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Neural correlates of speech impairment in children with posterior fossa tumours: A lesion-symptom mapping study
Poster Session A, Wednesday, September 30, 11:00 am - 1:00 pm, Wangari Maathai
This poster is part of the Sandbox Series.
Rida Ahmed1,2,3,4, Aliene Reinders3, Elisa Gottardi1,2,3,4, Jonathan Kjær Grønbæk5, Ditte Boeg Thomsen6, Annet Kingma7, Karin Persson8, René Mathiasen5, Christine Dahl5, Andrea Carai9, Bianca Andreozzi10, Angela Mastronuzzi11,12, Barry Pizer13,14, Colin Thorbinson14, Kristian Aquilina15, Eelco Hoving16, Marianne Juhler17, Roel Jonkers3,4, Natalie Boll-Avetisyan2, Vânia de Aguiar3,4,18; 1International Doctorate for Experimental Approaches to Language and Brain (IDEALAB), University of Potsdam, Potsdam, Germany; University of Groningen, Groningen, The Netherlands, 2Department of Linguistics, University of Potsdam, Germany., 3Center for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands., 4Behavioral and Cognitive Neuroscience research school (BCN), University of Groningen, Groningen, The Netherlands., 5Department of Paediatric and Adolescent Medicine, Rigshospitalet University Hospital, Denmark., 6Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark., 7Department of Pediatrics/Pediatric Oncology, University Medical Center Groningen, Groningen, The Netherlands., 8Department of Health Sciences, Lund University, Lund, Sweden., 9Neurosurgery Unit, Bambino Gesù Children’s Hospital, Rome, Italy., 10Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy., 11Department of Hematology/oncology, Cell Therapy, Gene Therapies and Hematopoietic Transplant, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy., 12Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Milan, Italy., 13University of Liverpool, Liverpool, United Kingdom., 14Department of Oncology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK., 15Department of Neurosurgery, Great Ormond Street Hospital, London, UK., 16Oncological Pediatric Neurosurgery, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands., 17Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark, 18Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands.
Patients with posterior fossa tumours (PFTs) can present with postoperative speech impairments, such as a monotonous voice, slow rate of speech, and ataxic speech (De Smet et al. 2007). Reports of preoperative speech impairment, although described more broadly, also exist (Bianchi et al., 2020). The cerebellum plays a critical role in speech processing beyond motor coordination (Ackermann et al., 2007; Mariën et al., 2014). Urban et al. (2003) reported that dysarthria in cerebellar stroke patients was associated with lesions in the rostral paravermal region of the anterior cerebellar lobe, particularly in the right cerebellar hemisphere. Similarly, Timmann et al. (2008) demonstrated associations between dysarthria and lesions in the intermediate cerebellar zone, especially lobules V and VI. However, previous studies have largely focused on the presence/absence of dysarthria rather than fine-grained acoustic speech characteristics. Different acoustic speech characteristics may be associated with distinct cerebellar regions, given evidence that the cerebellum exhibits a functional topography in which separate subregions contribute differentially to motor, linguistic, and sensorimotor aspects of speech processing and possibly different levels within the speech production system. (Ackermann et al., 2007; Stoodley & Schmahmann, 2009) The present study, therefore, aims to identify the neural correlates of specific acoustic speech features in children with PFTs before and after surgery. We hypothesize that lesions in the specific regions within the PF region will be associated with specific speech features. For example, based on the previous literature, lesions involving the superior and intermediate cerebellar regions, particularly lobules V and VI, may be associated with reduced articulatory precision, reflected in smaller articulatory acoustic vowel space (AAVS) and reduced speech and articulation rates. Similarly, lesions in or close to the brainstem may be associated with hypernasal speech and/or poor voice quality as evident from previous research on PFT children (Van Mourik et al., 1998). For most of the included acoustic features, our investigation remains exploratory. The study includes 160 children (Mean age = 9;7, Std Dev = 3;8) with PFTs recruited through the European Study of Cerebellar Mutism Syndrome across Danish, Dutch, English, and Italian cohorts. Preoperative structural MRI scans have been obtained for all participants. Tumours have been manually segmented on contrast-enhanced T1-weighted images using MRIcroGL. Next up, cerebellar structures will be isolated and normalized using the SUIT cerebellar atlas to allow voxel-wise analyses across participants. Narrative samples of Fish Story from the Expression, Reception and Recall of Narrative Instrument (ERRNI) will be used to extract acoustic speech measures, which include cepstral peak prominence-smoothed, signal intensity variability, mean and standard deviation of f0, speech and articulation rate, vowel duration, pause duration and frequency, pause-to-speech ratio, and articulatory acoustic vowel space (AAVS). Nasality will be assessed separately from a picture naming task. To establish how much the speech features of patients deviate from healthy controls, the study will also include data from 64 Italian and Dutch-speaking healthy children (Mean age = 9;4, Std Dev = 4;2). Multivariate voxel-based lesion-symptom mapping (VLSM) will be used to identify associations between lesion location and acoustic speech outcomes.
Topic Areas: Speech Motor Control, Disorders: Acquired