Speech entrainment compensates for Broca's area damage

Speech entrainment (SE), the online mimicking of an audiovisual speech model, has been shown to increase speech fluency in patients with Broca's aphasia. However, not all individuals with aphasia benefit from SE. The purpose of this study was to identify patterns of cortical damage that predict...

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Bibliographic Details
Published in:Cortex 2015-08, Vol.69 (Aug), p.68-75
Main Authors: Fridriksson, Julius, Basilakos, Alexandra, Hickok, Gregory, Bonilha, Leonardo, Rorden, Chris
Format: Article
Language:English
Subjects:
Aged
Aphasia, Broca - etiology
Aphasia, Broca - pathology
Aphasia, Broca - therapy
Broca Area - pathology
Broca's aphasia
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Non-fluent speech
Speech - physiology
Speech production
Speech Therapy - methods
Stroke - complications
Stroke - pathology
Treatment
Treatment Outcome
Voxel-based lesion-symptom mapping
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Summary:Speech entrainment (SE), the online mimicking of an audiovisual speech model, has been shown to increase speech fluency in patients with Broca's aphasia. However, not all individuals with aphasia benefit from SE. The purpose of this study was to identify patterns of cortical damage that predict a positive response SE's fluency-inducing effects. Forty-four chronic patients with left hemisphere stroke (15 female) were included in this study. Participants completed two tasks: 1) spontaneous speech production, and 2) audiovisual SE. Number of different words per minute was calculated as a speech output measure for each task, with the difference between SE and spontaneous speech conditions yielding a measure of fluency improvement. Voxel-wise lesion-symptom mapping (VLSM) was used to relate the number of different words per minute for spontaneous speech, SE, and SE-related improvement to patterns of brain damage in order to predict lesion locations associated with the fluency-inducing response to SE. Individuals with Broca's aphasia demonstrated a significant increase in different words per minute during SE versus spontaneous speech. A similar pattern of improvement was not seen in patients with other types of aphasia. VLSM analysis revealed damage to the inferior frontal gyrus predicted this response. Results suggest that SE exerts its fluency-inducing effects by providing a surrogate target for speech production via internal monitoring processes. Clinically, these results add further support for the use of SE to improve speech production and may help select patients for SE treatment.
ISSN:0010-9452
1973-8102
DOI:10.1016/j.cortex.2015.04.013