221 research outputs found
Mastication Dyspraxia: A Neurodevelopmental Disorder Reflecting Disruption of the Cerebellocerebral Network Involved in Planned Actions
This paper reports the longitudinal clinical, neurocognitive, and neuroradiological findings in an adolescent patient with nonprogressive motor and cognitive disturbances consistent with a diagnosis of developmental coordination disorder (DCD). In addition to prototypical DCD, the development of mastication was severely impaired, while no evidence of swallowing apraxia, dysphagia, sensorimotor disturbances, abnormal tone, or impaired general cognition was found. He suffered from bronchopulmonary dysplasia and was ventilated as a newborn for 1.5 months. At the age of 3 months, a ventriculoperitoneal shunt was surgically installed because of obstructive hydrocephalus secondary to perinatal intraventricular bleeding. At the age of 5 years, the patient’s attempts to masticate were characterized by rough, effortful, and laborious biting movements confined to the vertical plane. Solid food particles had a tendency to get struck in his mouth and there was constant spillage. As a substitute for mastication, he moved the unground food with his fingers in a lateral direction to the mandibular and maxillary vestibule to externally manipulate and squeeze the food between cheek and teeth with the palm of his hand. Once the food was sufficiently soft, the bolus was correctly transported by the tongue in posterior direction and normal deglutition took place. Repeat magnetic resonance imaging (MRI) during follow-up disclosed mild structural abnormalities as the sequelae of the perinatal intraventricular bleeding, but this could not explain impaired mastication behavior. Quantified Tc-99m-ethylcysteinate dimer single-photon emission computed tomography (Tc-99m-ECD SPECT), however, revealed decreased perfusion in the left cerebellar hemisphere, as well as in both inferior lateral frontal regions, both motor cortices, and the right anterior and lateral temporal areas. Anatomoclinical findings in this patient with DCD not only indicate that the functional integrity of the cerebellocerebral network is crucially important in the planning and execution of skilled actions, but also seem to show for the first time that mastication deficits may be of true apraxic origin. As a result, it is hypothesized that “mastication dyspraxia” may have to be considered as a distinct nosological entity within the group of the developmental dyspraxias following a disruption of the cerebellocerebral network involved in planned actions
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Intrinsic vowel F0, the size of vowel inventories and second language acquisition
The phenomenon of intrinsic vowel F0 (IF0), in which high vowels exhibit higher F0 than low vowels, has been widely attested in languages of the world. Most often, IF0 is regarded as an automatic, physiologically determined phenomenon, whereas some claim that IF0 is a controlled feature, introduced to enhance vowel contrasts. This paper presents new evidence on this issue by means of a cross-linguistic investigation of the influence of vowel inventory size on IF0 and a study of IF0 in second language (L2) acquisition. IF0 was measured in three language varieties: Arabic (a language with 3 vowels), Dutch (a 12-vowel system), and Dutch spoken by native Arabic-speaking learners. IF0 was significantly larger in Dutch than Arabic, but did not differ significantly between Arabic and Dutch produced by L2 learners. No spectral differences between the corresponding vowels of the three language varieties were found. While confirming the universality of IF0, these results also suggest that the size of IF0 may be language-specific, depending on the need to enhance vowel contrasts. Thus, these results agree well with a mixed physiological-enhancement account, which assumes that IF0 is physiologically determined, but also at least in part the effect of an interacting, controlled mechanism
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Lusoga (Lutenga)
Lusoga is an interlacustrine Bantu language spoken in the eastern part of Uganda in the region of Busoga, which is surrounded by the Victoria Nile in the west, Lake Kyoga in the north, the River Mpologoma in the east and Lake Victoria in the south. According to the 2002 census, this language is spoken by slightly over two million people (UBOS 2006: 12)
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Neurogenic foreign accent syndrome: Articulatory setting, segments and prosody in a Dutch speaker
Foreign accent syndrome (FAS) can be defined as a motor speech disorder in which patients develop a speech accent which is notably different from their premorbid habitual accent. This paper aims to provide an explicit description of the neurolinguistic and phonetic characteristics of a female speaker of Belgian Dutch who suffered from neurogenic FAS in which she developed a French/German foreign accent after a left hemisphere stroke. A detailed phonetic analysis of the speaker’s pronunciation errors revealed problems at both the segmental and suprasegmental level. At the segmental level a wide variety of pronunciation errors were observed which are consistent with a tense articulatory setting: creaky voice, strengthening of fricatives into stops and more carefully articulated consonants and vowels. The data suggest that the perception of the French accent may have resulted from a combination of speech pathology features and unaffected regional pronunciation characteristics of the patient’s Standard Dutch.
In contrast to the traditional view in the literature that FAS represents a primary dysprosodic disturbance, a detailed analysis of the speaker’s intonation contours by means of the stylization method revealed the entirely correct implementation of the most common pitch contours of Standard Dutch. This unique finding shows that FAS does not by definition follow from disruption of prosodic processing. However, the frequency of occurrence of the different types of pitch contours was clearly deviant since the patient very frequently used the Dutch continuation rise. It is hypothesized that this might represent a deliberate strategy of the speaker to stay in control of the speaking situation by keeping the speaking turn which she is at continuous risk of losing as the result of long and frequent pausing
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Developmental Foreign Accent Syndrome: report of a new case
This paper presents the case of a 17-year-old right-handed Belgian boy with developmental FAS and comorbid developmental apraxia of speech (DAS). Extensive neuropsychological and neurolinguistic investigations demonstrated a normal IQ but impaired planning (visuo-constructional dyspraxia). A Tc-99m-ECD SPECT revealed a significant hypoperfusion in the prefrontal and medial frontal regions, as well as in the lateral temporal regions. Hypoperfusion in the right cerebellum almost reached significance. It is hypothesized that these clinical findings support the view that FAS and DAS are related phenomena following impairment of the cerebro-cerebellar network
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Prosodic modulation in the babble of cochlear implanted and normally hearing infants: a perceptual study using a visual analogue scale
This study investigates prosodic modulation in the spontaneous canonical babble of congenitally deaf infants with cochlear implants (CI) and normally hearing (NH) infants. Research has shown that the acoustic cues to prominence are less modulated in CI babble. However acoustic measurements of individual cues to prominence give incomplete information about prosodic modulation. In the present study, raters are asked to judge prominence since they simultaneously take into account all prosodic cues. Disyllabic utterances produced by CI and NH infants were presented to naive adult raters who had to indicate the degree and direction of prosodic modulation between syllables on a visual analogue scale. The results show that the babble of infants with CI is rated as having less prosodic modulation. Moreover, segmentally more variegated babble is rated as having more prosodic modulation. Raters do not perceive the babble to be predominantly trochaic, which indicates that the predominant stress pattern of Dutch is not yet apparent in the children’s productions
Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer
Background: Prone whole breast irradiation (WBI) leads to reduced heart and lung doses in breast cancer patients receiving adjuvant radiotherapy. In this feasibility trial, we investigated the prone position for whole breast + lymph node irradiation (WB + LNI).
Methods: A new support device was developed for optimal target coverage, on which patients are positioned in a position resembling a phase from the crawl swimming technique (prone crawl position). Five left sided breast cancer patients were included and simulated in supine and prone position. For each patient, a treatment plan was made in prone and supine position for WB + LNI to the whole axilla and the unoperated part of the axilla. Patients served as their own controls for comparing dosimetry of target volumes and organs at risk (OAR) in prone versus in supine position.
Results: Target volume coverage differed only slightly between prone and supine position. Doses were significantly reduced (P < 0.05) in prone position for ipsilateral lung (Dmean, D2, V5, V10, V20, V30), contralateral lung (Dmean, D2), contralateral breast (Dmean, D2 and for total axillary WB + LNI also V5), thyroid (Dmean, D2, V5, V10, V20, V30), oesophagus (Dmean and for partial axillary WB + LNI also D2 and V5), skin (D2 and for partial axillary WB + LNI V105 and V107). There were no significant differences for heart and humeral head doses.
Conclusions: Prone crawl position in WB + LNI allows for good breast and nodal target coverage with better sparing of ipsilateral lung, thyroid, contralateral breast, contralateral lung and oesophagus when compared to supine position. There is no difference in heart and humeral head doses
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Psychogenic Foreign Accent Syndrome: A New Case
This paper presents the case of a 33-year-old, right-handed, French-speaking Belgian lady who was involved in a car accident as a pedestrian. Six months after the incident she developed a German/Flemish-like accent. The patient's medical history, the onset of the FAS and the possible psychological causes of the accent change are analyzed. Relevant neuropsychological, neurolinguistic, and psychodiagnostic test results are presented and discussed. The psychodiagnostic interview and testing will receive special attention, because these have been underreported in previous FAS case reports. Furthermore, an accent rating experiment was carried out in order to assess the foreign quality of the patient's speech. Pre- and post-morbid spontaneous speech samples were analyzed phonetically to identify the pronunciation characteristics associated with this type of FAS. Several findings were considered essential in the diagnosis of psychogenic FAS: the psychological assessments as well as the clinical interview confirmed the presence of psychological problems, while neurological damage was excluded by means of repeated neuroimaging and neurological examinations. The type and nature of the speech symptoms and the accent fluctuations associated with the patient's psychological state cannot be explained by a neurological disorder. Moreover, the indifference of the patient toward her condition may also suggest a psychogenic etiology, as the opposite is usually observed in neurogenic FAS patients
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Perceptual accent rating and attribution in psychogenic FAS: some further evidence challenging Whitaker's operational definition
A 40-year-old, non-aphasic, right-handed, and polyglot (L1: French, L2: Dutch, L3: English) woman with a 12 year history of addiction to opiates and psychoactive substances, and clear psychiatric problems, presented with a foreign accent of sudden onset in L1. Speech evolved towards a mostly fluent output, despite a stutter-like behavior and a marked grammatical output disorder. The psychogenic etiology of the accent foreignness was construed based upon the patient’s complex medical history, and psychodiagnostic, neuropsychological, and neurolinguistic assessments. The presence of a foreign accent was affirmed by a perceptual accent rating and attribution experiment.
It is argued that this patient provides additional evidence demonstrating the outdatedness of Whitaker’s (1982) definition of Foreign Accent Syndrome, as only one of the four operational criteria was unequivocally applicable to our patient: her accent foreignness was not only recognized by her relatives and the medical staff, but also by a group of native French-speaking laymen. However, our patient defied the three remaining criteria, as central nervous system damage could not conclusively be demonstrated, psychodiagnostic assessment raised the hypothesis of a conversion disorder, and the patient was a polyglot whose newly gained accent was associated with a range of foreign languages, which exceeded the ones she spoke
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