speech disorders

言语障碍
  • 文章类型: Journal Article
    背景:语音变化的检测和表征可能有助于识别神经退行性疾病,并有可能帮助患者表征和监测。然而,有有限的研究证实在不同类型的神经退行性疾病中存在言语变化.我们报告了患有不同痴呆症诊断的个体的言语与其他临床评估之间的关系,并与健康的老年人进行了比较。
    方法:我们分析了109例患者的语音记录(52F,57M;年龄=72.63±8.61),被诊断患有各种神经退行性疾病,包括老年痴呆症,额颞叶痴呆,和血管性认知障碍,在认知神经学记忆诊所。使用Winterlight语音分析平台处理开放式图片描述任务的语音记录,该平台生成>500个声学和语言特征。我们调查了言语特征与临床评估之间的线性关系,包括迷你精神状态检查(MMSE),西部失语症电池(WAB),和马蒂斯痴呆症评定量表,同时控制年龄,性别和教育年限。然后将与临床指标显着相关的言语特征与健康老年人进行组比较(N=74,〜39F;年龄=61.31±7.29)。
    结果:包括词汇和句法特征在内的语音特征与患者的临床评估显着相关,跨诊断。较低的MMSE评分与使用更熟悉的名词相关(β=-1.60,p<.001)。同样,WAB评估的损害增加与使用较高频率名词相关(β=-0.01,p<.001)。与健康老年人相比,患者使用的名词(z=6.25,p<.001)和较短的单词(z=8.33,p<.001)明显更多。他们的语音持续时间也明显较短(z=7.98,p<.001),并且他们暂停更多(z=5.19,p<.001)。
    结论:语音变化代表语音减少,使用更简单的词汇表和语法,在患有不同神经退行性疾病的患者中均可检测到,并与临床结局相关。与健康的老年人相比,神经退行性疾病患者的这些相同的语音模式有所不同。言语有可能成为检测各种神经退行性疾病的认知障碍的敏感措施。
    BACKGROUND: The detection and characterization of speech changes may help in the identification of neurodegenerative diseases and have the potential to help with patient characterization and monitoring. Yet, there is limited research validating the presence of speech changes across different types of neurodegenerative disease. We report on the relationships between speech and other clinical assessments in the individuals with different dementia diagnoses and in comparison to healthy older adults.
    METHODS: We analyzed speech recordings from 109 patients (52F, 57M; Age = 72.63± 8.61) who were diagnosed with various neurodegenerative diseases, including Alzheimer\'s disease, Frontotemporal Dementia, and Vascular Cognitive Impairment, in a cognitive neurology memory clinic. Speech recordings of an open-ended picture description task were processed using the Winterlight speech analysis platform which generates >500 acoustic and linguistic features. We investigated the linear relationship between the speech features and clinical assessments including the Mini Mental State Examination (MMSE), Western Aphasia Battery (WAB), and Mattis Dementia Rating Scale while controlling for age, sex and years of education. Speech features that were significantly associated with clinical measures were then included in group comparisons with healthy older adults (N = 74, ∼39F; Age = 61.31±7.29).
    RESULTS: Speech features including lexical and syntactic features were significantly correlated with clinical assessments in patients, across diagnoses. Lower MMSE scores were associated with the use of more familiar nouns (β = -1.60, p<.001). Similarly, increased impairment as assessed by the WAB was correlated with the use of higher frequency nouns (β = -0.01, p<.001). Patients used significantly more nouns (z = 6.25, p<.001) and shorter words (z = 8.33, p<.001) than the healthy older adults. Their speech duration was also significantly shorter (z = 7.98, p<.001) and they paused more (z = 5.19, p<.001).
    CONCLUSIONS: Speech changes representing decreased speech, with simpler vocabularies and syntax, were detectable in patients with different neurodegenerative diseases and correlated with clinical outcomes. These same speech patterns differed in patients with neurodegenerative disease compared to healthy older adults. Speech has the potential to be a sensitive measure for detecting cognitive impairments across various neurodegenerative diseases.
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  • 文章类型: Journal Article
    这项研究旨在证明使用一种新的无线脑电图(EEG)-肌电图(EMG)可穿戴方法来生成具有嘴巴运动的特征性EEG-EMG混合模式的可行性,以便检测严重言语障碍的不同运动模式。本文介绍了一种基于适用于传感器集成和机器学习应用的新型信号处理技术的嘴巴运动检测方法。本文研究了嘴巴运动与脑电波之间的关系,以努力为失去沟通能力的人开发非语言接口,比如瘫痪的人。进行了一组实验以评估所提出的特征选择方法的功效。确定了口腔运动的分类是有意义的。在音素无声口时也收集了EEG-EMG信号。训练了少量神经网络来对EEG-EMG信号中的音素进行分类,产生95%的分类准确率。这种用于数据收集和处理生物电信号以进行音素识别的技术证明了未来通信辅助工具的有希望的途径。
    This study aims to demonstrate the feasibility of using a new wireless electroencephalography (EEG)-electromyography (EMG) wearable approach to generate characteristic EEG-EMG mixed patterns with mouth movements in order to detect distinct movement patterns for severe speech impairments. This paper describes a method for detecting mouth movement based on a new signal processing technology suitable for sensor integration and machine learning applications. This paper examines the relationship between the mouth motion and the brainwave in an effort to develop nonverbal interfacing for people who have lost the ability to communicate, such as people with paralysis. A set of experiments were conducted to assess the efficacy of the proposed method for feature selection. It was determined that the classification of mouth movements was meaningful. EEG-EMG signals were also collected during silent mouthing of phonemes. A few-shot neural network was trained to classify the phonemes from the EEG-EMG signals, yielding classification accuracy of 95%. This technique in data collection and processing bioelectrical signals for phoneme recognition proves a promising avenue for future communication aids.
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  • 文章类型: Journal Article
    目的:本调查研究了诸如裂隙类型之类的因素,初级腭手术的年龄,诊断综合征,听力问题,咬合不正可以预测持续的言语困难和学龄儿童对言语服务的需求。
    方法:参与者包括100名学龄儿童腭裂。Americleft语音协议用于评估语音产生的感知方面。进行逻辑回归以评估自变量(IV)对因变量(DV)的影响:清晰度,后口腔CSCs,听得见的鼻发射,鼻音亢进,前口腔CSCs,需要言语治疗。
    结果:65%的儿童参加(或接受过)言语治疗。逻辑回归模型显示出与言语治疗需求数据的良好拟合(Hosmer和Lemeshow的χ2(8)=9.647,p=.291)。没有发现静脉注射对言语治疗的需要有重大影响。诊断的综合征与较低的清晰度相关(Pulkstenis-Robinson'sχ2(11)=7.120,p=.789)。被诊断为综合症的儿童的鼻塞性评分(赔率=5.703)的几率是其他儿童的六倍。裂隙类型与可听见的鼻发射显着相关(Fisher\'sexactp=.006)。同时,错牙合畸形与前口腔CSCs有显著关联(Fisher'sexactp=.005)。
    结论:根据英国Cleft注册和审计网络年度报告的最新数据,大多数腭裂儿童在五岁时达到典型的语言水平。然而,研究可能影响这个年龄后言语障碍持续的因素至关重要。这种理解对于制定旨在减轻个体年龄增长时言语障碍的长期影响的干预策略至关重要。
    OBJECTIVE: The present investigation examined how factors such as cleft type, age of primary palatal surgery, diagnosed syndromes, hearing problems, and malocclusions could predict persistent speech difficulties and the need for speech services in school-aged children with cleft palate.
    METHODS: Participants included 100 school-aged children with cleft palate. Americleft speech protocol was used to assess the perceptual aspects of speech production. The logistic regression was performed to evaluate the impact of independent variables (IV) on the dependent variables (DV): intelligibility, posterior oral CSCs, audible nasal emission, hypernasality, anterior oral CSCs, and speech therapy required.
    RESULTS: Sixty-five percent of the children were enrolled in (or had received) speech therapy. The logistic regression model shows a good fit to the data for the need for speech therapy (Hosmer and Lemeshow\'s χ2(8)=9.647,p=.291). No IVs were found to have a significant impact on the need for speech therapy. A diagnosed syndrome was associated with poorer intelligibility (Pulkstenis-Robinson\'s χ2(11)=7.120,p=.789). Children with diagnosed syndromes have about six times the odds of a higher hypernasality rating (Odds Ratio = 5.703) than others. The cleft type was significantly associated with audible nasal emission (Fisher\'sexactp=.006). At the same time, malocclusion had a significant association with anterior oral CSCs (Fisher\'sexactp=.005).
    CONCLUSIONS: According to the latest data in the Cleft Registry and Audit Network Annual Report for the UK, the majority of children with cleft palate attain typical speech by age five. However, it is crucial to delve into the factors that may influence the continuation of speech disorders beyond this age. This understanding is vital for formulating intervention strategies aimed at mitigating the long-term effects of speech disorders as individuals grow older.
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  • 文章类型: Journal Article
    The S3 Guideline on the Treatment of Language Development Disorders: Summary of Recommendations Abstract: The German S3 Guidelines on the Treatment of Developmental Speech and Language Disorders (AWMF: No. 049-015) were published on the AWMF homepage at the end of 2022. The German Society for Phoniatrics and Paedaudiologie coordinated the work and developed the guideline text together with linguists and speech and language therapists. Many scientific medical societies consented to the respective recommendations. For the first time in the German-speaking area, the guideline group reviewed international research results on the treatment of various speech and language disorders and formulated evidence- or consensus-based recommendations for clinical care. The present article summarizes these recommendations and evaluates the guidelines from the perspective of child and adolescent psychiatry and psychotherapy.
    Zusammenfassung: Die S3-Leitlinie zur Therapie von Sprachentwicklungsstörungen (AWMF: Nr. 049-015), die Ende 2022 auf der Homepage der AWMF veröffentlich wurde, ist unter Federführung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie in Kooperation mit zahlreichen Sprachwissenschaftler_innen und Sprachtherapeut_innen entwickelt und von zahlreichen wissenschaftlichen medizinischen Fachgesellschaften konsentiert worden. Die Leitliniengruppe hat erstmalig für den deutschen Sprachraum versucht, die internationale Studienlage zur Therapie unterschiedlicher Sprach- und Sprechstörungen aufzuarbeiten und darauf basierend Evidenz- oder auch Konsensus-basierte Empfehlungen für die klinische Versorgung zu formulieren. In dem vorliegenden Artikel werden diese Empfehlungen zusammenfassend dargestellt, und es wird eine Wertung der Leitlinie aus Kinder- und Jugendpsychiatrischer Sicht vorgenommen.
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  • 文章类型: Journal Article
    喉肌张力障碍是主要影响言语的潜在致残任务特异性肌张力障碍。喉肌张力障碍的评估和诊断仍然具有挑战性,通常需要多学科的方法,涉及语言病理学家之间的合作,神经学家和喉科医生(1-5)。由于不同的治疗方法和对肉毒杆菌毒素治疗或言语治疗的反应,正确区分喉肌张力障碍的类型至关重要。出于教育目的,我们将喉肌张力障碍分为两种主要类型:内收肌和外展肌张力障碍。在这篇文章中,我们描述了一系列检查技术,可以帮助运动障碍神经学家诊断这种情况,并适当区分最常见的喉肌张力障碍。
    Laryngeal dystonia is a potentially disabling task specific dystonia primarily affecting speech. The evaluation and diagnosis of laryngeal dystonia remain challenging, and often require a multi-disciplinary approach, involving collaboration among speech language pathologists, neurologists and laryngologists (1-5). It is crucial to correctly differentiate between the types of laryngeal dystonia due to the distinct therapeutic approaches and responses to botulinum toxin therapy or speech therapy. For educational purposes, we have divided laryngeal dystonia into two main types: adductor and abductor dystonia. In this article, we describe a series of examination techniques that can assist movement disorders neurologists diagnosing this condition, and appropriately differentiating the most common forms of laryngeal dystonia.
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  • 文章类型: Journal Article
    识别和管理神经系统疾病的过程面临挑战,促使新方法的研究,以提高诊断的准确性。在这项研究中,我们进行了系统的文献综述,以确定基于遗传和分子途径的机器学习(ML)模型在治疗神经系统疾病中的意义.根据研究的目标,开发了搜索策略,以使用数字图书馆提取研究。我们遵循严格的研究选择标准。共有24项研究符合纳入标准并被纳入审查。我们根据神经系统疾病对研究进行了分类。纳入的研究强调了治疗神经系统疾病的多种方法和出色的结果。研究结果强调了现有模型的潜力,根据个人情况提出个性化干预措施。这些发现提供了性能更好的方法,可以处理遗传学和分子数据以产生有效的结果。此外,我们讨论了未来的研究方向和挑战,强调在现实世界的临床环境中推广现有模型的需求。这项研究有助于提高神经系统疾病诊断和管理领域的知识。
    The process of identification and management of neurological disorder conditions faces challenges, prompting the investigation of novel methods in order to improve diagnostic accuracy. In this study, we conducted a systematic literature review to identify the significance of genetics- and molecular-pathway-based machine learning (ML) models in treating neurological disorder conditions. According to the study\'s objectives, search strategies were developed to extract the research studies using digital libraries. We followed rigorous study selection criteria. A total of 24 studies met the inclusion criteria and were included in the review. We classified the studies based on neurological disorders. The included studies highlighted multiple methodologies and exceptional results in treating neurological disorders. The study findings underscore the potential of the existing models, presenting personalized interventions based on the individual\'s conditions. The findings offer better-performing approaches that handle genetics and molecular data to generate effective outcomes. Moreover, we discuss the future research directions and challenges, emphasizing the demand for generalizing existing models in real-world clinical settings. This study contributes to advancing knowledge in the field of diagnosis and management of neurological disorders.
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  • 文章类型: Journal Article
    背景:有新的研究表明,患有脑瘫(CP)的儿童和年轻人(CYAs)患注意力缺陷/多动障碍(ADHD)的风险更高。然而,对这些共同发生的疾病的CYAs的临床和功能特征知之甚少。
    目的:评估CYAs与CP的ADHD诊断与临床和功能特征之间的关联。
    方法:本回顾性研究,横断面研究使用了CYAs(4-26岁)合并CP(n=1145)的电子健康记录数据.我们使用双变量和多变量分析来估计ADHD诊断之间的关联,CP类型,粗大运动功能分类系统(GMFCS)水平,言语或语言障碍,智力残疾。
    结果:18.1%的CYAs伴CP诊断为ADHD。痉挛-双侧CP的CYAs患ADHD的几率较低(调整后的优势比[AOR]=0.58;95%置信区间[CI],0.35-0.96)。对于GMFCS水平为III-V的患者,患有ADHD的几率显着降低(AOR=0.10;95%CI,0.06-0.15)。
    结论:我们的研究发现,与没有ADHD的人相比,在有CP的CYAs中诊断为ADHD与更大的临床和功能损害相关。研究结果强调,由于该人群的合并症率高,因此需要对这两种情况进行筛查。
    BACKGROUND: Emerging research shows that children and young adults (CYAs) with cerebral palsy (CP) are at higher risk for attention-deficit/hyperactivity disorder (ADHD). However, little is known about the clinical and functional characteristics of CYAs with these co-occurring disorders.
    OBJECTIVE: To estimate associations between a diagnosis of ADHD among CYAs with CP and clinical and functional characteristics.
    METHODS: This retrospective, cross-sectional study used data from the electronic health records of CYAs (aged 4-26 years) with CP (n = 1145). We used bivariate and multivariable analyses to estimate associations between an ADHD diagnosis, CP type, Gross Motor Function Classification System (GMFCS) level, speech or language disorder, and intellectual disability.
    RESULTS: 18.1 % of CYAs with CP had a diagnosis of ADHD. CYAs with spastic-bilateral CP had lower odds of ADHD (adjusted odds ratio [AOR] = 0.58; 95 % confidence interval [CI], 0.35-0.96). Odds of having ADHD were significantly lower for those with GMFCS levels III-V (AOR = 0.10; 95 % CI, 0.06-0.15).
    CONCLUSIONS: Our study found that a diagnosis of ADHD among CYAs with CP was associated with greater clinical and functional impairments compared to counterparts without ADHD. Findings highlight the need to screen for both conditions because of the high comorbidity rates in this population.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: English Abstract
    OBJECTIVE: To develop a universal system for assessing the speech function in patients with congenital palatal cleft in the postoperative period.
    METHODS: A universal system for assessing the speech function for patients with a palatal cleft can be applied both after the primary operation of uranoplasty and for patients diagnosed with velopharyngeal insufficiency (VPI). The patient\'s speech is assessed according to the following criteria: defects in the pronunciation of consonants by place of articulation: labial, labiodental, lingual-dental, lingual-palatal, lingual-alveolar; speech breathing; tongue position; directed air stream; voicing disorders; The patient\'s is also evaluated for the following findings: hypernasality (reflected speech); hypernasality (spontaneous speech); hyponasality; pharyngeal reflex; audible nasal emission/turbulence; facial grimaces; speech intelligibility. The speech therapy and dental assessments are added to obtain a value characterizing the patient\'s condition: from 0 to 10 scoring indicates than only speech therapy correction is needed; from 11 to 18 - the decision on the necessity of surgical treatment is made by the surgeon together with the speech therapist, from 18 to 25 - surgical treatment is necessary with subsequent sessions with a speech therapist.
    RESULTS: With the help of this questionnaire, the operating surgeon can more accurately and objectively assess in dynamics the result of the surgical treatment, regardless of the results of speech therapy treatment in the postoperative period. The creation of this scoring system for speech assessment is aimed at objectivizing the results of uranoplasty and speech-improving operations. It allows the surgeon to compare the effectiveness of different surgical methods.
    CONCLUSIONS: The universal scoring system for assessing the state of speech function can be applied in the diagnosis of a patient with a palatal cleft both after the primary operation on the palate and after corrective surgical interventions. It allows monitoring progress and identifying dynamics in surgical and speech therapy treatment.
    UNASSIGNED: Разработать универсальную систему оценки речевой функции у пациентов с врожденной расщелиной неба в послеоперационном периоде.
    UNASSIGNED: Была разработана универсальная система оценки речевой функции для пациентов с расщелиной неба, которая может быть применена как после первичной операции уранопластики, так и для пациентов с диагнозом небно-глоточная недостаточность (НГН). Речь пациента оценивают по следующим критериям: дефекты произношения согласных по месту артикуляции: губные, губно-зубные, язычно-зубные, язычно-небные, язычно-альвеолярные; речевое дыхание; положение языка; направленная воздушная струя; нарушение озвончения. Стоматологическая оценка включает следующие критерии: гиперназальность (отраженная речь); гиперназальность (спонтанная речь); гипоназальность; глоточный рефлекс; слышимая носовая эмиссия/турбулентность; лицевые гримасы; разборчивость речи. Логопедическую и стоматологическую оценки складывают и получают значение, характеризующее состояние пациента. При значении от 0 до 10 показана только логопедическая коррекция; от 11 до 18 — решение о необходимости хирургического лечения принимается хирургом совместно с логопедом, от 18 до 25 — необходимо хирургическое лечение с последующими занятиями с логопедом.
    UNASSIGNED: При помощи данной анкеты оперирующий хирург может более точно и объективно оценить в динамике результат оперативного лечения. Создание данной балльной системы оценки речи направлено на объективизацию результатов операции уранопластики и речеулучшающих операций, а также дает хирургу возможность сравнивать эффективность различных хирургических методик.
    UNASSIGNED: Универсальная балльная система оценки состояния речевой функции может быть применена в диагностике пациента с расщелиной неба как после первичной операции на небе, так и после корригирующих оперативных вмешательств. Она позволяет отследить прогресс и выявить динамику в хирургическом и логопедическом лечении.
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  • 文章类型: Journal Article
    背景:经典发作性皮质基底综合征(CBS)患者表现为不对称肢体失用症和帕金森病。我们有,然而,观察到最初出现言语和/或语言(SL)问题并在几年后发展为CBS的患者(即,SL发作CBS)。我们的目的是比较临床,经典发作CBS与SL发作CBS的神经影像学和病理学特征。
    方法:我们对62例符合CBS标准的患者进行了回顾性队列研究(17例出现经典发作的CBS,45例出现SL发作的CBS)。我们比较了人口统计,临床特征,两组之间使用SPM12的灰质和白质体积丢失,并评估了死亡和尸检患者的病理学和皮质基底变性(CBD)病理学病变计数。
    结果:CBS诊断的中位年龄在经典发作的CBS中为66.4岁,在SL发作的CBS中为73.6岁。经典发作的CBS有更高的肌张力障碍频率,肌阵鸣,和外星肢体现象,而SL发作的CBS的垂直核上凝视麻痹的频率更高。两组的额顶体积均小于对照组,SL发作的CBS在左辅助运动区的体积损失比经典发作的CBS更大。所有3例尸检经典发作的CBS病例(100%)均具有CBD病理学,而8/21的SL发作的CBS病例(38%)具有CBD。经典发作和SL发作CBS之间的病理病变负担(包括星形细胞斑块)没有差异。
    结论:经典发作和SL发作的CBS似乎是不同的综合征,前者是一种更严重的运动综合征。SL发作CBS中更广泛的体积损失可能反映了更长的病程。
    BACKGROUND: Patients with classic-onset corticobasal syndrome (CBS) present with asymmetric limb apraxia and parkinsonism. We have, however, observed patients who initially present with speech and/or language (SL) problems and several years later develop CBS (i.e., SL-onset CBS). We aimed to compare clinical, neuroimaging and pathological characteristics of classic-onset CBS with SL-onset CBS.
    METHODS: We conducted a retrospective cohort study of 62 patients who met criteria for CBS (17 presented with classic-onset CBS and 45 had SL-onset CBS). We compared demographics, clinical characteristics, and grey and white matter volume loss with SPM12 between groups and assessed pathology and corticobasal degeneration (CBD) pathological lesion counts in patients who had died and undergone autopsy.
    RESULTS: Median age at CBS diagnosis was 66.4 years in classic-onset CBS and 73.6 years in SL-onset CBS. Classic-onset CBS had higher frequencies of dystonia, myoclonus, and alien limb phenomenon, while SL-onset CBS had a higher frequency of vertical supranuclear gaze palsy. Both groups showed smaller frontoparietal volumes than controls, with SL-onset CBS having greater volume loss in the left supplementary motor area than classic-onset CBS. All three classic-onset CBS cases with autopsy (100 %) had CBD pathology while 8/21 of SL-onset CBS cases (38 %) had CBD. Pathological lesion burden (including astrocytic plaques) did not differ between classic-onset and SL-onset CBS.
    CONCLUSIONS: Classic-onset and SL-onset CBS appear to be different syndromes, with the former being a more profuse motor syndrome. The more widespread volume loss in SL-onset CBS likely reflects longer disease course.
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