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Journal of Dental Sciences Apr 2024Orofacial (OF) development is influenced by multiple factors. This study aimed to explore the relationship between OF dysfunction (OFD) and OF features, oral function,...
BACKGROUND/PURPOSE
Orofacial (OF) development is influenced by multiple factors. This study aimed to explore the relationship between OF dysfunction (OFD) and OF features, oral function, and eating performance among preschool children.
MATERIALS AND METHODS
There were 243 preschool children and their parents who participated in this cross-sectional study. Participant demographic information and eating performance were obtained from questionnaires completed by their mothers. OF features and functions were assessed using oral examinations. OFD assessments were performed using Nordic Orofacial Test-Screening (NOT-S).
RESULTS
Approximately 80% of participants had at least one domain of NOT-S affected. The main OFD in a structured interview was chewing and swallowing (64.61%). Dysarthria (40.38%), weak bite force (53.85%), inability to effectively chew (45.19%), and taking longer than 30 min to eat meals (75.00%) were significantly more prevalent among participants with OFD than among those without OFD (all < 0.05). Also, compared with participants born full-term, those born prematurely and who had OFD had higher rates of V-shaped dental arch (42.11%), high-arched palate (31.58%), small mouth opening capacity (7.89%), dysarthria (65.79%), preference to eating soft-textured food (42.11%), and weak cough strength (21.05%). Taking longer than 30 min to eat meals (adjusted odds ratio (AOR = 8.87, < 0.001) and not effectively chewing food (AOR = 8.81, < 0.001) were significantly associated with OFD.
CONCLUSION
Chewing and swallowing and habits are common among preschool children and associated with OFD. OFD is associated with OF features, and presented in oral function and eating performance.
PubMed: 38618088
DOI: 10.1016/j.jds.2023.06.022 -
IEEE Journal of Translational... 2024Acoustic features extracted from speech can help with the diagnosis of neurological diseases and monitoring of symptoms over time. Temporal segmentation of audio signals...
Acoustic features extracted from speech can help with the diagnosis of neurological diseases and monitoring of symptoms over time. Temporal segmentation of audio signals into individual words is an important pre-processing step needed prior to extracting acoustic features. Machine learning techniques could be used to automate speech segmentation via automatic speech recognition (ASR) and sequence to sequence alignment. While state-of-the-art ASR models achieve good performance on healthy speech, their performance significantly drops when evaluated on dysarthric speech. Fine-tuning ASR models on impaired speech can improve performance in dysarthric individuals, but it requires representative clinical data, which is difficult to collect and may raise privacy concerns. This study explores the feasibility of using two augmentation methods to increase ASR performance on dysarthric speech: 1) healthy individuals varying their speaking rate and loudness (as is often used in assessments of pathological speech); 2) synthetic speech with variations in speaking rate and accent (to ensure more diverse vocal representations and fairness). Experimental evaluations showed that fine-tuning a pre-trained ASR model with data from these two sources outperformed a model fine-tuned only on real clinical data and matched the performance of a model fine-tuned on the combination of real clinical data and synthetic speech. When evaluated on held-out acoustic data from 24 individuals with various neurological diseases, the best performing model achieved an average word error rate of 5.7% and a mean correct count accuracy of 94.4%. In segmenting the data into individual words, a mean intersection-over-union of 89.2% was obtained against manual parsing (ground truth). It can be concluded that emulated and synthetic augmentations can significantly reduce the need for real clinical data of dysarthric speech when fine-tuning ASR models and, in turn, for speech segmentation.
Topics: Humans; Speech; Speech Recognition Software; Dysarthria; Speech Disorders; Speech Perception
PubMed: 38606392
DOI: 10.1109/JTEHM.2024.3375323 -
Cureus Mar 2024This case report glances at the physiotherapy management and motor recovery outcomes of a 47-year-old female who had a pontine infarction complicated by Millard-Gubler...
This case report glances at the physiotherapy management and motor recovery outcomes of a 47-year-old female who had a pontine infarction complicated by Millard-Gubler syndrome. Pontine infarction is a stroke that occurs in the pons region of the brainstem, resulting in impaired blood flow and subsequent tissue damage. Millard-Gubler syndrome, a rare form of pontine infarction, is distinguished by ipsilateral abducens (sixth cranial nerve) and facial (seventh cranial nerve) nerve palsy, which cause horizontal gaze palsy and facial weakness, respectively. Other common symptoms include contralateral hemiparesis or hemiplegia, dysarthria, and hypertonia. In this case, the patient had nystagmus, dysarthria, hypertonia, decreased consciousness, and limited mobility. Physiotherapy interventions were used in a multidisciplinary approach to address these deficits, with a focus on improving gaze stability, reducing hypertonia, facilitating bed mobility, and improving respiratory function. The outcomes were evaluated using standardised measures such as the Brunnstrom staging for motor recovery, the Modified Ashworth Scale for hypertonia, and the Functional Independence Measure for functional status. This case demonstrates the critical role of physiotherapy in improving motor recovery and functional outcomes.
PubMed: 38595881
DOI: 10.7759/cureus.55894 -
Journal of Neural Transmission (Vienna,... Jul 2024Hypokinetic dysarthria (HD) is a common motor speech symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated short-term effects...
INTRODUCTION
Hypokinetic dysarthria (HD) is a common motor speech symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated short-term effects of transcranial direct current stimulation (tDCS) on HD in PD using acoustic analysis of speech. Based on our previous studies we focused on stimulation of the right superior temporal gyrus (STG) - an auditory feedback area.
METHODS
In 14 PD patients with HD, we applied anodal, cathodal and sham tDCS to the right STG using a cross-over design. A protocol consisting of speech tasks was performed prior to and immediately after each stimulation session. Linear mixed models were used for the evaluation of the effects of each stimulation condition on the relative change of acoustic parameters. We also performed a simulation of the mean electric field induced by tDCS.
RESULTS
Linear mixed model showed a statistically significant effect of the stimulation condition on the relative change of median duration of silences longer than 50 ms (p = 0.015). The relative change after the anodal stimulation (mean = -5.9) was significantly lower as compared to the relative change after the sham stimulation (mean = 12.8), p = 0.014. We also found a correlation between the mean electric field magnitude in the right STG and improvement of articulation precision after anodal tDCS (R = 0.637; p = 0.019).
CONCLUSIONS
The exploratory study showed that anodal tDCS applied over the auditory feedback area may lead to shorter pauses in a speech of PD patients.
Topics: Humans; Parkinson Disease; Transcranial Direct Current Stimulation; Pilot Projects; Male; Female; Aged; Middle Aged; Cross-Over Studies; Dysarthria; Speech; Treatment Outcome; Temporal Lobe
PubMed: 38592459
DOI: 10.1007/s00702-024-02771-5 -
European Journal of Case Reports in... 2024Sudden onset of reduced consciousness, psychomotor agitation and mydriasis are all indicative of an anticholinergic toxidrome. It is important to note that numerous...
INTRODUCTION
Sudden onset of reduced consciousness, psychomotor agitation and mydriasis are all indicative of an anticholinergic toxidrome. It is important to note that numerous drugs, as well as certain herbs and plants, possess anticholinergic properties.
CASE DESCRIPTION
An 84-year-old female patient had sudden nocturnal onset of uncoordinated hand movements and altered mental status. Shortly after, the patient's 83-year-old husband developed symptoms of dysarthria, gait ataxia, vertigo, and delirium.
CONCLUSION
Anticholinergic syndrome consists of a combination of central and peripheral anticholinergic symptoms. Physostigmine given intravenously resulted in rapid reversal of symptoms. Thorn apple seeds had been accidentally ingested and were identified as the cause.
LEARNING POINTS
The clinical presentation of an anticholinergic toxidrome includes both central and peripheral symptoms such as altered consciousness, mydriasis, dry mucous membranes and skin, and tachycardia.Prompt recognition of anticholinergic toxidrome and the administration of physostigmine can lead to rapid reversal of symptoms and improved patient outcomes.Treatment with physostigmine is indicated when a patient with an agitated delirium does not respond adequately to titrated benzodiazepines.
PubMed: 38584905
DOI: 10.12890/2024_004381 -
European Journal of Case Reports in... 2024We present a 30-year-old male who sustained a mild traumatic brain injury and then was intubated due to deterioration of consciousness. A head CT scan revealed mild...
UNLABELLED
We present a 30-year-old male who sustained a mild traumatic brain injury and then was intubated due to deterioration of consciousness. A head CT scan revealed mild brain oedema, a fractured nasal bone and mild left thoracic wall haematoma. Despite complete clinical and radiological normalisation within 36 hours, he failed to wean off the ventilator. The patient was found to have subtle bulbar manifestations including dysphonia, dysarthria, and dysphagia, with recurrent left lung collapse. He responded to an empirical pyridostigmine trial despite negative biochemical tests for myasthenia gravis (MG). The patient was weaned successfully from the ventilator, transferred to a long-term care facility, and then discharged home. Classic symptoms and signs of a disease may be absent, but the presence of dysarthria, dysphagia, transient vocal cord palsy, nasal speech, absent gag reflex and respiratory failure in difficult-to-wean patients, with no definitive diagnosis, may warrant an empirical trial of therapy for suspected MG and for the benefit of any doubt.
LEARNING POINTS
"Hidden" cranial injuries may account for subtle bulbar symptoms in victims of traumatic brain injury and should be searched for.Myasthenia gravis has been reported in association with trauma, which comes first and is often difficult to ascertain.A trial of pyridostigmine may be reasonable in difficult-to-wean patients when all other causes have been excluded for the benefit of the doubt.
PubMed: 38584891
DOI: 10.12890/2024_004363 -
Infectious Diseases and Therapy Apr 2024A broadened clinical spectrum of concomitant complications emerges among the escalating incidence of substance use, particularly within the 'chemsex' context. This case...
Toxic-Induced Encephalopathy Following Chemsex in a Young HIV-Positive Male: A Complex Case of Acute Cognitive Impairment with Anterograde Amnesia and Behavioral Alterations.
BACKGROUND
A broadened clinical spectrum of concomitant complications emerges among the escalating incidence of substance use, particularly within the 'chemsex' context. This case exemplifies the profound neurotoxic repercussions and neurological risk of chemsex in a young HIV-positive male and addresses the multifaceted challenges of such evolving paradigms in substance utilization.
CLINICAL FINDING
After consuming cannabis, poppers, methamphetamine, and cocaine, a 28-year-old HIV-positive male exhibited significant neurological and cognitive impairment. The initial presentation included dysarthria and profound anterograde amnesia. Laboratory findings showed leukocytosis with a PCR of 3 mg/dl - elevated cerebrospinal fluid protein levels with no cells. Urine toxicology returned positive for cannabis and amphetamines. A brain CT scan revealed bilateral and symmetrical hippocampi and pale globes hypodensity, indicative of toxic-metabolic encephalopathy. MRI further identified lesions in the globus pallidus, cerebellum, and hippocampi. Following the detection of toxic encephalopathy, Initial neuropsychological was performed screening using the Montreal Cognitive Assessment (MoCA), which highlighted immediate memory deficits. An in-depth neuropsychological assessment conducted 3 weeks later included the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV), the Rey Auditory Verbal Learning Test (RAVLT), and tests for visuospatial skills, motor functions, and memory recall. The evaluations revealed pronounced anterograde amnesia, persistent long-term memory inconsistencies, and notable executive function challenges, detailed in Table 1.
CONCLUSIONS
The detailed analysis of this case underpins the severe neurological consequences that can manifest from heavy substance use. Comprehensive diagnostic evaluations, including neuroimaging and neuropsychological assessments, are crucial in elucidating the full spectrum of substance-induced cognitive impairments. There is an urgent need for enhanced public awareness and preventative measures, especially in the context of chemsex, to bring forth multifaceted health, social, and government implications that modern society must adeptly navigate.
PubMed: 38570445
DOI: 10.1007/s40121-024-00962-x -
Scientific Reports Apr 2024Hypomyelinating leukodystrophy (HLD) is a rare genetic heterogeneous disease that can affect myelin development in the central nervous system. This study aims to analyze...
Hypomyelinating leukodystrophy (HLD) is a rare genetic heterogeneous disease that can affect myelin development in the central nervous system. This study aims to analyze the clinical phenotype and genetic function of a family with HLD-7 caused by POLR3A mutation. The proband (IV6) in this family mainly showed progressive cognitive decline, dentin dysplasia, and hypogonadotropic hypogonadism. Her three old brothers (IV1, IV2, and IV4) also had different degrees of ataxia, dystonia, or dysarthria besides the aforementioned manifestations. Their brain magnetic resonance imaging showed bilateral periventricular white matter atrophy, brain atrophy, and corpus callosum atrophy and thinning. The proband and her two living brothers (IV2 and IV4) were detected to carry a homozygous mutation of the POLR3A (NM_007055.4) gene c. 2300G > T (p.Cys767Phe), and her consanguineous married parents (III1 and III2) were p.Cys767Phe heterozygous carriers. In the constructed POLR3A wild-type and p.Cys767Phe mutant cells, it was seen that overexpression of wild-type POLR3A protein significantly enhanced Pol III transcription of 5S rRNA and tRNA Leu-CAA. However, although the mutant POLR3A protein overexpression was increased compared to the wild-type protein overexpression, it did not show the expected further enhancement of Pol III function. On the contrary, Pol III transcription function was frustrated (POLR3A, BC200, and tRNA Leu-CAA expression decreased), and MBP and 18S rRNA expressions were decreased. This study indicates that the POLR3A p.Cys767Phe variant caused increased expression of mutated POLR3A protein and abnormal expression of Pol III transcripts, and the mutant POLR3A protein function was abnormal.
Topics: Male; Female; Humans; Hereditary Central Nervous System Demyelinating Diseases; Mutation; Phenotype; Atrophy; RNA, Transfer; RNA Polymerase III
PubMed: 38561452
DOI: 10.1038/s41598-024-58452-6 -
Cureus Feb 2024Strokes are prevalent, although only some impact the pons, a brainstem region that performs essential functions. Because pontine infarcts are uncommon, there isn't...
Strokes are prevalent, although only some impact the pons, a brainstem region that performs essential functions. Because pontine infarcts are uncommon, there isn't sufficient research to back up efficient therapies that give patients functional advantages. This case report presents a 75-year-old male who was brought to the casualty with a history of falls and developed weakness on the left side of the body, dysarthria, and dysphagia, for which he was referred to the neurophysiotherapy department after performing the necessary investigations. A neurological examination was carried out, and a physiotherapy protocol was made. Outcome measures were taken before and after physiotherapy rehabilitation, including the Glasgow Coma Scale (GCS), Berg Balance Scale, and Functional Independence Measure (FIM). The physiotherapy treatment showed a considerable improvement in the patient's overall health.
PubMed: 38550496
DOI: 10.7759/cureus.55046 -
Rhode Island Medical Journal (2013) Apr 2024Brain abscess is a rare complication of esophagogastro- duodenoscopy (EGD) with few reported cases in the literature. In this report, we discuss a patient presenting...
Brain abscess is a rare complication of esophagogastro- duodenoscopy (EGD) with few reported cases in the literature. In this report, we discuss a patient presenting with altered mental status, headache, and dysarthria due to brain abscess caused by S. intermedius shortly after an EGD with an esophageal biopsy showing a new diagnosis of eosinophilic esophagitis. We highlight the rare association of EGD and brain abscess, and discuss the importance of prompt diagnosis and treatment.
Topics: Humans; Eosinophilic Esophagitis; Streptococcus intermedius; Duodenoscopy; Biopsy; Brain Abscess
PubMed: 38536131
DOI: No ID Found