Aix-Marseille Univ, CNRS, LPL, Aix-en-Provence, 13100, France.
Aix Marseille Univ, CNRS, LPL, Marseille, France.
Int J Lang Commun Disord. 2021 Nov;56(6):1204-1217. doi: 10.1111/1460-6984.12661. Epub 2021 Aug 12.
Hyperkinetic dysarthria is often present in isolated dystonia (ID) and is still understudied. Four main clusters of deviant speech dimensions in dystonia hyperkinetic dysarthria were initially provided: articulatory inaccuracy, phonatory stenosis, prosodic excess and prosodic insufficiency.
The aim of our exploratory study was to provide preliminary data on both perceptual and acoustic analyses in relation to three out of these four main clusters.
METHODS & PROCEDURES: Eleven patients with ID and 11 healthy controls (HC) participated in this study. Clinical/perceptual assessments and acoustic analyses of speech recordings were performed, the latter allowing for the analysis of parameters referring to aerophonatory control, voice quality, prosodic features and speech intelligibility estimated by nine listeners. Between-group statistical comparisons were performed (Wilcoxon tests, p < 0.05). Single-case differences between each patient and the control group were also carried out (effect size index and t < 0.05).
OUTCOMES & RESULTS: Between-group comparisons confirmed the presence of a 'phonatory stenosis'; in addition, deficit in aerophonatory control and hypophonia was also displayed. 'Prosodic insufficiency' was confirmed, but not at the individual level. 'Prosodic excess' manifested only in patients with marked and severe dysarthria. Correlations between altered maximum phonation time, loudness variation, speech and articulatory rates on the one hand, and several clinical speech assessments on the other hand, were also found.
CONCLUSIONS & IMPLICATIONS: From these findings, altogether, perceptual characteristics of hyperkinetic dysarthria, as suggested by Darley et al., were quantified by the acoustic parameters we measured. As regards to our data obtained in a small participant sample, we would suggest that Darley et al.'s clusters of excess and insufficiency prosody should be questioned in future studies involving larger numbers of dystonic patients. Our study provides novel and preliminary results that demonstrate the relevance of using quantitative measures to further characterise speech/voice deficits in patients with ID.
多动性构音障碍在孤立性肌张力障碍（ID）中经常出现，但其仍研究不足。最初提出了肌张力障碍性多动性构音障碍的 4 个主要的异常言语维度聚类：发音不准确、发声狭窄、韵律过度和韵律不足。
本探索性研究旨在提供与这 4 个主要聚类中的 3 个相关的感知和声学分析的初步数据。
11 名 ID 患者和 11 名健康对照（HC）参加了这项研究。对言语录音进行了临床/感知评估和声学分析，后者允许分析涉及呼吸控制、音质、韵律特征和由 9 位听众估计的言语可懂度的参数。对组间进行了统计比较（Wilcoxon 检验，p<0.05）。还对每位患者与对照组之间的单病例差异进行了比较（效应量指数和 t<0.05）。
组间比较证实存在“发声狭窄”；此外，呼吸控制和语音减弱也存在缺陷。“韵律不足”得到了证实，但在个体水平上没有得到证实。“韵律过度”仅在严重和明显构音障碍的患者中表现出来。还发现改变的最大发音时间、响度变化、言语和发音速率与其他几个临床言语评估之间存在相关性。
从这些发现中，我们通过所测量的声学参数，对由 Darley 等人提出的多动性构音障碍的感知特征进行了量化。就我们在小样本参与者中获得的数据而言，我们建议在涉及更多 ID 患者的未来研究中，应该对 Darley 等人的过度和不足韵律聚类提出质疑。我们的研究提供了新的初步结果，证明了使用定量措施进一步描述 ID 患者言语/语音缺陷的相关性。
