Impaired speech perception in aphasic patients: event-related potential and neuropsychological assessment

The mismatch negativity component (MMN) of auditory event-related potentials (ERP) was recorded in four aphasic patients and in age, gender and education matched controls. The MMN changes elicited by tone, vowel, voicing stop consonant and place-of articulation contrasts were recorded over both hemispheres. The results of MMN amplitude, latency and distribution differences between aphasics and controls were analyzed in detail. An extensive neuropsychological investigation was performed in order to highlight the assumed dissociation and possible interactions between the impaired acoustic/phonetic perception and deficient comprehension in aphasic patients. Our principal finding was that MMN elicited by pitch deviations is not enough sensitive to distinguish between patients and age-matched controls. The MMN elicited by consonant contrasts was found to be the most vulnerable in aphasic patients investigated. The MMN elicited by voicing ([ba:] vs. [pa:]) and place-of-articulation ([ba:] vs. [ga:]) could be characterized by total lack, distorted or very limited distribution and correlated with the patients' performance shown in the behavioral phoneme discrimination task. The magnitude of the deficient phoneme (vowel and consonant contrasts) processing shown by MMN anomalies was proportionally related to the non-word discrimination and did not interact with the word discrimination performance. The impact of deficient speech sound processing on higher level processes may depend on the type of aphasia, while the presence of perceptual deficits in processing acoustic/phonetic contrasts seems to be independent of the type of aphasia.