Solomon Nancy Pearl, Brungart Douglas S, Wince Jessica R, Abramowitz Jordan C, Eitel Megan M, Cohen Julie, Lippa Sara M, Brickell Tracey A, French Louis M, Lange Rael T
Walter Reed National Military Medical Center, Bethesda, MD.
Uniformed Services University of the Health Sciences, Bethesda, MD.
Am J Speech Lang Pathol. 2021 Jun 18;30(3S):1400-1409. doi: 10.1044/2020_AJSLP-20-00158. Epub 2021 Feb 25.
Purpose Syllabic diadochokinesis (DDK) is a standard assessment task for motor speech disorders. This study aimed to compare rate and regularity of DDK according to the presence or absence of traumatic brain injury (TBI) and severity of TBI, examine the stability of DDK over time, and explore associations between DDK and extemporaneous speech. Method Military service members and veterans were categorized into three groups: no history of TBI (control), uncomplicated mild TBI (mTBI), and moderate through severe (including penetrating) TBI (msTBI). Participants produced rapid alternating-motion and sequential-motion syllable repetitions during one or two sessions. A semi-automated protocol determined syllabic rate and regularity. Perceptual ratings of selected participants' connected speech samples were compared to DDK results. Results Two hundred sixty-three service members and veterans provided data from one session and 69 from two sessions separated by 1.9 years ( = 1.0). DDKs were significantly slower overall for mTBI and msTBI groups compared to controls. Regularity of productions did not differ significantly across groups. A significant Group × Task interaction revealed that the msTBI group produced sequential-motion syllable repetitions but not alternating-motion repetitions with greater regularity, whereas the opposite occurred for control and mTBI groups. DDK results did not differ significantly between sessions. Perceptual speech analysis for 30 participants, including 20 with atypical or questionable DDK performance, revealed two participants with mildly abnormal speech. Conclusions Overall, DDK productions are slower than normal in adults with moderate, severe, and penetrating TBI and are stable over time. Regularity of productions did not differentiate groups, although this result differed according to task. There were surprisingly few people identified with disordered speech, making comparisons to DDK data tenuous, and indicating that dysarthria is a rare complication in a population of adults with mostly uncomplicated mTBI who are not selected from referrals to a speech-language pathology clinic.
目的 音节交替运动速率（DDK）是运动性言语障碍的一项标准评估任务。本研究旨在比较有无创伤性脑损伤（TBI）及TBI严重程度情况下DDK的速率和规律性，检验DDK随时间的稳定性，并探讨DDK与即席言语之间的关联。方法 将现役军人和退伍军人分为三组：无TBI病史（对照组）、单纯性轻度TBI（mTBI）以及中度至重度（包括穿透性）TBI（msTBI）。参与者在一次或两次测试中进行快速交替运动和连续运动的音节重复。采用半自动方案确定音节速率和规律性。将部分参与者连贯言语样本的感知评分与DDK结果进行比较。结果 263名现役军人和退伍军人提供了一次测试的数据，69人提供了两次测试的数据，两次测试间隔1.9年（标准差 = 1.0）。与对照组相比，mTBI组和msTBI组的DDK总体明显较慢。各组之间发音的规律性没有显著差异。显著的组×任务交互作用表明，msTBI组进行连续运动音节重复时规律性更强，但交替运动重复时并非如此，而对照组和mTBI组情况相反。两次测试之间DDK结果没有显著差异。对30名参与者进行的感知言语分析，包括20名DDK表现不典型或有疑问的参与者，发现两名言语轻度异常。结论 总体而言，中度、重度和穿透性TBI的成年人中，DDK发音比正常人慢，且随时间稳定。发音规律性在各组之间没有差异，尽管这一结果因任务而异。令人惊讶的是，很少有人被发现存在言语障碍，这使得与DDK数据的比较变得薄弱，并表明构音障碍在大多数为单纯性mTBI且未从言语语言病理学诊所转诊而来的成年人群体中是一种罕见的并发症。
