Comparative analysis of gait and speech in Parkinson's disease: hypokinetic or dysrhythmic disorders?
Comparative analysis of gait and speech in Parkinson's disease: hypokinetic or dysrhythmic disorders?
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DOI：
10.1136/jnnp.2009.174375
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发表时间：
2010-02-01
影响因子：
11
通讯作者：
Azulay, Jean-Philippe
中科院分区：
文献类型：
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作者：
Cantiniaux, Stephanie;Vaugoyeau, Marianne;Azulay, Jean-Philippe
步态和语言是帕金森病患者经常受损的自动运动活动。这些疾病之间存在明显的临床相似性，但从未进行过调查。我们建议确定帕金森病的时空步态障碍和时间语言障碍之间是否存在任何共同特征。对11例帕金森病患者（PP）和11例对照者在自然、慢速和快速三种速度条件下进行丘脑下核深部脑刺激（STN-DBS）的步态和语言进行了分析。患者分别接受左旋多巴和刺激器开或关的测试。使用光电系统记录运动参数。研究人员用耳机记录了受试者在阅读一小段文字时的语音参数。结果证实，PP组的行走和阅读速度比对照组慢。患者在调节行走和言语速度方面的困难似乎主要是由于无法内部控制步长和停顿-言语持续时间（ISD）。STN-DBS和左旋多巴通过增加步长来提高患者的行走速度。STN-DBS和左旋多巴对语速没有影响，但恢复了患者调节ISD的能力。STN-DBS和左旋多巴治疗后患者的行走节奏和语速指数均有降低的趋势，且无明显改善。两组的言语和行走速度、ISD和步长均有相关性。两组的言语指数与行走节奏呈负相关。类似的基础运动障碍和可能类似的节奏因素同样影响患者的言语和步态。这些结果表明，在行走和说话功能障碍中存在类似的生理病理过程。
Gait and speech are automatic motor activities which are frequently impaired in Parkinson's disease. Obvious clinical similarities exist between these disorders but were never investigated. We propose to determine whether there exist any common features in Parkinson's disease between spatiotemporal gait disorders and temporal speech disorders.Gait and speech were analysed on 11 Parkinsonian patients (PP) undergoing deep-brain stimulation of the subthalamic nucleus (STN-DBS) and 11 control subjects under three conditions of velocity (natural, slow and speed). The patients were tested with and without L-dopa and stimulator ON or OFF. Locomotor parameters were recorded using an optoelectronic system. Speech parameters were recorded with a headphone while subjects were reading a short paragraph.The results confirmed that PP walk and read more slowly than controls. Patient's difficulties in modulating walking and speech velocities seem to be due mainly to an inability to internally control the step length and the interpause-speech duration (ISD).STN-DBS and levodopa increased patients' walking velocity by increasing the step length. STN-DBS and levodopa had no effect on speech velocity but restored the patients' ability to modulate the ISD. The walking cadence and speech index of rythmicity tended to be lower in patients and were not significantly improved by STN-DBS or levodopa. Speech and walking velocity as well as ISD and step length were correlated in both groups. Negative correlations between speech index of and walking cadence were observed in both groups. Similar fundamental hypokinetic impairment and probably a similar rhythmic factor similarly affected the patients' speech and gait. These results suggest a similar physiopathological process in both walking and speaking dysfunction.