Auditory Feedback Effects on Speech

Overseen By Ludo Max

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Must not be taking: Sensorimotor affecting

Disqualifiers: Neurological problems, Hearing loss, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

507 Participants Needed

Trial Summary

What is the purpose of this trial?

This study meets the NIH definition of a clinical trial, but is not a treatment study. Instead, the goal of this study is to investigate how hearing ourselves speak affects the planning and execution of speech movements. The study investigates this topic in both typical speakers and in patients with Deep Brain Stimulation (DBS) implants. The main questions it aims to answer are: * Does the way we hear our own speech while talking affect future speech movements? * Can the speech of DBS patients reveal which brain areas are involved in adjusting speech movements? Participants will read words, sentences, or series of random syllables from a computer monitor while their speech is being recorded. For some participants, an electrode cap is also used to record brain activity during these tasks. And for DBS patients, the tasks will be performed with the stimulator ON and with the stimulator OFF.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it mentions that participants should not be on medications that affect sensorimotor functioning, except for those in the DBS group.

What data supports the effectiveness of the treatment Auditory feedback perturbation during speech?

Research shows that altering auditory feedback can enhance the brain's ability to adapt speech motor commands, as seen in studies where noninvasive brain stimulation improved speech adaptation. This suggests that manipulating auditory feedback can help the brain adjust speech production, even though deep brain stimulation alone may not significantly affect speech in Parkinson's disease. ^{1 2 3 4 5}

Is auditory feedback manipulation generally safe for humans?

Research on deep brain stimulation (DBS) and auditory feedback manipulation suggests that while DBS can improve motor symptoms in Parkinson's disease, it may not significantly affect speech. However, DBS settings can sometimes impair speech, indicating the importance of careful adjustment. Overall, these treatments have been studied in humans, but their safety can vary depending on specific conditions and settings. ^{1 5 6 7 8}

How does auditory feedback treatment for speech differ from other treatments?

Auditory feedback treatment for speech is unique because it involves real-time monitoring and correction of speech errors by altering the pitch of auditory feedback, which helps the brain adjust motor responses to improve speech production. This approach focuses on the brain's ability to detect and correct errors through auditory-motor interaction, unlike other treatments that may not directly engage these neural processes. ^{1 4 7 9 10}

Research Team

Ludo Max, Ph.D.

Principal Investigator

University of Washington

Eligibility Criteria

This trial is for American English native speakers who have normal communication and neurological function, except those with DBS implants. Adults must be 18 or older with specific hearing thresholds. Children aged between 4 to nearly 7 years old or from 10 to nearly 13 are also eligible. Participants should not be on medications affecting sensorimotor skills, unless they're part of the DBS group.

Inclusion Criteria

My child is either 4 to 6 years old or 10 to 12 years old.

I am not on medication that affects my movement or senses, except if I'm in the DBS group.

I am a native American English speaker.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Data Collection

Participants read words, sentences, or series of random syllables while their speech is recorded. For some, an electrode cap records brain activity. DBS patients perform tasks with the stimulator ON and OFF.

1-2 hours

1 visit (in-person)

Follow-up

Participants are monitored for any immediate effects or changes post data collection

1 week

Treatment Details

Interventions

• Auditory feedback perturbation during speech
• DBS stimulation ON/OFF
• Visual feedback perturbation during reaching

Trial Overview The study examines how auditory feedback influences speech movements in typical individuals and patients with Deep Brain Stimulation (DBS) implants by having them read aloud while their speech and brain activity are monitored. For DBS patients, tasks will be done with stimulation turned both ON and OFF.

Participant Groups

Group I: Visual feedback perturbation during reaching Experimental Treatment 1 Intervention

The intervention consists of manipulating real-time visual feedback during upper limb reaching movements. In our lab, such feedback perturbations can be implemented with a virtual reality display system.

Group II: Deep brain stimulation Experimental Treatment 1 Intervention

This intervention consists of toggling the deep brain stimulation (DBS) implant ON/OFF prior to participation in the speech auditory-motor learning tasks and speech sequence learning tasks. This intervention can be implemented by the subject themselves as all patients have a hand- held controlled that they use to switch stimulation ON/OFF.

Group III: Auditory feedback perturbation during speech Experimental Treatment 1 Intervention

The intervention consists of manipulating real-time auditory feedback during speech production. In our lab, such feedback perturbations can be implemented with either a stand-alone digital vocal processor (a device commonly used by singers and the music industry) or with software-based signal processing routines (see Equipment section for details). Note that the study does not investigate the efficacy of these hardware or software methods to induce behavioral change in subjects' speech. Rather, the study addresses basic experimental questions regarding the general role of auditory feedback in the central nervous system's control of articulatory speech movements.

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Findings from Research

The study used magnetoencephalography (MEG) to investigate how the brain processes altered auditory feedback during speech, revealing that auditory cortical areas are more active when participants vocalize compared to when they listen without speaking.

Findings indicate that changes in brain wave patterns, specifically increases in θ and lower β band power, are linked to the brain's ability to detect motor errors and process sensory predictions, supporting the theory of an active comparison between expected and actual speech output.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-monitoring in the cerebral cortex: Neural responses to small pitch shifts in auditory feedback during speech production. Franken, MK., Eisner, F., Acheson, DJ., et al.[2019]

Anodal transcranial direct current stimulation (tDCS) over the speech motor cortex significantly increased the rate of sensorimotor adaptation in participants, suggesting a potential method to enhance speech motor control.

The study's computational modeling indicated that tDCS primarily improved the integration of auditory feedback into speech motor plans by increasing the feedforward learning rate, highlighting a mechanism for how neurostimulation can influence speech production.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Noninvasive neurostimulation of left ventral motor cortex enhances sensorimotor adaptation in speech production. Scott, TL., Haenchen, L., Daliri, A., et al.[2021]

The model of speech motor control suggests that speech production relies on a combination of feedforward control from the motor cortex and cerebellum, along with auditory and somatosensory feedback systems, highlighting the complexity of how we learn and produce speech.

This framework not only explains how new speech sounds are learned and refined through practice but also serves as a basis for understanding communication disorders linked to brain dysfunction, integrating various types of data from kinematic, acoustic, and neuroimaging studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cortical interactions underlying the production of speech sounds. Guenther, FH.[2022]

When subjects spoke and their auditory feedback was unexpectedly altered, they compensated for the change within about 136 milliseconds, demonstrating a quick neural response to auditory feedback.

Neuroimaging showed that this compensation involved increased activity in specific brain areas, particularly the bilateral superior temporal cortex and right prefrontal cortex, suggesting that these regions work together to correct speech based on auditory feedback.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neural mechanisms underlying auditory feedback control of speech. Tourville, JA., Reilly, KJ., Guenther, FH.[2021]

In a study involving 20 Parkinson's disease patients with subthalamic deep brain stimulation (DBS), the stimulation did not significantly change vocal responses to pitch-shifted feedback, indicating that DBS may not effectively modulate speech-related auditory-motor integration deficits.

While DBS did not enhance vocal compensations, it was associated with increased brain activity in auditory regions during listening tasks, suggesting that while DBS affects brain function, it does not translate to improved speech performance in these patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Deep Brain Stimulation Does Not Modulate Auditory-Motor Integration of Speech in Parkinson's Disease. Bahners, BH., Florin, E., Rohrhuber, J., et al.[2020]

Deep brain stimulation (DBS) can significantly improve speech in Parkinson's disease patients, bringing their speech closer to normal levels when settings are optimized for motor performance.

However, the study found that the DBS settings aimed at relieving motor symptoms can sometimes impair speech, highlighting the need for careful adjustment of DBS parameters to avoid negatively affecting communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acoustic Analysis of PD Speech. Chenausky, K., Macauslan, J., Goldhor, R.[2022]

The study identified three distinct brain networks involved in processing auditory feedback during speech, highlighting that one network encodes an 'error signal' when vocalizing, regardless of the type of distortion in the feedback.

Another network is sensitive to speech features during passive listening but shows reduced sensitivity when the same sounds are part of vocalization, indicating that speech motor control involves multiple, interactive neural systems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multivoxel patterns reveal functionally differentiated networks underlying auditory feedback processing of speech. Zheng, ZZ., Vicente-Grabovetsky, A., MacDonald, EN., et al.[2022]

High-definition transcranial direct current stimulation (HD-tDCS) of the left ventral motor cortex significantly affects voice motor control, particularly reducing vocal compensation in response to downward pitch-shift stimuli during altered auditory feedback.

The study found that both anodal and cathodal HD-tDCS reduced vocal compensation, with stronger effects from cathodal stimulation, suggesting that neurostimulation enhances feedforward motor mechanisms in speech production.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modulation of vocal pitch control through high-definition transcranial direct current stimulation of the left ventral motor cortex. Behroozmand, R., Johari, K., Bridwell, K., et al.[2021]

This study used magnetoencephalography (MEG) to identify distinct brain networks involved in processing auditory feedback during speech, revealing that the left ventral supramarginal gyrus/posterior superior temporal sulcus (vSMG/pSTS) plays a crucial role in monitoring and correcting pitch errors.

The research found that while speaking, the brain suppresses responses to speech onset but enhances activity in specific regions during pitch perturbations, indicating a complex network that helps speakers quickly adjust their pitch in response to auditory feedback.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A bilateral cortical network responds to pitch perturbations in speech feedback. Kort, NS., Nagarajan, SS., Houde, JF.[2021]

The study identified specific areas in the human brain, particularly in the posterior superior temporal gyrus, that respond differently to normal and altered auditory feedback during vocalization, indicating a complex network involved in pitch control.

When subjects' pitch was perturbed, they adjusted their vocal output accordingly, and the degree of these adjustments was linked to brain responses, suggesting that this sensorimotor network plays a crucial role in how we use auditory feedback to control our speech.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Human cortical sensorimotor network underlying feedback control of vocal pitch. Chang, EF., Niziolek, CA., Knight, RT., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Self-monitoring in the cerebral cortex: Neural responses to small pitch shifts in auditory feedback during speech production. [2019]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Noninvasive neurostimulation of left ventral motor cortex enhances sensorimotor adaptation in speech production. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Cortical interactions underlying the production of speech sounds. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Neural mechanisms underlying auditory feedback control of speech. [2021]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Deep Brain Stimulation Does Not Modulate Auditory-Motor Integration of Speech in Parkinson's Disease. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Acoustic Analysis of PD Speech. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Multivoxel patterns reveal functionally differentiated networks underlying auditory feedback processing of speech. [2022]

8. Germany pubmed.ncbi.nlm.nih.gov

Modulation of vocal pitch control through high-definition transcranial direct current stimulation of the left ventral motor cortex. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

A bilateral cortical network responds to pitch perturbations in speech feedback. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Human cortical sensorimotor network underlying feedback control of vocal pitch. [2022]