Dysarthric Patients Research Articles

Lee Silverman Voice Treatment for dysarthria in patients with Parkinson's disease: a systematic review and meta-analysis.

Approximately 89% of patients with Parkinson's disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech and voice functions. The objective was to assess the effectiveness of LSVT compared with other/no speech interventions for dysarthria in patients with PD. Electronic databases, including PubMed, Embase and the Cochrane Library, were searched. The publication date of all included studies was before 6 March 2020. Only randomized controlled trials (RCTs) that evaluated the LSVT intervention compared with other/no speech intervention were considered. The data obtained from the included studies were described and the mean differences were calculated. Eight RCTs were included in this meta-analysis comparing LSVT with other/no speech interventions. In the comparison of LSVT versus no intervention, vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage', monologue and describing a picture increased by 8.87, 4.34, 3.25 and 3.31dB, respectively, after 1month of therapy. Compared with the respiratory therapy group, the LSVT group also showed significant improvement in vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage' and monologue immediately after treatment (13.39, 6.66 and 3.19dB). Positive improvement still existed after 24months. There was no difference in the therapeutic effect between face-to-face and online LSVT. The effectiveness of LSVT for dysarthria in patients with PD was verified in these trials. However, future RCTs with sufficient participants are essential to evaluate the effectiveness of LSVT for dysarthria.

Assessment of dysarthria with Frenchay dysarthria assessment (FDA-2) in patients with Duchenne muscular dystrophy

Purpose The purpose of this study was to test the psychometric properties of the Japanese version of Frenchay Dysarthria Assessment (FDA-2) and to use this tool to describe the features of speech in patients with Duchenne muscular dystrophy (DMD). Materials and methods The Japanese version of FDA-2 was culturally adapted, and reliability and validity were examined in 22 and 50 patients, respectively. The Japanese version of FDA-2 was administered to 51 patients with DMD. Multiple regression analysis was performed to identify factors related to FDA-2 scores. Results Inter-/intra-rater reliabilities (ICCs) and internal consistency (Cronbach’s α) for total scores were 0.76, 0.97, and 0.94 respectively. For construct validity, two-way ANOVA showed a significant interaction between the disorders and FDA-2 sections (p < 0.05). In DMD patients, the item of tongue at rest was most severely affected, reflecting tongue hypertrophy. Multiple regression analysis identified age, swallowing status, and ventilator use as significantly related. Conclusions The results showed that the Japanese version of FDA-2 has satisfactory reliability and validity. The present study demonstrated the features of dysarthria and related factors in patients with DMD. Implications for rehabilitation In Duchenne muscular dystrophy (DMD), an absent or defective dystrophin protein causes progressive weakness of respiratory and oropharyngeal muscles, both of which are crucial contributors to speech production. This study shows that the Japanese version of FDA-2 has satisfactory reliability and validity compared to original version. The Japanese version of FDA-2 characterizes dysarthria in patients with DMD in this cohort.

Irinotecan-Associated Dysarthria in Patients with Pancreatic Cancer: A Single Site Experience

Case seriesPatients: Female, 56-year-old • Female, 72-year-old • Female, 68-year-oldFinal Diagnosis: Dysarthria asscoaited with irinotecan infusionSymptoms: Slurred speachMedication: —Clinical Procedure: —Specialty: OncologyObjective:Rare diseaseBackground:Irinotecan, a topoisomerase I inhibitor, is a cytotoxic chemotherapeutic agent used to treat multiple malignancies, including those of colorectal, pancreatic, cervical, esophageal, gastric, and lung origin. Dysarthria, a state of difficult or unclear articulation of speech, has been reported as a rare side effect of irinotecan through multiple case reports and case series, but with limited published data aimed at understanding the underlying mechanism and effective management strategies.Case Reports:We describe herein 3 cases of patients with pancreatic malignancy who experienced dysarthria while being treated with a chemotherapy regimen containing irinotecan at an ambulatory outpatient satellite chemotherapy site. All patients described received first-line FOLFIRINOX for pancreatic cancer and experienced dysarthria during their first infusion of irinotecan. In all cases, dysarthria was observed as a transient adverse drug reaction within the first 10 to 70 min of irinotecan infusion, which resolved rapidly upon pausing infusion without any long-term sequalae.All patients remained conscious and alert; physical and neurological examinations at dysarthria onset revealed no abnormalities. Some patients experienced distal extremity paresthesia, a known manifestation of oxaliplatin-induced acute neurotoxicity, and diaphoresis and nausea. Increased infusion time effectively prevented dysarthria during subsequent infusions.Conclusions:Oncologists, pharmacists, nurses, and other care team members should be aware that irinotecan-associated dysarthria is a rare, mild, and self-limiting phenomenon to avoid inadvertently altering or withholding therapy. We suggest extending irinotecan infusion time, as opposed to dose reduction or treatment discontinuation, as a practical clinical management strategy for patients who develop recurrent dysarthria secondary to irinotecan infusion.

Respiratory muscle training in stroke patients with respiratory muscle weakness, dysphagia, and dysarthria - a prospective randomized trial.

Objective:To examine the efficacy of combined inspiratory and expiratory respiratory muscle training (RMT) with respect to the swallowing function, pulmonary function, functional performance, and dysarthria in patients with stroke.Design:Prospective, randomized controlled trial.Setting:Tertiary hospital.Participants:The trial included 21 subjects (12 men, 9 women) aged 35 to 80 years presenting with 6 months history of unilateral stroke, respiratory muscle weakness (≥70% predicted maximal inspiratory pressure (MIP) and/or ≤70% maximal expiratory pressure (MEP)), dysphagia, or dysarthria. These subjects were randomly assigned to the control (n = 10, rehabilitation) and experimental (n = 11, rehabilitation with RMT) groups.Intervention:Inspiratory RMT starting from 30% to 60% of MIP and expiratory RMT starting from 15% to 75% of MEP for 5 days/week for 6 weeks.Main outcome measures:MIP, MEP, pulmonary function, peak cough flow, perception of dyspnea, Fatigue Assessment Scale, Modified Rankin Scale, Brunnstrom stage, Barthel index, Functional Oral Intake Scale (FOIS), and parameters of voice analysis.Results:Significant differences were observed between both groups in terms of MIP, forced vital capacity (FVC), and forced expiratory volume per second (FEV1) of the percentage predicted. Significant difference was found with respect to the change in fatigue, shimmer percent, amplitude perturbation quotient, and voice turbulence index (VTI) according to the acoustic analysis in the RMT group. The FEV1/FVC ratio was negatively correlated with jitter percent, relative average perturbation, pitch perturbation quotient, and VTI; the maximum mid-expiratory flow (MMEF) and MMEF% were also negatively correlated with VTI. Significant differences among participants of the same group were observed while comparing the Brunnstrom stage before and after training of the affected limbs and the Barthel scale and FOIS scores in both the groups.Conclusions:Altogether, 6-week combined inspiratory and expiratory RMT is feasible as adjuvant therapy for stroke patients to improve fatigue level, respiratory muscle strength, lung volume, respiratory flow, and dysarthria.Clinical trial registration number (Clinical Trial Identifier): NCT03491111.

Dysarthria in Patients with Schizophrenia

Speech and language difficulties have been reported in people with schizophrenia since the early 19th century, but they have been relatively poorly characterized. Research has mostly focused on pragmatics and the social aspects of communication, but changes in voice quality are common and can also interfere with intelligibility of speech, thus adding to the patient's disability. These changes in voice quality are not entirely related to effects of neuroleptics. A few common vocal characteristics have been identified; indeed, the most consistent vocal characteristic in people with schizophrenia may be the lack of consistent characteristics between patients. There has been little speculation about the etiology of vocal changes; they have been regarded as “neurological soft signs” indicative of mild central nervous system dysfunction but may be related to longstanding insensitivity to comprehension cues from the listener. Response to speech therapy in people with schizophrenia has been disappointing overall. We present three patients with schizophrenia and representative vocal changes, and we also discuss the sparse available literature available through the PubMed database. This may be a fruitful and relatively unexplored area of investigation with potential to substantially improve social interactions and quality of life for some patients with schizophrenia. [ Psychiatr Ann . 2020;50(1):33–37.]

Motor speech patterns in Huntington disease.

Dysarthric speech of persons with Huntington disease (HD) is typically described as hyperkinetic; however, studies suggest that dysarthria can vary and resemble patterns in other neurologic conditions. To test the hypothesis that distinct motor speech subgroups can be identified within a larger cohort of patients with HD, we performed a cluster analysis on speech perceptual characteristics of patient audio recordings. Audio recordings of 48 patients with mild to moderate dysarthria due to HD were presented to 6 trained raters. Raters provided scores for various speech features (e.g., voice, articulation, prosody) of audio recordings using the classic Mayo Clinic dysarthria rating scale. Scores were submitted to an unsupervised k-means cluster analysis to determine the most salient speech features of subgroups based on motor speech patterns. Four unique subgroups emerged from the cohort of patients with HD. Subgroup 1 was characterized by an abnormally fast speaking rate among other unique speech features, whereas subgroups 2 and 3 were defined by an abnormally slow speaking rate. Salient speech features for subgroup 2 overlapped with subgroup 3; however, the severity of dysarthria differed. Subgroup 4 was characterized by mild deviations of speech features with typical speech rate. Length of CAG repeats, Unified Huntington's Disease Rating Scale total motor score, and percent intelligibility were significantly different for pairwise comparisons of subgroups. This study supports the existence of distinct presentations of dysarthria in patients with HD, which may be due to divergent pathologic processes. The findings are discussed in relation to previous literature and clinical implications.

Effectiveness of a portable device on dysarthrias in daily life—Verification of the effects with DAF and without DAF

Several methods for rehabilitating speech rate control have been widely used to improve speech intelligibility in patients with mild dysarthria. However, few studies have reported the therapeutic effects of these methods in daily life. Delayed auditory feedback (DAF) is one such speech rate control method. A small, portable DAF device has recently been developed that can be used by patients in their daily life. In this study, three dysarthric patients wearing the portable DAF device underwent a 20-min practice per day for 3 months. During the practice, they were instructed to prolong vowel length while using the device. The improvement in the intelligibility of spontaneous conversation was more in patients wearing the portable DAF device than in those who did not wear the device. The patients mastered the speech method using prolonged vowel length pronunciation with the use of the device continuously over a period of time. This finding suggests that the portable DAF devices can be sustainably used in daily life. Even when the device was not used, patients’ speech rates significantly decreased at the word level after treatment. This finding suggests that the effectiveness of the portable DAF device is carried over after 3 months of its use.Several methods for rehabilitating speech rate control have been widely used to improve speech intelligibility in patients with mild dysarthria. However, few studies have reported the therapeutic effects of these methods in daily life. Delayed auditory feedback (DAF) is one such speech rate control method. A small, portable DAF device has recently been developed that can be used by patients in their daily life. In this study, three dysarthric patients wearing the portable DAF device underwent a 20-min practice per day for 3 months. During the practice, they were instructed to prolong vowel length while using the device. The improvement in the intelligibility of spontaneous conversation was more in patients wearing the portable DAF device than in those who did not wear the device. The patients mastered the speech method using prolonged vowel length pronunciation with the use of the device continuously over a period of time. This finding suggests that the portable DAF devices can be sustainably used in dail...

A speech recognition system based on electromyography for the rehabilitation of dysarthric patients: A Thai syllable study

The objective of this study is to develop a speech recognition system for classifying nine Thai syllables, which is used for the rehabilitation of dysarthric patients, based on five channels of surface electromyography (sEMG) signals from the human articulatory muscles. After the sEMG signal from each channel was collected, it was processed by a band-pass filter from 20–450Hz for noise removal. Then, six features from three feature categories were determined and analyzed, namely, mean absolute value (MAV) and wavelength (WL) from amplitude based features (ABF), zero crossing (ZC) and mean frequency (MNF) from frequency based features (FBF), and L-kurtosis (L-KURT) and L-skewness (L-SKW) from statistics based features (SBF). Subsequently, a spectral regression extreme learning machine (SRELM) was used as the feature projection technique to reduce the dimension of feature vector from 30 to 8. Finally, the projected features were classified using a feed forward neural network (NN) classifier with 5-fold cross-validation. The proposed system was evaluated with the sEMG signals from seven healthy volunteers and five dysarthric volunteers. The results show that the proposed system can recognize the sEMG signals from both healthy and dysarthric volunteers. The average classification accuracies obtained from all six features in the healthy and dysarthric volunteers were 94.5% and 89.4%, respectively.

Calidad de vida en personas con disartria

IntroductionDysarthria is an acquired motor speech disorder of neurological origin. Usually assessment focuses on describing the affected motor processes of speech, perceptual characteristics and determining the degree of severity through speech intelligibility, but rarely explores the impact it has on the quality of life of the person. MethodA quantitative, non-experimental, cross-sectional, descriptive and correlational study was performed. Twenty-one patients with dysarthria (51.04 ± 13.06 years, 13 men) were evaluated with the speech assessment protocol for dysarthric patients and the self-administered quality of life questionnaire for dysarthric speakers (QOL-Dys). ResultsThe quality of life of people with dysarthria is affected (QOL), which correlates significantly with the degree of severity of the dysarthria (r = -.5, p = .02). Intelligibility significantly predicts the score of the total quality of life questionnaire (R2 =.2, p = .04). The lowest score occurred in the perception of the reaction of the others (16.66 ± 12.93), and the highest in dealing with difficult situations (24.38 ± 9.12). ConclusionQuality of life is affected in people with dysarthria, its assessment is recommended to improve intervention in these people.

Speech training for neurological patients using a serious game

AbstractThe majority of patients with neurological impairment like Parkinson's Disease (PD) or stroke are affected by dysarthria. Dysarthria is a motor speech impairment which negatively affects speech dimensions such as articulation and loudness. This leads to reduced intelligibility, often hindering daily life communication. Intensive and prolonged speech training can increase patients’ speech intelligibility. Unfortunately, interventions by speech therapists are generally provided only for a short period of time, while continuing practice is needed to maintain or improve intelligibility. eHealth applications might provide a solution. In our research, we explored whether it is possible to develop a game that is suitable for providing speech training in elderly patients with dysarthria due to PD or stroke. In the game, we developed, called Treasure Hunters, two players interact verbally to find the way to the treasure, while receiving automatic feedback on voice loudness and pitch. Participants played with our game in several sessions and generally appreciated it, hinting at our game's potential for speech training in elderly patients. In a within‐subjects experiment with five dysarthric patients, our game was compared to a non‐game computer‐based speech training system: e‐learning‐based Speech Therapy (EST). We focussed on three variables: speech intelligibility, user satisfaction and user preference. Substantial variability between participants was observed, in the outcomes of these three variables and their relations. We conclude that ”one size that fits all” does not apply to computer‐based speech training, but a personalised approach is needed.

Acoustic analysis of Parkinsonian speech in the early stage after subthalamic nucleus deep brain stimulation

Objective To investigate the early efficacy of deep brain stimulation (DBS) of subthalamic nucleus (STN) in the treatment of dysarthria in patients with Parkinson's disease (PD). Methods From May 2017 to November 2017, 10 PD patients treated with STN-DBS at Neurosurgery Department affiliated to Nanjing Medical University and 10 healthy volunteers (healthy control group) were recruited retrospectively. Ten PD patients without anti-Parkinson disease medication were recorded in a relatively quiet room at the states of 1 month after operation with stimulation-off, 1 month after operation with stimulation-on, and 3 months after stimulation-on. The speech signal was analyzed by Praat software and 3 fundamental frequency parameters were extracted which were the mean fundamental frequency, the range and standard deviation of fundamental frequency. The speech signals from the healthy control subjects were collected and analyzed at the same time. Results The speech fundamental frequency range (PD group: 15.5±4.8 St, control group: 22.5±5.6 St, t=-2.962, P=0. 008) and the standard deviation of fundamental frequency (PD group: 2.4±0.7 St, control group: 3.7±0.8 St, t=-4.017, P=0. 001) in PD group with stimulation-off 1 month post operation were significantly lower than those in healthy control group. There was no significant difference in any parameter of fundamental frequency of the PD patients between the state of 1 month after stimulation-on and the state of 1 month after operation (all P > 0.05). At 3 months after stimulation-on, the fundamental frequency range (19.23.8 St, P=0.017) and the fundamental frequency standard deviation (3.20.8 St, P=0.001) of the speech were significantly higher than those at 1 month after operation with stimulation-off, and those was not significant statistical different compared with controls (all P > 0.05). Conclusion Early stage of STN-DBS treatment could improve the phonological tone of PD patients and relieve the stiffness of laryngeal muscles and vocal cord. Key words: Parkinson disease; Dysarthria; Deep brain stimulation; Subthalamic nucleus; Acoustic analysis

Italian Validation of a Test to Assess Dysarthria in Neurologic Patients: A Cross-Sectional Pilot Study

Dysarthria is a motor speech disorder that results from an impairment of the muscles devoted to speech production, thus affecting the movements of the orofacial district. The type and severity of dysarthria depend on which structures of the central or peripheral nervous system are affected. Due to the vast range of acute and progressive neurological disorders that may cause dysarthria, its prevalence may be not negligible. In Italian clinical practice dysarthria is assessed using a standardized protocol, which has never been validated. The aim of the study is to explore the intraand inter- reliability of a short-form of a protocol to assess dysarthria and compare scoring of the test face-to-face versus via video of patient assessment, which is broadly used in the Italian clinical practice. 50 dysarthric patients were enrolled for this pilot study and assessed by “Protocollo di Valutazione della Disartria”. Lin’s Concordance Correlation Coefficient (CCC) determined the consistency of measurements between the same rater and among different raters with different levels of expertise. Scoring was done both during face-to-face assessments and while watching video recordings of patients’ evaluations. Results indicated a good consistency of ratings in repeated measures over time (video-assessment intra-rater CCC>0.8). Nevertheless, inter-rater reliability was less satisfactory (video-assessment scoring inter-rater CCC<0.8), especially in the face-to-face administration of the protocol (face-to-face/video inter-rater CCC<0.8). In conclusion, the protocol showed to have potential clinical utility to assess dysarthria in neurological patients, due to its completeness and ease of training and administration. However generalizations of the findings are limited, due to the characteristics of the study. Indeed, further research is required for a better validation of the instrument.

Integration of a neurodynamic approach into the treatment of dysarthria for patients with idiopathic Parkinson's disease: A pilot study

PurposeDifferences between standard dysarthria treatment and the same treatment with the integration of neurodynamic techniques tailored to the severity of dysarthria in patients with Parkinson's disease were examined. MethodIn total, 10 subjects with idiopathic Parkinson's disease and rigid–hypokinetic dysarthria were enrolled in this quasi-randomized, controlled, single-blind, pre–post study. In each of 12 therapy sessions the control group (n = 5) received standard dysarthria treatment (usual care), while the intervention group (n = 5) received the same treatment with the addition of integrated neurodynamic treatment (special care). ResultsThere was no significant difference between the two groups for either the pre-test (p = 0.739) or the post-test (p = 0.156) results. However, significant differences between the pre-test and post-test results within each group (intervention group p = 0.001; control group p = 0.003) were found. ConclusionsThe significant differences in the pre–post comparison within the groups may indicate a high probability of a positive effect of standard dysarthria treatment on the severity of dysarthria. In between-group comparisons, the study results indicated no evidence of a significant difference between standard dysarthria treatment with or without neurodynamics. Due to the small sample size, the effectiveness of the integration of neurodynamics into speech therapy cannot be definitively concluded for now. In order to be able to have generalized applicability, future studies with larger numbers of participants are required.

Reference values of maximum performance tests of speech production

Purpose: Maximum performance tests examine upper limits of speech motor performance, as used by speech-language pathologists in dysarthria assessment protocols. The Radboud Dysarthria Assessment includes maximum repetition rate, maximum phonation time, fundamental frequency range and maximum phonation volume to assist in detecting pathological performance. This study aims to obtain reference values for each of these tests.Method: A group of 224 healthy Dutch adults aged 18–80 years performed the maximum performance tests. Age, sex, body height, smoking habit, and profession were registered. Using multivariable linear regression, a wide range of models was tested to examine the relationship between these person characteristics and speech performance. The likelihood ratio was used to test the goodness of fit to the data.Result: Above 60 years of age, maximum repetition rate, fundamental frequency range and maximum phonation volume were all negatively affected by age. Below 60 years, only women showed effects of age on fundamental frequency range (increase) and maximum phonation volume (decrease). Maximum phonation time was primarily related to body height (increase).Conclusion: This study presents reference values of four maximum performance tests for comparing the performance of dysarthric patients with non-pathological performance. Age was identified as most important factor influencing maximum speech performance.

The pulvinar nucleus is associated with the presence of dysarthria in patients with basal ganglia hemorrhage.

Dysarthria is a frequent symptom in patients with stroke. The anatomical structures responsible for dysarthria have been reported in patients with lacunar infarcts, but the related lesions in patients with basal ganglia hemorrhage (BGH) have not been investigated. The aim of this study was to identify associations between the lesion location and the presence/absence of dysarthria in patients with BGH using voxel-based lesion symptom mapping (VLSM) analyses. A retrospective analysis was conducted on 26 patients with acute BGH (mean age, 54.0 years; men:women, 14:12) who underwent conservative management. The patients were classified into groups based on the presence or absence of dysarthria at the time of admission, which was determined by reviewing the patients' medical records. Brain lesions were traced on magnetic resonance images that were acquired within the first 3 weeks after BGH onset, and then separate high-resolution region-of-interest images were generated. Associations between dysarthria and the lesion location were determined with the VLSM analyses. The average volume of the delimited lesions was 7.38±5.75cm3. The VLSM analyses identified several voxel clusters, mainly in the pulvinar nucleus of the left thalamus, that were significantly related to the presence of dysarthria at admission. These findings suggest that patients with BGH extending into the left pulvinar nucleus should be monitored for dysarthria.

Tratamiento de voz Lee Silverman en la disartria hipocinética: revisión de la efectividad del tratamiento en los enfermos de Parkinson

Dysarthria is a neurological disorder of the central and/or peripheral nervous system that affects muscle control mechanisms of speech. Parkinson's disease (PD) is characterised by hypokinetic dysarthria, which produces a weak, slow and monotonous speech. It is affected by breathing, resonance, phonation, prosody, and articulation. There is a voice treatment called “Lee Silverman” (LSVT), which stimulates and educates the patient to produce a higher voice through the increase of vocal effort.The purpose of this review is to determine the effectiveness of LSVT as a method of speech therapy rehabilitation of hypokinetic dysarthria in patients with PD.A literature review was conducted in the PubMed and Cochrane databases. A total of 65 articles selected articles, but they were reduced to 7 after applying the inclusion and exclusion criteria. A comparative analysis was performed on these.The results of the study and comparison with other reviews have shown significant improvements after LSVT. Significant changes have been observed in intelligibility, voice intensity with an increase in vocal loudness and greater tone of the buccal-phonation organs, as well as an improvement in the articulation and coordination movements. This has led to a more functional speech.To conclude, the results show that LSVT could be effective for the rehabilitation of the hypokinetic dysarthria in Parkinson's patients. However, the results cannot be considered universal, as only 7 articles have been compared, which is not sufficient to support or refute the effectiveness of the treatment.

Speech Signal Analysis and Pattern Recognition in Diagnosis of Dysarthria.

Background:Dysarthria refers to a group of disorders resulting from disturbances in muscular control over the speech mechanism due to damage of central or peripheral nervous system. There is wide subjective variability in assessment of dysarthria between different clinicians. In our study, we tried to identify a pattern among types of dysarthria by acoustic analysis and to prevent intersubject variability.Objectives:(1) Pattern recognition among types of dysarthria with software tool and to compare with normal subjects. (2) To assess the severity of dysarthria with software tool.Materials and Methods:Speech of seventy subjects were recorded, both normal subjects and the dysarthric patients who attended the outpatient department/admitted in AIMS. Speech waveforms were analyzed using Praat and MATHLAB toolkit. The pitch contour, formant variation, and speech duration of the extracted graphs were analyzed.Results:Study population included 25 normal subjects and 45 dysarthric patients. Dysarthric subjects included 24 patients with extrapyramidal dysarthria, 14 cases of spastic dysarthria, and 7 cases of ataxic dysarthria. Analysis of pitch of the study population showed a specific pattern in each type. F0 jitter was found in spastic dysarthria, pitch break with ataxic dysarthria, and pitch monotonicity with extrapyramidal dysarthria. By pattern recognition, we identified 19 cases in which one or more recognized patterns coexisted. There was a significant correlation between the severity of dysarthria and formant range.Conclusions:Specific patterns were identified for types of dysarthria so that this software tool will help clinicians to identify the types of dysarthria in a better way and could prevent intersubject variability. We also assessed the severity of dysarthria by formant range. Mixed dysarthria can be more common than clinically expected.

Isolated Word Recognition for Dysarthric Patients

In this paper, a HMM based speech recognition system is proposed for the Dysarthric patients. The speech samples recorded from patients with Spastic Dysarthria with mid to high intelligibility are taken from the UA Research database. The speech samples are de-noised using Discrete Wavelet Transform (DWT), after which the MFCC, LPC features are extracted. A comparative study on speech recognition using MFCC and LPC are presented. The recognition efficiency is found to be 68.50% using MFCC features and 66.54% using LPC features.

Vocal training, levodopa, and environment effects on ultrasonic vocalizations in a rat neurotoxin model of Parkinson disease

Levodopa does not improve dysarthria in patients with Parkinson Disease (PD), although vocal exercise therapy, such as “LSVT/LOUD®”, does improve vocal communication. Most patients receive vocal exercise therapy while concurrently being treated with levodopa, although the interaction between levodopa and vocal exercise therapy on communication in PD is relatively unknown. Further, carryover of vocal exercise therapy to novel situations is critical for successful outcomes, but the influence of novel situations on rehabilitated vocal communication is not well understood. To address the influence of exercise, medications, and environment on vocal communication with precise experimental control, we employed the widely used 6-OHDA rat neurotoxin model of PD (infusion to the medial forebrain bundle), and assessed ultrasonic vocalizations after: vocal exercise, vocal exercise with levodopa, levodopa alone, and control conditions. We tested USVs in the familiar training environment of the home cage and a novel cage. We hypothesized that parkinsonian rats that undergo vocal exercise would demonstrate significant improvement of ultrasonic vocalization (USV) acoustic parameters as compared to the control exercise and levodopa-only treatment groups. We further hypothesized that vocal exercise in combination with levodopa administration, similar to what is common in humans, would lead to improvement in USV outcomes, particularly when tested in a familiar versus a novel environment. We found that the combination of exercise and levodopa lead to some improvement in USV acoustic parameters and these effects were stronger in a familiar vs. a novel environment. Our results suggest that although treatment can improve aspects of communication, environment can influence the benefits of these effects.

Adaptive speech recognition framework for dysarthric patients

Adaptive speech recognition framework for dysarthric patients