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Journal of Speech, Language, and... Jan 2023Dysarthria is common among children with cerebral palsy (CP) and results in poor speech intelligibility and subsequently low communicative participation. Neuroplasticity...
PURPOSE
Dysarthria is common among children with cerebral palsy (CP) and results in poor speech intelligibility and subsequently low communicative participation. Neuroplasticity evidence suggests that adherence to principles of motor learning (PML) improves motor speech intervention outcomes. Motor speech interventions aim to improve speech intelligibility and ultimately facilitate participation, but the effectiveness of these interventions and their inclusion of PML are not clear. Aims are as follows: (a) evaluate the effectiveness motor speech interventions in improving speech intelligibility; (b) summarize the aims, outcome measures, and outcomes relating to the International Classification of Functioning and Disability Child and Youth; and (c) summarize the principles of motor learning used in the intervention.
METHOD
Eight databases were searched, complemented by a hand search. Studies of any level of evidence were included if they used a motor speech intervention and measured speech in children with CP aged 0-18 years. Studies before 2000 or not in English were excluded. The review was conducted and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was rated using the Single Case Experimental Design Scale and Physiotherapy Evidence Database-P rating scales. The strength of evidence was evaluated with Grading of Recommendations, Assessment, Development and Evaluation.
RESULTS
Of 1,036 initial articles, 21 were included. Eight interventions were identified including 131 participants aged 3-18 years. All studies aimed to improve speech intelligibility or articulation and reported improvement at sound, word, or sentence level. One study reported improvements in communicative participation. The strength of evidence ranged from very low to moderate for one intervention. Adherence to PML was inconsistent.
CONCLUSIONS
The quality of evidence is very low to moderate. More research on motor speech interventions that adhere to PML is required.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.21817959.
Topics: Adolescent; Child; Humans; Cerebral Palsy; Speech Intelligibility; Dysarthria; Disabled Children; Cognition
PubMed: 36623233
DOI: 10.1044/2022_JSLHR-22-00375 -
Psychology Research and Behavior... 2024Speech disorders profoundly impact the overall quality of life by impeding social operations and hindering effective communication. This study addresses the gap in... (Review)
Review
PURPOSE
Speech disorders profoundly impact the overall quality of life by impeding social operations and hindering effective communication. This study addresses the gap in systematic reviews concerning machine learning-based assistive technology for individuals with speech disorders. The overarching purpose is to offer a comprehensive overview of the field through a Systematic Literature Review (SLR) and provide valuable insights into the landscape of ML-based solutions and related studies.
METHODS
The research employs a systematic approach, utilizing a Systematic Literature Review (SLR) methodology. The study extensively examines the existing literature on machine learning-based assistive technology for speech disorders. Specific attention is given to ML techniques, characteristics of exploited datasets in the training phase, speaker languages, feature extraction techniques, and the features employed by ML algorithms.
ORIGINALITY
This study contributes to the existing literature by systematically exploring the machine learning landscape in assistive technology for speech disorders. The originality lies in the focused investigation of ML-speech recognition for impaired speech disorder users over ten years (2014-2023). The emphasis on systematic research questions related to ML techniques, dataset characteristics, languages, feature extraction techniques, and feature sets adds a unique and comprehensive perspective to the current discourse.
FINDINGS
The systematic literature review identifies significant trends and critical studies published between 2014 and 2023. In the analysis of the 65 papers from prestigious journals, support vector machines and neural networks (CNN, DNN) were the most utilized ML technique (20%, 16.92%), with the most studied disease being Dysarthria (35/65, 54% studies). Furthermore, an upsurge in using neural network-based architectures, mainly CNN and DNN, was observed after 2018. Almost half of the included studies were published between 2021 and 2022).
PubMed: 38835654
DOI: 10.2147/PRBM.S460283 -
Health Science Reports Nov 2022Facial palsy is a rare complication of the COVID-19 infection. Herein, we conducted a systematic review of all published cases of facial palsy post-COVID-19 infection in...
BACKGROUND AND AIMS
Facial palsy is a rare complication of the COVID-19 infection. Herein, we conducted a systematic review of all published cases of facial palsy post-COVID-19 infection in an attempt to educate the general population and medical practitioners regarding the likely occurrence of facial palsy in COVID-19 patients, its detection, effective treatment plan, and prognosis of the condition.
METHODS
We searched PubMed, Google Scholar, and Directory of Open Access Journals (DOAJ) from December 1, 2019 to September 21, 2021.
RESULTS
We included 49 studies bearing accounts of 75 cases who had facial palsy. The mean age of patients was 42.9 ± 19.59 years, with a male-to-female ratio of 8:7. The majority of the cases were reported from Brazil ( = 14), USA ( = 9), Turkey ( = 9), and Spain ( = 9). Noticeably, 30.14% of COVID-19 patients were diagnosed with Guillain-Barré syndrome. In total, 22.97% of patients complained of bilateral facial paralysis ( = 17), whereas ipsilateral paralysis was observed in 77.03% ( = 57). These were common complaints of Lagophthalmos, otalgia, facial drooping, dysarthria, and compromised forehead wrinkling. The treatment regimen mainly included the use of corticosteroids ( = 51) (69.86%), antivirals ( = 23) (31.51%), IVIG ( = 18) (24.66%), antibiotics ( = 13) (17.81%), antiretroviral ( = 9) (12.33%), and antimalarial ( = 8) (10.96%) medications. In all, 35.62% of patients ( = 26) adhered to a combination of antiviral and corticosteroid-based therapy. Positive treatment outcomes were observed in 83.58% ( = 56) of cases. In contrast, 10 patients (14.93%) showed nonsignificant recovery, out of which 3 (4.48%) died from the disease.
CONCLUSION
The association of facial palsy with COVID-19 is controversial and therefore requires further investigation and published work to confirm a causal relationship. However, physicians should not overlook the likelihood of facial palsy post-COVID-19 infection and treat it accordingly.
PubMed: 36320650
DOI: 10.1002/hsr2.887 -
Neuromodulation : Journal of the... Apr 2024Deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) has an ambiguous relation to speech. Speech impairment can be a... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) has an ambiguous relation to speech. Speech impairment can be a stimulation-induced side effect, and parkinsonian dysarthria can improve with STN-DBS. Owing to the lack of an up-to-date and evidence-based approach, DBS reprogramming for speech impairment is largely blind and greatly relies on the physician's experience. In this study, we aimed to establish an evidence- and experience-based algorithm for managing speech impairment in patients with PD treated with STN-DBS.
MATERIALS AND METHODS
We performed a single-center retrospective study to identify patients with STN-DBS and speech impairment. Onset of speech impairment, lead localization, and assessment of DBS-induced nature of speech impairment were collected. When DBS settings were adjusted for improving speech, the magnitude and duration of effect were collected. We also performed a systematic literature review to identify studies describing the effects of parameter adjustments aimed at improving speech impairment in patients with PD receiving STN-DBS.
RESULTS
In the retrospective study, 245 of 631 patients (38.8%) with STN-DBS had significant speech impairment. The probability of sustained marked improvement upon reprogramming was generally low (27.9%). In the systematic review, 23 of 662 identified studies were included. Only two randomized controlled trials have been performed, providing evidence for interleaving-interlink stimulation only. Considerable methodologic heterogeneity precluded the conduction of a meta-analysis.
CONCLUSIONS
Speech impairment in STN-DBS for PD is frequent, but high-quality evidence regarding DBS parameter adjustments is scarce, and the probability of sustained improvement is low. To improve this outcome, we propose an evidence- and experience-based approach to address speech impairment in STN-DBS that can be used in clinical practice.
Topics: Humans; Speech; Parkinson Disease; Subthalamic Nucleus; Deep Brain Stimulation; Retrospective Studies; Speech Disorders
PubMed: 37452799
DOI: 10.1016/j.neurom.2023.05.002 -
Journal of Neurology Jan 2022Deep brain stimulation (DBS) is used for treating dystonia, commonly targeting the subthalamic nucleus (STN). Optimal stimulation parameters are required to achieve... (Review)
Review
BACKGROUND AND OBJECTIVE
Deep brain stimulation (DBS) is used for treating dystonia, commonly targeting the subthalamic nucleus (STN). Optimal stimulation parameters are required to achieve satisfying results. However, recommended parameters for STN-DBS remain to be identified. In this review, we aimed to assess the optimal stimulation parameters by analyzing previously published STN-DBS data of patients with dystonia.
METHODS
We examined the STN-DBS stimulation parameters used in studies on dystonia selected on the PubMed/Medline database.
RESULTS
Of the 86 publications retrieved from the PubMed/Medline database, we included 24, which consisted of data from 94 patients and 160 electrodes. Overall, the following average stimulation parameters were observed: amplitude, 2.59 ± 0.67 V; pulse width, 83.87 ± 34.70 μs; frequency, 142.08 ± 37.81 Hz. The average improvement rate was 64.72 ± 24.74%. The improvement rate and stimulation parameters were linearly dependent. The average improvement rate increased by 3.58% at each 10-Hz increase in frequency. In focal and segmental dystonia, the improvement rate and stimulation parameters were linearly dependent. The improvement rate increased by 6.06% and decreased by 2.14% at each 10-Hz increase in frequency and pulse width, respectively. Seventeen publications (83 patients) mentioned stimulation-related adverse effects, including dyskinesia (17), depression (8), transient dysarthria (5), weight gain (4), transient dysphasia (3), transient paresthesia (2), and sustained hyperkinesia (2).
CONCLUSIONS
The optimal stimulation parameter for STN-DBS varies across patients. Our findings may be useful for DBS programming based on the specific dystonia subtypes, especially for patients with focal and segmental dystonia.
Topics: Deep Brain Stimulation; Dystonia; Dystonic Disorders; Humans; Subthalamic Nucleus; Weight Gain
PubMed: 33385242
DOI: 10.1007/s00415-020-10372-x -
Autoimmunity Reviews Dec 2018Multiple sclerosis produces neurological impairments that are variable in duration, severity and quality. Speech is frequently impaired, resulting in decreased...
IMPORTANCE
Multiple sclerosis produces neurological impairments that are variable in duration, severity and quality. Speech is frequently impaired, resulting in decreased communication skills and quality of life. Advancements in technology now makes it possible to use quantitative acoustic assessment of speech as biomarkers of disease progression.
OBSERVATIONS
Four domains of speech have been identified: articulation (slow articulation and imprecise consonants), voice (pitch and loudness instability), respiration (decreased phonatory time and expiratory pressure) and prosody (longer and frequent pauses, deficient loudness control). Studies also explored I) predictive models for diagnosis of MS and of ataxia using speech variables, II) the relationship of dysarthria with cognition and III) very few studies correlated neuroimaging with dysarthria. We could not identify longitudinal studies of speech or dysarthria in Multiple Sclerosis.
CONCLUSION AND RELEVANCE
Refinement of objective measures of speech has enhanced our understanding of Multiple Sclerosis-related deficits in cross-sectional analysis while both integrative and longitudinal studies are identified as major gaps. This review highlights the potential for using quantitative acoustic assessments as clinical endpoints for diagnosing, monitoring progression and treatment in disease modifying trials.
Topics: Disease Progression; Dysarthria; Humans; Multiple Sclerosis; Quality of Life; Severity of Illness Index; Speech
PubMed: 30316992
DOI: 10.1016/j.autrev.2018.06.010 -
Logopedics, Phoniatrics, Vocology Dec 2020A systematic review and a meta-analysis were performed to identify the main characteristics of voice disturbances in bulbar amyotrophic lateral sclerosis. Literature... (Meta-Analysis)
Meta-Analysis
A systematic review and a meta-analysis were performed to identify the main characteristics of voice disturbances in bulbar amyotrophic lateral sclerosis. Literature searches with the keywords: "amyotrophic lateral sclerosis" and "dysarthria" and "intelligibility" were conducted in PubMed, EMBASE, Cochrane Library and Web of Science to perform the systematic review about the articulatory disorders and with the keyword "amyotrophic lateral sclerosis" and "voice" to conduct the meta-analysis about the phonetic changes in patients with bulbar ALS. Seven publications met the inclusion criteria and were included in the meta-analysis, twenty-six publications were included in the systematic review. The data within the meta-analysis revealed that several voice parameters including Jitter, Shimmer, Noise to Harmonic Ratio discriminated best between bulbar amyotrophic lateral sclerosis and healthy controls. On the other hand, significant variations of fundamental frequency were not observed. Acoustic analysis of voice and articulatory analysis contributes to identification of the earliest signs of bulbar degeneration and allows the identification of changes in voice parameters for an early detection, for predicting bulbar involvement and the worsening of disease, for targeting specific intervention. Among the voice parameters, Jitter and Shimmer discriminated better bulbar involvement, they are significantly increased in the patients, on the contrary maximum phonation time is significantly worsened. The careful monitoring of speech symptoms improves diagnostic accuracy and the close cooperation of a multidisciplinary team (physicians as otolaryngologist and physiatrist, speech and language therapists, physiotherapist, dietitians, caregivers, the patients, and their relatives) could be essential.
Topics: Acoustics; Adult; Aged; Amyotrophic Lateral Sclerosis; Female; Humans; Male; Middle Aged; Sound Spectrography; Speech Acoustics; Speech Production Measurement; Voice Disorders; Voice Quality
PubMed: 31760837
DOI: 10.1080/14015439.2019.1687748 -
Cognitive and Behavioral Neurology :... Dec 2018A systematic review examining the presence and nature of language disorders associated with Huntington disease (HD).
OBJECTIVE
A systematic review examining the presence and nature of language disorders associated with Huntington disease (HD).
BACKGROUND
HD is characterized by gradual motor dysfunction, psychiatric problems, and cognitive decline. Communication abilities in HD may be affected not only by dysarthria but also by language impairment. However, the nature and type of this impairment is not well defined.
METHODS
We searched the PubMed and PsycINFO databases and selected studies on the basis of the original language of the article, peer-review status, and specificity of the results regarding language and communication disorders.
RESULTS
Thirty-one articles meeting the selection criteria were selected for this review. According to most of the studies, individuals with HD present with primary deficits of language. However, a few authors suggested that language deficits in HD result from nonlinguistic impairments, or that language abilities are largely preserved. More specifically, studies showed that HD is associated with difficulties in producing and understanding sentences and discourse, processing semantic representations of object and action concepts, retrieving lexical forms of nouns, and applying morphological and syntactic rules. There is some disagreement regarding whether HD affects reading abilities, sentence production, semantic processing, and application of morphological rules in verb conjugation.
CONCLUSIONS
Although people with HD present with language impairment, further studies are needed to identify their functional origin. Clinical studies are also needed to determine the impact of such impairments on an individual's functional communication in daily living and to chart the progression of the impairments over the course of the disease.
Topics: Adult; Female; Humans; Huntington Disease; Language Disorders; Male; Middle Aged
PubMed: 30562227
DOI: 10.1097/WNN.0000000000000171 -
The Journal of Surgical Research Dec 2018Speech is integral for human interaction and development. Speech assessments are critical in the growing child, especially in the surgical evaluation of patients...
BACKGROUND
Speech is integral for human interaction and development. Speech assessments are critical in the growing child, especially in the surgical evaluation of patients undergoing cleft palate and speech surgeries. Online crowdsourcing enables layperson raters, allowing rapid and large-scale data collection. This systematic review analyzes the utility of online crowdsourcing to evaluate perceptual speech outcomes.
METHODS
Terms related to "crowdsourcing" and "speech" were searched on PubMed, Scopus, CINAHL, Cochrane CENTRAL, and PsycINFO on August 16, 2017, returning 2812 unique articles. Inclusion and exclusion criteria concentrated on online crowdsourcing of perceptual speech outcomes: titles led to 140 abstracts that yielded 35 full-text articles, of which eight articles met criteria for analysis.
RESULTS
All studies used Amazon Mechanical Turk for online crowd raters, and one used an additional crowdsourcing site (CrowdFlower). Disordered speech was provided by 376 speakers, for which 2203 crowd workers produced over 700,000 unique ratings. Five studies compared crowdsourced assessments to gold standards and found high concordances. Data collection time ranged from 59 min to 23 h, with worker payments ranging from $0.05 to $2.00 per task. Studies examined child pronunciation of the /r/ sound, dysarthria in Parkinson's speech, and articulation of English words produced by non-English speakers learning English.
CONCLUSIONS
Online crowdsourcing for perceptual speech outcomes provides high-quality data consistent with previous speech-assessment standards in a rapid, cost-effective manner. This novel methodology incorporates lay perspective of speech intelligibility and has the potential to revolutionize surgical speech outcome assessments, including cleft palate and speech surgery.
Topics: Child; Child Development; Cleft Palate; Crowdsourcing; Humans; Orthognathic Surgical Procedures; Outcome Assessment, Health Care; Speech; Speech Disorders; Speech Perception
PubMed: 30463741
DOI: 10.1016/j.jss.2018.06.032 -
American Journal of Speech-language... Aug 2020Purpose Functional brain imaging is playing an increasingly important role in the diagnosis and treatment of communication disorders, yet many populations and settings...
Purpose Functional brain imaging is playing an increasingly important role in the diagnosis and treatment of communication disorders, yet many populations and settings are incompatible with functional magnetic resonance imaging and other commonly used techniques. We conducted a systematic review of neuroimaging studies using functional near-infrared spectroscopy (fNIRS) with individuals with speech or language impairment across the life span. We aimed to answer the following question: To what extent has fNIRS been used to investigate the neural correlates of speech-language impairment? Method This systematic review was preregistered with PROSPERO, the international prospective register of systematic reviews (CRD42019136464). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol for preferred reporting items for systematic reviews. The database searches were conducted between February and March of 2019 with the following search terms: (a) fNIRS or functional near-infrared spectroscopy or NIRS or near-infrared spectroscopy, (b) speech or language, and (c) disorder or impairment or delay. Results We found 34 fNIRS studies that involved individuals with speech or language impairment across nine categories: (a) autism spectrum disorders; (b) developmental speech and language disorders; (c) cochlear implantation and deafness; (d) dementia, dementia of the Alzheimer's type, and mild cognitive impairment; (e) locked-in syndrome; (f) neurologic speech disorders/dysarthria; (g) stroke/aphasia; (h) stuttering; and (i) traumatic brain injury. Conclusions Though it is not without inherent challenges, fNIRS may have advantages over other neuroimaging techniques in the areas of speech and language impairment. fNIRS has clinical applications that may lead to improved early and differential diagnosis, increase our understanding of response to treatment, improve neuroprosthetic functioning, and advance neurofeedback.
Topics: Brain; Humans; Language Development Disorders; Longevity; Spectroscopy, Near-Infrared; Speech
PubMed: 32640168
DOI: 10.1044/2020_AJSLP-19-00050