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Nanjundaswamy RKB, Jayakumar T. Eclectic Voice Therapy Program in Hyperfunctional Voice Disorders: Evidence from Multidimensional Vocal Profiling. J Voice 2024:S0892-1997(24)00146-2. [PMID: 38806326 DOI: 10.1016/j.jvoice.2024.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Hyperfunctional voice disorder (HFVD) is a disorder of multifactorial origin. It can be speculated that an eclectic voice therapy program that uses combinatory approaches could bring about better efficiency of voice in these individuals. Nevertheless, very less attempts have been made to examine the efficacy of eclectic voice therapy using multidimensional voice outcome measures in the treatment of HFVD. METHOD Ten individuals with HFVD in the age range of 20-55years attended Comprehensive Voice Habilitation Program (CVHP), an eclectic voice therapy approach for 15 sessions spread across 3weeks. A stroboscopy examination was performed at the baseline and post-therapy to track the changes in laryngeal functions. Further, perceptual voice analysis, Acoustic Voice Quality Index (AVQI), and Voice Handicap Index in Kannada (VHI-K) were obtained at the baseline, post-therapy, and two follow-ups to report the therapy outcomes. Related samples Friedman's Two-way Analysis of Variance by Ranks and Wilcoxon Signed Rank Test were used to note the pre-post and follow-up changes in voice outcomes. RESULTS Stroboscopy findings revealed significant improvement in movement patterns of the vocal folds and a reduction in ventricular hyperadduction. Perceptual ratings and AVQI scores decreased in post-therapy and follow-up evaluations indicating a decrease in dysphonia severity over time. In addition, a significant decrease in VHI-K scores indicated the alleviation of self-perceived disability/handicap. CONCLUSION The current study provided preliminary evidence to support the efficacy of eclectic voice therapy in HFVD by documenting significant changes in the voice-related outcome measures.
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Affiliation(s)
| | - Thirunavukkarasu Jayakumar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
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Wang F, Yiu EML. Predicting Dysphonia by Measuring Surface Electromyographic Activity of the Supralaryngeal Muscles. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:740-752. [PMID: 38315579 DOI: 10.1044/2023_jslhr-23-00110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
PURPOSE This study set out to investigate whether individuals with dysphonia, as determined by either self-assessment or clinician-based auditory-perceptual judgment, exhibited differences in perilaryngeal muscle activities using surface electromyography (sEMG) during various phonatory tasks. Additionally, the study aimed to assess the effectiveness of sEMG in identifying dysphonic cases. METHOD A total of 77 adults (44 women, 33 men, Mage = 30.4 years) participated in this study, with dysphonic cases identified separately using either a 10-item Voice Handicap Index (VHI-10) or clinician-based auditory-perceptual voice quality (APVQ) evaluation. sEMG activities were measured from the areas of suprahyoid and sternocleidomastoid muscles during prolonged vowel /i/ phonations at different pitch and loudness levels. Normalized root-mean-square value against the maximal voluntary contraction (RMS %MVC) of the sEMG signals was obtained for each phonation and compared between subject groups and across phonatory tasks. Additionally, binary logistic regression analysis was performed to determine how the sEMG measures could predict the VHI-10-based or APVQ-based dysphonic cases. RESULTS Participants who scored above the criteria on either the VHI-10 (n = 29) or APVQ judgment (n = 17) exhibited significantly higher RMS %MVC in the right suprahyoid muscles compared to the corresponding control groups. Although the RMS %MVC value from the right suprahyoid muscles alone was not a significant predictor of self-evaluated dysphonic cases, a combination of the RMS %MVC values from both the right and left suprahyoid muscles significantly predicted APVQ-based dysphonic cases with a 69.66% fair level. CONCLUSIONS This study found that individuals with dysphonia, as determined by either self-assessment or APVQ judgment, displayed more imbalanced suprahyoid muscle activities in voice production compared to nondysphonic groups. The combination of the sEMG measures from both left and right suprahyoid muscles showed potential as a predictor of dysphonia with a fair level of confidence. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25112804.
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Affiliation(s)
- Feifan Wang
- School of Humanities, Shanghai Normal University, Shanghai, China
- Voice Research Laboratory, The University of Hong Kong, Pokfulam
| | - Edwin M-L Yiu
- Voice Research Laboratory, The University of Hong Kong, Pokfulam
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Belder CRS, Marshall CR, Jiang J, Mazzeo S, Chokesuwattanaskul A, Rohrer JD, Volkmer A, Hardy CJD, Warren JD. Primary progressive aphasia: six questions in search of an answer. J Neurol 2024; 271:1028-1046. [PMID: 37906327 PMCID: PMC10827918 DOI: 10.1007/s00415-023-12030-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 09/27/2023] [Indexed: 11/02/2023]
Abstract
Here, we review recent progress in the diagnosis and management of primary progressive aphasia-the language-led dementias. We pose six key unanswered questions that challenge current assumptions and highlight the unresolved difficulties that surround these diseases. How many syndromes of primary progressive aphasia are there-and is syndromic diagnosis even useful? Are these truly 'language-led' dementias? How can we diagnose (and track) primary progressive aphasia better? Can brain pathology be predicted in these diseases? What is their core pathophysiology? In addition, how can primary progressive aphasia best be treated? We propose that pathophysiological mechanisms linking proteinopathies to phenotypes may help resolve the clinical complexity of primary progressive aphasia, and may suggest novel diagnostic tools and markers and guide the deployment of effective therapies.
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Affiliation(s)
- Christopher R S Belder
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, University College London, London, UK
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Charles R Marshall
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jessica Jiang
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK
| | - Salvatore Mazzeo
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
| | - Anthipa Chokesuwattanaskul
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK
- Division of Neurology, Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Cognitive Clinical and Computational Neuroscience Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK
| | - Anna Volkmer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK
| | - Chris J D Hardy
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, 8 - 11 Queen Square, London, WC1N 3BG, UK.
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Freeburn JL, Baker J. Functional Speech and Voice Disorders: Approaches to Diagnosis and Treatment. Neurol Clin 2023; 41:635-646. [PMID: 37775195 DOI: 10.1016/j.ncl.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Historically, formal training for speech-language therapists (SLTs) in the area of functional speech and voice disorders (FSVD) has been limited, as has the body of empirical research in this content area. Recent efforts in the field have codified expert opinions on best practices for diagnosing and treating FSVD and have begun to demonstrate positive treatment outcomes. To provide comprehensive interventions for these complex conditions at the intersection of neurology, psychiatry, and other medical specialties, the SLT must not only build knowledge of diagnostic strategies and components of symptomatic treatment in FSVD but also embrace behavior change techniques and counseling strategies.
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Affiliation(s)
- Jennifer L Freeburn
- Department of Speech, Language, and Swallowing Disorders, Massachusetts General Hospital, Boston, MA, USA.
| | - Janet Baker
- Flinders University, Adelaide, Unit 111/3 Young Street, Randwick, NSW 2031, Australia
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Adriaansen A, Van Lierde K, Meerschman I, Claeys S, D'haeseleer E. The Occurrence of Laryngeal Pathologies in a Treatment-Seeking Pediatric Population. J Voice 2023:S0892-1997(23)00210-2. [PMID: 37524580 DOI: 10.1016/j.jvoice.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES The purpose of this study was to 1) describe the age- and sex-specific occurrence of laryngeal pathologies in a treatment-seeking pediatric population in the voice unit of Ghent University Hospital, Belgium, and 2) describe this population in terms of vocal parameters, vocal complaints, influencing factors, and treatment history and recommendation. STUDY DESIGN Retrospective, observational study. METHODS All patient records were analyzed for children (0-18 years) who consulted the ear, nose, and throat department of Ghent University Hospital for the first time between July 2015 and June 2021 with complaints of dysphonia. In total, 103 children (66 males, 37 females) with a mean age of 10.01 years (SD: 3.4, range 3.93-17.96) were included in this study. Laryngeal pathology was diagnosed using a flexible videolaryngo(strobo)scopy. The influence of age and sex on laryngeal etiology (organic/functional voice disorder) was examined using a Welch-modified t test and a Fisher's exact test, respectively. RESULTS Organic lesions were observed in 77.7% of the participants, with vocal fold nodules (VFNs) being the most common diagnosis (66.0%). A functional voice disorder was diagnosed in 22.3% of the children. Children with a functional voice disorder are significantly older than children with an organic voice disorder. There was no statistically significant difference between males and females in laryngeal etiology. Mean dysphonia severity index was -2.7 (SD: 3.2, range -9.3 to +3.7), the mean acoustic voice quality index 4.70 (SD: 1.5, range 2.35-8.27), and the mean pediatric voice handicap index 29.8 (SD: 13.6, range 5-60). The occurrence of vocal misuse was mentioned in 80.6% of the patient records. CONCLUSION Organic voice disorders, especially VFNs, are predominant in treatment-seeking children with dysphonia. Functional voice disorders become more common with increasing age during childhood. A disordered vocal quality, reduced vocal capabilities and reduced voice-related quality of life were found.
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Affiliation(s)
- Anke Adriaansen
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kristiane Van Lierde
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South-Africa.
| | - Iris Meerschman
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Sofie Claeys
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
| | - Evelien D'haeseleer
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Royal Conservatory Brussels, Musical Department, Brussels, Belgium.
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Budală DG, Lupu CI, Vasluianu RI, Ioanid N, Butnaru OM, Baciu ER. A Contemporary Review of Clinical Factors Involved in Speech-Perspectives from a Prosthodontist Point of View. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1322. [PMID: 37512133 PMCID: PMC10385982 DOI: 10.3390/medicina59071322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Learning to speak properly requires a fully formed brain, good eyesight, and a functioning auditory system. Defective phonation is the outcome of a failure in the development of any of the systems or components involved in speech production. Dentures with strong phonetic skills can be fabricated with the help of a dentist who has a firm grasp of speech production and phonetic characteristics. Every dentist strives to perfect their craft by perfecting the balance between the technical, cosmetic, and acoustic aspects of dentistry, or "phonetics". The ideal prosthesis for a patient is one that not only sounds good but also functions well mechanically and aesthetically. Words are spoken by using articulators that alter their size and form. Conclusions: Therefore, a prosthesis should be made in such a way that it does not interfere with the ability to communicate. As a result, a prosthodontist has to have a solid grasp of how speech is made and the numerous parts that go into it.
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Affiliation(s)
- Dana Gabriela Budală
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Costin Iulian Lupu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Roxana Ionela Vasluianu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Nicoleta Ioanid
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania
| | - Oana Maria Butnaru
- Department of Biophysics, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena-Raluca Baciu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
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Roze E, Hingray C, Degos B, Drapier S, Tyvaert L, Garcin B, Carle-Toulemonde G. [Functional neurological disorders: A clinical anthology]. L'ENCEPHALE 2023:S0013-7006(23)00084-2. [PMID: 37400338 DOI: 10.1016/j.encep.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
Functional neurological disorders have a broad phenotypic spectrum and include different clinical syndromes, which are sometimes associated to each other or appear consecutively over the course of the disease. This clinical anthology provides details on the specific and sensitive positive signs that are to be sought in the context of a suspected functional neurological disorder. Beside these positive elements leading to the diagnosis of functional neurological disorder, we should keep in mind the possibility of an associated organic disorder as the combination of both organic and functional disorders is a relatively frequent situation in clinical practice. Here we describe the clinical characteristics of different functional neurological syndromes: motor deficits, abnormal hyperkinetic and hypokinetic movements, voice or speech disorders, sensory disorders, and functional dissociative seizures. The clinical examination and the identification of positive signs play a critical role in the diagnosis of functional neurological disorder. Knowledge of the specific signs associated with each phenotype render possible to make an early diagnosis. For that matter, it contributes to the improvement of patient care management. It allows to a better engagement in an appropriate care pathway, which influence their prognosis. Highlighting and discussing positive signs with patients can also be an interesting step in the process of explaining the disease and its management.
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Affiliation(s)
- Emmanuel Roze
- Hôpital Salpêtrière, DMU neurosciences, Assistance publique des Hôpitaux de Paris, Paris, France; Inserm, CNRS, Institut du Cerveau, Sorbonne Université, Paris, France
| | | | - Bertrand Degos
- Hôpital Avicenne, hôpitaux universitaires de Paris-Seine Saint Denis (HUPSSD), Assistance publique des Hôpitaux de Paris, Sorbonne Paris Nord, réseau NS-PARK/FCRIN, Bobigny, France; Centre de recherche interdisciplinaire en biologie (CIRB), Collège de France, CNRS UMR7241/Inserm U1050, Université PSL, Paris, France
| | - Sophie Drapier
- Département de neurologie, CHU de Rennes, CIC Inserm 1414, Rennes, France
| | - Louise Tyvaert
- Centre de psychothérapie du CHRU de Nancy, Nancy, France
| | - Béatrice Garcin
- Inserm, CNRS, Institut du Cerveau, Sorbonne Université, Paris, France; Hôpital Avicenne, hôpitaux universitaires de Paris-Seine Saint Denis (HUPSSD), Assistance publique des Hôpitaux de Paris, Sorbonne Paris Nord, réseau NS-PARK/FCRIN, Bobigny, France
| | - Guilhem Carle-Toulemonde
- Cabinet de psychosomatique et stimulation magnétique transcrânienne, clinique Saint-Exupery, 29, rue Émile-Lecrivain, 31400 Toulouse, France.
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Goldstein AN, Paredes-Echeverri S, Finkelstein SA, Guthrie AJ, Perez DL, Freeburn JL. Speech and language therapy: A treatment case series of 20 patients with functional speech disorder. NeuroRehabilitation 2023; 53:227-238. [PMID: 37599546 DOI: 10.3233/nre-220182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND While expert consensus recommendations support the use of speech and language therapy (SLT) for patients with functional speech disorder (FND-speech), there are limited published data on clinical outcomes. OBJECTIVE To retrospectively report the treatment outcomes and clinical characteristics of patients with FND-speech that attended outpatient SLT as part of a multidisciplinary program for functional neurological disorder (FND). METHODS In this case series, we included adult patients with FND-speech that consecutively participated in outpatient SLT at our institution between October 2014 and September 2021. Baseline demographic and neuropsychiatric characteristics were extracted from the medical records, along with data on FND-speech phenotypes, number of treatment sessions received, and clinician-determined outcomes. Only descriptive statistics were used to report findings. RESULTS Twenty patients met inclusion criteria; ages ranged from 21-77, with a mean of 51.6±16.2 years. 85% of the cohort presented with mixed FND-speech symptoms. Patients attended a range of 2-37 visits, with an average of 9.2±8.0 visits over 4.4±3.5 months. At the last treatment session, 3 patients were asymptomatic, 15 had improved, and 2 had not improved; 8 individuals that improved received video telehealth interventions. CONCLUSION This case series lends additional support for outpatient SLT in the assessment and management of individuals with FND-speech, and may help clarify patient and provider treatment expectations. Additional prospective research is needed to investigate baseline predictors of treatment response and further define the optimal frequency, intensity, duration, and clinical setting for SLT delivery in this population.
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Affiliation(s)
- Alexa N Goldstein
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sara Paredes-Echeverri
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sara A Finkelstein
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrew J Guthrie
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David L Perez
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer L Freeburn
- Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Speech, Language, and Swallowing Disorders, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Wang J, Xu H, Peng X, Liu J, He C. Pathological voice classification based on multi-domain features and deep hierarchical extreme learning machine. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:423. [PMID: 36732280 DOI: 10.1121/10.0016869] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/29/2022] [Indexed: 06/18/2023]
Abstract
The intelligent data-driven screening of pathological voice signals is a non-invasive and real-time tool for computer-aided diagnosis that has attracted increasing attention from researchers and clinicians. In this paper, the authors propose multi-domain features and the hierarchical extreme learning machine (H-ELM) for the automatic identification of voice disorders. A sufficient number of sensitive features are first extracted from the original voice signal through multi-domain feature extraction (i.e., features of the time domain and the sample entropy based on ensemble empirical mode decomposition and gammatone frequency cepstral coefficients). To eliminate redundancy in high-dimensional features, neighborhood component analysis is then applied to filter out sensitive features from the high-dimensional feature vectors to improve the efficiency of network training and reduce overfitting. The sensitive features thus obtained are then used to train the H-ELM for pathological voice classification. The results of the experiments showed that the sensitivity, specificity, F1 score, and accuracy of the H-ELM were 99.37%, 98.61%, 99.37%, and 98.99%, respectively. Therefore, the proposed method is feasible for the initial classification of pathological voice signals.
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Affiliation(s)
- Junlang Wang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Huoyao Xu
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Xiangyu Peng
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Jie Liu
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Chaoming He
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
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Mishra A, Pandey S. Functional Neurological Disorders: Clinical Spectrum, Diagnosis, and Treatment. Neurologist 2022; 27:276-289. [PMID: 35858632 DOI: 10.1097/nrl.0000000000000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Functional neurological disorders (FNDs) are common but often misdiagnosed. REVIEW SUMMARY The incidence of FNDs is between 4 and 12 per 100,000, comparable to multiple sclerosis and amyotrophic lateral sclerosis, and it is the second most common diagnosis in neurology clinics. Some clues in the history are sudden onset, intermittent time course, variability of manifestation over time, childhood trauma, and history of other somatic symptoms. Anxiety and depression are common, but not necessarily more than in the general population. Although there are no tests currently capable of demonstrating whether symptoms are willfully produced, there may not be a clear categorical difference between voluntary and involuntary symptoms. The prognosis of an FND is linked to early diagnosis and symptom duration, but unfortunately, the majority of the patients are diagnosed after considerable delays. CONCLUSIONS A positive diagnosis of FNDs can be made on the basis of history and neurological signs without reliance on psychological stressors. Past sensitizing events and neurobiological abnormalities contribute to the pathogenesis of FNDs. Physical rehabilitation and psychological interventions alone or in combination are helpful in the treatment.
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Affiliation(s)
- Anumeha Mishra
- Department of Neurology, Govind Ballabh Pant Postgraduate institute of medical education and research; New Delhi, India
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Baranets IV, Pakhomova NG, Okhrimenko IМ, Hubar OH, Padun VS, Drozd LV, Holovanova IA. COMPREHENSIVE APPROACH IN CORRECTIONAL WORK WITH OLDER PRESCHOOL CHILDREN WITH SPEECH DISORDERS. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1471-1476. [PMID: 35907218 DOI: 10.36740/wlek202206108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: To investigate the effectiveness of comprehensive approach in correctional work with older preschool children with speech disorders. PATIENTS AND METHODS Materials and methods: The research was conducted in 2018-2022. The research involved 250 children aged 5-7 years, who were divided into two groups. The experimental group consisted of 150 children with motor alalia (57 girls and 93 boys). The control group consisted of 100 children without speech disorders (48 girls and 52 boys). RESULTS Results: The analysis of outpatient cards of children with speech disorders of various aetiology was carried out. The main results of a comprehensive medical as well as psychological and pedagogical examination of children with motor alalia are highlighted. The result of the research revealed that organic lesion of the brain affects not only the clinical presentation of nonverbal symptoms, but also psychospeech development, in particular. CONCLUSION Conclusions: The expediency of using a comprehensive diagnostic methodology was proved, where the medical component consisted in studying the peculiarities of bioelectrical activity of the brain on electroencephalography, which reflects the process of its morphological maturation in ontogenesis.
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Affiliation(s)
- Inna V Baranets
- POLTAVA V. G. KOROLENKO NATIONAL PEDAGOGICAL UNIVERSITY, POLTAVA, UKRAINE
| | | | | | - Olha H Hubar
- POLTAVA V. G. KOROLENKO NATIONAL PEDAGOGICAL UNIVERSITY, POLTAVA, UKRAINE
| | - Valentyna S Padun
- POLTAVA V. G. KOROLENKO NATIONAL PEDAGOGICAL UNIVERSITY, POLTAVA, UKRAINE
| | - Larysa V Drozd
- POLTAVA V. G. KOROLENKO NATIONAL PEDAGOGICAL UNIVERSITY, POLTAVA, UKRAINE
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Baker J, Barnett C, Cavalli L, Dietrich M, Dixon L, Duffy JR, Elias A, Fraser DE, Freeburn JL, Gregory C, McKenzie K, Miller N, Patterson J, Roth C, Roy N, Short J, Utianski R, van Mersbergen M, Vertigan A, Carson A, Stone J, McWhirter L. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. J Neurol Neurosurg Psychiatry 2021; 92:1112-1125. [PMID: 34210802 DOI: 10.1136/jnnp-2021-326767] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/25/2021] [Indexed: 12/14/2022]
Abstract
Communication problems (eg, dysphonia, dysfluency and language and articulation disorders), swallowing disorders (dysphagia and globus), cough and upper airway symptoms, resulting from functional neurological disorder (FND), are commonly encountered by speech and language professionals. However, there are few descriptions in the literature of the most effective practical management approaches. This consensus document aims to provide recommendations for assessment and intervention that are relevant to both adults and young people. An international panel of speech and language professionals with expertise in FND were approached to take part. Participants responded individually by email to a set of key questions regarding best practice for assessment and interventions. Next, a video conference was held in which participants discussed and debated the answers to these key questions, aiming to achieve consensus on each issue. Drafts of the collated consensus recommendations were circulated until consensus was achieved. FND should be diagnosed on the basis of positive clinical features. Speech and language therapy for FND should address illness beliefs, self-directed attention and abnormal movement patterns through a process of education, symptomatic treatment and cognitive behavioural therapy within a supportive therapeutic environment. We provide specific examples of these strategies for different symptoms. Speech and language professionals have a key role in the management of people with communication and related symptoms of FND. It is intended that these expert recommendations serve as both a practical toolkit and a starting point for further research into evidence-based treatments.
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Affiliation(s)
- Janet Baker
- Speech Pathology, Flinders University, Adelaide, South Australia, Australia
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Caroline Barnett
- South Warwickshire NHS Foundation Trust, Warwick, Warwickshire, UK
| | - Lesley Cavalli
- Department of Speech & Language Therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, London, UK
- Division of Psychology and Language Sciences, University College London, London, London, UK
| | - Maria Dietrich
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Lorna Dixon
- National Hospital for Neurology and Neurosurgery, London, London, UK
| | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Annie Elias
- Speech and Language Therapy, Kent Community Health NHS Foundation Trust, Ashford, Kent, UK
| | - Diane E Fraser
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, Edinburgh, UK
| | | | | | | | - Nick Miller
- Speech Language Sciences, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Jo Patterson
- University of Liverpool, Liverpool, Merseyside, UK
| | - Carole Roth
- Speech Pathology Division, Naval Medical Center San Diego, San Diego, California, USA
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah, USA
- Division of Otolaryngology - Head and Neck Surgery (Adjunct), The University of Utah, Salt Lake City, Utah, USA
| | | | - Rene Utianski
- Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Speech Pathology and Neurology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, Institute for Intelligent Systems, The University of Memphis, Memphis, Tennessee, USA
| | - Anne Vertigan
- Speech Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia
- Centre for Healthy Lungs, Hunter Medical Research Institute; School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Alan Carson
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Edinburgh, UK
| | - Jon Stone
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Edinburgh, UK
| | - Laura McWhirter
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Edinburgh, UK
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Abstract
Background: Cranial functional movement disorders (CFMDs) affect the face, eyes, jaw, tongue, and palate. Objectives: We aimed to examine our large series of functional movement disorders (FMDs) patients where the cranial muscles were involved to determine their phenomenology and other clinical features. Methods: This is a chart review of 26 patients who presented with CFMDs. Results: There were 16 (61.53%) females and 10 (38.46%) male patients. The mean ± [standard deviation (SD)] age at the presentation was 33.96 ± 16.94 (Range: 11–83) years. The duration of symptoms ranged from one day to 6 years (Mean ±SD: 402.03 ±534.97 days). According to the Fahn-Williams criteria, CFMDs were documented in 24 patients and clinically established in two patients. The facial [38.46% (10/26)] involvement was the most common in our CFMDs patients. Oromandibular [19.23% (5/26)], ocular [15.38% (4/26)], lingual [15.38% (4/26)], speech [15.38% (4/26)] and palatal [(3.85; 1/26)] involvement was also seen. 10 (38.46%) patients also had associated FMD in the extracranial regions. Precipitating factors were present in 84.61% (22/26) of the patients and associated illnesses were present in 42.30% (11/26) of the patients. At 3 months follow-up, 9 (34.61%) patients had improved, 13 (50%) had partial improvement and 4 (15.38%) had no improvement. Conclusions: There was a slight female preponderance in our patients. CFMDs are more likely to involve facial muscles. Associated medical conditions like neuropsychiatric disturbances and headaches are frequently present in CFMDs patients. Early clinical diagnosis will avoid unnecessary investigations and allow the patient to seek the right treatment.
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Cognitive Complaints in Motor Functional Neurological (Conversion) Disorders: A Focused Review and Clinical Perspective. Cogn Behav Neurol 2020; 33:77-89. [DOI: 10.1097/wnn.0000000000000218] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Psychogene Aphonie – erfolgreiche multiprofessionelle Behandlung eines 13-jährigen Mädchens – ein Kurzbeitrag aus der Praxis. Prax Kinderpsychol Kinderpsychiatr 2020; 69:82-87. [DOI: 10.13109/prkk.2020.69.1.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kim MK, Kantarcigil C, Kim B, Baruah RK, Maity S, Park Y, Kim K, Lee S, Malandraki JB, Avlani S, Smith A, Sen S, Alam MA, Malandraki G, Lee CH. Flexible submental sensor patch with remote monitoring controls for management of oropharyngeal swallowing disorders. SCIENCE ADVANCES 2019; 5:eaay3210. [PMID: 31853500 PMCID: PMC6910838 DOI: 10.1126/sciadv.aay3210] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 10/10/2019] [Indexed: 05/05/2023]
Abstract
Successful rehabilitation of oropharyngeal swallowing disorders (i.e., dysphagia) requires frequent performance of head/neck exercises that primarily rely on expensive biofeedback devices, often only available in large medical centers. This directly affects treatment compliance and outcomes, and highlights the need to develop a portable and inexpensive remote monitoring system for the telerehabilitation of dysphagia. Here, we present the development and preliminarily validation of a skin-mountable sensor patch that can fit on the curvature of the submental (under the chin) area noninvasively and provide simultaneous remote monitoring of muscle activity and laryngeal movement during swallowing tasks and maneuvers. This sensor patch incorporates an optimal design that allows for the accurate recording of submental muscle activity during swallowing and is characterized by ease of use, accessibility, reusability, and cost-effectiveness. Preliminary studies on a patient with Parkinson's disease and dysphagia, and on a healthy control participant demonstrate the feasibility and effectiveness of this system.
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Affiliation(s)
- Min Ku Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Cagla Kantarcigil
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Bongjoong Kim
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Ratul Kumar Baruah
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
- Department of Electronics and Communication Engineering, Tezpur University, Assam 784028, India
| | - Shovan Maity
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Yeonsoo Park
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Kyunghun Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Seungjun Lee
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Jaime Bauer Malandraki
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Shitij Avlani
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Anne Smith
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Shreyas Sen
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Muhammad A. Alam
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Georgia Malandraki
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907, USA
- Corresponding author. (G.M.); (C.H.L.)
| | - Chi Hwan Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907, USA
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA
- Corresponding author. (G.M.); (C.H.L.)
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Barnett C, Armes J, Smith C. Speech, language and swallowing impairments in functional neurological disorder: a scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:309-320. [PMID: 30592118 DOI: 10.1111/1460-6984.12448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Functional neurological disorder (FND) is common across healthcare settings. The Diagnostic and Statistical Manual of Mental Disorders states that speech and swallowing symptoms can be present in FND. Despite this, there is a dearth of guidelines for speech and language therapists (SLTs) for this client group. AIMS To address the following question in order to identify gaps for further research: What is known about speech, language and swallowing symptoms in patients with FND? METHODS & PROCEDURES A scoping review was conducted. Six healthcare databases were searched for relevant literature: CINAHL PLUS, MEDLINE, ProQuest Nursing and Allied Health Professionals, Science Citation Index, Scopus, and PsychINFO. The following symptoms were excluded from the review: dysphonia, globus pharyngeus, dysfluency, foreign accent syndrome and oesophageal dysphagia. MAIN CONTRIBUTION A total of 63 papers were included in the final review; they ranged in date from 1953 to 2018. Case studies were the most frequent research method (n = 23, 37%). 'Psychogenic' was the term used most frequently (n = 24, 38%), followed by 'functional' (n = 21, 33%). Speech symptoms were reported most frequently (n = 41, 65%), followed by language impairments (n = 35, 56%) and dysphagia (n = 13, 21%). Only 11 publications comment on the involvement of SLTs. Eight papers report direct speech and language therapy input; however, none studied the effectiveness of speech and language therapy. CONCLUSIONS & IMPLICATIONS Speech, language and swallowing symptoms do occur in patients with FND, yet it is a highly under-researched area. Further research is required to create a set of positive diagnostic criteria, gather accurate data on numbers of patients with FND and speech, language or swallowing symptoms, and to evaluate the effectiveness of direct speech and language therapy involvement.
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Affiliation(s)
- Caroline Barnett
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jean Armes
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
| | - Christina Smith
- Department of Language and Cognition, University College London, London, UK
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