Brabenec L, Mekyska J, Galaz Z, Rektorova Irena
Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Kamenice 753/5, 625 00, Brno, Czech Republic.
Department of Telecommunications, Faculty of Electrical Engineering and Communication, Brno University of Technology, Technicka 3082/12, 61600, Brno, Czech Republic.
J Neural Transm (Vienna). 2017 Mar;124(3):303-334. doi: 10.1007/s00702-017-1676-0. Epub 2017 Jan 18.
Hypokinetic dysarthria (HD) occurs in 90% of Parkinson's disease (PD) patients. It manifests specifically in the areas of articulation, phonation, prosody, speech fluency, and faciokinesis. We aimed to systematically review papers on HD in PD with a special focus on (1) early PD diagnosis and monitoring of the disease progression using acoustic voice and speech analysis, and (2) functional imaging studies exploring neural correlates of HD in PD, and (3) clinical studies using acoustic analysis to evaluate effects of dopaminergic medication and brain stimulation. A systematic literature search of articles written in English before March 2016 was conducted in the Web of Science, PubMed, SpringerLink, and IEEE Xplore databases using and combining specific relevant keywords. Articles were categorized into three groups: (1) articles focused on neural correlates of HD in PD using functional imaging (n = 13); (2) articles dealing with the acoustic analysis of HD in PD (n = 52); and (3) articles concerning specifically dopaminergic and brain stimulation-related effects as assessed by acoustic analysis (n = 31); the groups were then reviewed. We identified 14 combinations of speech tasks and acoustic features that can be recommended for use in describing the main features of HD in PD. While only a few acoustic parameters correlate with limb motor symptoms and can be partially relieved by dopaminergic medication, HD in PD seems to be mainly related to non-dopaminergic deficits and associated particularly with non-motor symptoms. Future studies should combine non-invasive brain stimulation with voice behavior approaches to achieve the best treatment effects by enhancing auditory-motor integration.
运动减少型构音障碍（HD）见于90%的帕金森病（PD）患者。它具体表现在发音、发声、韵律、言语流畅性和面部运动等方面。我们旨在系统回顾关于PD中HD的文献，特别关注：（1）使用声学语音和言语分析进行PD的早期诊断及疾病进展监测；（2）探索PD中HD神经相关性的功能成像研究；（3）使用声学分析评估多巴胺能药物和脑刺激效果的临床研究。2016年3月之前发表的英文文章在Web of Science、PubMed、SpringerLink和IEEE Xplore数据库中使用并组合特定相关关键词进行了系统检索。文章分为三组：（1）使用功能成像关注PD中HD神经相关性的文章（n = 13）；（2）处理PD中HD声学分析的文章（n = 52）；（3）通过声学分析评估多巴胺能和脑刺激相关特定效果的文章（n = 31）；然后对这些组进行了回顾。我们确定了14种言语任务和声学特征的组合，可推荐用于描述PD中HD的主要特征。虽然只有少数声学参数与肢体运动症状相关且可被多巴胺能药物部分缓解，但PD中的HD似乎主要与非多巴胺能缺陷有关，尤其与非运动症状相关。未来的研究应将无创脑刺激与语音行为方法相结合，通过增强听觉 - 运动整合来实现最佳治疗效果。
