speech
Research Papers
Mapping typical and hypokinetic dysarthric speech production network using a connected speech paradigm in functional MRI
We developed a task paradigm whereby subjects spoke aloud while minimizing head motion during functional MRI (fMRI) in order to better understand the neural circuitry involved in motor speech disorders due to dysfunction of the central nervous system. To validate our overt continuous speech paradigm, we mapped the speech production network (SPN) in typical speakers (n = 19, 10 females) and speakers with hypokinetic dysarthria as a manifestation of Parkinson disease (HKD; n = 21, 8 females) in fMRI. We then compared it with the SPN derived during overt speech production by 15O-water PET in the same group of typical speakers and another HKD cohort (n = 10, 2 females). The fMRI overt connected speech paradigm did not result in excessive motion artifacts and successfully identified the same brain areas demonstrated in the PET studies in the two cohorts. The SPN derived in fMRI demonstrated significant spatial overlap with the corresponding PET derived maps (typical speakers: r = 0.52; speakers with HKD: r = 0.43) and identified the components of the neural circuit of speech production belonging to the feedforward and feedback subsystems. The fMRI study in speakers with HKD identified significantly decreased activity in critical feedforward (bilateral dorsal premotor and motor cortices) and feedback (auditory and somatosensory areas) subsystems replicating previous PET study findings in this cohort. These results demonstrate that the overt connected speech paradigm is feasible during fMRI and can accurately localize the neural substrates of typical and disordered speech production. Our fMRI paradigm should prove useful for study of motor speech and voice disorders, including stuttering, apraxia of speech, dysarthria, and spasmodic dysphonia.
View Full Paper →The Relative Efficacy of Connectivity Guided and Symptom Based EEG Biofeedback for Autistic Disorders
Autism is a neurodevelopmental disorder characterized by deficits in communication, social interaction, and a limited range of interests with repetitive stereotypical behavior. Various abnormalities have been documented in the brains of individuals with autism, both anatomically and functionally. The connectivity theory of autism is a recently developed theory of the neurobiological cause of autisic symptoms. Different patterns of hyper- and hypo-connectivity have been identified with the use of quantitative electroencephalogray (QEEG), which may be amenable to neurofeedback. In this study, we compared the results of two published controlled studies examining the efficacy of neurofeedback in the treatment of autism. Specifically, we examined whether a symptom based approach or an assessment/connectivity guided based approach was more effective. Although both methods demonstrated significant improvement in symptoms of autism, connectivity guided neurofeedback demonstrated greater reduction on various subscales of the Autism Treatment Evaluation Checklist (ATEC). Furthermore, when individuals were matched for severity of symptoms, the amount of change per session was significantly higher in the Coben and Padolsky (J Neurother 11:5–23, 2007) study for all five measures of the ATEC. Our findings suggest that an approach guided by QEEG based connectivity assessment may be more efficacious in the treatment of autism. This permits the targeting and amelioration of abnormal connectivity patterns in the brains of people who are autistic.
View Full Paper →EEG Neurofeedback Treatment of Patients with Down Syndrome
Down syndrome is the most common identifiable cause of intellectual disability, accounting for almost one third of cases and approximately 1 in 800 births. Neurofeedback (NF) is an operant conditioning method for retraining brain wave (EEG) patterns. An increasing number of clinicians use operant conditioning of EEG activity as a method of helping children with Attention Deficit Hyperactivity and Generalized Learning Disability (ADHD/ADD or GLDO). Some Down syndrome children display symptoms of ADHD/ADD, GLDO or both. We believed that NF may have potential in helping children with Down syndrome. Methodology: Eight children with Down Syndrome (ages 6-14) were evaluated through questionnaire, parent interview, and pre- and post-treatment quantitative EEG's. All eight children were seen by the first author and by the special educator at the baseline, and at the 20th, 40th and 60th treatment sessions. Pre-treatment QEEGs were analyzed using the NxLink normative database and generally showed excess delta and theta EEG patterns. None of the subjects were able to speak more than one word sentences and they had very limited vocabulary (between 5-10 words). They usually pointed a finger to communicate and were not able to engage in basic conversation. All children displayed very poor attention and concentration, poor memory, impulsivity, behavior problems, in some cases balance problems. The purpose of this preliminary study was to evaluate whether QEEG guided, bipolar montage NF training is effective in developing speech, improving attention and concentration, improving learning, decreasing behavioral problems or impulsivity, and alleviating balance problems in Down Syndrome children. All subjects were medication-free during treatment. NF training was conducted using Lexicor Biolex software with electrode placement guided by QEEG findings, seeking to normalize abnormal QEEG patterns. Training continued until the subjects demonstrated improvement and there were significant improvements in the reports of parents, or until a total of 60 treatment sessions were provided. Scores derived from a combination of questionnaire and parental ratings were obtained pre- and post-treatment in the areas of memory, speech and language, attention, behavior, and balance. Results. One subject dropped out after eight sessions. All seven children who completed NF training showed significant (p < .02) improvement in all areas evaluated based on the questionnaire and parent interviewing, and changes were found in QEEGs. Further study with a control group and additional outcome measures is warranted. © by The Haworth Press, Inc. All rights reserved.
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