INTRODUCTION: Hypokinetic dysarthria (HD) is a common motor speech symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated short-term effects of transcranial direct current stimulation (tDCS) on HD in PD using acoustic analysis of speech. Based on our previous studies we focused on stimulation of the right superior temporal gyrus (STG) - an auditory feedback area. METHODS: In 14 PD patients with HD, we applied anodal, cathodal and sham tDCS to the right STG using a cross-over design. A protocol consisting of speech tasks was performed prior to and immediately after each stimulation session. Linear mixed models were used for the evaluation of the effects of each stimulation condition on the relative change of acoustic parameters. We also performed a simulation of the mean electric field induced by tDCS. RESULTS: Linear mixed model showed a statistically significant effect of the stimulation condition on the relative change of median duration of silences longer than 50 ms (p = 0.015). The relative change after the anodal stimulation (mean = -5.9) was significantly lower as compared to the relative change after the sham stimulation (mean = 12.8), p = 0.014. We also found a correlation between the mean electric field magnitude in the right STG and improvement of articulation precision after anodal tDCS (R = 0.637; p = 0.019). CONCLUSIONS: The exploratory study showed that anodal tDCS applied over the auditory feedback area may lead to shorter pauses in a speech of PD patients.

• MeSH
• dysartrie etiologie   terapie   patofyziologie   MeSH
• klinické křížové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc * terapie   komplikace   patofyziologie   MeSH
• pilotní projekty MeSH
• přímá transkraniální stimulace mozku * MeSH
• řeč fyziologie   MeSH
• senioři MeSH
• spánkový lalok patofyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Hypokinetic dysarthria (HD) is common in Parkinson's disease (PD). Our objective was to evaluate articulatory networks and their reorganization due to PD pathology in individuals without overt speech impairment using a multimodal MRI protocol and acoustic analysis of speech. METHODS: A total of 34 PD patients with no subjective HD complaints and 25 age-matched healthy controls (HC) underwent speech task recordings, structural MRI, and reading task-induced and resting-state fMRI. Grey matter probability maps, task-induced activations, and resting-state functional connectivity within the regions engaged in speech production (ROIs) were assessed and compared between groups. Correlation with acoustic parameters was also performed. RESULTS: PD patients as compared Tto HC displayed temporal decreases in speech loudness which were related to BOLD signal increases in the right-sided regions of the dorsal language pathway/articulatory network. Among those regions, activation of the right anterior cingulate was increased in PD as compared to HC. We also found bilateral posterior superior temporal gyrus (STG) GM loss in PD as compared to HC that was strongly associated with diadochokinetic (DDK) irregularity in the PD group. Task-induced activations of the left STG were increased in PD as compared to HC and were related to the DDK rate control. CONCLUSIONS: The results provide insight into the neural correlates of speech production control and distinct articulatory network reorganization in PD apparent already in patients without subjective speech impairment.

• MeSH
• akustika řeči * MeSH
• dysartrie * diagnóza   etiologie   patologie   patofyziologie   MeSH
• konektom * MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• multimodální zobrazování MeSH
• nervová síť * diagnostické zobrazování   patologie   patofyziologie   MeSH
• Parkinsonova nemoc * komplikace   diagnostické zobrazování   patologie   patofyziologie   MeSH
• šedá hmota * diagnostické zobrazování   patologie   patofyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spánkový lalok * diagnostické zobrazování   patologie   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION: Hypokinetic dysarthria (HD) is a common symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated acute effects of repetitive transcranial magnetic stimulation (rTMS) of the motor and auditory feedback area on HD in PD using acoustic analysis of speech. METHODS: We used 10 Hz and 1 Hz stimulation protocols and applied rTMS over the left orofacial primary motor area, the right superior temporal gyrus (STG), and over the vertex (a control stimulation site) in 16 PD patients with HD. A cross-over design was used. Stimulation sites and protocols were randomised across subjects and sessions. Acoustic analysis of a sentence reading task performed inside the MR scanner was used to evaluate rTMS-induced effects on motor speech. Acute fMRI changes due to rTMS were also analysed. RESULTS: The 1 Hz STG stimulation produced significant increases of the relative standard deviation of the 2nd formant (p = 0.019), i.e. an acoustic parameter describing the tongue and jaw movements. The effects were superior to the control site stimulation and were accompanied by increased resting state functional connectivity between the stimulated region and the right parahippocampal gyrus. The rTMS-induced acoustic changes were correlated with the reading task-related BOLD signal increases of the stimulated area (R = 0.654, p = 0.029). CONCLUSION: Our results demonstrate for the first time that low-frequency stimulation of the temporal auditory feedback area may improve articulation in PD and enhance functional connectivity between the STG and the cortical region involved in an overt speech control.

• MeSH
• akustika řeči MeSH
• dysartrie diagnostické zobrazování   etiologie   patofyziologie   MeSH
• gyrus parahippocampalis diagnostické zobrazování   patofyziologie   MeSH
• konektom * MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• motorické korové centrum diagnostické zobrazování   patofyziologie   MeSH
• nervová síť diagnostické zobrazování   patofyziologie   MeSH
• Parkinsonova nemoc komplikace   diagnostické zobrazování   patofyziologie   MeSH
• senioři MeSH
• senzorická zpětná vazba fyziologie   MeSH
• spánkový lalok diagnostické zobrazování   patofyziologie   MeSH
• transkraniální magnetická stimulace * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Neurodegenerative pathologies as Parkinson's Disease (PD) show important distortions in speech, affecting fluency, prosody, articulation and phonation. Classically, measurements based on articulation gestures altering formant positions, as the Vocal Space Area (VSA) or the Formant Centralization Ratio (FCR) have been proposed to measure speech distortion, but these markers are based mainly on static positions of sustained vowels. The present study introduces a measurement based on the mutual information distance among probability density functions of kinematic correlates derived from formant dynamics. An absolute kinematic velocity associated to the position of the jaw and tongue articulation gestures is estimated and modeled statistically. The distribution of this feature may differentiate PD patients from normative speakers during sustained vowel emission. The study is based on a limited database of 53 male PD patients, contrasted to a very selected and stable set of eight normative speakers. In this sense, distances based on Kullback-Leibler divergence seem to be sensitive to PD articulation instability. Correlation studies show statistically relevant relationship between information contents based on articulation instability to certain motor and nonmotor clinical scores, such as freezing of gait, or sleep disorders. Remarkably, one of the statistically relevant correlations point out to the time interval passed since the first diagnostic. These results stress the need of defining scoring scales specifically designed for speech disability estimation and monitoring methodologies in degenerative diseases of neuromotor origin.

• MeSH
• biomechanika fyziologie   MeSH
• čelisti patofyziologie   MeSH
• datové soubory jako téma MeSH
• dysartrie etiologie   patofyziologie   MeSH
• jazyk patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc komplikace   diagnóza   MeSH
• poruchy artikulace etiologie   patofyziologie   MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

Although motor speech disorders represent an early and prominent clinical feature of multiple system atrophy (MSA), the potential usefulness of speech assessment as a diagnostic tool has not yet been explored. This cross-sectional study aimed to provide a comprehensive, objective description of motor speech function in the parkinsonian (MSA-P) and cerebellar (MSA-C) variants of MSA. Speech samples were acquired from 80 participants including 18 MSA-P, 22 MSA-C, 20 Parkinson's disease (PD), and 20 healthy controls. The accurate differential diagnosis of dysarthria subtypes was based on quantitative acoustic analysis of 14 speech dimensions. A mixed type of dysarthria involving hypokinetic, ataxic and spastic components was found in the majority of MSA patients independent of phenotype. MSA-P showed significantly greater speech impairment than PD, and predominantly exhibited harsh voice, imprecise consonants, articulatory decay, monopitch, excess pitch fluctuation and pitch breaks. MSA-C was dominated by prolonged phonemes, audible inspirations and voice stoppages. Inappropriate silences, irregular motion rates and overall slowness of speech were present in both MSA phenotypes. Speech features allowed discrimination between MSA-P and PD as well as between both MSA phenotypes with an area under curve up to 0.86. Hypokinetic, ataxic and spastic dysarthria components in MSA were correlated to the clinical evaluation of rigidity, cerebellar and bulbar/pseudobulbar manifestations, respectively. Distinctive speech alterations reflect underlying pathophysiology in MSA. Objective speech assessment may provide an inexpensive and widely applicable screening instrument for differentiation of MSA and PD from controls and among subtypes of MSA.

• MeSH
• akustika řeči MeSH
• dysartrie diagnóza   etiologie   patofyziologie   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• multisystémová atrofie komplikace   patofyziologie   MeSH
• nemoci mozečku komplikace   patofyziologie   MeSH
• parkinsonské poruchy komplikace   patofyziologie   MeSH
• průřezové studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Motor speech disorders in multiple sclerosis (MS) are poorly understood and their quantitative, objective acoustic characterization remains limited. Additionally, little data regarding relationships between the severity of speech disorders and neurological involvement in MS, as well as the contribution of pyramidal and cerebellar functional systems on speech phenotypes, is available. METHODS: Speech data were acquired from 141 MS patients with Expanded Disability Status Scale (EDSS) ranging from 1 to 6.5 and 70 matched healthy controls. Objective acoustic speech assessment including subtests on phonation, oral diadochokinesis, articulation and prosody was performed. RESULTS: The prevalence of dysarthria in our MS cohort was 56% while the severity was generally mild and primarily consisted of a combination of spastic and ataxic components. Prosodic-articulatory disorder presenting with monopitch, articulatory decay, excess loudness variations and slow rate was the most salient. Speech disorders reflected subclinical motor impairment with 78% accuracy in discriminating between a subgroup of asymptomatic MS (EDSS < 2.0) and control speakers. Speech disorder severity was related to the severity of neurological involvement. Decreased articulation rate was moderately correlated to EDSS as well as all subtests of the multiple sclerosis functional composite. The strongest correlation was observed between irregular oral diadochokinesis and the 9-Hole Peg Test (r = - 0.65, p < 0.001). Irregular oral diadochokinesis and excess loudness variations significantly separated pure pyramidal and mixed pyramidal-cerebellar MS subgroups. CONCLUSIONS: Automated speech analyses may provide valuable biomarkers of disease progression in MS as dysarthria represents common and early manifestation that reflects disease disability and underlying pyramidal-cerebellar pathophysiology.

• MeSH
• ataxie etiologie   patofyziologie   MeSH
• dospělí MeSH
• dysartrie etiologie   patofyziologie   MeSH
• fenotyp MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• motorické poruchy etiologie   patofyziologie   MeSH
• roztroušená skleróza klasifikace   komplikace   patofyziologie   MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• svalová spasticita etiologie   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Although smartphone technology provides new opportunities for the recording of speech samples in everyday life, its ability to capture prodromal speech impairment in persons with a high risk of developing Parkinson's disease (PD) has never been investigated. Speech data were acquired through a smartphone as well as a professional microphone with a linear frequency response from 50 participants with a rapid eye movement sleep behavior disorder that are at a high risk of developing PD and related neurodegenerative disorders. Additionally, recordings of 30 newly diagnosed, untreated PD patients and 30 healthy participants were evaluated. Acoustic assessment of 11 speech dimensions representing the key aspects of hypokinetic dysarthria in the early stages of PD was performed. Smartphone allowed the detection of speech abnormalities in participants with a high risk of developing PD. Acoustic measurements related to fundamental frequency variability, duration of pause intervals, and rate of speech timing extracted from spontaneous speech were sufficiently sensitive to significantly separate groups (area under curve of 0.85 between PD and controls) and showed very strong correlation and reliability between the professional microphone and the smartphone. Speech-based biomarkers collected through smartphones may have the potential to revolutionize the diagnostic process in neurodegenerative diseases and improve stratification for future neuroprotective therapy in PD.

• MeSH
• chytrý telefon * MeSH
• dysartrie patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc * diagnóza   komplikace   MeSH
• poruchy řeči * diagnóza   etiologie   MeSH
• reprodukovatelnost výsledků MeSH
• senioři MeSH
• software pro rozpoznávání řeči MeSH
• zdraví dobrovolníci pro lékařské studie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

Distinct speech characteristics that may aid in differentiation between Parkinson's disease (PD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) remain tremendously under-explored. Here, the patterns and degree of consonant articulation deficits across voiced and voiceless stop plosives in 16 PD, 16 PSP, 16 MSA and 16 healthy control speakers were evaluated using acoustic and perceptual methods. Imprecise consonant articulation was observed across all Parkinsonian groups. Voice onset time of voiceless plosives was more prolonged in both PSP and MSA compared to PD, presumably due to greater severity of dysarthria and slower articulation rate. Voice onset time of voiced plosives was significantly shorter only in MSA, likely as a consequence of damage to cerebellar structures. In agreement with the reduction of pre-voicing, MSA manifested increased number of voiced plosives misclassified as voiceless at perceptual evaluation. Timing of articulatory movements may provide important clues about the pathophysiology of underlying disease.

• MeSH
• dysartrie patofyziologie   MeSH
• hlas MeSH
• lidé středního věku MeSH
• lidé MeSH
• lingvistika * MeSH
• mozeček patofyziologie   MeSH
• multisystémová atrofie patofyziologie   MeSH
• Parkinsonova nemoc patofyziologie   MeSH
• progresivní supranukleární obrna patofyziologie   MeSH
• řeč * MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Vývojové poruchy řeči představují skupinu řečových poruch, které vzniknou v průběhu vývoje plodu, v perinatálním nebo postnatálním období dítěte do 1. roku věku. Pokud nejsou dobře a včas diagnostikovány, mohou přetrvávat, anebo se zhoršovat v dalším období až do dospělosti. Stav verbální komunikace ovlivňuje dítěti i jeho optimální psychický vývoj, dosažené vzdělání a do budoucna i profesní volbu.

Developmental language disorders is a group of speech disorders that arise during fetal development in the perinatal period, postnatal period of a child in its 1st year of age, or are specific individual periods during the speech development of the individual. If they are not diagnosed successfully right in time, they may persist or worsen in the next period up to adulthood. State of verbal communication affects the child´s optimal mental development, attained education and his/her future career choice.

• Klíčová slova
• dyslalie, patlavost, opožděný vývoj řeči, vývojová dysfázie, verbální dysfluence, vývojová dysartrie,
• MeSH
• afázie MeSH
• dítě * MeSH
• dysartrie klasifikace   patofyziologie   MeSH
• lidé MeSH
• poruchy řeči * klasifikace   patofyziologie   terapie   MeSH
• řečová terapie MeSH
• vývoj dítěte MeSH
• vývoj řeči MeSH
• Check Tag
• dítě * MeSH
• lidé MeSH
• Publikační typ
• přehledy MeSH

Hypokinetic dysarthria in Parkinson's disease (PD) can be characterized by monotony of pitch and loudness, reduced stress, variable rate, imprecise consonants, and a breathy and harsh voice. Using acoustic analysis, we studied the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) applied over the primary orofacial sensorimotor area (SM1) and the left dorsolateral prefrontal cortex (DLPFC) on motor aspects of voiced speech in PD. Twelve non-depressed and non-demented men with PD (mean age 64.58 ± 8.04 years, mean PD duration 10.75 ± 7.48 years) and 21 healthy age-matched men (a control group, mean age 64 ± 8.55 years) participated in the speech study. The PD patients underwent two sessions of 10 Hz rTMS over the dominant hemisphere with 2,250 stimuli/day in a random order: (1) over the SM1; (2) over the left DLPFC in the "on" motor state. Speech examination comprised the perceptual rating of global speech performance and an acoustic analysis based upon a standardized speech task. The Mann-Whitney U test was used to compare acoustic speech variables between controls and PD patients. The Wilcoxon test was used to compare data prior to and after each stimulation in the PD group. rTMS applied over the left SM1 was associated with a significant increase in harmonic-to-noise ratio and net speech rate in the sentence tasks. With respect to the vowel task results, increased median values and range of Teager-Kaiser energy operator, increased vowel space area, and significant jitter decrease were observed after the left SM1 stimulation. rTMS over the left DLPFC did not induce any significant effects. The positive results of acoustic analysis were not reflected in a subjective rating of speech performance quality as assessed by a speech therapist. Our pilot results indicate that one session of rTMS applied over the SM1 may lead to measurable improvement in voice quality and intensity and an increase in speech rate and tongue movements. Nevertheless, these changes were not accompanied by changes in a perceptual evaluation of speech performance by a speech therapist. Future placebo-controlled studies in larger patient cohorts should verify if rTMS would be clinically useful for treating hypokinetic dysarthria in PD.

• MeSH
• dysartrie komplikace   patofyziologie   terapie   MeSH
• jazykové testy MeSH
• lidé středního věku MeSH
• lidé MeSH
• motorické korové centrum patofyziologie   MeSH
• Parkinsonova nemoc komplikace   patofyziologie   terapie   MeSH
• prefrontální mozková kůra patofyziologie   MeSH
• řeč fyziologie   MeSH
• senioři MeSH
• transkraniální magnetická stimulace metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH