Monthly Archives: October 2007
Positive correlation of CTG expansion and pharyngoesophageal alterations in myotonic dystrophy patients
Abstract Alteration of the pharyngoesophageal musculature is a common finding in patients with myotonic dystrophy (MD), regardless of the presence of dysphagia. The aim of the present study was to determine whether a specific pattern of swallowing abnormalities could be identified in MD patients, and the possible correlation with the size of CTG repeats. Fifteen MD patients, 8 of whom were asymptomatic for dysphagia, underwent a videofluoroscopic study of swallowing. Alterations of the pharyngoesophageal phase of swallowing were detected in 12 of 15 patients, 6 without clinical evidence of dysphagia. Incomplete relaxation of the upper esophageal sphincter (UES) and esophageal hypotonia were the most common alterations. We found a significant correlation between the number of radiological alterations and the size of CTG repeats. A typical radiological pattern of swallowing has also been identified. The role of videofluoroscopy in evaluation of MD patients is briefly discussed.
Abstract Vertical and anterior displacement of the hyoid bone is a critical biomechanical component of normal swallowing function. The purpose of this study was to evaluate the maximal vertical and anterior displacement of the hyoid bone during oropharyngeal swallowing. A retrospective review of video-fluoroscopic swallowing exams in 40 normal subjects varying by age and gender was performed. Means and standard deviations for both vertical and anterior displacement were analyzed on both 5-ml and 10-ml thin liquids using an ImageJ program. Age and gender differences were submitted to a repeated-measures one-way analysis of variance. There was a significant difference between younger and older subjects for anterior displacement of the hyoid bone during the swallow but not for vertical displacement. No significant differences between male and female subjects were observed. Anterior displacement of the hyoid bone decreased with increasing age. This reduction may be related to muscle weakness. However, older people may adapt to preserve airway protection.
Abstract Although stroke affects mainly the oral and pharyngeal phases of swallowing, it may also impair esophageal contractions. Our hypothesis is that stroke may affect esophageal transit. The oral, pharyngeal, and esophageal transit was studied by the scintigraphic method in 26 patients (age range = 26–83 years), eight of whom had mild dysphagia but all were able to feed orally and who had suffered an acute first-ever ischemic stroke 10–56 days (median = 43 days) before transit evaluation. The control group included 15 healthy volunteers (age range = 27–86 years). All subjects swallowed a 5-ml liquid bolus and a 5-ml paste bolus labeled with technetium-99m phytate while sitting in front of the collimator of a gamma camara. The oral, pharyngeal, and proximal, middle, and distal esophageal transit was measured for 20 s. Three patients did not swallow the bolus during the scintigraphic evaluation. There was no difference between patients and controls with respect to oral and pharyngeal transit or clearance of liquid. For paste, the pharyngeal transit time was shorter for patients (0.48 ± 0.17 s) than for controls (0.61 ± 0.18 s, p = 0.027). Also for the paste bolus, the residue in the mouth was greater in patients (18.4 ± 13.6%) than in controls (10.2 ± 4.9%, p = 0.031). The liquid transit duration in the distal esophagus was shorter in patients with stroke (1.74 ± 0.84 s) than in controls (2.68 ± 1.65 s, p = 0.028). There was no difference between patients and controls in esophageal residue. In conclusion, patients with stroke and able to feed orally may have alterations in the esophageal transit of a liquid bolus.
Rehabilitative Management of Oropharyngeal Dysphagia in Acute Care Settings: Data from a Large Italian Teaching Hospital
Abstract A high incidence of oropharyngeal dysphagia (OD) in acute-care settings has been reported; however, no data on its management are found in the literature. Here we report the experience with rehabilitative management of OD in a large Italian hospital. The characteristics of inpatients with OD during 2004 have been studied prospectively. For each patient, demographic data, the department referring the patient, the disease causing OD, and the presence of a communication disorder were registered. The swallowing level at the beginning and at the end of rehabilitation were recorded. Of the 35,590 inpatients admitted to San Giovanni Battista Hospital of Turin during 2004, 222 of them were referred for the assessment and rehabilitation of OD. The inpatients with OD came from different departments and mainly had a neurologic disease. In 110 patients a communication disorder was present. The swallowing impairment was moderate to severe at the moment of referral, while on average patients were able to eat by mouth after swallowing therapy. Dysphagia rehabilitation in an acute care setting is requested from different departments because of its prevalence and severity; skilled specialists are needed for early assessment and the best management.
This study tested the hypothesis whether older dyslexic children may obtain fewer gains on fluency and accuracy with respect to their younger peers after specific remediation.
Changes in accuracy and fluency of a group of children with a diagnosis of dyslexia attending third and fourth grades were compared with those obtained by a group of children attending the sixth, seventh or eighth grade in two different treatments, one based on the Balance model (Bakker) and the second based on the automatization of syllable recognition (sublexical).
Among all comparisons between the gains in accuracy and fluency obtained by the two groups, only the younger group in the sublexical treatment obtained a statistically significant gain with respect to their older peers’ accuracy in reading words.
These outcomes suggest that, at least for the chronological ages and types of treatments considered in this study, older children with dyslexia may obtain comparable gains to their younger peers, suggesting that it is never too late to remediate reading fluency and accuracy. Copyright © 2007 John Wiley & Sons, Ltd.
Acetylcysteine [N-acetylcysteine] may prevent gentamicin-induced deafness among haemodialysis patients
No abstract available.
Abstract The temporal perception of simple auditory and visual stimuli can be modulated by exposure to asynchronous audiovisual speech. For instance, research using the temporal order judgment (TOJ) task has shown that exposure to temporally misaligned audiovisual speech signals can induce temporal adaptation that will influence the TOJs of other (simpler) audiovisual events (Navarra et al. (2005) Cognit Brain Res 25:499–507). Given that TOJ and simultaneity judgment (SJ) tasks appear to reflect different underlying mechanisms, we investigated whether adaptation to asynchronous speech inputs would also influence SJ task performance. Participants judged whether a light flash and a noise burst, presented at varying stimulus onset asynchronies, were simultaneous or not, or else they discriminated which of the two sensory events appeared to have occurred first. While performing these tasks, participants monitored a continuous speech stream for target words that were either presented in synchrony, or with the audio channel lagging 300 ms behind the video channel. We found that the sensitivity of participant’s TOJ and SJ responses was reduced when the background speech stream was desynchronized. A significant modulation of the point of subjective simultaneity (PSS) was also observed in the SJ task but, interestingly, not in the TOJ task, thus supporting previous claims that TOJ and SJ tasks may tap somewhat different aspects of temporal perception.
The present study explores word boundary behaviours in the spontaneous speech of a group of 6 preschool children. Speech collected in play settings is examined for the presence of normal and atypical connected speech behaviours, and to identify specific instances of open and close word juncture behaviours. The findings suggest that developmental and adult-like features co-exist in the speech of typically-developing children and that developmental changes occur in connected speech behaviours between the ages of 2-3 years. In particular, a shift from equal numbers of close and open junctures, to a preference for close junctures is noted. Individual differences are also apparent between speakers, and these are discussed.
In the present study, voice onset time (VOT) measurements were compared between a group of individuals with moderate Alzheimer’s disease (AD) and a group of healthy age- and gender-matched peers. Participants read a list of consonant-vowel-consonant (CVC) words, which included the six stop consonants. The VOT measurements were made from oscillographic displays obtained from the Brown Laboratory Interactive Speech System (BLISS) implemented on an IBM-compatible computer. VOT measures for the participants’ six stop consonant productions were subjected to statistical analysis. The results indicated that VOT values in speakers with Alzheimer’s disease were not statistically different from those for the normal control speakers.
Verb and sentence processing in Norwegian aphasic speakers compared to Dutch and English aphasic speakers: experimental evidence
The article reports on a comparative study of the abilities of aphasic speakers and normal control subjects to comprehend and produce verbs and sentences. The analysis is based on test results obtained as part of the standardization procedure for a test battery originally developed for Dutch and since translated and adapted for English and Norwegian. With a few exceptions, there is extensive similarity in the test results between the different languages. The exceptions can be accounted for with reference both to structural differences between the languages and to coincidental aspects of informant selection and scoring procedures. The Norwegian version contains an additional sub-test on past tense inflection, which correlates significantly with at least two other sub-tests in the test battery.
Recent brain mapping studies have provided new insights into the cortical systems that mediate human speech perception. Electrocortical stimulation mapping (ESM) is a brain mapping method that is used clinically to localize cortical functions in neurosurgical patients. Recent ESM studies have yielded new insights into the cortical systems that mediate speech perception and how these systems vary as a function of individual differences. ESM methods are described and findings from recent ESM studies of speech perception are reviewed. The clinical implications of these findings are discussed as they relate to current understanding of how individual differences in listening abilities are reflected in the underlying cortical representations.
Relation of melody complexity in infants’ cries to language outcome in the second year of life: A longitudinal study
This study is part of the German Language Development Study’s prospective longitudinal research programme on infants from birth until the age of 3 years. Thirty-four infants were retrospectively classified into two groups (normal/delayed) by their language skills at 2.5 years of age. Frequency spectrograms and melodies of about 11,000 cries from the first 16 weeks of life were analysed using a CSL 4400. A Melody Complexity Index was calculated at monthly intervals. Infants with less than 45% complex melodies in their cries during the second month were found to be almost five times more likely to develop a language delay as infants with a higher proportion. For infants above the cut-off of .45, development of a language delay condition could be ruled out with a probability of 89%. Although the results need to be interpreted cautiously, the data indicate a possible relation between early melody development and later language outcome.
Consonant production following the sensory restoration of audition was investigated in 22 prelinguistically deaf French children who received cochlear implants. Spontaneous speech productions were recorded at 6, 12, and 18 months post-surgery and consonant inventories were derived from both glossable and non-glossable phones using two acquisition criteria. The results showed that children initiated appropriate production of consonants after six months of implant use. Stops and labials were the most frequently produced speech sounds, whereas glides and palatals were still infrequent after 18 months. Speech accuracy also improved throughout the study. Consonant visibility appeared to influence the order of acquisition in the first months following the implantation and, as experience with auditory information increased, patterns of development tended to resemble those seen in children with normal hearing. Finally, a signed mode of communication and oral rehabilitation programs prior to implantation were better outcome predictors than age at implantation.
It has been proposed that poor non-word repetition is a marker of specific language impairment (SLI), and a precursor and marker of dyslexia. This study investigated whether a non-word repetition deficit underlies both disorders. A group of Dutch preschool SLI children and children at familial risk of dyslexia, as well as school-going groups of SLI and dyslexic children were presented with a non-word repetition task. The results showed that the SLI and the (at-risk of) dyslexia groups performed more poorly than the control children. Furthermore, with the exception of one child, all preschool SLI children scored significantly below the mean of the preschool control group, suggesting that non-word repetition performance is a marker of SLI. Approximately half of the at-risk group were poor performers, which was expected on the basis of the familial risk factor of the at-risk group. The results show that a non-word repetition deficit is attested early in life and underlies both dyslexia and SLI.
This review examines the literature on the use of non-pulmonic egressive sounds in disordered speech. Studies are described that report the use of pulmonic ingressive speech, clicks, ejectives, and implosives. Broad trends are identified linking the use of each type of non-pulmonic-egressive airstream use with particular disorders. The importance of including these airstream types in both phonetic theory and practice classes in the training of speech-language pathologists is stressed.