The Neuroanatomy of Speech Processing: A Large-scale Lesion Study.

The neural basis of language has been studied for centuries, yet the networks critically involved in simply identifying or understanding a spoken word remain elusive. Several functional-anatomical models of critical neural substrates of receptive speech have been proposed, including (1) auditory-related regions in the left mid-posterior superior temporal lobe, (2) motor-related regions in the left frontal lobe (in normal and/or noisy conditions), (3) the left anterior superior temporal lobe, or (4) bilateral mid-posterior superior temporal areas. One difficulty in comparing these models is that they often focus on different aspects of the sound-to-meaning pathway and are supported by different types of stimuli and tasks. Two auditory tasks that are typically used in separate studies-syllable discrimination and word comprehension-often yield different conclusions. We assessed syllable discrimination (words and nonwords) and word comprehension (clear speech and with a noise masker) in 158 individuals with focal brain damage: left (n = 113) or right (n = 19) hemisphere stroke, left (n = 18) or right (n = 8) anterior temporal lobectomy, and 26 neurologically intact controls. Discrimination and comprehension tasks are doubly dissociable both behaviorally and neurologically. In support of a bilateral model, clear speech comprehension was near ceiling in 95% of left stroke cases and right temporal damage impaired syllable discrimination. Lesion-symptom mapping analyses for the syllable discrimination and noisy word comprehension tasks each implicated most of the left superior temporal gyrus. Comprehension but not discrimination tasks also implicated the left posterior middle temporal gyrus, whereas discrimination but not comprehension tasks also implicated more dorsal sensorimotor regions in posterior perisylvian cortex.

Comparing global motor characteristics in children and adults with childhood apraxia of speech to a cerebellar stroke patient: evidence for the cerebellar hypothesis in a developmental motor speech disorder.

Individuals with childhood apraxia of speech (CAS) have motor deficits in systems beyond speech and also global deficits in sequential processing, consistent with cerebellar dysfunction. We investigated the cerebellar hypothesis of CAS in 18 children and adolescents with CAS, 11 typical controls, an adult with a probable CAS history, and an adult with a history of a cerebellar stroke. Compared to the controls, children and adolescents with CAS had the greatest difficulty with rapid syllable repetition when alternating between two different syllables types, less difficulty when switching among three different syllables, and no difficulty when repeating the same syllable. They also showed difficulty with alternating but not repetitive key tapping. Motor speeds during the syllable repetition and key tapping tasks where correlated, consistent with a central motor delimiter that governs both systems. Participants with CAS obtained low scores in a test of fine motor ability, where the tasks required rapid integration of complex hand movement sequences. The adult with the probable CAS history obtained motor performance scores that generally resembled those in the children and adolescents with CAS, consistent with motor deficits that persist into adulthood. The participant with the cerebellar stroke history showed deficits in tests of fine and gross motor ability as well as balance. His repetitive and alternating key tapping was slow in the ipsilateral hand relative to the stroke lesion. The shared deficits in sequential motor functions among all participants with CAS and the cerebellar stroke patient are consistent with persisting cerebellar dysfunctions in CAS.

Age-Related Atrophy and Compensatory Neural Networks in Reading Comprehension.

OBJECTIVES: Despite changes to brain integrity with aging, some functions like basic language processes remain remarkably preserved. One theory for the maintenance of function in light of age-related brain atrophy is the engagement of compensatory brain networks. This study examined age-related changes in the neural networks recruited for simple language comprehension. METHODS: Sixty-five adults (native English-speaking, right-handed, and cognitively normal) aged 17-85 years underwent a functional magnetic resonance imaging (fMRI) reading paradigm and structural scanning. The fMRI data were analyzed using independent component analysis to derive brain networks associated with reading comprehension. RESULTS: Two typical frontotemporal language networks were identified, and these networks remained relatively stable across the wide age range. In contrast, three attention-related networks showed increased activation with increasing age. Furthermore, the increased recruitment of a dorsal attention network was negatively correlated to gray matter thickness in temporal regions, whereas an anterior frontoparietal network was positively correlated to gray matter thickness in insular regions. CONCLUSIONS: We found evidence that older adults can exert increased effort and recruit additional attentional resources to maintain their reading abilities in light of increased cortical atrophy.

The effects of prosody on sentence comprehension: evidence from a neurotypical control group and seven cases of chronic stroke.

Both prosody and sentence structure (e.g., canonical versus non-canonical) affect sentence comprehension. However, few previous studies have examined a possible interaction between prosody and sentence structure. In adult controls we found a significant interaction: typical sentence prosody, versus list prosody, facilitated comprehension of only some sentence structures. In seven stroke patients, impaired attentional control was related to impaired comprehension with sentence prosody but not list prosody; impaired working memory was related to impaired comprehension with list prosody, but not sentence prosody. Thus, non-canonical sentence comprehension impairments in stroke patients may be modulated by prosody, based on a patient's cognitive abilities.

The Neurobiology of Agrammatic Sentence Comprehension: A Lesion Study.

Broca's area has long been implicated in sentence comprehension. Damage to this region is thought to be the central source of "agrammatic comprehension" in which performance is substantially worse (and near chance) on sentences with noncanonical word orders compared with canonical word order sentences (in English). This claim is supported by functional neuroimaging studies demonstrating greater activation in Broca's area for noncanonical versus canonical sentences. However, functional neuroimaging studies also have frequently implicated the anterior temporal lobe (ATL) in sentence processing more broadly, and recent lesion-symptom mapping studies have implicated the ATL and mid temporal regions in agrammatic comprehension. This study investigates these seemingly conflicting findings in 66 left-hemisphere patients with chronic focal cerebral damage. Patients completed two sentence comprehension measures, sentence-picture matching and plausibility judgments. Patients with damage including Broca's area (but excluding the temporal lobe; n = 11) on average did not exhibit the expected agrammatic comprehension pattern-for example, their performance was >80% on noncanonical sentences in the sentence-picture matching task. Patients with ATL damage ( n = 18) also did not exhibit an agrammatic comprehension pattern. Across our entire patient sample, the lesions of patients with agrammatic comprehension patterns in either task had maximal overlap in posterior superior temporal and inferior parietal regions. Using voxel-based lesion-symptom mapping, we find that lower performances on canonical and noncanonical sentences in each task are both associated with damage to a large left superior temporal-inferior parietal network including portions of the ATL, but not Broca's area. Notably, however, response bias in plausibility judgments was significantly associated with damage to inferior frontal cortex, including gray and white matter in Broca's area, suggesting that the contribution of Broca's area to sentence comprehension may be related to task-related cognitive demands.

Word Repetition Paired With Startling Stimuli Decreases Aphasia and Apraxia Severity in Severe-to-Moderate Stroke: A Stratified, Single-Blind, Randomized, Phase 1 Clinical Trial.

PURPOSE: This prospective, single-blinded, parallel, stratified, randomized clinical trial via telehealth aimed to investigate the impact of Startle Adjuvant Rehabilitation Therapy (START) on aphasia, apraxia of speech (AOS), and quality of life in individuals with chronic stroke. The study hypothesized that START would have a greater effect on AOS-related measures and more severe individuals. METHOD: Forty-two participants with poststroke aphasia, AOS, or both were randomly assigned to the START or control group. Both groups received 77-dB GET READY and GO cues during a word repetition task for three 1-hr sessions on consecutive days. The START group additionally received 105-dB white noise GO cues during one third of trials. The Western Aphasia Battery-Revised, Apraxia Battery for Adults, Stroke Impact Scale, and Communication Outcomes After Stroke scale were administered at Day 1, Day 5, and 1-month follow-up. RESULTS: START improved performance on some subtests of the Western Aphasia Battery (Comprehension, Repetition, Reading) and measures of AOS (Diadochokinetic Rate, Increasing Word Length) in individuals with moderate/severe aphasia, whereas moderate/severe controls saw no changes. Individuals with mild aphasia receiving START had improved Reading, whereas mild controls saw improved Comprehension. The START group had increased mood and perceived communication recovery by Day 5, whereas controls saw no changes in quality of life. CONCLUSIONS: This study is the first to evaluate the impact of training with startling acoustic stimuli on clinical measures of aphasia and AOS. Our findings suggest START can enhance both nontrained speech production and receptive speech tasks in moderate/severe aphasia, possibly by reducing poststroke cortical inhibition. Our findings should be considered carefully, as our limitations include small effect sizes, within-group variability, and low completion rates for quality-of-life assessments and follow-up visits. Future studies should explore a mechanism of action, conduct larger and longer Phase 2 clinical trials, and evaluate long-term retention. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24093519.

How can graph theory inform the dual-stream model of speech processing? a resting-state fMRI study of post-stroke aphasia.

The dual-stream model of speech processing has been proposed to represent the cortical networks involved in speech comprehension and production. Although it is arguably the prominent neuroanatomical model of speech processing, it is not yet known if the dual-stream model represents actual intrinsic functional brain networks. Furthermore, it is unclear how disruptions after a stroke to the functional connectivity of the dual-stream model's regions are related to specific types of speech production and comprehension impairments seen in aphasia. To address these questions, in the present study, we examined two independent resting-state fMRI datasets: (1) 28 neurotypical matched controls and (2) 28 chronic left-hemisphere stroke survivors with aphasia collected at another site. Structural MRI, as well as language and cognitive behavioral assessments, were collected. Using standard functional connectivity measures, we successfully identified an intrinsic resting-state network amongst the dual-stream model's regions in the control group. We then used both standard functional connectivity analyses and graph theory approaches to determine how the functional connectivity of the dual-stream network differs in individuals with post-stroke aphasia, and how this connectivity may predict performance on clinical aphasia assessments. Our findings provide strong evidence that the dual-stream model is an intrinsic network as measured via resting-state MRI, and that weaker functional connectivity of the hub nodes of the dual-stream network defined by graph theory methods, but not overall average network connectivity, is weaker in the stroke group than in the control participants. Also, the functional connectivity of the hub nodes predicted specific types of impairments on clinical assessments. In particular, the relative strength of connectivity of the right hemisphere's homologues of the left dorsal stream hubs to the left dorsal hubs versus right ventral stream hubs is a particularly strong predictor of post-stroke aphasia severity and symptomology.

Informational Masking in Aging and Brain-lesioned Individuals.

Auditory stream segregation and informational masking were investigated in brain-lesioned individuals, age-matched controls with no neurological disease, and young college-age students. A psychophysical paradigm known as rhythmic masking release (RMR) was used to examine the ability of participants to identify a change in the rhythmic sequence of 20-ms Gaussian noise bursts presented through headphones and filtered through generalized head-related transfer functions to produce the percept of an externalized auditory image (i.e., a 3D virtual reality sound). The target rhythm was temporally interleaved with a masker sequence comprising similar noise bursts in a manner that resulted in a uniform sequence with no information remaining about the target rhythm when the target and masker were presented from the same location (an impossible task). Spatially separating the target and masker sequences allowed participants to determine if there was a change in the target rhythm midway during its presentation. RMR thresholds were defined as the minimum spatial separation between target and masker sequences that resulted in 70.7% correct-performance level in a single-interval 2-alternative forced-choice adaptive tracking procedure. The main findings were (1) significantly higher RMR thresholds for individuals with brain lesions (especially those with damage to parietal areas) and (2) a left-right spatial asymmetry in performance for lesion (but not control) participants. These findings contribute to a better understanding of spatiotemporal relations in informational masking and the neural bases of auditory scene analysis.

Functional anatomy of language and music perception: temporal and structural factors investigated using functional magnetic resonance imaging.

Language and music exhibit similar acoustic and structural properties, and both appear to be uniquely human. Several recent studies suggest that speech and music perception recruit shared computational systems, and a common substrate in Broca's area for hierarchical processing has recently been proposed. However, this claim has not been tested by directly comparing the spatial distribution of activations to speech and music processing within subjects. In the present study, participants listened to sentences, scrambled sentences, and novel melodies. As expected, large swaths of activation for both sentences and melodies were found bilaterally in the superior temporal lobe, overlapping in portions of auditory cortex. However, substantial nonoverlap was also found: sentences elicited more ventrolateral activation, whereas the melodies elicited a more dorsomedial pattern, extending into the parietal lobe. Multivariate pattern classification analyses indicate that even within the regions of blood oxygenation level-dependent response overlap, speech and music elicit distinguishable patterns of activation. Regions involved in processing hierarchical aspects of sentence perception were identified by contrasting sentences with scrambled sentences, revealing a bilateral temporal lobe network. Music perception showed no overlap whatsoever with this network. Broca's area was not robustly activated by any stimulus type. Overall, these findings suggest that basic hierarchical processing for music and speech recruits distinct cortical networks, neither of which involves Broca's area. We suggest that previous claims are based on data from tasks that tap higher-order cognitive processes, such as working memory and/or cognitive control, which can operate in both speech and music domains.

Using whole-brain diffusion tensor analysis to evaluate white matter structural correlates of delayed visuospatial memory and one-week motor skill retention in nondemented older adults: A preliminary study.

Skill retention is important for motor rehabilitation outcomes. Recent work has demonstrated that delayed visuospatial memory performance may predict motor skill retention in older and neuropathological populations. White matter integrity between parietal and frontal cortices may explain variance in upper-extremity motor learning tasks and visuospatial processes. We performed a whole-brain analysis to determine the white matter correlates of delayed visuospatial memory and one-week motor skill retention in nondemented older adults. We hypothesized that better frontoparietal tract integrity would be positively related to better behavioral performance. Nineteen participants (age>58) completed diffusion-weighted imaging, then a clinical test of delayed visuospatial memory and 50 training trials of an upper-extremity motor task; participants were retested on the motor task one week later. Principal component analysis was used to create a composite score for each participant's behavioral data, i.e. shared variance between delayed visuospatial memory and motor skill retention, which was then entered into a voxel-based regression analysis. Behavioral results demonstrated that participants learned and retained their skill level after a week of no practice, and their delayed visuospatial memory score was positively related to the extent of skill retention. Consistent with previous work, neuroimaging results indicated that regions within bilateral anterior thalamic radiations, corticospinal tracts, and superior longitudinal fasciculi were related to better delayed visuospatial memory and skill retention. Results of this study suggest that the simple act of testing for specific cognitive impairments prior to therapy may identify older adults who will receive little to no benefit from the motor rehabilitation regimen, and that these neural regions may be potential targets for therapeutic intervention.

The role of Broca's area in sentence comprehension.

The role of Broca's area in sentence processing has been debated for the last 30 years. A central and still unresolved issue is whether Broca's area plays a specific role in some aspect of syntactic processing (e.g., syntactic movement, hierarchical structure building) or whether it serves a more general function on which sentence processing relies (e.g., working memory). This review examines the functional organization of Broca's area in regard to its contributions to sentence comprehension, verbal working memory, and other multimodal cognitive processes. We suggest that the data are consistent with the view that at least a portion of the contribution of Broca's area to sentence comprehension can be attributed to its role as a phonological short-term memory resource. Furthermore, our review leads us to conclude that there is no compelling evidence that there are sentence-specific processing regions within Broca's area.

Are mirror neurons the basis of speech perception? Evidence from five cases with damage to the purported human mirror system.

The discovery of mirror neurons in macaque has led to a resurrection of motor theories of speech perception. Although the majority of lesion and functional imaging studies have associated perception with the temporal lobes, it has also been proposed that the 'human mirror system', which prominently includes Broca's area, is the neurophysiological substrate of speech perception. Although numerous studies have demonstrated a tight link between sensory and motor speech processes, few have directly assessed the critical prediction of mirror neuron theories of speech perception, namely that damage to the human mirror system should cause severe deficits in speech perception. The present study measured speech perception abilities of patients with lesions involving motor regions in the left posterior frontal lobe and/or inferior parietal lobule (i.e., the proposed human 'mirror system'). Performance was at or near ceiling in patients with fronto-parietal lesions. It is only when the lesion encroaches on auditory regions in the temporal lobe that perceptual deficits are evident. This suggests that 'mirror system' damage does not disrupt speech perception, but rather that auditory systems are the primary substrate for speech perception.

Neural Resources Supporting Language Production vs. Comprehension in Chronic Post-stroke Aphasia: A Meta-Analysis Using Activation Likelihood Estimates.

In post-stroke aphasia, language tasks recruit a combination of residual regions within the canonical language network, as well as regions outside of it in the left and right hemispheres. However, there is a lack of consensus as to how the neural resources engaged by language production and comprehension following a left hemisphere stroke differ from one another and from controls. The present meta-analysis used activation likelihood estimates to aggregate across 44 published fMRI and PET studies to characterize the functional reorganization patterns for expressive and receptive language processes in persons with chronic post-stroke aphasia (PWA). Our results in part replicate previous meta-analyses: we find that PWA activate residual regions within the left lateralized language network, regardless of task. Our results extend this work to show differential recruitment of the left and right hemispheres during language production and comprehension in PWA. First, we find that PWA engage left perilesional regions during language comprehension, and that the extent of this activation is likely driven by stimulus type and domain-general cognitive resources needed for task completion. In contrast to comprehension, language production was associated with activation of the right frontal and temporal cortices. Further analyses linked right hemisphere regions involved in motor speech planning for language production with successful naming in PWA, while unsuccessful naming was associated with the engagement of the right inferior frontal gyrus, a region often implicated in domain-general cognitive processes. While the within-group findings indicate that the engagement of the right hemisphere during language tasks in post-stroke aphasia differs for expressive vs. receptive tasks, the overall lack of major between-group differences between PWA and controls implies that PWA rely on similar cognitive-linguistic resources for language as controls. However, more studies are needed that report coordinates for PWA and controls completing the same tasks in order for future meta-analyses to characterize how aphasia affects the neural resources engaged during language, particularly for specific tasks and as a function of behavioral performance.

Distinct Contributions of Working Memory and Attentional Control to Sentence Comprehension in Noise in Persons With Stroke.

Purpose Sentence comprehension deficits are common following a left hemisphere stroke and have primarily been investigated under optimal listening conditions. However, ample work in neurotypical controls indicates that background noise affects sentence comprehension and the cognitive resources it engages. The purpose of this study was to examine how background noise affects sentence comprehension poststroke using both energetic and informational maskers. We further sought to identify whether sentence comprehension in noise abilities are related to poststroke cognitive abilities, specifically working memory and/or attentional control. Method Twenty persons with chronic left hemisphere stroke completed a sentence-picture matching task where they listened to sentences presented in three types of maskers: multispeakers, broadband noise, and silence (control condition). Working memory, attentional control, and hearing thresholds were also assessed. Results A repeated-measures analysis of variance identified participants to have the greatest difficulty with the multispeakers condition, followed by broadband noise and then silence. Regression analyses, after controlling for age and hearing ability, identified working memory as a significant predictor of listening engagement (i.e., mean reaction time) in broadband noise and multispeakers and attentional control as a significant predictor of informational masking effects (computed as a reaction time difference score where broadband noise is subtracted from multispeakers). Conclusions The results from this study indicate that background noise impacts sentence comprehension abilities poststroke and that these difficulties may arise due to deficits in the cognitive resources supporting sentence comprehension and not other factors such as age or hearing. These findings also highlight a relationship between working memory abilities and sentence comprehension in background noise. We further suggest that attentional control abilities contribute to sentence comprehension by supporting the additional demands associated with informational masking. Supplemental Material https://doi.org/10.23641/asha.14984511.

Assessment of alerting, orienting, and executive control in persons with aphasia using the Attention Network Test.

BACKGROUND: Attention deficits frequently accompany language impairments in aphasia. Most research on attention in aphasia focuses on selective attention measured by executive control tasks such as the color-word Stroop or Erickson flanker. This is despite ample evidence in neurotypical adults indicating the existence of multiple, distinct attention subtypes. Thus, there is a disconnect between the documented attention impairments in persons with aphasia (PWA) and the literature in neurotypical adults indicating that multiple attention components independently modulate an individual's interactions with the world. AIMS: This study aimed to use the well-studied Attention Network Test (ANT) to quantify three subtypes of attention (alerting, orienting, and executive control) in PWA and matched controls. It was hypothesized that significant effects of alerting, orienting, and executive control would be observed in both groups, however, the effects would be reduced in PWA compared to the neurotypical controls. It was additionally expected that alerting, orienting, and executive control would not be correlated with one another in either group. METHODS & PROCEDURES: Twenty-two PWA along with 20 age, gender, and education matched controls completed the ANT. Briefly, the ANT consists of a cued-flanker task where the cues provide information about when and where the flanker executive control task will be presented. The combination of cues and flanker targets embedded within the ANT provides measures of alerting, orienting, and executive control. Participants are expected to respond faster and more accurately to the flanker task when cued as to when and where the task will be presented. OUTCOMES & RESULTS: In line with previous work, the control group demonstrated significant effects of alerting, orienting, and executive control. However, we only find significant orienting and executive control effects in the aphasia group. Between-group differences were only identified within orienting attention: the control group benefitted more from the orienting cue than the aphasia group. Additionally, alerting, orienting, and executive control were not correlated in the control group, yet, a relationship between orienting and executive control was observed in the aphasia group. CONCLUSIONS: Overall, our findings demonstrate that attention differs between PWA and controls, and that the ANT may provide a more complete picture of attention in aphasia; this may be particularly important when characterizing the relationship between attention and language in aphasia.

Cognitive and neural predictors of speech comprehension in noisy backgrounds in older adults.

Older adults often experience difficulties comprehending speech in noisy backgrounds, which hearing loss does not fully explain. It remains unknown how cognitive abilities, brain networks, and age-related hearing loss may uniquely contribute to speech in noise comprehension at the sentence level. In 31 older adults, using cognitive measures and resting-state fMRI, we investigated the cognitive and neural predictors of speech comprehension with energetic (broadband noise) and informational masking (multi-speakers) effects. Better hearing thresholds and greater working memory abilities were associated with better speech comprehension with energetic masking. Conversely, faster processing speed and stronger functional connectivity between frontoparietal and language networks were associated with better speech comprehension with informational masking. Our findings highlight the importance of the frontoparietal network in older adults' ability to comprehend speech in multi-speaker backgrounds, and that hearing loss and working memory in older adults contributes to speech comprehension abilities related to energetic, but not informational masking.

Selective attention to semantic and syntactic features modulates sentence processing networks in anterior temporal cortex.

Numerous studies have identified an anterior temporal lobe (ATL) region that responds preferentially to sentence-level stimuli. It is unclear, however, whether this activity reflects a response to syntactic computations or some form of semantic integration. This distinction is difficult to investigate with the stimulus manipulations and anomaly detection paradigms traditionally implemented. The present functional magnetic resonance imaging study addresses this question via a selective attention paradigm. Subjects monitored for occasional semantic anomalies or occasional syntactic errors, thus directing their attention to semantic integration, or syntactic properties of the sentences. The hemodynamic response in the sentence-selective ATL region (defined with a localizer scan) was examined during anomaly/error-free sentences only, to avoid confounds due to error detection. The majority of the sentence-specific region of interest was equally modulated by attention to syntactic or compositional semantic features, whereas a smaller subregion was only modulated by the semantic task. We suggest that the sentence-specific ATL region is sensitive to both syntactic and integrative semantic functions during sentence processing, with a smaller portion of this area preferentially involved in the later. This study also suggests that selective attention paradigms may be effective tools to investigate the functional diversity of networks involved in sentence processing.

Auditory attention following a left hemisphere stroke: comparisons of alerting, orienting, and executive control performance using an auditory Attention Network Test.

INTRODUCTION: Auditory attention is a critical foundation for successful language comprehension, yet is rarely studied in individuals with acquired language disorders. METHODS: We used an auditory version of the well-studied Attention Network Test to study alerting, orienting, and executive control in 28 persons with chronic stroke (PWS). We further sought to characterize the neurobiology of each auditory attention measure in our sample using exploratory lesion-symptom mapping analyses. RESULTS: PWS exhibited the expected executive control effect (i.e., decreased accuracy for incongruent compared to congruent trials), but their alerting and orienting attention were disrupted. PWS did not exhibit an alerting effect and they were actually distracted by the auditory spatial orienting cue compared to the control cue. Lesion-symptom mapping indicated that poorer alerting and orienting were associated with damage to the left retrolenticular part of the internal capsule (adjacent to the thalamus) and left posterior middle frontal gyrus (overlapping with the frontal eye fields), respectively. DISCUSSION: The behavioral findings correspond to our previous work investigating alerting and spatial orienting attention in persons with aphasia in the visual modality and suggest that auditory alerting and spatial orienting attention may be impaired in PWS due to stroke lesions damaging multi-modal attention resources.

Effects of prosody on the cognitive and neural resources supporting sentence comprehension: A behavioral and lesion-symptom mapping study.

Non-canonical sentence comprehension impairments are well-documented in aphasia. Studies of neurotypical controls indicate that prosody can aid comprehension by facilitating attention towards critical pitch inflections and phrase boundaries. However, no studies have examined how prosody may engage specific cognitive and neural resources during non-canonical sentence comprehension in persons with left hemisphere damage. Experiment 1 examines the relationship between comprehension of non-canonical sentences spoken with typical and atypical prosody and several cognitive measures in 25 persons with chronic left hemisphere stroke and 20 matched controls. Experiment 2 explores the neural resources critical for non-canonical sentence comprehension with each prosody type using region-of-interest-based multiple regressions. Lower orienting attention abilities and greater inferior frontal and parietal damage predicted lower comprehension, but only for sentences with typical prosody. Our results suggest that typical sentence prosody may engage attention resources to support non-canonical sentence comprehension, and this relationship may be disrupted following left hemisphere stroke.

Functional Connectivity of Heschl's Gyrus Associated With Age-Related Hearing Loss: A Resting-State fMRI Study.

A large proportion of older adults experience hearing loss. Yet, the impact of hearing loss on the aging brain, particularly on large-scale brain networks that support cognition and language, is relatively unknown. We used resting-state functional magnetic resonance imaging (fMRI) to identify hearing loss-related changes in the functional connectivity of primary auditory cortex to determine if these changes are distinct from age and cognitive measures known to decline with age (e.g., working memory and processing speed). We assessed the functional connectivity of Heschl's gyrus in 31 older adults (60-80 years) who expressed a range of hearing abilities from normal hearing to a moderate hearing loss. Our results revealed that both left and right Heschl's gyri were significantly connected to regions within auditory, sensorimotor, and visual cortices, as well as to regions within the cingulo-opercular network known to support attention. Participant age, working memory, and processing speed did not significantly correlate with any connectivity measures once variance due to hearing loss was removed. However, hearing loss was associated with increased connectivity between right Heschl's gyrus and the dorsal anterior cingulate in the cingulo-opercular network even once variance due to age, working memory, and processing speed was removed. This greater connectivity was not driven by high frequency hearing loss, but rather by hearing loss measured in the 0.5-2 kHz range, particularly in the left ear. We conclude that hearing loss-related differences in functional connectivity in older adults are distinct from other aging-related differences and provide insight into a possible neural mechanism of compensation for hearing loss in older adults.