The Neural Substrates of Multisensory Speech Perception

Comprehending speech is one of the most important human behaviors, but we are only beginning to understand how the brain accomplishes this difficult task. One key to speech perception seems to be that the brain integrates the independent sources of information available in the auditory and visual modalities in a process known as multisensory integration. This allows speech perception to be accurate, even in environments in which one modality or the other is ambiguous in the context of noise. Previous electrophysiological and functional magnetic resonance imaging (fMRI) experiments have implicated the posterior superior temporal sulcus (STS) in auditory-visual integration of both speech and non-speech stimuli. While evidence from prior imaging studies have found increases in STS activity for audiovisual speech compared with unisensory auditory or visual speech, these studies do not provide a clear mechanism as to how the STS communicates with early sensory areas to integrate the two streams of information into a coherent audiovisual percept. Furthermore, it is currently unknown if the activity within the STS is directly correlated with strength of audiovisual perception. In order to better understand the cortical mechanisms that underlie audiovisual speech perception, we first studied the STS activity and connectivity during the perception of speech with auditory and visual components of varying intelligibility. By studying fMRI activity during these noisy audiovisual speech stimuli, we found that STS connectivity with auditory and visual cortical areas mirrored perception; when the information from one modality is unreliable and noisy, the STS interacts less with the cortex processing that modality and more with the cortex processing the reliable information. We next characterized the role of STS activity during a striking audiovisual speech illusion, the McGurk effect, to determine if activity within the STS predicts how strongly a person integrates auditory and visual speech information. Subjects with greater susceptibility to the McGurk effect exhibited stronger fMRI activation of the STS during perception of McGurk syllables, implying a direct correlation between strength of audiovisual integration of speech and activity within an the multisensory STS.

The role of substance abuse treatment in preventing human immunodeficiency virus transmission among injecting drug users

This exploratory study assesses the utility of substance abuse treatment as a strategy for preventing human immunodeficiency virus (HIV) transmission among injecting drug users (IDUs). Data analyzed in this study were collected in San Antonio, TX, 1989 through 1995 using both qualitative and quantitative methods. Qualitative data included ethnographic interviews with 234 active IDUs; quantitative data included baseline risk assessments and HIV screening plus interviews follow-up interviews administered approximately six months later to 823 IDUs participating in a Federally-funded AIDS community outreach demonstration project.^ Findings that have particularly important implications for substance abuse treatment as an HIV prevention strategy for IDUs are listed below. (1) IDUs who wanted treatment were significantly more likely to be daily heroin users. (2) IDUs who want treatment were significantly more likely to have been to treatment previously. (3) IDUs who wanted treatment at baseline reported significantly higher levels of HIV risk than IDUs who did not want treatment. (4) IDUs who went to treatment between their baseline and follow-up interviews reported significantly higher levels of HIV risk at baseline than IDUs who did not go to treatment. (5) IDUs who went to treatment between their baseline and follow-up interviews reported significantly greater decreases in injection-related HIV risk behaviors. (6) IDUs who went to treatment reported significantly greater decreases in sexual HIV risk behaviors than IDUs who did not go to treatment.^ This study also noted a number of factors that may limit the effectiveness of substance abuse treatment in reducing HIV risk among IDUs. Findings suggest that the impact of methadone maintenance on HIV risk behaviors among opioid dependent IDUs may be limited by the negative manner in which it is perceived by IDUs as well as other elements of society. One consequence of the negative perception of methadone maintenance held by many elements of society may be an unwillingness to provide public funding for an adequate number of methadone maintenance slots. Thus many IDUs who would be willing to enter methadone maintenance are unable to enter it and many IDUs who do enter it are forced to drop out prematurely. ^