Department of Speech-Language-Hearing: Sciences & Disorders, The University of Kansas, Lawrence.
Department of Hearing and Speech, The University of Kansas Medical Center, Kansas City.
Am J Speech Lang Pathol. 2021 Jun 18;30(3S):1382-1399. doi: 10.1044/2020_AJSLP-20-00136. Epub 2021 Feb 25.
Purpose This study examined the articulatory control of speech and speechlike tasks in individuals with amyotrophic lateral sclerosis (ALS) and neurologically healthy individuals with the aim to identify the most useful set of articulatory features and tasks for assessing bulbar motor involvement in ALS. Method Tongue and jaw kinematics were recorded in 12 individuals with bulbar ALS and 10 healthy controls during a speech task and two speechlike tasks (i.e., alternating motion rate [AMR], sequential motion rate [SMR]). Eight articulatory features were derived for each participant per task, including the range, maximum speed, and acceleration time of tongue and jaw movements as well as the coupling and timing between tongue and jaw movements. The effects of task (i.e., AMR, SMR, speech) and group (i.e., ALS, control) on these articulatory features were evaluated. For each feature, the task that yielded the largest difference between the ALS and control groups was identified. The diagnostic efficacy of these task-specific features was assessed using the receiver operating characteristic analysis; the relation of these task-specific features to a well-established bulbar severity index-speaking rate-was determined using Spearman's rank correlation. Results Seven task-specific articulatory features were identified, including (a) tongue and jaw acceleration time during the AMR task, (b) tongue-jaw coupling during the SMR task, and (c) range of tongue movement, maximum tongue and jaw speed, and temporal lag between tongue and jaw movements during the speech task. Among these features, tongue and jaw acceleration time and their temporal lag showed relatively high accuracy (i.e., 0.83-0.95) in differentiating individuals with ALS from healthy controls. Range of tongue movement and maximum tongue and jaw speed showed significant correlations with speaking rate. Conclusion Findings provided preliminary evidence for the utility of task-specific articulatory measurements as a novel quantitative assessment to detect and predict bulbar motor involvement in ALS.
本研究旨在探讨肌萎缩侧索硬化症（ALS）患者和神经健康个体的言语和类言语任务的发音控制，以确定用于评估 ALS 延髓运动参与的最有用的发音特征和任务。
在 12 名延髓 ALS 患者和 10 名健康对照者中，记录了他们在言语任务和 2 种类言语任务（即交替运动速率 [AMR]、序列运动速率 [SMR]）期间的舌和颌骨运动的运动学。针对每个参与者，针对每个任务都从 8 个发音特征中得出了包括舌和颌骨运动的范围、最大速度和加速时间以及舌和颌骨运动之间的耦合和定时的特征。评估了任务（即 AMR、SMR、言语）和组（即 ALS、对照）对这些发音特征的影响。对于每个特征，确定了在 ALS 和对照组之间产生最大差异的任务。使用接收者操作特性分析评估了这些特定于任务的特征的诊断功效；使用 Spearman 等级相关确定了这些特定于任务的特征与既定的延髓严重程度指数（言语率）之间的关系。
确定了 7 个特定于任务的发音特征，包括：（a）在 AMR 任务期间的舌和颌骨加速度时间，（b）在 SMR 任务期间的舌-颌骨耦合，以及（c）言语任务期间的舌运动范围、最大舌和颌骨速度以及舌和颌骨运动之间的时间滞后。在这些特征中，舌和颌骨的加速度时间及其时间滞后在区分 ALS 患者和健康对照者方面具有较高的准确性（即 0.83-0.95）。舌运动范围和最大舌和颌骨速度与言语率呈显著相关。
研究结果初步证明了特定于任务的发音测量作为一种新的定量评估方法在检测和预测 ALS 延髓运动参与方面的效用。
