Pernon M, Trocello J-M, Vaissière J, Cousin C, Chevaillier G, Rémy P, Kidri-Osmani K, Fougeron C, Woimant F
CNR Wilson, service de neurologie, hôpital Lariboisière, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
Rev Neurol (Paris). 2013 Jun-Jul;169(6-7):502-9. doi: 10.1016/j.neurol.2012.12.003. Epub 2013 Apr 24.
Dysarthria is one of the first sign of neurological Wilson's disease and is often characterized by a decreased speech rate. The aim of this study is to determine the abilities of Wilson's disease dysarthric patients to control their speech rate. We examined the impact of dual-tasking on the speech rate of patients as compared to healthy control speakers and in relation with their ability to accelerate speech rate when instructed to do so.
Twenty-six patients and twenty-six age- and sex-matched healthy controls repeated a sentence during 20 seconds at a comfortable speech rate used as reference. They were then asked to perform the same repetition task but in dual task conditions, in which sentence repetition was done while performing three types of executive grapho-motor tasks. Finally, the ability to control speech rate was tested by asking the speakers to perform the sentence repetition task alone but at a fast rate of speech.
A significantly slower speech rate was observed for all patients as compared to controls. In the dual-task conditions, while the speech rate of healthy speakers accelerated significantly, two behaviors are found for the patients. Forty-two percent of the patients reproduced the control pattern with a significant increased in speech rate, while the other group significantly decreased their speech rate. Comparison of the ability of the two groups to intentionally modulate speech rate, when instructed to accelerate, shows that significantly better acceleration was achieved by speakers in the former group compared with the latter.
This study supports the finding that patients with Wilson's disease exhibit an impaired speech rate and also impaired control of speech rate. Indirect assessment of speech rate modulation with the help of a dual-task paradigm has proven to be useful to distinguish patient behaviors. This paradigm could also be envisioned as a tool for rehabilitation.
构音障碍是神经型威尔逊病的早期症状之一，其特征通常为语速减慢。本研究旨在确定威尔逊病构音障碍患者控制语速的能力。我们研究了与健康对照者相比，多任务处理对患者语速的影响，以及与他们在接到指令时加快语速的能力之间的关系。
26名患者和26名年龄及性别匹配的健康对照者以舒适语速重复一个句子20秒，以此作为参考。然后要求他们在多任务条件下执行相同的重复任务，即在执行三种类型的执行性书写运动任务时进行句子重复。最后，通过要求受试者单独以快速语速执行句子重复任务来测试其控制语速的能力。
与对照组相比，所有患者的语速均显著减慢。在多任务条件下，健康受试者的语速显著加快，而患者出现了两种行为。42%的患者呈现出与对照组相似的模式，语速显著加快，而另一组患者的语速则显著减慢。比较两组在接到加快语速指令时有意调节语速的能力，结果显示，前一组受试者的语速加快程度明显优于后一组。
本研究支持以下发现，即威尔逊病患者存在语速受损以及语速控制受损的情况。借助多任务范式对语速调节进行间接评估已被证明有助于区分患者的行为。该范式也可被设想为一种康复工具。
