ObjectiveTo determine whether right ventral stream and limbic structures (including posterior superior temporal gyrus [STG], STG, temporal pole, inferior frontal gyrus pars orbitalis, orbitofrontal cortex, amygdala, anterior cingulate, gyrus, and the sagittal stratum) are implicated in emotional prosody identification.MethodsPatients with MRI scans within 48 hours of unilateral right hemisphere ischemic stroke were enrolled. Participants were presented with 24 sentences with neutral semantic content spoken with happy, sad, angry, afraid, surprised, or bored prosody and chose which emotion the speaker was feeling based on tone of voice. Multivariable linear regression was used to identify individual predictors of emotional prosody identification accuracy from a model, including percent damage to proposed right hemisphere structures, age, education, and lesion volume across all emotions (overall emotion identification) and 6 individual emotions. Patterns of recovery were also examined at the chronic stage.ResultsThe overall emotion identification model was significant (adjusted r2 = 0.52; p = 0.043); greater damage to right posterior STG (p = 0.038) and older age (p = 0.009) were individual predictors of impairment. The model for recognition of fear was also significant (adjusted r2 = 0.77; p = 0.002), with greater damage to right amygdala (p = 0.047), older age (p < 0.001), and less education (p = 0.005) as individual predictors. Over half of patients with chronic stroke had residual impairments.ConclusionsRight posterior STG in the right hemisphere ventral stream is critical for emotion identification in speech. Patients with stroke with damage to this area should be assessed for emotion identification impairment.

Objective: To identify which aspects of prosody are negatively affected subsequent to right hemisphere brain damage (RHD) and to evaluate the methodological quality of the constituent studies. Method: Twenty-one electronic databases were searched to identify articles from 1970 to February 2020 by entering keywords. Eligibility criteria for articles included a focus on adults with acquired RHD, prosody as the primary research topic, and publication in a peer-reviewed journal. A quality appraisal was conducted using a rubric adapted from Downs and Black (1998). Results: Of the 113 articles appraised as eligible and appropriate for inclusion, 71 articles were selected to undergo data extraction for both meta-analyses of population effect size estimates and qualitative synthesis. Across all domains of prosody, the effect estimate was g = 2.51 [95% CI (1.94, 3.09), t = 8.66, p < 0.0001], based on 129 contrasts between RHD and non-brain-damaged healthy controls (NBD), indicating a significant random effects model. This effect size was driven by findings in emotional prosody, g = 2.48 [95% CI (1.76, 3.20), t = 6.88, p < 0.0001]. Overall, studies of higher quality (rpb = 0.18, p < 0.001) and higher sample size/contrast ratio (rpb = 0.25, p < 0.001) were more likely to report significant differences between RHD and NBD participants. Conclusions: The results confirm consistent evidence for emotional prosody deficits in the RHD population. Inconsistent evidence was observed across linguistic prosody domains and pervasive methodological issues were identified across studies, regardless of their prosody focus. These findings highlight the need for more rigorous and sufficiently high-powered designs to examine prosody subsequent to RHD, particularly within the linguistic prosody domain.

The neural basis of language has been studied for centuries, yet the networks critically involved in simply identifying or understanding a spoken word remain elusive. Several functional–anatomical models of critical neural substrates of receptive speech have been proposed, including (1) auditory-related regions in the left mid-posterior superior temporal lobe, (2) motor-related regions in the left frontal lobe (in normal and/or noisy conditions), (3) the left anterior superior temporal lobe, or (4) bilateral mid-posterior superior temporal areas. One difficulty in comparing these models is that they often focus on different aspects of the sound-to-meaning pathway and are supported by different types of stimuli and tasks. Two auditory tasks that are typically used in separate studies—syllable discrimination and word comprehension—often yield different conclusions. We assessed syllable discrimination (words and nonwords) and word comprehension (clear speech and with a noise masker) in 158 individuals with focal brain damage: left (n = 113) or right (n = 19) hemisphere stroke, left (n = 18) or right (n = 8) anterior temporal lobectomy, and 26 neurologically intact controls. Discrimination and comprehension tasks are doubly dissociable both behaviorally and neurologically. In support of a bilateral model, clear speech comprehension was near ceiling in 95% of left stroke cases and right temporal damage impaired syllable discrimination. Lesion-symptom mapping analyses for the syllable discrimination and noisy word comprehension tasks each implicated most of the left superior temporal gyrus. Comprehension but not discrimination tasks also implicated the left pMTG, whereas discrimination but not comprehension tasks also implicated more dorsal sensorimotor regions in posterior perisylvian cortex.

The neural basis of language has been studied for centuries, yet the networks critically involved in simply identifying or understanding a spoken word remain elusive. Several functional-anatomical models of the critical neural substrates of receptive speech processes have been proposed, including auditory-related regions in the (1) left mid-posterior superior temporal lobe, (2) left anterior superior temporal lobe, or (3) bilateral in the mid-posterior superior temporal areas, and (4) motor-related regions in the left frontal lobe (in normal and/or noisy conditions). One difficulty in comparing these models is that they often focus on different aspects of the sound-to-meaning pathway and different types of stimuli and tasks. Two auditory tasks that are typically used in separate studies-nonword discrimination and word comprehension-often yield different conclusions. We assessed word/nonword discrimination and clear/noisy word comprehension in 160 individuals with focal brain damage: left (n=115) or right (n=19) hemisphere stroke, left (n=18) or right (n=8) anterior temporal lobectomy, and 26 neurologically-intact controls. Discrimination and comprehension doubly dissociated both behaviorally and neurologically. In support of a bilateral model, clear speech comprehension was near ceiling in 92% of left stroke cases, and right temporal damage was, for the first time, found to impair phoneme discrimination. Lesion-symptom mapping analyses for the word discrimination, non-word discrimination, and noisy word comprehension tasks each implicated most of the left superior temporal gyrus (STG) except the anterior most regions. Comprehension tasks also implicated the left pMTG, while discrimination tasks also implicated more dorsal sensorimotor regions in posterior perisylvian cortex. 1 0Control Subjects. Twenty-six adults (21 female, age range = 42-83, mean age = 59 years, years of education range = 12-16, mean education = 15 years) were recruited and tested at San Diego State University. All control subjects were native English speakers, right-handed, and selfreported no history of psychological or neurological disease.Informed consent was obtained from each patient prior to participation in the study, and all procedures were approved by the Institutional Review Boards

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