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Poster E54, Friday, November 10, 10:00 – 11:15 am, Harborview and Loch Raven Ballrooms

Changed resting-state network connectivity following prosody treatment for apraxia of speech

Carl Coelho1, Jennifer Mozeiko1, Xiao Yang1, Lisa Mueller1;1University of Connecticut

-Introduction- Apraxia of speech (AOS) is a neurologic speech disorder resulting in impaired capacity to plan or program sensorimotor commands necessary for movements in phonetically and prosodically normal speech (Duffy, 2013). Treatment is typically focused on sounds or syllables initially, with prosody considered at the end of therapy (Brendel & Ziegler, 2008). New and colleagues (2015) have noted that individuals with AOS had reduced bilateral connectivity compared to stroke patients without AOS and that decreased connectivity of the left premotor cortex (PM) was correlated with AOS severity. In the current study, an intensive treatment targeting prosody was provided to an individual with mild aphasia and mild AOS. We predicted that improvement in measures of speech naturalness post-treatment would be associated with increased bilateral connectivity involving the PM. -Methods- Participant was a 43 year old, right-handed male, two years post-onset of a left CVA involving the posterior left frontal lobe and insular cortex. Pre-treatment testing revealed WAB AQ of 96, and 80% on an AOS screening (Duffy, 2013). Intensive treatment (30 hours over two weeks) was provided which consisted of drills focused on prosodic aspects of speech (stress, intonation, emotion, phrasing, & rhythm). A single-subject design was used to acquire and monitor treatment data over time. Treatment probes included samples of conversational speech, which were later rated for naturalness by naïve listeners. Structural and functional fMRI data were acquired on a Siemens 3T MRI scanner. A high resolution 1 mm3 T1-weighted structural image was collected. Preprocessing was performed using Data Processing & Analysis for Brain Imaging, (Yan et al., 2016). The participant was scanned at three time points: pre-treatment, immediately post-treatment and 7 weeks post-treatment. ROIs were selected based on the work by New et al. (2015) in order to compare findings. Connectivity of ROIs was calculated by performing correlation analysis of time series signals extracted from six ROIs. ---Results- Treatment data reflected modest-moderate gains across all of the targeted prosodic aspects of speech. Gains were maintained at the 7-week post-treatment follow-up. Naturalness of conversational speech ratings did not show considerable change. AOS screening scores improved to 91% and 93% at post-treatment and follow-up respectively. In each of the three scans, significant correlations were found in bilateral connections of IFG (p<0.01) and anterior insula (p<0.01), and in intrahemispheric connection of left IFG and left PM (p<0.001). Strength of connectivity in each of these ROIs increased after treatment The connection of bilateral PM, though not significant in scan 1 (p=0.029), increased in strength and was significant in both scan 2 (p<0.05) and scan 3 (p<0.001). ROI-wise correlation coefficients were transformed into Fisher’s z values that represent the functional connectivity strength for each connection. -Discussion- • Intensive prosody treatment appears to be a viable treatment option for mild AOS and warrants replication. • Increased connectivity in bilateral IFG resembles that of healthy controls. • Increased strength of connectivity between left and right PM and between left PM and right anterior insula corresponded with prosodic improvements, providing an additional indicator of success of treatment.

Topic Area: Language Therapy

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