Dysarthria

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

A Cochrane review of treatment for dysarthria following acquired brain injury in children and adolescents

Abstract: BACKGROUND: The expression ''acquired brain injury'' (ABI) incorporates a range of etiologies including cerebrovascular accident, brain tumour and traumatic brain injury. ABI is a common cause of disability in the pediatric population, and dysarthria is a common and often persistent sequelae associated with ABI in children. OBJECTIVES: The aim of this study was to assess the efficacy of intervention delivered by Speech and Language Pathologists/Therapists targeting dysarthric speech in children resulting from acquired brain injury. METHODS: Several electronic databases were searched up to January 2007. The review considered randomised controlled trials (RCTs) and quasi-randomised studies of children aged 3 to 16 years with acquired dysarthria grouped by aetiology (e.g., brain tumour, traumatic brain injury, cerebrovascular accident). Both authors independently assessed the titles and abstracts for relevance (100% inter-rater reliability) and the full text version of all potentially relevant articles was obtained. No studies met inclusion criteria. RESULTS: Of 2 091 titles and abstracts identified, full text versions of only three were obtained. The remaining 2 088 were excluded, largely on the basis of not including dysarthria, being diagnostic or descriptive papers, and for concerning adults rather than children. All obtained articles were excluded due to including populations without ABI, adults with dysarthria, or inappropriate design. Thus, no studies met inclusion criteria. CONCLUSION: The review demonstrates a critical lack of studies, let alone RCTs, addressing treatment efficacy for dysarthria in children with ABI. Possible reasons to explain this lack of data include 1) a lack of understanding of the characteristics or natural history of dysarthria associated with this population; 2) the lack of a diagnostic classification system for children precluding the development of well targeted intervention programs; and 3) the heterogeneity of both the etiologies and resultant possible dysarthria types of pediatric ABI. Efforts should first be directed at modest well-controlled studies to identify likely efficacious treatments that may then be trialled in multicentre collaborations using quasi-randomised or RCT methodology. Language: en

Perfil populacional de pacientes com disartria atendidos em hospital terciário

Abstract: PURPOSE: To characterize the populational profile of dysarthric patients assisted in a tertiary hospital, and to present the most frequent speech disorders found in this population. METHODS: A specific protocol proposed for dysarthric patients was applied, gathering data through tasks that evaluate breathing, phonation, resonance, articulation, and prosody. Sixty protocols applied to patients evaluated at the Communication Disorders Ambulatory of the institution were the study took place were randomly selected for analysis. Data was descriptively analyzed. RESULTS: Regarding the populational profile of the dysarthric patients attended at a tertiary hospital, it was observed prevalence of male subjects, mostly aged from 20 to 50 years. The most common types of dysarthria were flaccid and unilateral upper motor neuron. Stroke was the most prevalent etiology for this speech disorder. Regarding the motor bases evaluated, it was observed a predominance of mixed breathing, hoarse voice, and normal velar movement, although mild hypernasality was identified. Articulation was mostly severely altered, and mild prosody alterations were predominant in the investigated population. CONCLUSION: It was possible to draw a profile of dysarthric patients assisted in a tertiary hospital in Brazil. The most common characteristics were: short breathing cycles, hoarse hypernasal phonation, moderate to severe articulation disorders, mild prosody impairment and low speech rate.

The Effects of Various Drugs on Speech

Abstract: Although many drugs are known to alter the form and articulation of speech, surprisingly little systematic work has been done to study any possible interactions. Following reception and understanding of the written or spoken word, or when spontaneous speech has been initiated, several processes need to interact. The higher functions which determine the content of speech as opposed to its syntactic structure, can certainly be adversely affected by drugs, a fact which has been well recognised for many thousands of years. The next process necessary is some stimulus to initiation of speech itself. This is presumably a frontal lobe function and indeed in many neurological disorders in which the prefrontal areas are damaged, a condition of mutism may result. Mutism, of course, may also be psychological in aetiology.

Dysarthria in early Parkinson's disease

Abstract: The aim of the present study was threefold. First, to examine the incidence of dysarthria in patients in the beginning of Parkinson's disease by using a standardised test (Frenchay Dysarthria Assessment/FDA) and an intelligibility assessment tool. Second, to identify differences in speech and in measures of phonation between the Parkinsonian group and a matched control geriatric group using the FDA and electrolaryngography. Finally, to identify the effect of medication on speech and phonation in the dysarthric Parkinsonian group. The results showed that 8 out of 12 (66%) Parkinsonian subjects exhibited lower scores in the FDA compared to controls. Qualitative differences between the two groups were found in the isolated movements of the articulators but not in running speech and speech intelligibility. An improvement in the FDA scoring was found 3-3.5 months after medication. This improvement focused on the areas of tongue and lips and was accompanied with significant increases in intelligibility. No differences in measures of phonation were found either between the two groups or in the same group after medication. The above results suggest that in the beginning of Parkinson's disease, dysarthria is expressed as slowness and may be related to the primary diagnostic symptom of bradykinesia. Due to the small sample and the lack of dosage control, the significance of these findings appears to be inconclusive and warrants further investigation. Future research should employ instrumental quantitative measures on isolated movements of the articulators that may correlate with running speech and will aim to find clinical markers of speech in the diagnosis of Parkinson's disease.

Resolution of Dysarthria in Multiple Sclerosis by Treatment with Weak Electromagnetic Fields

Abstract: It has been reported that 50% or more of patients diagnosed with multiple sclerosis (MS) exhibit speech impairment (dysarthria) which in some cases can be exceedingly disabling. Currently there is no effective medical treatment for the dysarthria of MS which occurs as a result of lesions to the cerebellum and its outflow tracts. It was reported recently that extracranial application of brief AC pulsed electromagnetic fields (EMFs) in the picotesla (pT) range intensity produced in patients with MS sustained improvement in motor functions including cerebellar symptomatology. This communication concerns two MS patients with a chronic progressive course who exhibited severe dysarthria which improved already during the initial treatment with pulsed EMFs and which resolved completely 3-4 weeks later. Since application of EMFs has been shown to alter: (a) the resting membrane potential and synaptic neurotransmitter release through an effect involving changes in transmembrane calcium flux; and (b) the secretion of pineal melatonin which in turn influences the synthesis and release of serotonin (5-HT) and gamma-amino butyric acid (GABA) in the cerebellum, it is suggested that the immediate improvement of the dysarthria occurred as a result of changes in cerebellar neurotransmitter functions particularly 5-HT and GABA rather than from remyelination.