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帕金森病的喉部躯体感觉缺陷:对言语呼吸和发声控制的影响。

Laryngeal somatosensory deficits in Parkinson's disease: implications for speech respiratory and phonatory control.

机构信息

Division of Otolaryngology, Department of Surgery, University of Wisconsin, 600 Highland Avenue K4/769, Madison, WI 53792, USA.

出版信息

Exp Brain Res. 2010 Mar;201(3):401-9. doi: 10.1007/s00221-009-2048-2. Epub 2009 Dec 15.

Abstract

Parkinson's disease (PD) is often associated with substantial impairment of speech respiratory and phonatory control. However, the degree to which these impairments are related to abnormal laryngeal sensory function is unknown. This study examined whether individuals with PD exhibited abnormal and more asymmetric laryngeal somatosensory function compared with healthy controls, and whether these deficits were associated with disease and voice severity. Nineteen PD participants were tested and compared with 18 healthy controls. Testing included endoscopic assessment of laryngeal somatosensory function, with aerodynamic and acoustic assessment of respiratory and phonatory control, and clinical ratings of voice and disease severity. PD participants exhibited significantly abnormal and asymmetric laryngeal somatosensory function compared with healthy controls. Sensory deficits were significantly associated with timing of phonatory onset, voice intensity, respiratory driving pressure, laryngeal resistance, lung volume expended per syllable, disease severity, and voice severity. These results suggest that respiratory and phonatory control are influenced by laryngeal somatosensory function, that speech-related deficits in PD are related to abnormal laryngeal somatosensory function, and that this function may degrade as a function of disease severity. Thus, PD may represent a model of airway sensorimotor disintegration, highlighting the important role of the basal ganglia and related neural networks in the integration of laryngeal sensory input for speech-related motor control.

摘要

帕金森病(PD)常伴有言语呼吸和发声控制的严重损害。然而,这些损害与异常的喉部感觉功能的关系尚不清楚。本研究旨在探讨 PD 患者是否表现出异常的、更不对称的喉部躯体感觉功能,以及这些缺陷是否与疾病和声音严重程度相关。19 名 PD 参与者和 18 名健康对照者接受了测试。测试包括对喉部躯体感觉功能的内镜评估,以及对呼吸和发声控制的空气动力学和声学评估,以及对声音和疾病严重程度的临床评估。与健康对照组相比,PD 参与者表现出明显异常和不对称的喉部躯体感觉功能。感觉缺陷与发音起始时间、声音强度、呼吸驱动力、喉阻力、每个音节耗气量、疾病严重程度和声音严重程度显著相关。这些结果表明,呼吸和发声控制受到喉部躯体感觉功能的影响,PD 中的言语相关缺陷与异常的喉部躯体感觉功能有关,并且随着疾病严重程度的增加,这种功能可能会下降。因此,PD 可能代表了气道感觉运动解体的模型,突出了基底神经节和相关神经网络在整合喉部感觉输入以进行言语相关运动控制中的重要作用。

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