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      Frequency and Neural Correlates of Pauses in Patients with Formal Thought Disorder

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          Abstract

          Background: Pauses during speech may reflect the planning and monitoring of discourse, two processes putatively impaired in patients with schizophrenia, particularly those with formal thought disorder (FTD). We used functional MRI to examine the neural correlates of between-clause and of filled pauses, which are respectively associated with speech planning and speech monitoring.

          Methods: BOLD contrast was measured while six schizophrenia patients with FTD and six healthy subjects spoke about Rorshach inkblots. In an event-related design, we examined activity associated with pauses that occurred between clauses and with pauses that were filled.

          Results: There was no significant group difference in the frequency of between-clause pauses but patients with FTD made strikingly fewer filled pauses than controls. Between-clause pauses were associated with activation in the anterior part of the left superior temporal gyrus (STG) and the left insula in controls and the engagement of these regions was significantly attenuated in patients.

          Conclusion: The anterior part of the left STG and the left insula are normally involved in both the planning and monitoring of discourse. The attenuated engagement of these regions with between-clause pauses and the striking infrequency of filled pauses in the patients are consistent with cognitive models implicating defective speech planning and speech monitoring in schizophrenia, especially in relation to FTD.

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          Most cited references39

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          A classification of hand preference by association analysis.

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            Global, voxel, and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain.

            We describe almost entirely automated procedures for estimation of global, voxel, and cluster-level statistics to test the null hypothesis of zero neuroanatomical difference between two groups of structural magnetic resonance imaging (MRI) data. Theoretical distributions under the null hypothesis are available for 1) global tissue class volumes; 2) standardized linear model [analysis of variance (ANOVA and ANCOVA)] coefficients estimated at each voxel; and 3) an area of spatially connected clusters generated by applying an arbitrary threshold to a two-dimensional (2-D) map of normal statistics at voxel level. We describe novel methods for economically ascertaining probability distributions under the null hypothesis, with fewer assumptions, by permutation of the observed data. Nominal Type I error control by permutation testing is generally excellent; whereas theoretical distributions may be over conservative. Permutation has the additional advantage that it can be used to test any statistic of interest, such as the sum of suprathreshold voxel statistics in a cluster (or cluster mass), regardless of its theoretical tractability under the null hypothesis. These issues are illustrated by application to MRI data acquired from 18 adolescents with hyperkinetic disorder and 16 control subjects matched for age and gender.
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              Colored noise and computational inference in neurophysiological (fMRI) time series analysis: resampling methods in time and wavelet domains.

              Even in the absence of an experimental effect, functional magnetic resonance imaging (fMRI) time series generally demonstrate serial dependence. This colored noise or endogenous autocorrelation typically has disproportionate spectral power at low frequencies, i.e., its spectrum is (1/f)-like. Various pre-whitening and pre-coloring strategies have been proposed to make valid inference on standardised test statistics estimated by time series regression in this context of residually autocorrelated errors. Here we introduce a new method based on random permutation after orthogonal transformation of the observed time series to the wavelet domain. This scheme exploits the general whitening or decorrelating property of the discrete wavelet transform and is implemented using a Daubechies wavelet with four vanishing moments to ensure exchangeability of wavelet coefficients within each scale of decomposition. For (1/f)-like or fractal noises, e.g., realisations of fractional Brownian motion (fBm) parameterised by Hurst exponent 0 < H < 1, this resampling algorithm exactly preserves wavelet-based estimates of the second order stochastic properties of the (possibly nonstationary) time series. Performance of the method is assessed empirically using (1/f)-like noise simulated by multiple physical relaxation processes, and experimental fMRI data. Nominal type 1 error control in brain activation mapping is demonstrated by analysis of 13 images acquired under null or resting conditions. Compared to autoregressive pre-whitening methods for computational inference, a key advantage of wavelet resampling seems to be its robustness in activation mapping of experimental fMRI data acquired at 3 Tesla field strength. We conclude that wavelet resampling may be a generally useful method for inference on naturally complex time series.
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                Author and article information

                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                10 October 2013
                2013
                : 4
                : 127
                Affiliations
                [1] 1Department of Psychosis Studies, Institute of Psychiatry, King’s College London , London, UK
                [2] 2Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine , Sendai, Japan
                [3] 3Department of Psychiatry and Psychotherapy, Philipps-University Marburg , Marburg, Germany
                [4] 4Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, King’s College London , London, UK
                [5] 5Department of Neuroimaging, Institute of Psychiatry, King’s College London , London, UK
                [6] 6Developmental Psychiatry, University of Nottingham , Nottingham, UK
                Author notes

                Edited by: Judith M. Ford, Yale University School of Medicine, USA

                Reviewed by: Daphne J. Holt, Harvard University, USA; Ralph E. Hoffman, Yale School of Medicine, USA

                *Correspondence: Kazunori Matsumoto, Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan e-mail: kaz-mat@ 123456umin.net

                This article was submitted to Schizophrenia, a section of the journal Frontiers in Psychiatry.

                Article
                10.3389/fpsyt.2013.00127
                3794379
                24133459
                4b164537-4ead-4f48-8333-6e581d00a1d1
                Copyright © 2013 Matsumoto, Kircher, Stokes, Brammer, Liddle and McGuire.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 13 June 2013
                : 26 September 2013
                Page count
                Figures: 2, Tables: 4, Equations: 0, References: 55, Pages: 9, Words: 6964
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                schizophrenia,formal thought disorder,pause,language,fmri,speech planning,speech monitoring

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