Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY 14214, USA.
Department of Neurology, University at Buffalo, Buffalo, NY 14214, USA.
J Int Neuropsychol Soc. 2021 May;27(5):450-460. doi: 10.1017/S1355617720001113. Epub 2020 Nov 16.
To investigate the impact of cognitive impairment on spoken language produced by speakers with multiple sclerosis (MS) with and without dysarthria.
Sixty speakers comprised operationally defined groups. Speakers produced a spontaneous speech sample to obtain speech timing measures of speech rate, articulation rate, and silent pause frequency and duration. Twenty listeners judged the overall perceptual severity of the samples using a visual analog scale that ranged from no impairment to severe impairment (speech severity). A 2 × 2 factorial design examined main and interaction effects of dysarthria and cognitive impairment on speech timing measures and speech severity in individuals with MS. Each speaker group with MS was further compared to a healthy control group. Exploratory regression analyses examined relationships between cognitive and biopsychosocial variables and speech timing measures and perceptual judgments of speech severity, for speakers with MS.
Speech timing was significantly slower for speakers with dysarthria compared to speakers with MS without dysarthria. Silent pause durations also significantly differed for speakers with both dysarthria and cognitive impairment compared to MS speakers without either impairment. Significant interactions between dysarthria and cognitive factors revealed comorbid dysarthria and cognitive impairment contributed to slowed speech rates in MS, whereas dysarthria alone impacted perceptual judgments of speech severity. Speech severity was strongly related to pause duration.
The findings suggest the nature in which dysarthria and cognitive symptoms manifest in objective, acoustic measures of speech timing and perceptual judgments of severity is complex.
探讨认知障碍对多发性硬化症(MS)患者伴或不伴构音障碍的口语产生的影响。
60 名参与者被分为操作性定义的组。参与者进行了自发言语样本采集,以获得言语率、发音率和无声停顿频率和时长等言语时程测量指标。20 名听众使用视觉模拟量表(从无损伤到严重损伤,范围为 0 到 10)对样本的整体感知严重程度进行判断。采用 2×2 因子设计,考察了构音障碍和认知障碍对 MS 患者言语时程测量指标和言语严重程度的主效应和交互效应。将每个 MS 患者组与健康对照组进行比较。对 MS 患者的认知和生物心理社会变量与言语时程测量指标和言语严重程度的感知判断之间的关系进行了探索性回归分析。
与无构音障碍的 MS 患者相比,有构音障碍的患者的言语时程明显更慢。有构音障碍和认知障碍的患者的无声停顿时长也明显不同于无任何障碍的 MS 患者。构音障碍和认知因素之间存在显著的交互作用,表明共病构音障碍和认知障碍导致 MS 患者的言语率变慢,而构音障碍本身则影响对言语严重程度的感知判断。言语严重程度与停顿时长密切相关。
这些发现表明,构音障碍和认知症状在言语时程的客观声学测量和严重程度的感知判断中表现出的性质是复杂的。