疑似四重复 Tau 病患者的运动言语障碍的声学和运动学评估。
Acoustic and Kinematic Assessment of Motor Speech Impairment in Patients With Suspected Four-Repeat Tauopathies.
机构信息
Department of Speech, Language & Hearing Sciences, Boston University, MA.
Program in Speech and Hearing Bioscience and Technology, Harvard University, Cambridge, MA.
出版信息
J Speech Lang Hear Res. 2022 Nov 17;65(11):4112-4132. doi: 10.1044/2022_JSLHR-22-00177. Epub 2022 Oct 28.
PURPOSE
The aim of this study was to use acoustic and kinematic speech measures to characterize type of motor speech impairment-apraxia of speech (AOS) versus dysarthria-in individuals with four-repeat tauopathy (4RT)-associated syndromes, including nonfluent variant primary progressive aphasia (nfvPPA), primary progressive AOS (PPAOS), corticobasal syndrome (CBS), and progressive supranuclear palsy syndrome (PSPs).
METHOD
Twenty patient participants were recruited and stratified into two groups: (a) a motor-speech-impaired group of individuals with nfvPPA, PPAOS, CBS, or PSPs and suspected 4RT pathology ("MSI+") and (b) a non-motor-speech-impaired group of individuals with logopenic variant primary progressive aphasia ("MSI-"). Ten healthy, age-matched controls also participated in the study. Participants completed a battery of speech tasks, and 15 acoustic and kinematic speech measures were derived. Quantitative speech measures were grouped into feature categories ("AOS features," "dysarthria features," "shared features"). In addition to quantitative speech measures, two certified speech-language pathologists made independent, blinded auditory-perceptual ratings of motor speech impairment. A principal component analysis (PCA) was conducted to investigate the relative contributions of quantitative features.
RESULTS
Quantitative speech measures were generally concordant with independent clinician ratings of motor speech impairment severity. Hypothesis-driven groupings of quantitative measures differentiated predominantly apraxic from predominantly dysarthric presentations within the MSI+ group. PCA results provided additional evidence for differential profiles of motor speech impairment in the MSI+ group; heterogeneity across individuals is explained in large part by varying levels of overall severity-captured by the shared feature variable group-and degree of apraxia severity, as measured by the AOS feature variable group.
CONCLUSIONS
Quantitative features reveal heterogeneity of MSI in the 4RT group in terms of both overall severity and subtype of MSI. Results suggest the potential for acoustic and kinematic speech assessment methods to inform characterization of motor speech impairment in 4RT-associated syndromes.
SUPPLEMENTAL MATERIAL
目的
本研究旨在使用声学和运动学语音测量来描述运动性言语障碍——构音障碍（dysarthria）与口颜面失用症（apraxia of speech，AOS）——在四重复tau 蛋白病（4RT）相关综合征个体中的类型，包括非流利型原发性进行性失语（nonfluent variant primary progressive aphasia，nfvPPA）、原发性进行性 AOS（PPAOS）、皮质基底节综合征（corticobasal syndrome，CBS）和进行性核上性麻痹综合征（progressive supranuclear palsy syndrome，PSPs）。
方法
招募了 20 名患者参与者，并将其分为两组：（a）运动性言语障碍组，包括 nfvPPA、PPAOS、CBS 或 PSPs 且疑似存在 4RT 病理学的个体（“MSI+”）；和（b）非运动性言语障碍组，包括 logopenic 变异型原发性进行性失语（“MSI-”）的个体。10 名健康、年龄匹配的对照者也参与了研究。参与者完成了一系列语音任务，并得出了 15 项声学和运动学语音测量值。定量语音测量值被分为特征类别（“AOS 特征”“dysarthria 特征”“共享特征”）。除了定量语音测量值外，两名经认证的言语语言病理学家还对运动性言语障碍进行了独立的、盲目的听觉感知评估。进行了主成分分析（PCA）以调查定量特征的相对贡献。
结果
定量语音测量值通常与独立临床医生对运动性言语障碍严重程度的评估一致。针对定量测量值的假设驱动分组在 MSI+组内区分了主要为口颜面失用症的表现和主要为构音障碍的表现。PCA 结果为 MSI+组内运动性言语障碍的不同表现模式提供了额外的证据；个体之间的异质性在很大程度上可以由共同特征变量组中总体严重程度（由共享特征变量组捕获）和口颜面失用症严重程度（由 AOS 特征变量组测量）来解释。
结论
定量特征表明，4RT 组的 MSI 存在异质性，表现在整体严重程度和 MSI 亚型方面。结果表明，声学和运动学语音评估方法有可能为 4RT 相关综合征中的运动性言语障碍特征提供信息。
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