Speech Disorders following Severe Traumatic Brain Injury: Kinematic Analysis of Syllable Repetitions Using Electromagnetic Articulography

Abstract

Using electromagnetic articulography, the lips, the tip of the tongue, and the tongue dorsum were tracked during repetitions of the syllables [pa], [ta] and [ka] in 10 speakers with dysarthria following severe traumatic brain injury and in 10 age-matched control subjects. When asked to produce the syllable trains as fast as possible, the patient group showed a rather homogeneous pattern of movement abnormalities including prolonged syllable durations and reduced peak velocity/amplitude ratios. Most presumably, limited speed generation gives rise to the impaired ability to increase speech rate. During the habitual speaking condition, reduced velocity/amplitude ratios were restricted to the tongue tip and tongue dorsum. Obviously, the tongue and the lips are differentially affected in dysarthria following severe traumatic brain injury.

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

“…Hirose et al [26] and Hirose [35] showed dysarthric speakers with ALS had limited range of motion during AMR. Jaeger et al [19] reported that movement amplitude for dysarthric speakers after traumatic brain injury was larger than that for a control group during AMR.…”

“…However, a series of recent studies reported that perceptual and acoustic analyses do not always yield the same results [4,[13][14][15][16][17][18][19] . Nishio and Niimi [4] suggested that 'speaking rate is diffi cult to assess correctly using the perceptual rating system' and demonstrated the utility of the acoustic analysis.…”

“…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. Kinematic studies of articulation often reveal that dysarthric speakers tend to have lower velocities [19,26] . Hirose et al [26] and Hirose [35] showed dysarthric speakers with ALS had limited range of motion during AMR.…”

Perfil populacional de pacientes com disartria atendidos em hospital terciário

“…Durante a emissão das sílabas /pa/, /ta/ e /ka/ (sílabas também utilizadas no protocolo desta pesquisa), indivíduos com disartria apresentam um padrão homogêneo de anormalidades dos movimentos articulatórios, incluindo prolongações das sílabas, redução da velocidade e amplitude dos movimentos (27) . Esses achados corroboram com o presente estudo.…”

“…Eles identificaram que os erros produzidos por esses indivíduos foram caracterizados por omissões, substituições, distorções, acréscimos, repetições e prolongamentos (7,27) . Esses dados concordam com os resultados do presente estudo, já que os pacientes apresentaram esses tipos de erros, principalmente na emissão de monossílabos.…”