Modulation of Speech Motor Learning with Transcranial Direct Current Stimulation of the Inferior Parietal Lobe

HD-tDCS over left supplementary motor area differentially modulated neural correlates of motor planning for speech vs. limb movement

The supplementary motor area (SMA) is implicated in planning, execution, and control of speech production and limb movement. The SMA is among putative generators of pre-movement EEG activity which is thought to be neural markers of motor planning. In neurological conditions such as Parkinson's disease, abnormal pre-movement neural activity within the SMA has been reported during speech production and limb movement. Therefore, this region can be a potential target for non-invasive brain stimulation for both speech and limb movement. The present study took an initial step in examining the application of high-definition transcranial direct current stimulation (HD-tDCS) over the left SMA in 24 neurologically intact adults. Subsequently, event-related potentials (ERPs) were recorded while participants performed speech and limb movement tasks. Participants' data were collected in three counterbalanced sessions: anodal, cathodal and sham HD-tDCS. Relative to sham stimulation, anodal, but not cathodal, HD-tDCS significantly attenuated ERPs prior to the onset of the speech production. In contrast, neither anodal nor cathodal HD-tDCS significantly modulated ERPs prior to the onset of limb movement compared to sham stimulation. These findings showed that neural correlates of motor planning can be modulated using HD-tDCS over the left SMA in neurotypical adults, with translational implications for neurological conditions that impair speech production. The absence of a stimulation effect on ERPs prior to the onset of limb movement was not expected in this study, and future studies are warranted to further explore this effect.

Test-Retest Reliability of Behavioral Assays of Feedforward and Feedback Auditory-Motor Control of Voice and Articulation

PURPOSE

Behavioral assays of feedforward and feedback auditory-motor control of voice and articulation frequently are used to make inferences about underlying neural mechanisms and to study speech development and disorders. However, no studies have examined the test-retest reliability of such measures, which is critical for rigorous study of auditory-motor control. Thus, the purpose of the present study was to assess the reliability of assays of feedforward and feedback control in voice versus articulation domains.

METHOD

Twenty-eight participants (14 cisgender women, 12 cisgender men, one transgender man, one transmasculine/nonbinary) who denied any history of speech, hearing, or neurological impairment were measured for responses to predictable versus unexpected auditory feedback perturbations of vocal (fundamental frequency, fo) and articulatory (first formant, F1) acoustic parameters twice, with 3-6 weeks between sessions. Reliability was measured with intraclass correlations.

RESULTS

Opposite patterns of reliability were observed for fo and F1; fo reflexive responses showed good reliability and fo adaptive responses showed poor reliability, whereas F1 reflexive responses showed poor reliability and F1 adaptive responses showed moderate reliability. However, a criterion-referenced categorical measurement of fo adaptive responses as typical versus atypical showed substantial test-retest agreement.

CONCLUSIONS

Individual responses to some behavioral assays of auditory-motor control of speech should be interpreted with caution, which has implications for several fields of research. Additional research is needed to establish reliable criterion-referenced measures of F1 adaptive responses as well as fo and F1 reflexive responses. Furthermore, the opposite patterns of test-retest reliability observed for voice versus articulation add to growing evidence for differences in underlying neural control mechanisms.

Mechanisms of sensorimotor adaptation in a hierarchical state feedback control model of speech

Upon perceiving sensory errors during movements, the human sensorimotor system updates future movements to compensate for the errors, a phenomenon called sensorimotor adaptation. One component of this adaptation is thought to be driven by sensory prediction errors-discrepancies between predicted and actual sensory feedback. However, the mechanisms by which prediction errors drive adaptation remain unclear. Here, auditory prediction error-based mechanisms involved in speech auditory-motor adaptation were examined via the feedback aware control of tasks in speech (FACTS) model. Consistent with theoretical perspectives in both non-speech and speech motor control, the hierarchical architecture of FACTS relies on both the higher-level task (vocal tract constrictions) as well as lower-level articulatory state representations. Importantly, FACTS also computes sensory prediction errors as a part of its state feedback control mechanism, a well-established framework in the field of motor control. We explored potential adaptation mechanisms and found that adaptive behavior was present only when prediction errors updated the articulatory-to-task state transformation. In contrast, designs in which prediction errors updated forward sensory prediction models alone did not generate adaptation. Thus, FACTS demonstrated that 1) prediction errors can drive adaptation through task-level updates, and 2) adaptation is likely driven by updates to task-level control rather than (only) to forward predictive models. Additionally, simulating adaptation with FACTS generated a number of important hypotheses regarding previously reported phenomena such as identifying the source(s) of incomplete adaptation and driving factor(s) for changes in the second formant frequency during adaptation to the first formant perturbation. The proposed model design paves the way for a hierarchical state feedback control framework to be examined in the context of sensorimotor adaptation in both speech and non-speech effector systems.

Continuous theta burst stimulation over left and right supramarginal gyri demonstrates their involvement in auditory feedback control of vocal production

The supramarginal gyrus (SMG) has been implicated in auditory-motor integration for vocal production. However, whether the SMG is bilaterally or unilaterally involved in auditory feedback control of vocal production in a causal manner remains unclear. The present event-related potential (ERP) study investigated the causal roles of the left and right SMG to auditory-vocal integration using neuronavigated continuous theta burst stimulation (c-TBS). Twenty-four young adults produced sustained vowel phonations and heard their voice unexpectedly pitch-shifted by ±200 cents after receiving active or sham c-TBS over the left or right SMG. As compared to sham stimulation, c-TBS over the left or right SMG led to significantly smaller vocal compensations for pitch perturbations that were accompanied by smaller cortical P2 responses. Moreover, no significant differences were found in the vocal and ERP responses when comparing active c-TBS over the left vs. right SMG. These findings provide neurobehavioral evidence for a causal influence of both the left and right SMG on auditory feedback control of vocal production. Decreased vocal compensations paralleled by reduced P2 responses following c-TBS over the bilateral SMG support their roles for auditory-motor transformation in a bottom-up manner: receiving auditory feedback information and mediating vocal compensations for feedback errors.

tDCS modulates speech perception and production in second language learners

Accurate identification and pronunciation of nonnative speech sounds can be particularly challenging for adult language learners. The current study tested the effects of a brief musical training combined with transcranial direct current stimulation (tDCS) on speech perception and production in a second language (L2). The sample comprised 36 native Hebrew speakers, aged 18-38, who studied English as L2 in a formal setting and had little musical training. Training encompassed musical perception tasks with feedback (i.e., timbre, duration, and tonal memory) and concurrent tDCS applied over the left posterior auditory-related cortex (including posterior superior temporal gyrus and planum temporale). Participants were randomly assigned to anodal or sham stimulation. Musical perception, L2 speech perception (measured by a categorical AXB discrimination task) and speech production (measured by a speech imitation task) were tested before and after training. There were no tDCS-dependent effects on musical perception post-training. However, only participants who received active stimulation showed increased accuracy of L2 phoneme discrimination and greater change in the acoustic properties of L2 speech sound production (i.e., second formant frequency in vowels and center of gravity in consonants). The results of this study suggest neuromodulation can facilitate the processing of nonnative speech sounds in adult learners.

The role of the inferior parietal lobule in writer's cramp

Humans have a distinguishing ability for fine motor control that is subserved by a highly evolved cortico-motor neuronal network. The acquisition of a particular motor skill involves a long series of practice movements, trial and error, adjustment and refinement. At the cortical level, this acquisition begins in the parieto-temporal sensory regions and is subsequently consolidated and stratified in the premotor-motor cortex. Task-specific dystonia can be viewed as a corruption or loss of motor control confined to a single motor skill. Using a multimodal experimental approach combining neuroimaging and non-invasive brain stimulation, we explored interactions between the principal nodes of the fine motor control network in patients with writer's cramp and healthy matched controls. Patients and healthy volunteers underwent clinical assessment, diffusion-weighted MRI for tractography, and functional MRI during a finger tapping task. Activation maps from the task-functional MRI scans were used for target selection and neuro-navigation of the transcranial magnetic stimulation. Single- and double-pulse TMS evaluation included measurement of the input-output recruitment curve, cortical silent period, and amplitude of the motor evoked potentials conditioned by cortico-cortical interactions between premotor ventral (PMv)-motor cortex (M1), anterior inferior parietal lobule (aIPL)-M1, and dorsal inferior parietal lobule (dIPL)-M1 before and after inducing a long term depression-like plastic change to dIPL node with continuous theta-burst transcranial magnetic stimulation in a randomized, sham-controlled design. Baseline dIPL-M1 and aIPL-M1 cortico-cortical interactions were facilitatory and inhibitory, respectively, in healthy volunteers, whereas the interactions were converse and significantly different in writer's cramp. Baseline PMv-M1 interactions were inhibitory and similar between the groups. The dIPL-PMv resting state functional connectivity was increased in patients compared to controls, but no differences in structural connectivity between the nodes were observed. Cortical silent period was significantly prolonged in writer's cramp. Making a long term depression-like plastic change to dIPL node transformed the aIPL-M1 interaction to inhibitory (similar to healthy volunteers) and cancelled the PMv-M1 inhibition only in the writer's cramp group. These findings suggest that the parietal multimodal sensory association region could have an aberrant downstream influence on the fine motor control network in writer's cramp, which could be artificially restored to its normal function.

Failure of tDCS to modulate motor excitability and speech motor learning

Transcranial direct current stimulation (tDCS) modulates cortical excitability in a polarity-specific way and, when used in combination with a behavioural task, it can alter performance. TDCS has the potential, therefore, for use as an adjunct to therapies designed to treat disorders affecting speech, including, but not limited to acquired aphasias and developmental stuttering. For this reason, it is important to conduct studies evaluating its effectiveness and the parameters optimal for stimulation. Here, we aimed to evaluate the effects of bi-hemispheric tDCS over speech motor cortex on performance of a complex speech motor learning task, namely the repetition of tongue twisters. A previous study in older participants showed that tDCS could modulate performance on a similar task. To further understand the effects of tDCS, we also measured the excitability of the speech motor cortex before and after stimulation. Three groups of 20 healthy young controls received: (i) anodal tDCS to the left IFG/LipM1 and cathodal tDCS to the right hemisphere homologue; or (ii) cathodal tDCS over the left and anodal over the right; or (iii) sham stimulation. Participants heard and repeated novel tongue twisters and matched simple sentences before, during and 10 min after the stimulation. One mA tDCS was delivered concurrent with task performance for 13 min. Motor excitability was measured using transcranial magnetic stimulation to elicit motor-evoked potentials in the lip before and immediately after tDCS. The study was double-blind, randomized, and sham-controlled; the design and analysis were pre-registered. Performance on the task improved from baseline to after stimulation but was not significantly modulated by tDCS. Similarly, a small decrease in motor excitability was seen in all three stimulation groups but did not differ among them and was unrelated to task performance. Bayesian analyses provide substantial evidence in support of the null hypotheses in both cases, namely that tongue twister performance and motor excitability were not affected by tDCS. We discuss our findings in the context of the previous positive results for a similar task. We conclude that tDCS may be most effective when brain function is sub-optimal due to age-related declines or pathology. Further study is required to determine why tDCS failed to modulate excitability in the speech motor cortex in the expected ways.

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

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