Alternating motion rate as an index of speech motor disorder in traumatic brain injury

Abstract

The task of syllable alternating motion rate (AMR) (also called diadochokinesis) is suitable for examining speech disorders of varying degrees of severity and in individuals with varying levels of linguistic and cognitive ability. However, very limited information on this task has been published for subjects with traumatic brain injury (TBI). This study is a quantitative and qualitative acoustic analysis of AMR in seven subjects with TBI. The primary goal was to use acoustic analyses to assess speech motor control disturbances for the group as a whole and for individual patients. Quantitative analyses included measures of syllable rate, syllable and intersyllable gap durations, energy maxima, and voice onset time (VOT). Qualitative analyses included classification of features evident in spectrograms and waveforms to provide a more detailed description. The TBI group had (1) a slowed syllable rate due mostly to lengthened syllables and, to a lesser degree, lengthened intersyllable gaps, (2) highly correlated syllable rates between AMR and conversation, (3) temporal and energy maxima irregularities within repetition sequences, (4) normal median VOT values but with large variation, and (5) a number of speech production abnormalities revealed by qualitative analysis, including explosive speech quality, breathy voice quality, phonatory instability, multiple or missing stop bursts, continuous voicing, and spirantization. The relationships between these findings and TBI speakers' neurological status and dysarthria types are also discussed. It was concluded that acoustic analyses of the AMR task provides specific information on motor speech limitations in individuals with TBI.

Dysarthria in Traumatic Brain Injury: A Breath Group and Intonational Analysis

“…palatopharyngolaryngeal myoclonus), the subjects with TBI spent a longer time on each syllable than did the control subjects. This speech motor impairment also explains the limited range of speaking rate adjustment and the slow and irregular AMR performance [23] . Wang/Kent/Duffy/Thomas Although fi nal-syllable lengthening and f 0 downtrend were preserved in subjects with TBI, the prosodic disturbance refl ected by temporal and f 0 components within breath groups was roughly commensurate with speech severity.…”

Comparison of Speaking Rate, Articulation Rate and Alternating Motion Rate in Dysarthric Speakers

“…Ziegler and Wessel [37] examined 16 individuals with ataxic dysarthria, and reported that speaking rate and AMR exhibited a statistically signifi cant correlation. Nishio/Niimi Wang et al [31] also reported that speaking rate determined during conversation was strongly related to AMR in 7 dysarthric participants after traumatic brain injury.…”

“…Specifi cally, AMR involves the rapid repetition of a single syllable, such as /pa/, while the sequential motion rate refers to the rapid repetition of syllable sequences, such as /pataka/ [20] . A slow AMR in speakers with dysarthria has been reported in a series of cross-sectional group studies [5,7,11,14,[21][22][23][24][25][26][27][28][29][30][31] . Longitudinal studies by Kent et al [32] , Yorkston et al [33] , Mulligan et al [34] , and Nishio and Niimi [3] reported slower AMR in individuals with ALS.…”

Analysis of Diadochokinesis in Ataxic Dysarthria Using the Motor Speech Profile Program™

“…DDK rate appears to be a useful index of oral motor development in children [10][11][12][13][14] . DDK has been used as a measure of the speech deterioration in amyotrophic lateral sclerosis [15][16][17] , cerebellar and spinocerebellar damage [8,[18][19][20][21][22] , Friedreich disease [23] , multiple sclerosis [24,25] , Parkinson's disease [25,26] , hemispheric stroke [20,27] , traumatic brain injury [28] , apraxia of speech [29] , and cerebellar mutism syndrome [30] . Slow rate, temporal and intensity irregularities, and inaccuracy in the DDK task are reported in a number of studies on speech impairment associated with a neurogenic disease or damage, including cerebral palsy, developmental dyspraxia, stroke, amyotrophic lateral sclerosis, cerebellar diseases, and basal ganglia disorders [19] .…”