An exploration of dichotic listening among adults who stutter

Abstract

A pilot investigation of dichotic listening of CV stimuli was undertaken using seven adults who stutter (AWS) and a comparison group of seven adults who do not stutter (AWNS). The aim of this research was to investigate whether AWS show a difference in the strength of the right ear advantage (REA) in both undirected and directed attention tasks when compared to AWNS. The undirected attention task involved manipulating the interaural intensity difference (IID) of the CV stimuli presented to each ear. The CV stimuli were presented with equal intensity for the directed attention task. The undirected attention results indicated that both AWS and AWNS have a REA for processing speech information, with a primary difference observed between groups in regard to the IID point at which a REA shifts to a LEA. This crossing-over point occurred earlier for AWS, indicating a stronger right hemisphere involvement for the processing of speech compared to AWNS. No differences were found between groups in the directed attention task. The differences and similarities observed in dichotic listening between the two groups are discussed in regard to hemispheric specialization in the processing of speech.     

Posterior SMA Syndrome following subcortical stroke: Contralateral akinesia reversed by visual feedback

Background

The supplementary motor area (SMA) plays a key role in motor programming and production and is involved in internally-cued movements. In neurological populations, SMA syndrome following a lesion to the “SMA proper” is characterized by transient impairment of voluntary movements and motor sequences. This syndrome is assumed to follow on from an interruption of the motor cortico-subcortical loop, and some case reports indicate that such a syndrome could occur after a brain lesion isolating the SMA from subcortical structures.

Aim

To characterize the pattern of motor impairments in a patient whose stroke disconnects the SMA from the subcortical motor loop.

Method

A patient developed a moderate transient left hemiparesis following a subcortical stroke in the right anterior cerebral artery area, which disconnected the SMA from basal ganglia. Eight days after the stroke, when the hemiparesis had regressed, the patient presented a specific SMA motor disorder of the left hand which manifested as an akinesia and was exacerbated when his visual attention was not directed towards his hand. We assessed finger tapping with left and right hands, eyes closed and open, in the left and right hemispace. We indexed movement speed as the number of taps filmed over 5-s periods.

Results

Left motor weakness (grasping strength of right hand: 49 kg and left hand: 41 kg) was resolved in a week. Ideomotor and ideational gestures and motor sequences were preserved. On the tapping task, left-hand tapping was slower than right-hand tapping. Critically, visual feedback improved tapping speed for the left, but not for the right, hand. The hemispace of the task execution had no effect on tapping performance.

Conclusion

Our results suggest that SMA-basal ganglia disconnection decreases contralateral movement initiation and maintenance and this effect is partly compensated by visual cues.     

Segmental and metrical complexity during non-word repetition in adults who stutter

Non-word repetition is weaker for adults who stutter (AWS) compared to adults who do not stutter (AWNS) as phonological demands increase. However, non-word stimuli used in previous studies varied by length, but did not vary with regard to segmental or metrical complexity. The purpose of the present study was to examine the unique influence of these two distinct types of complexity on non-word repetition in AWS and AWNS via administration of the Test of Phonological Structure (TOPhS). Twenty-four adults (12 AWNS, 12 AWS) repeated 96 non-words within a soundproof booth immediately after auditory presentation. All 96 non-word targets included on the TOPhS were one to four syllables in length and ranked based on segmental complexity (simple, moderate and complex) and metrical complexity (simple, moderate and complex). No main effect of metrical complexity was detected between groups, and no differences in accuracy were observed for non-words with simple or moderate segmental complexity. However, AWS were significantly more likely to produce a phonemic error when repeating words with complex segmental structure than AWNS, irrespective of metrical complexity. Segmental complexity may contribute to the differences in phonological working memory in AWS when controlling for metrical complexity and length.     

Neural correlates of semantic activation spreading on the path to picture naming in adults who stutter

ObjectiveOn the path to picture naming, words that relate semantically to the pictured object become activated in the mental lexicon. We used a neuroscientific approach to investigate this semantic activation spreading process in adults who stutter (AWS).MethodsFourteen AWS and 14 adults who do not stutter (AWNS) completed a picture–word priming task. On each trial, a picture was named at a delay. On some trials, an unattended auditory probe word was presented after the picture, before naming commenced. Event-related potentials recorded to probe words Semantically-Related to the picture labels, and to probe words Semantically- and Phonologically-Unrelated to the picture labels, were compared using spatial–temporal principal component analysis.ResultsPosterior N400 amplitude was attenuated for Semantically-Related versus Unrelated probes in AWNS, while in AWS posterior N400 amplitude was enhanced for Semantically-Related versus Unrelated probes. Marginal albeit potentially relevant group differences in the morphology of other ERP components were also observed.ConclusionsThe posterior N400 results point to a strategic, inhibitory influence on semantic activation spreading in AWS on the path to naming. Group differences in the amplitude of other ERP components tentatively suggest that AWS allocated attentional resources differently than the AWNS during the task. Preliminary ERP evidence of intact conceptual (as opposed to lexical-semantic) priming in the AWS is also discussed.SignificanceThis study contributes to a growing body of research describing linguistic performance in AWS.     

EEG-based classification of imaginary left and right foot movements using beta rebound

Objective

The purpose of this study was to investigate cortical lateralization of event-related (de)synchronization during left and right foot motor imagery tasks and to determine classification accuracy of the two imaginary movements in a brain–computer interface (BCI) paradigm.

Methods

We recorded 31-channel scalp electroencephalograms (EEGs) from nine healthy subjects during brisk imagery tasks of left and right foot movements. EEG was analyzed with time–frequency maps and topographies, and the accuracy rate of classification between left and right foot movements was calculated.

Results

Beta rebound at the end of imagination (increase of EEG beta rhythm amplitude) was identified from the two EEGs derived from the right-shift and left-shift bipolar pairs at the vertex. This process enabled discrimination between right or left foot imagery at a high accuracy rate (maximum 81.6% in single trial analysis).

Conclusion

These data suggest that foot motor imagery has potential to elicit left–right differences in EEG, while BCI using the unilateral foot imagery can achieve high classification accuracy, similar to ordinary BCI, based on hand motor imagery.

Significance

By combining conventional discrimination techniques, the left–right discrimination of unilateral foot motor imagery provides a novel BCI system that could control a foot neuroprosthesis or a robotic foot.     

Functional neuromuscular stimulation to improve severe hand dysfunction after stroke: does inhibitory rTMS enhance therapeutic efficiency?

Background

Novel strategies to improve hand function after stroke are needed. Electromyography-triggered functional neuromuscular stimulation (EMG-FNMS) and repetitive transcranial magnetic stimulation (rTMS) are promising techniques to facilitate recovery of sensory-motor hand dysfunction after stroke.

Objective

To investigate if 1 Hz rTMS over the contralesional primary motor cortex enhances the effectiveness of EMG-triggered FNMS of the hand and finger extensors to improve severe sensory-motor hand dysfunction after stroke.

Methods

24 subjects with a first stroke received 10 daily sessions of 20 min EMG-triggered FNMS of the hand and finger extensors of the affected forearm preceded by 15 min of either 1 Hz rTMS (rTMS group, n = 12) or sham rTMS (control group, n = 12) over the contralesional primary motor cortex. Prior to and after each intervention motor function and spasticity were rated at both hands, and cortical excitability of the contralesional primary motor cortex was assessed.

Results

Motor function and spasticity of the affected hand were significantly improved by either intervention, whereas behavioural measures of the unaffected hand did not change. There were no significant differences between both intervention groups. Improvement of motor function of the affected hand was positively correlated with cortical excitability of the contralesional primary motor cortex after EMG-triggered FNMS preceded by 1 Hz rTMS.

Conclusions

1 Hz rTMS does not enhance the general effectiveness of EMG-FNMS to the wrist and finger extensors of the affected forearm after stroke. Motor recovery of the severely affected hand after stroke appears to depend on excitability of the contralesional primary motor cortex.     

Synchronized finger exercise reduces surround inhibition

Objective

To investigate whether hand muscle repetitive use reduces surround inhibition (SI) as observed in patients with focal hand dystonia, we performed a transcranial magnetic stimulation (TMS) study in 15 healthy right-handed volunteers.

Methods

TMS was set to be triggered by self-initiated flexion of the index finger at 3 ms after movement onset. Motor evoked potentials (MEPs) of the abductor digiti minimi (ADM) were measured before and at 0, 10, 20 and 30 min after ‘single’ (little finger abduction) and ‘dual’ (both index finger flexion and little finger abduction) exercise at 0.5 Hz for 30 min. SI was calculated as (mean control MEP – mean self-triggered MEP) × 100/mean control MEP.

Results

Compared to single exercise, dual exercise produced significantly larger and longer-lasting enhancements of self-triggered MEPs, and greater reduction in calculated SIs.

Conclusions

This result demonstrates that synchronized finger exercise can reduce SI between the involved muscles possibly due either to the strengthening of the excitatory connections or to the weakening of the inhibitory connections between them, and may illustrate the association between hand muscle repetitive use and disturbed SI observed in FHD.

Significance

The operation of surround inhibition can be reduced by practicing synchronous movements.     

The Myelin Content of the Human Precentral Hand Knob Reflects Interindividual Differences in Manual Motor Control at the Physiological and Behavioral Level

The primary motor cortex hand area (M1_HAND) and adjacent dorsal premotor cortex (PMd) form the so-called motor hand knob in the precentral gyrus. M1_HAND and PMd are critical for dexterous hand use and are densely interconnected via corticocortical axons, lacking a sharp demarcating border. In 24 young right-handed volunteers, we performed multimodal mapping to delineate the relationship between structure and function in the right motor hand knob. Quantitative structural magnetic resonance imaging (MRI) at 3 tesla yielded regional R1 maps as a proxy of cortical myelin content. Participants also underwent functional MRI (fMRI). We mapped task-related activation and temporal precision, while they performed a visuomotor synchronization task requiring visually cued abduction movements with the left index or little finger. We also performed sulcus-aligned transcranial magnetic stimulation of the motor hand knob to localize the optimal site (hotspot) for evoking a motor evoked potential (MEP) in two intrinsic hand muscles. Individual motor hotspot locations varied along the rostrocaudal axis. The more rostral the motor hotspot location in the precentral crown, the longer were corticomotor MEP latencies. “Hotspot rostrality” was associated with the regional myelin content in the precentral hand knob. Cortical myelin content also correlated positively with task-related activation of the precentral crown and temporal precision during the visuomotor synchronization task. Together, our results suggest a link among cortical myelination, the spatial cortical representation, and temporal precision of finger movements. We hypothesize that the myelination of cortical axons facilitates neuronal integration in PMd and M1_HAND and, hereby, promotes the precise timing of movements.SIGNIFICANCE STATEMENT Here we used magnetic resonance imaging and transcranial magnetic stimulation of the precentral motor hand knob to test for a link among cortical myelin content, functional corticomotor representations, and manual motor control. A higher myelin content of the precentral motor hand knob was associated with more rostral corticomotor presentations, with stronger task-related activation and a higher precision of movement timing during a visuomotor synchronization task. We propose that a high precentral myelin content enables fast and precise neuronal integration in M1 (primary motor cortex) and dorsal premotor cortex, resulting in higher temporal precision during dexterous hand use. Our results identify the degree of myelination as an important structural feature of the neocortex that is tightly linked to the function and behavior supported by the cortical area.     

Speech planning and execution in children who stutter: Preliminary findings from a fNIRS investigation

Few studies have investigated the neural mechanisms underlying speech production in children who stutter (CWS), despite the critical importance of understanding these mechanisms closer to the time of stuttering onset. The relative contributions of speech planning and execution in CWS therefore are also unknown. Using functional near-infrared spectroscopy, the current study investigated neural mechanisms of planning and execution in a small sample of 9–12 year-old CWS and controls (N = 12) by implementing two tasks that manipulated speech planning and execution loads. Planning was associated with atypical activation in bilateral inferior frontal gyrus and right supramarginal gyrus. Execution was associated with atypical activation in bilateral precentral gyrus and inferior frontal gyrus, as well as right supramarginal gyrus and superior temporal gyrus. The CWS exhibited some activation patterns that were similar to the adults who stutter (AWS) as reported in our previous study: atypical planning in frontal areas including left inferior frontal gyrus and atypical execution in fronto-temporo-parietal regions including left precentral gyrus, and right inferior frontal, superior temporal, and supramarginal gyri. However, differences also emerged. Whereas CWS and AWS both appear to exhibit atypical activation in right inferior and supramarginal gyri during execution, only CWS appear to exhibit this same pattern during planning. In addition, the CWS appear to exhibit atypical activation in left inferior frontal and right precentral gyri related to execution, whereas AWS do not. These preliminary results are discussed in the context of possible impairments in sensorimotor integration and inhibitory control for CWS.     

An event-related potential study on the time course of mental rotation in upper-limb amputees

Objective

Mental rotation of body parts involves sequential cognitive processes, including visual processing, categorization and the mental rotation process itself. However, how these processes are affected by the amputation of a limb is still unclear.

Vertebroplasty and kyphoplasty under dual guidance (CT and fluoroscopy): radiation dose to radiologist. A comparative study

Objectives

The goals of this study is to evaluate and compare the irradiation received by the practitioner when performing percutaneous vertebroplasty or kyphoplasty guided by CT and fluoroscopy, for precise anatomical sites.

Methods

For each intervention, radiothermoluminescent dosimeters were carefully positioned on both orbitals, both hands, and both ankles of the practitioner.

Results

Twenty-four vertebroplasties were performed in 18 patients and nine kyphoplasties on seven patients. The anatomical site that is most exposed to radiation is the right hand. The two other sites subjected to irradiation are the left hand and the left orbital. This study demonstrates a significant correlation between the irradiation dose and fluoroscopy duration, reflecting both the quantity of primary-beam radiation and backscattered radiation.

Conclusion

The radiation dose to radiologist is more important for kyphoplasty procedures than vertebroplasty.     

Asymmetric spatiotemporal patterns of event-related desynchronization preceding voluntary sequential finger movements: a high-resolution EEG study.

OBJECTIVE: To study spatiotemporal patterns of event-related desynchronization (ERD) preceding voluntary sequential finger movements performed with dominant right hand and nondominant left hand. METHODS: Nine subjects performed self-paced movements consisting of three key strokes with either hand. Subjects randomized the laterality and timing of movements. Electroencephalogram (EEG) was recorded from 122 channels. Reference-free EEG power measurements in the beta band were calculated off-line. RESULTS: During motor preparation (-2 to -0.5s with respect to movement onset), contralateral preponderance of event-related desynchronization (ERD) (lateralized power) was only observed during right hand finger movements, whereas ERD during left hand finger movements was bilateral. CONCLUSIONS: For right-handers, activation on the left hemisphere during left hand movements is greater than that on the right hemisphere during right hand movements. SIGNIFICANCE: We provide further evidence for motor dominance of the left hemisphere in early period of motor preparation for complex sequential finger movements.     

Timing speech: a review of lesion and neuroimaging findings

Time is a fundamental dimension of behavior and as such underlies the perception and production of speech. This paper reviews patient and neuroimaging studies that investigated brain structures that support temporal aspects of speech. The left-frontal cortex, the basal ganglia, and the cerebellum represent structures that have been implicated repeatedly. A comparison with the structures involved in the timing of non-speech events (e.g., tones, lights, finger movements) suggests both commonalities and differences: while the basal ganglia and the cerebellum contribute to the timing of speech and non-speech events, the contribution of left-frontal cortex seems to be specific to speech or rapidly changing acoustic information. Motivated by these commonalities and differences, this paper presents assumptions about the function of basal ganglia, cerebellum, and cortex in the timing of speech.     

Intermittent bilateral coherence in physiological and essential hand tremor

Objective

To investigate the prevalence and the temporal structure of bilateral coherence in physiological (PT) and essential (ET) hand tremor.

Oscillatory interaction between the hand area of human primary motor cortex and finger muscles during steady-state isometric contraction

Objective

To compare the magnitudes of β-band coherence between the primary motor cortex (M1) and electromyogram (EMG) for finger muscles, and to determine whether M1–EMG coherence is related to the stability of muscle contraction.

Methods

Cortical signals and EMG during steady-state isometric contraction of right thumb muscle (flexor pollicis brevis (FPB)) or right little finger muscle (flexor digiti minimi brevis (FDMB)) were recorded simultaneously with magnetoencephalography system from 13 right-handed healthy subjects.

Results

The magnitudes of β-band M1–EMG coherence and spectral power in the M1 for the FPB muscle were greater than that for the FDMB muscle (P < 0.001 and P < 0.005, respectively). The stability of EMG for the FPB was higher than that for FDMB (P < 0.001). Greater levels of β-band M1–EMG coherence were associated with higher levels of EMG stability (P < 0.05). The mean dipole sources of the FPB muscle were located more laterally, inferiorly and anteriorly than that of FDMB in the M1 hand area (P < 0.005).

Conclusions

The strength of β-band M1–EMG coherence would play an important role in the stability level of finger-muscle contraction.

Significance

The β-band M1–EMG coherence may reflect effective oscillatory interaction between the M1 and finger muscle during steady-state motor output.     

Comparison of unilateral and bilateral complex finger tapping-related activation in premotor and primary motor cortex

Sixteen healthy right-handed subjects performed a complex finger-tapping task that broadly activates the motor and premotor regions, including primary motor (M1), ventral premotor (PMv), and dorsal premotor (PMd) cortex. This task was performed with the right hand only, left hand only and both hands simultaneously. Behavioral performance and the possibility of mirror movements were controlled through the use of MRI-compatible gloves to monitor finger movements. Using spatially normalized ROIs from the Human Motor Area Template (HMAT), comparisons were made of the spatial extent and location of activation in the left and right motor regions between all three tasks. During unilateral right and left hand tapping, ipsilateral precentral gyrus activation occurred in all subjects, mainly in the PMv and PMd. Ipsilateral M1 activation was less consistent and shifted anteriorly within M1, towards the border of M1 and premotor cortex. Regions of ipsilateral activation were also activated during contralateral and bilateral tasks. Overall, 83%/70%/58% of the ipsilaterally activated voxels in M1/PMd/PMv were also activated during contralateral and bilateral tapping. The mean percent signal change of spatially overlapping activated voxels was similar in PMv and PMd between all three tasks. However, the mean percent signal change of spatially overlapping M1 activation was significantly less during ipsilateral tapping compared with contra- or bilateral tapping. Results suggest that the ipsilateral fMRI activation in unilateral motor tasks may not be inhibitory in nature, but rather may reflect part of a bilateral network involved in the planning and/or execution of tapping in the ipsilateral hand.     

Spatio-motor cueing in unilateral left neglect: the role of hemispace, hand and motor activation.

Reported beneficial effects of left arm activation on neglect are experimentally examined. The present study of a subject with left visual neglect compared left hand finger movement with an instruction to visually anchor perception on the left arm during letter cancellation. Only the finger movements significantly reduced neglect. Another comparison was between "out of sight" finger movements of the left hand in left and right hemispace, respectively. Only left hemispace "blind" finger movements significantly reduced neglect compared to the standard condition. Thirdly, blind left finger movements in left hemispace were compared with passive visual cueing (reading a changing number) and again it was found that only the finger movements reduced neglect. Finally, right finger movements in left hemispace were compared with left finger movements in left hemispace: only the latter reduced neglect. The implications of these findings for theory and therapy of neglect are discussed.     

Movement related cortical potentials of cued versus self-initiated movements: double dissociated modulation by dorsal premotor cortex versus supplementary motor area rTMS

The dorsal premotor cortex (PMd) is thought to play a significant role in movement preparation cued by sensory information rather than in self-initiated movements. The evidence in humans for this contention is still circumstantial. Here we explored the effects of modulation of PMd by excitability decreasing 1 Hz repetitive transcranial magnetic stimulation (rTMS) versus excitability increasing 5 Hz rTMS on two forms of movement related cortical potentials: contingent negative variation (CNV) versus Bereitschaftspotential (BP) reflecting externally cued versus self-triggered movement preparation. Ten healthy right-handed subjects performed visually cued or self-triggered simple sequential finger movements with their right hand. CNV and BP were recorded by 25 EEG electrodes covering the fronto-centro-parietal cortex and divided into an early (1500-500 ms before a go-signal or movement onset) and a late potential (500-0 ms). MRI-navigated 1 Hz rTMS of the left PMd resulted in significant increase of the late CNV over the left central region predominantly contralateral to the prepared right hand movement, while 5 Hz rTMS had no effect on CNV. In contrast, 1 and 5 Hz rTMS did not modify BP. Control experiments of 1 Hz rTMS of the supplementary motor area (SMA) and of low-intensity 1 Hz rTMS of the left primary motor cortex did not change CNV, but 1 Hz SMA-rTMS increased late BP. This double dissociation of effects of PMd-rTMS versus SMA-rTMS on CNV versus BP provides direct evidence that the left PMd in humans is more involved in preparatory processes of externally cued rather than self-initiated movements, contrasting with an opposite role of the SMA.     

Continuous theta-burst stimulation over the dorsal premotor cortex interferes with associative learning during object lifting

When lifting objects of different mass, humans scale grip force according to the expected mass. In this context, humans are able to associate a sensory cue, such as a colour, to a particular mass of an object and link this association to the grip forces necessary for lifting. Here, we study the role of the dorsal premotor cortex (PMd) in setting-up an association between a colour cue and a particular mass to be lifted. Healthy right-handed subjects used a precision grip between the index finger and thumb to lift two different masses. Colour cues provided information about which of the two masses subjects would have to lift. Subjects first performed a series of lifts with the right hand to establish a stable association between a colour cue and a mass, followed by 20 sec of continuous high frequency repetitive trancranial magnetic stimulation using a recently developed protocol (continuous theta-burst stimulation, cTBS) over (i) the left primary motor cortex, (ii) the left PMd and (iii) the left occipital cortex to be commenced by another series of lifts with either the right or left hand. cTBS over the PMd, but not over the primary motor cortex or O1, disrupted the predictive scaling of isometric finger forces based on colour cues, irrespective of whether the right or left hand performed the lifts after the stimulation. Our data highlight the role of the PMd to generalize and maintain associative memory processes relevant for predictive control of grip forces during object manipulation.     

Left hemispheric breakdown of LTP-like cortico-cortical plasticity in schizophrenic patients

Objective

Altered cortical connectivity and plasticity seems to be asymmetrical between the hemispheres in patients with schizophrenia (SCZ). We evaluated long-term potentiation (LTP) in parietal-frontal circuits of both hemispheres using a cortico-cortical Paired Associative Stimulation (cc-PAS) protocol testing the rules of Hebbian-like spike timing dependent plasticity (SPTD).