Abstract and Keywords
This chapter summarizes the clinical features, cognitive mechanisms, and neuroanatomical substrates of voice-processing disorders associated with the major dementias. Although disturbances of voice processing are rarely the leading feature of these diseases, impaired perception or recognition of voice identity and non-verbal vocal signals contributes to daily-life disability in the dementias and constitutes a significant source of distress for patients and caregivers. The brain networks targeted in particular diseases provide a substrate for the characteristic clinico-anatomical phenotypes that define different dementias and, more particularly, for the development of voice-processing deficits, as the networks overlap closely those implicated in the processing of voices in the healthy brain. The chapter firstly reviews key clinical and neuroanatomical characteristics of common dementias that affect voice processing, and considers the challenges of assessing voice processing in these diseases. It then outlines a taxonomy of voice-processing symptoms and deficits in the dementias, related to the perception and recognition of voices as complex ‘auditory objects’ that signal speaker identity as well as much other paralinguistic information. The extent to which deficits may be selective for voice attributes versus other domains of non-verbal sound and person knowledge, and the demands of integrating vocal with other sensory information, are considered. The chapter surveys the neuroanatomical correlates of disordered voice processing in neurodegenerative syndromes, and concludes by proposing a framework for understanding voice processing in the dementias and by indicating directions for future work.
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