Auzou P, Ozsancak C, Jan M, Ménard J F, Eustache F, Hannequin D
Fédération de Neurologie, CHU, Rouen.
Rev Neurol (Paris). 2000 Jan;156(1):47-52.
Perceptual analysis is not sufficient enough to identify specific dysarthria types. In order to improve the discrimination between dysarthria types, we developed a standardized evaluation of different functions controlling speech motor performances. This was applied to 90 patients suffering from hypokinetic, spastic or ataxic dysarthria and 15 control subjects. A discriminate analysis showed that 71.4 p. 100 of the cases were correctly classified. This model was validated within a new group of 21 patients and showed that the less severe dysarthric parkinsonian patients were difficult to distinguish from control subjects. The discriminate analysis was then used for 20 patients with atypical parkinsonism. Seven patients with progressive supranuclear palsy were considered to have hypokinetic dysarthria. The 6 patients with multisystem atrophy and 7 with corticobasal degeneration were classified among the 3 dysarthric types. We suggest that motor speech evaluation may contribute to differential diagnosis within groups of patients suffering from atypical parkinsonism.
知觉分析不足以识别特定的构音障碍类型。为了提高不同构音障碍类型之间的区分度,我们开发了一种对控制言语运动表现的不同功能的标准化评估方法。该方法应用于90名患有运动减少型、痉挛型或共济失调型构音障碍的患者以及15名对照受试者。判别分析表明,100例中有71.4%的病例被正确分类。该模型在一组新的21名患者中得到验证,结果显示病情较轻的帕金森病构音障碍患者难以与对照受试者区分开来。然后,判别分析被用于20例非典型帕金森病患者。7例进行性核上性麻痹患者被认为患有运动减少型构音障碍。6例多系统萎缩患者和7例皮质基底节变性患者被归类到3种构音障碍类型中。我们认为,言语运动评估可能有助于非典型帕金森病患者群体的鉴别诊断。