Changes in auditory feedback connections determine the severity of speech processing deficits after stroke

Thomas M Schofield, Will D. Penny, Klaas E Stephan, Jennifer T Crinion, Alan J Thompson, Cathy J Price, Alexander P Leff

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30 Citations (Scopus)


We compared brain structure and function in two subgroups of 21 stroke patients with either moderate or severe chronic speech comprehension impairment. Both groups had damage to the supratemporal plane; however, the severe group suffered greater damage to two unimodal auditory areas: primary auditory cortex and the planum temporale. The effects of this damage were investigated using fMRI while patients listened to speech and speech-like sounds. Pronounced changes in connectivity were found in both groups in undamaged parts of the auditory hierarchy. Compared to controls, moderate patients had significantly stronger feedback connections from planum temporale to primary auditory cortex bilaterally, while in severe patients this connection was significantly weaker in the undamaged right hemisphere. This suggests that predictive feedback mechanisms compensate in moderately affected patients but not in severely affected patients. The key pathomechanism in humans with persistent speech comprehension impairments may be impaired feedback connectivity to unimodal auditory areas.

Original languageEnglish
Pages (from-to)4260-4270
Number of pages11
JournalThe Journal of Neuroscience
Issue number12
Publication statusPublished - 21 Mar 2012


  • Acoustic Stimulation
  • Adult
  • Aged
  • Aged 80 and over
  • Auditory Cortex
  • Auditory Pathways
  • Brain Mapping
  • Comprehension
  • Female
  • Humans
  • Computer-Assisted Image Processing
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Statistical Models
  • Nonlinear Dynamics
  • Oxygen
  • Speech Disorders
  • Speech Perception
  • Stroke

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