Speech and Nonspeech Parameters in the Clinical Assessment of Dysarthria: A Dimensional Analysis.

Nonspeech (or paraspeech) parameters are widely used in clinical assessment of speech impairment in persons with dysarthria (PWD). Virtually every standard clinical instrument used in dysarthria diagnostics includes nonspeech parameters, often in considerable numbers. While theoretical considerations have challenged the validity of these measures as markers of speech impairment, only a few studies have directly examined their relationship to speech parameters on a broader scale. This study was designed to investigate how nonspeech parameters commonly used in clinical dysarthria assessment relate to speech characteristics of dysarthria in individuals with movement disorders. Maximum syllable repetition rates, accuracies, and rates of isolated and repetitive nonspeech oral-facial movements and maximum phonation times were compared with auditory-perceptual and acoustic speech parameters. Overall, 23 diagnostic parameters were assessed in a sample of 130 patients with movement disorders of six etiologies. Each variable was standardized for its distribution and for age and sex effects in 130 neurotypical speakers. Exploratory Graph Analysis (EGA) and Confirmatory Factor Analysis (CFA) were used to examine the factor structure underlying the diagnostic parameters. In the first analysis, we tested the hypothesis that nonspeech parameters combine with speech parameters within diagnostic dimensions representing domain-general motor control principles. In a second analysis, we tested the more specific hypotheses that diagnostic parameters split along effector (lip vs. tongue) or functional (speed vs. accuracy) rather than task boundaries. Our findings contradict the view that nonspeech parameters currently used in dysarthria diagnostics are congruent with diagnostic measures of speech characteristics in PWD.

The Role of the Dorsolateral Prefrontal Cortex for Speech and Language Processing.

This review article summarizes various functions of the dorsolateral prefrontal cortex (DLPFC) that are related to language processing. To this end, its connectivity with the left-dominant perisylvian language network was considered, as well as its interaction with other functional networks that, directly or indirectly, contribute to language processing. Language-related functions of the DLPFC comprise various aspects of pragmatic processing such as discourse management, integration of prosody, interpretation of nonliteral meanings, inference making, ambiguity resolution, and error repair. Neurophysiologically, the DLPFC seems to be a key region for implementing functional connectivity between the language network and other functional networks, including cortico-cortical as well as subcortical circuits. Considering clinical aspects, damage to the DLPFC causes psychiatric communication deficits rather than typical aphasic language syndromes. Although the number of well-controlled studies on DLPFC language functions is still limited, the DLPFC might be an important target region for the treatment of pragmatic language disorders.

Cortical phase locking to accelerated speech in blind and sighted listeners prior to and after training.

Cross-correlation of magnetoencephalography (MEG) with time courses derived from the speech signal has shown differences in phase-locking between blind subjects able to comprehend accelerated speech and sighted controls. The present training study contributes to disentangle the effects of blindness and training. Both subject groups (baseline: n = 16 blind, 13 sighted; trained: 10 blind, 3 sighted) were able to enhance speech comprehension up to ca. 18 syllables per second. MEG responses phase-locked to syllable onsets were captured in five pre-defined source locations comprising left and right auditory cortex (A1), right visual cortex (V1), left inferior frontal gyrus (IFG) and left pre-supplementary motor area. Phase locking in A1 was consistently increased while V1 showed opposite training effects in blind and sighted subjects. Also the IFG showed some group differences indicating enhanced top-down strategies in sighted subjects while blind subjects may have a more fine-grained bottom-up resolution for accelerated speech.

Reduced Performance During a Sentence Repetition Task by Continuous Theta-Burst Magnetic Stimulation of the Pre-supplementary Motor Area.

The pre-supplementary motor area (pre-SMA) is engaged in speech comprehension under difficult circumstances such as poor acoustic signal quality or time-critical conditions. Previous studies found that left pre-SMA is activated when subjects listen to accelerated speech. Here, the functional role of pre-SMA was tested for accelerated speech comprehension by inducing a transient "virtual lesion" using continuous theta-burst stimulation (cTBS). Participants were tested (1) prior to (pre-baseline), (2) 10 min after (test condition for the cTBS effect), and (3) 60 min after stimulation (post-baseline) using a sentence repetition task (formant-synthesized at rates of 8, 10, 12, 14, and 16 syllables/s). Speech comprehension was quantified by the percentage of correctly reproduced speech material. For high speech rates, subjects showed decreased performance after cTBS of pre-SMA. Regarding the error pattern, the number of incorrect words without any semantic or phonological similarity to the target context increased, while related words decreased. Thus, the transient impairment of pre-SMA seems to affect its inhibitory function that normally eliminates erroneous speech material prior to speaking or, in case of perception, prior to encoding into a semantically/pragmatically meaningful message.

New Developments in Understanding the Complexity of Human Speech Production.

Speech is one of the most unique features of human communication. Our ability to articulate our thoughts by means of speech production depends critically on the integrity of the motor cortex. Long thought to be a low-order brain region, exciting work in the past years is overturning this notion. Here, we highlight some of major experimental advances in speech motor control research and discuss the emerging findings about the complexity of speech motocortical organization and its large-scale networks. This review summarizes the talks presented at a symposium at the Annual Meeting of the Society of Neuroscience; it does not represent a comprehensive review of contemporary literature in the broader field of speech motor control.

The role of the supplementary motor area for speech and language processing.

Apart from its function in speech motor control, the supplementary motor area (SMA) has largely been neglected in models of speech and language processing in the brain. The aim of this review paper is to summarize more recent work, suggesting that the SMA has various superordinate control functions during speech communication and language reception, which is particularly relevant in case of increased task demands. The SMA is subdivided into a posterior region serving predominantly motor-related functions (SMA proper) whereas the anterior part (pre-SMA) is involved in higher-order cognitive control mechanisms. In analogy to motor triggering functions of the SMA proper, the pre-SMA seems to manage procedural aspects of cognitive processing. These latter functions, among others, comprise attentional switching, ambiguity resolution, context integration, and coordination between procedural and declarative memory structures. Regarding language processing, this refers, for example, to the use of inner speech mechanisms during language encoding, but also to lexical disambiguation, syntax and prosody integration, and context-tracking.

Context-dependent impact of presuppositions on early magnetic brain responses during speech perception.

Discourse structure enables us to generate expectations based upon linguistic material that has already been introduced. The present magnetoencephalography (MEG) study addresses auditory perception of test sentences in which discourse coherence was manipulated by using presuppositions (PSP) that either correspond or fail to correspond to items in preceding context sentences with respect to uniqueness and existence. Context violations yielded delayed auditory M50 and enhanced auditory M200 cross-correlation responses to syllable onsets within an analysis window of 1.5s following the PSP trigger words. Furthermore, discourse incoherence yielded suppression of spectral power within an expanded alpha band ranging from 6 to 16Hz. This effect showed a bimodal temporal distribution, being significant in an early time window of 0.0-0.5s following the PSP trigger and a late interval of 2.0-2.5s. These findings indicate anticipatory top-down mechanisms interacting with various aspects of bottom-up processing during speech perception.

Network Modeling for Functional Magnetic Resonance Imaging (fMRI) Signals during Ultra-Fast Speech Comprehension in Late-Blind Listeners.

In many functional magnetic resonance imaging (fMRI) studies blind humans were found to show cross-modal reorganization engaging the visual system in non-visual tasks. For example, blind people can manage to understand (synthetic) spoken language at very high speaking rates up to ca. 20 syllables/s (syl/s). FMRI data showed that hemodynamic activation within right-hemispheric primary visual cortex (V1), bilateral pulvinar (Pv), and left-hemispheric supplementary motor area (pre-SMA) covaried with their capability of ultra-fast speech (16 syllables/s) comprehension. It has been suggested that right V1 plays an important role with respect to the perception of ultra-fast speech features, particularly the detection of syllable onsets. Furthermore, left pre-SMA seems to be an interface between these syllabic representations and the frontal speech processing and working memory network. So far, little is known about the networks linking V1 to Pv, auditory cortex (A1), and (mesio-) frontal areas. Dynamic causal modeling (DCM) was applied to investigate (i) the input structure from A1 and Pv toward right V1 and (ii) output from right V1 and A1 to left pre-SMA. As concerns the input Pv was significantly connected to V1, in addition to A1, in blind participants, but not in sighted controls. Regarding the output V1 was significantly connected to pre-SMA in blind individuals, and the strength of V1-SMA connectivity correlated with the performance of ultra-fast speech comprehension. By contrast, in sighted controls, not understanding ultra-fast speech, pre-SMA did neither receive input from A1 nor V1. Taken together, right V1 might facilitate the "parsing" of the ultra-fast speech stream in blind subjects by receiving subcortical auditory input via the Pv (= secondary visual pathway) and transmitting this information toward contralateral pre-SMA.

Experience-related structural changes of degenerated occipital white matter in late-blind humans - a diffusion tensor imaging study.

Late-blind humans can learn to understand speech at ultra-fast syllable rates (ca. 20 syllables/s), a capability associated with hemodynamic activation of the central-visual system. Thus, the observed functional cross-modal recruitment of occipital cortex might facilitate ultra-fast speech processing in these individuals. To further elucidate the structural prerequisites of this skill, diffusion tensor imaging (DTI) was conducted in late-blind subjects differing in their capability of understanding ultra-fast speech. Fractional anisotropy (FA) was determined as a quantitative measure of the directionality of water diffusion, indicating fiber tract characteristics that might be influenced by blindness as well as the acquired perceptual skills. Analysis of the diffusion images revealed reduced FA in late-blind individuals relative to sighted controls at the level of the optic radiations at either side and the right-hemisphere dorsal thalamus (pulvinar). Moreover, late-blind subjects showed significant positive correlations between FA and the capacity of ultra-fast speech comprehension within right-hemisphere optic radiation and thalamus. Thus, experience-related structural alterations occurred in late-blind individuals within visual pathways that, presumably, are linked to higher order frontal language areas.

Comparing speech characteristics in spinocerebellar ataxias type 3 and type 6 with Friedreich ataxia.

Patterns of dysarthria in spinocerebellar ataxias (SCAs) and their discriminative features still remain elusive. Here we aimed to compare dysarthria profiles of patients with (SCA3 and SCA6 vs. Friedreich ataxia (FRDA), focussing on three particularly vulnerable speech parameters (speaking rate, prosodic modulation, and intelligibility) in ataxic dysarthria as well as on a specific oral non-speech variable of ataxic impairment, i.e., the irregularity of oral motor diadochokinesis (DDK). 30 Patients with SCA3, SCA6, and FRDA, matched for group size (n = 10 each), disease severity, and disease duration produced various speech samples and DDK tasks. A discriminant analysis was used to differentiate speech and non-speech parameters between groups. Regularity of DDK was specifically impaired in SCA3, whereas impairments of speech parameters, i.e., rate and modulation were stronger affected in SCA6. Speech parameters are particularly vulnerable in SCA6, while non-speech oral motor features are notably impaired in SCA3.

Neural correlates of rate-dependent finger-tapping in Parkinson's disease.

Functional imaging demonstrated hemodynamic activation within specific brain areas that contribute to frequency-dependent movement control. Previous investigations demonstrated a linear relationship between movement and hemodynamic response rates within cortical regions, whereas the basal ganglia displayed an inverse neural activation pattern. We now investigated neural correlates of frequency-related finger movements in patients with Parkinson's disease (PD) to further elucidate the neurofunctional alterations in cortico-subcortical networks in that disorder. We studied ten PD patients (under dopaminergic medication) and ten healthy subjects using a finger-tapping task at three different frequencies (1-4 Hz), implemented in an event-related, sparse sampling fMRI design. FMRI data were analyzed by means of a parametric approach to relate movement rates and regional BOLD signal alteration. Compared to healthy controls, PD patients showed higher tapping response rates only during the lower 1 Hz condition. FMRI analysis revealed a rate-dependent neural activity within the supplemental motor area, primary sensorimotor cortex, thalamus and the cerebellum with higher neural activity at higher frequency conditions in both groups. Within the putamen/pallidum, an inverse neural activity and frequency response correlation could be observed in healthy subjects with higher BOLD signal responses in slow frequencies, whereas this relationship was not evident in PD patients. We could demonstrate similar behavioral responses and neural activation patterns at the level both of frontal and cerebellar areas in PD compared to healthy controls, whereas regions like the putamen/pallidum appear to be still dysfunctional under medication regarding frequency-related neural activation. These findings may, potentially, serve as a neural signature of basal ganglia dysfunctions in frequency-related task requirements.

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.

Brain mechanisms of acoustic communication in humans and nonhuman primates: an evolutionary perspective.

Any account of "what is special about the human brain" (Passingham 2008) must specify the neural basis of our unique ability to produce speech and delineate how these remarkable motor capabilities could have emerged in our hominin ancestors. Clinical data suggest that the basal ganglia provide a platform for the integration of primate-general mechanisms of acoustic communication with the faculty of articulate speech in humans. Furthermore, neurobiological and paleoanthropological data point at a two-stage model of the phylogenetic evolution of this crucial prerequisite of spoken language: (i) monosynaptic refinement of the projections of motor cortex to the brainstem nuclei that steer laryngeal muscles, presumably, as part of a "phylogenetic trend" associated with increasing brain size during hominin evolution; (ii) subsequent vocal-laryngeal elaboration of cortico-basal ganglia circuitries, driven by human-specific FOXP2 mutations.;>This concept implies vocal continuity of spoken language evolution at the motor level, elucidating the deep entrenchment of articulate speech into a "nonverbal matrix" (Ingold 1994), which is not accounted for by gestural-origin theories. Moreover, it provides a solution to the question for the adaptive value of the "first word" (Bickerton 2009) since even the earliest and most simple verbal utterances must have increased the versatility of vocal displays afforded by the preceding elaboration of monosynaptic corticobulbar tracts, giving rise to enhanced social cooperation and prestige. At the ontogenetic level, the proposed model assumes age-dependent interactions between the basal ganglia and their cortical targets, similar to vocal learning in some songbirds. In this view, the emergence of articulate speech builds on the "renaissance" of an ancient organizational principle and, hence, may represent an example of "evolutionary tinkering" (Jacob 1977).

Training of ultra-fast speech comprehension induces functional reorganization of the central-visual system in late-blind humans.

Individuals suffering from vision loss of a peripheral origin may learn to understand spoken language at a rate of up to about 22 syllables (syl) per seconds (s)-exceeding by far the maximum performance level of untrained listeners (ca. 8 syl/s). Previous findings indicate the central-visual system to contribute to the processing of accelerated speech in blind subjects. As an extension, the present training study addresses the issue whether acquisition of ultra-fast (18 syl/s) speech perception skills induces de novo central-visual hemodynamic activation in late-blind participants. Furthermore, we asked to what extent subjects with normal or residual vision can improve understanding of accelerated verbal utterances by means of specific training measures. To these ends, functional magnetic resonance imaging (fMRI) was performed while subjects were listening to forward and reversed sentence utterances of moderately fast and ultra-fast syllable rates (8 or 18 syl/s) prior to and after a training period of ca. 6 months. Four of six participants showed-independently from residual visual functions-considerable enhancement of ultra-fast speech perception (about 70% points correctly repeated words) whereas behavioral performance did not change in the two remaining participants. Only subjects with very low visual acuity displayed training-induced hemodynamic activation of the central-visual system. By contrast, participants with moderately impaired or even normal visual acuity showed, instead, increased right-hemispheric frontal or bilateral anterior temporal lobe responses after training. All subjects with significant training effects displayed a concomitant increase of hemodynamic activation of left-hemispheric SMA. In spite of similar behavioral performance, trained "experts" appear to use distinct strategies of ultra-fast speech processing depending on whether the occipital cortex is still deployed for visual processing.

Neuromotor speech impairment: it's all in the talking.

The aim of this article is to explicate the uniqueness of the motor activity implied in spoken language production and to emphasize how important it is, from a theoretical and a clinical perspective, to consider the motor events associated with speaking as domain-specific, i.e., as pertaining to the domain of linguistic expression. First, phylogenetic data are reviewed demonstrating the specificity of the human vocal tract motor network regarding (i) the entrenchment of laryngeal motor skills within the organization of vocal tract movements, (ii) the evolution of a neural basis for skill acquisition within this system, and (iii) the integration of this system into an auditory-motor network. Second, ontogenetic evidence and existing knowledge about the experience-dependent plasticity of the brain are reported to explicate that during speech acquisition the vocal tract motor system is constrained by universal properties of speech production and by the specific phonological properties of the speaker's ambient language. Third, clinical data from dysarthria and apraxia of speech provide the background for a discussion about the theoretical underpinnings of domain-general versus domain-specific views of speech motor control. The article ends with a brief sketch of a holistic neurophonetic approach in experimental inquiries, assessment, and treatment of neuromotor speech impairment.

How can audiovisual pathways enhance the temporal resolution of time-compressed speech in blind subjects?

In blind people, the visual channel cannot assist face-to-face communication via lipreading or visual prosody. Nevertheless, the visual system may enhance the evaluation of auditory information due to its cross-links to (1) the auditory system, (2) supramodal representations, and (3) frontal action-related areas. Apart from feedback or top-down support of, for example, the processing of spatial or phonological representations, experimental data have shown that the visual system can impact auditory perception at more basic computational stages such as temporal signal resolution. For example, blind as compared to sighted subjects are more resistant against backward masking, and this ability appears to be associated with activity in visual cortex. Regarding the comprehension of continuous speech, blind subjects can learn to use accelerated text-to-speech systems for "reading" texts at ultra-fast speaking rates (>16 syllables/s), exceeding by far the normal range of 6 syllables/s. A functional magnetic resonance imaging study has shown that this ability, among other brain regions, significantly covaries with BOLD responses in bilateral pulvinar, right visual cortex, and left supplementary motor area. Furthermore, magnetoencephalographic measurements revealed a particular component in right occipital cortex phase-locked to the syllable onsets of accelerated speech. In sighted people, the "bottleneck" for understanding time-compressed speech seems related to higher demands for buffering phonological material and is, presumably, linked to frontal brain structures. On the other hand, the neurophysiological correlates of functions overcoming this bottleneck, seem to depend upon early visual cortex activity. The present Hypothesis and Theory paper outlines a model that aims at binding these data together, based on early cross-modal pathways that are already known from various audiovisual experiments on cross-modal adjustments during space, time, and object recognition.

Ultra-fast speech comprehension in blind subjects engages primary visual cortex, fusiform gyrus, and pulvinar - a functional magnetic resonance imaging (fMRI) study.

BACKGROUND: Individuals suffering from vision loss of a peripheral origin may learn to understand spoken language at a rate of up to about 22 syllables (syl) per second - exceeding by far the maximum performance level of normal-sighted listeners (ca. 8 syl/s). To further elucidate the brain mechanisms underlying this extraordinary skill, functional magnetic resonance imaging (fMRI) was performed in blind subjects of varying ultra-fast speech comprehension capabilities and sighted individuals while listening to sentence utterances of a moderately fast (8 syl/s) or ultra-fast (16 syl/s) syllabic rate. RESULTS: Besides left inferior frontal gyrus (IFG), bilateral posterior superior temporal sulcus (pSTS) and left supplementary motor area (SMA), blind people highly proficient in ultra-fast speech perception showed significant hemodynamic activation of right-hemispheric primary visual cortex (V1), contralateral fusiform gyrus (FG), and bilateral pulvinar (Pv). CONCLUSIONS: Presumably, FG supports the left-hemispheric perisylvian "language network", i.e., IFG and superior temporal lobe, during the (segmental) sequencing of verbal utterances whereas the collaboration of bilateral pulvinar, right auditory cortex, and ipsilateral V1 implements a signal-driven timing mechanism related to syllabic (suprasegmental) modulation of the speech signal. These data structures, conveyed via left SMA to the perisylvian "language zones", might facilitate - under time-critical conditions - the consolidation of linguistic information at the level of verbal working memory.

Language aptitude for pronunciation in advanced second language (L2) learners: behavioural predictors and neural substrates.

Individual differences in second language (L2) aptitude have been assumed to depend upon a variety of cognitive and personality factors. Especially, the cognitive factor phonological working memory has been conceptualised as language learning device. However, strong associations between phonological working memory and L2 aptitude have been previously found in early-stage learners only, not in advanced learners. The current study aimed at investigating the behavioural and neurobiological predictors of advanced L2 learning. Our behavioural results showed that phonetic coding ability and empathy, but not phonological working memory, predict L2 pronunciation aptitude in advanced learners. Second, functional neuroimaging revealed this behavioural trait to be correlated with hemodynamic responses of the cerebral network of speech motor control and auditory-perceptual areas. We suggest that the acquisition of L2 pronunciation aptitude is a dynamic process, requiring a variety of neural resources at different processing stages over time.

Tracking the speech signal--time-locked MEG signals during perception of ultra-fast and moderately fast speech in blind and in sighted listeners.

Blind people can learn to understand speech at ultra-high syllable rates (ca. 20 syllables/s), a capability associated with hemodynamic activation of the central-visual system. To further elucidate the neural mechanisms underlying this skill, magnetoencephalographic (MEG) measurements during listening to sentence utterances were cross-correlated with time courses derived from the speech signal (envelope, syllable onsets and pitch periodicity) to capture phase-locked MEG components (14 blind, 12 sighted subjects; speech rate=8 or 16 syllables/s, pre-defined source regions: auditory and visual cortex, inferior frontal gyrus). Blind individuals showed stronger phase locking in auditory cortex than sighted controls, and right-hemisphere visual cortex activity correlated with syllable onsets in case of ultra-fast speech. Furthermore, inferior-frontal MEG components time-locked to pitch periodicity displayed opposite lateralization effects in sighted (towards right hemisphere) and blind subjects (left). Thus, ultra-fast speech comprehension in blind individuals appears associated with changes in early signal-related processing mechanisms both within and outside the central-auditory terrain.