The relationship between verbal and nonverbal auditory signal processing in conduction aphasia: behavioral and anatomical evidence for common decoding mechanisms.

The processing of nonverbal auditory stimuli has not yet been sufficiently investigated in patients with aphasia. On the basis of a duration discrimination task, we examined whether patients with left-sided cerebrovascular lesions were able to perceive time differences in the scale of approximately 150 ms. Further linguistic and memory-related tasks were used to characterize more exactly the relationships in the performances between auditory nonverbal task and selective linguistic or mnemonic disturbances. All examined conduction aphasics showed increased thresholds in the duration discrimination task. The low thresholds on this task were in a strong correlative relation to the reduced performances in repetition and working memory task. This was interpreted as an indication of a pronounced disturbance in integrating auditory verbal information into a long-term window (sampling disturbance) resulting in an additional load of working memory. In order to determine the lesion topography of patients with sampling disturbances, the anatomical and psychophysical data were correlated on the basis of a voxelwise statistical approach. It was found that tissue damage extending through the insula, the posterior superior temporal gyrus, and the supramarginal gyrus causes impairments in sequencing of time-sensitive information.

Temporal processing capabilities in repetition conduction aphasia.

This study investigates the temporal resolution capacities of the central-auditory system in a subject (NP) suffering from repetition conduction aphasia. More specifically, the patient was asked to detect brief gaps between two stretches of broadband noise (gap detection task) and to evaluate the duration of two biphasic (WN-3) continuous noise elements, starting with white noise (WN) followed by 3kHz bandpass-filtered noise (duration discrimination task). During the gap detection task, the two portions of each stimulus were either identical ("intra-channel condition") or differed ("inter-channel condition") in the spectral characteristics of the leading and trailing acoustic segments. NP did not exhibit any deficits in the intra-channel condition of the gap detection task, indicating intact auditory temporal resolution across intervals of 1-3ms. By contrast, the inter-channel condition yielded increased threshold values. Based upon the "multiple-looks" model of central-auditory processing, this profile points at a defective integration window operating across a few tens of milliseconds - a temporal range associated with critical features of the acoustic speech signal such as voice onset time and formant transitions. Additionally, NP was found impaired during a duration discrimination task addressing longer integration windows (ca. 150ms). Concerning speech, this latter time domain approximately corresponds to the duration of stationary segmental units such as fricatives and long vowels. On the basis of our results we suggest, that the patient's auditory timing deficits in non-speech tasks may account, at least partially, for his impairments in speech processing.

Pre-lexical disorders in repetition conduction aphasia.

At the level of clinical speech/language evaluation, the repetition type of conduction aphasia is characterized by repetition difficulties concomitant with reduced short-term memory capacities, in the presence of fluent spontaneous speech as well as unimpaired naming and reading abilities. It is still unsettled which dysfunctions of the pre-lexical processing stage of spoken word recognition contribute to this syndrome and whether there is any relevant top-down impact of the mental lexicon upon the phonetic/phonological level of speech perception. In order to further specify the underlying pathomechanisms, a comprehensive battery of psycholinguistic tests was applied to a patient suffering from repetition conduction aphasia. The obtained results point at a pre-lexical disorder in this subject. To further specify the assumed pre-lexical dysfunction, computer simulations of single-word processing, based upon an interactive activation model (IAM), were conducted. An attenuation of the features-to-phonemes inhibition value was found to simulate the observed profile of psycholinguistic deficits. Conceivably, these pre-lexical disorders interfere with the task-dependent adjustment of the temporal windows of signal analysis, giving rise to compromised sequencing of auditory-verbal information.