Right ventral stream damage underlies both poststroke aprosodia and amusia

Abstract

Background and purpose This study was undertaken to determine and compare lesion patterns and structural dysconnectivity underlying poststroke aprosodia and amusia, using a data‐driven multimodal neuroimaging approach. Methods Thirty‐nine patients with right or left hemisphere stroke were enrolled in a cohort study and tested for linguistic and affective prosody perception and musical pitch and rhythm perception at subacute and 3‐month poststroke stages. Participants listened to words spoken with different prosodic stress that changed their meaning, and to words spoken with six different emotions, and chose which meaning or emotion was expressed. In the music tasks, participants judged pairs of short melodies as the same or different in terms of pitch or rhythm. Structural magnetic resonance imaging data were acquired at both stages, and machine learning‐based lesion–symptom mapping and deterministic tractography were used to identify lesion patterns and damaged white matter pathways giving rise to aprosodia and amusia. Results Both aprosodia and amusia were behaviorally strongly correlated and associated with similar lesion patterns in right frontoinsular and striatal areas. In multiple regression models, reduced fractional anisotropy and lower tract volume of the right inferior fronto‐occipital fasciculus were the strongest predictors for both disorders, over time. Conclusions These results highlight a common origin of aprosodia and amusia, both arising from damage and disconnection of the right ventral auditory stream integrating rhythmic–melodic acoustic information in prosody and music. Comorbidity of these disabilities may worsen the prognosis and affect rehabilitation success.

Surgical Removal of the Right Arcuate Fasciculus Does Not Impair Music and Affective Prosody: a Single Case Study

“…More importantly, a recent study (Sihvonen et al, 2022) investigated for the rst time the overlap of lesions resulting in both aprosodia and amusia in a large sample of subacute stroke patients. These authors showed that both acquired aprosodia (linguistic and affective) and acquired amusia (pitch and rhythm) were associated with signi cantly overlapping lesion patterns in the right frontal and basal ganglia regions.…”

“…Indeed, neuropsychological overlap between coinciding de cits in prosody and music processing have been reported (Hausen et al, 2013;Nicholson et al, 2003;. Patel et al, 1998, Sihvonen et al, 2022. Moreover, subtle de cits in linguistic and affective prosody have been observed in congenital amusics (Lima et al, 2016;Thompson et al, 2012).…”

The Neural Basis of Tonal Processing in Music: An ALE Meta-Analysis

“…In addition, amusic individuals show impaired performance in explicitly judging the emotional prosody of short vocal samples based on pitch and spectro-temporal parameters (Pralus et al, 2019). Aprosodia and amusia are jointly associated with an abnormality in the right ventral pathway (Sihvonen et al, 2022). Overall, the ventral auditory pathway might not merely be a semantic pathway, but a system that also encodes affective semantics, especially in the right hemisphere.…”

Elevated Activity in Left Homologous Music Circuits is Maladaptive for Music Perception but Mediated by Decoupled Structure and Function

“…In which, right superior temporal gyrus (STG) and inferior frontal gyrus (IFG) are core regions, other regions such as the right insula and inferior parietal lobule (IPL) located on both circuits also play a role in music processing. Altered function or structure in both circuits were reported (Albouy et al, 2019; Albouy et al, 2013; Chen and Yuan, 2016; Hyde et al, 2007; Jin et al, 2021a; Liao et al, 2022; Norman-Haignere et al, 2016; Sihvonen et al, 2016; Sihvonen et al, 2017a; Sihvonen et al, 2021; Sihvonen et al, 2017b; Sun et al, 2021). There is an acknowledged cognition-related interaction between structure and function, however, current studies only explored musical neural processes via multiple unimodal features separately to date.…”