Dysarthria

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

Language impairment in amyotrophic lateral sclerosis

Abstract: For a long time, amyotrophic lateral sclerosis (ALS) was thought to be a neuro-degenerative disease with selective involvement of the motor neuron system. However, it has recently been established that ALS is a multisystem disorder that not only involve the motor system but also affects cognition. A typical cognitive impairment in ALS is frontotemporal dementia: a clinical subtype of frontotemporal lobar degeneration (FTLD). Furthermore, language impairment, including progressive non-fluent aphasia (PA) and semantic dementia (SD), which are also FTLD subtypes, have been linked to bulbar-onset ALS. Beside recent studies a Japanese paper published in 1893 gives an account of aphasia in bulbar-onset ALS. Interestingly, this was the first account of aphasia in Japan. Thus, language-related problems in ALS may have been overlooked, because evaluation of aphasic problems in ALS patients is difficult, mainly because of progressive bulbar or pseudo-bulbar palsy that results in and dysarthria. From a clinical point of view, progressing bulbar symptoms and medical interventions, such artificial ventilation make it difficult to evaluate language functions in ALS. However, we do observe frequent omission and paragraphia of kana letters, and syntactic errors in writing. Interestingly, some patients make exhibit errors exclusively in the case of kanji characters. Thus, evaluation of writing samples is important if order to identify language problems in ALS patients. The findings may also provide additional information such as dissociation between errors made in kana and kanji characters. The characteristic features of writing errors are thought to reflect the nature of aphasia including PA and SD, that are easily masked by dysarthria. In addition, writing errors can appear as "isolated agraphia" without aphasia and dementia. Pathologically, writing errors should indicate the brain regions involved by ALS, e.g., hemispheric dominance and frontal or temporal lobe involvement. In addition, selective involvement of Exner's writing center in the frontal lobe may be responsible for "isolated agraphia". Hence, further studies are required to determine the clinical significance of writing errors in ALS patients and their pathological correlation.

Motivating Individuals with Spastic Cerebral Palsy to Speak Using Mobile Speech Recognition

Abstract: Individuals with cerebral palsy (CP) struggle with conditions such as dysarthria, dysphagia, and dyspraxia as they speak. While speech therapy is successful in practice, outside practice requires increased commitment and effort from caregivers. Researchers developed a speech recognition game designed to encourage out-of-office exercises and motivate users to practice. Next they recruited a participant with cerebral palsy to investigate the performance of the system in a live environment. The participant joined the game after demonstration from the caregiver and temporarily increased speech loudness and clarity during play. The participant found sound effects more rewarding than animations. The total number of sentences spoken during the session was found to be less than half that of a speaker without any impairment. Researchers also observed two instances of cheating. This work provides insight into the automated motivation of motivating speech production with individuals with cerebral palsy.

Indicators of Communication Limitation in Dysarthria and Their Relation to Auditory-Perceptual Speech Symptoms: Construct Validity of the KommPaS Web App

Abstract: Despite extensive research into communication-related parameters in dysarthria, such as intelligibility, naturalness, and perceived listener effort, the existing evidence has not been translated into a clinically applicable, comprehensive, and valid diagnostic tool so far. This study addresses Communication-Related Parameters in Speech Disorders (KommPaS), a new web-based diagnostic instrument for measuring indices of communication limitation in individuals with dysarthria through online crowdsourcing. More specifically, it answers questions about the construct validity of KommPaS. In the first part, the interrelationship of the KommPaS variables intelligibility, naturalness, perceived listener effort, and speech rate were explored in order to draw a comprehensive picture of a patient's limitations and avoid the collection of redundant information. Second, the influences of motor speech symptoms on the KommPaS variables were studied in order to delineate the structural relationships between two complementary diagnostic perspectives.One hundred persons with dysarthria of different etiologies and varying degrees of severity were examined with KommPaS to obtain layperson-based data on communication-level parameters, and with the Bogenhausen Dysarthria Scale (BoDyS) to obtain expert-based, function-level data on dysarthria symptoms. The internal structure of the KommPaS variables and their dependence on the BoDyS variables were analyzed using structural equation modeling.Despite a high multicollinearity, all KommPaS variables were shown to provide complementary diagnostic information and their mutual interconnections were delineated in a path graph model. Regarding the influence of the BoDyS scales on the KommPaS variables, separate linear regression models revealed plausible predictor sets. A complete path model of KommPaS and BoDyS variables was developed to map the complex interplay between variables at the functional and the communication levels of dysarthria assessment.In validating a new clinical tool for the diagnostics of communication limitations in dysarthria, this study is the first to draw a comprehensive picture of how auditory-perceptual characteristics of dysarthria interact at the levels of expert-based functional and layperson-based communicative assessments.