A Neuropsychological Perspective of Aprosody: Features, Function, Assessment, and Treatment

Abstract

Aprosodia, the inability to either produce or comprehend the affective components of speech or gesture, is a common occurrence after brain injury. The prosodic components of speech assist in inferring the attitude and emotion of the speaker and are vital in everyday communication. A review of the literature suggests that the left hemisphere is responsible for modulating the linguistic components of prosody (e.g., timing), whereas the right hemisphere is predominantly responsible for modulating the affective components of prosody (e.g., spectral information or pitch). Disorders of affective aprosodia have been classified along the same dimensions as the aphasias. Bedside evaluation and neuroimaging have been used to identify and classify types of aprosodia. The treatment goals for aphasia may be adapted and applied to aprosodia. Additionally, pharmacotherapy and biofeedback have been found useful in the treatment of aprosodia and associated features.

Acute Ischemic Lesions Associated With Impairments in Expression and Recognition of Affective Prosody

“…Not only is acute RH dysfunction better predicted by emotional prosody impairments as compared to neglect (Dara et al, 2014), it can also lead to important breakdowns in communication and relationships. Interpretation and use of prosodic elements are crucial for communicative interactions and for the well-being of speakers and communication partners (Carton, Kessler, & Pape, 1999; Heilman, 2002; Ross, 1997; Trauner, Ballantyne, Friedland, & Chase, 1996; Voeller, 1995; Weintraub & Mesulam, 1983; Wymer, Lindman, & Booksh, 2002). Recognition of prosody is one means to judge emotional tenor, and thus evoke an appropriately empathetic response.…”

Stuttered and fluent speech production: An ALE meta‐analysis of functional neuroimaging studies

“…Wildgruber et al [2004] found bilateral activations in the frontal operculum on discrimination tasks for both affective and linguistic prosody; their right-hemisphere activations were located in BA45/46. Much neuropsychological evidence suggests that the right hemisphere may be dominant for production and perception of affective speech prosody [reviewed in Wymer et al, 2002]. Production and perception of vocal fundamental frequency therefore seems mediated, at least in part, by the right frontal operculum/ anterior insula.…”

The right hemisphere's contribution to emotional word processing in currently depressed, remitted depressed, and never-depressed individuals

“…According to this theory, the RH is responsible for processing all emotional information, positive and negative, perceptive and expressive. For example, there is evidence of RH dominance in the comprehension of emotional content in facial expressions and in the processing of prosody, into national and affective information conveyed during speech (Bobes, Martin, Olivares, & Valdez-Sosa, 2000;Bower, Bauer, Coslett, & Heilman, 1993;Ross & Mesulam, 1979;Wymer, Lindman, & Booksh, 2002). This RH dominance for emotion processing is illustrated in Safer and Leventhal's (1977) classic study, in which participants were asked to make a valence judgement for monaurally presented verbal passages differing in affective tone.…”