. Marsh
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
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18
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Durfee AZ, Sheppard SM, Meier EL, Bunker L, Cui E, Crainiceanu C, Hillis AE. Explicit Training to Improve Affective Prosody Recognition in Adults with Acute Right Hemisphere Stroke. Brain Sci 2021; 11:brainsci11050667. [PMID: 34065453 PMCID: PMC8161405 DOI: 10.3390/brainsci11050667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Difficulty recognizing affective prosody (receptive aprosodia) can occur following right hemisphere damage (RHD). Not all individuals spontaneously recover their ability to recognize affective prosody, warranting behavioral intervention. However, there is a dearth of evidence-based receptive aprosodia treatment research in this clinical population. The purpose of the current study was to investigate an explicit training protocol targeting affective prosody recognition in adults with RHD and receptive aprosodia. Eighteen adults with receptive aprosodia due to acute RHD completed affective prosody recognition before and after a short training session that targeted proposed underlying perceptual and conceptual processes. Behavioral impairment and lesion characteristics were investigated as possible influences on training effectiveness. Affective prosody recognition improved following training, and recognition accuracy was higher for pseudo- vs. real-word sentences. Perceptual deficits were associated with the most posterior infarcts, conceptual deficits were associated with frontal infarcts, and a combination of perceptual-conceptual deficits were related to temporoparietal and subcortical infarcts. Several right hemisphere ventral stream regions and pathways along with frontal and parietal hypoperfusion predicted training effectiveness. Explicit acoustic-prosodic-emotion training improves affective prosody recognition, but it may not be appropriate for everyone. Factors such as linguistic context and lesion location should be considered when planning prosody training.
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Affiliation(s)
- Alexandra Zezinka Durfee
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
| | - Shannon M. Sheppard
- Department of Communication Sciences and Disorders, Chapman University, Irvine, CA 92618, USA;
| | - Erin L. Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MD 02115, USA
| | - Lisa Bunker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
| | - Erjia Cui
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA; (E.C.); (C.C.)
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA; (E.C.); (C.C.)
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (A.Z.D.); (E.L.M.); (L.B.)
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21287, USA
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, USA
- Correspondence:
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19
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Sheppard SM, Meier EL, Zezinka Durfee A, Walker A, Shea J, Hillis AE. Characterizing subtypes and neural correlates of receptive aprosodia in acute right hemisphere stroke. Cortex 2021; 141:36-54. [PMID: 34029857 DOI: 10.1016/j.cortex.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/20/2021] [Accepted: 04/09/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Speakers naturally produce prosodic variations depending on their emotional state. Receptive prosody has several processing stages. We aimed to conduct lesion-symptom mapping to determine whether damage (core infarct or hypoperfusion) to specific brain areas was associated with receptive aprosodia or with impairment at different processing stages in individuals with acute right hemisphere stroke. We also aimed to determine whether different subtypes of receptive aprosodia exist that are characterized by distinctive behavioral performance patterns. METHODS Twenty patients with receptive aprosodia following right hemisphere ischemic stroke were enrolled within five days of stroke; clinical imaging was acquired. Participants completed tests of receptive emotional prosody, and tests of each stage of prosodic processing (Stage 1: acoustic analysis; Stage 2: analyzing abstract representations of acoustic characteristics that convey emotion; Stage 3: semantic processing). Emotional facial recognition was also assessed. LASSO regression was used to identify predictors of performance on each behavioral task. Predictors entered into each model included 14 right hemisphere regions, hypoperfusion in four vascular territories as measured using FLAIR hyperintense vessel ratings, lesion volume, age, and education. A k-medoid cluster analysis was used to identify different subtypes of receptive aprosodia based on performance on the behavioral tasks. RESULTS Impaired receptive emotional prosody and impaired emotional facial expression recognition were both predicted by greater percent damage to the caudate. The k-medoid cluster analysis identified three different subtypes of aprosodia. One group was primarily impaired on Stage 1 processing and primarily had frontotemporal lesions. The second group had a domain-general emotion recognition impairment and maximal lesion overlap in subcortical areas. Finally, the third group was characterized by a Stage 2 processing deficit and had lesion overlap in posterior regions. CONCLUSIONS Subcortical structures, particularly the caudate, play an important role in emotional prosody comprehension. Receptive aprosodia can result from impairments at different processing stages.
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Affiliation(s)
- Shannon M Sheppard
- Department of Communication Sciences & Disorders, Chapman University, Irvine, CA, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Erin L Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Alex Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer Shea
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
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20
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O'Connell K, Marsh AA, Edwards DF, Dromerick AW, Seydell-Greenwald A. Emotion recognition impairments and social well-being following right-hemisphere stroke. Neuropsychol Rehabil 2021; 32:1337-1355. [PMID: 33615994 PMCID: PMC8379297 DOI: 10.1080/09602011.2021.1888756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Accurately recognizing and responding to the emotions of others is essential for proper social communication and helps bind strong relationships that are particularly important for stroke survivors. Emotion recognition typically engages cortical areas that are predominantly right-lateralized including superior temporal and inferior frontal gyri - regions frequently impacted by right-hemisphere stroke. Since prior work already links right-hemisphere stroke to deficits in emotion recognition, this research aims to extend these findings to determine whether impaired emotion recognition after right-hemisphere stroke is associated with worse social well-being outcomes. Eighteen right-hemisphere stroke patients (≥6 months post-stroke) and 21 neurologically healthy controls completed a multimodal emotion recognition test (Geneva Emotion Recognition Test - Short) and reported engagement in social/non-social activities and levels of social support. Right-hemisphere stroke was associated with worse emotion recognition accuracy, though not all patients exhibited impairment. In line with hypotheses, emotion recognition impairments were associated with greater loss of social activities after stroke, an effect that could not be attributed to stroke severity or loss of non-social activities. Impairments were also linked to reduced patient-reported social support. Results implicate emotion recognition difficulties as a potential antecedent of social withdrawal after stroke and warrant future research to test emotion recognition training post-stroke.
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Affiliation(s)
- Katherine O'Connell
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, USA
| | - Abigail A Marsh
- Department of Psychology, Georgetown University, Washington, DC, USA
| | - Dorothy Farrar Edwards
- Department of Kinesiology and Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Alexander W Dromerick
- MedStar National Rehabilitation Hospital, Washington, DC, USA.,Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
| | - Anna Seydell-Greenwald
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center, Washington, DC, USA
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21
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Minga J, Johnson M, Blake ML, Fromm D, MacWhinney B. Making Sense of Right Hemisphere Discourse Using RHDBank. TOPICS IN LANGUAGE DISORDERS 2021; 41:99-122. [PMID: 34584326 PMCID: PMC8475789 DOI: 10.1097/tld.0000000000000244] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
PURPOSE Right hemisphere brain damage (RHD) commonly causes pragmatic language disorders that are apparent in discourse production. Specific characteristics and approaches to assessment, diagnosis, and treatment of these disorders are not well-defined. RHDBank, a shared database of multimedia interactions for the study of communication using discourse, was created to address these gaps. The database, materials, and related analysis programs are free resources to clinicians, researchers, educators, and students. METHOD A standard discourse protocol was developed to elicit multiple types of discourse: free speech, conversation, picture description, storytelling, procedural discourse, and question-asking. Testing included measures of cognition, unilateral neglect, and communicative participation. Language samples were video-recorded and transcribed in CHAT format. Currently, the database includes 24 adults with RHD and 24 controls. RESULTS Illustrative analyses show how RHDBank can facilitate research using micro- and macrolinguistic discourse analysis techniques both within this population and across populations. Educational resources, such as the Grand Rounds tutorial, were developed using case studies from the database. CONCLUSIONS RHDBank is a shared database of resources that can facilitate educational and research efforts to address the gaps in knowledge about RHD communication and improve the clinical management of individuals with RHD.
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Affiliation(s)
- Jamila Minga
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Melissa Johnson
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Margaret Lehman Blake
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Davida Fromm
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
| | - Brian MacWhinney
- Communication Disorders Program, Department of Allied Professions, North Carolina Central University, Durham (Dr Minga); Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina (Dr Minga); Department of Communication Sciences and Disorders, Nazareth College, Rochester, New York (Dr Johnson); Department of Communication Sciences and Disorders, University of Houston, Houston, Texas (Dr Blake); and Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Fromm and MacWhinney)
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22
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Disorders of vocal emotional expression and comprehension: The aprosodias. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:63-98. [PMID: 34389126 DOI: 10.1016/b978-0-12-822290-4.00005-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
INTRODUCTION Stroke is among the most common causes of disability worldwide. Nonmotor symptoms of stroke are common and disabling. Many are treatable, and intervention improves the quality of life for stroke survivors. AREAS COVERED Here the author summarizes the evidence-based treatment of depression and other mood disorders, aphasia, hemispatial neglect, impairments of emotional communication and empathy, deficits in memory and other cognitive functions, sleep disorders, pain, fatigue, and seizures resulting from stroke. The author focuses on treatments supported by randomized controlled trials (RCTs), from the literature cited in Google Scholar, Embase, and Pubmed. EXPERT OPINION While behavioral rehabilitation is the most common intervention for many of the sequelae of stroke, relatively small RCTs support the use of noninvasive brain stimulation (transcranial direct current stimulation and transcranial direct current stimulation) and medications that facilitate neural plasticity and recovery. These noninvasive brain stimulation methods remain investigational for post-stroke symptoms. The strongest evidence for pharmacological intervention is in the domains of post-stroke mood disorders and epilepsy, but additional RCTs are needed to confirm the efficacy of selective serotonin reuptake inhibitors and other medications for improving recovery of cognition, language, and energy after stroke.
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Affiliation(s)
- Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine , Baltimore, MD, USA.,Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine , Baltimore, MD, USA.,Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University , Baltimore, MD, USA
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