Progressive dysfluency associated with right hemisphere disease

A late onset progressive dysfluency following a right hemisphere stroke occurred in a 62-year-old male. Dysfluency was characterized by pronounced word and phrase reiterations, and sound and syllable reiterations to a lesser degree. Spontaneous speech was significantly more dysfluent than oral reading and repetition. Recitation and singing were minimally dysfluent. Reiterations were accompanied by reduced vocal loudness and increased rate of speech. Reiterations occurred in initial, medial, and final sentence position. Secondary symptoms such as facial grimacing were absent. In contrast to acquired cortical stuttering which is characterized by a preponderance of sound and syllable sentence initial repetitions, dysfluency was more closely characteristic of palilalia. The dysfluency occurred as a symptom of a diffuse nonspecific subcortical projection system defect related to massive infarction in the right middle cerebral artery distribution with associated atrophy.     

Palilalia and repetitive speech: two case studies.

Palilalia, a disorder of speech characterized by compulsive repetitions of utterances has been found in various neurological and psychiatric disorders. It has commonly been interpreted as a defect of motor speech. This article describes palilalia and other variants of verbal repetitive behavior, such as monosyllabic iterations and conduite d'approche. The clinical features of palilalia, its prevalence in different language tasks, and the individual patterns of verbal repetitive behavior are illustrated in two patients with a long-standing cerebrovascular disease. An attempt is made to locate the origin of different forms of verbal repetitions in a standard model of speech production (Butterworth, 1980a; Garrett, 1980; Levelt, 1989) by analysis of their morphology and correlation with impairments of lexical or phonological processes. From these observations it is suggested that palilalia results from control malfunctions at the level of the Articulator, whereas other variants of pathological verbal iterations result from an impairment of the Formulator or from malfunctions of both the Articulator and the Formulator.     

A different form of agraphia: Syntactic writing errors in patients with motor speech and movement disorders

Three patients are described who displayed syntactic writing errors in combination with a motor speech disturbance and impaired motor limb function. Two of the patients had bulbar amyotrophic lateral sclerosis (ALS). Agraphia appeared when verbal communication was no longer possible. Autopsy in one patient disclosed only lesions consistent with ALS. The third patient had palilalia and chorea and, although not aphasic, his written language showed persistent syntactic errors. We hypothesize that the agraphia in these patients occurred because of the combination of disordered feedback from the motor speech apparatus and limbs.     

Vibrotactile timing: Are vibrotactile judgements of duration affected by repetitive stimulation?

Timing in the vibrotactile modality was explored. Previous research has shown that repetitive auditory stimulation (in the form of click-trains) and visual stimulation (in the form of flickers) can alter duration judgements in a manner consistent with a “speeding up” of an internal clock. In Experiments 1 and 2 we investigated whether repetitive vibrotactile stimulation in the form of vibration trains would also alter duration judgements of either vibrotactile stimuli or visual stimuli. Participants gave verbal estimates of the duration of vibrotactile and visual stimuli that were preceded either by five seconds of 5-Hz vibration trains, or, by a five-second period of no vibrotactile stimulation, the end of which was signalled by a single vibration pulse (control condition). The results showed that durations were overestimated in the vibrotactile train conditions relative to the control condition; however, the effects were not multiplicative (did not increase with increasing stimulus duration) and as such were not consistent with a speeding up of the internal clock, but rather with an additive attentional effect. An additional finding was that the slope of the vibrotactile psychometric (control condition) function was not significantly different from that of the visual (control condition) function, which replicates a finding from a previous cross-modal comparison of timing.     

Electromyography analysis of the denervation and reinnervation processes

An analysis of motor unit action potentials duration in 1065 patients suffering from various disorders of peripheral motor nerve and the results of fiber density measure in 88 patients are presented. The authors show the benefits of using of action potential duration histograms for diagnostic aims. The measurement of average potential duration is not recommended.     

Asymmetrical hand usage in infancy: An ethological approach

Observations of the motor behavior of 22 infants were made by 8-hour daily video recording of nursery school activity over 11 days. Recorded object-oriented manipulating or holding actions were scored as the number of movements made by each hand separately and together, by each child, each day, and the average duration of hand activity. For the group, the right hand made significantly more movements than the left, and the duration of right-hand use was longer than the left. Although individual differences in frequency of hand use were reliably consistent, they were not for movement duration. The results show that data from spontaneous object manipulation can be a highly reliable and valid means of assessing differences in hand usage.     

Detailed analysis of the male copulatory motor pattern in mammals: hormonal bases

Data obtained, using a polygraphic technique, on the characteristics of the motor and genital copulatory responses of male rabbits, rats, mice, hamsters, and guinea pigs are reviewed. This methodology provided detailed information, not accessible to other analyses, on the frequency and dynamic organization of copulatory pelvic thrusting trains of the species studied. This comparative analysis showed that: (1) The male rat may display two types of ejaculatory responses, differing in the dynamic organization of the pelvic thrusting train, and in the duration of the intravaginal thrusting period preceding ejaculation. (2) In the guinea pigs and small rodents, but not in rabbits, pelvic thrusting at ejaculatory responses persists during intromission, and a period of fast intravaginal thrusting is associated with ejaculation. (3) The motor copulatory pattern of the rabbit, but not of the rat, hamster, or guinea pig, is affected by castration and hormone treatment, suggesting that, in rabbits, androgen acts both on motivation and on the spinal neural systems related to copulation.     

The effects of sound duration on newborns' head orientation

Two experiments assessed the importance of sound duration for eliciting head orientation responses from newborn infants. In Experiment 1, thirty infants turned with equal frequency toward 20-s continuous rattle sounds and 20-s trains of rattle segments. The duration of the rattle segments--14 and 100 ms (2/s), or 500 ms (1/s)--did not influence the likelihood of turning. Response latencies and durations proved quite similar for all stimuli. In Experiment 2, twenty-four infants heard continuous rattle sounds of four different durations: 1, 5, 10, and 20 s. They turned reliably to all stimulus durations; furthermore, the magnitude and temporal characteristics of head orientation responses did not differ for the four stimulus durations. These results suggest that the newborn's head orientation response may reflect a motor program that is initiated by auditory input and then executed in a similar fashion regardless of further stimulation.     

Effects of utterance length on lip kinematics in aphasia

Most existing models of language production and speech motor control do not explicitly address how language requirements affect speech motor functions, as these domains are usually treated as separate and independent from one another. This investigation compared lip movements during bilabial closure between five individuals with mild aphasia and five age and gender-matched control speakers when the linguistic characteristics of the stimuli were varied by increasing the number of syllables. Upper and lower lip movement data were collected for mono-, bi- and tri-syllabic nonword sequences using an AG 100 EMMA system. Each task was performed under both normal and fast rate conditions. Single articulator kinematic parameters (peak velocity, amplitude, duration, and cyclic spatio-temporal index) were measured to characterize lip movements. Results revealed that compared to control speakers, individuals with aphasia showed significantly longer movement duration and lower movement stability for longer items (bi- and tri-syllables). Moreover, utterance length affected the lip kinematics, in that the monosyllables had smaller peak velocities, smaller amplitudes and shorter durations compared to bi- and trisyllables, and movement stability was lowest for the trisyllables. In addition, the rate-induced changes (smaller amplitude and shorter duration with increased rate) were most prominent for the short items (i.e., monosyllables). These findings provide further support for the notion that linguistic changes have an impact on the characteristics of speech movements, and that individuals with aphasia are more affected by such changes than control speakers.     

Investigating speech motor practice and learning in people who stutter

In this exploratory study, we investigated whether or not people who stutter (PWS) show motor practice and learning changes similar to those of people who do not stutter (PNS). To this end, five PWS and five PNS repeated a set of non-words at two different rates (normal and fast) across three test sessions (T1, T2 on the same day and T3 on a separate day, at least 1 week apart). The results indicated that PWS and PNS may resemble each other on a number of performance variables (such as movement amplitude and duration), but they differ in terms of practice and learning on variables that relate to movement stability and strength of coordination patterns. These findings are interpreted in support of recent claims about speech motor skill limitations in PWS.

Educational objectives: The reader will be able to: (1) define oral articulatory changes associated with motor practice and learning and their measurement; (2) summarize findings from previous studies examining motor practice and learning in PWS; and (3) discuss hypotheses that could account for the present findings that suggest PWS and PNS differ in their speech motor learning abilities.     

A method for increasing the reinforcement magnitude of intracranial stimulation

Schedules of intermittent brain-stimulation reinforcement have been shown to maintain performances when a reinforcement is defined as several response-produced, brief trains of stimulation. The present experiments show that the number of response-produced trains permitted per reinforcement is a variable analogous to amount or magnitude of reinforcement in the conventional food-reinforcement experiment. Systematic effects were obtained when that variable was manipulated within a multiple schedule and also on variable-interval schedules programmed concurrently.     

Involuntary vocalisations and a complex hyperkinetic movement disorder following left side thalamic haemorrhage

A variety of involuntary speech phenomena as for example palilalia have been described as consequences of neurological disorders. Palilalia is the involuntary repetition of syllabels, words and phrases in ongoing speech. We describe a 73 year old woman who suffered from a hypertensive thalamic haemorrhage. MRI revealed that the lesion was predominantly located within the pulvinar, extending to the lateroposterior thalamic nuclei and to the pretectal area with possible involvement of the medial geniculate body. Few months after the event she developed involuntary vocalisations with whole words and meaningless syllables being rapidly reiterated. In contrast to typical palilalia these vocalisations were not meaningfully related to the ongoing speech of the patient. In addition, the patient developed a complex hyperkinetic movement disorder with right-sided painful hemidystonia and bilateral clonic jerks and a right-sided postural tremor.     

Reaction time methods in the study of motor programming: the precuing of hand, digit, and duration

Recent reaction time analysis of motor programming has utilized a precue stimulus that provides advance information about some or all of the attributes for the upcoming motor response. This kind of precue typically confounds the number of remaining stimuli with the motoric processes under investigation (Zelaznik, 1978). In Experiments 1 and 2 the precuing of hand, digit, and duration of a key press response was manipulated. A new precuing procedure was utilized that does not confound the number of stimuli with the motoric processes under investigation. The findings of Experiments 1 and 2 demonstrate that none of the advance information was helpful in reducing reaction time and as such, suggest that these features of movement are not selected in any particular order. Experiment 3 compared this new method of precuing to the other, traditional method. The results of this experiment suggested that there is parallel processing of the perceptual and motor mental operations in this reaction-time task, since there was an underadditive interaction between the number of stimulus response alternatives and the non-precued movement dimensions. This paper highlights problems inherent in the utilization of precursing methods to understand motor programming processes. It appears that a better understanding about the variables involved in movement control is necessary before examining the order of selection of those variables.     

Effect of manipulating the risetime of an acoustic stimulus on two protective reflexes: cardiac defense and motor startle

Effect of manipulating the risetime of an acoustic stimulus on two protective reflexes: cardiac defense and motor startle. The risetime is a parametric characteristic of the eliciting stimulus frequently used to differentiate among psychophysiological reflexes. The aim of the present study was to examine the effect of manipulating the risetime of an acoustic stimulus on two protective reflexes: cardiac defense and motor startle. 100 participants underwent a psychophysiological reactivity test to five presentations of an intense acoustic stimulus (105 dB white noise) under one of five risetime conditions: 0, 24, 48, 96, and 240 ms. Total energy of the stimulus was controlled by increasing the base duration of the stimulus (1000 ms) by one third of the risetime. Results showed that risetime significantly affected motor startle but not cardiac defense. Startle amplitude decreased linearly with increasing risetime after 24 ms. On the other hand, repetition of the stimulus significantly affected cardiac defense but not motor startle. These results question the traditional differentiation between startle and defense based on risetime.     

Reaction Time Methods in the Study of Motor Programming

Recent reaction time analysis of motor programming has utilized a precue stimulus that provides advance information about some or all of the attributes for the upcoming motor response. This kind of precue typically confounds the number of remaining stimuli with the motoric processes under investigation (Zelaznik, 1978). In Experiments 1 and 2 the precuing of hand, digit, and duration of a key press response was manipulated. A new precuing procedure was utilized that does not confound the number of stimuli with the motoric processes under investigation. The findings of Experiments 1 and 2 demonstrate that none of the advance information was helpful in reducing reaction time and as such, suggest that these features of movement are not selected in any particular order. Experiment 3 compared this new method of precuing to the older, traditional method. The results of this experiment suggested that there is parallel processing of the perceptual and motor mental operations in this reaction-time task, since there was an underadditive interaction between the number of stimulus response alternatives and the non-precued movement dimensions. This paper highlights problems inherent in the utilization of precuing methods to understand motor programming processes. It appears that a better understanding about the variables involved in movement control is necessary before examining the order of selection of those variables.     

Anxiety and speaking in people who stutter: An investigation using the emotional Stroop task

People with anxiety disorders show an attentional bias towards threat or negative emotion words. This exploratory study examined whether people who stutter (PWS), who can be anxious when speaking, show similar bias and whether reactions to threat words also influence speech motor planning and execution. Comparisons were made between 31 PWS and 31 fluent controls in a modified emotional Stroop task where, depending on a visual cue, participants named the colour of threat and neutral words at either a normal or fast articulation rate. In a manual version of the same task participants pressed the corresponding colour button with either a long or short duration. PWS but not controls were slower to respond to threat words than neutral words, however, this emotionality effect was only evident for verbal responding. Emotionality did not interact with speech rate, but the size of the emotionality effect among PWS did correlate with frequency of stuttering. Results suggest PWS show an attentional bias to threat words similar to that found in people with anxiety disorder. In addition, this bias appears to be contingent on engaging the speech production system as a response modality. No evidence was found to indicate that emotional reactivity during the Stroop task constrains or destabilises, perhaps via arousal mechanisms, speech motor adjustment or execution for PWS.Educational objectives: The reader will be able to: (1) explain the importance of cognitive aspects of anxiety, such as attentional biases, in the possible cause and/or maintenance of anxiety in people who stutter, (2) explain how the emotional Stroop task can be used as a measure of attentional bias to threat information, and (3) evaluate the findings with respect to the relationship between attentional bias to threat information and speech production in people who stutter.     

Bicycle fatalities: Trends in crashes with and without motor vehicles in The Netherlands

Boufous and Olivier (2015) recently found an increasing trend of police-reported cyclist deaths in single-vehicle crashes while a decreasing trend was found for fatal bicycle-motor vehicle crashes. This study sets out to conduct the same trend analyses for the Netherlands using causes of death statistics. The results show that for 1996–2014, the number of cyclist deaths in motor vehicle collisions per km cycled (i.e. the risk) has declined by 3.8% per annum (95% CI: −4.6%, −3.0%) while the risk of cyclist deaths in crashes without motor vehicles increased by 7.0% per annum (95% CI: 5.5%, 8.7%). The large majority of cyclist deaths at the beginning of the study period were due to bicycle-motor vehicle crashes. By 2014, however, the share with motor vehicles was only slightly higher than the share without motor vehicles. We also conducted trend analyses controlling for age by stratifying into nine age groups. After controlling for age, the average annual decrease of cyclist deaths in crashes with motor vehicles was 5.4% (95% CI: −6.0% to − 4.7%). The average annual increase of deaths in crashes without motor vehicles was 4.4% (95% CI: 3.1–5.7%). These trends are more favourable than those without controlling for age which can be explained by more cycling among the elderly who have an elevated risk. We conclude that, similar to Australia, cyclist deaths following motor vehicle crashes in the Netherlands have decreased while deaths without motor vehicles have increased.     

Effect of click rate and delay on breakdown of the precedence effect

The precedence effect was tested as a function of echo-click delay and click rate after an abrupt switch in location between leading and lagging clicks. Click trains at three rates, 1/sec, 2/sec, and 4/sec, with delays ranging between 2 and 20 msec, were presented to subjects in an anechoic chamber. Duration of the click train after the switch in location was 12 sec, and echo click perceptibility was assessed throughout this period. The number of echo clicks heard was an increasing monotonic function of delay. The subjects reported a "fade-out" of echo clicks after a set number of clicks at each delay, regardless of rate. This result was interpreted as a buildup in inhibition of echoes produced by the ongoing click train. Suppression of echoes was stronger when the leading click originated from the right side than from the left side.     

Fluency disorders in genetic syndromes

The characteristics of various genetic syndromes have included “stuttering” as a primary symptom associated with that syndrome. Specifically, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Tourette syndrome, Neurofibromatosis type I, and Turner syndrome all list “stuttering” as a characteristic of that syndrome. An extensive review of these syndromes indicated clients diagnosed with these syndromes do show evidence of nonfluency patterns, but not all would be considered stuttering. Many of the syndromes are marked by degrees of mental retardation that probably contribute to a higher than average prevalence of stuttering, as well as a higher than average prevalence of other fluency disorders (when compared to the population at large).

An in-depth analysis of the available data indicates that some of these genetic syndromes show patterns of stuttering that may be indicative of only that syndrome (or similar syndromes) that can be differentially diagnosed from developmental stuttering. Among these patterns are the word-final nonfluencies noted in Prader-Willi syndrome; the presence of stuttering in the absence of secondary behaviors noted in Prader-Willi syndrome and; the presence of palilalia, word-final and word-medial nonfluencies, and word-medial and word-final nonfluencies in Tourette syndrome. Implications for future research are discussed in light of these findings.

Educational objectives: The reader will be able to: (1) describe the various different genetic syndromes that are associated with fluency disorders; (2) describe the types of nonfluencies that are associated with the major types of genetic syndromes that have fluency disorders; (3) describe the behaviors that may assist in differentially diagnosing different types of speech characteristics associated with various genetic syndromes.     

Sustained increase in hippocampal sharp-wave ripple activity during slow-wave sleep after learning

High-frequency oscillations, known as sharp-wave/ripple (SPW-R) complexes occurring in hippocampus during slow-wave sleep (SWS), have been proposed to promote synaptic plasticity necessary for memory consolidation. We recorded sleep for 3 h after rats were trained on an odor-reward association task. Learning resulted in an increased number SPW-Rs during the first hour of post-learning SWS. The magnitude of ripple events and their duration were also elevated for up to 2 h after the newly formed memory. Rats that did not learn the discrimination during the training session did not show any change in SPW-Rs. Successful retrieval from remote memory was likewise accompanied by an increase in SPW-R density and magnitude, relative to the previously recorded baseline, but the effects were much shorter lasting and did not include increases in ripple duration and amplitude. A short-lasting increase of ripple activity was also observed when rats were rewarded for performing a motor component of the task only. There were no increases in ripple activity after habituation to the experimental environment. These experiments show that the characteristics of hippocampal high-frequency oscillations during SWS are affected by prior behavioral experience. Associative learning induces robust and sustained (up to 2 h) changes in several SPW-R characteristics, while after retrieval from remote memory or performance of a well-trained procedural aspect of the task, only transient changes in ripple density were induced.