Cases reported "Dysarthria"

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1/3. A kinematic analysis of anticipatory coarticulation in the speech of anterior aphasic subjects using electromagnetic articulography.

    An investigation was made into the extent and time course of anticipatory coarticulation in the speech of two normal and two anterior aphasic, German-speaking subjects. Both labial and velar coarticulation gestures were investigated. Subjects produced sentences containing target words contrasting in postconsonantal vowel rounding (e.g., [geli:ge]/[gely:gel]) and in nasality (e.g., [ti:de]/[ti:ne]). speech kinematics were monitored by means of electromagnetic articulography. The data revealed that for correct productions, aphasic speakers' coarticulatory patterns were more highly variable than those of control subjects. These differences, however, were found chiefly for spatial displacement characteristics, while the temporal aspects of articulator movement necessary for anticipatory coarticulation appeared largely intact. Articulator mistiming did not appear to explain a small corpus of stop/nasal substitution errors produced by one of the aphasic speakers.
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2/3. speech freezing in Parkinson's disease: a kinematic analysis of orofacial movements by means of electromagnetic articulography.

    Kinematic recordings of orofacial movements by means of electromagnetic articulography were performed in an akinetic-rigid Parkinsonian patient presenting with intermittent speech freezing in diadochokinesis tasks (rapid repetitions of the syllable /ta/). During freezing periods the patient produced a sustained /a/ instead of the required consonant-vowel sequences. The underlying articulatory trajectories were characterized by repetition rates amounting to 8-10 Hz concomitant with reduced movement amplitudes. Obviously, the undershooting of articulatory gestures failed to establish a sufficient occlusion of the vocal tract giving rise to the perceived speech freezing. In contrast, preserved diadochokinesis occurred at frequencies of 4-6 Hz. Most probably, the increased articulatory repetition rate reflects a pacing of orofacial movements by released tremor oscillations. Due to slowing of articulatory movements spastic dysarthrics can also present with missing syllabic modulation during oral diadochokinesis. The results of the articulographic recordings demonstrate the different pathophysiology of Parkinsonian freezing.
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3/3. Resolution of dysarthria in multiple sclerosis by treatment with weak electromagnetic fields.

    It has been reported that 50% or more of patients diagnosed with multiple sclerosis (MS) exhibit speech impairment (dysarthria) which in some cases can be exceedingly disabling. Currently there is no effective medical treatment for the dysarthria of MS which occurs as a result of lesions to the cerebellum and its outflow tracts. It was reported recently that extracranial application of brief AC pulsed electromagnetic fields (EMFs) in the picotesla (pT) range intensity produced in patients with MS sustained improvement in motor functions including cerebellar symptomatology. This communication concerns two MS patients with a chronic progressive course who exhibited severe dysarthria which improved already during the initial treatment with pulsed EMFs and which resolved completely 3-4 weeks later. Since application of EMFs has been shown to alter: (a) the resting membrane potential and synaptic neurotransmitter release through an effect involving changes in transmembrane calcium flux; and (b) the secretion of pineal melatonin which in turn influences the synthesis and release of serotonin (5-HT) and gamma-amino butyric acid (GABA) in the cerebellum, it is suggested that the immediate improvement of the dysarthria occurred as a result of changes in cerebellar neurotransmitter functions particularly 5-HT and GABA rather than from remyelination.
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