Many patients with Alzheimer?s Disease (AD) and Frontotemporal Degeneration (FTD) have impairments in social function, including impaired recognition and expression of emotions in speech. Diminished affective prosody (understanding and conveying emotion through vocal intonation, rate, pauses, and stress) often appears even in the early stages of disease. It is also a common impairment in patients with right hemisphere (RH) strokes. In the parent grant of this supplement, we seek to identify the perceptual, cognitive, and motor deficits that can disrupt affective prosody, and characterize the natural history of spontaneous recovery following a RH stroke. In this Administrative Supplement we extend our research to focus on affective prosody deficits in patients with AD and FTD. Affective prosody deficits can negatively impact social relationships and quality of life in patients with neurodegenerative diseases, and they often lead to more behavioral problems and increased conflict with caregivers. The main objective of this supplement is to identify the perceptual, cognitive, and motor deficits that disrupt affective prosody in AD and FTD, and to identify the neural networks that support these functions. Furthermore, evidence suggests patterns of deficits in expressive and receptive affective prosody differ between the different variants of AD and FTD. Therefore, we will compare patterns of deficits in the following five subtypes of AD and FTD. Two subtypes of AD: (1) typical AD, and (2) logopenic variant Primary Progressive Aphasia (lvPPA); three subtypes of FTD: (1) behavioral variant FTD (bvFTD), (2) nonfluent variant PPA (nfvPPA), and (3) semantic variant PPA (svPPA). PPA is a neurodegenerative syndrome where language impairments are the most prominent deficit in early stages of the disease.
In Specific Aim 1 we will identify acoustic abnormalities and the deficit underlying these abnormalities in perception and expression of affective prosody that can be independently damaged by focal atrophy in each subtype. We will also examine the impact of these deficits on quality of life. Patients will be tested on a battery of cognitive and affective prosody tests, developed as part of the parent grant, to identify behavioral patterns of deficits.
In Specific Aim 2 we will identify the neural streams necessary for the processes that subserve affective prosody. We will use structural MRI measures to investigate relationships between atrophy patterns and performance on the cognitive and affective prosody tasks. These data will provide robust preliminary data for the submission of a larger grant that will be designed to longitudinally follow patients to identify variation in the course of the disease, and will allow us to better predict to which variant early stage unclassifiable AD and FTD patients will evolve. Our research will also provide the basis for designing future behavioral and neuromodulatory treatments to slow the rate of decline in affective prosody.

Public Health Relevance

Many people with Alzheimer?s Disease (AD) and Frontotemporal Degeneration (FTD) have difficulty recognizing the emotions of others, as well as expressing their emotions, through voice, loudness, and rate of speech. Deficits in these functions lead to severe consequences for social interactions and relationships, and frequently lead to more behavioral problems and conflict with caregivers. In the current Administrative Supplement, we propose to investigate the behavioral patterns and neural correlates of these deficits in AD and FTD in order to help develop future treatments.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
3R01DC015466-03S1
Application #
9881544
Study Section
Language and Communication Study Section (LCOM)
Program Officer
Cooper, Judith
Project Start
2017-09-01
Project End
2022-06-30
Budget Start
2019-07-01
Budget End
2020-06-30
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Neurology
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Hillis, Argye E; Beh, Yuan Ye; Sebastian, Rajani et al. (2018) Predicting recovery in acute poststroke aphasia. Ann Neurol 83:612-622
Tippett, Donna C; Godin, Brittany R; Oishi, Kumiko et al. (2018) Impaired Recognition of Emotional Faces after Stroke Involving Right Amygdala or Insula. Semin Speech Lang 39:87-100
Sheppard, Shannon M; Hillis, Argye E (2018) That's right! Language comprehension beyond the left hemisphere. Brain 141:3280-3289
Agis, Daniel; Hillis, Argye E (2017) The cart before the horse: When cognitive neuroscience precedes cognitive neuropsychology. Cogn Neuropsychol 34:420-429