Lowit Anja, Xing Kaiyue, Shanmugarajah D Priya, Foster Emma, Duty Suzanna, Young David, Stanier Jan, Kobylecki Christopher, Hadjivassiliou Marios
University of Strathclyde, Glasgow, UK.
Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, G1 1QE, UK.
Cerebellum. 2025 Aug 14;24(5):142. doi: 10.1007/s12311-025-01895-y.
Speech problems are an early feature of Multiple System Atrophy (MSA). They can lead to social withdrawal and have significant impact on people's quality of life. There is a considerable lack of clinical trials and clinicians lack guidance on how best to support this population. This project aimed to establish the feasibility and acceptability of a novel treatment approach, ClearSpeechTogether, in patients with the cerebellar variant of MSA (MSA-C), and to pilot an RCT comparing this treatment to standard speech and language therapy (SLT) treatment (ST). We recruited 24 patients with clinically probable MSA-C and dysarthria who were randomised to either treatment arm. Full data were available for 9 participants for ST, and 11 for ClearSpeechTogether. Both interventions lasted 6 weeks, ST offered 1 h of individual therapy a week, ClearSpeechTogether provided four individual therapy sessions over two weeks, followed by four weeks of daily, patient led group practice. Assessment and intervention were provided online via videoconferencing software. Data collection focused on feasibility, acceptability and signal of efficacy. Recruitment, conversion and attrition rates were within or close to target, and neither participants nor clinicians highlighted any acceptability issues. Communication outcomes were mixed, with biggest gains made in communication confidence and participation across both groups. Rapid decline in overall health status appeared to have impacted results. Results were generally positive and support the implementation of larger follow up trials. The study also demonstrated that people with MSA-C can benefit from speech therapy even at more severe stages of their disease progression.
言语问题是多系统萎缩（MSA）的早期特征。它们会导致社交退缩，并对人们的生活质量产生重大影响。目前临床试验相当匮乏，临床医生也缺乏关于如何最好地支持这一群体的指导。本项目旨在确定一种新型治疗方法ClearSpeechTogether在小脑型多系统萎缩（MSA-C）患者中的可行性和可接受性，并开展一项随机对照试验（RCT），将这种治疗方法与标准言语和语言治疗（SLT）进行比较。我们招募了24名临床诊断为可能患有MSA-C且存在构音障碍的患者，并将他们随机分配到两个治疗组。有9名参与者完成了标准言语和语言治疗（ST）的全部数据，11名参与者完成了ClearSpeechTogether治疗的全部数据。两种干预均持续6周，标准言语和语言治疗每周提供1小时的个体治疗，ClearSpeechTogether在两周内提供4次个体治疗，随后四周为每日由患者主导的小组练习。评估和干预通过视频会议软件在线进行。数据收集集中在可行性、可接受性和疗效信号方面。招募率、转化率和损耗率均在目标范围内或接近目标，参与者和临床医生均未强调任何可接受性问题。沟通结果喜忧参半，两组在沟通信心和参与度方面都有最大的提升。总体健康状况的快速下降似乎影响了结果。结果总体呈阳性，支持开展更大规模的后续试验。该研究还表明，即使在疾病进展的更严重阶段，MSA-C患者也能从言语治疗中受益。
