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Cognitive deficits often accompany language impairments post-stroke. Past research has focused on working memory in aphasia, but attention is largely underexplored. Therefore, this dissertation will first quantify attention deficits post-stroke before investigating whether preserved cognitive abilities, including attention, can improve auditory sentence comprehension post-stroke. In Experiment 1a, three components of

Cognitive deficits often accompany language impairments post-stroke. Past research has focused on working memory in aphasia, but attention is largely underexplored. Therefore, this dissertation will first quantify attention deficits post-stroke before investigating whether preserved cognitive abilities, including attention, can improve auditory sentence comprehension post-stroke. In Experiment 1a, three components of attention (alerting, orienting, executive control) were measured in persons with aphasia and matched-controls using visual and auditory versions of the well-studied Attention Network Test. Experiment 1b then explored the neural resources supporting each component of attention in the visual and auditory modalities in chronic stroke participants. The results from Experiment 1a indicate that alerting, orienting, and executive control are uniquely affected by presentation modality. The lesion-symptom mapping results from Experiment 1b associated the left angular gyrus with visual executive control, the left supramarginal gyrus with auditory alerting, and Broca’s area (pars opercularis) with auditory orienting attention post-stroke. Overall, these findings indicate that perceptual modality may impact the lateralization of some aspects of attention, thus auditory attention may be more susceptible to impairment after a left hemisphere stroke.

Prosody, rhythm and pitch changes associated with spoken language may improve spoken language comprehension in persons with aphasia by recruiting intact cognitive abilities (e.g., attention and working memory) and their associated non-lesioned brain regions post-stroke. Therefore, Experiment 2 explored the relationship between cognition, two unique prosody manipulations, lesion location, and auditory sentence comprehension in persons with chronic stroke and matched-controls. The combined results from Experiment 2a and 2b indicate that stroke participants with better auditory orienting attention and a specific left fronto-parietal network intact had greater comprehension of sentences spoken with sentence prosody. For list prosody, participants with deficits in auditory executive control and/or short-term memory and the left angular gyrus and globus pallidus relatively intact, demonstrated better comprehension of sentences spoken with list prosody. Overall, the results from Experiment 2 indicate that following a left hemisphere stroke, individuals need good auditory attention and an intact left fronto-parietal network to benefit from typical sentence prosody, yet when cognitive deficits are present and this fronto-parietal network is damaged, list prosody may be more beneficial.
ContributorsLaCroix, Arianna (Author) / Rogalsky, Corianne (Thesis advisor) / Azuma, Tamiko (Committee member) / Braden, B. Blair (Committee member) / Liss, Julie (Committee member) / Arizona State University (Publisher)
Created2019
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Description

The distinctions between the neural resources supporting speech and music comprehension have long been studied using contexts like aphasia and amusia, and neuroimaging in control subjects. While many models have emerged to describe the different networks uniquely recruited in response to speech and music stimuli, there are still many questions,

The distinctions between the neural resources supporting speech and music comprehension have long been studied using contexts like aphasia and amusia, and neuroimaging in control subjects. While many models have emerged to describe the different networks uniquely recruited in response to speech and music stimuli, there are still many questions, especially regarding left-hemispheric strokes that disrupt typical speech-processing brain networks, and how musical training might affect the brain networks recruited for speech after a stroke. Thus, our study aims to explore some questions related to the above topics. We collected task-based functional MRI data from 12 subjects who previously experienced a left-hemispheric stroke. Subjects listened to blocks of spoken sentences and novel piano melodies during scanning to examine the differences in brain activations in response to speech and music. We hypothesized that speech stimuli would activate right frontal regions, and music stimuli would activate the right superior temporal regions more than speech (both findings not seen in previous studies of control subjects), as a result of functional changes in the brain, following the left-hemispheric stroke and particularly the loss of functionality in the left temporal lobe. We also hypothesized that the music stimuli would cause a stronger activation in right temporal cortex for participants who have had musical training than those who have not. Our results indicate that speech stimuli compared to rest activated the anterior superior temporal gyrus bilaterally and activated the right inferior frontal lobe. Music stimuli compared to rest did not activate the brain bilaterally, but rather only activated the right middle temporal gyrus. When the group analysis was performed with music experience as a covariate, we found that musical training did not affect activations to music stimuli specifically, but there was greater right hemisphere activation in several regions in response to speech stimuli as a function of more years of musical training. The results of the study agree with our hypotheses regarding the functional changes in the brain, but they conflict with our hypothesis about musical expertise. Overall, the study has generated interesting starting points for further explorations of how musical neural resources may be recruited for speech processing after damage to typical language networks.

ContributorsKarthigeyan, Vishnu R (Author) / Rogalsky, Corianne (Thesis director) / Daliri, Ayoub (Committee member) / Harrington Bioengineering Program (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description

Aphasia is an impairment that affects many different aspects of language and makes it more difficult for a person to communicate with those around them. Treatment for aphasia is often administered by a speech-language pathologist in a clinical setting, but researchers have recently begun exploring the potential of virtual reality

Aphasia is an impairment that affects many different aspects of language and makes it more difficult for a person to communicate with those around them. Treatment for aphasia is often administered by a speech-language pathologist in a clinical setting, but researchers have recently begun exploring the potential of virtual reality (VR) interventions. VR provides an immersive environment and can allow multiple users to interact with digitized content. This exploratory paper proposes the design of a VR rehabilitation game –called Pact– for adults with aphasia that aims to improve the word-finding and picture-naming abilities of users to improve communication skills. Additionally, a study is proposed that will assess how well Pact improves the word-finding and picture-naming abilities of users when it is used in conjunction with speech therapy. If the results of the study show an increase in word-finding and picture-naming scores compared to the control group (patients receiving traditional speech therapy alone), the results would indicate that Pact can achieve its goal of promoting improvement in these domains. There is a further need to examine VR interventions for aphasia, particularly with larger sample sizes that explore the gains associated with or design issues associated with multi-user VR programs.

ContributorsGringorten, Rachel (Author) / Johnson, Mina (Thesis director) / Rogalsky, Corianne (Committee member) / English, Stephen (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / College of Health Solutions (Contributor) / School of Music, Dance and Theatre (Contributor)
Created2023-05
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Description
Previous research of impulse control disorders, common in adults with a diagnosis of Parkinson’s, were reviewed to determine possible links between impulse control disorders in in adults with aphasia. Aphasia is a disorder often caused by a stroke that can impact speech and language both receptively and expressively. Impulse control

Previous research of impulse control disorders, common in adults with a diagnosis of Parkinson’s, were reviewed to determine possible links between impulse control disorders in in adults with aphasia. Aphasia is a disorder often caused by a stroke that can impact speech and language both receptively and expressively. Impulse control disorders (ICDs) (i.e., pathological gambling, hypersexuality, compulsive eating and shopping, etc.) have drastic consequences and can cause harm to the individual affected as well as their caregivers and family. This study sought to identify if symptoms of ICDs are prevalent in adults with aphasia by utilizing self-report surveys and a Go/No-Go impulsivity computer task. The findings of this study indicate that some impulsive factors are significantly heightened in adults who have had a stroke when compared to healthy same-age peers and that these differences are perhaps best captured by the self-report surveys. Despite a large amount of literature on the impact of stroke and quality of life, this area of impulse control has remained largely unexplored. Further investigation is warranted for the prevalence of impulse control disorders in adults with aphasia, however, this study is a step forward into understanding how aphasia and stroke affect the quality of life of those impacted.
ContributorsMajors, Madilyn (Author) / Rogalsky, Corianne (Thesis advisor) / Trueba, Elizabeth (Committee member) / Azuma, Tamiko (Committee member) / Arizona State University (Publisher)
Created2023
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Description
Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost and low success rates. Therefore, the ability to make functionally

Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost and low success rates. Therefore, the ability to make functionally significant changes in individuals with severe post- stroke aphasia remains a key challenge for the rehabilitation community. This dissertation aimed to evaluate the efficacy of Startle Adjuvant Rehabilitation Therapy (START), a tele-enabled, low- cost treatment, to improve quality of life and speech in individuals with severe-to-moderate stroke. START is the exposure to startling acoustic stimuli during practice of motor tasks in individuals with stroke. START increases the speed and intensity of practice in severely impaired post-stroke reaching, with START eliciting muscle activity 2-3 times higher than maximum voluntary contraction. Voluntary reaching distance, onset, and final accuracy increased after a session of START, suggesting a rehabilitative effect. However, START has not been evaluated during impaired speech. The objective of this study is to determine if impaired speech can be elicited by startling acoustic stimuli, and if three days of START training can enhance clinical measures of moderate to severe post-stroke aphasia and apraxia of speech. This dissertation evaluates START in 42 individuals with post-stroke speech impairment via telehealth in a Phase 0 clinical trial. Results suggest that impaired speech can be elicited by startling acoustic stimuli and that START benefits individuals with severe-to-moderate post-stroke impairments in both linguistic and motor speech domains. This fills an important gap in aphasia care, as many speech therapies remain ineffective and financially inaccessible for patients with severe deficits. START is effective, remotely delivered, and may likely serve as an affordable adjuvant to traditional therapy for those that have poor access to quality care.
ContributorsSwann, Zoe Elisabeth (Author) / Honeycutt, Claire F (Thesis advisor) / Daliri, Ayoub (Committee member) / Rogalsky, Corianne (Committee member) / Liss, Julie (Committee member) / Schaefer, Sydney (Committee member) / Arizona State University (Publisher)
Created2022
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Description

Aphasia is an acquired speech-language disorder that is brought upon because of post-stroke damage to the left hemisphere of the brain. Treatment for individuals with these speech production impairments can be challenging for clinicians because there is high variability in language recovery after stroke and lesion size does not predict

Aphasia is an acquired speech-language disorder that is brought upon because of post-stroke damage to the left hemisphere of the brain. Treatment for individuals with these speech production impairments can be challenging for clinicians because there is high variability in language recovery after stroke and lesion size does not predict language outcome (Lazar et al, 2008). It is also important to note that adequate integration between the sensory and motor systems is critical for many aspects of fluent speech and correcting speech errors. The present study seeks to investigate how delayed auditory-feedback paradigms, which alter the time scale of sensorimotor interactions in speech, might be useful in characterizing the speech production impairments in individuals with aphasia. To this end, six individuals with aphasia and nine age-matched control subjects were introduced to delayed auditory feedback at 4 different intervals during a sentence reading task. Our study found that the aphasia group generated more errors in 3 out of the 4 linguistic categories measured across all delay lengths, but that there was no significant main effect delay or interaction between group and delay. Acoustic analyses revealed variability among scores within the control and aphasia groups on all phoneme types. For example, acoustic analyses highlighted how the individual with conduction aphasia showed significantly longer amplitudes at all delays, and significantly larger duration at no delay, but that significance diminished as delay periods increased. Overall, this study suggests that delayed auditory feedback’s effects vary across individuals with aphasia and provides a base of research to be further built on by future testing of individuals with varying aphasia types and levels of severity.

ContributorsPettijohn, Madilyn (Author) / Rogalsky, Corianne (Thesis director) / Daliri, Ayoub (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2022-05