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Elliott D. Ross - One of the best experts on this subject based on the ideXlab platform.
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Aprosodia and prosoplegia with right frontal neurodegeneration
Neurocase, 2019Co-Authors: James R Bateman, Elliott D. Ross, Christopher M Filley, Brianne M Bettcher, Isabel H Hubbard, Miranda Babiak, Peter PressmanAbstract:Affective prosody and facial expression are essential components of human communication. Aprosodic syndromes are associated with focal right cerebral lesions that impair the affective-prosodic aspects of language, but are rarely identified because affective prosody is not routinely assessed by clinicians. Inability to produce emotional faces (affective prosoplegia) is a related and important aspect of affective communication has overlapping neuroanatomic substrates with affective prosody. We describe a patient with progressive Aprosodia and prosoplegia who had right greater than left perisylvian and temporal atrophy with an anterior predominance. We discuss the importance of assessing affective prosody and facial expression to arrive at an accurate clinical diagnosis.
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Aprosodia and Prosoplegia With Right Frontal Neurodegeneration
Neurocase, 2019Co-Authors: James R Bateman, Elliott D. Ross, Christopher M Filley, Brianne M Bettcher, Miranda Babiak, H. Isabel Hubbard, Peter PressmanAbstract:Affective prosody and facial expression are essential components of human communication. Aprosodic syndromes are associated with focal right cerebral lesions that impair the affective-prosodic aspe...
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Affective prosody: what do comprehension errors tell us about hemispheric lateralization of emotions, sex and aging effects, and the role of cognitive appraisal.
Neuropsychologia, 2010Co-Authors: Elliott D. Ross, Marilee MonnotAbstract:The Aprosodia Battery was developed to distinguish different patterns of affective-prosodic deficits in patients with left versus right brain damage by using affective utterances with incrementally reduced verbal-articulatory demands. It has also been used to assess affective-prosodic performance in various clinical groups, including patients with schizophrenia, PTSD, multiple sclerosis, alcohol abuse and Alzheimer disease and in healthy adults, as means to explore maturational-aging effects. To date, all studies using the Aprosodia Battery have yielded statistically robust results. This paper describes an extensive, quantitative error analysis using previous results from the Aprosodia Battery in patients with left and right brain damage, age-equivalent controls (old adults), and a group of young adults. This inductive analysis was performed to address three major issues in the literature: (1) sex and (2) maturational-aging effects in comprehending affective prosody and (3) differential hemispheric lateralization of emotions. We found no overall sex effects for comprehension of affective prosody. There were, however, scattered sex effects related to a particular affect, suggesting that these differences were related to cognitive appraisal rather than primary perception. Results in the brain damaged groups did not support the Valence Hypothesis of emotional lateralization but did support the Right Hemisphere Hypothesis of emotional lateralization. When comparing young versus old adults, a robust maturational-aging effect was observed in overall error rates and in the distribution of errors across affects. This effect appears to be mediated, in part, by cognitive appraisal, causing an alteration in the salience of different affective-prosodic stimuli with increasing age. In addition, the maturational-aging effects lend support for the Emotion-Type hypothesis of emotional lateralization and the “classic aging effect” that is due primarily to decline of right hemisphere cognitive functions in senescence. The results of our inductive analysis may help direct future deductive research efforts, exploring the neuropsychology of emotional communication, by taking into account the potentially confounding influence of (1) methodological differences involving construction of test stimuli and assessment procedures, (2) developmental, maturational and aging effects related to cognitive appraisal and (3) whether a stimulus has a primary or social–emotional bias.
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Deficits in affective prosody comprehension: family history of alcoholism versus alcohol exposure.
Alcohol and alcoholism (Oxford Oxfordshire), 2009Co-Authors: Kristen H. Sorocco, Marilee Monnot, Elliott D. Ross, Andrea S. Vincent, William R. LovalloAbstract:Background: Abstinent alcoholics have deficits in comprehending the affective intonation in speech. Prior work suggests that these deficits are due to alcohol exposure rather than preexisting risk factors for alcoholism. The present paper examines whether family history of alcoholism is a contributor to affective prosody deficits in alcoholics. Methods: Fifty-eight healthy, nonabusing young adults with and without a family history of alcoholism or other substance abuse (29 FH+ and 29 FH−) were compared on affective prosody comprehension using the Aprosodia Battery. A secondary analysis was done comparing affective prosody comprehension in FH+ and FH− detoxified alcoholics from an earlier study (17 FH+ and 14 FH−). Results: Performance on the Aprosodia Battery was not related to FH status in either the healthy, nonabusing sample or in the detoxified alcoholic group. Conclusions: The present study lends support to previous research suggesting that deficits in affective prosody comprehension observed in detoxified alcoholics are associated with a history of heavy drinking rather than with a family history of alcoholism.
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Comprehension of affective prosody in veterans with chronic posttraumatic stress disorder.
The Journal of neuropsychiatry and clinical neurosciences, 2009Co-Authors: Thomas W. Freeman, Tim A Kimbrell, John Hart, Elliott D. RossAbstract:Posttraumatic stress disorder (PTSD) is one of the few psychiatric conditions in which a subjective decrease in emotional range serves as a diagnostic criterion. In order to investigate whether veterans with chronic PTSD also experienced objective limitations in emotional perception, the authors administered the Aprosodia Battery to a group of 11 veterans with chronic PTSD, nine subjects with right hemisphere damage, seven subjects with left hemisphere damage, and 12 comparison subjects. The patients with PTSD displayed significant deficiencies in the comprehension and discriminative components of affective speech, similar in severity and performance profile on the Aprosodia Battery to the individuals with focal right hemisphere damage due to ischemic infarction.
Kenneth M. Heilman - One of the best experts on this subject based on the ideXlab platform.
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Journal of Rehabil itation Research & Development Effects of two treatments for Aprosodia secondary to acquired brain injury
2015Co-Authors: Kenneth M. Heilman, Leslie J. Gonzalez RothiAbstract:Abstract—Expressive Aprosodia is an impaired ability to change one’s voice to express common emotions such as joy, anger, and sadness. Individuals with Aprosodia speak in a flat, unemotional voice that often results in miscommunicated emotional messages. This study investigated two conceptually based treatments for expressive Aprosodia: imitative treatment and cognitive-linguistic treatment. Five women and nine men with expressive Aprosodia following right-hemisphere brain damage received the treatments in two phases 1 month apart in random order. Treatment was received 3 to 4 days a week for a total of 20 sessions each phase. As the outcome measure, sentences that elicited treated (happy, angry, sad, neutral) and untreated (fear) emotional tones of voice were administered during baseline, prior to treatment sessions, following treatment termination, and at 1- and 3-month follow-ups. Effect sizes indicated that treatment effects were modest to substantial and that 12 participants responded to at least one treat-ment. Four responsive participants who were available for fol-low-up showed benefit at 1 and 3 months posttreatment. Most visual and statistical analyses were congruent
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Effects of two treatments for Aprosodia secondary to acquired brain injury.
Journal of rehabilitation research and development, 2006Co-Authors: John C. Rosenbek, Amy D. Rodriguez, Kenneth M. Heilman, Susan A. Leon, Gregory P. Crucian, Bethany Hieber, Timothy U. Ketterson, Maribel Ciampitti, Floris Singletary, Leslie J. Gonzalez RothiAbstract:Expressive Aprosodia is an impaired ability to change one's voice to express common emotions such as joy, anger, and sadness. Individuals with Aprosodia speak in a flat, unemotional voice that often results in miscommunicated emotional messages. This study investigated two conceptually based treatments for expressive Aprosodia: imitative treatment and cognitive-linguistic treatment. Five women and nine men with expressive Aprosodia following right-hemisphere brain damage received the treatments in two phases 1 month apart in random order. Treatment was received 3 to 4 days a week for a total of 20 sessions each phase. As the outcome measure, sentences that elicited treated (happy, angry, sad, neutral) and untreated (fear) emotional tones of voice were administered during baseline, prior to treatment sessions, following treatment termination, and at 1- and 3-month followups. Effect sizes indicated that treatment effects were modest to substantial and that 12 participants responded to at least one treatment. Four responsive participants who were available for follow-up showed benefit at 1 and 3 months posttreatment. Most visual and statistical analyses were congruent.
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Active treatments for Aprosodia secondary to right hemisphere stroke.
Journal of rehabilitation research and development, 2005Co-Authors: Susan A. Leon, John C. Rosenbek, Amy D. Rodriguez, Gregory P. Crucian, Bethany Hieber, Beth Holiway, Timothy U. Ketterson, Maribel Ciampitti, Shawna Freshwater, Kenneth M. HeilmanAbstract:This study investigates the effects of two mechanism-based treatments for expressive Aprosodia. Three participants, two women and one man, had a right hemisphere cerebral infarction resulting in affective Aprosodia with greater expressive than receptive deficits. Trained raters determined presence of Aprosodia by judging participants' performance on two emotional communication batteries. A single-subject design with replication across three participants was employed. Sentence production with the use of treated and nontreated emotions was measured during baseline and treatment phases. Sentences were scored for accuracy by a trained rater blind to time of testing and analyzed visually and statistically. Effect sizes calculated on the resulting data for each participant and treatment confirmed modest to substantial treatment effects for both treatments in all three participants. Because of a relative paucity of treatment studies investigating expressive Aprosodia, these data are among the first to suggest that Aprosodia may be amenable to behavioral treatments.
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Novel treatments for expressive Aprosodia: a phase I investigation of cognitive linguistic and imitative interventions.
Journal of the International Neuropsychological Society : JINS, 2004Co-Authors: John C. Rosenbek, Amy D. Rodriguez, Kenneth M. Heilman, Susan A. Leon, Gregory P. Crucian, Bethany Hieber, Beth Holiway, Timothy U. Ketterson, Maribel Ciampitti, Leslie J. Gonzalez-rothiAbstract:This study investigated two mechanism-based treatments for expressive Aprosodia, a disturbance in emotional prosody thought to be governed by the right hemisphere. The 3 participants all suffered right CVA's resulting in expressive Aprosodia. Presence of expressive Aprosodia was determined by performance on two batteries of emotional communication. A single subject ABAC design was employed in which two treatments, one imitative and one cognitive linguistic, were assigned in random order. All participants in this study were randomly assigned to begin with the cognitive linguistic treatment. Probes of treated and untreated emotions were completed during baseline and therapy phases. Probe items were judged by a reliable, trained rater blind to time of testing. Visual and statistical analyses were completed. These analyses confirmed that both treatments were active. For example, effect size calculations confirmed modest to substantial treatment effects for both treatments in all 3 patients. Replication to increase confidence about treatment effect and enhance understanding of the neuromechanisms underlying Aprosodia is underway.
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Emotional prosody in primary progressive aphasia.
Neurology, 2004Co-Authors: Jack W. Tsao, David Dickey, Kenneth M. HeilmanAbstract:Speech often simultaneously communicates propositional and emotional messages. Whereas the propositional message is conveyed by a complex code requiring semantic, lexical, syntactic, and phonemic encoding, the emotional message is often conveyed by prosody, which includes pitch, tempo, and rhythm.1 Broca2 demonstrated in right-handed people that injury to the anterior perisylvian region interferes with the expression of speech. However, Jackson3 observed that even nonfluent aphasic patients could imbue their simple utterances with emotional content by using intonations. He posited that the right hemisphere might be mediating this activity, but this postulate was not tested until Tucker et al.4 demonstrated that patients with right hemisphere damage had impaired ability to express emotional messages by using prosody. Ross and Mesulam5 subsequently described two patients with anterior perisylvian lesions who could not express emotionally intoned speech but could express propositional speech and could comprehend propositional and emotional prosody. Ghacibeh and Heilman6 recently described a woman with a primary progressive expressive affective Aprosodia …
Diana M. Orbelo - One of the best experts on this subject based on the ideXlab platform.
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Impaired comprehension of affective prosody in elderly subjects is not predicted by age-related hearing loss or age-related cognitive decline.
Journal of Geriatric Psychiatry and Neurology, 2005Co-Authors: Diana M. Orbelo, Michael A. Grim, Richard E. Talbott, Elliott D. RossAbstract:Impairments in the ability of elderly people to comprehend affective prosody have been reported, but little is known about the relationship between affective prosodic comprehension and age-related changes in hearing and cognition. The Aprosodia Battery, which included an assessment of attitudinal comprehension, was used to compare affective-prosodic comprehension in young and elderly subjects and to investigate the relationship of results to selected hearing and neuropsychological measures. As a group, the healthy elderly subjects were impaired relative to young subjects on all tasks assessing comprehension of affective prosody. Variability within the elderly group was not predicted by mild to moderate peripheral hearing loss and was only marginally predicted by traditional cognitive measures. These findings along with those of other researchers suggest that loss of affective-prosodic comprehension in elderly persons is related to a specific aging effect that impairs right hemisphere function.
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Age-related impairments in comprehending affective prosody with comparison to brain-damaged subjects.
Journal of geriatric psychiatry and neurology, 2003Co-Authors: Diana M. Orbelo, Julie A. Testa, Elliott D. RossAbstract:This study evaluated the ability to produce and comprehend affective prosody across age groups and compared patterns of impaired performance to deficits observed after focal brain damage. Sixty-nine healthy subjects, ages 22 to 83 years, were given the Aprosodia Battery, a test that distinguishes between affective prosodic processing deficits following right- versus left-brain damage through the use of stimuli with progressively reduced verbal articulatory content. Production of affective prosody, measured by variation in fundamental frequency, was unimpaired in older subjects, whereas comprehension of affective prosody was impaired, particularly for tasks with reduced verbal articulatory content. The pattern of performance across affective comprehension tasks in the older subjects resembled the pattern found after right-brain damage. The results demonstrate age-related loss in comprehension of affective prosody that is most likely due to a processing deficit involving the right hemisphere.
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Comprehension of affective prosody in multiple sclerosis.
Multiple sclerosis (Houndmills Basingstoke England), 2003Co-Authors: William W. Beatty, Diana M. Orbelo, Kristen H. Sorocco, Elliott D. RossAbstract:Deficits in cognition have been repeatedly documented in patients with multiple sclerosis (MS), but their ability to comprehend emotional information has received little study. Forty-seven patients with MS and 19 demographic controls received the comprehension portion of the Aprosodia Battery, which is known to be sensitive to the impairments of patients with strokes and other neurological conditions. Patients also received tests of hearing, verbal comprehension and naming, a short cognitive battery, and the Beck Depression Inventory. Patients with MS were impaired in identifying emotional states from prosodic cues. The magnitude of the deficits was greatest for patients with severe physical disability and under test conditions of limited prosodic information. Correlational analyses suggested that the patients' difficulties in comprehending affective prosodic information were not secondary to hearing loss, aphasic deficits, cognitive impairment, or depression. For some patients with MS, deficits in comprehending emotional information may contribute to their difficulties in maintaining effective social interactions.
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Impaired affective prosody in AD: relationship to aphasic deficits and emotional behaviors.
Neurology, 2001Co-Authors: Julie A. Testa, Diana M. Orbelo, William W. Beatty, A. C. Gleason, Elliott D. RossAbstract:Objective: To assess the ability of patients with AD to produce, repeat, and comprehend affective prosody in relationship to severity of dementia, aphasic deficits, and changes in emotional behaviors. Methods: An Aprosodia Battery was used to assess affective-prosodic performance and to identify patterns of deficits in affective communication. In addition, the presence and severity of aberrant behaviors, depression, and aphasia were assessed using standardized assessment tools. Results: Patients with AD had significant impairments in their ability to repeat, comprehend, and discriminate affective aspects of speech, but maintained normal spontaneous affective-prosodic performances. As dementia severity increased, performance on the comprehension tasks and, to a lesser degree, on the repetition tasks became more impaired; spontaneous affective prosody remained normal. In the current study, affective-prosodic comprehension impairments were present in patients with all stages of AD; comparable aphasic deficits were not observed until patients were severely demented. The majority of aphasic deficits involved anomia without loss of comprehension. Patients with AD with sensory Aprosodia had increased frequency and severity of behavioral changes whereas patients with AD with normal affective-prosodic performance were significantly less demented, had normal linguistic ability, and displayed fewer aberrant psychiatric behaviors. Conclusion: Patients with mild AD are at considerable risk for affective-prosodic comprehension deficits. As patients become more demented and develop sensory Aprosodia, they are at greater risk for disturbances in behavior and mood.
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Affective-prosodic deficits in schizophrenia: profiles of patients with brain damage and comparison with relation to schizophrenic symptoms
Journal of neurology neurosurgery and psychiatry, 2001Co-Authors: Elliott D. Ross, Diana M. Orbelo, J Cartwright, S Hansel, M Burgard, Julie A. Testa, R BuckAbstract:OBJECTIVE—Although affective prosody seems to be a dominant and lateralised communication function of the right hemisphere, focal lesions of either hemisphere may cause problems with its modulation. When impairment occurs after brain damage, the profiles of affective-prosodic disturbances differ depending on the hemisphere injured. Patients with left brain damage (LBD) improve their performance whereas patients with right brain damage (RBD) do not when the verbal-articulatory demands of the test stimuli are reduced systematically. One of the major arguments for a right hemispheric contribution to schizophrenia has been the documentation of affective prosodic deficits under the assumption that these abnormalities reflect right hemispheric dysfunction. Thus, an essential question to resolve is whether the profile of affective prosodic disturbances in schizophrenia is similar to LBD or RBD, or represents a unique variation. METHODS—Data were collected from four subject groups: 45 chronic, medication-stabilised, schizophrenic patients, 10 patients with focal LBD, nine patients with focal RBD, and 19 controls. All groups were tested on the Aprosodia battery, which uses stimuli having incrementally reduced verbal-articulatory demands. Schizophrenic and aphasic symptoms were evaluated using standard assessment tools. RESULTS—For patients with impaired performance on the Aprosodia battery, schizophrenic patients were statistically identical to patients with RBD and robustly different from those with LBD. Thirty eight schizophrenic patients (84.4%) were found to have some type of affective prosodic deficit with the predominant pattern indicating, at minimum, right posterior sylvian dysfunction (57.8%). When schizophrenic symptoms and aprosodic deficits were examined using a principal component analysis, affective comprehension and repetition loaded uniquely as separate factors. CONCLUSIONS—The profile of affective-prosodic deficits found in impaired schizophrenic patients is characteristic of RBD, supporting the concept that schizophrenia is a bihemispheric disease process. These deficits may also represent cardinal symptoms of schizophrenia as they are highly prevalent and, except for spontaneous affective prosody, are not associated statistically with traditional clusters of schizophrenic symptoms.
Susan A. Leon - One of the best experts on this subject based on the ideXlab platform.
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Journal of Rehabil itation Research & Development Active treatments for Aprosodia secondary to right hemisphere stroke
2015Co-Authors: Susan A. Leon, Gregory P. Crucian, Shawna Freshwater, Ma John, C. Rosenbek, Phd Bethany Hieber, Phd Kenneth Heilman, Leslie J. Gonzalez-rothiAbstract:Abstract—This study investigates the effects of two mecha-nism-based treatments for expressive Aprosodia. Three partici-pants, two women and one man, had a right hemisphere cerebral infarction resulting in affective Aprosodia with greater expressive than receptive deficits. Trained raters determined presence of Aprosodia by judging participants ’ performance on two emotional communication batteries. A single-subject design with replication across three participants was employed. Sentence production with the use of treated and nontreated emotions was measured during baseline and treatment phases. Sentences were scored for accuracy by a trained rater blind to time of testing and analyzed visually and statistically. Effect sizes calculated on the resulting data for each participant and treatment confirmed modest to substantial treatment effects for both treatments in all three participants. Because of a relativ
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Right Hemisphere Damage and Prosody
Oxford Handbooks Online, 2015Co-Authors: Susan A. Leon, Amy D. Rodriguez, John C. RosenbekAbstract:Communication requires interdependent functioning of large portions of the brain, and damage to any of these systems can disrupt effective and appropriate communication. Damage to the right hemisphere or basal ganglia can result in difficulty using or understanding prosodic contours in speech. Prosody includes pitch, loudness, rate, and voice quality, and is used to convey emotional connotation or linguistic intent. A disorder in the comprehension or production of prosody is known as Aprosodia; affective Aprosodia is a specific deficit affecting emotional or affective prosodic contours. The right hemisphere has been shown to play a critical role in processing emotional prosody and Aprosodia syndromes resulting from damage to right hemisphere areas have been proposed. These include an expressive Aprosodia resulting from anterior damage and a receptive Aprosodia resulting from more posterior damage. Assessment and diagnosis of Aprosodia in clinical settings are often perceptually based; however, acoustic analyses of means and ranges of frequency, intensity, and rate provide an instrumented analysis of prosody production. The treatment of Aprosodia following stroke has received scant attention in comparison to other disorders of communication, although a few studies investigating cognitive–linguistic and imitative treatments have reported some positive results.
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Aprosodia and Its Treatment
Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 2008Co-Authors: Susan A. Leon, Amy D. RodriguezAbstract:Abstract Aprosodia is a deficit in comprehending or expressing variations in tone of voice used to express both linguistic and emotional information. Affective Aprosodia refers to a specific defici...
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Effects of two treatments for Aprosodia secondary to acquired brain injury.
Journal of rehabilitation research and development, 2006Co-Authors: John C. Rosenbek, Amy D. Rodriguez, Kenneth M. Heilman, Susan A. Leon, Gregory P. Crucian, Bethany Hieber, Timothy U. Ketterson, Maribel Ciampitti, Floris Singletary, Leslie J. Gonzalez RothiAbstract:Expressive Aprosodia is an impaired ability to change one's voice to express common emotions such as joy, anger, and sadness. Individuals with Aprosodia speak in a flat, unemotional voice that often results in miscommunicated emotional messages. This study investigated two conceptually based treatments for expressive Aprosodia: imitative treatment and cognitive-linguistic treatment. Five women and nine men with expressive Aprosodia following right-hemisphere brain damage received the treatments in two phases 1 month apart in random order. Treatment was received 3 to 4 days a week for a total of 20 sessions each phase. As the outcome measure, sentences that elicited treated (happy, angry, sad, neutral) and untreated (fear) emotional tones of voice were administered during baseline, prior to treatment sessions, following treatment termination, and at 1- and 3-month followups. Effect sizes indicated that treatment effects were modest to substantial and that 12 participants responded to at least one treatment. Four responsive participants who were available for follow-up showed benefit at 1 and 3 months posttreatment. Most visual and statistical analyses were congruent.
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Active treatments for Aprosodia secondary to right hemisphere stroke.
Journal of rehabilitation research and development, 2005Co-Authors: Susan A. Leon, John C. Rosenbek, Amy D. Rodriguez, Gregory P. Crucian, Bethany Hieber, Beth Holiway, Timothy U. Ketterson, Maribel Ciampitti, Shawna Freshwater, Kenneth M. HeilmanAbstract:This study investigates the effects of two mechanism-based treatments for expressive Aprosodia. Three participants, two women and one man, had a right hemisphere cerebral infarction resulting in affective Aprosodia with greater expressive than receptive deficits. Trained raters determined presence of Aprosodia by judging participants' performance on two emotional communication batteries. A single-subject design with replication across three participants was employed. Sentence production with the use of treated and nontreated emotions was measured during baseline and treatment phases. Sentences were scored for accuracy by a trained rater blind to time of testing and analyzed visually and statistically. Effect sizes calculated on the resulting data for each participant and treatment confirmed modest to substantial treatment effects for both treatments in all three participants. Because of a relative paucity of treatment studies investigating expressive Aprosodia, these data are among the first to suggest that Aprosodia may be amenable to behavioral treatments.
John C. Rosenbek - One of the best experts on this subject based on the ideXlab platform.
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Right Hemisphere Damage and Prosody
Oxford Handbooks Online, 2015Co-Authors: Susan A. Leon, Amy D. Rodriguez, John C. RosenbekAbstract:Communication requires interdependent functioning of large portions of the brain, and damage to any of these systems can disrupt effective and appropriate communication. Damage to the right hemisphere or basal ganglia can result in difficulty using or understanding prosodic contours in speech. Prosody includes pitch, loudness, rate, and voice quality, and is used to convey emotional connotation or linguistic intent. A disorder in the comprehension or production of prosody is known as Aprosodia; affective Aprosodia is a specific deficit affecting emotional or affective prosodic contours. The right hemisphere has been shown to play a critical role in processing emotional prosody and Aprosodia syndromes resulting from damage to right hemisphere areas have been proposed. These include an expressive Aprosodia resulting from anterior damage and a receptive Aprosodia resulting from more posterior damage. Assessment and diagnosis of Aprosodia in clinical settings are often perceptually based; however, acoustic analyses of means and ranges of frequency, intensity, and rate provide an instrumented analysis of prosody production. The treatment of Aprosodia following stroke has received scant attention in comparison to other disorders of communication, although a few studies investigating cognitive–linguistic and imitative treatments have reported some positive results.
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The Effect of Incorporating Knowledge of Performance in the Treatment of Aprosodia
2011Co-Authors: Amy D. Rodriguez, Sona Patel, Nour Bashiti, Rahul Shrivastav, John C. RosenbekAbstract:Evidence suggests that expressive Aprosodia, an impairment of emotional communication, results from a deficit in motor planning/programming. We investigated a treatment incorporating knowledge of performance (KP), an important component in motor learning. Four males with Aprosodia following right hemisphere stroke completed 30 treatment sessions in which prosodic features of targets and responses were displayed using VisiPitch IV®. Perceptual analysis of a sentence-level outcome measure revealed significant improvement in emotional expression. Thus, KP in the form of visual/auditory feedback may be an important component in Aprosodia treatments. Further investigation comparing this approach to traditional forms of clinician feedback is warranted.
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Effects of two treatments for Aprosodia secondary to acquired brain injury.
Journal of rehabilitation research and development, 2006Co-Authors: John C. Rosenbek, Amy D. Rodriguez, Kenneth M. Heilman, Susan A. Leon, Gregory P. Crucian, Bethany Hieber, Timothy U. Ketterson, Maribel Ciampitti, Floris Singletary, Leslie J. Gonzalez RothiAbstract:Expressive Aprosodia is an impaired ability to change one's voice to express common emotions such as joy, anger, and sadness. Individuals with Aprosodia speak in a flat, unemotional voice that often results in miscommunicated emotional messages. This study investigated two conceptually based treatments for expressive Aprosodia: imitative treatment and cognitive-linguistic treatment. Five women and nine men with expressive Aprosodia following right-hemisphere brain damage received the treatments in two phases 1 month apart in random order. Treatment was received 3 to 4 days a week for a total of 20 sessions each phase. As the outcome measure, sentences that elicited treated (happy, angry, sad, neutral) and untreated (fear) emotional tones of voice were administered during baseline, prior to treatment sessions, following treatment termination, and at 1- and 3-month followups. Effect sizes indicated that treatment effects were modest to substantial and that 12 participants responded to at least one treatment. Four responsive participants who were available for follow-up showed benefit at 1 and 3 months posttreatment. Most visual and statistical analyses were congruent.
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Active treatments for Aprosodia secondary to right hemisphere stroke.
Journal of rehabilitation research and development, 2005Co-Authors: Susan A. Leon, John C. Rosenbek, Amy D. Rodriguez, Gregory P. Crucian, Bethany Hieber, Beth Holiway, Timothy U. Ketterson, Maribel Ciampitti, Shawna Freshwater, Kenneth M. HeilmanAbstract:This study investigates the effects of two mechanism-based treatments for expressive Aprosodia. Three participants, two women and one man, had a right hemisphere cerebral infarction resulting in affective Aprosodia with greater expressive than receptive deficits. Trained raters determined presence of Aprosodia by judging participants' performance on two emotional communication batteries. A single-subject design with replication across three participants was employed. Sentence production with the use of treated and nontreated emotions was measured during baseline and treatment phases. Sentences were scored for accuracy by a trained rater blind to time of testing and analyzed visually and statistically. Effect sizes calculated on the resulting data for each participant and treatment confirmed modest to substantial treatment effects for both treatments in all three participants. Because of a relative paucity of treatment studies investigating expressive Aprosodia, these data are among the first to suggest that Aprosodia may be amenable to behavioral treatments.
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Novel treatments for expressive Aprosodia: a phase I investigation of cognitive linguistic and imitative interventions.
Journal of the International Neuropsychological Society : JINS, 2004Co-Authors: John C. Rosenbek, Amy D. Rodriguez, Kenneth M. Heilman, Susan A. Leon, Gregory P. Crucian, Bethany Hieber, Beth Holiway, Timothy U. Ketterson, Maribel Ciampitti, Leslie J. Gonzalez-rothiAbstract:This study investigated two mechanism-based treatments for expressive Aprosodia, a disturbance in emotional prosody thought to be governed by the right hemisphere. The 3 participants all suffered right CVA's resulting in expressive Aprosodia. Presence of expressive Aprosodia was determined by performance on two batteries of emotional communication. A single subject ABAC design was employed in which two treatments, one imitative and one cognitive linguistic, were assigned in random order. All participants in this study were randomly assigned to begin with the cognitive linguistic treatment. Probes of treated and untreated emotions were completed during baseline and therapy phases. Probe items were judged by a reliable, trained rater blind to time of testing. Visual and statistical analyses were completed. These analyses confirmed that both treatments were active. For example, effect size calculations confirmed modest to substantial treatment effects for both treatments in all 3 patients. Replication to increase confidence about treatment effect and enhance understanding of the neuromechanisms underlying Aprosodia is underway.