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中风的神经放射学和语音表现

Neuroradiology and voice findings in stroke.

作者信息

Godoy Juliana Fernandes, Brasolotto Alcione Ghedini, Berretin-Félix Giédre, Fernandes Adriano Yacubian

机构信息

School of Odontology of Bauru, Universidade de São Paulo, Bauru, SP, Brazil.

Department of Speech-Language Pathology and Audiology, School of Odontology of Bauru, Universidade de São Paulo, Bauru, SP, Brazil.

出版信息

Codas. 2014 Mar-Apr;26(2):168-74. doi: 10.1590/2317-1782/2014531in.

Abstract

Neurological dysphonias are vocal disorders followed by injuries or changes in the nervous system. Stroke is the second leading cause of death worldwide and the brain damage caused by it can affect communication in several aspects. The changes in the vocal features caused by these lesions are poorly described regarding the location and extent of cerebral involvement. The aim of this study was to describe vocal parameters of ten elderly patients affected by stroke according to the topography of the lesion at neuroimaging. We recorded from them: perceptual and auditory evaluation of voice and laryngeal diadochokinesis. Neuroimaging studies were classified according to location, extent, laterality territory of brain injury. The results show a population of extensive middle cerebral artery strokes and strokes with varied location in the brain. The subjects' voices showed predominantly the presence of roughness, breathiness, richeness and instability, and change in laryngeal motor control, demonstrated by reduced speed and instability in laryngeal diadochokinesis. These features presented in patients with extensive middle cerebral artery stroke and in patients with short strokes with varied location in the brain. The results suggest that the vocal features in the assessed cases do not depend only on the topography of the brain damage. Thus, it is important to consider the patient as unique in clinical evaluation.

摘要

神经性发声障碍是由神经系统损伤或变化引起的嗓音疾病。中风是全球第二大死因,其所导致的脑损伤会在多个方面影响交流。关于这些病变引起的嗓音特征变化,在大脑受累的位置和程度方面描述甚少。本研究的目的是根据神经影像学上病变的部位,描述十名中风老年患者的嗓音参数。我们记录了他们的:嗓音的感知和听觉评估以及喉肌运动速度。神经影像学研究根据脑损伤的位置、范围、偏侧性区域进行分类。结果显示,研究对象主要是大脑中动脉大面积中风以及脑部不同位置的中风患者。受试者的嗓音主要表现为粗糙、气息声、圆润度和不稳定性,以及喉运动控制的变化,表现为喉肌运动速度降低和不稳定。这些特征在大脑中动脉大面积中风患者以及脑部不同位置的小面积中风患者中均有出现。结果表明,在评估的病例中,嗓音特征不仅仅取决于脑损伤的部位。因此,在临床评估中把患者视为个体非常重要。

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