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Formulaic language resources may help overcome difficulties in speech-motor planning after stroke

MPG-Autoren
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Stahl,  Benjamin
Department of Neurology, Ernst Moritz Arndt University of Greifswald, Germany;
Department of Neurology, Charité University Medicine Berlin, Germany;
Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Psychologische Hochschule Berlin, Germany;

Kotz,  Sonja A.
Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Department of Neuropsychology and Psychopharmacology, Maastricht University, Germany;

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Zitation

Stahl, B., Gawron, B., Regenbrecht, F., Flöel, A., & Kotz, S. A. (2020). Formulaic language resources may help overcome difficulties in speech-motor planning after stroke. PLOS One, 15(6): e0233608. doi:10.1371/journal.pone.0233608.


Zitierlink: https://hdl.handle.net/21.11116/0000-0006-8EEB-2
Zusammenfassung
Purpose. Decades of research have explored communication in cerebrovascular diseases by focusing on formulaic expressions (e.g., “Thank you”—“You’re welcome”). This category of utterances is known for engaging primarily right-hemisphere frontotemporal and bilateral subcortical neural networks, explaining why left-hemisphere stroke patients with speech-motor planning disorders often produce formulaic expressions comparatively well. The present proof-of-concept study aims to confirm that using verbal cues derived from formulaic expressions can alleviate word-onset difficulties, one major symptom in apraxia of speech.

Methods. In a cross-sectional repeated-measures design, 20 individuals with chronic post-stroke apraxia of speech were asked to produce (i) verbal cues (e.g., /guː/) and (ii) subsequent German target words (e.g., “Tanz”) with critical onsets (e.g., /t/). Cues differed, most notably, in aspects of formulaicity (e.g., stereotyped prompt: /guː/, based on formulaic phrase “Guten Morgen”; unstereotyped prompt: /muː/, based on non-formulaic control word “Mutig”). Apart from systematic variation in stereotypy and communicative-pragmatic embeddedness possibly associated with holistic language processing, cues were matched for consonant-vowel structure, syllable-transition frequency, noun-verb classification, meter, and articulatory tempo.

Results. Statistical analyses revealed significant increases in correctly produced word onsets after verbal cues with distinct features of formulaicity (e.g., stereotyped versus unstereotyped prompts: p < 0.001), as reflected in large effect sizes (Cohen’s d ≤ 2.2).

Conclusions. The current results indicate that using preserved formulaic language skills can relieve word-onset difficulties in apraxia of speech. This finding is consistent with a dynamic interplay of left perilesional and right intact language networks in post-stroke rehabilitation and may inspire new treatment strategies for individuals with apraxia of speech.