Intelligibility Rating Scale For Motor Speech Disorders

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Intelligibility Rating Scale For Motor Speech Disorders – Background: Deep brain stimulation of the subthalamic nucleus, although highly effective in the treatment of movement disorders in Parkinson’s disease (PD), may cause speech impairment in a subset of patients. The aim of the current study was to investigate (1) whether there are distinctive effects of stimulation on various voice and speech parameters and (2) whether there is a particular pattern of pre-existing speech abnormalities that indicate a risk of further deterioration with stimulation.

Methods: N = 38 PD patients were required to complete a medication-free speech test with stimulation on (StimON) and stimulation off (StimOFF). Speech samples were analyzed: (1) in terms of a four-dimensional perceptual speech score and (2) using acoustic analysis to obtain quantitative measures of characteristic speech parameters.

Intelligibility Rating Scale For Motor Speech Disorders

Intelligibility Rating Scale For Motor Speech Disorders

Results: Voice quality was improved with StimON and there were trends towards higher volume and better pitch variability. N = 8 patients showed speech impairment with StimON due to impaired articulation and/or fluency. Even under StimOFF conditions, these patients had more severe general speech disorders with characteristic signs of articulatory vagueness and articulatory acceleration.

Pdf] The Preschool Speech Intelligibility Measure

Conclusion: The effect of subthalamic speech StimON Parkinsonian varies greatly between individual patients, but there is a tendency to improve voice quality and prosody. Patients with stimulation-related speech impairment had greater overall speech impairment and exhibited a characteristic pattern of articulatory abnormalities at baseline. Further studies are needed to confirm these preliminary findings, allowing neurologists to assess individual risk for speech impairment with preoperative stimulation.

Chronic deep brain stimulation of the subthalamic nucleus (STN-DBS) has been shown to be superior to the best treatment in patients with motor fluctuations in Parkinson’s disease (PD) (1, 2). However, the effects of STN-DBS on voice and speech appear to be variable or even unfavorable, at least in a subset of patients. The prevalence of dysarthria in STN-DBS ranges from 1% at 6 months to 70% at 3 months based on a global assessment of perception based on the speech question of the Unified Parkinson’s Disease/Motor Rating Scale (UPDRS III). years of observation with an average of 9.3% (3-5). In addition, “communication” was the only PD questionnaire item that showed worsening with STN-DBS in the recently published EARLYSTIM study (6). However, there are also reports of improvements in voice characteristic parameters, loudness, and non-speech vocal performance in selected CP patients with STN-DBS (7-13). As a possible explanation for these conflicting findings, it has been suggested that STN-DBS may reduce several characteristic dysartrophonic symptoms, such as decreased loudness and glottis tremor, in PD. However, these beneficial effects may be outweighed by general dysarthrogenic effects on prosodic and articulatory functions, resulting in reduced overall speech intelligibility (7, 14–17). As a possible indication of a negative effect on basal motor speech performance, STN-DBS has been found to cause impairments in the speed and regularity of non-linguistic syllable repetition (18). Regarding these conflicting results, there is still no reliable predictability of speech motor outcome in individual patients, although clinical and surgical factors (eg, anatomical location of electrode contact, current amplitude in right and left STN) are evident. to be critical for speech outcome within STN-DBS (19).

The aim of the current study was to analyze the effects of STN-DBS on voice and speech in a group of patients with CKD based on perceptual and acoustic analysis of characteristic speech patterns. It was chosen to test patients without the additive effect of dopaminergic drugs to determine the exclusive effects of STN-DBS with stimulation settings previously optimized for best gross motor performance to test patients in their “natural” stimulation situation. Based on previous studies, it was hypothesized that patients’ speech performance would differ under stimulation, so further planning was better to define the pattern of changes within a single speech modality. Specifically, attention was paid to the expected subgroup of patients with speech impairment under stimulation to identify patterns of preexisting speech impairment that may serve as a “risk profile” for further deterioration with STN-DBS.

From 2008 to 2010, 38 patients with idiopathic PD and chronic bilateral STN-DBS were recruited for this study. The diagnosis of PD was based on the UK Parkinson Society brain bank criteria (20). After an overnight drug washout period, each patient was tested under two drug OFF conditions: stimulation OFF (StimOFF) and stimulation ON (StimON) and underwent a neurological examination according to the UPDRS motor scale (UPDRS III) immediately before the speech task. . Patient characteristics are listed in Table 1.

Measuring Speech Intelligibility In Children With Motor Speech Disorders

All participants were native German speakers, and the spoken score was based on the German text. For the speaking test, each participant had to read a given text consisting of four phonetically balanced sentences; in addition, participants had to pronounce the vowel /a/ as long as possible. Speech samples were digitally recorded using commercial audio software (Steinberg WaveLab

/Steinberg Media Technologies GmbH, Hamburg, Germany) and a headset microphone with a specified mouth-to-microphone distance. The speech recordings of the reading task were perceptually analyzed independently by two examiners (Sabina Škoda and Wenke Greenheit) who were not familiar with the speaker’s condition, according to the four-dimensional scoring system used to describe parkinsonian dysarthria in our clinic (Table 2). Interrater reliability was high with w = .923; in cases of disagreement, the higher score was selected for further analysis.

In addition, acoustic speech analysis was performed for several speech parameters to objectively describe voice, articulation, fluency, and prosody using PRAAT (21) (Table 3). Tremor, shimmer, and noise-to-harmony ratio as measures of voice quality were based on sustained phonation analysis (22). Mean fundamental frequency (meanF

Intelligibility Rating Scale For Motor Speech Disorders

) of the reading task was taken as a measure of phonation. Loudness was defined as the average sound pressure level for the entire reading task. The description of intonation variability was based on the standard deviation (SD) of the fundamental frequency (F

And Differential Diagnosis Of Developmental Disorders Of Speech And Language

SD). Speech rate analysis was performed by measuring the length of each syllable or each pause based on the oscillographic sound pressure signal. In addition to the usual speech rate variables, such as net speaking rate (NSR) and pause ratio (PR%), we additionally determined the percentage of pauses in polysyllabic words (Pinw%), which can be taken as a measure of the accuracy of articulation of stop consonants. (23). Articulatory acceleration (AA) during reading was defined as the NSR difference between the first and last sentences, with values ​​>0 indicating acceleration (23). The description of vowel articulation was based on the recently introduced Vowel Articulation Index/VAI, which is a surrogate parameter of the first and second formant frequencies (F1 and F2) of the three angular vowels /α/, /i/ and /u/ (24, 25). Because it means F

SD and VAI are related to the pitch of the speaker’s voice, comparisons of these parameters between PD patients and controls were performed separately for both sexes.

Winstat© (Bad Krozingen/Germany) was used for statistical analysis. ANOVA and paired t-test were performed for patient versus control group comparisons and within-group comparisons (StimOFF vs. StimON). Variables were normally distributed (Shapiro-Wilk test). Continuous variables are presented using mean ± SD. Discrete data are presented with median and quartile deviation. Kendall’s coefficient of concordance was used to calculate interrater reliability. Spearman’s rank test was used to perform correlation analysis to account for potential differences, particularly within subgroup analyses. Due to the exploratory nature of the study, no adjustments were made for multiple comparisons, and the level of significance was set at p <0.05.

Our study conformed to the Declaration of Helsinki and was approved by local ethics committees. Written informed consent was obtained from each participant.

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Based on perceptual scores, the control group showed significantly better voice characteristics, articulation, fluency, and prosody. This was reflected in the acoustic analysis with lower values ​​of jitter, flicker and noise-to-harmonic ratio, indicating better voice quality, higher sound pressure levels, higher values ​​for articulation accuracy (Pinw%, VAI) and pitch variability (F

In female carriers. Speech rate and PR% measurements showed no significant differences between the control group and the PD group under the StimOFF condition.

This pattern of speech abnormalities generally persisted with StimON, with significantly worse values ​​for Blink, Loudness, VAI, Pinw%, and F

Intelligibility Rating Scale For Motor Speech Disorders

Table 4. Comparison between PD groups with stimulation on and off, and comparison between the PD/StimOFF group and the control group.

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In the group with PD in the OFF condition, some significant correlations were found between “voice” values ​​and tremor (r = 0.343, p = 0.019) and blinking (r = 0.289, p = 0.041), between “articulation” and Pinw % ( r = − 0.277, p = 0.046), but not with VAI, between “fluency” and NSR (r = 0.385, p = 0.008) and AA (r = 0.478, p = 0.001), but not with PR% and between “prosody ” and F

SD (r = -0.311, p = 0.028). Generally similar

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