Lingual Kinematics in Dysarthric and Nondysarthric Speakers with Parkinson's Disease

Articulatory dysfunction is recognised as a major contributor to the speech disturbances seen in Parkinson's disease (PD). The present study aimed to compare lingual kinematics during consonant production within a sentence in eight dysarthric (DPD) and seven nondysarthric (NDPD) speakers with PD with those of eleven nonneurologically impaired normal participants. The tongue tip and tongue back movements of the participants during sentence production were recorded using electromagnetic articulography (EMA). Results showed that both the DPD and NDPD had deviant articulatory movement during consonant production that resulted in longer duration of consonant production. When compared with the NDPD group, the DPD group primarily exhibited increased range of lingual movement and compatible duration of production with an accompanying increase in maximum velocity, maximum acceleration, and maximum deceleration. These findings are contrary to proposed theories that suggest articulatory imprecision in dysarthric speakers with PD is the outcome of reduced range of articulatory movement

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

The Use of Segmental and Suprasegmental Sequencing Skills to Differentiate Children With and Without Childhood Apraxia of Speech: Protocol for a Comparative Accuracy Study

BackgroundChildhood apraxia of speech (CAS) is a motor-based speech sound disorder (SSD) with a core impairment in the planning and programming of spatiotemporal parameters of speech movement sequences. CAS may cause deficits in both segmental and suprasegmental components of speech, and it can severely affect children’s ability to speak intelligibly and communicate effectively and impact their quality of life. Assessment tasks, such as the maximum performance tasks (MPT) and Syllable Repetition Task (SRT), examine children’s segmental sequencing skills to assist with the diagnosis of CAS. In Hong Kong, although the MPT and SRT have been used clinically to diagnose CAS in Cantonese-speaking children, their validity has not been reported. There is an urgent need for such investigations. Suprasegmentally, lexical stress errors have been reported as a consensual feature and to aid in the diagnosis of CAS. However, there are challenges in diagnosing CAS in children who speak tonal languages like Cantonese. A recent study has reported lexical tone errors in Cantonese-speaking children with CAS. Furthermore, deficits in pitch-variation skills were found in Cantonese-speaking children with CAS using a tone sequencing task (TST). It is hypothesized that there is a universal deficit in pitch-variation skills among tonal and nontonal language speakers with CAS. Further investigations of pitch-variation skills using the TST in Cantonese-speaking children with CAS may shed light on suprasegmental deficits in tonal languages and contribute to the development of a valid diagnostic tool for CAS in children who speak other tonal languages, such as Vietnamese, Thai, and Mandarin. ObjectiveThis study aims to examine the diagnostic potential of the MPT, SRT, and TST in diagnosing Cantonese-speaking children with CAS and to investigate pitch-variation skills in Cantonese-speaking children with and without CAS. MethodsA total of 25 children with CAS and 3 groups of age- and gender-matched controls (non-CAS SSD only group, non-CAS SSD co-occurring with language impairment group, and typical development group) will be recruited. All participants will perform the MPT, SRT, and TST measures. Their performances on these tools will be perceptually judged and acoustically measured. ResultsData collection will last from January 1, 2022, to October 30, 2023. As of August 2022, the project has recruited 4 children in the CAS group, 21 children in the non-CAS SSD group, 4 children in the speech and language impairment group, and 53 children in the typical development group. ConclusionsIt is anticipated that Cantonese-speaking children with CAS will have poorer pitch-variation skills than the control groups and that the MPT, SRT, and TST will be appropriate diagnostic tools for identifying CAS in Cantonese-speaking children. The project will benefit the field of speech-language pathology locally and internationally, with short- and long-term impacts. International Registered Report Identifier (IRRID)DERR1-10.2196/4046

Tongue function in nondysarthric speakers with Parkinson's disease: An electromagnetic articulography investigation

Articulatory imprecision in Parkinson's disease (PD) has been attributed to reduced range of movement, rigidity, and abnormal speed of movement of the articulatory structures. Previous studies provided acoustic and kinematic evidence of lip muscle rigidity, reduced amplitude, and velocity of lip and jaw movement, mainly based on nonspeech measures. Very limited studies have documented the effects of PD on lingual kinematics during speech production. The present study aimed to investigate lingual kinematics during sentence production in a group of 7 nondysarthric speakers with PD using the electromagnetic articulograph (AG-200 EMA). Tongue-tip and tongue-back movements were recorded by the EMA system during sentence production. Seven non-neurologically impaired participants matched for age and sex served as a control group. Results revealed no significant difference on the distance of tongue movement. However, the PD group did show significantly reduced maximum velocity, maximum acceleration, maximum deceleration, and significantly longer duration of tongue movement. Rates of sentence production were also slower for the PD group. The subclinical differences in tongue kinematics of the nondysarthric speakers with PD documented in this study support that limitations in the range of tongue movement leading to articulatory undershoot may be a major contributor to articulatory impairment in dysarthric speakers with PD. Copyright © 2010 Delmar Cengage Learning

Kinematic analysis of lingual function in dysarthric speakers with Parkinson's disease: An electromagnetic articulograph study

Dysarthria in people with Parkinson's disease (PD) has been widely studied. However, a limited number of studies have investigated lingual function during speech production in this population. This study aimed to investigate lingual kinematics during speech production using electromagnetic articulography (AG-200 EMA). The PD group consisted of eight dysarthric speakers with PD and was matched with a group of eight controls. The tongue tip and tongue back movements of all participants during sentence production were recorded by EMA. Results showed that, perceptually, the participants with PD were mildly dysarthric. Kinematic results documented comparable (for alveolar sentence production) and increased (for velar sentence production) range of lingual movement in the PD group when compared to the control group. Lingual movement velocity, acceleration, and deceleration were also increased in the PD group, predominantly for the release phase of consonant production during sentence utterances. The PD group had longer duration in the production of alveolar consonant and comparable duration in the production of velar consonant. The results of the present study suggest the presence of impaired lingual control in individuals with PD. Increased range of articulatory movement, primarily in the release phase of consonant production, may account for articulatory imprecision in this population. © 2010 The Speech Pathology Association of Australia Limited

Differential effects of increased loudness on tongue kinematics in individuals with PD? Analyses of two cases

Previous studies have suggested significant variation in the perceptual speech deficit displayed by individuals with Parkinson's disease (PD). This heterogeneity is partly attributed to differential changes in the underlying articulatory kinematics across speakers. Loudness-based treatment has been frequently used in individuals with PD. An improved understanding of individual differences and the effects of loudness on tongue movement in individuals with PD may help optimize speech intervention. The present study aimed to (1) examine individual differences in tongue kinematics during habitual and loud sentence production in two dysarthric speakers with PD, and (2) examine the effect of loudness manipulations on tongue kinematics during sentence production within each dysarthric speaker with PD. Electromagnetic articulography was used to record tongue tip movement during habitual and loud sentence productions in two participants with PD. Their performance was first matched with the performance of an age and gender-matched healthy individual. Subsequently, a within-participant comparison between habitual and loud sentence production was carried out to examine the effect of increased loudness. When compared with an age and gender-matched healthy control, both PD individuals showed greater tongue kinematic parameters during habitual and loud sentence productions. Subsequently, a within-participant comparison showed that, from habitual to loud speech, one PD speaker increased distance and maximum velocity of tongue movement while the other reduced maximum acceleration of tongue movement. The observed individual differences in tongue kinematics may be predictive of the efficacy of loudness-based treatments for articulatory and consequent perceptual improvements for individual participants

Effects of transcranial direct current stimulation over the Broca’s area on tongue twister production

<p><i>Purpose</i>: The present study aimed to explore the short-term effect of anodal transcranial direct current stimulation (tDCS) on tongue twister production.</p> <p><i>Method</i>: Thirty healthy native Cantonese adult speakers were randomly assigned to the anodal tDCS group or the sham tDCS group. Anodal tDCS of 2 mA was applied over the Broca’s area of the brain. The stimulation lasted for 20 min for the anodal tDCS group and 30 s for the sham tDCS group. The participants were instructed to produce a list of tongue twisters before, immediately after and 4 h after tDCS.</p> <p><i>Result</i>: Speech rate and response accuracy measured immediately after stimulation were significantly faster and higher, respectively, than before stimulation. Although there was no change in speech rate measured at 4 h after stimulation, response accuracy at that time point was significantly lower than that measured immediately after stimulation. However, there were no significant differences between the anodal tDCS and sham tDCS groups in either speech rate or response accuracy.</p> <p><i>Conclusion</i>: The findings revealed that a single session of anodal tDCS over the Broca’s area did not significantly improve speech production during tongue twister production.</p