Parkinson's disease or atypical parkinsonism? The importance of acoustic voice analysis in differential diagnosis of speech disorders
Parkinson's disease or atypical parkinsonism? The importance of acoustic voice analysis in differential diagnosis of speech disorders
复制标题
帕金森氏症还是非典型帕金森氏症？声学语音分析在言语障碍鉴别诊断中的重要性
DOI：
10.1002/brb3.1700
复制
发表时间：
2020-06-11
影响因子：
3.1
通讯作者：
Koziorowski, Dariusz
中科院分区：
文献类型：
--
作者：
Kowalska-Taczanowska, Renata;Friedman, Andrzej;Koziorowski, Dariusz
前言言语障碍是帕金森病和非典型帕金森综合征患者常见的临床表现，往往发生在轴性帕金森症状发作之前。由于帕金森病的特征与帕金森病的特征重叠，声音和言语障碍的区分主要在疾病的早期阶段对临床医生来说是一个挑战。方法收集116例受试者的语音样本，其中帕金森病患者30例，进行性核上性麻痹患者30例，多系统萎缩患者30例，正常对照组26例。构音障碍亚型的鉴别诊断是基于特定语音成分的定量声学分析。此外，语音障碍指数问卷被用来区分研究组中语音障碍的严重程度。结果帕金森病与非典型帕金森综合征的声学参数分布有显著性差异。在非典型帕金森综合征患者中发现了一种混合型构音障碍，具有运动功能减退、痉挛和共济失调的特征。在临床诊断为帕金森变异型多系统萎缩的患者中，观察到构音障碍的共济失调成分。PD患者表现为纯粹的运动功能减退性构音障碍。部分参数可作为PD早期诊断的指标。非典型帕金森综合征患者的嗓音障碍明显比帕金森病患者更频繁和严重。结论嗓音声学分析是一种非常敏感和无创的工具，为不同语音成分的评估提供了客观信息，具有为改进诊断过程提供定量数据的潜力，可能成为帕金森综合征鉴别诊断的有用工具。
Introduction Speech disorder is a common clinical manifestation in patients with Parkinson's disease and atypical parkinsonian syndromes and tends to occur before the onset of the axial parkinsonian symptoms. Due to parkinsonian features that overlap those of Parkinson's disease, the differentiation of voice and a speech disorder is a challenge for clinicians primarily in the early stage of the disease. Methods Speech samples were obtained from 116 subjects including 30 cases of Parkinson's disease, 30 cases of progressive supranuclear palsy, 30 cases of multiple system atrophy, and control group consisted of 26 subjects. Differential diagnosis of dysarthria subtypes was based on the quantitative, acoustic analysis of particular speech components. Additionally, Voice Handicap Index questionnaire was taken into account to differentiate the severity of voice impairment in the study groups. Results Our results showed significant differences in the distribution of acoustic parameters between Parkinson's disease and atypical parkinsonian syndromes. A mixed type of dysarthria with a combination of hypokinetic, spastic, and atactic features has been found in patients with atypical parkinsonism. In patients with the clinical diagnosis of the parkinsonian variant of multiple system atrophy, ataxic components of dysarthria were observed. Patients with PD presented pure hypokinetic dysarthria. Some parameters may be used as a marker for the diagnosis of the initial stage of PD. Voice impartment was significantly more frequent and severe in atypical parkinsonism than in Parkinson's disease. Conclusion Acoustic voice analysis is a very sensitive and noninvasive tool, provides objective information for the assessment of different speech components, has the specific potential to provide quantitative data essential for the improvement of the diagnostic process, and maybe a useful instrument in the differential diagnosis of parkinsonian syndromes.