Gottfried Schlaug

University of Massachusetts Medical School | UMMS · Department of Neurology

Brain tumors remain a critical global health challenge, necessitating advancements in diagnostic techniques and treatment methodologies. In response to the growing need for age-specific segmentation models, particularly for pediatric patients, this study explores the deployment of deep learning techniques using magnetic resonance imaging (MRI) moda...

Brain tumors, particularly glioblastoma, continue to challenge medical diagnostics and treatments globally. This paper explores the application of deep learning to multi-modality magnetic resonance imaging (MRI) data for enhanced brain tumor segmentation precision in the Sub-Saharan Africa patient population. We introduce an ensemble method that co...

A major challenge in stroke research and stroke recovery predictions is the determination of a stroke lesion's extent and its impact on relevant brain systems. Manual segmentation of stroke lesions from 3D magnetic resonance (MR) imaging volumes, the current gold standard, is not only very time-consuming, but its accuracy highly depends on the oper...

Concurrent transcranial direct current stimulation (tDCS) and proton Magnetic Resonance Spectroscopy (1H MRS) experiments have shown up- or downregulation of neurotransmitter concentration. However, effects have been modest applying mostly lower current doses and not all studies found significant effects. Dose of stimulation might be an important v...

Non-invasive transcranial direct current stimulation (tDCS) can modulate activity of targeted brain regions. Whether tDCS can reliably and repeatedly modulate intrinsic connectivity of entire brain networks is unclear. We used concurrent tDCS-MRI to investigate the effect of high dose anodal tDCS on resting state connectivity within the Arcuate Fas...

Transcranial direct current stimulation (tDCS) can noninvasively modulate behavior, cognition, and physiologic brain functions depending on polarity and dose of stimulation as well as montage of electrodes. Concurrent tDCS-fMRI presents a novel way to explore the parameter space of non-invasive brain stimulation and to inform the experimenter as we...

Brain extraction is a critical preprocessing step in almost every neuroimaging study, enabling accurate segmentation and analysis of Magnetic Resonance Imaging (MRI) data. FSL's Brain Extraction Tool (BET), although considered the current gold standard, presents limitations such as over-extraction, which can be particularly problematic in brains wi...

Ischemic cerebrovascular events often lead to aphasia. Previous work provided hints that such strokes may affect women and men in distinct ways. Women tend to suffer strokes with more disabling language impairment, even if the lesion size is comparable to men. In 1401 patients, we isolate data-led representations of anatomical lesion patterns and h...

Background: Acquired prosopagnosia is often associated with other deficits, such as dyschromatopsia and topographagnosia, from damage to adjacent perceptual networks. A recent study showed that some subjects with developmental prosopagnosia also have congenital amusia, but problems with music perception have not been described in the acquired vari...

The ability to produce words through singing can be preserved in severe aphasia, but the benefits of group-based singing rehabilitation in aphasia are largely unknown. Our aim was to determine the efficacy of a multicomponent singing intervention on communication and speech production, emotional-social functioning and caregiver well-being in aphasi...

Mitochondrial encephalomyopathy, lactic acidosis, stroke-like episodes, and other features (short stature, headaches, seizures, and sensorineural hearing loss) constitute characteristics of MELAS syndrome. MELAS is a rare condition due to mutations in maternally inherited mitochondrial DNA with levels of heteroplasmy possibly related to late adulth...

Patients with large left-hemisphere lesions and post-stroke aphasia often remain nonfluent. Melodic intonation therapy (MIT) may be an effective alternative to traditional speech therapy for facilitating recovery of fluency in those patients. In an open-label, proof-of-concept study, 14 subjects with nonfluent aphasia with large left-hemisphere les...

Transcranial direct current stimulation (tDCS) can noninvasively modulate behavior, cognition, and brain functions depending on polarity and dose of the stimulation as well as electrode montage. Concurrent tDCS-fMRI presents a novel way to explore the parameter space of non-invasive brain stimulation and to inform if a targeted brain region or a ne...

Major advances in music neuroscience have fueled a growing interest in music‐based neurological rehabilitation among researchers and clinicians. Musical activities are excellently suited to be adapted for clinical practice because of their multisensory nature, their demands on cognitive, language, and motor functions, and music's ability to induce...

Dysphagia is a serious stroke complication but lacks effective therapy . We investigated safety and preliminary efficacy of anodal transcranial direct current stimulation (atDCS) paired with swallowing exercises in improving post-stroke dysphagia from an acute unilateral hemispheric infarction (UHI). We conducted a double-blind, early phase-2 rando...

We tested an intonation‐based speech treatment for minimally verbal children with autism (auditory‐motor mapping training, AMMT) against a nonintonation–based control treatment (speech repetition therapy, SRT). AMMT involves singing, rather than speaking, two‐syllable words or phrases. In time with each sung syllable, therapist and child tap togeth...

Up-or downregulation of neurotransmitter/receptor concentration have been seen when transcranial direct current stimulation (tDCS) and proton Magnetic Resonance Spectroscopy (MRS) were combined in concurrent experiments; however, results have been mixed and not reliable across studies. In this study, we investigated dose and polarity effects of tDC...

Background: Dysphagia is a serious stroke complication but lacks effective therapy. We investigated safety and preliminary efficacy of anodal transcranial direct current stimulation (atDCS) paired with swallowing exercises in improving post-stroke dysphagia from an acute unilateral hemispheric infarction (UHI). Methods: Double-blind, early phase-2...

Low-intensity transcranial electrical stimulation (tES), including alternating or direct current stimulation, applies weak electrical stimulation to modulate the activity of brain circuits. Integration of tES with concurrent functional MRI (fMRI) allows for the mapping of neural activity during neuromodulation, supporting causal studies of both bra...

Ischemic cerebrovascular events often lead to aphasia. Previous work provided hints that such strokes may affect women and men in distinct ways. Women tend to suffer strokes with more disabling language impairment, even if the lesion size is comparable to men. In 1,401 patients, we isolated data-led representations of anatomical lesion patterns and...

A classical observation in neurology is that aphasic stroke patients with impairments in speech production can nonetheless sing the same utterances. This preserved ability suggests a distinctive neural architecture for singing that could contribute to speech recovery. However, to date, these structural correlates remain unknown. Here, we combined a...

Background and Purpose Hematoma volume (HV) is a powerful determinant of outcome after intracerebral hemorrhage. We examined whether the effect of the iron chelator, deferoxamine, on functional outcome varied depending on HV in the i-DEF trial (Intracerebral Hemorrhage Deferoxamine). Methods A post hoc analysis of the i-DEF trial; participants wer...

Objective Using multimodal imaging, we tested the hypothesis that patients after hemispherotomy recruit non-primary motor areas and non-pyramidal descending motor fibers to restore motor function of the impaired limb. Methods Functional and structural MRI data were acquired in a group of 25 patients who had undergone hemispherotomy and in a matche...

We used three dose levels (Sham, 2mA, and 4mA) and two different electrode montages (unihemispheric or bihemispheric) to examine DOSE and MONTAGE effects on regional cerebral blood flow (rCBF) as a surrogate marker of neural activity, and on a finger sequence task, as a surrogate behavioral measure drawing on brain regions targeted by transcranial...

We studied the effects of motor region tDCS on metabolite levels in a spectroscopic voxel with repeated episodes of 5min of constant current dose levels anticipating stimulation-induced alterations in metabolite concentration at rest. The cumulative change in GABA from before the first tDCS stimulation epoch to after the last epoch showed a signifi...

Purpose Understanding what limits speech development in minimally verbal (MV) children with autism spectrum disorder (ASD) is important for providing highly effective targeted therapies. This preliminary investigation explores the extent to which developmental speech deficits predicted by Directions Into Velocities of Articulators (DIVA), a computa...

Previous studies have shown that transcranial direct current stimulation (tDCS) can affect performance by decreasing regional excitability in a brain region that contributes to the task of interest. To our knowledge, no research to date has found both enhancing and diminishing effects on performance, depending upon which polarity of the current is...

We used three dose levels (Sham, 2mA, and 4mA) and two different electrode montages (unihemispheric or bihemispheric) to examine DOSE and MONTAGE effects on regional cerebral blood flow (rCBF) as a surrogate marker of neural activity, and on a finger sequence task, as a surrogate behavioral measure drawing on brain regions targeted by transcranial...

Previous studies have shown that transcranial direct current stimulation (tDCS) can affect performance by decreasing regional excitability in a brain region that contributes to the task of interest. To our knowledge, no research to date has found both enhancing and diminishing effects on performance, depending upon which polarity of current is appl...

Absolute pitch (AP) refers to the ability of identifying the pitch of a given tone without reliance on any reference pitch. The downside of possessing AP may be the experience of disturbance when exposed to out-of-tune tones. Here, we investigated this so-far unexplored phenomenon in AP, which we refer to as auditory aversion. Electroencephalograph...

Background Low intensity transcranial electrical stimulation (tES), including alternating or direct current stimulation (tACS or tDCS), applies weak electrical stimulation to modulate brain circuits. Integration of tES with concurrent functional magnetic resonance imaging (fMRI) allows neuromodulation of brain regions while mapping network function...

Non-invasive electrical stimulation can modulate not only targeted local intrinsic brain activity, but also activity in remote, yet connected brain regions. Such modulation of connected regions and/or entire networks may account for some of the treatment-induced changes in complex behaviors and cognitive processes. The current study tested whether...

Stroke is a leading cause of disability, most commonly with motor deficit. The motor recovery is associated with the structural and/or functional degree of injury to descending motor pathways. Additionally, neuroplasticity contributes to the recovery by unmasking pre-existing connections, establishing new synaptic contacts, reorganizing peri-lesion...

A novel electrode placement strategy for transcranial direct current stimulation method is explored to stimulate nodal cortical endpoints of the arcuate fasciculus. The poster discusses the preliminary results of this study

Attention and working memory (WM) are core components of executive functions, and they can be enhanced by training. One activity that has shown to improve executive functions is musical training, but the brain networks underlying these improvements are not well known. We aimed to identify, using functional MRI (fMRI), these networks in children who...

Purpose To investigate the latent factors underlying signs of childhood apraxia of speech (CAS) in a group of 57 children with CAS. Method The speech of 57 children with CAS (aged 3;5 to 17;0) was coded for signs of CAS. All participants showed at least five signs of CAS and were judged to have CAS by speech pathologists experienced in pediatric s...

Absolute pitch (AP) refers to the ability of identifying the pitch of a given tone without reliance on any reference pitch. The downside of possessing AP may be the experience of disturbance when exposed to out-of-tune tones. Here, we investigated this so-far unexplored phenomenon in AP, which we refer to as auditory aversion. Electroencephalograph...

Background The COVID-19 pandemic has broadly disrupted biomedical treatment and research including non-invasive brain stimulation (NIBS). Moreover, the rapid onset of societal disruption and evolving regulatory restrictions may not have allowed for systematic planning of how clinical and research work may continue throughout the pandemic or be rest...

Transcranial direct current stimulation (tDCS) is increasingly being used as a possible tool to enhance plasticity in brain regions that might undergo remodeling after a stroke. Our aim was to determine whether dose and montage of tDCS leads to differential changes in regional cerebral blood flow (rCBF) and differential effect on a finger sequence...

Background: Effective therapy for dysphagia recovery after stroke is currently lacking. We conducted a phase-2 RCT to investigate the effects of anodal transcranial direct current stimulation (atDCS) in reducing aspiration risk, improving diet, and analyzed its safety in the acute-subacute stroke phase. Hypothesis: Since swallowing has bi-hemispher...

Motor function after hemispheric lesions has been associated with the structural integrity of either the pyramidal tract (PT) or alternate motor fibers (aMF). In this study, we aimed to differentially characterize the roles of PT and aMF in motor compensation by relating diffusion-tensor-imaging-derived parameters of white matter microstructure to...

Objective: To determine the contributions of apraxia of speech (AOS) and anomia to conversational dysfluency. Methods: In this observational study of 52 patients with chronic aphasia, 47 with concomitant AOS, fluency was quantified using correct information units per minute (CIUs/min) from propositional speech tasks. Videos of patients performin...

Background/objective Isolated dissection of the posterior cerebellar artery (PICA) is very rare, with only few cases reported in the literature. Ischemic stroke or subarachnoid hemorrhage (SAH) may follow isolated PICA dissection depending on the dissection plane of the artery. The aim of this is study is to investigate similarities and variations...

Background Acquired prosopagnosia is often associated with other deficits, such as dyschromatopsia and topographagnosia, from damage to adjacent perceptual networks. A recent study showed that some subjects with developmental prosopagnosia also have congenital amusia, but problems with music perception have not been described in the acquired varian...

Background and purpose: Predicting motor outcome following intracerebral hemorrhage is challenging. We tested whether the combination of clinical scores and DTI-based assessment of corticospinal tract damage within the first 12 hours of symptom onset after intracerebral hemorrhage predicts motor outcome at 3 months. Materials and methods: We pro...

Studies of developmental prosopagnosia have often shown that developmental prosopagnosia differentially affects human face processing over non-face object processing. However, little consideration has been given to whether this condition is associated with perceptual or sensorimotor impairments in other modalities. Comorbidities have played a role...

Non-invasive brain-stimulation has been reported to modulate cortical excitability, synaptic plasticity, and interhemispheric interactions of homotop brain regions. All of these processes could play a role in facilitating stroke recovery. Modulation in cortical excitability covaries with changes in regional cerebral blood flow. Our aim was to deter...

INTERNATIONAL STROKE CONFERENCE 2019 ORAL ABSTRACTS SESSION TITLE: CLINICAL REHABILITATION AND RECOVERY ORAL ABSTRACTS I Abstract 67: Contributions of the Unaffected Hemisphere to Outcome Predictions of Acute Aphasia Gottfried Schlaug , Andrea Norton , Karen Chenausky , Sarah Marchina , Julius Kernbach Originally published January 30, 2019 https:...

Music-making is a widespread leisure activity that has garnered interest over the years due to its effect on brain and cognitive development and its potential as a rehabilitative therapy of brain dysfunction. We investigated whether music-making has a potential age-protecting effect on the brain. For this, we studied anatomical magnetic resonance i...

Studies have shown subtle gray and white matter abnormalities in subjects with several developmental disorders including prosopagnosia, tone-deafness, and dyslexia. Correlational evidence suggests that tone-deafness and dyslexia tend to co-occur, suggesting a link between these two developmental disorders. However, it is not known whether tone-deaf...

Background and Purpose— Physiological effects of stroke are best assessed over entire brain networks rather than just focally at the site of structural damage. Resting-state functional magnetic resonance imaging can map functional-anatomic networks by analyzing spontaneously correlated low-frequency activity fluctuations across the brain, but its p...

The Harvard Beat Assessment Test (H-BAT) is a battery of tests to assess abilities to perceive, produce, and synchronize with a music beat, and the inter-individual differences (Fujii & Schlaug, 2013). However, the original version of H-BAT requires particular hardware setups and is difficult to distribute. Here we developed an iOS application of H...

We investigated the relationship between eight theoretically motivated behavioral variables and a spoken‐language‐related outcome measure, after 25 sessions of treatment for speech production in 38 minimally verbal children with autism. After removing potential predictors that were uncorrelated with the outcome variable, two remained. We used both...

Epilepsy has been associated with a dysfunction of the blood-brain barrier. While there is ample evidence that a dysfunction of the blood-brain barrier contributes to epileptogenesis, blood-brain barrier dysfunction as a consequence of single epileptic seizures has not been systematically investigated. We hypothesized that blood-brain barrier dysfu...

There has been a renewed research interest in transcranial direct current stimulation (tDCS) as an adjunctive tool for poststroke motor recovery as it has a neuro-modulatory effect on the human cortex. However, there are barriers towards its successful application in motor recovery as several scientific issues remain unresolved, including device-re...

Autism affects ∼1.5% of children under age 8; its core symptoms include impairment in social-communicative functioning and repetitive behaviors/restricted interests. Music-based interventions have been considered one modality through which to treat autism. This report discusses considerations to take into account when developing a music-based inter...

Functional imaging studies have provided insight into the effect of rate on production of syllables, pseudowords, and naturalistic speech, but the influence of rate on repetition of commonly-used words/phrases suitable for therapeutic use merits closer examination. Aim: To identify speech-motor regions responsive to rate and test the hypothesis tha...

Perceiving and producing vocal sounds are important functions of the auditory-motor system and are fundamental to communication. Prior studies have identified a network of brain regions involved in pitch production, specifically pitch matching. Here we reverse engineer the function of the auditory perception-production network by targeting specific...

Introduction: Making accurate predictions about a stroke patient’s language/speech-motor outcome and recovery potential is a challenge. We previously showed that a combined variable of lesion site and size pertinent to relevant white matter language structures, the Arcuate Fasciculus lesion load (AF-LL), correlated highly with measures of speech fl...

Introduction: Initial motor impairment assessed in the acute stroke phase (as measured by the Fugl-Meyer (FM) Assessment) is a strong predictor of lower extremity (LE) motor impairment at 3 months (Smith et al., 2017). The predictive value of measures of motor tract integrity, lesion size and location is not known. For our analysis we combined two...

Music-making is a widespread leisure and professional activity that has garnered interest over the years due to its effect on brain and cognitive development and its potential as a rehabilitative and restorative therapy of brain dysfunctions. We investigated whether music-making has a potential age-protecting effect on the brain. For this, we studi...

We tested the effect of Auditory-Motor Mapping Training (AMMT), a novel, intonation-based treatment for spoken language originally developed for minimally verbal (MV) children with autism, on a more-verbal child with autism. We compared this child’s performance after 25 therapy sessions with that of: (1) a child matched on age, autism severity, and...

From expert percussionists to individuals who cannot dance, there are widespread differences in people's abilities to perceive and synchronize with a musical beat. The aim of our study was to identify candidate brain regions that might be associated with these abilities. For this purpose, we used Voxel-Based-Morphometry to correlate inter-individua...

We investigated the relationship between imaging variables for two language/speech-motor tracts and speech fluency variables in 10 minimally verbal (MV) children with autism. Specifically, we tested whether measures of white matter integrity—fractional anisotropy (FA) of the arcuate fasciculus (AF) and frontal aslant tract (FAT)—were related to cha...

PurposeDespite improved acute treatment and new tools to facilitate recovery, most patients have motor deficits after stroke, often causing disability. However, motor impairment varies considerably among patients, and recovery in the acute/subacute phase is difficult to predict using clinical measures alone, particularly in severely impaired patien...

Introduction: Upper-limb spasticity is a very disabling complication after stroke. There has been no simple clinical standard scale to predict spasticity immediately after stroke. This study aims to develop a simple bedside grading scale with the information collected during the acute phase to predict spasticity at 3 month post-stroke Methods: This...

Introduction: Recruitments of stroke recovery trials have been challenging. NIH stroke scale (NIHSS) has been universally collected in the acute stroke phase, but stroke recovery trials generally use Fugl-Meyer Motor Scale (FMMS) for outcome measure as well as patient selection criteria. The knowledge gap on the relationship between the two scales...

Over the past 100 years, the literature has become full of case reports indicating that patients with severe nonfluent aphasia are better at singing lyrics than they are at speaking the same words. This observation has been the basis for developing intonation-based speech therapy, which is commonly referred to as Melodic Intonation Therapy (MIT). A...

This study compared Auditory-Motor Mapping Training (AMMT), an intonation-based treatment for facilitating spoken language in minimally verbal children with autism spectrum disorder (ASD), to a matched control treatment, Speech Repetition Therapy (SRT). 23 minimally verbal children with ASD (20 male, mean age 6;5) received at least 25 sessions of A...