Neuroradiology and voice findings in stroke

Abstract

Neurological dysphonias are vocal disorders followed by injuries or changes in the nervous system. Stroke is the second leading cause of death worldwide and the brain damage caused by it can affect communication in several aspects. The changes in the vocal features caused by these lesions are poorly described regarding the location and extent of cerebral involvement. The aim of this study was to describe vocal parameters of ten elderly patients affected by stroke according to the topography of the lesion at neuroimaging. We recorded from them: perceptual and auditory evaluation of voice and laryngeal diadochokinesis. Neuroimaging studies were classified according to location, extent, laterality territory of brain injury. The results show a population of extensive middle cerebral artery strokes and strokes with varied location in the brain. The subjects' voices showed predominantly the presence of roughness, breathiness, richeness and instability, and change in laryngeal motor control, demonstrated by reduced speed and instability in laryngeal diadochokinesis. These features presented in patients with extensive middle cerebral artery stroke and in patients with short strokes with varied location in the brain. The results suggest that the vocal features in the assessed cases do not depend only on the topography of the brain damage. Thus, it is important to consider the patient as unique in clinical evaluation.

Efeitos da terapia manual laríngea e da estimulação elétrica nervosa transcutânea (TENS) na diadococinesia laríngea em mulheres disfônicas: estudo clínico randomizado

“…Most of the works on laryngeal DDK was performed in neurological (13,15) , elderly patients (17) , or children (18) . Only two studies evaluated oral and laryngeal DDK in individuals with behavioral dysphonia with several types of vocal affections, comparing the diadochokinetic parameters between dysphonic and non-dysphonic individuals (20) , and investigated vocal folds behavior by age groups of men and women with vocal alterations (21) .…”

“…It is defined as the ability to perform fast repetitions of relatively simple patterns composed of oppositional contractions (9) , which may suggest information about individuals' neuromotor integration and maturation (9) . This acoustic evaluation has been used in several cases and populations, such as in children with speech sound disorders (10) , cochlear implants (11) , and fluency disorder (12) , in neurological patients (13)(14)(15)(16) , healthy elderly individuals (17) , youngsters and children (18,19) , as well as in patients with behavioral dysphonia (20,21) . Considering the DDK evaluations in clinical speech-language practice, laryngeal DDK aims to investigate neuromotor control of vocal folds (22) , being used mainly for the assessment of voice disorders (13,15,17,18,20,22) .…”

Intervenção fonoaudiológica e fisioterapêutica em uma mulher após acidente vascular cerebral isquêmico

“…No que tange aos aspectos intrínsecos, o tipo isquêmico, encontrado em 90% dos casos de AVC, tem prognóstico de recuperação mais favorável quando comparado ao AVC hemorrágico [1,10]. Sob essa perspectiva, a recuperação dessa paciente pode ter sido facilitada pelo mecanismo de lesão, respondendo de forma muito efetiva à estimulação fonoaudiológica e fisioterapêutica [1,2].…”

“…A participação do fonoaudiólogo e do fisioterapeuta na reabilitação do paciente pós-AVC constitui uma contribuição fundamental, que pode viabilizar maior resolução em relação aos efeitos da doença. No entanto, a literatura, principalmente sob uma perspectiva multidisciplinar, ainda é escassa no que se refere a estudos sobre a reabilitação fonoaudiológica e fisioterapêutica conjunta desses pacientes [8][9][10].…”

Distúrbios vocais associados ao AVC: uma revisão sistemática

“…após exclusão por repetição; em seguida, os títulos e resumos foram analisados e 165 trabalhos foram excluídos, pois não estavam no escopo da proposta da pesquisa. Assim, admitiram-se dois artigos para a análise final18,20 , ambos estudos de relato de caso (Figura 1).…”