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运动性言语障碍对进行性核上性麻痹吞咽障碍表现的影响。

Influences of motor speech impairments on the presentation of dysphagia in progressive supranuclear palsy.

机构信息

Department of Neurology, Mayo Clinic, Rochester, MN, USA.

Department of Otolaryngology, Navy Medicine Readiness and Training Command, San Diego, CA, USA, and.

出版信息

Int J Speech Lang Pathol. 2024 Apr;26(2):278-288. doi: 10.1080/17549507.2023.2221407. Epub 2023 Jun 19.

Abstract

PURPOSE

The purpose of this study was to examine whether differences in motor speech features are related to presentations of dysphagia in progressive supranuclear palsy (PSP) given the sparsity of data examining this relationship.

METHOD

Motor speech disorder (MSD) type and severity along with specific swallowing variables were analysed to obtain insights among these relationships in 73 participants with PSP.

RESULT

Results revealed that most participants (93%) had dysarthria, with 19% having co-occurring apraxia of speech (AOS). Greater MSD severity was related to more severe pharyngeal phase impairments (95% CI [-0.917, -0.146],  = 0.008). While certain motor speech and swallowing scores varied minimally across participants, incremental changes in these functions were more likely to occur when specific MSD features were present. A trend for participants with spastic dysarthria and/or AOS to exhibit more severe dysphagia was observed.

CONCLUSION

This study points to the need for thorough neurological evaluation, with inclusion of speech-language pathology consultation, in the standard of care for PSP. Comprehensive assessment of both motor speech and swallowing functions can inform differential diagnosis and assist patients/families facing decisions regarding modalities for communication and nutrition in the setting of neurodegenerative disease. Additional research may yield greater insights about relevant assessment and intervention considerations in PSP.

摘要

目的

本研究旨在探讨运动言语特征的差异是否与进行性核上性麻痹(PSP)中的吞咽障碍表现有关,鉴于目前关于这种关系的数据较少。

方法

对 73 名 PSP 患者的运动言语障碍(MSD)类型和严重程度以及特定的吞咽变量进行了分析,以获得这些关系的深入了解。

结果

结果表明,大多数参与者(93%)有构音障碍,其中 19%同时存在言语失用(AOS)。MSD 严重程度越高,咽部阶段损伤越严重(95%CI[-0.917,-0.146],=0.008)。虽然某些运动言语和吞咽评分在参与者之间变化很小,但当存在特定的 MSD 特征时,这些功能更有可能出现递增变化。观察到痉挛性构音障碍和/或 AOS 的参与者更有可能表现出严重的吞咽困难。

结论

本研究表明,在 PSP 的标准治疗中需要进行全面的神经学评估,包括言语病理学咨询。对运动言语和吞咽功能的全面评估可以为鉴别诊断提供信息,并为面临神经退行性疾病中沟通和营养方式选择的患者/家庭提供帮助。进一步的研究可能会为 PSP 中的相关评估和干预考虑提供更多的见解。

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本文引用的文献

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The Apraxia of Speech Rating Scale: Reliability, Validity, and Utility.言语失用症评定量表:信度、效度和实用性。
Am J Speech Lang Pathol. 2023 Mar 9;32(2):469-491. doi: 10.1044/2022_AJSLP-22-00148. Epub 2023 Jan 11.
4
Motor Speech Disorders and Communication Limitations in Progressive Supranuclear Palsy.进行性核上性麻痹中的运动性言语障碍和交流受限。
Am J Speech Lang Pathol. 2021 Jun 18;30(3S):1361-1372. doi: 10.1044/2020_AJSLP-20-00126. Epub 2021 Mar 9.
5
Dysphagia in Progressive Supranuclear Palsy.进行性核上性麻痹中的吞咽困难
Dysphagia. 2020 Aug;35(4):667-676. doi: 10.1007/s00455-019-10073-2. Epub 2019 Nov 1.
6
An Evaluation of the Progressive Supranuclear Palsy Speech/Language Variant.进行性核上性麻痹言语/语言变异型的评估
Mov Disord Clin Pract. 2019 May 29;6(6):452-461. doi: 10.1002/mdc3.12796. eCollection 2019 Jul.

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