Prosodic+Speech

EMOTIONAL & PROSODIC SPEECH Right frontal lobe injuries are thus associated with disinhibited states, including manic neuro-psychosis coupled with disturbances of thought and speech.

-Rushed -Contaminated with unusual, tangential, and delusional ideas -Melodic control over speech may appear to be lost - melody of voice may not correspond with or parallel what is being said; e.g. they may be saying one thing, but tone of voice seem to imply meaning something else altogether.
 * although language per se, is not aphasic, speech may become **

-Flat and monotonous -Conversely, ability to alter/convey melodic and prosodic elements become exceedingly abnormal and distorted. -May sound as if crying, wailing, or screeching -May lose the ability to engage in vocal mimicry or to accurately repeat various statements in an emotional manner
 * With massive damage speech may become: **

-Intonational qualities of the voice can become mildly abnormal and patients may seem to be speaking with an odd midwestern-like accent--(particularly with deep lesions of the right frontal area, perhaps involving the cingulate or basal ganglia. Prosodic distortion in the form of an unusual accent is sometimes seen in seizure disorders involving deep right frontal or frontal-temporal areas.
 * With mild damage: **

Feeling and attitude are conveyed through the melody (musical qualities), inflection, intonation, and prosody of one's voice, and by varying the pitch, inflection, timbre, stress contours, melody, as well as the rate and amplitude of speech --capacities predominantly mediated by the right half of the cerebrum.

<span style="color: #000000; font-family: 'Times New Roman',serif;">Patients with severe forms of Broca's expressive aphasia are unable to discourse fluently. However, they may be capable of swearing, making statements of self-pity, praying, singing, and even learning new songs -although in the absence of music they would be unable to say the very words they had just sung. This is because the ability to produce non-linguistic and musical/emotional sounds is mediated by the undamaged right frontal lobe and limbic nuclei. Just as the left frontal convexity (i.e. Broca's area) subserves the syntactical, temporal-sequential, motoric, and grammatical aspects of linguistic expression, there is a similar region within the right frontal area which mediates the expression of emotional and melodic speech.

<span style="color: #000000; font-family: 'Times New Roman',serif;">With left frontal lesions some patients develop what sounds like an unlearned foreign accent, as if they were from Germany, France, etc. This is due, in part, to distortions involving the pronounciation of vowells.
 * <span style="color: #000000; font-family: 'Times New Roman',serif;">Differential Dx: **

<span style="font-family: 'Times New Roman',serif; font-size: medium;">With right temporal injuries, the ability to comprehend and understand prosodic-emotional nuances may be lost. When damage is limited to the right frontal emotional-motor speech area, this ability appears to be somewhat intact.