Dynamic brain activation during processing of emotional intonation: influence of acoustic parameters, emotional valence, and sex.

Appreciation of the emotional tone of verbal utterances represents an important aspect of social life. It is still unsettled, however, which brain areas mediate processing of intonational information and whether the presumed right-sided superiority depends upon acoustic properties of the speech signal. Functional magnetic resonance imaging was used to disentangle brain activation associated with (i) extraction of specific acoustic cues and (ii) detection of specific emotional states. Stimulus material comprised pairs of emotionally intonated utterances, exclusively differing either in pitch range or in the length of stressed vowels. Hemodynamic responses showed a dynamic pattern of cerebral activation including sequenced bilateral responses of various cortical and subcortical structures. Activation associated with discrimination of emotional expressiveness predominantly emerged within the right inferior parietal lobule, within the bilateral mesiofrontal cortex and--with an asymmetry toward the right hemisphere--at the level of bilateral dorsolateral frontal cortex. Lateralization did not depend upon acoustic structure or emotional valence of stimuli. These findings might prove helpful in reconciling the controversial previous clinical and experimental data.

ET gets HIT--thrombocytotic heparin-induced thrombocytopenia (HIT) in a patient with essential thrombocythemia (ET).

Immune-mediated heparin-induced thrombocytopenia (HIT) is a relatively common complication in patients receiving heparin, and represents a strong risk factor for thromboembolic disease associated with high morbidity and mortality. The condition is commonly defined as a platelet count fall of greater than 30-50% to values below 150 x 10(9)/l. Despite this, several cases with platelet count nadirs in the normal range have been reported. This report describes a patient with status post-carotid thrombendarterectomy presenting with neurological symptoms and thrombocytosis (1235 x 10(9)/l), which in due course was diagnosed to be caused by essential thrombocythemia (ET). Heparin therapy was established and symptoms resolved markedly. After 5 days of standard heparin therapy, serologically confirmed HIT with new neurological symptoms occurred. The platelet count nadir attributed to HIT was far above normal (633 x 10(9)/l), which nevertheless represented a substantial relative platelet count fall (49%). This is the first reported case of serologically confirmed HIT in a patient with ET. Furthermore, it represents the first published case of HIT being present in thrombocytosis. Clinicians should be aware that atypical HIT can even be present in thrombocytosis and, because of nomenclature, HIT with normal and elevated platelet count nadirs is likely to be largely underdiagnosed.

Cortical activation patterns of affective speech processing depend on concurrent demands on the subvocal rehearsal system. A DC-potential study.

In order to delineate brain regions specifically involved in the processing of affective components of spoken language (affective or emotive prosody), we conducted two event-related potential experiments. Cortical activation patterns were assessed by recordings of direct current components of the EEG signal from the scalp. Right-handed subjects discriminated pairs of declarative sentences with either happy, sad or neutral intonation. Each stimulus pair was derived from two identical original utterances that, due to digital signal manipulations, slightly differed in fundamental frequency (F0) range or in duration of stressed syllables. In the first experiment, subjects were asked: (i) to denote the original emotional category of each sentence pair and (ii) to decide which of the two items displayed stronger emotional expressiveness. Participants in the second experiment were asked to repeat the utterances using inner speech during stimulus presentation in addition to the discrimination task. In the absence of inner speech, a predominant activation of right frontal regions was observed, irrespective of emotional category. In the second experiment, a bilateral activation with left frontal preponderance emerged from discrimination during additional performance of inner speech. Compared with the first experiment, a new pattern of acoustic signal processing arose. A relative decrease of brain activity during processing of F0 stimulus variants was observed together with increased activation during discrimination of duration-manipulated sentence pairs. Analysis of behavioural data revealed no significant differences in evaluation of expressiveness between the two experiments. We conclude that the topographical shift of cortical activity originates from left hemisphere (LH) mechanisms of speech processing that centre around the subvocal rehearsal system as an articulatory control component of the phonological loop. A strong coupling of acoustic input and (planned) verbal output channel in the LH is initiated by subvocal articulatory activity like inner speech. These neural networks may provide interpretations of verbal acoustic signals in terms of motor programs and facilitate continuous control of speech output by comparing the signal produced with that intended. Most likely, information on motor aspects of suprasegmental signal characteristics contributes to the evaluation of affective components of spoken language. In consequence, the right hemisphere (RH) holds a merely relative dominance, both for processing of F0 and for evaluation of emotional significance of sensory input. Psychophysically, an important determinant on expression of lateralization patterns seems to be given by the degree of communicative demands such as solely perceptive (RH) or perceptive and verbal-expressive (RH and LH).

The cortical processing of perceived emotion: a DC-potential study on affective speech prosody.

Direct current (DC) components of the EEG signal were recorded in 16 right-handed subjects during presentation of pairs of declarative sentences with either happy, sad or neutral intonation. Each stimulus pair had identical wording, but differed at the acoustic level either in pitch (fundamental frequency = FO) range or in duration of stressed syllables. Subjects were asked, first, to identify the emotional category of each sentence pair and, second, to indicate the utterance displaying stronger emotional expressiveness. Stimuli with happy or sad intonation, as well as FO-manipulated neutral sentences, yielded a significantly lateralized negativity towards the right hemisphere (RH). Compared with FO-varied neutral utterances, the discrimination of time-manipulated neutral stimuli resulted in significantly reduced amplitudes, predominantly over RH areas. These results corroborate the suggestion of a dominant role of the RH for the evaluation of the emotional significance of sensory input.