13 research outputs found
RĂ©organisation neurocognitive et linguistique du langage et de la parole dans l'aphasie post-AVC. Approche interdisciplinaire
The language disorders that characterize post-stroke aphasia interfere with patientsâ communication abilities, with multiple impacts on daily life. There is considerable variability in the initial severity of language disorders, as well as the degree of speech and language recovery among patients. Moreover, the effectiveness of classical speech therapy methods decreases after a few months of application. In addition, socio-economic and medical factors are known to influence the management of patients in the chronic phase. Therefore, there are two essential steps towards advancing the treatment of patients with post-stroke aphasia. First, there is a need for a more thorough understanding of the neurocognitive mechanisms and factors influencing language representation and neuroplasticity in patients with post-stroke disorders. Second, new methods and programs for speech and language rehabilitation in patients with disorders following a brain injury need to be developed on the basis of these novel findings and adapted to long-term management.Following these requirements and in line with current theoretical models of speech production, the two main goals of this thesis are (i) to better understand the alteration of speech and language mechanisms in relation to other cognitive processes and the reorganization of the underlying brain networks and (ii) to propose new perspectives for speech and language rehabilitation. Specifically, we propose a new rehabilitation method based on technology that provides a realistic visual illustration of lingual and labial articulatory dynamics (the Ultraspeech-player software). We assume that adding visual information could improve the multisensory phonological representations on which motor planning and programming rely during speech production. This visual information could thus contribute to the reorganization of language networks and to the compensation of deficits observed in post-stroke non-fluent aphasia. Beyond developing a new method, we highlight the interest of applying rehabilitation programs combining at least two methods to increase the efficiency and speed of speech and language recovery.In the first part of this work, we focus on the role of determinants of initial severity and recovery of language and speech in patients with post-stroke aphasia. We show the importance of intensive rehabilitation in patients with severe aphasia following a frontal injury involving the inferior frontal gyrus. In addition, we argue that reinforcing phonological mechanisms through audio-visual training of speech would allow for optimal anatomo-functional reorganization of language networks.In the second part, we propose to supplement classical language and speech therapy with visually augmented rehabilitation (the Ultraspeech-player software). Our results suggest that this new rehabilitation program strengthens phonological representations and contributes to reorganizing language networks in patients with post-stroke aphasia.Taken together, the results of this thesis allow us to propose an experimental protocol that evaluates, at the group level, the efficiency of the augmented rehabilitation at the language, cognitive and cerebral levels. More precisely, in future studies, we aim to demonstrate in patients with non-fluent aphasia: (i) the effectiveness of visually augmented rehabilitation, compared to conventional speech therapy, and (ii) the effectiveness of a rehabilitation program combining several methods, compared to a single method. By including a control group of age-matched healthy participants, we will also provide new evidence of the effects of aging on cognitive mechanisms and the reorganization of speech and language brain networks.Les troubles langagiers qui caractĂ©risent lâaphasie post-AVC entravent les capacitĂ©s de communication des patients, avec des consĂ©quences multiples. Il existe une grande variabilitĂ© en termes de sĂ©vĂ©ritĂ© initiale des troubles langagiers et de degrĂ© de rĂ©cupĂ©ration du langage et de la parole chez ces patients. Par ailleurs, l'efficacitĂ© des mĂ©thodes de rĂ©Ă©ducation orthophonique classique diminue aprĂšs quelques mois dâapplication. De plus, nous savons que des facteurs socio-Ă©conomiques et mĂ©dico-sanitaires entravent la prise en charge des patients en phase chronique. Il nous semble donc Ă©vident quâil est nĂ©cessaire, dâune part, de mieux comprendre les mĂ©canismes neurocognitifs et les facteurs dĂ©terminants de la reprĂ©sentation du langage et de sa neuroplasticitĂ©, et dâautre part, de dĂ©velopper de nouvelles mĂ©thodes et des programmes de rĂ©Ă©ducation de la parole et du langage, adaptĂ©s Ă la prise en charge Ă long terme, pour les patients prĂ©sentant des troubles suite Ă une lĂ©sion cĂ©rĂ©brale.Dans cette thĂšse, nous nous plaçons dans le cadre des modĂšles thĂ©oriques actuels de production de la parole afin de (i) mieux comprendre lâaltĂ©ration des mĂ©canismes de parole et du langage, en lien avec dâautres processus cognitifs, et la rĂ©organisation des rĂ©seaux cĂ©rĂ©braux sous-jacents, et (ii) proposer de nouvelles perspectives pour la rĂ©Ă©ducation du langage et de la parole. ConcrĂštement, nous proposons une nouvelle mĂ©thode de rĂ©Ă©ducation sâappuyant sur une technologie offrant une illustration visuelle rĂ©aliste de la dynamique articulatoire linguale et labiale (le logiciel Ultraspeech-player). Nous supposons ainsi que lâajout dâinformations visuelles pourrait amĂ©liorer les reprĂ©sentations phonologiques multisensorielles, sur lesquelles sâappuient la planification et la programmation motrices lors de la production de parole, et pourrait ainsi contribuer Ă la rĂ©organisation des rĂ©seaux langagiers et Ă la compensation des dĂ©ficits observĂ©s dans lâaphasie non fluente post-AVC. Au-delĂ du dĂ©veloppement dâune nouvelle mĂ©thode, nous promouvons lâintĂ©rĂȘt dâappliquer des programmes de rĂ©Ă©ducation associant au moins deux mĂ©thodes pour augmenter lâefficacitĂ© et la rapiditĂ© de la rĂ©cupĂ©ration langagiĂšre.Dans la premiĂšre partie de ce travail, nous nous focalisons sur le rĂŽle des dĂ©terminants de la sĂ©vĂ©ritĂ© initiale et de la rĂ©cupĂ©ration du langage et de la parole chez des patients atteints d'aphasie post-AVC. Ainsi, nous montrons lâimportance du caractĂšre intensif de la rĂ©Ă©ducation chez les patients prĂ©sentant une aphasie sĂ©vĂšre, suite Ă une lĂ©sion frontale impliquant le gyrus frontal infĂ©rieur. Par ailleurs, nous proposons que le renforcement des mĂ©canismes phonologiques par un entraĂźnement audio-visuel de la parole permettrait une rĂ©organisation anatomo-fonctionnelle optimale des rĂ©seaux langagiers.Dans la seconde partie, nous proposons de complĂ©menter la rĂ©Ă©ducation orthophonique classique avec une rĂ©Ă©ducation augmentĂ©e visuellement (le logiciel Ultraspeech-player). Nos rĂ©sultats suggĂšrent que ce nouveau programme de rĂ©habilitation renforce les reprĂ©sentations phonologiques et contribue Ă la rĂ©organisation des rĂ©seaux langagiers chez les patients atteints d'aphasie post-AVC.Lâensemble de ces rĂ©sultats nous permet de proposer par la suite un protocole expĂ©rimental qui Ă©value, Ă l'Ă©chelle du groupe, l'efficacitĂ© sur les plans langagier, cognitif et cĂ©rĂ©bral de la rĂ©Ă©ducation renforcĂ©e. Plus prĂ©cisĂ©ment, nous souhaitons dĂ©montrer chez des patients prĂ©sentant une aphasie non fluente : lâefficacitĂ© de la rĂ©Ă©ducation visuellement augmentĂ©e, en comparaison Ă la rĂ©Ă©ducation orthophonique classique, et l'efficacitĂ© dâun programme de rĂ©Ă©ducation associant plusieurs mĂ©thodes, en comparaison Ă une mĂ©thode unique. En intĂ©grant un groupe de participants sains contrĂŽle appariĂ©s en Ăąge, nous nous intĂ©ressons Ă©galement, indirectement, aux effets du vieillissement sur les mĂ©canismes cognitifs et la rĂ©organisation des rĂ©seaux cĂ©rĂ©braux de la parole et du langage
RĂ©organisation neurocognitive et linguistique du langage et de la parole dans l'aphasie post-AVC. Approche interdisciplinaire
The language disorders that characterize post-stroke aphasia interfere with patientsâ communication abilities, with multiple impacts on daily life. There is considerable variability in the initial severity of language disorders, as well as the degree of speech and language recovery among patients. Moreover, the effectiveness of classical speech therapy methods decreases after a few months of application. In addition, socio-economic and medical factors are known to influence the management of patients in the chronic phase. Therefore, there are two essential steps towards advancing the treatment of patients with post-stroke aphasia. First, there is a need for a more thorough understanding of the neurocognitive mechanisms and factors influencing language representation and neuroplasticity in patients with post-stroke disorders. Second, new methods and programs for speech and language rehabilitation in patients with disorders following a brain injury need to be developed on the basis of these novel findings and adapted to long-term management.Following these requirements and in line with current theoretical models of speech production, the two main goals of this thesis are (i) to better understand the alteration of speech and language mechanisms in relation to other cognitive processes and the reorganization of the underlying brain networks and (ii) to propose new perspectives for speech and language rehabilitation. Specifically, we propose a new rehabilitation method based on technology that provides a realistic visual illustration of lingual and labial articulatory dynamics (the Ultraspeech-player software). We assume that adding visual information could improve the multisensory phonological representations on which motor planning and programming rely during speech production. This visual information could thus contribute to the reorganization of language networks and to the compensation of deficits observed in post-stroke non-fluent aphasia. Beyond developing a new method, we highlight the interest of applying rehabilitation programs combining at least two methods to increase the efficiency and speed of speech and language recovery.In the first part of this work, we focus on the role of determinants of initial severity and recovery of language and speech in patients with post-stroke aphasia. We show the importance of intensive rehabilitation in patients with severe aphasia following a frontal injury involving the inferior frontal gyrus. In addition, we argue that reinforcing phonological mechanisms through audio-visual training of speech would allow for optimal anatomo-functional reorganization of language networks.In the second part, we propose to supplement classical language and speech therapy with visually augmented rehabilitation (the Ultraspeech-player software). Our results suggest that this new rehabilitation program strengthens phonological representations and contributes to reorganizing language networks in patients with post-stroke aphasia.Taken together, the results of this thesis allow us to propose an experimental protocol that evaluates, at the group level, the efficiency of the augmented rehabilitation at the language, cognitive and cerebral levels. More precisely, in future studies, we aim to demonstrate in patients with non-fluent aphasia: (i) the effectiveness of visually augmented rehabilitation, compared to conventional speech therapy, and (ii) the effectiveness of a rehabilitation program combining several methods, compared to a single method. By including a control group of age-matched healthy participants, we will also provide new evidence of the effects of aging on cognitive mechanisms and the reorganization of speech and language brain networks.Les troubles langagiers qui caractĂ©risent lâaphasie post-AVC entravent les capacitĂ©s de communication des patients, avec des consĂ©quences multiples. Il existe une grande variabilitĂ© en termes de sĂ©vĂ©ritĂ© initiale des troubles langagiers et de degrĂ© de rĂ©cupĂ©ration du langage et de la parole chez ces patients. Par ailleurs, l'efficacitĂ© des mĂ©thodes de rĂ©Ă©ducation orthophonique classique diminue aprĂšs quelques mois dâapplication. De plus, nous savons que des facteurs socio-Ă©conomiques et mĂ©dico-sanitaires entravent la prise en charge des patients en phase chronique. Il nous semble donc Ă©vident quâil est nĂ©cessaire, dâune part, de mieux comprendre les mĂ©canismes neurocognitifs et les facteurs dĂ©terminants de la reprĂ©sentation du langage et de sa neuroplasticitĂ©, et dâautre part, de dĂ©velopper de nouvelles mĂ©thodes et des programmes de rĂ©Ă©ducation de la parole et du langage, adaptĂ©s Ă la prise en charge Ă long terme, pour les patients prĂ©sentant des troubles suite Ă une lĂ©sion cĂ©rĂ©brale.Dans cette thĂšse, nous nous plaçons dans le cadre des modĂšles thĂ©oriques actuels de production de la parole afin de (i) mieux comprendre lâaltĂ©ration des mĂ©canismes de parole et du langage, en lien avec dâautres processus cognitifs, et la rĂ©organisation des rĂ©seaux cĂ©rĂ©braux sous-jacents, et (ii) proposer de nouvelles perspectives pour la rĂ©Ă©ducation du langage et de la parole. ConcrĂštement, nous proposons une nouvelle mĂ©thode de rĂ©Ă©ducation sâappuyant sur une technologie offrant une illustration visuelle rĂ©aliste de la dynamique articulatoire linguale et labiale (le logiciel Ultraspeech-player). Nous supposons ainsi que lâajout dâinformations visuelles pourrait amĂ©liorer les reprĂ©sentations phonologiques multisensorielles, sur lesquelles sâappuient la planification et la programmation motrices lors de la production de parole, et pourrait ainsi contribuer Ă la rĂ©organisation des rĂ©seaux langagiers et Ă la compensation des dĂ©ficits observĂ©s dans lâaphasie non fluente post-AVC. Au-delĂ du dĂ©veloppement dâune nouvelle mĂ©thode, nous promouvons lâintĂ©rĂȘt dâappliquer des programmes de rĂ©Ă©ducation associant au moins deux mĂ©thodes pour augmenter lâefficacitĂ© et la rapiditĂ© de la rĂ©cupĂ©ration langagiĂšre.Dans la premiĂšre partie de ce travail, nous nous focalisons sur le rĂŽle des dĂ©terminants de la sĂ©vĂ©ritĂ© initiale et de la rĂ©cupĂ©ration du langage et de la parole chez des patients atteints d'aphasie post-AVC. Ainsi, nous montrons lâimportance du caractĂšre intensif de la rĂ©Ă©ducation chez les patients prĂ©sentant une aphasie sĂ©vĂšre, suite Ă une lĂ©sion frontale impliquant le gyrus frontal infĂ©rieur. Par ailleurs, nous proposons que le renforcement des mĂ©canismes phonologiques par un entraĂźnement audio-visuel de la parole permettrait une rĂ©organisation anatomo-fonctionnelle optimale des rĂ©seaux langagiers.Dans la seconde partie, nous proposons de complĂ©menter la rĂ©Ă©ducation orthophonique classique avec une rĂ©Ă©ducation augmentĂ©e visuellement (le logiciel Ultraspeech-player). Nos rĂ©sultats suggĂšrent que ce nouveau programme de rĂ©habilitation renforce les reprĂ©sentations phonologiques et contribue Ă la rĂ©organisation des rĂ©seaux langagiers chez les patients atteints d'aphasie post-AVC.Lâensemble de ces rĂ©sultats nous permet de proposer par la suite un protocole expĂ©rimental qui Ă©value, Ă l'Ă©chelle du groupe, l'efficacitĂ© sur les plans langagier, cognitif et cĂ©rĂ©bral de la rĂ©Ă©ducation renforcĂ©e. Plus prĂ©cisĂ©ment, nous souhaitons dĂ©montrer chez des patients prĂ©sentant une aphasie non fluente : lâefficacitĂ© de la rĂ©Ă©ducation visuellement augmentĂ©e, en comparaison Ă la rĂ©Ă©ducation orthophonique classique, et l'efficacitĂ© dâun programme de rĂ©Ă©ducation associant plusieurs mĂ©thodes, en comparaison Ă une mĂ©thode unique. En intĂ©grant un groupe de participants sains contrĂŽle appariĂ©s en Ăąge, nous nous intĂ©ressons Ă©galement, indirectement, aux effets du vieillissement sur les mĂ©canismes cognitifs et la rĂ©organisation des rĂ©seaux cĂ©rĂ©braux de la parole et du langage
RĂ©organisation neurocognitive et linguistique du langage et de la parole dans l'aphasie post-AVC. Approche interdisciplinaire
The language disorders that characterize post-stroke aphasia interfere with patientsâ communication abilities, with multiple impacts on daily life. There is considerable variability in the initial severity of language disorders, as well as the degree of speech and language recovery among patients. Moreover, the effectiveness of classical speech therapy methods decreases after a few months of application. In addition, socio-economic and medical factors are known to influence the management of patients in the chronic phase. Therefore, there are two essential steps towards advancing the treatment of patients with post-stroke aphasia. First, there is a need for a more thorough understanding of the neurocognitive mechanisms and factors influencing language representation and neuroplasticity in patients with post-stroke disorders. Second, new methods and programs for speech and language rehabilitation in patients with disorders following a brain injury need to be developed on the basis of these novel findings and adapted to long-term management.Following these requirements and in line with current theoretical models of speech production, the two main goals of this thesis are (i) to better understand the alteration of speech and language mechanisms in relation to other cognitive processes and the reorganization of the underlying brain networks and (ii) to propose new perspectives for speech and language rehabilitation. Specifically, we propose a new rehabilitation method based on technology that provides a realistic visual illustration of lingual and labial articulatory dynamics (the Ultraspeech-player software). We assume that adding visual information could improve the multisensory phonological representations on which motor planning and programming rely during speech production. This visual information could thus contribute to the reorganization of language networks and to the compensation of deficits observed in post-stroke non-fluent aphasia. Beyond developing a new method, we highlight the interest of applying rehabilitation programs combining at least two methods to increase the efficiency and speed of speech and language recovery.In the first part of this work, we focus on the role of determinants of initial severity and recovery of language and speech in patients with post-stroke aphasia. We show the importance of intensive rehabilitation in patients with severe aphasia following a frontal injury involving the inferior frontal gyrus. In addition, we argue that reinforcing phonological mechanisms through audio-visual training of speech would allow for optimal anatomo-functional reorganization of language networks.In the second part, we propose to supplement classical language and speech therapy with visually augmented rehabilitation (the Ultraspeech-player software). Our results suggest that this new rehabilitation program strengthens phonological representations and contributes to reorganizing language networks in patients with post-stroke aphasia.Taken together, the results of this thesis allow us to propose an experimental protocol that evaluates, at the group level, the efficiency of the augmented rehabilitation at the language, cognitive and cerebral levels. More precisely, in future studies, we aim to demonstrate in patients with non-fluent aphasia: (i) the effectiveness of visually augmented rehabilitation, compared to conventional speech therapy, and (ii) the effectiveness of a rehabilitation program combining several methods, compared to a single method. By including a control group of age-matched healthy participants, we will also provide new evidence of the effects of aging on cognitive mechanisms and the reorganization of speech and language brain networks.Les troubles langagiers qui caractĂ©risent lâaphasie post-AVC entravent les capacitĂ©s de communication des patients, avec des consĂ©quences multiples. Il existe une grande variabilitĂ© en termes de sĂ©vĂ©ritĂ© initiale des troubles langagiers et de degrĂ© de rĂ©cupĂ©ration du langage et de la parole chez ces patients. Par ailleurs, l'efficacitĂ© des mĂ©thodes de rĂ©Ă©ducation orthophonique classique diminue aprĂšs quelques mois dâapplication. De plus, nous savons que des facteurs socio-Ă©conomiques et mĂ©dico-sanitaires entravent la prise en charge des patients en phase chronique. Il nous semble donc Ă©vident quâil est nĂ©cessaire, dâune part, de mieux comprendre les mĂ©canismes neurocognitifs et les facteurs dĂ©terminants de la reprĂ©sentation du langage et de sa neuroplasticitĂ©, et dâautre part, de dĂ©velopper de nouvelles mĂ©thodes et des programmes de rĂ©Ă©ducation de la parole et du langage, adaptĂ©s Ă la prise en charge Ă long terme, pour les patients prĂ©sentant des troubles suite Ă une lĂ©sion cĂ©rĂ©brale.Dans cette thĂšse, nous nous plaçons dans le cadre des modĂšles thĂ©oriques actuels de production de la parole afin de (i) mieux comprendre lâaltĂ©ration des mĂ©canismes de parole et du langage, en lien avec dâautres processus cognitifs, et la rĂ©organisation des rĂ©seaux cĂ©rĂ©braux sous-jacents, et (ii) proposer de nouvelles perspectives pour la rĂ©Ă©ducation du langage et de la parole. ConcrĂštement, nous proposons une nouvelle mĂ©thode de rĂ©Ă©ducation sâappuyant sur une technologie offrant une illustration visuelle rĂ©aliste de la dynamique articulatoire linguale et labiale (le logiciel Ultraspeech-player). Nous supposons ainsi que lâajout dâinformations visuelles pourrait amĂ©liorer les reprĂ©sentations phonologiques multisensorielles, sur lesquelles sâappuient la planification et la programmation motrices lors de la production de parole, et pourrait ainsi contribuer Ă la rĂ©organisation des rĂ©seaux langagiers et Ă la compensation des dĂ©ficits observĂ©s dans lâaphasie non fluente post-AVC. Au-delĂ du dĂ©veloppement dâune nouvelle mĂ©thode, nous promouvons lâintĂ©rĂȘt dâappliquer des programmes de rĂ©Ă©ducation associant au moins deux mĂ©thodes pour augmenter lâefficacitĂ© et la rapiditĂ© de la rĂ©cupĂ©ration langagiĂšre.Dans la premiĂšre partie de ce travail, nous nous focalisons sur le rĂŽle des dĂ©terminants de la sĂ©vĂ©ritĂ© initiale et de la rĂ©cupĂ©ration du langage et de la parole chez des patients atteints d'aphasie post-AVC. Ainsi, nous montrons lâimportance du caractĂšre intensif de la rĂ©Ă©ducation chez les patients prĂ©sentant une aphasie sĂ©vĂšre, suite Ă une lĂ©sion frontale impliquant le gyrus frontal infĂ©rieur. Par ailleurs, nous proposons que le renforcement des mĂ©canismes phonologiques par un entraĂźnement audio-visuel de la parole permettrait une rĂ©organisation anatomo-fonctionnelle optimale des rĂ©seaux langagiers.Dans la seconde partie, nous proposons de complĂ©menter la rĂ©Ă©ducation orthophonique classique avec une rĂ©Ă©ducation augmentĂ©e visuellement (le logiciel Ultraspeech-player). Nos rĂ©sultats suggĂšrent que ce nouveau programme de rĂ©habilitation renforce les reprĂ©sentations phonologiques et contribue Ă la rĂ©organisation des rĂ©seaux langagiers chez les patients atteints d'aphasie post-AVC.Lâensemble de ces rĂ©sultats nous permet de proposer par la suite un protocole expĂ©rimental qui Ă©value, Ă l'Ă©chelle du groupe, l'efficacitĂ© sur les plans langagier, cognitif et cĂ©rĂ©bral de la rĂ©Ă©ducation renforcĂ©e. Plus prĂ©cisĂ©ment, nous souhaitons dĂ©montrer chez des patients prĂ©sentant une aphasie non fluente : lâefficacitĂ© de la rĂ©Ă©ducation visuellement augmentĂ©e, en comparaison Ă la rĂ©Ă©ducation orthophonique classique, et l'efficacitĂ© dâun programme de rĂ©Ă©ducation associant plusieurs mĂ©thodes, en comparaison Ă une mĂ©thode unique. En intĂ©grant un groupe de participants sains contrĂŽle appariĂ©s en Ăąge, nous nous intĂ©ressons Ă©galement, indirectement, aux effets du vieillissement sur les mĂ©canismes cognitifs et la rĂ©organisation des rĂ©seaux cĂ©rĂ©braux de la parole et du langage
Complémenter la méthode orthophonique avec des nouvelles approches de rééducation du langage et de la parole dans l'aphasie post-AVC Complementing the speech therapy method with new approaches to speech and language rehabilitation in post-stroke aphasia
International audienc
Speech rehabilitation in chronic post-stroke aphasia using visual illustration of speech articulators.A case report study
International audienceQuestion: Studies on the remediation of speech disorders suggest that providing visual information on speech articulators may contribute to improve speech production abilities. We evaluated the effect of a new rehabilitation method based on the display of pre-recorded articulatory movements, on the speech recovery of a patient with post-stroke non-fluent chronic aphasia. We propose that visualizing speech articulators, such as the tongue and lips, can increase the patientâs ability to recover speech motor programs and can improve their speech abilities.Methods: The rehabilitation was based on the Ultraspeech-player software which presents speech sounds together with the movements of the speech articulators (tongue and lips) of a reference speaker, recorded using ultrasound and video imaging. The patient was trained for 4 weeks (3 sessions/week) by watching and hearing target phonemes and syllables and by imitating them. The effects of this method were assessed by analyzing, before and after rehabilitation: (i) the accuracy scores during four speech tasks (phoneme and word repetitions, word reading and phonemic discrimination); (ii) the phonological processes identified in the errors made during the phoneme repetition task and (iii) the acoustic parameters (voice onset time VOT, formants F1 and F2, spectral moments) obtained from the audio signal recorded in the phoneme repetition task. A neuropsychological assessment was also performed, before and after rehabilitation, in order to evaluate: cognitive performances, executive function, visual episodic memory, mental rotation abilities and mood.Results: Our results showed that the illustration-based rehabilitation method had a beneficial effect on the patientâs speech production and reading abilities. The positive impact was stronger for stop and fricative consonants, which are targeted by the software (higher visibility of the articulatory configurations). Acoustic parameters reveal an improvement in the VOT for stop consonants and in the place of articulation for fricatives (alveolar, post-alveolar and labiodental). However, the patient showed little improvement for vowels. Moreover, the integrity of visuo-spatial ability, short-term and working memory and some executive functions also supports the effectiveness of the rehabilitation method. Conclusion: These findings support the use of an illustration-based rehabilitation method and argue for the necessity of detailed qualitative and quantitative assessment in speech production to provide more thorough descriptions of speech abilities in patients with non-fluent aphasia
Comparing the selectivity of vowel representations in cortical auditory vs. motor areas: A repetition-suppression study
International audienc
Interactive mapping of language and memory with the GE2REC protocol
International audiencePrevious studies have highlighted the importance of considering cognitive functions from a dynamic and interactive perspective and multiple evidence was brought for a language and memory interaction. In this study performed with healthy participants, we present a new protocol entitled GE2REC that interactively accesses the neural representation of language-and-memory network. This protocol consists of three runs related to each other, providing a link between tasks, in order to assure an interactive measure of linguistic and episodic memory processes. GE2REC consists of a sentence generation (GE) in the auditory modality and two recollecting (2REC) memory tasks, one recognition performed in the visual modality, and another one recall performed in the auditory modality. Its efficiency was evaluated in 20 healthy volunteers using a 3T MR imager. Our results corroborate the ability of GE2REC to robustly activate fronto-temporo-parietal language network as well as temporal mesial, prefrontal and parietal cortices in encoding during sentence generation and recognition. GE2REC is useful because it: (a) requires simultaneous and interactive language-and-memory processes and jointly maps their neural basis; (b) explores encoding and retrieval, managing to elicit activation of mesial temporal structures; (c) is easy to perform, hence being suitable for more restrictive settings, and (d) has an ecological dimension of tasks and stimuli. GE2REC may be useful for studying neuroplasticity of cognitive functions, especially in patients with temporal lobe epilepsy who show reorganization of both language and memory networks. Overall, GE2REC can provide valuable information in terms of the practical foundation of exploration language and memory interconnection
Retour visuel en aphasiologie : résultats comportementaux, acoustiques et en neuroimagerie
National audienceArticulatory disorders in aphasia need an adapted rehabilitation. If various methods are available for language disordersâ rehabilitation, for speech disorders, they are limited because of visualization difficulties of speech articulators dissimulated in the oral cavity. Visual feedback is very used. Articulatory gestures are often shown on lips. An interesting method of visual feedback is studied here. This technique is particularly used abroad. An ultrasound machine helps lingual reading and patients can see their own tongue to enhance articulatory knowledge of their lingual movement.In this pilot study we wanted to show effects of an intensive rehabilitation with ultrasound. Comportemental, acoustical and neuroimaging assessments were done before and after this rehabilitation to measure patient progress. An experimental fMRI protocol was validated on healthy subjects.Acoustical results have shown a more canonical production of /u/, /o/ and /a/ vowels on the second formant after rehabilitation compared to session before rehabilitation. Moreover, voiced consonants with devoicing before rehabilitation have improved. Speech therapyâs assessments do not show significant improvement between the two sessions of tests. Neuroimaging results are hard to interpret. We cannot judge of any positive effect of speech rehabilitation with ultrasound visual feedback for the moment but we hope to validateLes troubles articulatoires chez les patients aphasiques, bien que peu frĂ©quents par rapport aux troubles du langage, nĂ©cessitent nĂ©anmoins une prise en charge adaptĂ©e. Si la rĂ©Ă©ducation des troubles du langage dispose de techniques de rĂ©Ă©ducation variĂ©es, en rĂ©Ă©ducation de la parole, les moyens sont limitĂ©s Ă©tant donnĂ© la difficultĂ© de visualisation des articulateurs de la parole dissimulĂ©s dans la cavitĂ© orale. Le canal visuel est cependant trĂšs utilisĂ©. Ainsi, le geste articulatoire est le plus souvent montrĂ© sur les lĂšvres oĂč il est bien visible. Il nous a paru intĂ©ressant dâĂ©tudier une technique de retour visuel utilisĂ©e avec succĂšs hors de nos frontiĂšres pour pouvoir exploiter le potentiel de la lecture linguale câest-Ă -dire permettre au patient de visualiser sa propre langue, afin dâamĂ©liorer la connaissance articulatoirede son propre mouvement lingual.Nous avons Ă©tudiĂ©, au cours dâune Ă©tude prĂ©liminaire, lâeffet dâune rĂ©Ă©ducation intensive par Ă©chographie. Des Ă©valuations comportementales, acoustiques et en neuroimagerie centrĂ©es sur lâexpression orale avaient lieu avant et aprĂšs rĂ©Ă©ducation afin de mesurer les progrĂšs du patient. La validation du protocole expĂ©rimental utilisĂ© en IRM fonctionnelle a prĂ©alablement Ă©tĂ© rĂ©alisĂ©e sur une cohorte de sujets sains.Les analyses acoustiques ont montrĂ© une production plus canonique des voyelles /u/, /o/ et /a/ sur le plan du formant F2 aprĂšs rĂ©Ă©ducation par rapport au bilan en prĂ©-rĂ©Ă©ducation et des consonnes voisĂ©es remplacĂ©es par leurs correspondants sourds avant rĂ©Ă©ducation. Le bilan orthophonique ne permet pas de constater de franche amĂ©lioration entre la session prĂ©-rĂ©Ă©ducation et la session post-rĂ©Ă©ducation. Les rĂ©sultats en neuroimagerie sont difficiles Ă interprĂ©ter. Nous ne pouvons donc juger de lâeffet de la rĂ©Ă©ducation par retour visuel de la langue de façon positive pour le moment mais nous espĂ©rons valider cette technique par lâapplication Ă une cohorte de patients aphasiques non-fluents
Neural correlates of inner speaking, imitating and hearing: an fMRI study
International audienc
The ConDialInt Model: Condensation, Dialogality, and Intentionality Dimensions of Inner Speech Within a Hierarchical Predictive Control Framework
International audienceInner speech has been shown to vary in form along several dimensions. Along condensation, condensed inner speech forms have been described, that are supposed to be deprived of acoustic, phonological and even syntactic qualities. Expanded forms, on the other extreme, display articulatory and auditory properties. Along dialogality, inner speech can be monologal, when we engage in internal soliloquy, or dialogal, when we recall past conversations or imagine future dialogs involving our own voice as well as that of others addressing us. Along intentionality, it can be intentional (when we deliberately rehearse material in short-term memory) or it can arise unintentionally (during mind wandering). We introduce the ConDialInt model, a neurocognitive predictive control model of inner speech that accounts for its varieties along these three dimensions. ConDialInt spells out the condensation dimension by including inhibitory control at the conceptualization, formulation or articulatory planning stage. It accounts for dialogality, by assuming internal model adaptations and by speculating on neural processes underlying perspective switching. It explains the differences between intentional and spontaneous varieties in terms of monitoring. We present an fMRI study in which we probed varieties of inner speech along dialogality and intentionality, to examine the validity of the neuroanatomical correlates posited in ConDialInt. Condensation was also informally tackled. Our data support the hypothesis that expanded inner speech recruits speech production processes down to articulatory planning, resulting in a predicted signal, the inner voice, with auditory qualities. Along dialogality, covertly using an avatar's voice resulted in the activation of right hemisphere homologs of the regions involved in internal own-voice soliloquy and in reduced cerebellar activation, consistent with internal model adaptation. Switching from first-person to third-person perspective resulted in activations in precuneus and parietal lobules. Along intentionality, compared with intentional inner speech, mind wandering with inner speech episodes was associated with greater bilateral inferior frontal activation and decreased activation Frontiers in Psychology | www.frontiersin.org