Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Victoria, Australia.
Redenlab, Melbourne, Victoria, Australia.
J Clin Exp Neuropsychol. 2023 Aug;45(5):452-463. doi: 10.1080/13803395.2023.2249172. Epub 2023 Sep 1.
Verbal fluency tests (VFTs) are widely used to assess cognitive-linguistic performance in neurological diseases. However, the influence of dysarthria on performance in tests requiring oral responses is unclear in ataxia and Parkinson's disease.
To determine the impact of dysarthria on VFT performance and evaluate the validity and reliability of alternative methods for analyzing VFT data.
Trained raters evaluated dysarthria using VFT recordings in people with ataxia (N = 61) or Parkinson's disease (PD; N = 69). Total Correct Items scores and qualitative parameters (intrusions, ambiguous verbalizations, perseverations, and interjections) were compared across semantic, phonemic, and alternating fluency tasks. Disease severity was considered as a covariate in the regression model.
VFT dysarthria ratings correlated with the benchmark (ground truth) dysarthria scores derived from a monologue. Ambiguous responses resulting from unclear speech impeded the rater's ability to determine if a response was correct. Regression analysis indicated that more severe dysarthria ratings predicted diminished scores in all three tasks (semantic fluency, phonemic fluency and alternating fluency) in the ataxia group. The contribution of disease severity to semantic, phonemic and alternating fluency was reduced substantially in the ataxia group after accounting for dysarthria severity in the model in both groups.
Dysarthria severity can be estimated based on speech samples derived from VFT. Dysarthria can lead to lower total correct items and is associated with more ambiguous verbalizations in VFT. Dysarthria severity should be considered when interpreting VFT performance in common movement disorders.
言语流畅性测试（VFT）广泛用于评估神经疾病中的认知语言表现。然而，在共济失调和帕金森病中，言语障碍对需要口头反应的测试表现的影响尚不清楚。
确定言语障碍对 VFT 表现的影响，并评估分析 VFT 数据的替代方法的有效性和可靠性。
经过培训的评估员使用 VFT 记录评估了共济失调患者（N=61）或帕金森病患者（PD；N=69）的言语障碍。在语义、语音和交替流畅性任务中，比较了总正确项目分数和定性参数（侵入、含糊言语、持续言语和插话）。疾病严重程度被视为回归模型中的协变量。
VFT 言语障碍评分与来自独白的基准（真实）言语障碍评分相关。由于言语不清导致的含糊反应阻碍了评估者确定反应是否正确的能力。回归分析表明，在共济失调组中，更严重的言语障碍评分预测了所有三个任务（语义流畅性、语音流畅性和交替流畅性）的得分下降。在两组中，在模型中考虑言语障碍严重程度后，疾病严重程度对语义、语音和交替流畅性的贡献大大降低。
可以根据 VFT 中得出的语音样本来估计言语障碍的严重程度。言语障碍会导致总正确项目减少，并且与 VFT 中更多的含糊言语有关。在解释常见运动障碍的 VFT 表现时，应考虑言语障碍的严重程度。
