Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park.
Am J Speech Lang Pathol. 2018 Aug 6;27(3):996-1009. doi: 10.1044/2018_AJSLP-17-0064.
The current study examined overall articulatory range of movement (ROM) in individuals with amyotrophic lateral sclerosis (ALS). Differential involvement of articulators was also tested using articulatory working space in individuals with varying degrees of dysarthria severity and in typically aging individuals. A strong association between overall articulatory ROM and severity measures among individuals with ALS was hypothesized. In addition, it was hypothesized that differential involvement of articulators would be detected using overall articulatory ROM measures.
Twenty-two speakers with dysarthria secondary to ALS and 22 typically aging speakers participated. Speech intelligibility and speaking rate were used as indices of severity. Movement range and overall articulatory working space area (convex hull) of the tongue, lower lip, and jaw were each measured by electromagnetic articulography while the speakers produced the Rainbow Passage.
Tongue convex hull size was significantly correlated with both indices of severity. A significant interaction between articulators and groups was observed. Individuals with severe dysarthria had reduced tongue convex hull size and exaggerated lower lip convex hull size. ROM in the anterior-posterior dimension showed a more notable differential involvement pattern than ROM in the superior-inferior dimension. Results in the area under a receiver operating characteristic curve analysis revealed group-specific ROM sensitivity.
The findings indicate that tongue ROM is reduced in individuals with more severe dysarthria when estimated using a standardized paragraph containing all American English phonemes. The articulatory working space measure could be useful for estimating speech dysfunction in ALS. ROM of the tongue decreases, but ROM of the lower lip and jaw each increase in individuals with severe dysarthria. Differential involvement of the articulators in the anterior-posterior dimension needs to be further investigated.
本研究考察了肌萎缩侧索硬化症（ALS）患者的整体发音运动幅度（ROM）。还通过具有不同构音障碍严重程度的个体和典型衰老个体的构音工作空间，测试了构音器官的不同参与情况。假设在 ALS 患者中，整体构音 ROM 与严重程度测量之间存在很强的关联。此外，假设使用整体构音 ROM 测量值可以检测到构音器官的不同参与情况。
22 名因 ALS 导致构音障碍的患者和 22 名典型衰老的个体参与了研究。言语清晰度和说话速度被用作严重程度的指标。在参与者说出 Rainbow Passage 时，使用电磁口部运动描记法测量了舌、下唇和下颌的运动范围和整体构音工作空间面积（凸壳）。
舌凸壳大小与两个严重程度指标均显著相关。在构音器官和组别之间观察到显著的交互作用。严重构音障碍的个体的舌凸壳尺寸减小，下唇凸壳尺寸增大。前-后向 ROM 比上-下向 ROM 显示出更明显的差异参与模式。接收器操作特性曲线分析下的面积结果表明，ROM 具有组特异性敏感性。
这些发现表明，当使用包含所有美国英语音素的标准段落估计时，严重构音障碍的个体的舌 ROM 减小。构音工作空间测量可能有助于估计 ALS 中的言语障碍。严重构音障碍的个体的舌 ROM 减小，但下唇和下颌的 ROM 均增加。需要进一步研究构音器官在前-后向维度的不同参与情况。
