Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Boston, MA.
Program in Speech and Hearing Bioscience and Technology, Harvard University, Boston, MA.
J Speech Lang Hear Res. 2021 Dec 13;64(12):4772-4783. doi: 10.1044/2021_JSLHR-21-00123. Epub 2021 Oct 29.
Hypernasality and atypical voice characteristics are common features of dysarthric speech due to amyotrophic lateral sclerosis (ALS). Existing acoustic measures have been developed to primarily target either hypernasality or voice impairment, and the effects of co-occurring hypernasality-voice problems on these measures are unknown. This report explores (a) the extent to which acoustic measures are affected by concurrent perceptually identified hypernasality and voice impairment due to ALS and (b) candidate acoustic measures of early indicators of hypernasality and voice impairment in the presence of multisystem involvement in individuals with ALS.
Two expert listeners rated severity of hypernasality and voice impairment in sentences produced by individuals with ALS ( = 27). The samples were stratified based on perceptual ratings: voice/hypernasality asymptomatic, predominantly hypernasal, predominantly voice impairment, and mixed (co-occurring hypernasality and voice impairment). Groups were compared using established acoustic measures of hypernasality (one-third octave analysis) and voice (cepstral/spectral analysis) impairment.
The one-third octave analysis differentiated all groups; the cepstral peak prominence differentiated all groups except asymptomatic versus mixed, whereas the low-to-high spectral ratio did not differ among groups. Additionally, one-third octave analyses demonstrated promising speech diagnostic potential.
The results highlight the need to consider the validity of measures in the context of multisubsystem involvement. Our preliminary findings further suggest that the one-third octave analysis may be an optimal approach to quantify hypernasality and voice abnormalities in the presence of multisystem speech impairment. Future evaluation of the diagnostic accuracy of the one-third octave analysis is warranted.
由于肌萎缩性侧索硬化症（ALS），构音障碍语音的常见特征是hypernasality 和非典型的声音特征。现有的声学测量方法主要针对 hypernasality 或声音障碍，而同时存在的 hypernasality-voice 问题对这些测量方法的影响尚不清楚。本报告探讨了（a）由于 ALS 多系统受累，同时存在感知到的 hypernasality 和声音障碍对声学测量的影响程度，以及（b）ALS 个体存在多系统受累时，hypernasality 和声音障碍的早期指标的候选声学测量方法。
两位专家听众对 ALS 患者（n = 27）所发出句子的 hypernasality 和声音障碍严重程度进行了评分。根据感知评分对样本进行分层：无声音/hypernasality 症状、主要为 hypernasal、主要为声音障碍和混合（同时存在 hypernasality 和声音障碍）。使用已建立的 hypernasality（三分之一倍频程分析）和声音（倒谱/频谱分析）障碍的声学测量方法对各组进行比较。
三分之一倍频程分析可区分所有组；倒谱峰突出度可区分所有组，除无症状组与混合组外，而高低谱比在各组之间无差异。此外，三分之一倍频程分析显示出有希望的言语诊断潜力。
结果强调了在多系统受累的情况下，需要考虑测量方法的有效性。我们的初步发现进一步表明，三分之一倍频程分析可能是一种量化多系统言语障碍中 hypernasality 和声音异常的最佳方法。需要进一步评估三分之一倍频程分析的诊断准确性。
