Electropalatographic (EPG) assessment of tongue-to-palate contacts in dysarthric speakers following TBI

Use of an advanced 3-T MRI movie to investigate articulation

OBJECTIVE

To develop a magnetic resonance imaging (MRI) movie to reveal the dynamic movement of articulators and teeth.

STUDY DESIGN

Five healthy females with normal occlusion participated in this study. Various concentrations of MRI contrast media (ferric ammonium citrate [FAC]) were tested for visualization of teeth, according to facial markers and with the use of a gel. Custom-made circuitry was connected to synchronize pronunciation of fricative sounds (/asa/) with scans. Three gradient echo sequences (True fast imaging with steady state precession [true FISP], FISP, and fast low angle shot [FLASH]) with a segmented cine were tested with the use of repetition times (TRs) of 9 ms and 31.5 ms. The MRI movie images were superimposed over the boundaries of teeth. The images produced during pronunciation, using the two different TRs (9 ms and 31 ms), were compared to assess the position of the lips and the tongue.

RESULTS

Images obtained using the FLASH sequence, with a TR of 9 ms or 31.5 ms, can be used for diagnostic purposes. A TR of 9 ms, with 161 continuous images acquired, produced the highest-quality images of teeth, with few artifacts present. Pronunciation of the consonant "s" was clearly discernable.

CONCLUSIONS

Our 3-T MRI movie system, with a temporal resolution less than 9 ms, can provide detailed information pertaining to variations in speech or oropharyngeal function.

Consonant accuracy after severe pediatric traumatic brain injury: a prospective cohort study

PURPOSE

The authors sought to describe longitudinal changes in Percentage of Consonants Correct-Revised (PCC-R) after severe pediatric traumatic brain injury (TBI), to compare the odds of normal-range PCC-R in children injured at older and younger ages, and to correlate predictor variables and PCC-R outcomes.

METHOD

In 56 children injured between age 1 month and 11 years, PCC-R was calculated over 12 monthly sessions beginning when the child produced ≥ 10 words. At each session, the authors compared odds of normal-range PCC-R in children injured at younger (≤ 60 months) and older (> 60 months) ages. Correlations were calculated between final PCC-R and age at injury, injury mechanism, gender, maternal education, residence, treatment, Glasgow Coma Score, and intact brain volume.

RESULTS

PCC-Rs varied within and between children. Odds of normal-range PCC-R were significantly higher for the older than for the younger group at all sessions but the first; odds of normal-range PCC-R were 9 to 33 times higher in the older group in sessions 3 to 12. Age at injury was significantly correlated with final PCC-R.

CONCLUSION

Over a 12-month period, severe TBI had more adverse effects for children whose ages placed them in the most intensive phase of PCC-R development than for children injured later.

Measures to Evaluate the Effects of DBS on Speech Production

The purpose of this paper is to review and evaluate measures of speech production that could be used to document effects of Deep Brain Stimulation (DBS) on speech performance, especially in persons with Parkinson disease (PD). A small set of evaluative criteria for these measures is presented first, followed by consideration of several speech physiology and speech acoustic measures that have been studied frequently and reported on in the literature on normal speech production, and speech production affected by neuromotor disorders (dysarthria). Each measure is reviewed and evaluated against the evaluative criteria. Embedded within this review and evaluation is a presentation of new data relating speech motions to speech intelligibility measures in speakers with PD, amyotrophic lateral sclerosis (ALS), and control speakers (CS). These data are used to support the conclusion that at the present time the slope of second formant transitions (F2 slope), an acoustic measure, is well suited to make inferences to speech motion and to predict speech intelligibility. The use of other measures should not be ruled out, however, and we encourage further development of evaluative criteria for speech measures designed to probe the effects of DBS or any treatment with potential effects on speech production and communication skills.

Differential articulatory movements during Japanese /s/ and /t/ as revealed by MR image sequences with tooth visualization

OBJECTIVE

To evaluate the spatio-temporal relationships between articulators in the anterior oral cavity, during the production of Japanese fricative and plosive articulation using our proposed method for tooth visualization in MR image sequences.

DESIGN

Ten healthy adults without malocclusion participated in the study. Customized maxillary and mandibular plates with space around the central incisors that was to be filled with MR-compatible contrast medium were made. During image-acquisition by a cine magnetic resonance imaging (MRI) technique, the subjects repeated vowel-consonant-vowel syllables (/asa/ and /ata/) without wearing the plates. The subjects then wore the plates for tooth imaging. All data were acquired in the midsagittal plane. Tooth boundaries were superimposed using landmarks. Several parameters and spatio-temporal changes in the centre of gravity (CoG) of the tongue were measured.

RESULTS

During /t/, the duration and amount of tongue-to-palate/incisor contact were significantly greater and the radius of the inscribed circle between the tongue-maxillary incisor-mandibular incisor was significantly shorter than those during /s/. /t/ also had a more anteriorly located CoG of the tongue than /s/ during maximum constriction. The spatio-temporal changes in the CoG of the tongue were significantly different between /asa/ and /ata/.

CONCLUSIONS

We conclude that increased tongue-to-palate/incisor contact and greater anterior closure are necessary for the production of Japanese /t/ compared to /s/. With the use of this new method for tooth visualization in MR image sequences, it should be possible to evaluate the interaction of teeth and other articulators during speech.