Dysarthria

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

Expanding the speech and language phenotype in Koolen-de Vries syndrome: late onset and periodic stuttering a novel feature

Abstract: Speech and language impairment is core in Koolen-de Vries syndrome (KdVS), yet only one study has examined this empirically. Here we define speech, language, and functional/adaptive behaviour in KdVS; while deeply characterising the medical/neurodevelopmental phenotype in the largest cohort to date. Speech, language, literacy, and social skills were assessed using standardised measures, alongside an in-depth health and medical questionnaire. 81 individuals with KdVS were recruited (35 female, mean age 9y 10mo), 56 of whom harboured the typical 500-650 kb 17q21.31 deletion. The core medical phenotype was intellectual disability (largely moderate), eye anomalies/vision disturbances, structural brain anomalies, dental problems, sleep disturbance, musculoskeletal abnormalities, and cardiac defects. Most were verbal (62/81, 76.5%), while minimally-verbal communicators used alternative and augmentative communication (AAC) successfully in spite of speech production delays. Speech was characterised by apraxia (39/61, 63.9%) and dysarthria (28/61, 45.9%) in verbal participants. Stuttering was described in 36/47 (76.6%) verbal participants and followed a unique trajectory of late onset and fluctuating presence. Receptive and expressive language abilities were commensurate with one another, but literacy skills remained a relative weakness. Social competence, successful behavioural/emotional control, and coping skills were areas of relative strength, while communication difficulties impacted daily living skills as an area of comparative difficulty. Notably, KdVS individuals make communication gains beyond childhood and should continue to access targeted therapies throughout development, including early AAC implementation, motor speech therapy, language/literacy intervention, as well as strategies implemented to successfully navigate activities of daily living that rely on effective communication.

Articulatory undershoot of vowels in isolated REM sleep behavior disorder and early Parkinson’s disease

Abstract: Imprecise vowels represent a common deficit associated with hypokinetic dysarthria resulting from a reduced articulatory range of motion in Parkinson's disease (PD). It is not yet unknown whether the vowel articulation impairment is already evident in the prodromal stages of synucleinopathy. We aimed to assess whether vowel articulation abnormalities are present in isolated rapid eye movement sleep behaviour disorder (iRBD) and early-stage PD. A total of 180 male participants, including 60 iRBD, 60 de-novo PD and 60 age-matched healthy controls performed reading of a standardized passage. The first and second formant frequencies of the corner vowels /a/, /i/, and /u/ extracted from predefined words, were utilized to construct articulatory-acoustic measures of Vowel Space Area (VSA) and Vowel Articulation Index (VAI). Compared to controls, VSA was smaller in both iRBD (p = 0.01) and PD (p = 0.001) while VAI was lower only in PD (p = 0.002). iRBD subgroup with abnormal olfactory function had smaller VSA compared to iRBD subgroup with preserved olfactory function (p = 0.02). In PD patients, the extent of bradykinesia and rigidity correlated with VSA (r = -0.33, p = 0.01), while no correlation between axial gait symptoms or tremor and vowel articulation was detected. Vowel articulation impairment represents an early prodromal symptom in the disease process of synucleinopathy. Acoustic assessment of vowel articulation may provide a surrogate marker of synucleinopathy in scenarios where a single robust feature to monitor the dysarthria progression is needed.

A case of cerebellar infarction with pure dysarthria

Abstract: We report a 69-year-old man with pure ataxic speech. He was admitted to the surgical ward of our hospital because of exercise-induced pain in the right arm. He underwent angiography of the right arm, and was discharged the next day. When he returned home, he exhibited an acute-onset dysarthria. He was admitted to our neurology ward the next day because the dysarthria did not improve. On admission, neurological examinations revealed moderately ataxic speech, but other neurological findings were within normal limits. Cranial MRI revealed an infarct localized from the lobulus simplex to the lobulus quadrangularis in the right cerebellum. Three cases of pure dysarthria due to cerebellar infarction have been reported previously. We compared cerebellar lesions in the 4 cases of pure dysarthria due to cerebellar infarction. Since the lobulus simplex of the upper cerebellar hemisphere was involved in all 4 cases, we speculated that ataxic speech occurred from the impairment of this cerebellar area.

Speech Processes in Dysarthria

Abstract: Dysarthric speech processes are considered through the Mayo Classification of motor speech disorders, beginning with how their conceptualization emerged late in the 19th century, to become defined within a neurological perspective around 1950. From this review, it will be apparent that the Mayo perceptual classification brought the phenomenology of dysarthria within the scope of speech pathology, yet retained existing neurological concepts where dysarthric speech processes are concerned, leaving prosodic speech processes outside its scope. Recent models have challenged basic tenets of the theory, and question its applicability to dysarthric processes in children.

Basic Epidemiology of Stroke and Risk Assessment

Abstract: Definition of stroke In epidemiological studies, stroke is defined by clinical findings and symptoms [1]: rapidly developed signs of focal (or global) disturbance of cerebral function lasting more than 24 hours (unless interrupted by surgery or death), with no apparent cause other than a vascular origin This approach is supplemented with neuroimaging but even with advanced imaging techniques the diagnosis is based on clinical signs Therefore, precise definitions of clinical signs are needed WHO definitions are [1]: Definite focal signs: unilateral or bilateral motor impairment (including dyscoordination) unilateral or bilateral sensory impairment aphasis/dysphasis (non-fluent speech) hemianopia (half-sided impairment of visual fields) diplopia forced gaze (conjugate deviation) dysphagia of acute onset apraxia of acute onset ataxia of acute onset perception deficit of acute onset Not acceptable as sole evidence of focal dysfunction: dizziness, vertigo localized headache blurred vision of both eyes dysarthria (slurred speech) impaired cognitive function (including confusion) impaired consciousness seizures (Although strokes can present in this way, these signs are not specific and cannot therefore be accepted as definite evidence of stroke) Neuroimaging studies are needed for classification of stroke by subtypes: subarachnoid hemorrhage, intracerebral hemorrhage and brain infarction (necrosis) Although there may be large variations in stroke subtype distributions between populations, thrombotic and embolic strokes are responsible for about 80–85% of all strokes in the Indo-European populations, and as low as 65% in some Asian populations Subarachnoid hemorrhage represents 5–10% of all strokes, and occurs more often in younger subjects, while both intracerebral and especially thrombotic and embolic stroke increase markedly with age