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American Journal of Speech-language... Aug 2023Few studies have reported on the vowel space area (VSA) in both acoustic and kinematic domains. This study examined acoustic and kinematic VSAs for speakers with and...
PURPOSE
Few studies have reported on the vowel space area (VSA) in both acoustic and kinematic domains. This study examined acoustic and kinematic VSAs for speakers with and without dysarthria and evaluated effects of normalization on acoustic and kinematic VSAs and the relationship between these measures.
METHOD
Vowel data from 12 speakers with and without dysarthria, presenting with a range of speech abilities, were examined. The speakers included four speakers with Parkinson's disease (PD), four speakers with brain injury (BI), and four neurotypical (NT) speakers. Speech acoustic and kinematic data were acquired simultaneously using electromagnetic articulography during a passage reading task. Raw and normalized VSAs calculated from corner vowels /i/, /æ/, /ɑ/, and /u/ were evaluated. Normalization was achieved through score transformations to the acoustic and kinematic data. The effect of normalization on variability within and across groups was evaluated. Regression analysis was used across speakers to assess the association between acoustic and kinematic VSAs for both raw and normalized data.
RESULTS
When evaluating the speakers as three different groups (i.e., PD, BI, and NT), normalization reduced the standard deviations within each group and changed the relative differences in average magnitude between groups. Regression analysis revealed a significant relationship between normalized, but not raw, acoustic and kinematic VSAs, after the exclusion of an outlier speaker.
CONCLUSIONS
Normalization reduces the variability across speakers, within groups, and changes average magnitudes affecting speaker group comparisons. Normalization also influences the correlation between acoustic and kinematic measures. Further investigation of the impact of normalization techniques upon acoustic and kinematic measures is warranted.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.22669747.
Topics: Humans; Speech Intelligibility; Speech Production Measurement; Speech Acoustics; Dysarthria; Biomechanical Phenomena; Acoustics; Parkinson Disease; Phonetics
PubMed: 37105919
DOI: 10.1044/2023_AJSLP-22-00158 -
Logopedics, Phoniatrics, Vocology Apr 2022Myasthenia Gravis (MG) is an autoimmune disease. The characteristic symptoms of the disease are muscle weakness and fatigue. These symptoms affect de oral muscles...
INTRODUCTION
Myasthenia Gravis (MG) is an autoimmune disease. The characteristic symptoms of the disease are muscle weakness and fatigue. These symptoms affect de oral muscles causing dysarthria, affecting about 60% of patients with disease progression.
PURPOSE
Describe the speech pattern of patients with MG and comparing with healthy controls (HC).
MATERIAL AND METHODS
Case-control study. Participants were divided in MG group (MGG) with 38 patients MG diagnosed and HC with 18 individuals matched for age and sex. MGG was evaluated with clinical and motor scales and answered self-perceived questionnaires. Speech assessment of both groups included: recording of speech tasks, acoustic and auditory-perceptual analysis.
RESULTS
In the MGG, 68.24% of the patients were female, with average age of 50.21 years old (±16.47), 14.18 years (±9.52) of disease duration and a motor scale of 11.19 points (±8.79). The auditory-perceptual analysis verified that 47.36% ( = 18) participants in MGG presented mild dysarthria, 10.52% ( = 4) moderate dysarthria, with a high percentage of alterations in phonation (95.2%) and breathing (52.63%). The acoustic analysis verified a change in phonation, with significantly higher shimmer values in the MGG compared to the HC and articulation with a significant difference between the groups for the first formant of the /iu/ ( = <.001). No correlation was found between the diagnosis of speech disorder and the dysarthria self-perception questionnaire.
CONCLUSION
We found dysarthria mild in MG patients with changes in the motor bases phonation and breathing, with no correlation with severity and disease duration.
Topics: Case-Control Studies; Dysarthria; Female; Humans; Male; Middle Aged; Myasthenia Gravis; Speech; Speech Acoustics; Voice Quality
PubMed: 33106062
DOI: 10.1080/14015439.2020.1834614 -
Journal of Speech, Language, and... Aug 2021Purpose Early studies of perceptual learning of dysarthric speech, those summarized in Borrie, McAuliffe, and Liss (2012), yielded preliminary evidence that listeners... (Review)
Review
Purpose Early studies of perceptual learning of dysarthric speech, those summarized in Borrie, McAuliffe, and Liss (2012), yielded preliminary evidence that listeners could to better understand the speech of a person with dysarthria, revealing a potentially promising avenue for future intelligibility interventions. Since then, a programmatic body of research grounded in models of perceptual processing has unfolded. The current review provides an updated account of the state of the evidence in this area and offers direction for moving this work toward clinical implementation. Method The studies that have investigated perceptual learning of dysarthric speech ( = 24) are summarized and synthesized first according to the proposed learning source and then by highlighting the parameters that appear to mediate learning, culminating with additional learning outcomes. Results The recent literature has established strong empirical evidence of intelligibility improvements following familiarization with dysarthric speech and a theoretical account of the mechanisms that facilitate improved processing of the neurologically degraded acoustic signal. Conclusions There are no existing intelligibility interventions for individuals with dysarthria who cannot behaviorally modify their speech. However, there is now robust support for the development of an approach that shifts the weight of behavioral change from speaker to listener, exploiting perceptual learning to ease the intelligibility burden of dysarthria. To move this work from bench to bedside, recommendations for translational studies that establish best practices and candidacy for listener-targeted dysarthria remediation, perceptual training, are provided.
Topics: Cognition; Dysarthria; Humans; Learning; Speech Intelligibility; Speech Perception; Speech Production Measurement
PubMed: 34289312
DOI: 10.1044/2021_JSLHR-21-00012 -
Age Estimation and Gender Attribution in Typically Developing Children and Children With Dysarthria.American Journal of Speech-language... May 2024The purposes of this study were (a) to investigate adult listeners' perceptions of age and gender in typically developing children and children with dysarthria and (b)...
PURPOSE
The purposes of this study were (a) to investigate adult listeners' perceptions of age and gender in typically developing children and children with dysarthria and (b) to identify predictors of their estimates among auditory-perceptual parameters and an acoustic measure of vocal pitch (0). We aimed to evaluate the influence of dysarthria on the listeners' impressions of age and gender against the background of typical developmental processes.
METHOD
In a listening experiment, adult listeners completed age and gender estimates of 144 typically developing children (3-9 years of age) and 25 children with dysarthria (5-9 years of age). The Bogenhausen Dysarthria Scales for Childhood Dysarthria (BoDyS-KiD) were applied to record speech samples and to complete auditory-perceptual judgments covering all speech subsystems. Furthermore, each child's mean 0 was determined from samples of four BoDyS-KiD sentences.
RESULTS
Age estimates for the typically developing children showed a regression to the mean, whereas children with dysarthria were systematically underestimated in their age. The estimates of all children were predicted by developmental speech features; for the children with dysarthria, specific dysarthria symptoms had an additional effect. We found a significantly higher accuracy of gender attribution in the typically developing children than in the children with dysarthria. The prediction accuracy of the listeners' gender attribution in the preadolescent children by the included speech characteristics was limited.
CONCLUSIONS
Children with dysarthria are more difficult to estimate for their age and gender than their typically developing peers. Dysarthria thus alters the auditory-perceptual impression of indexical speech features in children, which must be considered another facet of the communication disorder associated with childhood dysarthria.
Topics: Humans; Dysarthria; Female; Male; Child, Preschool; Child; Speech Acoustics; Speech Perception; Age Factors; Speech Production Measurement; Child Language; Sex Factors; Adult; Voice Quality; Judgment
PubMed: 38416062
DOI: 10.1044/2023_AJSLP-23-00246 -
American Journal of Speech-language... Aug 2023This exploratory study aimed to characterize motor speech impairments in a small sample of children with epilepsy, both with and without a known seizure etiology. A...
PURPOSE
This exploratory study aimed to characterize motor speech impairments in a small sample of children with epilepsy, both with and without a known seizure etiology. A secondary aim was to evaluate the validity of the Profile for Childhood Apraxia of speech and Dysarthria (ProCAD), a newly developed tool for differential diagnosis of childhood apraxia of speech and dysarthria.
METHOD
Thirteen children with seizure disorders completed a comprehensive speech and language assessment. Three expert speech-language pathologists rated the presence of auditory-perceptual features of motor speech impairment using the ProCAD. Motor speech features, diagnoses, and standardized test scores were compared between children with a known seizure etiology and children with idiopathic epilepsy.
RESULTS
Nine of the 13 children exhibited motor speech impairment; dysarthria was the most common diagnosis. Most children (11/13) exhibited language impairment. Group comparisons showed that children with a known seizure etiology had more atypical motor speech features and lower language scores than children with idiopathic seizures.
CONCLUSION
These preliminary findings suggest a high rate of motor speech impairment among children with epilepsy.
Topics: Child; Humans; Dysarthria; Speech; Speech Disorders; Apraxias; Epilepsy; Phenotype; Seizures
PubMed: 36827527
DOI: 10.1044/2022_AJSLP-22-00176 -
International Journal of Environmental... Oct 2022Dysphagia is associated with dysarthria in stroke patients. Vowel space decreases in stroke patients with dysarthria; destruction of the vowel space is often observed....
Dysphagia is associated with dysarthria in stroke patients. Vowel space decreases in stroke patients with dysarthria; destruction of the vowel space is often observed. We determined the correlation of destruction of acoustic vowel space with dysphagia in stroke patients. Seventy-four individuals with dysphagia and dysarthria who had experienced stroke were enrolled. For /a/, /ae/, /i/, and /u/ vowels, we determined formant parameter (it reflects vocal tract resonance frequency as a two-dimensional coordinate point), formant centralization ratio (FCR), and quadrilateral vowel space area (VSA). Swallowing function was assessed using the videofluoroscopic dysphagia scale (VDS) during videofluoroscopic swallowing studies. Pearson's correlation and linear regression were used to determine the correlation between VSA, FCR, and VDS. Subgroups were created based on VSA; vowel space destruction groups were compared using ANOVA and Scheffe's test. VSA and FCR were negatively and positively correlated with VDS, respectively. Groups were separated based on mean and standard deviation of VSA. One-way ANOVA revealed significant differences in VDS, FCR, and age between the VSA groups and no significant differences in VDS between mild and moderate VSA reduction and vowel space destruction groups. VSA and FCR values correlated with swallowing function. Vowel space destruction has characteristics similar to VSA reduction at a moderate-to-severe degree and has utility as an indicator of dysphagia severity.
Topics: Humans; Dysarthria; Deglutition Disorders; Speech Acoustics; Deglutition; Stroke
PubMed: 36293884
DOI: 10.3390/ijerph192013301 -
PloS One 2023The available quantitative methods for evaluating bulbar dysfunction in patients with amyotrophic lateral sclerosis (ALS) are limited. We aimed to characterize vowel...
The available quantitative methods for evaluating bulbar dysfunction in patients with amyotrophic lateral sclerosis (ALS) are limited. We aimed to characterize vowel properties in Korean ALS patients, investigate associations between vowel parameters and clinical features of ALS, and analyze subclinical articulatory changes of vowel parameters in those with perceptually normal voices. Forty-three patients with ALS (27 with dysarthria and 16 without dysarthria) and 20 healthy controls were prospectively collected in the study. Dysarthria was assessed using the ALS Functional Rating Scale-Revised (ALSFRS-R) speech subscores, with any loss of 4 points indicating the presence of dysarthria. The structured speech samples were recorded and analyzed using Praat software. For three corner vowels (/a/, /i/, and /u/), data on the vowel duration, fundamental frequency, frequencies of the first two formants (F1 and F2), harmonics-to-noise ratio, vowel space area (VSA), and vowel articulation index (VAI) were extracted from the speech samples. Corner vowel durations were significantly longer in ALS patients with dysarthria than in healthy controls. The F1 frequency of /a/, F2 frequencies of /i/ and /u/, the VSA, and the VAI showed significant differences between ALS patients with dysarthria and healthy controls. The area under the curve (AUC) was 0.912. The F1 frequency of /a/ and the VSA were the major determinants for differentiating ALS patients who had not yet developed apparent dysarthria from healthy controls (AUC 0.887). In linear regression analyses, as the ALSFRS-R speech subscore decreased, both the VSA and VAI were reduced. In contrast, vowel durations were found to be rather prolonged. The analyses of vowel parameters provided a useful metric correlated with disease severity for detecting subclinical bulbar dysfunction in ALS patients.
Topics: Humans; Dysarthria; Amyotrophic Lateral Sclerosis; Speech Intelligibility; Phonetics; Republic of Korea; Speech Acoustics
PubMed: 37831677
DOI: 10.1371/journal.pone.0292460 -
Seminars in Speech and Language Jul 2017
Review
Topics: Dysarthria; Humans; Respiration; Respiration, Artificial; Speech; Speech Therapy; Spinal Cord Injuries
PubMed: 28618439
DOI: 10.1055/s-0037-1602835 -
NeuroRehabilitation 2016Stroke is the leading cause of mortality and disability worldwide. Important sequels are frequent, including dysphagia and communication disorders.
BACKGROUND
Stroke is the leading cause of mortality and disability worldwide. Important sequels are frequent, including dysphagia and communication disorders.
OBJECTIVE
to determine the prevalence of dysphagia and communication disorders following stroke, and to identify if communication disorders can predict dysphagia.
METHODS
Thirty-one prospective and consecutive patients were admitted to the Otolaryngology-Dysphagia Outpatient Clinic with diagnosis of ischemic or hemorrhagic stroke. Stroke was confirmed by computed tomography or magnetic resonance imaging, and medical evaluation. All patients had a swallowing and communication evaluation. We compared patients with and without dysphagia, and established the co-occurrence among dysphagia and communication disorders.
RESULTS
Twenty-five patients presented dysphagia. Aphasia occurred in 32.3% of the patients; dysarthria in 45.2%. Dysphagia and aphasia co-occurred in 29% of the population; dysphagia and dysarthria in 45.2%; the three conditions co-occurred in 22.6%. Dysarthria was a predictor of dysphagia, and it was associated with the presence of oral stage problems.
CONCLUSIONS
A comprehensive evaluation of dysphagia, aphasia, and dysarthria are important to improve clinical outcome following stroke. The identification of dysarthria as a predictor of dysphagia can help identify risk for dysphagia in stroke and assist in the therapeutic process of swallowing problems.
Topics: Adult; Aged; Aged, 80 and over; Aphasia; Communication Disorders; Deglutition Disorders; Dysarthria; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Risk Assessment; Risk Factors; Stroke; Tomography, X-Ray Computed
PubMed: 26923355
DOI: 10.3233/NRE-161305 -
Parkinsonism & Related Disorders Apr 2023Deep brain stimulation of the subthalamic nucleus is an effective treatment of Parkinson's disease, yet it is often associated with a general deterioration of speech...
BACKGROUND
Deep brain stimulation of the subthalamic nucleus is an effective treatment of Parkinson's disease, yet it is often associated with a general deterioration of speech intelligibility. Clustering the phenotypes of dysarthria has been proposed as a strategy to tackle these stimulation-induced speech problems.
METHODS
In this study, we examine a cohort of 24 patients to test the real-life application of the proposed clustering and attempt to attribute the clusters to specific brain networks with two different approaches of connectivity analysis.
RESULTS
Both our data-driven and hypothesis-driven approaches revealed strong connections of variants of stimulation-induced dysarthria to brain regions that are known actors of motor speech control. We showed a strong connection between the spastic dysarthria type and the precentral gyrus and supplementary motor area, prompting a possible disruption of corticobulbar fibers. The connection between the strained voice dysarthria and more frontal areas hints toward a deeper disruption of the motor programming of speech production.
CONCLUSIONS
These results provide insights into the mechanism of stimulation-induced dysarthria in deep brain stimulation of the subthalamic nucleus and may guide reprogramming attempts for individual Parkinson's patients based on pathophysiological understanding of the affected networks.
Topics: Humans; Dysarthria; Deep Brain Stimulation; Parkinson Disease; Brain; Phenotype
PubMed: 36870157
DOI: 10.1016/j.parkreldis.2023.105347