Explicit Training to Improve Affective Prosody Recognition in Adults with Acute Right Hemisphere Stroke

Abstract

Difficulty recognizing affective prosody (receptive aprosodia) can occur following right hemisphere damage (RHD). Not all individuals spontaneously recover their ability to recognize affective prosody, warranting behavioral intervention. However, there is a dearth of evidence-based receptive aprosodia treatment research in this clinical population. The purpose of the current study was to investigate an explicit training protocol targeting affective prosody recognition in adults with RHD and receptive aprosodia. Eighteen adults with receptive aprosodia due to acute RHD completed affective prosody recognition before and after a short training session that targeted proposed underlying perceptual and conceptual processes. Behavioral impairment and lesion characteristics were investigated as possible influences on training effectiveness. Affective prosody recognition improved following training, and recognition accuracy was higher for pseudo- vs. real-word sentences. Perceptual deficits were associated with the most posterior infarcts, conceptual deficits were associated with frontal infarcts, and a combination of perceptual-conceptual deficits were related to temporoparietal and subcortical infarcts. Several right hemisphere ventral stream regions and pathways along with frontal and parietal hypoperfusion predicted training effectiveness. Explicit acoustic-prosodic-emotion training improves affective prosody recognition, but it may not be appropriate for everyone. Factors such as linguistic context and lesion location should be considered when planning prosody training.

Emotions and the Right Hemisphere: Editorial

“…The third anatomo-clinical paper is the study of Durfee et al [ 7 ], dedicated to an explicit training protocol targeting affective prosody recognition in adults with acute right hemisphere stroke and receptive aprosodia. This investigation has shown that several ventral stream regions and pathways of the right hemisphere can influence training effectiveness.…”

Progress and Trends of Affective Prosody Research over 25 Years: A Bibliometrics-Based Visualization Analysis (1997–2021)

“…Prior experiments that used emotional prosodic cues in a dichotic listening paradigm observed a right-hemisphere privilege (Ocklenburg et al, 2016;Thompson, 1995). Recent studies tried to apply explicit prosody training to patients with RH damage and to identify specific damage areas that can predict training effectiveness (Durfee, Sheppard, Meier et al, 2021). Superior temporal sulcus (STS), as part of the multi-sensory cerebral regions with an observable proportion of bimodal neurons (Watson et al, 2014), modulates audiovisual emotion integration.…”

Reversing the Ruin: Rehabilitation, Recovery, and Restoration After Stroke

“…There has unfortunately been limited investigation of treatment for communication disorders stemming from right-hemisphere stroke [ 123 ] besides cognitive deficits (reported above). Response to a single session of training for affective prosody recognition is reported [ 124 ] and an RCT crossover trial treating right-hemisphere communication deficits (aprosodia) is planned (NCT04575909). One previous study reported gains in prosody production with either cognitive-linguistic or imitative therapy [ 125 ].…”