Crossed aprosodia in strongly dextral patients

Impaired perception of vocal emotions in Parkinson's disease: influence of speech time processing and executive functioning

Little is known about the underlying dimensions of impaired recognition of emotional prosody that is frequently observed in patients with Parkinson's disease (PD). Because patients with PD also suffer from working memory deficits and impaired time perception, the present study examined the contribution of (a) working memory (frontal executive functioning) and (b) processing of the acoustic parameter speech rate to the perception of emotional prosody in PD. Two acoustic parameters known to be important for emotional classifications (speech duration and pitch variability) were systematically varied in prosodic utterances. Twenty patients with PD and 16 healthy controls (matched for age, sex, and IQ) participated in the study. The findings imply that (1) working memory dysfunctions and perception of emotional prosody are not independent in PD, (2) PD and healthy control subjects perceived vocal emotions categorically along two acoustic manipulation continua, and (3) patients with PD show impairments in processing of speech rate information.

Saying it with feeling: neural responses to emotional vocalizations

To determine how vocally expressed emotion is processed in the brain, we measured neural activity in healthy volunteers listening to fearful, sad, happy and neutral non-verbal vocalizations. Enhanced responses to emotional vocalizations were seen in the caudate nucleus, as well as anterior insular, temporal and prefrontal cortices. The right amygdala exhibited decreased responses to fearful vocalizations as well as fear-specific inhibitory interactions with left anterior insula. A region of the pons, implicated in acoustic startle responses also showed fear-specific interactions with the amygdala. The data demonstrate: firstly, that processing of vocal emotion involves a bilaterally distributed network of brain regions; and secondly, that processing of fear-related auditory stimuli involves context-specific interactions between the amygdala and other cortical and brainstem regions implicated in fear processing.

Lateralization of affective prosody in brain and the callosal integration of hemispheric language functions

Although affective prosody appears to be a dominant function of the right hemisphere, its degre of lateralization has not yet been established since various publications have reported affective-prosodic deficits following left brain damage in association with aphasia. This paper explores the mechanisms underlying affective-prosodic deficits following left and right brain damage by testing the ability of subjects to repeat and comprehend affective prosody under progressively reduced verbal-articulatory conditions. The results demonstrate that reducing verbal-articulatory conditions robustly improves the performance of left but not right brain damaged patients, a finding that supports the supposition that affective prosody is strongly lateralized to the right hemisphere. However, the performance of left brain damaged patients was not correlated to the presence, severity, or type of aphasic deficit(s). Based on functional-anatomic correlations for spontaneous affective prosody and affective-prosodic repetition, deep white matter lesions located below the supplementary motor area that disrupt interhemispheric connections coursing through the mid-rostral corpus callosum may contribute to affective-prosodic deficits that are both additive and independent of any aphasic deficits. In light of these and other findings, various anatomical, functional, and maturational hierarchic relationships between the affective-prosodic and verbal-linguistic aspects of language are posited in order to help further explain discrepancies that exist in the literature regarding the neurology of affective prosody.

Treatment of motor aprosodia with pitch biofeedback and expression modelling

In motor aprosodia, imitation and production of emotional prosody and facial gestures are compromised. Despite the frequency with which aprosodia occurs after brain damage, and its potential to cause social and vocational disability, no formal treatments are available for this disorder. A case of motor aprosodia treated with voice pitch biofeedback and modelling of affective communication is presented. Utilizing the patient as her own control, the affective communication treatment was compared to traditional rehabilitation therapy. The results obtained suggest that affective communication treatment has potential in improving affective communication in brain-injured patients. Also notable was the fact that the improvements in emotional expression were stable over a 2-month follow-up period, and could not be attributed to recovery of function as a result of time passage, the effect of traditional rehabilitation, the effect of the extra attention paid to the patient, or examiner bias.

Reversed laterality of cerebral functions in a non-right-hander: neuropsychological and spect findings in a case of 'atypical' dominance

A 54-year-old non-right-handed man with positive familial sinistrality showed a pure right hemisphere syndrome following a left hemisphere stroke. Severe right side hemineglect, transcortical motor dysprosodia, spatial dysgraphia and visuo-constructive impairments were observed. At no time were the expected left hemisphere abnormalities such as aphasia, alexia, right-left disorientation or finger agnosia noted. A left fronto-temporal subcortical lesion was documented on CT scan. A Tc-99m HM-PAO SPECT study revealed no cerebral blood flow changes in the right hemisphere while in the left hemisphere a fronto-temporo-parietal cerebral blood flow reduction was evident. This case of a complete reversed laterality of cognitive functions argues for a distinction to be made between 'anomalous' cerebral dominance and 'atypical' cerebral dominance.