Clear speech in ALS: Effects of feedback from a novel ASR practice paradigm and practice dosage

项目摘要 构音障碍是一种运动性言语障碍，其特征是感觉运动异常， [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19构音障碍经常 严重损害沟通，进而威胁患者参与日常生活活动和质量 人生[2][7]然而，针对构音障碍的治疗方法相对较少，而且患者获得治疗的机会往往很小 受财政和地理障碍的限制[8]-[10]。肌萎缩侧索硬化症（ALS）是一种神经退行性疾病， 上、下运动神经元逐渐丧失的疾病。几乎所有ALS患者 [11][12][13][14][15][16][17][18][19 痉挛性构音障碍鉴于ALS患者严重的语言障碍，迫切需要循证医学。 帮助患者保持功能性语言。清晰的语言，它训练一种语言模式， 刻意发音，是一种成功的构音障碍治疗，全面影响语音系统， 可理解性然而，清晰的语音训练使用来自合作伙伴的主观反馈，其对 ALS中的可理解性已经被充分研究。此外，虽然增加了实践量， 与运动功能未受损的人的积极运动学习结果相关[13]，[69]， 缺乏关于单次练习剂量对受损肢体[57]和运动语言影响的研究 函数[10]，[14].本研究探讨了一种新的方法，提供反馈使用噪声增强 自动语音识别，以自动和客观地促进健康患者的清晰语音治疗， 参与者和延髓ALS参与者。它还研究了单次练习剂量对 学习清晰的说话方式。初步结果支持nASR和增加实践剂量， 便于清晰的语音。

PROJECT SUMMARY Dysarthria is a motor speech impairment characterized by sensorimotor abnormalities that affect the movements required for speech, frequently resulting in reduced speech intelligibility and naturalness [1], [2]. Dysarthria often significantly impairs communication, in turn threatening a patient’s participation in daily life activities and quality of life [2]–[7]. However, relatively few treatments for dysarthria exist, and patient access to treatments is often limited by financial and geographic barriers [8]–[10]. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive loss of upper and lower motor neurons. Nearly all individuals with ALS will at some point experience speech impairment [11], [12], characterized by flaccid, spastic, or mixed flaccid- spastic dysarthria. Given the devastating loss of speech in ALS, there is a critical need for evidence-based treatments to help patients maintain their functional speech. Clear speech, which trains a mode of speech with deliberate enunciation, is a successful dysarthria treatment that globally affects the speech system and intelligibility. However, clear speech training uses subjective feedback from a partner, and its effects on intelligibility in ALS have been understudied. Additionally, although increased practice amount has been associated with positive motor learning outcomes in people with unimpaired motor function [13], [69], there is a dearth of research into the effects of single-session practice dosage on impaired limb [57] and motor speech function [10], [14]. This study investigates a novel method for providing feedback using noise-augmented automatic speech recognition to automatically and objectively facilitate clear speech treatment in healthy participants and participants with bulbar ALS. It also examines the effects of single-session practice dosage on learning a clear mode of speaking. Preliminary results support both nASR and increased practice dosage for facilitating clear speech.