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Neural Plasticity
Volume 2014 (2014), Article ID 841982, 14 pages
Clinical Study

Paving the Way for Speech: Voice-Training-Induced Plasticity in Chronic Aphasia and Apraxia of Speech—Three Single Cases

1Interdisciplinary Institute for Music- and Speech-Therapy, Am Lipkamp 14, 47269 Duisburg, Germany
2Clinical Cognition Research, University Hospital Aachen University, RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
3Aphasia Center North Rhine Westphalia, Laarmannstraße 21, 45359 Essen, Germany
4Interdisciplinary Centre for Clinical Research—Neurofunctional Imaging Lab, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany

Received 9 March 2014; Revised 3 May 2014; Accepted 3 May 2014; Published 25 May 2014

Academic Editor: Lin Xu

Copyright © 2014 Monika Jungblut et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Difficulties with temporal coordination or sequencing of speech movements are frequently reported in aphasia patients with concomitant apraxia of speech (AOS). Our major objective was to investigate the effects of specific rhythmic-melodic voice training on brain activation of those patients. Three patients with severe chronic nonfluent aphasia and AOS were included in this study. Before and after therapy, patients underwent the same fMRI procedure as 30 healthy control subjects in our prestudy, which investigated the neural substrates of sung vowel changes in untrained rhythm sequences. A main finding was that post-minus pretreatment imaging data yielded significant perilesional activations in all patients for example, in the left superior temporal gyrus, whereas the reverse subtraction revealed either no significant activation or right hemisphere activation. Likewise, pre- and posttreatment assessments of patients’ vocal rhythm production, language, and speech motor performance yielded significant improvements for all patients. Our results suggest that changes in brain activation due to the applied training might indicate specific processes of reorganization, for example, improved temporal sequencing of sublexical speech components. In this context, a training that focuses on rhythmic singing with differently demanding complexity levels as concerns motor and cognitive capabilities seems to support paving the way for speech.