Kieling Maiara Laís Mallmann, Finkelsztejn Alessandro, Konzen Viviana Regina, Dos Santos Vanessa Brzoskowski, Ayres Annelise, Klein Iasmin, Rothe-Neves Rui, Olchik Maira Rozenfeld
Post-Graduate Program in Medicine, Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Neurology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Front Neurol. 2023 Jun 13;14:1075736. doi: 10.3389/fneur.2023.1075736. eCollection 2023.
Dysarthria is one of the most frequent communication disorders in patients with Multiple Sclerosis (MS), with an estimated prevalence of around 50%. However, it is unclear if there is a relationship between dysarthria and the severity or duration of the disease.
Describe the speech pattern in MS, correlate with clinical data, and compare with controls.
A group of MS patients ( = 73) matched to healthy controls ( = 37) by sex and age. Individuals with neurological and/or systemic conditions that could interfere with speech were excluded. MS group clinical data were obtained through the analysis of medical records. The speech assessment consisted of auditory-perceptual and speech acoustic analysis, from recording the following speech tasks: phonation and breathing (sustained vowel/a/); prosody (sentences with different intonation patterns) and articulation (diadochokinesis; spontaneous speech; diphthong/iu/repeatedly).
In MS, 72.6% of the individuals presented mild dysarthria, with alterations in speech subsystems: phonation, breathing, resonance, and articulation. In the acoustic analysis, individuals with MS were significantly worse than the control group (CG) in the variables: standard deviation of the fundamental frequency ( = 0.001) and maximum phonation time ( = 0.041). In diadochokinesis, individuals with MS had a lower number of syllables, duration, and phonation time, but larger pauses per seconds, and in spontaneous speech, a high number of pauses were evidenced as compared to CG. Correlations were found between phonation time in spontaneous speech and the Expanded Disability Status Scale (EDSS) ( = - 0.238, = 0.043) and phonation ratio in spontaneous speech and EDSS ( = -0.265, = 0.023), which indicates a correlation between the number of pauses during spontaneous speech and the severity of the disease.
The speech profile in MS patients was mild dysarthria, with a decline in the phonatory, respiratory, resonant, and articulatory subsystems of speech, respectively, in order of prevalence. The increased number of pauses during speech and lower rates of phonation ratio can reflect the severity of MS.
构音障碍是多发性硬化症（MS）患者中最常见的交流障碍之一，估计患病率约为50%。然而，目前尚不清楚构音障碍与疾病的严重程度或病程之间是否存在关联。
描述MS患者的言语模式，与临床数据进行关联，并与对照组进行比较。
一组MS患者（n = 73），按性别和年龄与健康对照组（n = 37）匹配。排除患有可能干扰言语的神经和/或全身疾病的个体。通过分析病历获取MS组的临床数据。言语评估包括听觉感知和言语声学分析，通过记录以下言语任务：发声和呼吸（持续元音/a/）；韵律（具有不同语调模式的句子）和清晰度（快速交替运动；自发言语；双元音/iu/重复）。
在MS患者中，72.6%的个体表现为轻度构音障碍，言语子系统存在改变：发声、呼吸、共鸣和清晰度。在声学分析中，MS患者在以下变量方面明显比对照组（CG）差：基频标准差（p = 0.001）和最长发声时间（p = 0.041）。在快速交替运动中，MS患者的音节数量、时长和发声时间较少，但每秒的停顿较多，并且在自发言语中，与CG相比，停顿次数较多。发现自发言语中的发声时间与扩展残疾状态量表（EDSS）之间存在相关性（p = - 0.238，p = 0.043），以及自发言语中的发声率与EDSS之间存在相关性（p = -0.265，p = 0.023），这表明自发言语中的停顿次数与疾病严重程度之间存在相关性。
MS患者的言语特征为轻度构音障碍，言语的发声、呼吸、共鸣和清晰度子系统分别按患病率顺序下降。言语中停顿次数的增加和较低的发声率可反映MS的严重程度。
