Dysarthric Patients Research Articles

The nature of verbal impairment after closed head injury.

Fifty-six closed head injured patients referred to a rehabilitation medicine center were examined to determine the presence and nature of verbal deficits. Eighteen (32 per cent) presented classical symptoms of aphasia, 21 (38 per cent) had motor dysarthria, and 17 (30 per cent) had no discernible aphasic deficit in spontaneous speech, but showed clear evidence of verbal deficit on testing. No patient admitted with sequelae of closed head injuries was spared some degree of verbal impairment, however mild or apparent. Dysarthric patients, without exception, showed subclinical linguistic deficits. Although the patients studied were thought to be more severe than most of those reported in the literature, our findings suggest the desirability of a careful linguistic evaluation of all closed head injured patients because of the potential impact of verbal deficits on rehabilitation out come.

Abnormal articulatory dynamics in a patient with apraxia of speech: X-ray microbeam observation

The temporal organization of articulatory movements in a patient diagnosed as having apraxia of speech was explored by means of pellet tracking techniques using an X-ray microbeam system. The results indicated that the temporal organization among different articulators of the patient was sometimes disturbed in his production of a meaningful Japanese word /deenee/. It was also observed that the pattern and velocity of the articulatory movements of the patient in repetitions of monosyllables were different from those of typical dysarthric patients.

Production deficits in aphasia: A voice-onset time analysis

An experimental study was conducted to examine phonetic and phonemic deficits in the speech production of aphasics. Subjects included four Broca's aphasics, four Conduction aphasics, five Wernicke's aphasics, one nonaphasic dysarthric patient, and four normal controls. The subjects read a list of words containing word-initial stop consonants which were subsequently measured acoustically for voice-onset time. The results showed that Broca's aphasics exhibit a more severe production disorder than Conduction aphasics who in turn exhibit a more severe disorder than Wernicke's aphasics, in accord with clinical observations. In addition, although Broca's aphasics produced both phonetic and phonemic errors, the results showed that they have a pervasive phonetic disorder which affects their correct target productions as well as the total number of phonetic errors produced. This deficit however seems to be a speech deficit rather than a low-level motor control problem. In contrast, the Wernicke's aphasics show a deficit characterized by isolated phonemic mistargeting errors. Finally, the pattern of productions for the Conduction aphasics indicates that some patients show a predominantly phonetic disorder similar to the Broca's aphasics and others show predominantly a phonemic disorder similar to the Wernicke's aphasics.

Language Development in Another Mode: The Acquisition of Signs by a Brain-Damaged Adult

A 49-year-old brain-damaged, dysarthric patient was given in instructional program in sign language communication tailored to the needs of his particular disability. The man learned a large lexicon of signs and showed improvement in his sicial behavior over the nine-month period of the study. The patient’s success in acquiring a sign language vocabulary must be viewed in the light of a medical evaluation of severe cerebral damage, an aphasic condition, and partial paralysis, all resulting from an accident that occurred more than ten years before. This improvement is in contrast with his past history of failure to respond to speech therapy.

Speech Characteristics in Parkinsonism

The purpose of the present study was to analyze and describe the characteristics of speech in dysarthric patients diagnosed as idiopathic Parkinsonism, based on auditory impressions.Eight judges independently rated each of speech samples of 34 patients on each of 39 dimensions of speech using a 4-point scale of severity. The results were as follows;1) Speech of the patients was characterized by those dimensions such as“imprecise consonants”, “harsh voice”, “breathy voice”and“phoneme repeated”.2) In comparison with previous reports on the speech characteristics of cerebellar diseases, pseudobulbar palsy and amyotrophic lateral sclerosis, the severity of Parkinsonian dysarthria is considered to be relatively mild. It should also be noted that Parkinsonian dysarthria was the only type in which slow rate of speech was insignificant.3) The present results showed a considerable discrepancy when compared with those reported by Darley et al., who conducted a similar study on American English speakers. It was considered that the discrepancy might be due either to the remarkable progress in medical treatment for Parkinsonism during the ten years after the report of Darley et al, or to the linguistic difference between the two languages. On the other hand, quite similar results were obtained for comparable items of a previous report on Japanese patients by Hirose.

On the Use of Kana-Typewriter for Dysarthric Patients

A portable electromotive Kana-typewriter was developed as a communication method for dysarthric patients. As the size of this machine is 215×90×30mm, it is easy to carry in the pocket or bag. This machine has 50 keys (Kana-letters) with a thermal print system. Using this typewriter, the dysarthric patients who had almost no speech output and showed only a gesture of“yes”or“no”reaction, could express their ideas correctly and communicate actively with other people. It was believed that the device was very helpful for the dysarthric patients. But the effectiveness of this machine was greatly dependent on their intelligences, vocations and their motivations and so on. Other technical problems are the sharpness of the printed letters and the size of the apparatus to be carried more conveniently. By improving these technical points, utility of this Kana-typewriter will be multiplied and it will be useful as an aid of communication for severe dysarthric patients.

Effects of a palatal lift prosthesis upon the speech intelligibility of a dysarthric patient

This report describes the construction and objective evaluation of the effects of a palatal lift prosthesis upon the speech intelligibility of a single dysarthric patient. Tape recordings of three 50 item word lists were made prior to insertion of the prosthesis (L1), 7 days after insertion of the appliance (L2), and 68 days after insertion of the device (L3). Six judges listened individually to each list and wrote down each word as they heard it from the tape. In all instances the patient was most intelligible after 68 days and least intelligible before the appliance was inserted. Differences between the intelligibility score means for L1 and L3 and L2 and L3 were statistically significant (P < 0.05). Results suggest that dysarthric patients can improve their speech intelligibility with a palatal lift prosthesis and that the effects of a prosthesis upon a patient's speech might be more adequately determined after the individual has used the device for a considerable period of time.

Dysphonia associated with cortical neoplasms.

H UGHLINGS JACKSON'S fundamental paper 14 on dysphasia entitled Notes on the Physiology and Pathology of Language has the significant sub-title, Remarks on those Cases of Disease of the Nervous System in which Defect of Expression is the most Striking Symptom. Medical and surgical neurologists encounter disorders of language or speech (dysphasia) and articulation (dysarthria) more frequently than disorders of phonation (dysphonia). The distinction between dysphasia, dysarthria, and dysphonia may be amplified by the following definitions: Speech is the term employed for the whole process by which meanings are comprehended and expressed in words . . . Articulation is the motor function whereby words having been formulated are converted into sounds . . . In the dysarthric patient symbolic verbal formulation is normal; only the mechanism of verbal sound production is f a u l t y . . . In aphonia (dysphonia) phonation is lost but articulation is preserved; hence the patient talks in a whisper. ''7 Dysphonia is generally due to acute or chronic infection, trauma, or neoplasm of the larynx or pharynx, psychogenic factors, and certain systemic diseases (myxedema, tetany). Less frequent causes of dysphonia are neurological disorders including parkinsonism, pseudobulbar palsy, lesions involving brain stem or lower cranial nerves, and neuromuscular dysfunction as in myasthenia gravis. When these etiological factors are absent, dysphonia in association with neoplasms of the cerebral cortex is rare, and to our knowledge has not been reported. On the other hand, disorders of vocalization are well documented in clinicopathologic studies, 1~ during stimulation of exposed cerebral cortex of patients undergoing surgery for cerebral seizures, ~'17 and postoperatively following excision of lesions in the supplementary