MGH Institute of Health Professions, Boston, MA, USA.
Department of Speech-Language Pathology & Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
Int J Speech Lang Pathol. 2023 Aug;25(4):486-499. doi: 10.1080/17549507.2022.2089234. Epub 2022 Aug 24.
Neurodegenerative motor diseases (NMDs) have devastating effects on the lives of patients and their loved ones, in part due to the impact of neurologic abnormalities on speech, which significantly limits functional communication. Clinical speech researchers have thus spent decades investigating speech features in populations suffering from NMDs. Features of impaired articulatory function are of particular interest given their detrimental impact on intelligibility, their ability to encode a variety of distinct movement disorders, and their potential as diagnostic indicators of neurodegenerative diseases. The objectives of this scoping review were to identify (1) which components of articulation (i.e. coordination, consistency, speed, precision, and repetition rate) are the most represented in the acoustic literature on NMDs; (2) which acoustic articulatory features demonstrate the most potential for detecting speech motor dysfunction in NMDs; and (3) which articulatory components are the most impaired within each NMD.
This review examined literature published between 1976 and 2020. Studies were identified from six electronic databases using predefined key search terms. The first research objective was addressed using a frequency count of studies investigating each articulatory component, while the second and third objectives were addressed using meta-analyses.
Findings from 126 studies revealed a considerable emphasis on articulatory precision. Of the 24 features included in the meta-analyses, vowel dispersion/distance and stop gap duration exhibited the largest effects when comparing the NMD population to controls. The meta-analyses also revealed divergent patterns of articulatory performance across disease types, providing evidence of unique profiles of articulatory impairment.
This review illustrates the current state of the literature on acoustic articulatory features in NMDs. By highlighting the areas of need within each articulatory component and disease group, this work provides a foundation on which clinical researchers, speech scientists, neurologists, and computer science engineers can develop research questions that will both broaden and deepen the understanding of articulatory impairments in NMDs.
神经退行性运动疾病(NMDs)对患者及其亲人的生活造成了毁灭性的影响,部分原因是神经异常对言语的影响,这极大地限制了其功能交流。因此,临床言语研究人员几十年来一直在研究患有 NMD 人群的言语特征。由于发音器官功能障碍的特征对可理解性、对各种不同运动障碍的编码能力以及作为神经退行性疾病诊断指标的潜力具有不利影响,因此它们尤其受到关注。本综述的目的是确定:(1)在 NMD 的声学文献中,发音的哪些组成部分(即协调性、一致性、速度、精度和重复率)最具代表性;(2)哪些声学发音特征在 NMD 中最有可能检测到言语运动功能障碍;以及(3)每种 NMD 中哪些发音组件受损最严重。
本综述检查了 1976 年至 2020 年期间发表的文献。使用预定义的关键搜索词从六个电子数据库中识别研究。使用研究中每个发音组件的频率计数来解决第一个研究目标,而使用荟萃分析来解决第二个和第三个目标。
126 项研究的结果表明,人们对发音精度给予了相当大的重视。在纳入荟萃分析的 24 个特征中,元音分散/距离和闭塞间隙持续时间在将 NMD 人群与对照组进行比较时表现出最大的效果。荟萃分析还揭示了疾病类型之间发音表现的不同模式,为发音障碍的独特模式提供了证据。
本综述说明了 NMD 中声学发音特征文献的现状。通过突出每个发音组件和疾病组中的需求领域,这项工作为临床研究人员、言语科学家、神经学家和计算机科学工程师提供了一个基础,可以提出将拓宽和深化对 NMD 发音障碍的理解的研究问题。