Communication Sciences and Disorders Commons^™

Brain Age Predicts Long-Term Recovery In Post-Stroke Aphasia, Sigfus Kristinsson, Natalie Busby, Christopher Rorden, Roger Newman-Norlund, Dirk B. Den Ouden, Sigridur Magnusdottir, Haukur Hjaltason, Helga Thors, Argye E. Hillis, Olafur Kjartansson, Leonardo Bonilha, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

The association between age and language recovery in stroke remains unclear. Here, we used neuroimaging data to estimate brain age, a measure of structural integrity, and examined the extent to which brain age at stroke onset is associated with (i) cross-sectional language performance, and (ii) longitudinal recovery of language function, beyond chronological age alone. A total of 49 participants (age: 65.2 ± 12.2 years, 25 female) underwent routine clinical neuroimaging (T1) and a bedside evaluation of language performance (Bedside Evaluation Screening Test-2) at onset of left hemisphere stroke. Brain age was estimated from enantiomorphically reconstructed brain scans using a machine …

Predictors Of Therapy Response In Chronic Aphasia: Building A Foundation For Personalized Aphasia Therapy, Sigfus Kristinsson, Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Jean Neils-Strunjas, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Chronic aphasia, a devastating impairment of language, affects up to a third of stroke survivors. Speech and language therapy has consistently been shown to improve language function in prior clinical trials, but few clinicially applicable predictors of individual therapy response have been identified to date. Consequently, clinicians struggle substantially with prognostication in the clinical management of aphasia. A rising prevalence of aphasia, in particular in younger populations, has emphasized the increasing demand for a personalized approach to aphasia therapy, that is, therapy aimed at maximizing language recovery of each individual with reference to evidence-based clinical recommendations. In this narrative review, …

The Company Prosodic Deficits Keep Following Right Hemisphere Stroke: A Systematic Review, Shannon M. Sheppard, Melissa D. Stockbridge, Lynsey M. Keator, Laura L. Murray, Margaret Lehman Blake

Communication Sciences and Disorders Faculty Articles and Research

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 …

Neural Correlates Of Syntactic Comprehension: A Longitudinal Study, Shannon M. Sheppard, Erin L. Meier, Kevin T. Kim, Bonnie L. Breining, Lynsey M. Keator, Bohao Tang, Brian Caffo, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Broca’s area is frequently implicated in sentence comprehension but its specific role is debated. Most lesion studies have investigated deficits at the chronic stage. We aimed (1) to use acute imaging to predict which left hemisphere stroke patients will recover sentence comprehension; and (2) to better understand the role of Broca’s area in sentence comprehension by investigating acute deficits prior to functional reorganization. We assessed comprehension of canonical and noncanonical sentences in 15 patients with left hemisphere stroke at acute and chronic stages. LASSO regression was used to conduct lesion symptom mapping analyses. Patients with more severe word-level comprehension deficits …

Dysfunctional Tissue Correlates Of Unrelated Naming Errors In Acute Left Hemisphere Stroke, Erin L. Meier, Shannon M. Sheppard, Emily B. Goldberg, Catherine R. Kelly, Alexandra Walker, Delaney M. Ubellacker, Emilia Vitti, Kristina Ruch, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Most naming error lesion-symptom mapping (LSM) studies have focused on semantic and/or phonological errors. Anomic individuals also produce unrelated word errors, which may be linked to semantic or modality-independent lexical deficits. To investigate the neural underpinnings of rarely-studied unrelated errors, we conducted LSM analyses in 100 individuals hospitalised with a left hemisphere stroke who completed imaging protocols and language assessments. We used least absolute shrinkage and selection operator regression to capture relationships between naming errors and dysfunctional brain tissue metrics (regional damage or hypoperfusion in vascular territories) in two groups: participants with and without impaired single-word auditory comprehension. Hypoperfusion—particularly within …

Individualized Response To Semantic Versus Phonological Aphasia Therapies In Stroke, Sigfus Kristinsson, Alexandra Basilakos, Jordan Elm, Leigh Ann Spell, Leonardo Bonilha, Chris Rorden, Dirk B. Den Ouden, Christy Cassarly, Souvik Sen, Argye Hillis, Gregory Hickok, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Attempts to personalize aphasia treatment to the extent where it is possible to reliably predict individual response to a particular treatment have yielded inconclusive results. The current study aimed to (i) compare the effects of phonologically versus semantically focussed naming treatment and (ii) examine biographical and neuropsychological baseline factors predictive of response to each treatment. One hundred and four individuals with chronic post-stroke aphasia underwent 3 weeks of phonologically focussed treatment and 3 weeks of semantically focussed treatment in an unblinded cross-over design. A linear mixed-effects model was used to compare the effects of treatment type on proportional change in …

Lesion Loci Of Impaired Affective Prosody: A Systematic Review Of Evidence From Stroke, Alexandra Zezinka Durfee, Shannon M. Sheppard, Margaret L. Blake, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

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. …

Explicit Training To Improve Affective Prosody Recognition In Adults With Acute Right Hemisphere Stroke, Alexandra Zezinka Durfee, Shannon M. Sheppard, Erin L. Meier, Lisa Bunker, Erjia Cui, Ciprian Crainiceanu, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

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 …

Neural Regions Underlying Object And Action Naming: Complementary Evidence From Acute Stroke And Primary Progressive Aphasia, Bonnie L. Breining, Andreia V. Feria, Brian Caffo, Erin L. Meier, Shannon M. Sheppard, Rajani Sebastian, Donna C. Tippett, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Background: Naming impairment is commonly noted in individuals with aphasia. However, object naming receives more attention than action naming. Furthermore, most studies include participants with aphasia due to only one aetiology, commonly stroke. We developed a new assessment, the Hopkins Action Naming Assessment (HANA), to evaluate action naming impairments.

Methods >& Procedures: Participants (N = 138 PPA, N = 37 acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N = 31 PPA, N = 37 acute stroke) provided neuroimaging data. The whole brain was automatically segmented into regions of interest (ROIs). …

Characterizing Subtypes And Neural Correlates Of Receptive Aprosodia In Acute Right Hemisphere Stroke, Shannon M. Sheppard, Erin L. Meier, Alexandra Zezinka Durfee, Alex Walker, Jennifer Shea, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

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 …

Standardizing Assessment Of Spoken Discourse In Aphasia: A Working Group With Deliverables, Brielle C. Stark, Manaswita Dutta, Laura L. Murray, Lucy Bryant, Davida Fromm, Brian Macwhinney, Amy E. Ramage, Angela Roberts, Dirk B. Den Ouden, Kris Brock, Katy Mckinney-Bock, Eun Jin Paek, Tyson G. Harmon, Si On Yoon, Charalambos Themistocleous, Hyunsoo Yoo, Katharine Aveni, Stephanie Gutierrez, Saryu Sharma

Communication Sciences and Disorders Faculty Articles and Research

Purpose

Method

Automatic Subtyping Of Individuals With Primary Progressive Aphasia, Charalambos Themistocleous, Bronte Ficek, Kimberly Webster, Dirk B. Den Ouden, Argye Hillis, Kyrana Tsapkini

Communication Sciences and Disorders Faculty Articles and Research

Background:

Objective:

Methods:

Diagnosing And Managing Post-Stroke Aphasia, Shannon M. Sheppard, Rajani Sebastian

Communication Sciences and Disorders Faculty Articles and Research

Introduction: Aphasia is a debilitating language disorder and even mild forms of aphasia can negatively affect functional outcomes, mood, quality of life, social participation, and the ability to return to work. Language deficits after post-stroke aphasia are heterogeneous.

Areas covered: The first part of this manuscript reviews the traditional syndrome-based classification approach as well as recent advances in aphasia classification that incorporate automatic speech recognition for aphasia classification. The second part of this manuscript reviews the behavioral approaches to aphasia treatment and recent advances such as noninvasive brain stimulation techniques and pharmacotherapy options to augment the effectiveness of …

Agrammatism And Paragrammatism: A Cortical Double Dissociation Revealed By Lesion-Symptom Mapping, William Matchin, Alexandra Basilakos, Brielle C. Stark, Dirk B. Den Ouden, Fridolin Gross, Gregory Hickok

Communication Sciences and Disorders Faculty Articles and Research

The fundamental distinction of grammatical deficits in aphasia, agrammatism and paragrammatism, was made over a century ago. However, the extent to which the agrammatism/paragrammatism distinction exists independently of differences in speech fluency has not clearly been investigated. Despite much research on agrammatism, the lesion correlates of paragrammatism are essentially unknown. Lesion-symptom mapping was used to investigate the degree to which the lesion correlates of agrammatism and paragrammatism overlap or dissociate. Four expert raters assessed videos of 53 right-handed patients with aphasia following chronic left-hemisphere stroke retelling the Cinderella story. Consensus discussion determined each subject’s classification with respect to grammatical deficits …

Brain Damage Associated With Impaired Sentence Processing In Acute Aphasia, Sigfus Kristinsson, Helga Thors, Grigori Yourganov, Sigridur Magnusdottir, Haukur Hjaltason, Brielle C. Stark, Alexandra Basilakos, Dirk B. Den Ouden, Leo Bonilha, Chris Rorden, Gregory Hickok, Argye E. Hillis, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Left-hemisphere brain damage commonly affects patients' abilities to produce and comprehend syntactic structures, a condition typically referred to as “agrammatism.” The neural correlates of agrammatism remain disputed in the literature, and distributed areas have been implicated as important predictors of performance, for example, Broca's area, anterior temporal areas, and temporo-parietal areas. We examined the association between damage to specific language-related ROIs and impaired syntactic processing in acute aphasia. We hypothesized that damage to the posterior middle temporal gyrus, and not Broca's area, would predict syntactic processing abilities. One hundred four individuals with acute aphasia (< 20 days poststroke) were included in the study. Structural MRI scans were obtained, and all participants completed a 45-item sentence–picture matching task. We performed an ROI-based stepwise regression analyses to examine the relation between cortical brain damage and impaired comprehension of canonical and noncanonical sentences. Damage to the posterior middle temporal gyrus was the strongest predictor for overall task performance and performance on noncanonical sentences. Damage to the angular gyrus was the strongest predictor for performance on canonical sentences, and damage to the posterior superior temporal gyrus predicted noncanonical scores when performance on canonical sentences was included as a cofactor. Overall, our models showed that damage to temporo-parietal and posterior temporal areas was associated with impaired syntactic comprehension. Our results indicate that the temporo-parietal area is crucially implicated in complex syntactic processing, whereas the role of Broca's area may be complementary.

Behavioral And Neural Correlates Of Normal Aging Effects On Motor Preparatory Mechanisms Of Speech Production And Limb Movement, Karim Johari, Dirk B. Den Ouden, Roozbeh Behroozmand

Communication Sciences and Disorders Faculty Articles and Research

Normal aging is associated with decline of the sensorimotor mechanisms that support movement function in the human brain. In this study, we used behavioral and event-related potential (ERP) recordings to investigate the effects of normal aging on the motor preparatory mechanisms of speech production and limb movement. The experiment involved two groups of older and younger adults who performed randomized speech vowel vocalization and button press motor reaction time tasks in response to temporally predictable and unpredictable visual stimuli. Behavioral results revealed age-related slowness of motor reaction time only during speech production in response to temporally unpredictable stimuli, and this …

A Child With Congenital Aglossia: A Narrative Review And Descriptive Case Study, Betty Mcmicken

Communication Sciences and Disorders Faculty Articles and Research

This article details an account of a young female with congenial aglossia. Because of the low incidence of this anatomical and physiological presentation, this narrative review includes a brief historical review of the disorder and a detailed description of: (1) reports in the literature of congenital hypoglossia and aglossia, (2) characteristics of speech in children with congenital aglossia below the age of 18 years, and (3) the medical history, speech acquisition, and course of intervention of a 5-year-old girl with congenital aglossia currently in speech treatment.

Exploring In Silence: Hearing And Deaf Infants Explore Objects Differently Before Cochlear Implantation, Mary K. Fagan

Communication Sciences and Disorders Faculty Articles and Research

Infant development has rarely been informed by the behavior of infants with sensory differences despite increasing recognition that infant behavior itself creates sensory learning opportunities. The purpose of this study of object exploration was to compare the behavior of hearing and deaf infants, with and without cochlear implants, in order to identify the effects of profound sensorineural hearing loss on infant exploration before cochlear implantation, the behavioral effects of access to auditory feedback after cochlear implantation, and the sensory motivation for exploration behaviors performed by hearing infants as well. The results showed that 9-month-old deaf infants explored objects as often …

Effects Of Aging On Temporal Predictive Mechanisms Of Speech And Hand Motor Reaction Time, Karim Johari, Dirk B. Den Ouden, Roozbeh Behroozmand

Communication Sciences and Disorders Faculty Articles and Research

Evidence from previous studies has suggested that movement execution in younger adults is accelerated in response to temporally predictable vs. unpredictable sensory stimuli. This effect indicates that external temporal information can modulate motor behavior; however, how aging can influence temporal predictive mechanisms in motor system has yet to be understood. The objective of the present study was to investigate aging effects on the initiation and inhibition of speech and hand movement reaction times in response to temporally predictable and unpredictable sensory stimuli. Fifteen younger (mean age 22.6) and fifteen older (mean age 63.8) adults performed a randomized speech vowel vocalization …

Non-Fluent Speech Following Stroke Is Caused By Impaired Efference Copy, Lynda Feenaughty, Alexandra Basilakos, Leonardo Bonilha, Dirk B. Den Ouden, Chris Rorden, Brielle C. Stark, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Efference copy is a cognitive mechanism argued to be critical for initiating and monitoring speech: however, the extent to which breakdown of efference copy mechanisms impact speech production is unclear. This study examined the best mechanistic predictors of non-fluent speech among 88 stroke survivors. Objective speech fluency measures were subjected to a principal component analysis (PCA). The primary PCA factor was then entered into a multiple stepwise linear regression analysis as the dependent variable, with a set of independent mechanistic variables. Participants’ ability to mimic audio-visual speech (“speech entrainment response”) was the best independent predictor of non-fluent speech. We suggest …

Vowel Formant Dispersion Reflects Severity Of Apraxia Of Speech, Dirk B. Den Ouden, Elena Galkina, Alexandra Basilakos, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Background: Apraxia of Speech (AOS) has been associated with deviations in consonantal voice onset time (VOT), but studies of vowel acoustics have yielded conflicting results. However, a speech motor planning disorder that is not bound by phonological categories is expected to affect vowel as well as consonant articulations.

Aims: We measured consonant VOTs and vowel formants produced by a large sample of stroke survivors, and assessed to what extent these variables and their dispersion are predictive of AOS presence and severity, based on a scale that uses clinical observations to rate gradient presence of AOS, aphasia, and dysarthria. …

Bilabial Substitution Patterns During Consonant Production In A Case Of Congenital Aglossia, Betty Mcmicken, Frederico Salles, Shelley Von Berg, Margaret Vento-Wilson, Kelly Rogers, Asterios Toutios, Shrikanth S. Narayanan

Communication Sciences and Disorders Faculty Articles and Research

Purpose: Congenital aglossia is a rare syndrome in which an individual is born without a tongue. The present paper examines articulatory details of the production of multiple consonants by an aglossic speaker.

Method: Real-time magnetic resonance imaging data of the upper airway were collected from the aglossic speaker. Air-tissue boundaries were determined from the video sequences using a segmentation algorithm, and dynamics of vocal-tract constrictions and cross-dimensions were calculated.

Results: The aglossic speaker produced the consonants /t, d, th, l ,r, f ,v, s, sh/ with a bilabial closure instead of a normal lingua-alveolar closure; however, in …

Wine Flavor Perception In A Person With Isolated Congenital Aglossia, Naïve Wine Taster, And Sommelier, Kristin Mahood, Long Wang, Betty Mcmicken, Cheryl Rock

Communication Sciences and Disorders Faculty Articles and Research

Objective: This study aimed to augment previous research that investigated flavor perception in isolated congenital aglossia by a whole food/beverage approach. Isolated congenital aglossia is the rare condition of absence of a tongue at birth without the presence of other symptoms. Previous studies confirmed taste perception in isolated congenital aglossia using single taste solutions including sour, salty, sweet, bitter, and umami.

Methods: The current randomized, double-blinded study age- and sex-matched a naïve wine taster and sommelier to the 46 year-old female with isolated congenital aglossia. A Nose and Palate Survey with 54 variables created based on the Court …

Language Assessment In A Snap: Monitoring Progress Up To 36 Months, Jill Gilkerson, Jeffrey A. Richards, Charles R. Greenwood, Judy K. Montgomery

Communication Sciences and Disorders Faculty Articles and Research

This article describes the development and validation of the Developmental Snapshot, a 52-item parent questionnaire on child language and vocal communication development that can be administered monthly and scored automatically. The Snapshot was created to provide an easily administered monthly progress monitoring tool that enables parents to better recognize language milestones and offers professionals prompt information to fine-tune intervention strategies. Initial items were piloted by 15 families; refinement and further development of the instrument was conducted with parents of 308 typically developing children. Reliability and criterion validity metrics were examined on subsets of approximately 60 children who completed the Snapshot …

Revealing The Dual Streams Of Speech Processing, Julius Fridriksson, Grigori Yourganov, Leonardo Bonilha, Alexandra Basilakos, Dirk B. Den Ouden, Chris Rorden

Communication Sciences and Disorders Faculty Articles and Research

Several dual route models of human speech processing have been proposed suggesting a large-scale anatomical division between cortical regions that support motor–phonological aspects vs. lexical–semantic aspects of speech processing. However, to date, there is no complete agreement on what areas subserve each route or the nature of interactions across these routes that enables human speech processing. Relying on an extensive behavioral and neuroimaging assessment of a large sample of stroke survivors, we used a data-driven approach using principal components analysis of lesion-symptom mapping to identify brain regions crucial for performance on clusters of behavioral tasks without a priori separation into …

Different Neural Mechanisms For Causal Processing In Language And Perception: An Fmri Study, Brett B. Bankson, Dirk B. Den Ouden

Communication Sciences and Disorders Faculty Articles and Research

Information that is used to establish and evaluate causal relationships between objects and events can be gleaned from many sources, especially those that rely on language and perception. For example, sentences with a verb structure using change of state verbs such as “to break” or “to freeze” imply sequential events that express understood causal relationships. At this time, little research has examined the neural correlates of causal verb processing or has compared them to the more well researched brain activity involved in perceptual causal processing. This study investigated the extent to which the evaluation of causal verbs and causal image …

High Definition Transcranial Direct Current Stimulation Als Mogelijke Hulp Bij Afasie-Herstel, Dirk B. Den Ouden

Communication Sciences and Disorders Faculty Articles and Research

Samenvatting

Nieuwe kennis over het plastische vermogen van het volwassen brein, ook na hersenschade, heeft geleid tot hernieuwde interesse in technieken om deze plasticiteit fysiek te sturen. Een van die technieken is transcranial Direct Current Stimulation (tDCS), waarmee de exciteerbaarheid van hersencellen beïnvloed wordt door een zwakke gelijkstroom door de hersenschors te leiden. Als met deze methode hersenplasticiteit bevorderd en gestuurd kan worden, is het wellicht mogelijk om de uitkomsten van afasietherapie te verbeteren, door het aanpakken van de fysieke bron van de stoornis. Dit artikel behandelt kort de geschiedenis en de werking van tDCS, alvorens een overzicht te geven …

High-Definition Tdcs Of Noun And Verb Retrieval In Naming And Lexical Decision, Svetlana Malyutina, Dirk B. Den Ouden

Communication Sciences and Disorders Faculty Articles and Research

High-definition transcranial direct current stimulation (HD-tDCS) is a novel brain stimulation method that has high potential for use in language therapy for speakers with aphasia, due to its safety and focality. This study aimed to obtain foundational data on using HD-tDCS to modulate language processing in healthy speakers. Participants received stimulation either of left Broca’s area or of angular gyrus (20 minutes of anodal, cathodal and sham stimulation on separate days), followed by naming and lexical decision tasks with single-word verb and noun stimuli. We found that cathodal stimulation over both Broca’s area and left angular gyrus increased naming speed …

Aac Intervention As An Immersion Model, Janet L. Dodd, Megan Gorey

Communication Sciences and Disorders Faculty Articles and Research

Augmentative and alternative communication (AAC) based interventions support individuals with complex communication needs (CCN) in becoming effective and efficient communicators. However, there is often a disconnect between language models, communication opportunities, and desired intervention outcomes in the intervention process. This paper outlines a service delivery model that unites these elements of intervention. The social theory of language acquisition provides the foundation of this immersion model (Paul & Norbury, 2012; Pence & Justice, 2013) while adaptations of indirect language stimulation strategies create (Beukelman & Mirenda, 2013; Paul & Norbury, 2012) the support system necessary to develop an independent and functional communicator. …

Aac Camp As An Alternative School-Based Service Delivery Model: A Retrospective Survey, Janet L. Dodd, Darla K. Hagge

Communication Sciences and Disorders Faculty Articles and Research

School-based speech-language pathologists are obligated to apply evidence-based practice and document progress of their students’ response to intervention in compliance with federal law. The purpose of this preliminary study was to explore the effects of an augmentative and alternative communication (AAC)–based intervention provided in a camp format and begin the exploration of examining strategies to monitor and document progress. Through the use of a survey, data were also collected regarding the demographics of camp attendees and their response to the camp-based intervention model. Results indicated children with autism and intellectual disability comprised a significant portion of the children referred for …