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帕金森病患者声学语音特征与非言语运动表现之间的相关性

Correlation between acoustic speech characteristics and non-speech motor performance in Parkinson Disease.

作者信息

Goberman Alexander M

机构信息

Department of Communication Disorders, Bowling Green State University, Bowling Green, OH 43403, USA.

出版信息

Med Sci Monit. 2005 Mar;11(3):CR109-16.

Abstract

BACKGROUND

Research has found that non-speech motor deficits in Parkinson Disease (PD) can be consistently improved by levodopa medications and surgical treatment, but that speech and voice are only partially responsive to treatment. This has led to the assertion that speech is an axial (non-peripheral) feature of PD, along with other features that are only partially responsive to treatment (e.g., postural stability and gait). The current study tested this assertion via examination of the relationship between multiple measures of speech production and multiple measures of non-speech movement in individuals with PD.

MATERIAL/METHODS: Nine individuals with idiopathic PD were studied, and all participants were taking levodopa-carbidopa medication. Motor performance was examined using the motor portion of the Unified Parkinson's Disease Rating Scale, and speech was examined via acoustic analysis of phonation, articulation, and prosody.

RESULTS

Seven of sixteen speech acoustic measures (FoSD in vowels, F2 slope for /u/ and /ae/, FoSD in reading, articulation rate in monologue, and percent pause in reading and monologue) were significantly correlated with non-speech movements. Results suggested that speech measures are correlated with both axial motor symptoms (e.g., gait, facial expression, posture, postural stability) and non-axial motor symptoms (e.g., rest tremor, left and right bradykinesia, postural tremor).

CONCLUSIONS

It has been hypothesized that axial symptoms of PD are more purely dopaminergic, and non-axial symptoms are related to non-dopaminergic lesions. Therefore, the current results indicate that certain speech deficits in PD may result from dopaminergic lesions, while others appear to result from non-dopaminergic lesions.

摘要

背景

研究发现,帕金森病(PD)中的非言语运动缺陷可通过左旋多巴药物和手术治疗持续改善,但言语和声音对治疗仅部分有反应。这导致了一种观点,即言语是PD的一种轴性(非外周性)特征,与其他对治疗仅部分有反应的特征(如姿势稳定性和步态)一样。本研究通过检查PD患者言语产生的多种测量指标与非言语运动的多种测量指标之间的关系来验证这一观点。

材料/方法:对9名特发性PD患者进行了研究,所有参与者均服用左旋多巴-卡比多巴药物。使用统一帕金森病评定量表的运动部分检查运动表现,并通过对发声、发音和韵律的声学分析来检查言语。

结果

16项言语声学测量指标中的7项(元音中的基频标准差、/u/和/ae/的F2斜率、阅读中的基频标准差、独白中的发音速率以及阅读和独白中的停顿百分比)与非言语运动显著相关。结果表明,言语测量指标与轴性运动症状(如步态、面部表情、姿势、姿势稳定性)和非轴性运动症状(如静止性震颤、左右运动迟缓、姿势性震颤)均相关。

结论

据推测,PD的轴性症状更多是纯粹的多巴胺能性的,而非轴性症状与非多巴胺能性病变有关。因此,目前的结果表明,PD中的某些言语缺陷可能是由多巴胺能性病变引起的,而其他缺陷似乎是由非多巴胺能性病变引起的。

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