SPEECH DETERIORATION IN AMYOTROPHIC-LATERAL-SCLEROSIS - A CASE-STUDY
SPEECH DETERIORATION IN AMYOTROPHIC-LATERAL-SCLEROSIS - A CASE-STUDY
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DOI：
10.1044/jshr.3406.1269
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发表时间：
1991-12-01
期刊：
影响因子：
--
通讯作者：
BROOKS, BR
中科院分区：
文献类型：
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作者：
KENT, RD;SUFIT, RL;BROOKS, BR
关于肌萎缩侧索硬化症（ALS）病程中言语和声音变化的性质，很少有详细的报道。本病例研究的对象是一名53岁时被诊断为ALS伴延髓体征的女性。在她大约2年的病程中，对语言清晰度、肺功能和选定的语言和声音功能进行了测试。在此期间，她的语言可懂度，通过多选择单词识别测试测量，从98%下降到48%。语音功能，受影响最大的可懂度下降包括音节首和音节尾辅音的发音对比，发音对比的地方舌辅音，发音方式舌辅音，停止与鼻的生产方式，功能相关的液体辅音，和各种功能相关的音节形状。声学测量，第二共振峰频率的平均斜率，下降与可懂度降低，并被认为反映了舌运动神经元的损失。她的肺功能在观察期间也下降，特别是气流测量值严重降低。在测试过程中，口腔内的舒张运动和发声功能的测量（包括抖动、微光和信噪比）变化很大。这些结果进行了讨论，他们提出的挑战，以敏感的评估变化和管理的沟通障碍ALS。
Few detailed reports have been published on the nature of speech and voice changes during the course of amyotrophic lateral sclerosis (ALS). The subject of this case study is a woman who was diagnosed as having ALS with bulbar signs at the age of 53. Speech intelligibility, pulmonary function, and selected speech and voice functions were tested during an approximately 2-year course of her disease. Over this period, her speech intelligibility, as measured by a multiplechoice word identification test, declined from 98% to 48%. Phonetic features that were most affected during the intelligibility decline included voicing contrast for syllable-initial and syllablefinal consonants, place of articulation contrasts for lingual consonants, manner of articulation for lingual consonants, stop versus nasal manner of production, features related to the liquid consonants, and various features related to syllable shape. An acoustic measure, average slope of the second-formant frequency, declined in association with the intelligibility reduction and is thought to reflect the loss of lingual motoneurons. Her pulmonary function also declined over the observation interval, with particularly severe reduction in measures of air flow. Oral diadochokinesis and measures of vocal function (including jitter, shimmer, and signal-to-noise ratio) were highly variable across test sessions. These results are discussed in terms of the challenges they present to sensitive assessment of change and to management of the communication disability in ALS.