Cortical response to the natural speech envelope correlates with neuroimaging evidence of cognition in severe brain injury

Recent studies identify severely brain-injured patients with limited or no behavioral responses who successfully perform functional magnetic resonance imaging (fMRI) or electroencephalogram (EEG) mental imagery tasks [1, 2, 3, 4, 5]. Such tasks are cognitively demanding [1]; accordingly, recent studies support that fMRI command following in brain-injured patients associates with preserved cerebral metabolism and preserved sleep-wake EEG [5, 6]. We investigated the use of an EEG response that tracks the natural speech envelope (NSE) of spoken language [7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22] in healthy controls and brain-injured patients (vegetative state to emergence from minimally conscious state). As audition is typically preserved after brain injury, auditory paradigms may be preferred in searching for covert cognitive function [23, 24, 25]. NSE measures are obtained by cross-correlating EEG with the NSE. We compared NSE latencies and amplitudes with and without consideration of fMRI assessments. NSE latencies showed significant and progressive delay across diagnostic categories. Patients who could carry out fMRI-based mental imagery tasks showed no statistically significant difference in NSE latencies relative to healthy controls; this subgroup included patients without behavioral command following. The NSE may stratify patients with severe brain injuries and identify those patients demonstrating “cognitive motor dissociation” (CMD) [26] who show only covert evidence of command following utilizing neuroimaging or electrophysiological methods that demand high levels of cognitive function. Thus, the NSE is a passive measure that may provide a useful screening tool to improve detection of covert cognition with fMRI or other methods and improve stratification of patients with disorders of consciousness in research studies

Is the fluency of language outputs related to individual differences in intelligence and executive function?

There has been little research on the fluency of language production and individual differences variables, such as intelligence and executive function. In this study, we report data from 106 participants who completed a battery of standardized cognitive tasks and a sentence production task. For the sentence production task, participants were presented with two objects and a verb and their task was to formulate a sentence. Four types of disfluency were examined: filled pauses (e.g. uh, um), unfilled pauses, repetitions, and repairs. Repetitions occur when the speaker suspends articulation and then repeats the previous word/phrase, and repairs occur when the speaker suspends articulation and then starts over with a different word/phrase. Hierarchical structural equation modeling revealed a significant relationship between repair disfluencies and inhibition. Conclusions focus on the role of individual differences in cognitive ability and their role in models and theories of language production