“I am going to the other movies” Acute Ischemic Lesions Associated with Impairments in Expression & Recognition of Affective Prosody Amy Wright, BA1; Donna Tippett, MPH, MA, CCC-SLP1,2,3; Cameron Davis, MS1; Yessenia Gomez, BS1; Joseph Posner, BA1; Christopher Rorden, PhD5; Argye E. Hillis, MD, MA1,3,4 Department of Neurology1, Department of Otolaryngology—Head and Neck Surgery2, Department of Physical Medicine and Rehabilitation3, Department of Cognitive Science4, Johns Hopkins University, Baltimore MD and Cognitive Neuropsychology Lab, Center for Aphasia Research and Rehabilitation, University of South Carolina, Columbia, SC5 Figure 2. Z-score of atrophy of bvFTD patient compared to age matched controls Goals (1) Test the hypothesis that there are double dissociations in impairment of expression and recognition of affective prosody after acute right hemisphere ischemic stroke (2) Identify areas of acute ischemia associated with impaired expression and/or recognition of affective prosody after acute ischemic right hemisphere stroke Methods 23 patients with acute right hemisphere ischemic stroke Aprosodia Battery (Ross, Thompson & Yenkosky, 1997): Three types of stimuli were presented to patients, with each type said twice in 6 different emotional tones (happy, sad, neutral, angry, surprised, disinterested) (1) Repetition Task Patients repeated utterances The coefficient of variation of the fundamental frequency (F0 – CV%) was measured Impairment in expressive prosody was indicated by reduced F0 – CV% relative to normal controls (2) Recognition Task Patients listened to the utterances and indicated which emotional tone was used Imaging Lesion maps were manually drawn on the mean diffusivity image generated from the DWI sequence. For lesion symptom mapping we computed permutation thresholded t-tests, using mean Z-score of the production tasks as our index of impairment. Results 9/23 patients had impairments in expression of affective prosody 5 also had impaired recognition of affective prosody 2 had selective deficits in expressive prosody 2 did not complete the prosody recognition tasks 6/23 patients had selective impairment in recognition of affective prosody In lesion mapping the expressive deficit, only right temporal pole survived a p < 0.05 (threshold z < -2.45) with an observed Z- score of -2.46. All patients with right temporal pole lesions had deficits in both expression and recognition of affective prosody (Figure 1). The 2 patients with selective deficits in expressive prosody had right frontal lesions Patients with selective deficits in affective prosody recognition had posterior temporal (n=3), caudate (n=2), or thalamic (n=1) lesions Results are also consistent with a study from our lab, we evaluated variation in prosody of spontaneous speech (using mean F0-CV% across segments) in 50 LH stroke patients, 35 RH stroke patients, and 18 age-matched controls. Only one patient had F0-CV% more than 2 SD below the mean for controls. This patient (MRI at right) also impaired recognition of affective prosody, as well as impaired expression of affective prosody, associated with hypoperfusion of right temporal pole (Figure 3). Conclusions (1) Double dissociation between impaired expressive prosody and impaired recognition of prosody Provides evidence that at least some distinct mechanisms underlying expression and recognition of prosody can be selectively impaired (2) Previous studies have proposed anterior temporal poles as a “semantic hub” in object meaning, and important for understanding social concepts (Pobric, Jefferies, & Ralph, 2010; Zahn et al., 2009) (3) A possible role of right anterior temporal pole in representing the meaning of emotions may account for the associations between lesions (or atrophy or hypoperfusion in this area) and both recognition and expression of affective prosody. Word “I am going to the other movies” Monosyllabic “ba ba ba ba ba ba” Asyllabic “aaaaaahhhh” Discussion Results are consistent with a previous study reporting severe impaired expression and recognition of affective prosody in an individual with behavioral variant frontotemporal dementia (bvFTD) and severe atrophy in right temporal pole (Figure 2), as well as other cases of impaired prosody in bvFTD (Ibanez & Manes, 2012). Results are also consistent with fMRI studies that show activation in right frontotemporal cortex during affective prosody tasks (e.g., Buchanan et al., 2000; Beaucousin et al., 2007). References Beaucousin V, Lacheret A, Turbelin M-R, Morel Ml, Mazoyer B, Tzourio-Mazoyer N. FMRI study of emotional speech comprehension. Cerebral Cortex. 2007; 17:339-352. Buchanan TW, Lutz K, Mirzazade S, Specht K, Shah NJ, Zilles K, Jäncke L. Recognition of emotional prosody and verbal components of spoken language: an fMRI study. Cognitive Brain Research. 2000; 9:227 - 238. Ibanez, A., & Manes, F. (2012). Contextual social cognition and the behavioral variant of frontotemporal dementia. Neurology, 78(17), 1354-1362. doi:10.1212/WNL.0b013e3182518375 [doi] Pobric, G., Jefferies, E., & Ralph, M. A. L. (2010). Amodal semantic representations depend on both anterior temporal lobes: Evidence from repetitive transcranial magnetic stimulation. Neuropsychologia, 48(5), 1336-1342. Ross, E.D., Thompson, R.D., Yenkosky, J.P. (1997). Lateralization of affective prosody in brain and the callosal integration of hemispheric language functions. Brain and Language, 56, 27-54. doi: 10.1006/brln.1997.1731 Zahn, R., Moll, J., Iyengar, V., Huey, E. D., Tierney, M., Krueger, F., & Grafman, J. (2009). Social conceptual impairments in frontotemporal lobar degeneration with right anterior temporal hypometabolism. Brain : A Journal of Neurology, 132(Pt 3), 604-616. doi:10.1093/brain/awn343 [doi] This work was made possible by NIH grant R01NS047691. We gratefully acknowledge this support and our participants.