Département de réadaptation, Faculté de Médecine, Université Laval, Québec, Canada.
Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec, Canada.
Am J Speech Lang Pathol. 2021 Jun 18;30(3S):1459-1476. doi: 10.1044/2020_AJSLP-20-00162. Epub 2021 Mar 9.
Purpose This study aimed to track changes in acoustical and perceptual features of motor speech in patients with phonetic and prosodic primary progressive apraxia of speech (PPAOS) in Québec French over an 18-month period. Method A prospective multiple-case series with multiple testing periods, including four participants with a diagnosis of PPAOS, was conducted. Participants were 0.5-4 years postonset of disease at baseline. They underwent comprehensive motor speech and language assessments and cognitive screening every 6 months for up to 18 months. Acoustical and perceptual analyses of motor speech were conducted. Results Results showed a considerable impairment in motor speech abilities for patients with PPAOS at all time points and a significant decrease in performance for almost all articulatory and prosodic measures over time. Passage reading and diadochokinesis seemed particularly promising for the tracking of changes in PPAOS motor speech characteristics and PPAOS classification. Quantifying length of speech runs made it possible to distinguish phonetic from prosodic PPAOS. Finally, the patients who evolved to phonetic PPAOS developed aphasia, and the two with prosodic PPAOS showed greater motor symptoms such as unequivocal dysarthria. Conclusion This study extends the growing literature on PPAOS and its subtypes by describing specific changes in articulatory and prosodic abilities over a period of at least 6 months, which are important for the diagnosis and management of PPAOS.
目的 本研究旨在追踪在魁北克法语中患有语音和韵律原发性进行性构音障碍(PPAOS)的患者,在 18 个月的时间内,其言语运动的声学和感知特征的变化。
方法 进行了一项前瞻性多病例系列研究,包括 4 名 PPAOS 患者,具有多个测试时间点。参与者在基线时处于疾病发作后 0.5-4 年。他们每 6 个月接受一次全面的言语运动和语言评估以及认知筛查,最多进行 18 个月。对言语运动进行了声学和感知分析。
结果 结果显示,在所有时间点,PPAOS 患者的言语运动能力都有很大的损伤,而且几乎所有的发音和韵律测量指标在一段时间内都有显著的下降。短文朗读和双音节词发音似乎特别适合跟踪 PPAOS 言语运动特征和 PPAOS 分类的变化。量化言语长度可以区分语音 PPAOS 和韵律 PPAOS。最后,演变为语音 PPAOS 的患者发展为失语症,而有韵律 PPAOS 的两名患者表现出更大的运动症状,如明确的构音障碍。
结论 本研究通过描述在至少 6 个月的时间内发音和韵律能力的特定变化,扩展了 PPAOS 及其亚型的不断增长的文献,这对于 PPAOS 的诊断和管理很重要。