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Updated: Oct 25, 2026
Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
Published on: July 2, 2013
Functional neural activity and connectivity deficits underlying vocal auditory feedback control in post-stroke
Roozbeh Behroozmand1, Jonathan Venezia2, Kimaya Sarmukadam3
1Speech Neuroscience Lab, Department of Speech Language and Hearing, Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA.
Objective:
This study investigated the functional neural activity and connectivity correlates of disrupted sensorimotor integration underlying vocal production and motor control deficits in post-stroke aphasia.
Methods:
fMRI data were acquired from 15 aphasia and 15 control participants during vocalization of speech vowel sounds under altered auditory feedback with randomized ± 100-cents pitch-shift stimuli.
Results:
We found that stroke-induced brain damage in aphasia was associated with diminished activation within left-hemisphere dorsal stream networks, including premotor and motor cortices, posterior superior temporal regions, and supramarginal gyrus. Functional connectivity analysis revealed reduced left-hemisphere coupling between posterior superior temporal gyrus (pSTG) and dorsal and ventral precentral speech areas (dPSA and vPSA) in aphasia, indicating disrupted auditory-motor integration. Aphasia participants exhibited reduced following and opposing (i.e., compensatory) vocal responses to pitch-shifted auditory feedback, reflecting impairments in both rapid feedforward and slower feedback-based control mechanisms. In addition, impaired vocal compensatory behavior was associated with reduced functional connectivity between pSTG and the left dorsal precentral speech areas (dPSA) as well as the right dorsal laryngeal motor cortex (dLMC), suggesting the critical role of these networks in auditory-feedback-based laryngeal motor control during vocal production and their stroke-induced impairment in aphasia.
Conclusions:
Our data provide converging evidence of disrupted auditory-motor integration and impaired neural communications within dorsal stream networks in aphasia.
Significance:
These findings emphasize that clinical interventions for aphasia therapy benefit from targeting sensorimotor mechanisms supporting vocal auditory feedback processing and control. Personalized interventions that strengthen sensorimotor integration pathways could further enhance recovery of fluent verbal communication.
