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Mechanisms of voice processing in dementia

Hailstone, JC; (2012) Mechanisms of voice processing in dementia. Doctoral thesis , UCL (University College London). Green open access

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Perception of nonverbal vocal information is essential in our daily lives. Patients with degenerative dementias commonly have difficulty with such aspects of vocal communication; however voice processing has seldom been studied in these diseases. This thesis comprises a series of linked studies of voice processing in canonical dementias: Alzheimer’s disease, behavioural variant frontotemporal dementia, semantic dementia and progressive nonfluent aphasia. A series of neuropsychological tests were developed to examine perceptual and semantic stages of voice processing and to assess two aspects of accent processing: comprehension of foreign accented speech and recognition of regional and foreign accents; patient performance was referenced to healthy control subjects. Neuroanatomical associations of voice processing performance were assessed using voxel based morphometry. Following a symptom-led approach, a syndrome of progressive associative phonagnosia was characterised in two detailed case studies. Following a disease-led approach, this work was extended systematically to cohorts of patients representing the target diseases and assessing voice processing in relation to other aspects of person recognition (faces and names). This work provided evidence for separable profiles of voice processing impairment in different diseases: associative deficits were particularly severe in semantic dementia, whilst perceptual deficits showed relative specificity for Alzheimer’s disease. Neuroanatomical associations were identified for voice recognition in the right temporal pole and anterior fusiform gyrus, and for voice discrimination in the right inferior parietal lobe. The final phase of this work addressed the neuropsychological and neuroanatomical basis of accent processing, as an important dimension of nonverbal vocal analysis that is not dependent on voice identity. This work provides evidence for impaired processing of accents in progressive nonfluent aphasia and Alzheimer’s with neuroanatomical associations in the anterior and superior temporal lobe. The thesis contributes new information about voice processing in the degenerative dementias and furthers our understanding of the mechanisms of human voice analysis.

Type: Thesis (Doctoral)
Title: Mechanisms of voice processing in dementia
Open access status: An open access version is available from UCL Discovery
Language: English
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/1365988
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