Transcranial electric stimulation for the investigation of speech perception and comprehension.

Transcranial electric stimulation (tES), comprising transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), involves applying weak electrical current to the scalp, which can be used to modulate membrane potentials and thereby modify neural activity. Critically, behavioural or perceptual consequences of this modulation provide evidence for a causal role of neural activity in the stimulated brain region for the observed outcome. We present tES as a tool for the investigation of which neural responses are necessary for successful speech perception and comprehension. We summarise existing studies, along with challenges that need to be overcome, potential solutions, and future directions. We conclude that, although standardised stimulation parameters still need to be established, tES is a promising tool for revealing the neural basis of speech processing. Future research can use this method to explore the causal role of brain regions and neural processes for the perception and comprehension of speech

Rapid computations of spectrotemporal prediction error support perception of degraded speech.

Human speech perception can be described as Bayesian perceptual inference but how are these Bayesian computations instantiated neurally? We used magnetoencephalographic recordings of brain responses to degraded spoken words and experimentally manipulated signal quality and prior knowledge. We first demonstrate that spectrotemporal modulations in speech are more strongly represented in neural responses than alternative speech representations (e.g. spectrogram or articulatory features). Critically, we found an interaction between speech signal quality and expectations from prior written text on the quality of neural representations; increased signal quality enhanced neural representations of speech that mismatched with prior expectations, but led to greater suppression of speech that matched prior expectations. This interaction is a unique neural signature of prediction error computations and is apparent in neural responses within 100 ms of speech input. Our findings contribute to the detailed specification of a computational model of speech perception based on predictive coding frameworks

Hierarchical organization of auditory and motor representations in speech perception: Evidence from searchlight similarity analysis

How humans extract the identity of speech sounds from highly variable acoustic signals remains unclear. Here, we use searchlight representational similarity analysis (RSA) to localize and characterize neural representations of syllables at different levels of the hierarchically organized temporo-frontal pathways for speech perception. We asked participants to listen to spoken syllables that differed considerably in their surface acoustic form by changing speaker and degrading surface acoustics using noise-vocoding and sine wave synthesis while we recorded neural responses with functional magnetic resonance imaging. We found evidence for a graded hierarchy of abstraction across the brain. At the peak of the hierarchy, neural representations in somatomotor cortex encoded syllable identity but not surface acoustic form, at the base of the hierarchy, primary auditory cortex showed the reverse. In contrast, bilateral temporal cortex exhibited an intermediate response, encoding both syllable identity and the surface acoustic form of speech. Regions of somatomotor cortex associated with encoding syllable identity in perception were also engaged when producing the same syllables in a separate session. These findings are consistent with a hierarchical account of how variable acoustic signals are transformed into abstract representations of the identity of speech sounds

Designing remote synchronous auditory comprehension assessment for severely impaired individuals with aphasia

Background The use of telepractice in aphasia research and therapy is increasing in frequency. Teleassessment in aphasia has been demonstrated to be reliable. However, neuropsychological and clinical language comprehension assessments are not always readily translatable to an online environment and people with severe language comprehension or cognitive impairments have sometimes been considered to be unsuitable for teleassessment. Aim This project aimed to produce a battery of language comprehension teleassessments at the single word, sentence and discourse level suitable for individuals with moderate‐severe language comprehension impairments. Methods Assessment development prioritised response consistency and clinical flexibility during testing. Teleassessments were delivered in PowerPoint over Zoom using screen sharing and remote control functions. The assessments were evaluated in 14 people with aphasia and 9 neurotypical control participants. Modifiable assessment templates are available here: https://osf.io/r6wfm/. Main Contributions People with aphasia were able to engage in language comprehension teleassessment with limited carer support. Only one assessment could not be completed for technical reasons. Statistical analysis revealed above chance performance in 141/151 completed assessments. Conclusions People with aphasia, including people with moderate‐severe comprehension impairments, are able to engage with teleassessment. Successful teleassessment can be supported by retaining clinical flexibility and maintaining consistent task demands. WHAT THIS PAPER ADDS What is already known on the subject Teleassessment for aphasia is reliable but assessment of auditory comprehension is difficult to adapt to the online environment. There has been limited evaluation of the ability of people with severe aphasia to engage in auditory comprehension teleassessment. What this paper adds to existing knowledge Auditory comprehension assessment can be adapted for videoconferencing administration while maintaining clinical flexibility to support people with severe aphasia. What are the potential or actual clinical implications of this work? Teleassessment is time and cost effective and can be designed to support inclusion of severely impaired individuals

Neural Prediction Errors Distinguish Perception and Misperception of Speech

Humans use prior expectations to improve perception, especially of sensory signals that are degraded or ambiguous. However, if sensory input deviates from prior expectations, correct perception depends on adjusting or rejecting prior expectations. Failure to adjust or reject the prior leads to perceptual illusions especially if there is partial overlap (hence partial mismatch) between expectations and input. With speech, “Slips of the ear” occur when expectations lead to misperception. For instance, a entomologist, might be more susceptible to hear "The ants are my friends" for "The answer, my friend" (in the Bob Dylan song "Blowing in the Wind"). Here, we contrast two mechanisms by which prior expectations may lead to misperception of degraded speech. Firstly, clear representations of the common sounds in the prior and input (i.e., expected sounds) may lead to incorrect confirmation of the prior. Secondly, insufficient representations of sounds that deviate between prior and input (i.e., prediction errors) could lead to deception. We used cross-modal predictions from written words that partially match degraded speech to compare neural responses when male and female human listeners were deceived into accepting the prior or correctly reject it. Combined behavioural and multivariate representational similarity analysis of functional magnetic resonance imaging data shows that veridical perception of degraded speech is signalled by representations of prediction error in the left superior temporal sulcus. Instead of using top-down processes to support perception of expected sensory input, our findings suggest that the strength of neural prediction error representations distinguishes correct perception and misperception

Mapping visual symbols onto spoken language along the ventral visual stream.

Reading involves transforming arbitrary visual symbols into sounds and meanings. This study interrogated the neural representations in ventral occipitotemporal cortex (vOT) that support this transformation process. Twenty-four adults learned to read 2 sets of 24 novel words that shared phonemes and semantic categories but were written in different artificial orthographies. Following 2 wk of training, participants read the trained words while neural activity was measured with functional MRI. Representational similarity analysis on item pairs from the same orthography revealed that right vOT and posterior regions of left vOT were sensitive to basic visual similarity. Left vOT encoded letter identity and representations became more invariant to position along a posterior-to-anterior hierarchy. Item pairs that shared sounds or meanings, but were written in different orthographies with no letters in common, evoked similar neural patterns in anterior left vOT. These results reveal a hierarchical, posterior-to-anterior gradient in vOT, in which representations of letters become increasingly invariant to position and are transformed to convey spoken language information

Epidemiological and Economic Trends in Inpatient and Outpatient Thyroidectomy in the United States, 1996–2006

Background: Traditionally, thyroid surgery has been an inpatient procedure due to the risk of several well-documented complications. Recent research suggests that for selected patients, outpatient thyroid surgery is safe and feasible, with the additional potential benefit of cost savings. In recognition of these observations, we hypothesized that there would be an increase in U.S. outpatient thyroidectomies with a concurrent decline in inpatient thyroidectomies over time. Methods: Comparative cross-sectional analyses of the National Survey of Ambulatory Surgery (NSAS) and Nationwide Inpatient Sample (NIS) databases from 1996 and 2006 were performed. All cases of thyroid surgery were extracted, as well as data on age, sex, and insurance status. Diagnoses and surgical cases were identified using International Classification of Diseases, Ninth Revision (ICD-9) diagnostic and treatment codes. Hospital charges were acquired from the NIS 1996 and 2006 and NSAS 2006 releases, using imputed data where necessary. After survey weights were applied, patient characteristics, diagnoses, and procedures were compared for inpatient versus outpatient procedures. Results: The total number of thyroidectomies increased 39%, from 66,864 to 92,931 cases per year during the study timeframe. Outpatient procedures increased by 61%, while inpatient procedures increased by 30%. The proportion of privately insured inpatients declined slightly from 63.8% to 60.1%, while those covered by Medicare increased from 22.8% to 25.8%. In contrast, the proportion of privately insured outpatients declined sharply from 76.8% to 39.9%, while those covered by Medicare rose from 17.2% to 45.7%. These trends coincided with a small increase in the mean inpatient age from 50.2 to 52.3 years and a larger increase in the mean outpatient age from 50.7 to 58.1 years. Inflation-adjusted per-capita charges for inpatient thyroidectomies more than doubled from $9,934 in 1996 to$22,537 in 2006, while aggregate national inpatient charges tripled from $464 million to$1.37 billion. By comparison, per-capita charges for outpatient thyroidectomy totaled $7,222 in 2006. Conclusions: From 1996 to 2006, there has been a concurrent modest increase in inpatient and pronounced increase in outpatient thyroidectomies in the United States, with a consequential demographic shift and economic impact.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140257/1/thy.2012.0218.pd

From specific examples to general knowledge in language learning

AbstractThe extraction of general knowledge from individual episodes is critical if we are to learn new knowledge or abilities. Here we uncover some of the key cognitive mechanisms that characterise this process in the domain of language learning. In five experiments adult participants learned new morphological units embedded in fictitious words created by attaching new affixes (e.g., -afe) to familiar word stems (e.g., “sleepafe is a participant in a study about the effects of sleep”). Participants’ ability to generalise semantic knowledge about the affixes was tested using tasks requiring the comprehension and production of novel words containing a trained affix (e.g., sailafe). We manipulated the delay between training and test (Experiment 1), the number of unique exemplars provided for each affix during training (Experiment 2), and the consistency of the form-to-meaning mapping of the affixes (Experiments 3–5). In a task where speeded online language processing is required (semantic priming), generalisation was achieved only after a memory consolidation opportunity following training, and only if the training included a sufficient number of unique exemplars. Semantic inconsistency disrupted speeded generalisation unless consolidation was allowed to operate on one of the two affix-meanings before introducing inconsistencies. In contrast, in tasks that required slow, deliberate reasoning, generalisation could be achieved largely irrespective of the above constraints. These findings point to two different mechanisms of generalisation that have different cognitive demands and rely on different types of memory representations

Distinct neural specializations for learning to read words and name objects

Understanding the neural systems that underpin reading acquisition is key if neuroscientific findings are to inform educational practice. We provide a unique window into these systems by teaching 19 adults to read 24 novel words written in unfamiliar letters and to name 24 novel objects while in an MRI scanner. Behavioral performance on trained items was equivalent for the two stimulus types. However, componential letter-sound associations were extracted when learning to read, as shown by correct reading of untrained words, whereas object-name associations were holistic and arbitrary. Activity in bilateral anterior fusiformgyri was greater during object name learning than learning to read, and ROI analyses indicated that left mid-fusiform activity was predictive of success in object name learning but not in learning to read. In contrast, activity in bilateral parietal cortices was predictive of success for both stimulus types but was greater during learning and recall of written word pronunciations relative to object names. We argue that mid-to-anterior fusiform gyri preferentially process whole items and contribute to learning their spoken form associations, processes that are required for skilled reading. In contrast, parietal cortices preferentially process componential visual-verbal mappings, a process that is crucial for early reading development