Characterizing Subtypes and Neural Correlates of Receptive Aprosodia in Acute Right Hemisphere Stroke

Authors

Shannon M. Sheppard, Chapman UniversityFollow
Erin L. Meier, Johns Hopkins UniversityFollow
Alexandra Zezinka Durfee, Johns Hopkins UniversityFollow
Alex Walker, Johns Hopkins University
Jennifer Shea, Johns Hopkins University
Argye E. Hillis, Johns Hopkins UniversityFollow

Document Type

Article

Publication Date

4-24-2021

Abstract

Introduction: Speakers naturally produce prosodic variations depending on their emotional state. Receptive prosody has several processing stages. We aimed to conduct lesion-symptom mapping to determine whether damage (core infarct or hypoperfusion) to specific brain areas was associated with receptive aprosodia or with impairment at different processing stages in individuals with acute right hemisphere stroke. We also aimed to determine whether different subtypes of receptive aprosodia exist that are characterized by distinctive behavioral performance patterns.

Methods: Twenty patients with receptive aprosodia following right hemisphere ischemic stroke were enrolled within five days of stroke; clinical imaging was acquired. Participants completed tests of receptive emotional prosody, and tests of each stage of prosodic processing (Stage 1: acoustic analysis; Stage 2: analyzing abstract representations of acoustic characteristics that convey emotion; Stage 3: semantic processing). Emotional facial recognition was also assessed. LASSO regression was used to identify predictors of performance on each behavioral task. Predictors entered into each model included 14 right hemisphere regions, hypoperfusion in four vascular territories as measured using FLAIR hyperintense vessel ratings, lesion volume, age, and education. A k-medoid cluster analysis was used to identify different subtypes of receptive aprosodia based on performance on the behavioral tasks.

Results: Impaired receptive emotional prosody and impaired emotional facial expression recognition were both predicted by greater percent damage to the caudate. The k-medoid cluster analysis identified three different subtypes of aprosodia. One group was primarily impaired on Stage 1 processing and primarily had frontotemporal lesions. The second group had a domain-general emotion recognition impairment and maximal lesion overlap in subcortical areas. Finally, the third group was characterized by a Stage 2 processing deficit and had lesion overlap in posterior regions.

Conclusions: Subcortical structures, particularly the caudate, play an important role in emotional prosody comprehension. Receptive aprosodia can result from impairments at different processing stages.

Comments

NOTICE: this is the author’s version of a work that was accepted for publication in Cortex. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Cortex, volume 141, in 2021. https://doi.org/10.1016/j.cortex.2021.04.003

The Creative Commons license below applies only to this version of the article.

Recommended Citation

Sheppard SM, Meier EL, Zezinka Durfee A, Walker A, Shea J, Hillis AE. Characterizing subtypes and neural correlates of receptive aprosodia in acute right hemisphere stroke. Cortex. 2021;141:36-54. https://doi.org/10.1016/j.cortex.2021.04.003

Peer Reviewed

1

Copyright

Elsevier

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.