Finitzo T, Freeman F
Dallas Center for Vocal Motor Control, University of Texas 75235.
J Speech Hear Res. 1989 Sep;32(3):541-55. doi: 10.1044/jshr.3203.541.
Two questions are addressed in this presentation and integration of experimental data from seven years of research. They are (a) is spasmodic dysphonia (SD) a neurologic disorder; and (b) if so, where in the nervous system does the dysfunction have its locus? The conclusion is that SD is a supranuclear movement disorder primarily, but not exclusively, affecting the larynx. For over 50% of the subjects, isolated, multifocal, cortical lesions can be identified, specifically in left frontal/temporal cortex (perisylvian region), medial frontal cortex, and right posterior temporal/parietal cortex. Twenty-five percent have mixed subcortical and cortical pathology. Seven percent manifest subcortical lesions alone. For 16%, neither cortical nor subcortical structural or functional lesions are identified. Three etiologic processes that could produce mild multiple cortical and subcortical lesions are closed head injury, multi-infarct microvascular disease, and exposure to neurotoxins. These processes are discussed with reference to the population studied.
本报告及来自七年研究的实验数据整合探讨了两个问题。它们是：（a）痉挛性发音障碍（SD）是否为一种神经系统疾病；以及（b）如果是，神经系统功能障碍的病灶位于何处？结论是，SD主要是一种核上运动障碍，但并非仅影响喉部。超过50%的受试者可发现孤立的、多灶性的皮质病变，具体位于左侧额叶/颞叶皮质（岛周区）、内侧额叶皮质以及右侧颞后/顶叶皮质。25%的受试者存在皮质下和皮质混合性病变。7%的受试者仅表现为皮质下病变。16%的受试者未发现皮质或皮质下结构或功能病变。可能导致轻度多发性皮质和皮质下病变的三个病因过程为闭合性颅脑损伤、多梗死性微血管疾病以及接触神经毒素。结合所研究的人群对这些过程进行了讨论。
