The right hemisphere supports but does not replace left hemisphere auditory function in patients with persisting aphasia

In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) a...

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Vydáno v:	Brain (London, England : 1878) Ročník 136; číslo Pt 6; s. 1901
Hlavní autoři:	Teki, Sundeep, Barnes, Gareth R, Penny, William D, Iverson, Paul, Woodhead, Zoe V J, Griffiths, Timothy D, Leff, Alexander P
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England 01.06.2013
Témata:	Acoustic Stimulation - methods Adult Aged Aged, 80 and over Aphasia - epidemiology Aphasia - physiopathology Auditory Cortex - physiology Auditory Perception - physiology Female Functional Laterality - physiology Humans Magnetoencephalography - methods Male Middle Aged Stroke - epidemiology Stroke - physiopathology mismatch negativity aphasia speech dynamic causal modelling MEG
ISSN:	1460-2156, 1460-2156
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Abstract	In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) and acoustic (same word) oddballs using dynamic causal modelling. We found stronger modulation of self-connections as a function of phonemic differences for control subjects versus aphasics in left primary auditory cortex and bilateral superior temporal gyrus. The patients showed stronger modulation of connections from right primary auditory cortex to right superior temporal gyrus (feed-forward) and from left primary auditory cortex to right primary auditory cortex (interhemispheric). This differential connectivity can be explained on the basis of a predictive coding theory which suggests increased prediction error and decreased sensitivity to phonemic boundaries in the aphasics' speech network in both hemispheres. Within the aphasics, we also found behavioural correlates with connection strengths: a negative correlation between phonemic perception and an inter-hemispheric connection (left superior temporal gyrus to right superior temporal gyrus), and positive correlation between semantic performance and a feedback connection (right superior temporal gyrus to right primary auditory cortex). Our results suggest that aphasics with impaired speech comprehension have less veridical speech representations in both temporal lobes, and rely more on the right hemisphere auditory regions, particularly right superior temporal gyrus, for processing speech. Despite this presumed compensatory shift in network connectivity, the patients remain significantly impaired.
AbstractList	In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) and acoustic (same word) oddballs using dynamic causal modelling. We found stronger modulation of self-connections as a function of phonemic differences for control subjects versus aphasics in left primary auditory cortex and bilateral superior temporal gyrus. The patients showed stronger modulation of connections from right primary auditory cortex to right superior temporal gyrus (feed-forward) and from left primary auditory cortex to right primary auditory cortex (interhemispheric). This differential connectivity can be explained on the basis of a predictive coding theory which suggests increased prediction error and decreased sensitivity to phonemic boundaries in the aphasics' speech network in both hemispheres. Within the aphasics, we also found behavioural correlates with connection strengths: a negative correlation between phonemic perception and an inter-hemispheric connection (left superior temporal gyrus to right superior temporal gyrus), and positive correlation between semantic performance and a feedback connection (right superior temporal gyrus to right primary auditory cortex). Our results suggest that aphasics with impaired speech comprehension have less veridical speech representations in both temporal lobes, and rely more on the right hemisphere auditory regions, particularly right superior temporal gyrus, for processing speech. Despite this presumed compensatory shift in network connectivity, the patients remain significantly impaired.In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) and acoustic (same word) oddballs using dynamic causal modelling. We found stronger modulation of self-connections as a function of phonemic differences for control subjects versus aphasics in left primary auditory cortex and bilateral superior temporal gyrus. The patients showed stronger modulation of connections from right primary auditory cortex to right superior temporal gyrus (feed-forward) and from left primary auditory cortex to right primary auditory cortex (interhemispheric). This differential connectivity can be explained on the basis of a predictive coding theory which suggests increased prediction error and decreased sensitivity to phonemic boundaries in the aphasics' speech network in both hemispheres. Within the aphasics, we also found behavioural correlates with connection strengths: a negative correlation between phonemic perception and an inter-hemispheric connection (left superior temporal gyrus to right superior temporal gyrus), and positive correlation between semantic performance and a feedback connection (right superior temporal gyrus to right primary auditory cortex). Our results suggest that aphasics with impaired speech comprehension have less veridical speech representations in both temporal lobes, and rely more on the right hemisphere auditory regions, particularly right superior temporal gyrus, for processing speech. Despite this presumed compensatory shift in network connectivity, the patients remain significantly impaired. In this study, we used magnetoencephalography and a mismatch paradigm to investigate speech processing in stroke patients with auditory comprehension deficits and age-matched control subjects. We probed connectivity within and between the two temporal lobes in response to phonemic (different word) and acoustic (same word) oddballs using dynamic causal modelling. We found stronger modulation of self-connections as a function of phonemic differences for control subjects versus aphasics in left primary auditory cortex and bilateral superior temporal gyrus. The patients showed stronger modulation of connections from right primary auditory cortex to right superior temporal gyrus (feed-forward) and from left primary auditory cortex to right primary auditory cortex (interhemispheric). This differential connectivity can be explained on the basis of a predictive coding theory which suggests increased prediction error and decreased sensitivity to phonemic boundaries in the aphasics' speech network in both hemispheres. Within the aphasics, we also found behavioural correlates with connection strengths: a negative correlation between phonemic perception and an inter-hemispheric connection (left superior temporal gyrus to right superior temporal gyrus), and positive correlation between semantic performance and a feedback connection (right superior temporal gyrus to right primary auditory cortex). Our results suggest that aphasics with impaired speech comprehension have less veridical speech representations in both temporal lobes, and rely more on the right hemisphere auditory regions, particularly right superior temporal gyrus, for processing speech. Despite this presumed compensatory shift in network connectivity, the patients remain significantly impaired.
Author	Leff, Alexander P Woodhead, Zoe V J Griffiths, Timothy D Teki, Sundeep Barnes, Gareth R Penny, William D Iverson, Paul
Author_xml	– sequence: 1 givenname: Sundeep surname: Teki fullname: Teki, Sundeep email: sundeep.teki.10@ucl.ac.uk organization: Wellcome Trust Centre for Neuroimaging, University College London, London WC1N 3BG, UK. sundeep.teki.10@ucl.ac.uk – sequence: 2 givenname: Gareth R surname: Barnes fullname: Barnes, Gareth R – sequence: 3 givenname: William D surname: Penny fullname: Penny, William D – sequence: 4 givenname: Paul surname: Iverson fullname: Iverson, Paul – sequence: 5 givenname: Zoe V J surname: Woodhead fullname: Woodhead, Zoe V J – sequence: 6 givenname: Timothy D surname: Griffiths fullname: Griffiths, Timothy D – sequence: 7 givenname: Alexander P surname: Leff fullname: Leff, Alexander P
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SubjectTerms	Acoustic Stimulation - methods Adult Aged Aged, 80 and over Aphasia - epidemiology Aphasia - physiopathology Auditory Cortex - physiology Auditory Perception - physiology Female Functional Laterality - physiology Humans Magnetoencephalography - methods Male Middle Aged Stroke - epidemiology Stroke - physiopathology
Title	The right hemisphere supports but does not replace left hemisphere auditory function in patients with persisting aphasia
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