Showing papers on "Dysarthria published in 2002"
TL;DR: Overall, dysdiadochokinesis was correlated with the degree of speech impairment, but there was a strong interaction between task type and motor speech syndrome, which affected DDK to a relatively greater extent than sentence production.
178 citations
TL;DR: The results show that this speaker was significantly less intelligible when speaking spontaneously than in the other tasks, which indicates that speech production task may be an important variable to consider during the evaluation of dysarthria.
175 citations
TL;DR: In this article, a multiple regression model was applied to determine the relative influence of the four basic dimensions on intelligibility in dysarthric patients, which revealed the relative importance of the individual dimensions on overall intelligibility.
164 citations
TL;DR: Results suggest that intelligibility decrements arise from the perceptual challenges posed by the degraded segmental and suprasegmental aspects of the signal, but that this type of familiarization process may differentially facilitate mapping segmental information onto existing phonological categories.
Abstract: This study is the third in a series that has explored the source of intelligibility decrement in dysarthria by jointly considering signal characteristics and the cognitive–perceptual processes employed by listeners. A paradigm of lexical boundary error analysis was used to examine this interface by manipulating listener constraints with a brief familiarization procedure. If familiarization allows listeners to extract relevant segmental and suprasegmental information from dysarthric speech, they should obtain higher intelligibility scores than nonfamiliarized listeners, and their lexical boundary error patterns should approximate those obtained in misperceptions of normal speech. Listeners transcribed phrases produced by speakers with either hypokinetic or ataxic dysarthria after being familiarized with other phrases produced by these speakers. Data were compared to those of nonfamiliarized listeners [Liss et al., J. Acoust. Soc. Am. 107, 3415–3424 (2000)]. The familiarized groups obtained higher intelligibility scores than nonfamiliarized groups, and the effects were greater when the dysarthria type of the familiarization procedure matched the dysarthria type of the transcription task. Remarkably, no differences in lexical boundary error patterns were discovered between the familiarized and nonfamiliarized groups. Transcribers of the ataxic speech appeared to have difficulty distinguishing strong and weak syllables in spite of the familiarization. Results suggest that intelligibility decrements arise from the perceptual challenges posed by the degraded segmental and suprasegmental aspects of the signal, but that this type of familiarization process may differentially facilitate mapping segmental information onto existing phonological categories.
122 citations
TL;DR: This experiment demonstrates that a fixed set of sentence-level utterances, obtained from 4 individuals with dysarthria as well as 3 neurologically normal speakers, is scaled differently depending on the identity of the standard, suggesting possible standardization of midrange intelligibility exemplars for DME experiments.
Abstract: Direct magnitude estimation (DME) has been used frequently as a perceptual scaling technique in studies of the speech intelligibility of persons with speech disorders. The technique is typically us...
100 citations
TL;DR: Criteria that have been proposed for differentiating apraxic from phonological and dysarthric disorders are described and it is suggested that syndrome-based approaches to the diagnosis of AOS may obscure important differences between individual presentations of apraxia of speech.
Abstract: Presented in this article is a discussion of current progress in behavioral, cognitive, and neuroanatomic definitions of apraxia of speech (AOS). A behavioral definition summarizes the speech symptoms that should be considered diagnostic of AOS with or without co-occurring aphasia and dysarthria. AOS is defined in cognitive terms as an impairment in the translation of phonological representations into specifications for articulation. Progress toward a neuroanatomic definition of AOS will rely on mapping the processes described by increasingly sophisticated cognitive models of normal speech production to the brain. The article describes criteria that have been proposed for differentiating apraxic from phonological and dysarthric disorders and suggests that syndrome-based approaches to the diagnosis of AOS may obscure important differences between individual presentations of apraxic disruption as well as similarities between AOS and other speech-language disorders.
70 citations
TL;DR: Consistent with intelligibility results, the present study found that combined cues resulted in higher comprehension scores than any other cue condition and that no cues resulted on intelligibility of unrelated and related sentences produced by 4 women with severe dysorthria secondary to cerebral palsy.
Abstract: This study is the second in a two-part series examining the effects of linguistic variables on listener processing of dysarthric speech. The first study (see K. C. Hustad & D. R. Beukelman, 2001) e...
53 citations
TL;DR: Developmental delay has been widely described as a major feature of BBS, with two-thirds to three-quarters of patients performing in the mental retardation range on formal testing.
Abstract: Bardet-Biedl syndrome (BBS), also known as Laurence-Moon-Bardet-Biedl syndrome (LMBBS), has long been regarded as an autosomal recessive condition but recent evidence now points to a more complex pattern of inheritance.1–3 Prevalence rates range from 1 in 100 000 to 1 in 160 000,4–6 although there are communities in which BBS appears to be more common as a result of consanguinity.3,7 BBS is a heterogeneous genetic condition with six gene loci mapped to date: 11q13 ( BBS1 ),8 16q21 ( BBS2 ),9 3p12-13 ( BBS3 ),10 15q23 ( BBS4 ),11 2q31 ( BBS5 ),12 and 20p12 ( BBS6 / MKKS ).13,14 Three of these genes have now been identified, BBS2 , BBS4 , and BBS6 .15 The phenotype of BBS varies from one family to another and within families, with only subtle phenotypic difference related to the different genes identified to date.16,17
The accepted major criteria for diagnosis include retinal dystrophy, obesity, polydactyly, male hypogonadism, mental retardation, and renal dysfunction.3 In addition to the primary features, a number of associated secondary features, including neurological, speech, and language deficits, behavioural traits, facial dysmorphism, and dental anomalies have been identified.18 The motor problems identified include delay in acquisition of motor skills, unsteady gait, and ataxia.18 Language development is delayed in many cases, although this may be commensurate with overall intellectual function, and there are also reports of speech problems that include articulation difficulties, consonant omission or distortions, dysarthria and hypernasality.3,4,17–19 Developmental delay has been widely described as a major feature of BBS, with two-thirds to three-quarters of patients performing in the mental retardation range on formal testing4,18,20 (but see Green et al 3 for an exception).
Disturbances in behaviour have been reported in …
51 citations
TL;DR: That speakers with dysarthria were able to exert sufficient control to signal the question-statement contrast has implications for diagnostic and intervention practices aimed to optimally exploit prosodic control for enhancing communication efficiency.
Abstract: Speakers with severe dysarthria are known to have reduced range in prosody. Consistent control within that range, however, has largely been ignored. In earlier investigations speakers with severe d...
51 citations
TL;DR: Magnetic resonance images showing cerebellar atrophy in the majority of patients suggest that Cerebellar degeneration and the interruption of afferent and efferent cerebellAR connections could be related to the cognitive deficits shown by patients with Friedreich's ataxia.
Abstract: Although recognized as one of the most common hereditary diseases of the nervous system, the neuropsychological deficits in Friedreich's ataxia (FA) have rarely been studied. A protocol was constructed to assess the major cognitive areas in patients with FA and pair-matched normal controls. Motor difficulties, dysarthria and fatigability were taken into account. Neuropsychological assessment showed decreased motor and mental reaction times, reduced verbal span, deficits in letter fluency, impaired acquisition and consolidation of verbal information, proactive interference effect, and alterations in complex visuoperceptual and visuoconstructive abilities, in comparison with the control group. Magnetic resonance images showing cerebellar atrophy in the majority of patients suggest that cerebellar degeneration and the interruption of afferent and efferent cerebellar connections could be related to the cognitive deficits shown by our patients.
47 citations
TL;DR: The study examined whether eight speakers with severe dysarthria caused by cerebral palsy could control the pitch and duration of sustained vowel productions at three distinct levels, and indicated that all speakers were able to consistently control sustained production of the vowel /a/ at three durations.
Abstract: Augmentative and alternative communication (AAC) users with severe dysarthria may benefit greatly from using residual vocalizations to enhance communication efficiency and naturalness. Many individuals use their residual vocal control to gain attention, express emotions, and convey intentions to familiar care givers. This research was designed to test the hypothesis that speakers signal such information through the control of phonatory features such as pitch and duration, despite severe degradation of segmental speech sounds. The study examined whether eight speakers with severe dysarthria caused by cerebral palsy could control the pitch and duration of sustained vowel productions at three distinct levels. The results indicated that all speakers were able to consistently control sustained production of the vowel /a/ at three durations (short, medium, and long). Speakers were more variable, however, in their ability to control pitches (low, medium, and high). Seven of the eight speakers were able to produc...
TL;DR: The data show that developmental as well as acquired lesions of the cerebellum disrupt motor speech, and add to the developmental role of the Cerebellum in the automatization of motor skills, including speech.
TL;DR: There is no evidence of the quality required by this review to support or refute the effectiveness of speech and language therapy interventions for adults with dysarthria following nonprogressive brain damage.
Abstract: Background: Dysarthria is a common sequel of nonprogressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population.Objective: To determine the efficacy of speech and language therapy interventions for adults with dysarthria following nonprogressive brain damage.Design: Systematic review.Search strategy: This review has drawn on the search strategies developed for the following Cochrane Groups as a whole: Stroke, Injuries, and Infectious Diseases. Relevant trials were identified in the Specialised Registers of Controlled Trials. We also searched the trials register of the Cochrane Rehabilitation and Related Therapies Field. The Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PsycLIT, and Linguistics and Language Behavior Abstracts were electronically searched. Hand-searching of the International Journal of Language and Communicati...
TL;DR: FMRI demonstrates for the first time by means of fMRI a selective ‘shift’ of the cortical representation of speech motor control to the right Rolandic cortex and the left cerebellum during restitution of articulation in a case of transient dysarthria following infarction of the left internal capsule.
Abstract: Based on clinical data, Geschwind assumed left hemisphere dominance of speech production to extend to the cortical representation of articulatory and phonatory functions at the motor cortex. This author suggested, furthermore, that the clinical observation of rapid recovery from articulatory impairments after damage to the left-sided corticobulbar tracts reflects compensatory activation of an alternative pathway involving the contralateral pre-central gyrus and its efferent projections. In order to test this hypothesis, functional magnetic resonance imaging (fMRI) was performed 4 and 35 days after stroke in a 38-year-old man who had experienced sudden speech deterioration ('dysarthric speech') concomitant with weakness of the right upper limb and the right side of the face. Computerized tomography demonstrated an ischaemic infarction within the left internal capsule. The patient fully recovered from dysarthria within 9 days. Activation of the right hemisphere analogues of Broca and Wernicke areas has been assumed to contribute to recovery from aphasia. As a further aspect of the reorganization of speech function, the present case study demonstrates for the first time by means of fMRI a selective 'shift' of the cortical representation of speech motor control to the right Rolandic cortex and the left cerebellum during restitution of articulation in a case of transient dysarthria following infarction of the left internal capsule.
TL;DR: Across research studies, pharmacological methods of treatment in isolation do not appear to significantly improve voice and speech function in PD, but in a single subject study, the dopamine agonist Mirapex was shown to have beneficial effects on vocal intensity.
Abstract: The purpose of this paper was to examine the effects of speech therapy and various pharmacological treatment approaches on the voice and speech of persons with Parkinson s disease (PD). Approximately 80% of PD patients have voice and speech problems including reduced vocal intensity, reduced vocal pitch, monopitch and monoloudness, and imprecise articulation. Research prior to 1970's had not demonstrated significant improvements following speech therapy. However, recent research has shown that speech therapy (when persons with PD are optimally medicated) has proven to be the most efficacious therapeutic method for improving voice and speech function. Across research studies, pharmacological methods of treatment in isolation do not appear to significantly improve voice and speech function in PD. In a single subject study, however, the dopamine agonist Mirapex was shown to have beneficial effects on vocal intensity. Possible explanations for the differential responses to treatment are discussed. It is suggested that the goal of future studies should be investigations of the effects of combined treatment approaches.
TL;DR: This sample of 192 patients contributes to a better understanding of neurological patients with speech and language disturbances and may be useful as a reference for health professionals involved in the rehabilitation of such disorders.
Abstract: CONTEXT: Aphasia is a very disabling condition caused by neurological diseases. In Brazil, we have little data on the profile of aphasics treated in rehabilitation centers. OBJECTIVE: To present a descriptive study of 192 patients, providing a reference sample of speech and language disturbances among Brazilians. DESIGN: Retrospective study. SETTING: Speech Pathology Unit linked to the Neurology Division of the Hospital das Clinicas of the Faculdade de Medicina da Universidade de Sao Paulo. SAMPLE: All patients (192) referred to our Speech Pathology service from 1995 to 2000. PROCEDURES: We collected data relating to demographic variables, etiology, language evaluation (functional evaluation, Boston Diagnostic Aphasia Examination, Boston Naming and Token Test), and neuroimaging studies. MAIN MEASUREMENTS: The results obtained in language tests and the clinical and neuroimaging data were organized and classified. Seventy aphasics were chosen for constructing a profile. Fourteen subjects with left single-lobe dysfunction were analyzed in detail. Seventeen aphasics were compared with 17 normal subjects, all performing the Token Test. RESULTS: One hundred subjects (52%) were men and 92 (48%) women. Their education varied from 0 to 16 years (average: 6.5; standard deviation: 4.53). We identified the lesion sites in 104 patients: 89% in the left hemisphere and 58% due to stroke. The incidence of aphasia was 70%; dysarthria and apraxia, 6%; functional alterations in communication, 17%; and 7% were normal. Statistically significant differences appeared when comparing the subgroup to controls in the Token Test. CONCLUSIONS: We believe that this sample contributes to a better understanding of neurological patients with speech and language disturbances and may be useful as a reference for health professionals involved in the rehabilitation of such disorders.
TL;DR: The 16 dysarthric TBI subjects were significantly less intelligible than the control subjects, and demonstrated significant impairment in 12 of the 33 speech dimensions rated, indicating some degree of pre-clinical speech impairment.
Abstract: Primary objective : To investigate perceptually the speech dimensions, oromotor function, and speech intelligibility of a group of individuals with traumatic brain injury (TBI) acquired in childhood. Research design : The speech of 24 children with TBI was analysed perceptually and compared with that of a group of non-neurologically impaired children matched for age and sex. Main outcome and results : The 16 dysarthric TBI subjects were significantly less intelligible than the control subjects, and demonstrated significant impairment in 12 of the 33 speech dimensions rated. In addition, the eight non-dysarthric TBI subjects were significantly impaired in many areas of oromotor function on the Frenchay Dysarthria Assessment, indicating some degree of pre-clinical speech impairment. Conclusion : The results of the perceptual analysis are discussed in terms of the possible underlying pathophysiological bases of the deviant speech features identified, and the need for a comprehensive instrumental assessment, ...
01 Nov 2002-The International journal of orofacial myology : official publication of the International Association of Orofacial Myology
TL;DR: Post-therapy measures indicated significant improvements in the stated goals as well as in speech intelligibility for single words in patients diagnosed with mild to moderate dysarthria following right hemisphere brain damage.
Abstract: Various types of orofacial myofunctional disorders co-exist with speech problems in individuals with dysarthria. Controlled studies stating the efficacy of orofacial myofunctional therapy (OMT) in dysarthric individuals are very scant. The present study was undertaken to examine the efficacy of OMT in twelve patients diagnosed with mild to moderate dysarthria following right hemisphere brain damage. Pre-therapy assessment focused on existing orofacial myofunctional problems and speech intelligibility in the clients. The goals of OMT were to increase strength and mobility of buccal, facial, labial, and lingual musculature. No speech intervention was provided while OMT was in progress. Post-therapy measures indicated significant improvements in the stated goals as well as in speech intelligibility for single words. Patients observed functional improvements in swallowing functions too. A high positive correlation was found between speech intelligibility and diadochokinetic rate. Clinical implications regarding use of OMT in dysarthria are discussed.
Journal Article•
TL;DR: The authors' patient appeared to meet the clinical criteria for frontotemporal degeneration of motor neuron disease type, and is the first case of amyotrophic lateral sclerosis showing alexia of kanji and word meaning aphasia.
Abstract: We report a 63-year-old right-handed Japanese man with progressive bulbar dysfunction and alexia of kanji (Japanese morphograms) He was well until his 62 years of age, when he noted difficulty of reading kanji, which was followed by disturbances in his speech Reading of kana (Japanese phonograms) was preserved He also showed naming difficulties with semantic memory loss for words, which were characterized for word meaning aphasia or semantic dementia He showed dysarthria and mild dysphagia with atrophy and fasciculations of the tongue The electromyographic studies disclosed diffuse neurogenic pattern He was diagnosed as having bulbar type amyotrophic lateral sclerosis Cranial magnetic resonance imaging and single-photon emission computed tomography revealed bilateral involvements of the temporal lobes Our patient appeared to meet the clinical criteria for frontotemporal degeneration of motor neuron disease type, and is the first case of amyotrophic lateral sclerosis showing alexia of kanji and word meaning aphasia
TL;DR: A miniature pressure transducer was used to assess the interlabial contact pressures produced by a group of 19 adults with dysarthria following severe traumatic brain injury (TBI) during a set of speech and nonspeech tasks, and the TBI group’s inter labial pressures appeared to have been generated with greater physiological effort.
Abstract: A miniature pressure transducer was used to assess the interlabial contact pressures produced by a group of 19 adults (mean age 30.6 years) with dysarthria following severe traumatic brain injury (TBI
TL;DR: Individuals with motor-speech disorders are frequently admonished by clinicians to "slow down" to improve speech intelligibility and comprehensibility, but most reports of rate-control therapy are negative.
Abstract: Individuals with motor-speech disorders are frequently admonished by clinicians to "slow down" to improve speech intelligibility and comprehensibility. Although most reports of rate-control therapy...
Journal Article•
Journal Article•
TL;DR: A 71-year-old woman showing rapidly progressive non-fluent aphasia and dementia accompanied by motor neuron disease (MND) is reported, who might be likely to be much more common in dementia with bulbar MND than is currently recognized.
Abstract: We report a 71-year-old woman showing rapidly progressive non-fluent aphasia and dementia accompanied by motor neuron disease (MND). There was no family history of dementia or motor neuron disease. There was 10 months history of dysarthria and dysphagia. On examination, she showed profound difficulty in articulation. Her comprehension was impaired in that she was unable to obey three-stage command. Her written language was also impaired with phonological spelling errors, syntactic errors, and perseveration. Neuroradiological investigations showed atrophic changes and hypoperfusion of left temporal and bilateral parietal region revealed by MRI and SPECT, respectively. Her subsequent decline was rapid. It might be likely that aphasia is much more common in dementia with bulbar MND than is currently recognized because bulbar palsy might mask the language disorder.
TL;DR: Acoustic and aerodynamic results were comparable to those reported for individuals with spasmodic dysphonia, and the most marked change was increased DC airflow.
01 Jan 2002
TL;DR: The aim of this study was to characterize the voice and the speech of patients with MSA, where hypokinetic, ataxic and spastic components were seen in each of the patients, although hypokeretic component predominated among the others.
Abstract: Multiple system atrophy (MSA) is characterized by parkinsonian, cerebellar and pyramidal features along with autonomic dysfunction in different combinations. Onset of dysarthria during the first year of the manifestation of a parkinsonian syndrome suggests the diagnosis of MSA. The aim of this study was to characterize the voice and the speech of patients with MSA. We studied five MSA patients with a mean age of 51.2 years. Each patient was submitted to a neurological and a specific speech and voice assessment. The latter consisted of the following: clinical interview, myofunctional examination, and perceptual speech evaluation. Speech and voice complaints occurred at an average time of 1.1 year after the onset of the motor symptomatology. All MSA patients had the mixed type of dysarthrophonia, where hypokinetic, ataxic and spastic components were seen in each of the patients, although hypokinetic component predominated among the others. Our findings are different from what is commonly seen in Parkinson's disease in which hypokinetic component is the only abnormal finding. We think that specific speech and voice assessment is important to establish the diagnosis and to choose the best management of MSA patients.