Speech Deterioration of Amyotrophic Lateral Sclerosis Before and After Diagnosis: A Case Study of a Newscaster

2019 ◽  
Vol 4 (5) ◽  
pp. 1189-1198
Author(s):  
Emily Watkins ◽  
Austin Thompson ◽  
Yunjung Kim
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Speech Disorders ◽  
Formant Frequency ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Vowel Space ◽  
Before And After ◽  
Second Formant ◽  
Lateral Sclerosis

Purpose This case study traced speech deterioration in an individual before and after the time of diagnosis of amyotrophic lateral sclerosis (ALS). Our participant was diagnosed with spinal-onset, familial ALS in 2017. The speaker's occupation, a professional newscaster for 37 years, allowed a retrospective examination of her speech during news segments over 37 months around the diagnosis, including prediagnosis. Method A total of 6 time points were selected to track auditory-perceptual and acoustic speech deterioration (2 years, 14 months, and 7 months prior to diagnosis; the month of diagnosis; and 7 months and 12 months after diagnosis). For perceptual ratings, 2 experts in motor speech disorders rated 17 speech dimensions on a 7-point scale. Four acoustic parameters were chosen for measurement: articulation rate, utterance duration, second formant frequency slope, and acoustic vowel space. Additionally, kinematic data were obtained from 1 time-point (8 months postdiagnosis) and descriptively compared to the movement of other individuals with ALS and to healthy speakers. Results As expected, both perceptual and acoustic results indicated a decline in the selected speech measures as the disease progressed. More interestingly, the measures showed a consistent curvilinear appearance in which the speech parameters exhibit an improvement until immediately before and around the diagnosis, followed by sudden, drastic deterioration. Kinematic results indicated a greater degree of movement and speed compared to healthy speakers, probably due to the speaker's occupation. Conclusions Based on the findings, the time around diagnosis is considered a critical period with respect to speech deterioration in ALS wherein a dynamic, increasing–decreasing pattern of changes occur. This finding appears to reflect the patient's compensatory strategies and the speech deficits associated with bulbar involvement.

scholarly journals (Dys)Prosody in Parkinson’s Disease: Effects of Medication and Disease Duration on Intonation and Prosodic Phrasing

2021 ◽  
Vol 11 (8) ◽  
pp. 1100
Author(s):  
Sónia Frota ◽  
Marisa Cruz ◽  
Rita Cardoso ◽  
Isabel Guimarães ◽  
Joaquim Ferreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Duration ◽  
Speech Disorders ◽  
Motor Fluctuations ◽  
Prosodic Phrasing ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Before And After ◽  
Prosodic Categories

The phonology of prosody has received little attention in studies of motor speech disorders. The present study investigates the phonology of intonation (nuclear contours) and speech chunking (prosodic phrasing) in Parkinson’s disease (PD) as a function of medication intake and duration of the disease. Following methods of the prosodic and intonational phonology frameworks, we examined the ability of 30 PD patients to use intonation categories and prosodic phrasing structures in ways similar to 20 healthy controls to convey similar meanings. Speech data from PD patients were collected before and after a dopaminomimetic drug intake and were phonologically analyzed in relation to nuclear contours and intonational phrasing. Besides medication, disease duration and the presence of motor fluctuations were also factors included in the analyses. Overall, PD patients showed a decreased ability to use nuclear contours and prosodic phrasing. Medication improved intonation regardless of disease duration but did not help with dysprosodic phrasing. In turn, disease duration and motor fluctuations affected phrasing patterns but had no impact on intonation. Our study demonstrated that the phonology of prosody is impaired in PD, and prosodic categories and structures may be differently affected, with implications for the understanding of PD neurophysiology and therapy.

Speech Deterioration in Amyotrophic Lateral Sclerosis

1991 ◽  
Vol 34 (6) ◽  
pp. 1269-1275 ◽  
Author(s):  
Raymond D. Kent ◽  
Robert L. Sufit ◽  
John C. Rosenbek ◽  
Jane F. Kent ◽  
Gary Weismer ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Pulmonary Function ◽  
Speech Intelligibility ◽  
Word Identification ◽  
Signal To Noise Ratio ◽  
Observation Interval ◽  
Formant Frequency ◽  
Phonetic Features ◽  
Second Formant ◽  
Lateral Sclerosis

Few detailed reports have been published on the nature of speech and voice changes during the course of amyotrophic lateral sclerosis (ALS). The subject of this case study is a woman who was diagnosed as having ALS with bulbar signs at the age of 53. Speech intelligibility, pulmonary function, and selected speech and voice functions were tested during an approximately 2-year course of her disease. Over this period, her speech intelligibility, as measured by a multiplechoice word identification test, declined from 98% to 48%. Phonetic features that were most affected during the intelligibility decline included voicing contrast for syllable-initial and syllablefinal consonants, place of articulation contrasts for lingual consonants, manner of articulation for lingual consonants, stop versus nasal manner of production, features related to the liquid consonants, and various features related to syllable shape. An acoustic measure, average slope of the second-formant frequency, declined in association with the intelligibility reduction and is thought to reflect the loss of lingual motoneurons. Her pulmonary function also declined over the observation interval, with particularly severe reduction in measures of air flow. Oral diadochokinesis and measures of vocal function (including jitter, shimmer, and signal-to-noise ratio) were highly variable across test sessions. These results are discussed in terms of the challenges they present to sensitive assessment of change and to management of the communication disability in ALS.

scholarly journals Changes in speech charactersitics post thymoma

2018 ◽  
Vol 5 (1) ◽  
pp. 212
Author(s):  
Shantanu Arya ◽  
Sachin . ◽  
L. N. Garg ◽  
Tashi Wangmo ◽  
Nima Zangmo ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Neuromuscular Disorders ◽  
Cranial Nerves ◽  
Anterior Mediastinum ◽  
Speech Disorders ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Speech Characteristics ◽  
Present Case Study

<p class="abstract">Thymomas are rare tumors of the anterior mediastinum that may be benign or malignant. Thymomas are frequently associated with neuromuscular disorders like myasthenia gravis. Multiple cranial nerves are involved which may affect speech of the patients. Flaccid dysarthria is one of the common motor speech disorders associated with thymoma. Other characteristics may include decrease of intelligibility, reduced vocal stamina, reduction of emotional expressivity etc. The present case study illustrates changes in speech characteristics in a 35 year old male patient with thymoma associated with myasthenia gravis. Detailed speech assessment was done which revealed deviant speech patterns like vocal tremors, decreased loudness, hypernasality etc. The aim of the study was to document speech characteristics in a known case of thymoma associated with myasthenia gravis.</p>

The Labeling Problem in Aphasia

1986 ◽  
Vol 51 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Audrey L. Holland ◽  
Davida Fromm ◽  
Carol S. Swindell
Keyword(s):  
Speech Disorders ◽  
Case Description ◽  
Test Results ◽  
Apraxia Of Speech ◽  
Poor Agreement ◽  
Motor Speech ◽  
Motor Speech Disorders ◽  
Communication Difficulties ◽  
Token Test ◽  
Primary Problem

Twenty-five "experts" on neurogenic motor speech disorders participated in a tutorial exercise. Each was given information on M, a patient who had communication difficulties as the result of stroke, and asked to complete a questionnaire about his problem. The information included a detailed case description, an audiotape of M's speech obtained at 4, 9, 13, and 17 days post-stroke, and test results from the Western Aphasia Battery, the Token Test, and a battery for apraxia of speech. The experts were in excellent agreement on M's primary problem, although it was called by seven different names. The experts were in poor agreement on his secondary problem(s), e.g., the presence and type of aphasia and dysarthria. The results suggest that labeling is difficult, even for "experts." Furthermore, the practicing clinician needs to be sensitive to the likelihood of more than one coexisting problem.

scholarly journals Lingual–Alveolar Contact Pressure During Speech in Amyotrophic Lateral Sclerosis: Preliminary Findings

2017 ◽  
Vol 60 (4) ◽  
pp. 810-825 ◽  
Author(s):  
Jeff Searl ◽  
Stephanie Knollhoff ◽  
Richard J. Barohn
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Healthy Volunteers ◽  
Contact Pressure ◽  
Statistical Difference ◽  
Healthy Controls ◽  
Perceptual Judgments ◽  
Before And After ◽  
Preliminary Study ◽  
Contact Pressures ◽  
Lateral Sclerosis

Purpose This preliminary study on lingual–alveolar contact pressures (LACP) in people with amyotrophic lateral sclerosis (ALS) had several aims: (a) to evaluate whether the protocol induced fatigue, (b) to compare LACP during speech (LACP-Sp) and during maximum isometric pressing (LACP-Max) in people with ALS (PALS) versus healthy controls, (c) to compare the percentage of LACP-Max utilized during speech (%Max) for PALS versus controls, and (d) to evaluate relationships between LACP-Sp and LACP-Max with word intelligibility. Method Thirteen PALS and 12 healthy volunteers produced /t, d, s, z, l, n/ sounds while LACP-Sp was recorded. LACP-Max was obtained before and after the speech protocol. Word intelligibility was obtained from auditory–perceptual judgments. Results LACP-Max values measured before and after completion of the speech protocol did not differ. LACP-Sp and LACP-Max were statistically lower in the ALS bulbar group compared with controls and PALS with only spinal symptoms. There was no statistical difference between groups for %Max. LACP-Sp and LACP-Max were correlated with word intelligibility. Conclusions It was feasible to obtain LACP-Sp measures without inducing fatigue. Reductions in LACP-Sp and LACP-Max for bulbar speakers might reflect tongue weakness. Although confirmation of results is needed, the data indicate that individuals with high word intelligibility maintained LACP-Sp at or above 2 kPa and LACP-Max at or above 50 kPa.

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