University of Colorado Boulder, 2501 Kittredge Loop Drive, Boulder, CO, 80039, USA.
Skagit Regional Health, 300 Hospital Parkway, Mount Vernon, WA, 98274, USA.
Cerebellum. 2023 Aug;22(4):601-612. doi: 10.1007/s12311-022-01427-y. Epub 2022 Jun 7.
The purpose of this analysis was to document intelligibility and naturalness in ataxia, a neurological condition that results from cerebellar damage. The cerebellum is important for normal speech production to scale and coordinate articulatory and laryngeal movements. The disruption of these cerebellar mechanisms has unique implications for how intelligibility and naturalness are affected in ataxia. The results of research on speech in ataxia have important clinical implications for assessment and treatment of individuals with ataxic dysarthria. Speech samples from 27 participants with ataxia and 28 age- and sex-matched control participants were assessed by nine speech-language pathology graduate students for intelligibility and naturalness. Intelligibility was measured as the percentage of words transcribed correctly, and naturalness was assessed as a subjective rating on a seven-point interval scale. Both intra- and inter-rater reliability were moderate to high for both intelligibility and naturalness. Speech intelligibility and naturalness were robustly decreased in the ataxia group compared to the control group; however, the difference was greater for measures of speech naturalness. There were robust relationships among dysarthria severity, length of diagnosis, and speech naturalness in speakers with ataxia, but there were no other robust effects for age, sex, or impact on quality of life for intelligibility or naturalness. Speech naturalness was more impaired than intelligibility in speakers with ataxia. Impaired naturalness can have debilitating consequences for communicative participation, effectiveness, and quality of life. Assessment and treatment for ataxic dysarthria should include aspects of prosodic control for speech naturalness.
本分析旨在记录小脑损伤引起的共济失调患者言语的可懂度和自然度。小脑对于正常的言语产生非常重要，它可以调节发音和喉部运动的幅度和协调性。这些小脑机制的破坏对可懂度和自然度的影响具有独特的意义。对共济失调患者言语的研究结果对评估和治疗共济失调性构音障碍患者具有重要的临床意义。本研究对 27 名共济失调患者和 28 名年龄和性别匹配的对照组参与者的言语样本进行了分析，由 9 名言语语言病理学研究生评估可懂度和自然度。可懂度通过正确转录的单词百分比来衡量，自然度通过 7 点间隔量表的主观评分来评估。可懂度和自然度的组内和组间信度均为中等至高。与对照组相比，共济失调组的言语可懂度和自然度均显著降低；然而，自然度的差异更大。在共济失调患者中，构音障碍严重程度、诊断时间长短与言语自然度之间存在显著关系，但年龄、性别或对生活质量的影响与可懂度或自然度之间没有其他显著关系。共济失调患者的言语自然度比可懂度受损更严重。自然度的受损可能会对交流参与、效率和生活质量产生严重影响。对共济失调性构音障碍的评估和治疗应包括对言语自然度的韵律控制方面。
