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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study evaluated the relationship between specific acoustic features of speech and perceptual judgments of word intelligibility of adults with cerebral palsy-dysarthria. Use of a contrasting word task allowed for intelligibility analysis and correlated acoustic analysis according to specified spectral and temporal features. Selected phonemic contrasts included syllable-initial voicing; syllable-final voicing; stop-nasal; fricative-affricate; front-back, high-low, and tense-lax vowels. Speech materials included a set of CVC stimulus words. Acoustic data are reported on vowel duration, formant frequency locations, voice onset times, amplitude rise times, and frication durations. Listeners' perceptual assessment of intelligibility of the 16 dysarthric adults by transcription and rating tasks is also presented. All but one acoustic contrast was successfully made as evidenced by measured acoustic differences between contrast pairs. However, the generally successful acoustic contrasts stood in marked contrast to the poorly rated intelligibility scores and high error percentages that were ascribed to the opposite pair members. A second analysis examined the contribution of these acoustic features towards estimates and prediction of intelligibility deficits in speakers with dysarthria. The scaled intelligibility was predicted by multiple regression analysis with 62.6% accuracy by acoustic measures related to one consonant contrast (fricative-affricate) and three vowel contrasts (front-back, high-low, and tense-lax). Other measured contrasts, such as those related to contrast voicing effects and stop-nasal distinctions, did not seem to contribute in a significant way to variability in the intelligibility estimates. These findings are discussed in relation to specific areas of production deficiency that are consistent across different types of dysarthria with cerebral palsy as the etiology.
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PMID:Acoustic-phonetic contrasts and intelligibility in the dysarthria associated with mixed cerebral palsy. 157 70

Cerebral palsy is a permanent and non-progressive brain damage due to various causes affecting a child from the intrauterine life up to the first two years of life. Its most common cause is neonatal hypoxic encephalopathy. The cerebral damage is diffuse so that it is commonly associated with epilepsy, mental retardation, dysarthria, hearing loss and oculomotor abnormalities. Strabismus is found in 50% of children with cerebral palsy. This prevalence is significantly different from the 2% incidence of oculomotor abnormalities in the pre-school age, it is noteworthy that strabismus and refractive errors respond to the classical therapeutic measures.
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PMID:[Physiopathology of ocular movements in infantile cerebral paralysis]. 270 64

Time domain and frequency domain analyses were performed on smoothed and averaged electromyographic (IEMG) activity recorded intramuscularly from 6 muscles of the lips, tongue and jaw during speech in normal and athetoid cerebral palsy subjects. The speech IEMG waveforms in both groups were composed of slowly changing tonic activity merging with more rapidly changing phasic bursts. Significant increases both in the durations and average levels of IEMG activity in the athetoid subjects resulted in a 5- to 30-fold increase in the speech muscle energy expended by these subjects. The peak-to-peak amplitudes of the IEMG activity were significantly increased in the athetoid subjects, commensurate with their increased average levels, thus demonstrating that they could vary their muscle contraction levels over a wide range. The velocities (rates of change) of muscle IEMG activity did not differ significantly between the two groups. The velocity of the IEMG activity increased linearly with its amplitude in both subject groups, but the durations of the IEMG bursts nevertheless were highly variable. The slope of the velocity-amplitude relation in the athetoid subjects was less than half that in the normal subjects, suggesting that the frequency bandwidth of muscle activity was reduced in the athetoid subjects, despite a normal range of IEMG velocities. The frequency analysis confirmed this suggestion. The upper limit of the average frequency spectrum of voluntary muscle activity for speech was 7 Hz in the normal subjects, whereas this limit was 4 Hz in the athetoid subjects. In the normal subjects each muscle had a different frequency spectrum, whereas the spectra for the 6 muscles were remarkably uniform in the athetoid subjects, implying an abnormality in the functional organization of their muscles. The findings of this study showed clearly that the temporospatial patterns of voluntary muscle activity in the athetoid subjects were grossly abnormal. Since this voluntary activity was reproducible across multiple repetitions of the same speech sample, the dysarthria in these speakers may be attributed to abnormal control of voluntary activity, not to involuntary movement. The results support the view that the primary disability in cerebral palsy is a disruption of the physiological mechanisms which subserve the acquisition of motor skills.
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PMID:Voluntary muscle control in normal and athetoid dysarthric speakers. 340 88

A quantitative study was made of the effects of focal cerebellar stimulation on oral-motor control, duration of phonation, articulation and vocal characteristics in 10 patients with cerebral palsy. The patients were evaluated prior to surgery and again after approximately two and six months of cerebellar stimulation. One patient had normal speech, which was not affected by the stimulation; another case with moderate dysarthria due to severe hearing loss was not helped by the stimulation. Seven patients increased their duration of vowel phonation by about two seconds, a significant amount. Four of the patients with moderate dysarthria improved their articulation, particularly for the consonants S, Sh and Th, after two months of stimulation. Two patients had changes in oral-motor control, which included better tongue and lip movements, and two other cases had small alterations in hypernasality or breathiness. Most of the changes in sound production and speech intelligibility appear to be related to improved intra-oral breath control.
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PMID:Speech changes in cerebral-palsied patients after cerebellar stimulation. 696 96

An unselected series of 116 dyskinetic cerebral palsy cases born 1959-70 was delineated and subgrouped according to neurological criteria into 35 hyperkinetic (30%) and 81 dystonic (70%) cases. Of the hyperkinetics, 80% had a mild motor disability, while 90% of the dystonics had moderate or severe disability. Subordinated spastic signs were found in 9% of the hyperkinetic and in 44% of the dystonic cases. IQ was greater than 90 in 69% of the hyperkinetics and 25% of the dystonics and less than 50 in 11% and 41%, respectively. Two or more additional neurological abnormalities (spasticity, mental retardation, epilepsy, anarthria, dysarthria, hearing deficit) were detected in 46% hyperkinetic and 81% dystonic cases. A heavy multihandicap complex was present predominantly in the dystonic subgroup. The 5-19 year mortality rate was 6% and was confined to the most severely handicapped dystonic cases. The twin rate was 5%. A total of 9% had birth weights less than or equal to 1500 g, and 31% had less than or equal to 2500 g. The weight- and age-specific incidences increased rapidly with decreasing birth weights and gestational ages. The crude incidence of hyperkinetic cerebral palsy was 0.07 and dystonic cerebral palsy 0.17 per thousand live births.
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PMID:Dyskinetic cerebral palsy. I. Clinical categories, associated neurological abnormalities and incidences. 713 69

Chronic cerebellar stimulation (CCS) of the anterior lobe is undertaken for relief or motor dysfunction in cerebral palsy, but the long-term effect on speech and voice has been uncertain. The present study evaluated speech before cerebellar stimulation and between one year and two years, seven months following stimulation in nine patients with congenital cerebral palsy and one patient with traumatic brain damage. Severity of dysarthria was not significantly altered as assessed by a panel of listeners. No patient demonstrated deteriorations in speech. Only two of the 10 patients showed small positive changes in the majority of parameters evaluated including rate, articulation, and voice.
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PMID:Long-term effects on speech of chronic cerebellar stimulation in cerebral palsy. 727 73

Electromyograms were recorded with hooked-wire electrodes from sixteen lip, tongue and jaw muscles in six normal and seven cerebral palsied adult subjects during a variety of speech and non-speech tasks. The recorded patterns of muscle activity fail to support a number of theories concerning the pathophysiology of dysarthria in cerebral palsy. There was no indication of weakness in individual articulator muscles. There was no evidence of uncontrolled sustained background activity or of abnormal tonic stretch reflex responses in lip or tongue muscles. Primitive or pathological reflexes could not be elicited by orofacial stimulation. No imbalance between positive and negative oral responses was observed. The view that random involuntary movement disrupts essentially normal voluntary control in athetosis was not supported. Each cerebral palsied subject displayed an idiosyncratic pattern of abnormal muscle activity which was reproduced across repetitions of the same phrase, indicating a consistent defect in motor programming.
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PMID:Pathophysiology of dysarthria in cerebral palsy. 733 87

The adequacy of biting, sucking, swallowing, and chewing as well as the presence or absence of nine infantile oral reflexes were assessed in 60 cerebral-palsied individuals. The effect of the asymmetric tonic neck reflex and the Moro reflex on the infantile oral reflexes was also studied. There was a trend for subjects with more adequate feeding skills to achieve higher levels of overall speech proficiency and articulatory competency, but this trend was not completely systematic. Fifteen subjects displayed abnormal oral reflexes, but these reflexes could not be elicited consistently. The effect of the ATNR and Moro reflex on the oral reflexes seemed limited. Results generally supported the value of the widespread prescription of improving feeding in cerebral palsy, but the need to modify abnormal oral reflexes received less support. The question of using prespeech oromotor training to reduce possible future dysarthria is discussed in terms of the findings.
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PMID:Speech performance, dysphagia and oral reflexes in cerebral palsy. 735 31

The speech intelligibility and articulatory impairment of 32 spastic and 18 athetoid males, aged 17-55, were examined. Selection was based on a definite diagnosis of cerebral palsy, and adequate intelligence, hearing, and ability to perform the required tasks. Two estimates of speech intelligibility were obtained from naive listeners: single words correctly recognized and prose intelligibility rating. Diadochokinetic (DDK) syllable rates and percent correct articulation of selected phonemes were employed as indices of articulatory impairment. The 50 subjects were, on average, judged to be 50% intelligible on both intelligibility estimates. Group mean DDK rate was 2.9 syllables per second and 78% of phonemes were transcribed as correctly articulated. :The mean scores of the spastic subjects were superior to the athetoids on all speech measures, significantly so for single-word intelligibility and DDK rate even when group inequalities for physical disability and I.Q. were adjusted. In this sample, spastics were less physically disabled and had lower I.Q.'s than athetoids. Specific phonemic features characteristic of the dysarthria in cerebral-palsied subjects were: (1) anterior lingual place inaccuracy; (2) reduced precision of fricative and affricate manners; and (3) inability to achieve the extreme positions in the vowel articulatory space. A comparison of these results with those reported for children with cerebral palsy suggests that the consonantal place and manner problems are fairly stable features of cerebral palsy dysarthria.
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PMID:Dysarthria of adult cerebral palsy: I. Intelligibility and articulatory impairment. 744 82

Language disturbances in cerebral palsy with mutism. The analysis of the afferent side of language in 18 cerebral palsy children with no oral expression shows that they form a very heterogeneous population. The semiological analysis concerning comprehension leads to their classification into four main groups akin to the classical dysphasia syndromes. Major agrammatism occurring in phonologico-syntactic dysphasia. Sensory dysphasias (or verbal deafness). Mixed (or global) dysphasias. Motor dysphasias: phonological programmation disturbances (anarthria) and motor production disturbances (dysarthria). The disclosure of these various dysphasias allows for specific rehabilitation and for education procedures suitable for each individual patient.
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PMID:[Symptomatology of language disorders in cerebral palsy with mutism]. 821 52


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