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Rhythm and language in post-stroke aphasia: Preliminary findings
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Poster B47 in Poster Session B, Tuesday, October 24, 3:30 - 5:15 pm CEST, Espace Vieux-Port
This poster is part of the Sandbox Series.
Anna V. Kasdan1, Marianne Casilio2, Katherine M. Bryan2, Lily Walljasper2, Noah R. Fram2, Nori Jacoby3, Deborah F. Levy4, Michael de Riesthal2, Reyna L. Gordon2, Stephen M. Wilson2,5; 1Vanderbilt University, 2Vanderbilt University Medical Center, 3Max Planck Institute for Empirical Aesthetics, 4University of California San Francisco, 5University of Queensland
Speech-language pathologists frequently use rhythm-based strategies (e.g., tapping, pacing) in clinical settings to facilitate speech output in individuals with aphasia. These strategies have been incorporated into more formalized therapies such as Melodic Intonation Therapy, predominantly geared towards individuals with severe, non-fluent aphasia. However, there is little empirical research surrounding this well-established clinical practice. Here, we asked which aspects of linguistic processing specifically may be related to musical rhythm in this population using a rigorous battery of tasks. For this sandbox presentation, we present data from 33 individuals with chronic, post-stroke aphasia (age: 58.4+15.9, female: 9) and 29 neurotypical controls matched on age and education (age 62.0+16.6, female: 15). All participants completed rhythm production and perception tasks and a music experience survey designed specifically for the purposes of this study. Individuals with aphasia also completed the Quick Aphasia Battery (QAB; Wilson et al., 2018) and two motor assessments. The rhythm tasks consisted of 1) tapping to three metronome sequences, 2) tapping to the beat of six different musical excerpts, and 3) the perception component of the Beat Alignment Test (Iversen & Patel, 2008). Rhythm tapping data were analyzed using circular statistics, where we derived two dependent variables indexing tapping accuracy and consistency (vector angle and length, respectively). Based on a principal components analysis which supported a single rhythmic tapping construct, we created a rhythm composite score for each individual (sum of z-score normalized vector length and angle, averaged across all tapping trials). Individuals with aphasia varied significantly in their rhythm tapping abilities, with many performing within the range of control participants. However at a group level, individuals with aphasia performed worse than controls (β=1.35+0.46, 95% CI = [0.42, 2.27], t=2.92, p=0.0049). Demographic factors including age, sex, and education were not significant predictors of rhythm tapping performance. This result highlights that therapeutic approaches incorporating rhythmic elements must consider that some individuals with aphasia are impaired in this domain. Exploratory correlations with QAB summary scores indicated that rhythm tapping was associated with all of the language production measures (word finding: r=0.47; grammatical construction: r=0.49; repetition: r=0.39; reading: r=0.39; QAB overall: r=0.39) but none of the motor speech (apraxia, dysarthria) or language perception (word and sentence comprehension) measures. The strength of these correlations was not influenced by formal music training. Tapping was most strongly correlated with grammatical construction even when controlling for overall aphasia severity (with QAB overall in the model, grammatical construction: β = 0.44+0.21, CI = [0.02, 0.86], t=2.15, p=0.040). Our preliminary results largely align with the finding from Zipse et al. (2014) in a smaller sample that some individuals with aphasia exhibit rhythm impairments. In future work, we will explore the neural correlates of rhythm production and perception in post-stroke aphasia using lesion-symptom mapping, which may elucidate possible neuroanatomical links between rhythm and language.
Topic Areas: Disorders: Acquired, Language Production