Brain changes underlying progression of speech motor programming impairment

Aquired apraxia of speech is a disorder that impairs speech production, despite intact peripheral neuromotor function. Its pathomechanism remains to be established. Neurodegenerative lesion models provide an unequalled opportunity to explore the neural correlates of apraxia of speech, which is present in a subset of patients diagnosed with non-semantic variants of primary progressive aphasia. The normalised pairwise variability index, an acoustic measure of speech motor programming, has shown high sensitivity and specificity for apraxia of speech in cross-sectional studies. Here, we aimed to examine the strength of the pairwise variability index and overall word duration (i.e. articulation rate) as markers of progressive motor programming deficits in primary progressive aphasia with apraxia of speech. Seventy-nine individuals diagnosed with primary progressive aphasia (39 with non-fluent variant, 40 with logopenic variant) and 40 matched healthy controls participated. Patients were followed-up annually (range 1–6 years, median number of visits = 2). All participants completed a speech assessment task and a high-resolution MRI. Our analyses investigated trajectories of speech production (e.g. pairwise variablity index and word duration) and associations with cortical atrophy in the patients. At first presentation, word duration differentiated the nonfluent and logopenic cases statistically, but the range of scores overlapped substantially across groups. Longitudinally, we observed progressive deterioration in pairwise variability index and word duration specific to the non-fluent group only. The pairwise variability index showed particularly strong associations with progressive atrophy in speech motor programming brain regions. Of novelty, our results uncovered a key role of the right frontal gyrus in underpinning speech motor programming changes in non-fluent cases, highlighting the importance of right brain regions in responding to progressive neurological changes in the speech motor network. Taken together, our findings validate the use of a new metric, the pairwise variability index, as a robust marker of apraxia of speech in contrast to more generic measures of speaking rate. Sensitive/specific neuroimaging biomarkers of the emergence and progression of speech impairments will be useful to inform theories of the pathomechanisms underpinning impaired speech motor control. Our findings justify developing more sensitive measures of rhythmic temporal control of speech that may enable confident detection of emerging speech disturbances and more sensitive tracking of intervention-related changes for pharmacological, neuromodulatory, and behavioural interventions. A more reliable detection of speech disturbances has relevance for patient care, with predominance of progressive apraxia of speech a high-risk factor for later diagnosis of progressive supranuclear palsy or corticobasal degeneration.

The Psychology of Reaching: Action Selection, Movement Implementation, and Sensorimotor Learning

The study of motor planning and learning in humans has undergone a dramatic transformation in the 20 years since this journal's last review of this topic. The behavioral analysis of movement, the foundational approach for psychology, has been complemented by ideas from control theory, computer science, statistics, and, most notably, neuroscience. The result of this interdisciplinary approach has been a focus on the computational level of analysis, leading to the development of mechanistic models at the psychological level to explain how humans plan, execute, and consolidate skilled reaching movements. This review emphasizes new perspectives on action selection and motor planning, research that stands in contrast to the previously dominant representation-based perspective of motor programming, as well as an emerging literature highlighting the convergent operation of multiple processes in sensorimotor learning.

The impact of co-occurring communicative impairments on the understandability of atypical speakers’ talk

Contributing to conversation analytic research into ‘atypical interaction’ (i.e. naturally-occurring interactions involving one or more participants with a communication disorder), this paper focuses on talk by individuals who present with both aphasic (language) impairments and other communicative impairments (motor, motor programming or cognitive in nature). It shows how, in three such cases, the co-occurring impairments may each contribute to turns at talk by the atypical speaker which are particularly problematic in terms of their understandability. In each case these trouble source turns result in (1) the production of other-initiations of repair by the recipient which are ‘off track’, and (2) repair sequences which are notably prolonged. This type of investigation fills a gap in existing atypical interaction research where most analysis has focused on the impact of individual communicative impairments on talk-in-interaction.

MOTOR PROGRAMMING PREDICTS THE FUNCTIONAL RECOVERY GAIN IN PATIENTS WITH RIGHT HEMISPHERIC FRONTAL STROKE

Executive functioning significantly affects the functional rehabilitation progress in stroke patients. The current study are aimed to examine the impact of executive functions on functional recovery gain in a sample of right hemispheric (RH) frontal stroke patients. A total of 50 inpatients admitted to the Theseus Rehabilitation Center and diagnosed with RH frontal stroke were included in this study. The initial assessment of executive functioning was conducted using the Frontal Assessment Battery (FAB). Functional recovery of basic activities of daily living (ADLs) was computed by the difference between follow-up and baseline Barthel Index (BI) scores. Pearson’s analysis revealed that the FAB global scores significantly correlated with the BI gain scores. Additionally, multiple regression analysis showed a significant contribution of only motor programming to the basic ADLs recovery gain. The global status of executive function was found to be significantly associated with functional recovery gain, and motor programming was the strongest predictor in RH frontal stroke patients. These findings are discussed for the treatment rehabilitation prognosis.

Speech Intervention Effects for Childhood Apraxia of Speech: Quality Appraisal of Systematic Reviews

Purpose A number of justification have examined the effects of speech interventions on outcomes in childhood apraxia of speech (CAS). The findings have been summarized in the form of systematic reviews (SRs) and meta-analyses, which are used to support evidence-based clinical practice decisions. Yet without acceptable rigor, SRs/meta-analyses may be biased in their recommendations. We appraised the quality of existing SRs for CAS treatment using a tool developed within epidemiology, the AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews). Method A search of five databases to identify published SRs that coalesced treatment research for CAS revealed six systematic reviews that met inclusion criteria. Two examiners coded each article with the AMSTAR-2 to rate the methodologic rigor of the SRs and extracted summary data. Results One rigorous systematic review included only one randomized controlled trial. A second moderately rigorous review examined multiple single participant research designs. The weight of high-quality evidence supported the positive effects of motor programming treatments for children with CAS. Conclusions Findings of six systematic reviews, two of which were conducted with relative rigor, suggest that motor programming treatments have the best evidence base for treatment decisions pertaining to CAS. Clinicians are referred to online resources to implement these treatments according to published protocols.

Dissociation between phonological working memory structures and motor programming units during speech motor-sequence learning

Purpose: This study investigated the nature of phonological working memory (PWM) structures and speech motor programming units by examining how performance gains from practicing non-native phoneme sequences generalize to novel sequences that overlap to varying degrees with the practiced sequences.Method: CCVCC words were constructed using consonant clusters that violated English phonological constraints, thus making them difficult to produce initially. After practicing a subset of the words over two consecutive days, participants were tested on the production of several types of word pairs, including novel words containing unpracticed clusters, practiced cluster words containing consonant clusters that were practiced but in different words from the test words, and fully learned words that were practiced in their entirety.Results: Utterance duration improvements from practicing clusters in one syllabic context fully transferred to novel words that included these clusters, while error rate improvements from practicing clusters in one syllabic context only partially generalized to new syllables utilizing these practiced clusters. Additionally, error rates for the first word in the pair (which depend primarily on motor program structure) showed partial improvements for learned clusters regardless of whether the cluster was practiced in the same part of the syllabic frame (onset or coda), whereas error rates for the second word (which reflect both PWM and motor programming mechanisms) were higher than even novel words if the cluster was practiced in the wrong syllable frame location, presumably due to interference effects in PWM. Conclusions: These results provide support for an onset-nucleus-coda syllabic frame structure in PWM and a syllable-frame-independent representation of common phoneme sub-sequences for motor programs.

A-Na(d) tayaSati Hubungan Anapanasati (Nafas Buddha) di dalam Struktur Tari Klasik Thailand

RingkasanA-Na(d)tayaSati adalah penciptaan karya tari dengan menyatukan prinsip hubungan Anapanasati (napas Buddha) dengan struktur gerak tari klasik Thailand. Tujuan penciptaan agar bisa mengarah pada salah satu bentuk atau metode gerakan tari Thailand yang berfokus pada penggunaan napas sebagai landasan struktur gerakan independen, alami, dengan mengambil kekuatan energi dari dalam ke luar. Hal ini untuk membuat gerakan tersebut bertahan lama sehingga bisa bergerak dalam jangka waktu yang lebih lama, dan merupakan gerak yang tenang melalui meditasi yang alami, tanpa memaksa tubuh. Karya ini bertujuan pula untuk menciptakan gerakan lain dalam tarian Thailand yang konsisten dengan doktrin Buddha, yang sadar akan jangkauannya saat ini dan alami melalui latihan dan kesadaran diri. Dengan menerapkan prinsip-prinsip meditasi dalam bentuk Anapanasati dan teori gerakan tubuh sesuai dengan (teori Pemrograman Motor) dalam anatomi untuk menemukan hubungan dari gerakan tari klasik Thailand yang memberikan arti penting bagi gerakan dengan napas penari. Proses penciptaan hubungan Anapanasati (Napas Buddha) dengan struktur gerak tari klasik Thailand, sebagai pengakuan adanya gerakan baru yang memiliki energi aerobik (Aerobic system) yang beredar sepanjang waktu. Hal ini merupakan sistem tubuh yang menggunakan oksigen untuk membakar sepenuhnya dan terbentuk sebagai energi yang berkelanjutan dan damai dari dalam tubuh yang disebabkan oleh meditasi dengan metode pernapasan sambil melalukan gerakan tari klasik Thailand. Selain itu, tubuh tetap memiliki postur yang jelas, kuat dan unik dengan struktur gerakan tari klasik Thailand namun menjadi lebih ringan, lebih nyaman dan lebih alami. Energi dari napas masuk dan ke luar itu membuat gerakan menjadi terus-menerus, tanpa akhir, tanpa masalah kelelahan dan kontraksi otot saat bergerak ketika menari.AbstractThe dance work creation with the principle of the relationship of Anapanasati (Buddha's breath) in the structure of the classical Thai dance movement. In the aim of being able to lead to one form or method of Thai dance movements that focuses on the use of breath as a foundation for the structure of independent movements, natural, and take energy from the inside to outside. This makes the movement very durable so that it can move for a longer period of time and is a quiet movement through natural meditation, without force. To create another movement in Thai dance that is consistent with Buddhist doctrine, which is aware of its current and natural reach through practice and self-awareness. By applying the principles of meditation in the form of Anapanasati and the theory of appropriate body movements (Motor Programming theory) in anatomy to find the connection of classical dance movements Thailand which gives importance mean to movement with the breath of dancers. The process of creating Anapanasati (Buddha's Breath) with the movement structure of the Thai classical dance as recognition of a new movement that has an aerobic system circulating around the time. This is a body system that uses oxygen to burn completely and is formed as a continuous and peaceful energy from the inside caused by meditation with the breathing method while moving the Thai classical dance movement. Besides that, the body still has a clear and strong posture that is unique with the structure of Thai classical dance movements such as lighter, more comfortable and more natural. The energy of in and out breath makes the movement become continuous, endless, without a problem of fatigue and muscle contraction during movements in the dance.