Audiovisual Integration in Apraxia of Speech

Speech perception is a unique audiovisual experience in part because timing of the speech signal is influenced by simultaneous overlapping gestures in coarticulation. Apraxia of speech (AOS) is a motor planning disorder that impairs coarticulation. Imaging studies show that brain regions damaged in AOS are critical to audiovisual speech perception. Although AOS is a motor planning disorder, individuals with AOS may have a disruption to the perceptual system for speech gestures. To evaluate this hypothesis we investigated audiovisual mismatch negativity (MMN) brain responses in adults with damage to Broca’s area (n =5) compared to a healthy age-matched comparison group (n = 5). We utilized the McGurk effect, in which incongruent auditory and visual information alters perception. Participants viewed videos of a speaker articulating the syllable /ba/ (standard) for 80% trials and /ga/ (deviant) for 20% of the trials while the auditory stimulus /ba/ remained consistent throughout. Responses to this McGurk audiovisual condition were compared to an inverse McGurk audiovisual condition in which the visual stimulus remained constant while the auditory stimulus changed, and a visual-only condition without sound to control for evoked activity from changes to the visual stimulus. Incongruent McGurk deviants elicited an MMN over left hemisphere electrodes in the comparison group, while the AOS group exhibited a later, attention-based response, a P300. The AOS group similarly responded to inverse McGurk deviants, which do not require fusion of the percept, with a P300 response, indicating that auditory and visual aspects of the incongruent McGurk deviants were not integrated. In the visual-only control condition, the AOS group showed a left-lateralized MMN, suggesting greater influence of visual processing when confronted with conflicting multisensory information compared to the comparison group. Overall, the comparison group’s responses were indicative of early and automatic audiovisual integration of incongruent McGurk percepts while the responses of the AOS group showed contributions of both attentional and visual processing. The timing of the response in the AOS group was correlated with speech production characteristics of apraxia, as well as performance on taxing motor speech tasks. Results of this study support the hypothesis that AOS is a disorder beyond motor planning, with implications for higher-level linguistic and cognitive systems.