11/23. Effects of chronic cerebellar stimulation (CCS) setting on the gait and speech of a spastic cerebral palsy adult.A single (N = 1) spastic cerebral palsy adult who had experienced Chronic Cerebellar Stimulation (CCS) for 9 years without any change in the stimulator settings was assessed at six different stimulator settings. These voltage settings varied from 0 volts to 40 volts and frequencies of stimulation from 0 to 200 Hz. Stimulation was with bipolar rectangular pulses with less than 0.2 C/mm2 charge per phase. Responses measured at each setting were quantitative gait, speech, and somatosensory evoked potential measurements. Additional clinical assessments were done by a neurologist and speech therapist. Alteration in stimulator settings occurred 1 week apart to allow for stabilization and all assessments were completed in the same sequence each day. None of the individual stimulator settings were known to any of the assessors or to the patient. The results showed consistently that the patient's gait and speech were poorest when the stimulator was switched off completely. Switching on the stimulator caused improved function according to all assessments. There was consistent improvement in gait and speech when the rate of the cerebellar stimuli was high (for voltages between 0 and 40 V). Changing the voltage (within the range 0 to 40 V), while keeping the frequency of stimulation constant, did not appear to have as much effect. This preliminary evaluation suggests that the technique of CCS is safe and can improve function in a measurable manner.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
12/23. The influence of chronic cerebellar stimulation on respiratory muscle coordination in a patient with cerebral palsy.The effect of chronic cerebellar stimulation on respiratory muscle coordination has been evaluated using a relatively simple and objective target breathing test on one patient. Seven normal subjects were used as controls. Magnetometer recordings were used to determine whether abdominal and rib cage expansion were in phase. Subjects were asked to match their breathing frequency to a metronome signal. Their ability to control respiratory timing voluntarily was assessed in terms of the coefficient of variation (CV) of inspiratory time (Ti) and of expiratory time (Te). The CV's of Ti and Te were much greater in the patient in the absence of cerebrellar stimulation than they were in normal subjects. Both at 3 weeks and 6 months after implantation of the stimulator, a significant improvement in the performance of the patient was demonstrable with the stimulator on, although normal values were never achieved. This demonstrable influence of chronic cerebellar stimulation on respiratory muscle coordination has important implications for both the avoidance of respiratory complications and the potential improvement of speech in patients with cerebral palsy.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
13/23. Cerebellar stimulation in the management of cerebral palsy: clinical and physiological studies.Cerebellar stimulators were inserted into seven children who had cerebral palsy and in whom extensive investigation, including computerized tomography, had revealed no structural brain abnormality. A team including physiotherapists, occupational therapists, speech pathologists, and respiratory physiologists assessed the children pre- and postoperatively; their somatosensory evoked potentials were also measured. The mean age at implantation was 8.6 yearsl follow-up has ranged from 8 to 23 months (mean, 17.3 months). No adverse effects of the cerebellar stimulation have been noted. Detailed case histories obtained from the parents, together with formal assessment scores, indicate good improvement in six patients and mild but significant improvement in the seventh. Clinically, there has been gradual improvement in all seven patients. The charge density range associated with clinical improvement was 0.8 to 2.1 muCi/cm2/phase. The stimulation equipment must be monitored very carefully to ensure that any variation from the desired output is acceptably small because it is probable that sizable deviation is a determining factor in lack of response to this therapy.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
14/23. An interaction between haloperidol and carbamazepine in a patient with cerebral palsy.A 37-year-old woman with cerebral palsy and a rapid cycling bipolar affective disorder developed drowsiness and slurred speech when being treated with a combination of haloperidol and a low dose of carbamazepine. This effect occurred twice but did not appear when the patient was given carbamazepine alone at much higher doses. This suggests that some patients who appear intolerant of carbamazepine may still benefit from this drug if concomitant haloperidol therapy is ceased.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
15/23. Computer-aided communication device for a child with cerebral palsy.This paper describes a portable computer-aided communication device designed for a 13-year-old child with athetoid cerebral palsy. The device was intended to provide vocal output, hard-copy, correctable display, word storage capabilities, and utilize currently available technology. The design incorporated the Epson HX-20 computer, the Votrax Type 'N Talk speech synthesizer, and a customized laptray.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
16/23. DAF as instrumental treatment for dysarthria in progressive supranuclear palsy: a case report.In this case study, a 59-year-old male with progressive supranuclear palsy and hypokinetic dysarthria wore a small, solid state, battery operated, delayed auditory feedback device to reduce speech rate and to aid speech intelligibility. time series measurements were made from tape recordings taken at the beginning of treatment and again after three months of daily wearing of the device. Measures of speech rate, intensity, and overall intelligibility indicate that when the instrument is worn, the subject's speech is slowed, vocal intensity increases, and intelligibility is markedly improved. The subject and his family report satisfaction with the instrument. The application of delayed auditory feedback to the treatment of communication disorders is discussed.- - - - - - - - - - ranking = 0.5keywords = speech (Clic here for more details about this article) |
17/23. Articulatory abnormalities in athetoid cerebral palsy.This report presents cinefluorographic data on the articulation of isolated vowels, VCV nonsense utterances, and short sentences by five subjects with athetoid cerebral palsy. Articulatory abnormalities were identified from tracings of vocal tract shapes and from displacement-by-time plots of articulatory events. The most frequent abnormalities were large ranges of jaw movement, inappropriate positioning of the tongue for various phonetic segments (especially because of a reduced range of tongue movement in the anteroposterior dimension), intermittency of velopharyngeal closure caused by an instability of velar elevation, prolonged transition times for articulatory movements, and retrusion of the lower lip. The speech disorder associated with athetosis is considered with respect to a model of motor learning.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
18/23. Chronic self-stimulation of the dentate nucleus for the relief of spasticity.It has been assumed but not yet proved that cerebellar cortical stimulation activates the purkinje cells, with subsequent inhibition of the deep cerebellar nuclei. However, the relatively crude, widespread excitation induced by several surface electrode arrays and the parameters of stimulation currently used, may produce other effects than selective activation of only one specific cellular type which, furthermore, seems to be rarely present in these particular patients, as demonstrated by biopsy studies prior to electrode placement. The dentate nucleus was chronically implanted with a stimulating system in a patient with spasticity due to cerebral palsy. Chronic self-stimulation induced a significant improvement in motor function, with relief of spasticity and improvement in speech, posture, balance and gait. Electrophysiological studies demonstrated a decrease in the amplitude of V1 and V2 responses and in the H/M and T/M ratios, an increase in the silent period, and marked effects in the H reflex recovery curve, as well as diminished contralateral cortical somato-sensory evoked potentials. This result seems to indicate that the clinical effects of cerebellar cortical stimulation are not due to prosthetically induced inhibition of the dentate nucleus.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
19/23. Reversibility of chronic neurologic deficits. Some effects of electrical stimulation of the thalamus and internal capsule in man.Stimulation of the thalamus and internal capsule with Medtronic deep brain stimulation electrodes produced improvement in pain, hemiparesis, dystonia, torticollis, tremor. speech impairment and epilepsy. Stimulation at voltages above or below clinically effective levels (e.g., 6 V, 0.3 ms, 74 Hz) resulted in a loss of clinical efficacy. Somatosensory evoked responses (short and long latency) and depth electrode recordings were helpful in localisation and 'biocalibration' of electrical stimulation.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
20/23. students with word finding disorders: three case studies.Case studies of three students of different ages with different types and degrees of word finding disorders are presented. One student is at the beginning of his school career, one has been in school for 7 years, and the third individual is a young adult who left school after completing only 11 grades. Each student's word finding profile and characteristics are presented as well as the impact of the disorder upon school performance particularly in the area of reading. Recommendations are made for intervention involving collaboration between speech-language pathologists and educators.- - - - - - - - - - ranking = 0.125keywords = speech (Clic here for more details about this article) |
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