Dysarthria

About: Dysarthria is a research topic. Over the lifetime, 2402 publications have been published within this topic receiving 56554 citations.

Preparing an E-learning-based Speech Therapy (EST) efficacy study: Identifying suitable outcome measures to detect within-subject changes of speech intelligibility in dysarthric speakers.

Abstract: We explored the suitability of perceptual and acoustic outcome measures to prepare E-learning based Speech Therapy (EST) efficacy tests regarding speech intelligibility in dysarthric speakers. Eight speakers with stroke (n=3), Parkinson's disease (n=4) and traumatic brain injury (n=1) participated in a 4 weeks EST trial. A repeated measures design was employed. Perceptual measures were (a) scale ratings for "ease of intelligibility" and "pleasantness" in continuous speech and (b) orthographic transcription scores of semantically unpredictable sentences. Acoustic measures were (c) "intensity during closure" (ΔIDC) in the occlusion phase of voiceless plosives, (d) changes in the vowel space of /a/, /e/ and /o/ and (e) the F0 variability in semantically unpredictable sentences. The only consistent finding concerned an increased (instead of the expected decreased) ΔIDC after EST, possibly caused by increased speech intensity without articulatory adjustments. The importance of suitable perceptual and acoustic measures for efficacy research is discussed.

Features of speech and swallowing dysfunction in pre-ataxic spinocerebellar ataxia type 2.

Abstract: Objective To determine whether objective and quantitative assessment of dysarthria and dysphagia in spinocerebellar ataxia type 2 (SCA2), specifically at pre-ataxic and early disease phases, can act as sensitive disease markers. Methods Forty-six individuals (16 with pre-ataxic SCA2, 14 with early-stage ataxic SCA2, and 16 healthy controls) were recruited in Holguin, Cuba. All participants underwent a comprehensive battery of assessments including objective acoustic analysis, clinician-derived ratings of speech function and swallowing, and quality of life assessments of swallowing. Results Reduced speech agility manifest at the pre-ataxic stage was observed during diadochokinetic tasks, with the magnitude of speech deficit augmented in the early ataxic stage. Speech rate was slower in early-stage ataxic SCA2 compared with pre-ataxic SCA2 and healthy controls. Reduced speech agility and speech rate correlated with disease severity and time to ataxia onset, verifying that speech deficits occur prior to ataxia onset and increase in severity as the disease progresses. Whereas dysphagia was observed in both pre-ataxic and ataxic SCA2, it was not associated with swallowing-related quality of life, disease severity, or time to ataxia onset. Conclusions Speech and swallowing deficits appear sensitive to disease progression in early-stage SCA2, with syllabic rate a viable marker. Findings provide insight into mechanisms of disease progression in early-stage SCA2, signaling an opportunity for stratifying early-stage SCA2 and identifying salient markers of disease onset as well as outcome measures in future early-stage therapeutic studies.

The Collaboration of Music Therapy and Speech-Language Pathology in the Treatment of Neurogenic Communication Disorders: Part I—Diagnosis, Therapist Roles, and Rationale for Music

Abstract: This two-part article addresses collaboration of music therapists (MTs) and speech-language pathologists (SLPs), specifically in the treatment of neurogenic communication disorders (NCDs). Part I of this article will include the following: (a) definitions and descriptions of several NCDs relevant to music therapy practice; (b) a brief overview of SLP treatment approaches and techniques for these disorders; and (c) a rationale for applying music therapy methods with these disorders and discussion of several techniques commonly used. When language is impaired due to neurological damage, it is referred to as a neurogenic communication disorder (NCD) (Brookshire, 2003). The term neurogenic is comprised of the prefix neuro-, meaning "related to nerves" or "the nervous system," and the suffix -genic, meaning "resulting from" or "caused by"; therefore, neurogenic communication disorders are disorders resulting from nervous system pathology (Brookshire, 2003, p. 1). Because communication is a primary treatment area, a patient with a NCD is likely to be referred to a speech-language pathologist (SLP) for assessment and/or subsequent habilitation or rehabilitation. Some of the treatment goals may be effectively addressed in music therapy as well; however, the role of the music therapist (MT), at present time, may be less clearly defined within the treatment team. Therefore, this two-part article will address defining NCDs, their treatment, rationale for the use of music with NCDs, and the role of SLPs and MTs respectively in collaborative treatment. Music therapists likely have general familiarity with the role of SLPs: assessment, treatment, and referral services for individuals with communication and other related disorders, such as speech, language, voice, and swallowing disorders (ASHA, 20016; Brookshire, 2003). Beyond that, some MTs may lack a comprehensive understanding of what SLPs actually do. Conversely, SLPs may be unfamiliar with possible applications of music therapy for persons with communication disorders or may harbor concerns regarding whether MTs are professionally prepared to address the treatment objectives of this clientele. This lack of understanding can contribute to communication breakdown that can reduce provision of treatment options for clients who can benefit from a collaborative treatment approach. An understanding of NCDs and their characteristics can provide an important foundation for effective collaboration. Neurogenic Communication Disorders Neurogenic communication disorders can be further categorized in terms or neurogenic language disorders, including various forms of aphasia or neurogenic motor speech disorders, such as apraxia of speech and various forms of dysarthria (Brookshire, 2003; Hegde, 1998). Neurogenic Language Disorders Aphasia is a neurogenic language disorder resulting from acquired brain damage, such as cerebrovascular accidents (CVAs, i.e., strokes), brain trauma (e.g., brain injury from automobile accidents), brain tumors, or progressive neurological diseases (Brookshire, 2003; Hegde, 1998). Multiple definitions of aphasia can be found in the literature due to the various considerations of types of aphasia and varying definitions of language (Hegde, 1998); however, for the purposes of this article, aphasia can be defined as "a language impairment that crosses all input and output modalities" (Brookshire, 2003, p. 569) or a deficiency in the ability to understand and/or create language (Brookshire, 2003; J. Gordon, personal communication, September 16, 2002; Hegde, 1998). Aphasia can affect different aspects of language, such as speaking, comprehension, reading, writing, and gesturing, for example. There are several kinds of aphasia and differential diagnosis is often controversial (Hegde, 1998). In broad terms, aphasia can be categorized in terms of fluency or prosodie (melodic) aspects of speech. Individuals with a form of fluent aphasia speak naturally and with ease, incorporating more normal speech rate and emphasis, whereas individuals with a form of nonfluent aphasia speak slowly and laboriously with frequent pauses (Brookshire, 2003). …

Automated speech analysis in early untreated Parkinson's disease: Relation to gender and dopaminergic transporter imaging.

Abstract: BACKGROUND The mechanisms underlying speech abnormalities in Parkinson's disease (PD) remain poorly understood, with most of the available evidence based on male patients. This study aimed to estimate the occurrence and characteristics of speech disorder in early, drug-naive PD patients with relation to gender and dopamine transporter imaging. METHODS Speech samples from 60 male and 40 female de novo PD patients as well as 60 male and 40 female age-matched healthy controls were analyzed. Quantitative acoustic vocal assessment of 10 distinct speech dimensions related to phonation, articulation, prosody, and speech timing was performed. All patients were evaluated using [123]I-2b-carbomethoxy-3b-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single-photon emission computed tomography and Montreal Cognitive Assessment. RESULTS The prevalence of speech abnormalities in the de novo PD cohort was 56% for male and 65% for female patients, mainly manifested with monopitch, monoloudness, and articulatory decay. Automated speech analysis enabled discrimination between PD and controls with an area under the curve of 0.86 in men and 0.93 in women. No gender-specific speech dysfunction in de novo PD was found. Regardless of disease status, females generally showed better performance in voice quality, consonant articulation, and pauses production than males, who were better only in loudness variability. The extent of monopitch was correlated to nigro-putaminal dopaminergic loss in men (r = 0.39, p = 0.003) and the severity of imprecise consonants was related to cognitive deficits in women (r = -0.44, p = 0.005). CONCLUSIONS Speech abnormalities represent a frequent and early marker of motor abnormalities in PD. Despite some gender differences, our findings demonstrate that speech difficulties are associated with nigro-putaminal dopaminergic deficits.