Méndez Orellana Carolina P, van de Sandt-Koenderman Mieke E, Saliasi Emi, van der Meulen Ineke, Klip Simone, van der Lugt Aad, Smits Marion
Department of Radiology, Erasmus MC - University Medical Center Rotterdam Rotterdam, The Netherlands ; Department of Neurology, Erasmus MC - University Medical Center Rotterdam Rotterdam, The Netherlands.
Rehabilitation Medicine, Erasmus MC - University Medical Center Rotterdam Rotterdam, The Netherlands ; Rijndam Rehabilitation Center Rotterdam, The Netherlands.
Brain Behav. 2014 Sep;4(5):615-25. doi: 10.1002/brb3.245. Epub 2014 Jul 3.
Melodic Intonation Therapy (MIT) uses the melodic elements of speech to improve language production in severe nonfluent aphasia. A crucial element of MIT is the melodically intoned auditory input: the patient listens to the therapist singing a target utterance. Such input of melodically intoned language facilitates production, whereas auditory input of spoken language does not.
Using a sparse sampling fMRI sequence, we examined the differential auditory processing of spoken and melodically intoned language. Nineteen right-handed healthy volunteers performed an auditory lexical decision task in an event related design consisting of spoken and melodically intoned meaningful and meaningless items. The control conditions consisted of neutral utterances, either melodically intoned or spoken.
Irrespective of whether the items were normally spoken or melodically intoned, meaningful items showed greater activation in the supramarginal gyrus and inferior parietal lobule, predominantly in the left hemisphere. Melodically intoned language activated both temporal lobes rather symmetrically, as well as the right frontal lobe cortices, indicating that these regions are engaged in the acoustic complexity of melodically intoned stimuli. Compared to spoken language, melodically intoned language activated sensory motor regions and articulatory language networks in the left hemisphere, but only when meaningful language was used.
Our results suggest that the facilitatory effect of MIT may - in part - depend on an auditory input which combines melody and meaning.
Combined melody and meaning provide a sound basis for the further investigation of melodic language processing in aphasic patients, and eventually the neurophysiological processes underlying MIT.
旋律语调疗法（MIT）利用言语的旋律元素来改善严重非流畅性失语症患者的语言表达。MIT的一个关键要素是旋律语调的听觉输入：患者聆听治疗师唱出目标语句。这种旋律语调语言的输入有助于表达，而口语的听觉输入则不然。
我们使用稀疏采样功能磁共振成像序列，研究了口语和旋律语调语言的差异听觉处理。19名右利手健康志愿者在一个事件相关设计中执行听觉词汇判断任务，该设计包括口语和旋律语调的有意义和无意义项目。对照条件包括旋律语调或口语的中性语句。
无论项目是正常口语还是旋律语调，有意义的项目在缘上回和顶下小叶中均表现出更强的激活，主要在左半球。旋律语调语言对称地激活了双侧颞叶以及右侧额叶皮质，表明这些区域参与了旋律语调刺激的声学复杂性。与口语相比，旋律语调语言激活了左半球的感觉运动区域和发音语言网络，但仅在使用有意义的语言时如此。
我们的结果表明，MIT的促进作用可能部分取决于将旋律和意义结合的听觉输入。
旋律和意义的结合为进一步研究失语症患者的旋律语言处理以及最终研究MIT背后的神经生理过程提供了良好的基础。
