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Vocal Motor Disorders *
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
Aprosodia may be defined as a motor vocalization dysfunction in which there is loss of audible emotional expression. It refers to inability to express moods nonverbally (i.e., with a musical, expressive quality), lacking the musical quality (pitch variations, volume, emphasis, pacing changes) that usually communicates mood, reaction, social expectation, desire to influence others, and so forth. Thus, aprosodia is a mismatch between verbal expressions of experienced emotional distress, and the intensity and quality of overt expression of feelings. It is differentiable from indifference, the inability to experience feelings deeply, or anhedonia.
Variability of clinical syndromes and cerebral glucose metabolism in symptomatic frontotemporal lobar degeneration associated with progranulin mutations
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2020
Abigail Licata, Timo Grimmer, Juliane Winkelmann, Matias Wagner, Oliver Goldhardt, Lina Riedl, Carola Roßmeier, Igor Yakushev, Janine Diehl-Schmid
Furthermore, a few pathology studies have shown a predominant atrophy of the frontal lobes with mild-to-moderate involvement of the temporal and parietal lobes (22). Pathological case reports (23) and studies (24) have also stressed an overt parietal lobe involvement in GRN + FTLD. Hence, the question arises, if GRN + patients are correctly subsumed under the term “frontotemporal lobar degeneration”. It bears the danger that parietal lobe function is not comprehensively assessed and therefore underrated. This potential oversight of the parietal lobe may occur particularly when the right parietal lobe is affected. Contrary to the deficits that are typical for left-sided parietal lesions and that not only can be identified in neuropsychological testing but also impair every day functioning (aphasia, agnosia, apraxia), deficits of right parietal lesions (spatial agnosia, sensory neglect, aprosodia (25)) are clinically less salient. They might be overlooked and/or not assessed, when routine neuropsychological testing is performed instead of comprehensive test batteries that include, for example, more challenging tasks of visuospatial functioning, like the Rey Osterrieth complex figure.
Developments in treating the nonmotor symptoms of stroke
Published in Expert Review of Neurotherapeutics, 2020
Impairments in expression or recognition of emotion through variations in tone, rate, rhythm, and loudness of voice (prosody) are even more frequent (about 21%) than hemispatial neglect (about 18%) after right hemisphere stroke [63], although the prevalence varies widely, depending on how these deficits are identified and the age of the population. The spectrum of deficits in emotional communication is often underestimated and under-recognized. While some of these disturbances are specific to negative emotions (e.g. fear and disgust) after right temporal-insular stroke [64] or amygdala stroke [65], they usually affect recognition and/or expression of all emotions. There have been very few trials of treatment to improve prosody comprehension or production, but one trial showed promise of behavioral treatment to improve the production of emotional prosody [66]. A recent study indicated that impaired emotional prosody expression and recognition (aprosodia) can be caused by impairment in knowing how an emotion (e.g. sad) ‘should’ sound. Right hemisphere stroke patients with this deficit often improved by cues to reestablish this abstract knowledge (e.g. sad: low-pitched, quiet, slow, monotone) [67]. These behavioral treatments require further investigation, and might be augmented by tDCS.
Does Music Matter? A Look at the Issues and the Evidence
Published in Developmental Neuropsychology, 2019
Evidence for functional overlap comes from many studies of healthy as well as clinical populations. For examples of the former, in college students, structural equation modeling reveals a strong correlation (r = .61) between melody perception and pitch perception in speech, independent of cognitive ability (Morrill, McAuley, Dilley, & Hambrick, 2015); and in adults, the recognition of “musical syntax,” defined as harmonically inappropriate chords within a major-minor tonal context, is processed in Broca’s region in the left hemisphere (Maess, Koelsch, Gunter, & Friederici, 2001). Clinical examples include two conditions associated with right-hemisphere stroke: “acquired aprosodia” (Gorelick & Ross, 1987) and “acquired amusia” (McChesney-Atkins, Davies, Montouris, Silver, & Menkes, 2003), in the first case with deficits in the emotional content of speech, in the second case in musical ability. An example of the latter is a singer who, following a right-hemisphere cerebral infarction involving the territory of the middle cerebral artery, including temporal cortex, could still sing in rhythm but had difficulty with pitch (Murayama, Kashiwagi, Kashiwagi, & Mimura, 2004; see also Ayotte, Peretz, Rousseau, Bard, & Bojanowski, 2000; Tramo, Shah, & Braida, 2002).