Steurer Hanna, Schalling Ellika, Franzén Erika, Albrecht Franziska
Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden.
R&D Unit, Stockholms Sjukhem, Stockholm, Sweden.
Front Aging Neurosci. 2022 May 16;14:870998. doi: 10.3389/fnagi.2022.870998. eCollection 2022.
Alterations in speech and voice are among the most common symptoms in Parkinson's disease (PD), often resulting in motor speech disorders such as hypokinetic dysarthria. We investigated dysarthria, verbal fluency, executive functions, and global cognitive function in relation to structural and resting-state brain changes in people with PD.
Participants with mild-moderate PD ( = 83) were recruited within a randomized controlled trial and divided into groups with varying degrees of dysarthria: no dysarthria (noDPD), mild dysarthria (mildDPD), moderate dysarthria (modDPD), and also combined mildDPD and modDPD into one group (totDPD). Voice sound level and dysphonia, verbal fluency, motor symptoms, executive functions, disease severity, global cognition, and neuroimaging were compared between groups. Gray matter volume and intensity of spontaneous brain activity were analyzed. Additionally, regressions between behavioral and neuroimaging data were performed.
The groups differed significantly in mean voice sound level, dysphonia, and motor symptom severity. Comparing different severity levels of dysarthria to noDPD, groups differed focally in resting-state activity, but not in brain structure. In totDPD, lower scores on semantic verbal fluency, a composite score of executive functions, and global cognition correlated with lower superior temporal gyrus volume.
This study shows that severity of dysarthria may be related to underlying structural and resting-state brain alterations in PD as well as behavioral changes. Further, the superior temporal gyrus may play an important role in executive functions, language, and global cognition in people with PD and dysarthria.
言语和嗓音改变是帕金森病（PD）最常见的症状之一，常导致运动性言语障碍，如运动减少型构音障碍。我们研究了PD患者构音障碍、言语流畅性、执行功能和整体认知功能与大脑结构及静息态变化之间的关系。
在一项随机对照试验中招募了轻度至中度PD患者（n = 83），并将其分为不同程度构音障碍组：无构音障碍（noDPD）、轻度构音障碍（mildDPD）、中度构音障碍（modDPD），还将mildDPD和modDPD合并为一组（totDPD）。比较了各组之间的语音声级、发声障碍、言语流畅性、运动症状、执行功能、疾病严重程度、整体认知和神经影像学。分析了灰质体积和大脑自发活动强度。此外，还进行了行为和神经影像学数据之间的回归分析。
各组在平均语音声级、发声障碍和运动症状严重程度方面存在显著差异。将不同严重程度的构音障碍组与noDPD组进行比较，各组在静息态活动方面存在局部差异，但在脑结构方面无差异。在totDPD组中，语义言语流畅性得分较低、执行功能综合得分较低以及整体认知与颞上回体积较小相关。
本研究表明，构音障碍的严重程度可能与PD患者潜在的结构和静息态大脑改变以及行为变化有关。此外，颞上回可能在PD和构音障碍患者的执行功能、语言和整体认知中起重要作用。
