Articulatory Kinematic Characteristics Across the Dysarthria Severity Spectrum in Individuals With Amyotrophic Lateral Sclerosis

2018 ◽  
Vol 27 (1) ◽  
pp. 258-269 ◽  
Author(s):  
Jimin Lee ◽  
Michael Bell ◽  
Zachary Simmons
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speech Intelligibility ◽  
Speaking Rate ◽  
Tongue Movement ◽  
Jaw Movement ◽  
Movement Trajectories ◽  
Electromagnetic Articulography ◽  
Kinematic Characteristics ◽  
Temporal Measures ◽  
Lateral Sclerosis

Purpose The current study investigated whether articulatory kinematic patterns can be extrapolated across the spectrum of dysarthria severity in individuals with amyotrophic lateral sclerosis (ALS). Method Temporal and spatial articulatory kinematic data were collected using electromagnetic articulography from 14 individuals with dysarthria secondary to ALS and 6 typically aging speakers. Speech intelligibility and speaking rate were used as indices of severity. Results Temporal measures (duration, speed of articulators) were significantly correlated with both indices of severity. In speakers with dysarthria, spatial measures were not correlated with severity except in 3 measures: tongue movement displacement was more reduced in the anterior–posterior dimension; jaw movement distance was greater in the inferior–superior dimension; jaw convex hull area was larger in speakers with slower speaking rates. Visual inspection of movement trajectories revealed that overall spatial kinematic characteristics in speakers with severe dysarthria differed qualitatively from those in speakers with mild or moderate dysarthria. Unlike speakers with dysarthria, typically aging speakers displayed variable tongue movement and minimal jaw movement. Conclusions The current study revealed that spatial articulatory characteristics, unlike temporal characteristics, showed a complicated pattern across the severity spectrum. The findings suggest that articulatory characteristics in speakers with severe dysarthria cannot simply be extrapolated from those in speakers with mild-to-moderate dysarthria secondary to ALS.

Direction-Specific Jaw Dysfunction and Its Impact on Tongue Movement in Individuals With Dysarthria Secondary to Amyotrophic Lateral Sclerosis

2020 ◽  
Vol 63 (2) ◽  
pp. 499-508 ◽  
Author(s):  
Jimin Lee ◽  
Elizabeth Rodriguez ◽  
Antje Mefferd
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speech Production ◽  
Tongue Movement ◽  
Jaw Movement ◽  
Electromagnetic Articulography ◽  
Movement Characteristics ◽  
Jaw Opening ◽  
Opening And Closing ◽  
Lateral Sclerosis ◽  
Anterior Posterior

Purpose The current study tested jaw movement characteristics and their impact on tongue movement for speech production in individuals with amyotrophic lateral sclerosis (ALS). Specifically, the study examined tongue and jaw movement in multiple directions during jaw opening and closing strokes in individuals with ALS and controls. Method Twenty-two individuals with ALS and 22 controls participated in the current study. Tongue and jaw movements during the production of the words “Iowa” and “Ohio” (produced in a carrier phrase) were recorded using electromagnetic articulography. Tongue and jaw distances were measured for jaw opening and closing strokes. Distance was measured in the anterior–posterior and superior–inferior dimensions (retraction, advancement, lowering, and raising). Results Findings revealed that individuals with ALS exaggerated their jaw opening movements, but not their jaw closing movements, compared to controls. Between the groups, a comparable tongue lowering distance was observed during jaw opening movements. In contrast, reduced tongue raising was observed during the jaw closing movements in individuals with ALS compared to controls. Conclusion The findings suggest that individuals with ALS produce excessive jaw opening movements in the absence of excessive jaw closing movements. The lack of excessive jaw closing movements results in reduced tongue raising in these individuals. Excessive jaw opening movements alone suggest a direction-specific jaw dysfunction. Future studies should examine whether excessive jaw raising can be facilitated and if it enhances tongue raising movement for speech production in individuals with dysarthria secondary to ALS.

Automated Acoustic Analysis of Oral Diadochokinesis to Assess Bulbar Motor Involvement in Amyotrophic Lateral Sclerosis

2020 ◽  
Vol 63 (1) ◽  
pp. 59-73 ◽  
Author(s):  
Panying Rong
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Acoustic Analysis ◽  
Speaking Rate ◽  
Disease Stage ◽  
Healthy Controls ◽  
Tongue Movement ◽  
Major Barrier ◽  
Syllable Repetition ◽  
Oral Diadochokinesis ◽  
Lateral Sclerosis

Purpose The purpose of this article was to validate a novel acoustic analysis of oral diadochokinesis (DDK) in assessing bulbar motor involvement in amyotrophic lateral sclerosis (ALS). Method An automated acoustic DDK analysis was developed, which filtered out the voice features and extracted the envelope of the acoustic waveform reflecting the temporal pattern of syllable repetitions during an oral DDK task (i.e., repetitions of /tɑ/ at the maximum rate on 1 breath). Cycle-to-cycle temporal variability (cTV) of envelope fluctuations and syllable repetition rate (sylRate) were derived from the envelope and validated against 2 kinematic measures, which are tongue movement jitter (movJitter) and alternating tongue movement rate (AMR) during the DDK task, in 16 individuals with bulbar ALS and 18 healthy controls. After the validation, cTV, sylRate, movJitter, and AMR, along with an established clinical speech measure, that is, speaking rate (SR), were compared in their ability to (a) differentiate individuals with ALS from healthy controls and (b) detect early-stage bulbar declines in ALS. Results cTV and sylRate were significantly correlated with movJitter and AMR, respectively, across individuals with ALS and healthy controls, confirming the validity of the acoustic DDK analysis in extracting the temporal DDK pattern. Among all the acoustic and kinematic DDK measures, cTV showed the highest diagnostic accuracy (i.e., 0.87) with 80% sensitivity and 94% specificity in differentiating individuals with ALS from healthy controls, which outperformed the SR measure. Moreover, cTV showed a large increase during the early disease stage, which preceded the decline of SR. Conclusions This study provided preliminary validation of a novel automated acoustic DDK analysis in extracting a useful measure, namely, cTV, for early detection of bulbar ALS. This analysis overcame a major barrier in the existing acoustic DDK analysis, which is continuous voicing between syllables that interferes with syllable structures. This approach has potential clinical applications as a novel bulbar assessment.

Articulatory Range of Movement in Individuals With Dysarthria Secondary to Amyotrophic Lateral Sclerosis

2018 ◽  
Vol 27 (3) ◽  
pp. 996-1009 ◽  
Author(s):  
Jimin Lee ◽  
Michael Bell
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Convex Hull ◽  
Speaking Rate ◽  
Range Of Movement ◽  
Lower Lip ◽  
Working Space ◽  
Electromagnetic Articulography ◽  
Differential Involvement ◽  
Lateral Sclerosis ◽  
Anterior Posterior

Purpose The current study examined overall articulatory range of movement (ROM) in individuals with amyotrophic lateral sclerosis (ALS). Differential involvement of articulators was also tested using articulatory working space in individuals with varying degrees of dysarthria severity and in typically aging individuals. A strong association between overall articulatory ROM and severity measures among individuals with ALS was hypothesized. In addition, it was hypothesized that differential involvement of articulators would be detected using overall articulatory ROM measures. Method Twenty-two speakers with dysarthria secondary to ALS and 22 typically aging speakers participated. Speech intelligibility and speaking rate were used as indices of severity. Movement range and overall articulatory working space area (convex hull) of the tongue, lower lip, and jaw were each measured by electromagnetic articulography while the speakers produced the Rainbow Passage. Results Tongue convex hull size was significantly correlated with both indices of severity. A significant interaction between articulators and groups was observed. Individuals with severe dysarthria had reduced tongue convex hull size and exaggerated lower lip convex hull size. ROM in the anterior–posterior dimension showed a more notable differential involvement pattern than ROM in the superior–inferior dimension. Results in the area under a receiver operating characteristic curve analysis revealed group-specific ROM sensitivity. Conclusions The findings indicate that tongue ROM is reduced in individuals with more severe dysarthria when estimated using a standardized paragraph containing all American English phonemes. The articulatory working space measure could be useful for estimating speech dysfunction in ALS. ROM of the tongue decreases, but ROM of the lower lip and jaw each increase in individuals with severe dysarthria. Differential involvement of the articulators in the anterior–posterior dimension needs to be further investigated.

Spatiotemporal Control of Articulation During Speech and Speechlike Tasks in Amyotrophic Lateral Sclerosis

2021 ◽  
pp. 1-18
Author(s):  
Panying Rong ◽  
Lindsey Heidrick
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speaking Rate ◽  
Healthy Controls ◽  
Tongue Movement ◽  
Characteristic Analysis ◽  
Jaw Movements ◽  
Acceleration Time ◽  
Speech Task ◽  
Articulatory Features ◽  
Lateral Sclerosis

Purpose This study examined the articulatory control of speech and speechlike tasks in individuals with amyotrophic lateral sclerosis (ALS) and neurologically healthy individuals with the aim to identify the most useful set of articulatory features and tasks for assessing bulbar motor involvement in ALS. Method Tongue and jaw kinematics were recorded in 12 individuals with bulbar ALS and 10 healthy controls during a speech task and two speechlike tasks (i.e., alternating motion rate [AMR], sequential motion rate [SMR]). Eight articulatory features were derived for each participant per task, including the range, maximum speed, and acceleration time of tongue and jaw movements as well as the coupling and timing between tongue and jaw movements. The effects of task (i.e., AMR, SMR, speech) and group (i.e., ALS, control) on these articulatory features were evaluated. For each feature, the task that yielded the largest difference between the ALS and control groups was identified. The diagnostic efficacy of these task-specific features was assessed using the receiver operating characteristic analysis; the relation of these task-specific features to a well-established bulbar severity index—speaking rate—was determined using Spearman's rank correlation. Results Seven task-specific articulatory features were identified, including (a) tongue and jaw acceleration time during the AMR task, (b) tongue–jaw coupling during the SMR task, and (c) range of tongue movement, maximum tongue and jaw speed, and temporal lag between tongue and jaw movements during the speech task. Among these features, tongue and jaw acceleration time and their temporal lag showed relatively high accuracy (i.e., 0.83–0.95) in differentiating individuals with ALS from healthy controls. Range of tongue movement and maximum tongue and jaw speed showed significant correlations with speaking rate. Conclusion Findings provided preliminary evidence for the utility of task-specific articulatory measurements as a novel quantitative assessment to detect and predict bulbar motor involvement in ALS.

scholarly journals Predicting Early Bulbar Decline in Amyotrophic Lateral Sclerosis: A Speech Subsystem Approach

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Panying Rong ◽  
Yana Yunusova ◽  
Jun Wang ◽  
Jordan R. Green
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speech Intelligibility ◽  
Disease Onset ◽  
Principal Component ◽  
Speaking Rate ◽  
Linear Mixed Effects ◽  
Data Mining Approach ◽  
Kaplan Meier ◽  
Bulbar Dysfunction ◽  
Lateral Sclerosis

Purpose. To develop a predictive model of speech loss in persons with amyotrophic lateral sclerosis (ALS) based on measures of respiratory, phonatory, articulatory, and resonatory functions that were selected using a data-mining approach.Method. Physiologic speech subsystem (respiratory, phonatory, articulatory, and resonatory) functions were evaluated longitudinally in 66 individuals with ALS using multiple instrumentation approaches including acoustic, aerodynamic, nasometeric, and kinematic. The instrumental measures of the subsystem functions were subjected to a principal component analysis and linear mixed effects models to derive a set of comprehensive predictors of bulbar dysfunction. These subsystem predictors were subjected to a Kaplan-Meier analysis to estimate the time until speech loss.Results. For a majority of participants, speech subsystem decline was detectible prior to declines in speech intelligibility and speaking rate. Among all subsystems, the articulatory and phonatory predictors were most responsive to early bulbar deterioration; and the resonatory and respiratory predictors were as responsive to bulbar decline as was speaking rate.Conclusions. The articulatory and phonatory predictors are sensitive indicators of early bulbar decline due to ALS, which has implications for predicting disease onset and progression and clinical management of ALS.

scholarly journals Shorter Sentence Length Maximizes Intelligibility and Speech Motor Performance in Persons With Dysarthria Due to Amyotrophic Lateral Sclerosis

2019 ◽  
Vol 28 (1) ◽  
pp. 96-107 ◽  
Author(s):  
Kristen M. Allison ◽  
Yana Yunusova ◽  
Jordan R. Green
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speech Intelligibility ◽  
Motor Performance ◽  
Pause Duration ◽  
Sentence Length ◽  
Speaking Rate ◽  
Event Duration ◽  
Severity Levels ◽  
Speech Motor ◽  
Lateral Sclerosis

Purpose The purpose of this study was to investigate the effect of sentence length on intelligibility and measures of speech motor performance in persons with amyotrophic lateral sclerosis (ALS) and to determine how these effects were influenced by dysarthria severity levels. Method One hundred thirty-one persons with ALS were included in this study, stratified into 4 dysarthria severity groups. All participants produced sentences from 5 to 15 words in length. Intelligibility, speaking rate, and measures of speech pausing behavior (i.e., total speech duration, total pause duration, and mean speech event duration) were measured for each sentence. Linear mixed-effects models were used to determine the effect of sentence length on speech measures for speakers at different dysarthria severity levels. Results Results showed that speech intelligibility significantly declined at longer sentence lengths only for the speakers with ALS who had more advanced dysarthria symptoms; however, speakers with mild-to-severe dysarthria showed significant declines in speaking rate and speech pausing behavior at longer sentence lengths. Conclusions Findings suggest that producing shorter sentences may help maximize intelligibility for speakers with moderate-to-severe dysarthria secondary to ALS and may be a beneficial compensatory strategy for preserving motor effort for all speakers with dysarthria secondary to ALS.

The Influence of Speaking Rate on Vowel Space and Speech Intelligibility for Individuals With Amyotrophic Lateral Sclerosis

1995 ◽  
Vol 38 (5) ◽  
pp. 1001-1013 ◽  
Author(s):  
Greg S. Turner ◽  
Kris Tjaden ◽  
Gary Weismer
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speech Intelligibility ◽  
Speaking Rate ◽  
Age And Gender ◽  
Vowel Space ◽  
Global Estimates ◽  
And Gender ◽  
The Relationship ◽  
Neurologically Intact ◽  
Lateral Sclerosis

The relationship between speaking rate, vowel space area, and speech intelligibility was studied in a group of 9 subjects with amyotrophic lateral sclerosis (ALS) and 9 age- and gender-matched controls. Subjects read a standard passage (the Farm Passage) at three speaking rates, including HABITUAL, FAST, and SLOW. Vowel segment durations and target formant frequencies were measured at each speaking rate from select words containing the vowels /i/, /æ/, /a/, and /u/. To quantify changes in vowel space area across speaking rate, the area of the vowel quadrilateral was calculated for each speaker at each speaking rate. In addition, intelligibility estimates at each speaking rate were obtained for the dysarthric speakers. Results revealed that dysarthric speakers exhibited smaller vowel space areas and less systematic changes in vowel space as a function of speaking rate, when compared to the neurologically intact speakers. In an examination of the relationship between vowel space area and speech intelligibility, vowel space was found to account for 45% of the variance in speech intelligibility. This result suggests that vowel space area is an important component of global estimates of speech intelligibility.

Psychometric Properties of Rapid Word-Based Rate Measures in the Assessment of Bulbar Amyotrophic Lateral Sclerosis: Comparisons With Syllable-Based Rate Tasks

2021 ◽  
pp. 1-14
Author(s):  
Sanjana Shellikeri ◽  
Reeman Marzouqah ◽  
Benjamin Rix Brooks ◽  
Lorne Zinman ◽  
Jordan R. Green ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Psychometric Properties ◽  
Speaking Rate ◽  
Real Word ◽  
Characteristic Analysis ◽  
Motor Speech ◽  
Discriminatory Ability ◽  
Discrimination Ability ◽  
Electromagnetic Articulography ◽  
Lateral Sclerosis

Purpose Rapid maximum performance repetition tasks have increasingly demonstrated their utility as clinimetric markers supporting diagnosis and monitoring of bulbar disease in amyotrophic lateral sclerosis (ALS). A recently developed protocol uses novel real-word repetitions instead of traditional nonword/syllable sequences in hopes of improving sensitivity to motor speech impairments by adding a phonological target constraint that would activate a greater expanse of the motor speech neuroanatomy. This study established the psychometric properties of this novel clinimetric protocol in its assessment of bulbar ALS and compared performance to traditional syllable sequence dysdiadochokinetic (DDK) tasks. Specific objectives were to (a) compare rates between controls and speakers with symptomatic versus presymptomatic bulbar disease, (b) characterize their discriminatory ability in detecting presymptomatic bulbar disease compared to healthy speech, (c) determine their articulatory movement underpinnings, and (d) establish within-individual longitudinal changes. Method DDK and novel tongue (“ticker”—TAR) and labial (“pepper”—LAR) articulatory rates were compared between n = 18 speakers with presymptomatic bulbar disease, n = 10 speakers with symptomatic bulbar disease, and n = 13 healthy controls. Bulbar disease groups were determined by a previously validated speaking rate cutoff. Discriminatory ability was determined using receiver operating characteristic analysis. Within-individual change over time was characterized in a subset of 16 participants with available longitudinal data using linear mixed-effects models. Real-time articulatory movements of the tongue front, tongue dorsum, jaw, and lips were captured using 3-D electromagnetic articulography; effects of movement displacement and speed on clinimetric rates were determined using stepwise linear regressions. Results All clinimetric rates (traditional DDK tasks and novel tasks) were reduced in speakers with symptomatic bulbar disease; only TAR was reduced in speakers with presymptomatic bulbar disease and was able to detect this group with an excellent discrimination ability (area under the curve = 0.83). Kinematic analyses revealed associations with expected articulators, greater motor complexity, and differential articulatory patterns for the novel real-word repetitions than their DDK counterparts. Only LAR significantly declined longitudinally over the disease course. Conclusion Novel real-word clinimetric rate tasks evaluating tongue and labial articulatory dysfunction are valid and effective markers for early detection and tracking of bulbar disease in ALS.

scholarly journals A Phonetic Complexity-Based Approach for Intelligibility and Articulatory Precision Testing: A Preliminary Study on Talkers With Amyotrophic Lateral Sclerosis

2018 ◽  
Vol 61 (9) ◽  
pp. 2205-2214 ◽  
Author(s):  
Mili Kuruvilla-Dugdale ◽  
Claire Custer ◽  
Lindsey Heidrick ◽  
Richard Barohn ◽  
Raghav Govindarajan
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speech Intelligibility ◽  
Speech Impairments ◽  
Word Level ◽  
Preliminary Study ◽  
Perceived Impact ◽  
Complex Words ◽  
Level Analysis ◽  
Precision Testing ◽  
Lateral Sclerosis

Purpose This study describes a phonetic complexity-based approach for speech intelligibility and articulatory precision testing using preliminary data from talkers with amyotrophic lateral sclerosis. Method Eight talkers with amyotrophic lateral sclerosis and 8 healthy controls produced a list of 16 low and high complexity words. Sixty-four listeners judged the samples for intelligibility, and 2 trained listeners completed phoneme-level analysis to determine articulatory precision. To estimate percent intelligibility, listeners orthographically transcribed each word, and the transcriptions were scored as being either accurate or inaccurate. Percent articulatory precision was calculated based on the experienced listeners' judgments of phoneme distortions, deletions, additions, and/or substitutions for each word. Articulation errors were weighted based on the perceived impact on intelligibility to determine word-level precision. Results Between-groups differences in word intelligibility and articulatory precision were significant at lower levels of phonetic complexity as dysarthria severity increased. Specifically, more severely impaired talkers showed significant reductions in word intelligibility and precision at both complexity levels, whereas those with milder speech impairments displayed intelligibility reductions only for more complex words. Articulatory precision was less sensitive to mild dysarthria compared to speech intelligibility for the proposed complexity-based approach. Conclusions Considering phonetic complexity for dysarthria tests could result in more sensitive assessments for detecting and monitoring dysarthria progression.

Sign in / Sign up

Export Citation Format

Share Document