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Kenyon KH, Strik M, Noffs G, Morgan A, Kolbe S, Harding IH, Vogel AP, Boonstra FMC, van der Walt A. Volumetric and diffusion MRI abnormalities associated with dysarthria in multiple sclerosis. Brain Commun 2024; 6:fcae177. [PMID: 38846538 PMCID: PMC11154149 DOI: 10.1093/braincomms/fcae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/16/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Up to half of all people with multiple sclerosis experience communication difficulties due to dysarthria, a disorder that impacts the motor aspects of speech production. Dysarthria in multiple sclerosis is linked to cerebellar dysfunction, disease severity and lesion load, but the neuroanatomical substrates of these symptoms remain unclear. In this study, 52 participants with multiple sclerosis and 14 age- and sex-matched healthy controls underwent structural and diffusion MRI, clinical assessment of disease severity and cerebellar dysfunction and a battery of motor speech tasks. Assessments of regional brain volume and white matter integrity, and their relationships with clinical and speech measures, were undertaken. White matter tracts of interest included the interhemispheric sensorimotor tract, cerebello-thalamo-cortical tract and arcuate fasciculus, based on their roles in motor and speech behaviours. Volumetric analyses were targeted to Broca's area, Wernicke's area, the corpus callosum, thalamus and cerebellum. Our results indicated that multiple sclerosis participants scored worse on all motor speech tasks. Fixel-based diffusion MRI analyses showed significant evidence of white matter tract atrophy in each tract of interest. Correlational analyses further indicated that higher speech naturalness-a perceptual measure of dysarthria-and lower reading rate were associated with axonal damage in the interhemispheric sensorimotor tract and left arcuate fasciculus in people with multiple sclerosis. Axonal damage in all tracts of interest also correlated with clinical scales sensitive to cerebellar dysfunction. Participants with multiple sclerosis had lower volumes of the thalamus and corpus callosum compared with controls, although no brain volumetrics correlated with measures of dysarthria. These findings indicate that axonal damage, particularly when measured using diffusion metrics, underpin dysarthria in multiple sclerosis.
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Affiliation(s)
- Katherine H Kenyon
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC 3052, Australia
| | - Myrte Strik
- Spinoza Centre for Neuroimaging, Netherlands Institute for Neuroscience, Royal Academy for Arts and Sciences, KNAW, Amsterdam 1105 BK, The Netherlands
- Melbourne Brain Centre Imaging Unit, Department of Radiology, University of Melbourne, Parkville, VIC 3052, Australia
| | - Gustavo Noffs
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC 3052, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC 3052, Australia
- Redenlab Inc, Melbourne, VIC 3000, Australia
| | - Angela Morgan
- Murdoch Children’s Research Institute, Genomic Medicine, Speech and Language Group, Parkville 3052, Australia
- Department of Speech Pathology and Audiology, University of Melbourne, Parkville 3052, Australia
| | - Scott Kolbe
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Ian H Harding
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Adam P Vogel
- Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC 3052, Australia
- Melbourne Brain Centre Imaging Unit, Department of Radiology, University of Melbourne, Parkville, VIC 3052, Australia
- Redenlab Inc, Melbourne, VIC 3000, Australia
- Division of Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany
- Center for Neurology, University Hospital Tübingen, Tübingen 72076, Germany
- The Bionics Institute, East Melbourne, VIC 3002, Australia
| | - Frederique M C Boonstra
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Anneke van der Walt
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
- Spinoza Centre for Neuroimaging, Netherlands Institute for Neuroscience, Royal Academy for Arts and Sciences, KNAW, Amsterdam 1105 BK, The Netherlands
- The Bionics Institute, East Melbourne, VIC 3002, Australia
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Erensoy İ, Yaşar Ö, Şahvelioğlu Ö, İnan K, Terzi M. Reliability and validity of the Turkish version of speech pathology-specific questionnaire for persons with multiple sclerosis (SMS-TR). INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:841-848. [PMID: 36308425 DOI: 10.1080/17549507.2022.2134454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study is to validate the speech pathology-specific questionnaire for persons with Multiple Sclerosis (SMS) in Turkish. METHOD A total of 218 participants were included in the study. The study group was composed of 104 persons diagnosed with MS, and the control group was 114 healthy participants without any neurological deficits. The translated version of the SMS was administered to all participants. Test-retest reliability, internal consistency, construct validity, floor and ceiling effects were investigated. Dysphagia in multiple sclerosis questionnaire (DYMUS) was used for criterion validity. Finally, sensitivity and specificity of the SMS-TR was calculated using a ROC curve analysis. RESULT SMS-TR has an excellent internal consistency (Cronbach's alpha = 0.92). Item-total correlations range between 0.45 and 0.78. The intraclass correlation coefficient (ICC) obtained for the test-retest indicates a good level of reproducibility (ICC = 0.86). According to confirmatory factor analysis, the fit measures of the scale were found to be acceptable. A significant difference was found between the total SMS scores of the study group and the control group (20.6 ± 10.4 and 1.9 ± 2.8, P < 0.001, respectively). A statistically significant correlation was observed between SMS and DYMUS (r = 0.833, P < 0.001). There were no floor and ceiling effects found in the study group. According to the ROC curve analysis, the area under the curve of SMS-TR was 0.98. The optimal cut-off value was 8, with a sensitivity of 91.3% and a specificity of 95.6%. CONCLUSION SMS-TR is a valid and reliable patient-reported outcome measure suitable for the assessment of language, speech, and swallowing disorders in persons with MS. A score >8 is an indicator of language, speech, and swallowing pathology for persons.
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Affiliation(s)
- İbrahim Erensoy
- Department of Speech and Language Therapy, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Özlem Yaşar
- Department of Speech and Language Therapy, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Özge Şahvelioğlu
- Department of Speech and Language Therapy, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Kübra İnan
- Department of Speech and Language Therapy, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Murat Terzi
- Department of Neurology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Stipancic KL, Wilding G, Tjaden K. Lexical Characteristics of the Speech Intelligibility Test: Effects on Transcription Intelligibility for Speakers With Multiple Sclerosis and Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3115-3131. [PMID: 36931064 PMCID: PMC10555462 DOI: 10.1044/2023_jslhr-22-00279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/19/2022] [Accepted: 01/01/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Lexical characteristics of speech stimuli can significantly impact intelligibility. However, lexical characteristics of the widely used Speech Intelligibility Test (SIT) are unknown. We aimed to (a) define variation in neighborhood density, word frequency, grammatical word class, and type-token ratio across a large corpus of SIT sentences and tests and (b) determine the relationship of lexical characteristics to speech intelligibility in speakers with multiple sclerosis (MS), Parkinson's disease (PD), and neurologically healthy controls. METHOD Using an extant database of 92 speakers (32 controls, 30 speakers with MS, and 30 speakers with PD), percent correct intelligibility scores were obtained for the SIT. Neighborhood density, word frequency, word class, and type-token ratio were calculated and summed for each of the 11 sentences of each SIT test. The distribution of each characteristic across SIT sentences and tests was examined. Linear mixed-effects models were performed to assess the relationship between intelligibility and the lexical characteristics. RESULTS There was large variability in the distribution of lexical characteristics across this large corpus of SIT sentences and tests. Modeling revealed a relationship between intelligibility and the lexical characteristics, with word frequency and word class significantly contributing to the model. CONCLUSIONS Three primary findings emerged: (a) There was considerable variability in lexical characteristics both within and across the large corpus of SIT tests; (b) there was not a robust association between intelligibility and the lexical characteristics; and (c) findings from a study demonstrating an effect of neighborhood density and word frequency on intelligibility were replicated. Clinical and research implications of the findings are discussed, and three exemplar SIT tests systematically controlling for neighborhood density and word frequency are provided.
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Affiliation(s)
- Kaila L. Stipancic
- Department of Communicative Disorders and Sciences, University at Buffalo, The State University of New York
| | - Gregory Wilding
- Department of Biostatistics, University at Buffalo, The State University of New York
| | - Kris Tjaden
- Department of Communicative Disorders and Sciences, University at Buffalo, The State University of New York
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Feenaughty L. Social Network Characteristics and Correlations With Cognitive, Psychosocial, and Speech Function and Communication Participation for Adults With Multiple Sclerosis: A Pilot Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:163-177. [PMID: 36580547 DOI: 10.1044/2022_jslhr-22-00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE This cross-sectional observational pilot study investigated egocentric social networks for 10 paired sex- and age-matched adults with and without multiple sclerosis (MS). This study also investigated the relationship between social network measures and various disease factors associated with MS. The relationship between social network measures and communication participation restrictions was also examined. METHOD Participants completed a seven-item social network survey. Social network structure and composition were quantified. The network organization measures (structure analysis) included the total number of members (network size) and extent to which members are connected (network density). The measured characteristics of people around a participant (composition analysis) included the amount of kin relative to network size (proportion of kin), gender variation (gender diversity index), and age variation (standard deviation of age). Standard clinical neuropsychological, psychosocial, and speech metrics quantified processing speed, memory, depression, fatigue, and sentence intelligibility. Measures of communication participation and MS severity were also obtained. RESULTS Matched-pairs tests indicated that the proportion of kin significantly differed between paired participants, whereas all other social network measures were similar. For participants with MS, correlation analyses indicated weak associations between proportion of kin and cognitive, psychosocial, and speech measures. However, strong correlations were found between social network size and processing speed, memory, fatigue, MS severity, and communication participation. Gender diversity index also strongly correlated with depression. CONCLUSIONS Results from this pilot study highlight the importance of evaluating egocentric networks in the clinical management of MS, as maintaining nonkin friendships may be difficult for adults with MS making them vulnerable to social isolation. Furthermore, those with small and less diverse networks may experience more severe cognitive and psychosocial problems and limited communication participation.
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Affiliation(s)
- Lynda Feenaughty
- School of Communication Sciences and Disorders, The University of Memphis, TN
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Summaka M, Hannoun S, Harati H, Daoud R, Zein H, Estephan E, Naim I, Nasser Z. Neuroanatomical regions associated with non-progressive dysarthria post-stroke: a systematic review. BMC Neurol 2022; 22:353. [PMID: 36114518 PMCID: PMC9479301 DOI: 10.1186/s12883-022-02877-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
Background Dysarthria is a common and persisting sequela to stroke. It can have a negative influence on psychological wellbeing, and quality of life. This systematic review aimed to describe and identify the neuroanatomical regions associated with non-progressive dysarthria following stroke. Methods A systematic search of PubMed, Ovid Medline, CINAHL, Cochrane, Scopus, and ScienceDirect was conducted to identify all relevant articles published in peer-reviewed journals up to December 2021. Following data extraction, the National Institutes of Health (NIH) quality assessment tools were used to evaluate the methodological quality of the included studies. Results Out of 2186 papers found in the literature related to dysarthria post-stroke, 24 met the inclusion criteria. Eligible articles assessed 1150 post-stroke subjects. Out of them, 420 subjects had dysarthria from isolated lesions. Regarding dysarthric subjects with ischemic strokes, 153 sustained supratentorial infarctions, while 267 had infratentorial infarctions. The majority had pontine infarctions (n = 142), followed by infarctions in the corona radiata (n = 104), and the cerebellum (n = 64). Conclusion This systematic review is the first step toward establishing a neuroanatomical model of dysarthria throughout the whole brain. Our findings have many implications for clinical practice and provide a framework for implementing guidelines for early detection and management of dysarthria post-stroke. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02877-x.
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Stipancic KL, Tjaden K. Minimally Detectable Change of Speech Intelligibility in Speakers With Multiple Sclerosis and Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1858-1866. [PMID: 35442761 PMCID: PMC9559772 DOI: 10.1044/2022_jslhr-21-00648] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 05/19/2023]
Abstract
PURPOSE This study sought to determine the minimally detectable change (MDC) of sentence intelligibility for speakers with multiple sclerosis (MS) and Parkinson's disease (PD). METHOD Speakers included 78 participants consisting of 32 neurologically healthy control speakers, 30 speakers with MS, and 16 speakers with PD. All speakers were recorded reading 11 sentences comprising the Speech Intelligibility Test (SIT), which were subsequently transcribed by inexperienced listeners. Percent correct scores were calculated for each sentence. An average percent correct score was also calculated for each speaker. The MDC at the 95% confidence interval was calculated using the following formula: MDC95 = 1.96 × √2 × standard error of measurement. Speakers were divided into operationally defined categories of severity, and MDCs were calculated for each category to permit comparison to MDCs reported for speakers with amyotrophic lateral sclerosis (ALS). Kruskal-Wallis tests were conducted to compare MDCs between groups and severity categories. RESULTS The average MDC95 for control speakers was 5.53% (range = 3.21%-7.47%) and was statistically smaller than MDCs for speakers with MS (average = 10.08%, range = 5.30%-15.62%) and those for speakers with PD (average = 10.98%, range = 8.60%-13.98%). Statistical analyses further revealed significant differences between MDCs across severity categories. CONCLUSIONS In agreement with previous work in ALS conducted under similar conditions (i.e., orthographic transcription of SIT sentences in a quiet listening environment), the MDC95 of speech intelligibility ranged from 3% to 10% for speakers with MS and PD who have mildly impaired speech. These estimates are a step toward the development of a universal language with which to evaluate speech changes in a variety of patient populations.
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Affiliation(s)
- Kaila L. Stipancic
- Department of Communicative Disorders and Sciences, University at Buffalo, The State University of New York
| | - Kris Tjaden
- Department of Communicative Disorders and Sciences, University at Buffalo, The State University of New York
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Stipancic KL, Kuo YL, Miller A, Ventresca HM, Sternad D, Kimberley TJ, Green JR. The effects of continuous oromotor activity on speech motor learning: speech biomechanics and neurophysiologic correlates. Exp Brain Res 2021; 239:3487-3505. [PMID: 34524491 PMCID: PMC8599312 DOI: 10.1007/s00221-021-06206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
Sustained limb motor activity has been used as a therapeutic tool for improving rehabilitation outcomes and is thought to be mediated by neuroplastic changes associated with activity-induced cortical excitability. Although prior research has reported enhancing effects of continuous chewing and swallowing activity on learning, the potential beneficial effects of sustained oromotor activity on speech improvements is not well-documented. This exploratory study was designed to examine the effects of continuous oromotor activity on subsequent speech learning. Twenty neurologically healthy young adults engaged in periods of continuous chewing and speech after which they completed a novel speech motor learning task. The motor learning task was designed to elicit improvements in accuracy and efficiency of speech performance across repetitions of eight-syllable nonwords. In addition, transcranial magnetic stimulation was used to measure the cortical silent period (cSP) of the lip motor cortex before and after the periods of continuous oromotor behaviors. All repetitions of the nonword task were recorded acoustically and kinematically using a three-dimensional motion capture system. Productions were analyzed for accuracy and duration, as well as lip movement distance and speed. A control condition estimated baseline improvement rates in speech performance. Results revealed improved speech performance following 10 min of chewing. In contrast, speech performance following 10 min of continuous speech was degraded. There was no change in the cSP as a result of either oromotor activity. The clinical implications of these findings are discussed in the context of speech rehabilitation and neuromodulation.
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Affiliation(s)
- Kaila L Stipancic
- Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, USA
| | - Yi-Ling Kuo
- Department of Physical Therapy, Upstate Medical University, Syracuse, NY, USA
| | - Amanda Miller
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, USA
| | - Hayden M Ventresca
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA
| | - Dagmar Sternad
- Department of Biology, Northeastern University, Boston, MA, USA
| | - Teresa J Kimberley
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA
| | - Jordan R Green
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA.
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De Biagi F, Heikkola LM, Nordio S, Ruhaak L. Update on Recent Developments in Communication and Swallowing in Multiple Sclerosis. Int J MS Care 2021; 22:270-275. [PMID: 33424482 DOI: 10.7224/1537-2073.2020-023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Swallowing and communication disorders are common in persons with multiple sclerosis (MS). Both disorders are extremely variable and can have a major effect on health status and quality of life. This is why it is important to provide health care professionals who are working with persons with MS with tools to signal, assess, and treat swallowing and communication disorders. This synthesis gives an update on relevant and recent literature on swallowing and communication disorders, supplemented with current practice-based evidence. Studies on swallowing and communication disorders in MS are scarce: more and higher-quality research is needed. It should be emphasized that therapists need to focus on the patient's acquisition of skills to participate in daily life. This means that each patient requires an individual approach based on their own needs.
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Pommée T, Balaguer M, Mauclair J, Pinquier J, Woisard V. Assessment of adult speech disorders: current situation and needs in French-speaking clinical practice. LOGOP PHONIATR VOCO 2021; 47:92-108. [PMID: 33423572 DOI: 10.1080/14015439.2020.1870245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Speech assessment methods used in clinical practice are varied and mainly perceptual and motor. Reliable assessment of speech disorders is essential for the tailoring of the patient's treatment plan. OBJECTIVE To describe current clinical practices and identify the shortcomings and needs reported by French-speaking clinicians regarding the assessment of speech disorders in adult patients. METHODS Data were collected using an online questionnaire for French-speaking speech and language pathologists (SLPs) in Belgium, France, Switzerland, Luxembourg, and Maghreb. Forty-nine questions were grouped into six domains: participant data, educational and occupational background, experience with speech disorders, patient population, tools and tasks for speech assessment, and possible lacks regarding the current assessment of speech disorders. RESULTS Responses from 119 clinicians were included in the analyses. SLPs generally use "à la carte" assessment with a large variety of tasks and speech samples. About one quarter of them do not use existing assessment batteries. Those who do mostly use them partially. Pseudo-words are rarely used and are absent from standardized batteries, in contrast to the major use of words and sentences. Perceptual evaluation largely prevails (mainly overall ratings of speech "intelligibility", "severity," and "comprehensibility" and percent-correct phonemes), whereas the recording equipment for acoustic measures is not standardized and only scarcely described by the SLPs. The most commonly used questionnaire to assess the functional impact of the speech disorder is the Voice Handicap Index; one quarter of the SLPs does not use any questionnaire. Overall, the available tools are considered only moderately satisfactory. The main reported shortcomings are a lack of objectivity and reproducibility of speech measures; exhaustiveness and consideration of specific speech parameters (prosody, speech rate, and nasality); practicality of the assessment tools. CONCLUSION This study highlights a lack of standardization of the speech assessment in French-speaking adults and the need to offer new reliable tools for an optimized, accurate speech assessment. The automation of these tools would allow for rapid, reproducible, and accurate measures.
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Affiliation(s)
| | - Mathieu Balaguer
- IRIT, CNRS, University Paul Sabatier, Toulouse, France.,ENT department, University Hospital of Toulouse Larrey, Toulouse, France
| | | | | | - Virginie Woisard
- ENT department, University Hospital of Toulouse Larrey, Toulouse, France.,Oncorehabilitation unit, University Cancer Institute of Toulouse Oncopole, Toulouse, France.,Laboratoire Octogone Lordat, Jean Jaurès University Toulouse II, Toulouse, France
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Balchin R, Hersh D, Grantis J, Godfrey M. "Ode to confidence": Poetry groups for dysarthria in multiple sclerosis. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:347-358. [PMID: 32212872 DOI: 10.1080/17549507.2020.1739333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: Approximately 40-50% of people with multiple sclerosis (MS) have dysarthria impacting confidence in communication. This study explored how people with MS experienced a novel therapeutic approach combining dysarthria therapy with poetry in a group format.Method: Participants were recruited through MSWA (formerly known as the Multiple Sclerosis Society of Western Australia), a leading service provider for people living with all neurological conditions in Western Australia. They attended eight weekly sessions led by a speech pathologist and a professional poet. The study was co-designed and qualitative, using observational field notes recorded during sessions and semi-structured in-depth interviews with participants after programme completion. The results from an informal, unstandardised rating scale of communication confidence, along with standardised voice and speech measures, were used to facilitate discussion about confidence in the interviews.Result: Nine participants with MS completed the group programme. Analysis of the qualitative data revealed participants' positive views regarding the pairing of speech pathology and poetry. Thematic analysis identified four core themes: living with MS and its "series of griefs"; belonging to a group - "meeting with a purpose"; the power of poetry; and poetry as a medium for speech pathology.Conclusion: Poetry in combination with dysarthria therapy represents a novel, interprofessional approach for improving communication confidence in individuals with MS.
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Affiliation(s)
- Rebecca Balchin
- North East Metropolitan Language Development Centre, Perth, Australia
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Jamaica Grantis
- Department of Speech Pathology, Senses Australia, Perth, Australia
| | - Maddie Godfrey
- School of Media, Culture and Creative Arts, Curtin University, Perth, Australia
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Sander L, Kugler J, Elsner B. [The influence of multiple sclerosis-related symptoms on health-related quality of life]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2020; 88:704-712. [PMID: 32356284 DOI: 10.1055/a-1113-7702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic disease that is associated with a variety of MS-specific symptoms. Many of these symptoms have a negative impact on health-related quality of life (HRQoL). Until now it is unclear which MS-specific symptoms have the highest impact on the HRQoL. METHODOLOGY The study is based on the data of a member survey of the German MS Society (DMSG) in 2015 (n = 424). Considering socio-demographic variables and general medical variables, the influence of MS-specific symptoms on HRQoL was examined. The HRQoL was collected using the Multiple Sclerosis Quality of Life-54 (MSQOL-54) instrument. In a pretest, all influencing variables were tested for a significant mean difference (p = 0.05), or a mean correlation (Pearson's r ≥ 0.3). Subsequently, the influence of the variables identified in the pretest on the HRQoL was investigated by multiple linear regression analysis. RESULTS We calculated a mean physical health composite score (PHCS) of 48.3 (sd = 17.7) and a mean mental health composite score (MHCS) of 56.0 (sd = 20.1). The most fundamental factors influencing HRQoL were the MS-specific symptoms of depression, pain and cognitive impairment. MS-related symptoms with a mobility context showed declining PHCS. Speech disorder and dizziness were associated with a decreasing MHCS. Employment status was the only socio-economic factor that significantly affected HRQoL in multiple regression. The general medical factors showed no significant influence on HRQoL. CONCLUSION MS-specific symptoms have a major impact on the HRQoL of people with MS. Our study show that especially the so-called 'hidden symptoms' such as the symptoms of depression, pain and cognitive impairment have a significant influence on the HRQoL. Greater attention should be paid to these in the care of people with MS.
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Affiliation(s)
- Lydia Sander
- Medizinische Fakultät Carl Gustav Carus, Institut für Arbeits- und Sozialmedizin, Technische Universität Dresden
| | - Joachim Kugler
- Lehrstuhl für Gesundheitswissenschaften/Public Health, Technische Universitat Dresden
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El-Wahsh S, Heard R, Bogaardt H. Development and validation of a speech pathology-specific questionnaire for persons with multiple sclerosis (SMS). INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:553-563. [PMID: 30348018 DOI: 10.1080/17549507.2018.1499802] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/07/2018] [Accepted: 07/08/2018] [Indexed: 06/08/2023]
Abstract
Purpose: The aim of this study was to develop and validate the Speech pathology-specific questionnaire for persons with Multiple Sclerosis (SMS).Method: Forty-one items were generated through a literature review. Items were submitted to a preliminary psychometric validation process consisting of principal component analysis, internal consistency, test-retest reliability, and floor and ceiling effects using data from 164 participants. Criterion validity was assessed by comparing the SMS with the 12-item Short Form Health Survey (SF-12). Participants were recruited internationally through online channels and questionnaires were completed online.Result: The SMS contains 16 items describing three components: speech and voice, language, and swallowing. Internal consistency (Cronbach's alpha) of the three components was satisfactory (α = 0.89-α = 0.91). Criterion validity was evaluated using Spearman's rank correlation coefficient (ρ). A statistically significant weak to moderate correlation between the SMS and the SF-12 was identified (ρ = -0.004-ρ = -0.359). No floor or ceiling effects were present. The SMS demonstrated strong test-retest reliability. All items had an intra-class correlation coefficient ≥0.70.Conclusion: The SMS is a psychometrically robust patient-reported outcome measure to assess speech-language pathology symptoms in persons with MS.
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Affiliation(s)
- Sarah El-Wahsh
- Department of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Robert Heard
- Department of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Hans Bogaardt
- Department of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
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Friedova L, Rusz J, Motyl J, Srpova B, Vodehnalova K, Andelova M, Novotna K, Novotny M, Ruzickova H, Tykalova T, Kubala Havrdova E, Horakova D, Uher T. Slowed articulation rate is associated with information processing speed decline in multiple sclerosis: A pilot study. J Clin Neurosci 2019; 65:28-33. [PMID: 31072740 DOI: 10.1016/j.jocn.2019.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/28/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Impairment of cognition and speech are common in multiple sclerosis (MS) patients, but their relationship is not well understood. OBJECTIVE To describe the relationship between articulation rate characteristics and processing speed and to investigate the potential role of objective speech analysis for the detection of cognitive decline in MS. METHODS A total of 122 patients with clinically definite MS were included in this cross-sectional pilot study. Patients underwent three speaking tasks (oral diadochokinesis, reading text and monologue) and assessment of processing speed (Symbol Digit Modalities Test [SDMT], Paced Auditory Serial Addition Test-3 s [PASAT-3]). Association between articulation rate and cognition was analyzed using linear regression analysis. We estimated the area under the receiver operating characteristics curves (AUC) to evaluate the predictive accuracy of articulation rate measures for the detection of abnormal processing speed. RESULTS We observed an association between articulation rate and cognitive measures (rho = 0.45-0.58; p < 0.001). Faster reading speed by one word per second was associated with an 18.7 point (95% confidence interval [CI] 14.9-22.5) increase of the SDMT score and 14.7 (95% CI 8.9-20.4) point increase of PASAT-3 score (both p < 0.001). AUC values of articulation rate characteristics for the identification of processing speed impairment ranged between 0.67 and 0.79. Using a cutoff of 3.10 in reading speed, we were able to identify impairment in both the SDMT and PASAT-3 with 91% sensitivity and 54% specificity. CONCLUSION Slowed articulation rate is strongly associated with processing speed decline. Objective quantitative speech analysis identified patients with abnormal cognitive performance.
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Affiliation(s)
- Lucie Friedova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic.
| | - Jan Rusz
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic; Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, 160 00 Prague 6, Czech Republic
| | - Jiri Motyl
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Barbora Srpova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Karolina Vodehnalova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Michaela Andelova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Klara Novotna
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Michal Novotny
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, 160 00 Prague 6, Czech Republic
| | - Hana Ruzickova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Tereza Tykalova
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, 160 00 Prague 6, Czech Republic
| | - Eva Kubala Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
| | - Tomas Uher
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, 120 00 Prague 2, Czech Republic
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Noffs G, Perera T, Kolbe SC, Shanahan CJ, Boonstra FM, Evans A, Butzkueven H, van der Walt A, Vogel AP. What speech can tell us: A systematic review of dysarthria characteristics in Multiple Sclerosis. Autoimmun Rev 2018; 17:1202-1209. [DOI: 10.1016/j.autrev.2018.06.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
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15
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Nordio S, Bernitsas E, Meneghello F, Palmer K, Stabile MR, Dipietro L, Di Stadio A. Expiratory and phonation times as measures of disease severity in patients with Multiple Sclerosis. A case-control study. Mult Scler Relat Disord 2018; 23:27-32. [DOI: 10.1016/j.msard.2018.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/21/2018] [Accepted: 04/16/2018] [Indexed: 11/16/2022]
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16
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Moon JH, Hong DG, Kim KH, Park YA, Hahm SC, Kim SJ, Won YS, Cho HY. Effects of lingual strength training on lingual strength and articulator function in stroke patients with dysarthria. J Phys Ther Sci 2017; 29:1201-1204. [PMID: 28744047 PMCID: PMC5509591 DOI: 10.1589/jpts.29.1201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 04/23/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the effects of lingual strength training (LST) on lingual strength and articulator function in stroke patients with dysarthria. [Subjects and Methods] 16 stroke patients with dysarthria were randomly assigned into two groups: the experimental group (n=8) or the control group (n=8). Both groups received the conventional rehabilitation therapy at 30 min/day, 5 times for week, and during 4 weeks, and the experimental group received an additional 30 min of LST using the Iowa Oral Performance Instrument (IOPI). The Maximum Isometric Tongue Pressures (MIPs) was used to assess the lingual strength and the Alternating-Motion Rate (AMR) and Sequential-Motion Rate (SMR) were used to measure the articulator function. [Results] After the intervention, the experimental group showed a significant improvement in MIPs and AMR (/tə/) than the control group. [Conclusion] Findings of this study suggest that LST provides positive effects on lingual strength and articulator function, and thus can be used as an interventional method in stroke patients with dysarthria.
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Affiliation(s)
- Jong Hoon Moon
- Department of Occupational Therapy, Gachon University Graduate School, Republic of Korea.,Department of Occupational Therapy, Incheon Sarang Hospital, Republic of Korea
| | - Deok Gi Hong
- Department of Occupational Therapy, Shinsung University, Republic of Korea
| | - Kye Ho Kim
- Cybermedic Corporation, Cyber Medic, Republic of Korea
| | - Yo An Park
- Department of Occupational Therapy, National Rehablitation Center, Republic of Korea
| | - Suk-Chan Hahm
- Department of Rehabilitation Standard and Policy, National Rehabilitation Research Institute, National Rehabilitation Center, Republic of Korea
| | - Sung-Jin Kim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Young Sik Won
- Department of Occupational Therapy, Shinsung University, Republic of Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Republic of Korea
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The analysis of semantic networks in multiple sclerosis identifies preferential damage of long-range connectivity. Mult Scler Relat Disord 2015; 4:387-394. [DOI: 10.1016/j.msard.2015.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/29/2015] [Accepted: 07/03/2015] [Indexed: 11/22/2022]
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Kelly L, Jenkinson C, Morley D. Outcome measurement in neurodegenerative disease: attributes, applications & interpretation. Neurodegener Dis Manag 2015; 5:305-16. [PMID: 26295721 DOI: 10.2217/nmt.15.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
There has been a marked shift from clinically assessed to patient assessed outcomes of treatment in neurodegenerative conditions over recent decades. The use of patient-reported outcome measures (PROMs) provides a method with which researchers and clinicians can gain insightful and meaningful data on health status from the patients' perspective. It is imperative that high-quality PROMs are chosen based upon their measurement properties and their suitability for use in the intended clinical or research context. This review aims to give a brief overview of best practice standards for selecting PROMs, current instruments used in exemplar neurodegenerative conditions and their application in clinical trials and routine measurement.
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Affiliation(s)
- Laura Kelly
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
| | - David Morley
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
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