Speech and communication in Parkinson's disease: a cross-sectional exploratory study in the UK
Speech and communication in Parkinson's disease: a cross-sectional exploratory study in the UK
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DOI：
10.1136/bmjopen-2016-014642
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发表时间：
2017-05-01
期刊：
影响因子：
2.9
通讯作者：
Deane, Katherine H. O.
中科院分区：
文献类型：
--
作者：
Barnish, Maxwell S.;Horton, Simon M. C.;Deane, Katherine H. O.
目的评估帕金森病患者的认知状态、可懂度、声学和功能性沟通之间的关系。设计功能性沟通的横断面探索性研究，包括一个用于听者评估的参与者内实验设计。地点：英国英格兰东部的一个主要学术医学中心。参与者问卷数据评估了45名帕金森病（PD）患者，自我报告有言语或沟通困难，没有临床痴呆症。对20名PD患者和20名不说话的熟悉交谈伙伴进行了阅读和会话语音的声学和听者分析，结果PD患者在阅读、语言或认知障碍方面的可理解性均低于对照组，而在语言或认知障碍方面的可理解性则低于对照组，两组比较差异有统计学意义（P <0.05）。（平均差异13.7%，p = 0.009）和会话（平均差异16.2%，p = 0.04）句子。强度和停顿是统计学上显着的预测可理解性阅读句子。听者在识别PD患者言语中的预期情绪时不太准确（不同条件下的差异为14.8%，p = 0.02），这与说话者的认知状态较差有关（差异为16.7%，p = 0.04）。认知状态是使用CPIB（F = 8.99，p = 0.005，chi（2）= 0.15）进行功能性沟通的重要预测因素，但不是CES。会话句子的可理解性是CPIB（F = 4.96，p = 0.04，chi（2）= 0.19）和CES（F = 13.65，p = 0.002，chi（2）= 0.43）的统计学显著预测因子。阅读句子的可懂度是不是一个显着的预测任何outcome.Conclusions认知状态是一个重要的预测功能的沟通的作用，可懂度是温和的，仅限于会话，而不是阅读语音。我们的研究结果强调了在PD的言语和语言治疗（PART）中关注功能性沟通以及物理言语障碍的重要性。我们的研究结果可以为未来的帕金森病治疗技术的试验提供信息。
Objective To assess associations between cognitive status, intelligibility, acoustics and functional communication in PD.Design Cross-sectional exploratory study of functional communication, including a within-participants experimental design for listener assessment.Setting A major academic medical centre in the East of England, UK.Participants Questionnaire data were assessed for 45 people with Parkinson's disease (PD), who had self-reported speech or communication difficulties and did not have clinical dementia. Acoustic and listener analyses were conducted on read and conversational speech for 20 people with PD and 20 familiar conversation partner controls without speech, language or cognitive difficulties.Main outcome measures Functional communication assessed by the Communicative Participation Item Bank (CPIB) and Communicative Effectiveness Survey (CES).Results People with PD had lower intelligibility than controls for both the read (mean difference 13.7%, p=0.009) and conversational (mean difference 16.2%, p=0.04) sentences. Intensity and pause were statistically significant predictors of intelligibility in read sentences. Listeners were less accurate identifying the intended emotion in the speech of people with PD (14.8% point difference across conditions, p=0.02) and this was associated with worse speaker cognitive status (16.7% point difference, p=0.04). Cognitive status was a significant predictor of functional communication using CPIB (F=8.99, p=0.005, chi(2)=0.15) but not CES. Intelligibility in conversation sentences was a statistically significant predictor of CPIB (F=4.96, p=0.04, chi(2)=0.19) and CES (F=13.65, p=0.002, chi(2)=0.43). Read sentence intelligibility was not a significant predictor of either outcome.Conclusions Cognitive status was an important predictor of functional communication-the role of intelligibility was modest and limited to conversational and not read speech. Our results highlight the importance of focusing on functional communication as well as physical speech impairment in speech and language therapy (SLT) for PD. Our results could inform future trials of SLT techniques for PD.