Speech disorders reflect differing pathophysiology in Parkinson’s disease, progressive supranuclear palsy and multiple system atrophy
| Autor: | Tereza Tykalová, Jiří Klempíř, Evžen Růžička, Aaron M. Rulseh, Jan Rusz, Cecilia Bonnet, Eva Baborová, Michal Novotný |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Parkinson's disease Neurology Audiology Speech Disorders Progressive supranuclear palsy Dysarthria Atrophy Motor speech medicine Spastic Humans Longitudinal Studies Aged Retrospective Studies Parkinson Disease Middle Aged Multiple System Atrophy medicine.disease eye diseases nervous system diseases nervous system Female Speech disorder Supranuclear Palsy Progressive Neurology (clinical) medicine.symptom Psychology |
| Zdroj: | Journal of Neurology. 262:992-1001 |
| ISSN: | 1432-1459 0340-5354 |
| Popis: | Although speech disorder is frequently an early and prominent clinical feature of Parkinson's disease (PD) as well as atypical parkinsonian syndromes (APS) such as progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), there is a lack of objective and quantitative evidence to verify whether any specific speech characteristics allow differentiation between PD, PSP and MSA. Speech samples were acquired from 77 subjects including 15 PD, 12 PSP, 13 MSA and 37 healthy controls. The accurate differential diagnosis of dysarthria subtypes was based on the quantitative acoustic analysis of 16 speech dimensions. Dysarthria was uniformly present in all parkinsonian patients but was more severe in PSP and MSA than in PD. Whilst PD speakers manifested pure hypokinetic dysarthria, ataxic components were more affected in MSA whilst PSP subjects demonstrated severe deficits in hypokinetic and spastic elements of dysarthria. Dysarthria in PSP was dominated by increased dysfluency, decreased slow rate, inappropriate silences, deficits in vowel articulation and harsh voice quality whereas MSA by pitch fluctuations, excess intensity variations, prolonged phonemes, vocal tremor and strained-strangled voice quality. Objective speech measurements were able to discriminate between APS and PD with 95% accuracy and between PSP and MSA with 75% accuracy. Dysarthria severity in APS was related to overall disease severity (r = 0.54, p = 0.006). Dysarthria with various combinations of hypokinetic, spastic and ataxic components reflects differing pathophysiology in PD, PSP and MSA. Thus, motor speech examination may provide useful information in the evaluation of these diseases with similar manifestations. |
| Databáze: | OpenAIRE |
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