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Left-hemispheric dominance for articulation: a prospective study on acute ischaemic dysarthria at different localizations
Dysarthria is a frequent symptom in cerebral ischaemia. However, speech characteristics of these patients have not previously been investigated in relation to lesion site in a prospective study. We investigated the auditory perceptual features in 62 consecutive patients with dysarthria due to a sing...
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| Published in: | Brain (London, England : 1878) England : 1878), 2006-03, Vol.129 (3), p.767-777 |
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| container_title | Brain (London, England : 1878) |
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| creator | Urban, P. P. Rolke, R. Wicht, S. Keilmann, A. Stoeter, P. Hopf, H. C. Dieterich, M. |
| description | Dysarthria is a frequent symptom in cerebral ischaemia. However, speech characteristics of these patients have not previously been investigated in relation to lesion site in a prospective study. We investigated the auditory perceptual features in 62 consecutive patients with dysarthria due to a single, non-space-occupying cerebral infarction confirmed by MRI. Standardized speech samples of all patients were stored within 72 h after stroke onset using a digital tape recorder. Speech samples were assessed independently by two experienced speech therapists, who were unaware of the clinical and neuroradiological findings, using an interval scale ranging from 0 to 6. Separately assessed were features of articulation, phonation, prosody, and the global severity for a total of 31 items. Extracerebellar infarctions (85.5%) were located in the lower motor cortex (14.5%), striatocapsular region (46.8%) and base of the pons (24.2%). Isolated cerebellar infarctions were present in 14.5% of patients. There was a strong correlation between the findings of both examiners, showing identical scores, or only minor differences ( |
| doi_str_mv | 10.1093/brain/awh708 |
| format | article |
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P. ; Rolke, R. ; Wicht, S. ; Keilmann, A. ; Stoeter, P. ; Hopf, H. C. ; Dieterich, M.</creator><creatorcontrib>Urban, P. P. ; Rolke, R. ; Wicht, S. ; Keilmann, A. ; Stoeter, P. ; Hopf, H. C. ; Dieterich, M.</creatorcontrib><description>Dysarthria is a frequent symptom in cerebral ischaemia. However, speech characteristics of these patients have not previously been investigated in relation to lesion site in a prospective study. We investigated the auditory perceptual features in 62 consecutive patients with dysarthria due to a single, non-space-occupying cerebral infarction confirmed by MRI. Standardized speech samples of all patients were stored within 72 h after stroke onset using a digital tape recorder. Speech samples were assessed independently by two experienced speech therapists, who were unaware of the clinical and neuroradiological findings, using an interval scale ranging from 0 to 6. Separately assessed were features of articulation, phonation, prosody, and the global severity for a total of 31 items. Extracerebellar infarctions (85.5%) were located in the lower motor cortex (14.5%), striatocapsular region (46.8%) and base of the pons (24.2%). Isolated cerebellar infarctions were present in 14.5% of patients. There was a strong correlation between the findings of both examiners, showing identical scores, or only minor differences (<1 on the assessment scale) for 80% of all items. The average severity of dysarthria was 2.9 ± 1.3. Articulatory abnormalities were the predominant deviation characteristics, affecting in particular the production of consonants. However, phonatory and prosodic abnormalities were also frequently observed speech characteristics. As revealed by factor analysis of speech characteristics the total severity of dysarthria was mainly influenced by the impairment of articulation. Speech parameters describing characteristics of articulation and prosody showed significant side-to-side and area differences, while this effect was lacking for any voice parameter. Left cerebral lesions showed a more severe overall impairment of speech and articulation, independent of lesion topography. Thirty-eight of 62 patients were available for follow-up. Speech evaluation showed normal speech within weeks in 15 out of 38 patients (39.5%). In the other 23 patients overall severity of dysarthria was mild. This is the first prospective study which describes speech characteristics of dysarthria due to acute unilateral cerebral infarctions. We could demonstrate that dysarthria in extracerebellar infarctions was more frequently caused by left-sided lesions and that the severity of dysarthria was more pronounced in left-sided lesions independent from lesion topography. All extracerebellar lesions were located along the course of the cortico-bulbar tract fibres. Compatible with a common pathophysiological basis of dysarthria in these patients, none of the 31 speech items differed significantly between subcortical and brainstem lesions.</description><identifier>ISSN: 0006-8950</identifier><identifier>EISSN: 1460-2156</identifier><identifier>DOI: 10.1093/brain/awh708</identifier><identifier>PMID: 16418180</identifier><identifier>CODEN: BRAIAK</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Articulation Disorders - etiology ; Biological and medical sciences ; Brain Mapping - methods ; Cerebral Infarction - complications ; Cerebral Infarction - pathology ; cerebral ischaemia ; dysarthria ; Dysarthria - etiology ; Dysarthria - pathology ; Female ; Follow-Up Studies ; Functional Laterality ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; lesion topography ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Prospective Studies ; Severity of Illness Index ; Speech Perception ; Speech Production Measurement ; stroke ; Tomography, X-Ray Computed ; Vascular diseases and vascular malformations of the nervous system ; Voice Quality</subject><ispartof>Brain (London, England : 1878), 2006-03, Vol.129 (3), p.767-777</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Mar 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c550t-3e9e85b3b29957a364259b94fc364b5f795fdd3e492d82fb6c0eee6c009a02933</citedby><cites>FETCH-LOGICAL-c550t-3e9e85b3b29957a364259b94fc364b5f795fdd3e492d82fb6c0eee6c009a02933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,31270</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17577312$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16418180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Urban, P. P.</creatorcontrib><creatorcontrib>Rolke, R.</creatorcontrib><creatorcontrib>Wicht, S.</creatorcontrib><creatorcontrib>Keilmann, A.</creatorcontrib><creatorcontrib>Stoeter, P.</creatorcontrib><creatorcontrib>Hopf, H. C.</creatorcontrib><creatorcontrib>Dieterich, M.</creatorcontrib><title>Left-hemispheric dominance for articulation: a prospective study on acute ischaemic dysarthria at different localizations</title><title>Brain (London, England : 1878)</title><addtitle>Brain</addtitle><description>Dysarthria is a frequent symptom in cerebral ischaemia. However, speech characteristics of these patients have not previously been investigated in relation to lesion site in a prospective study. We investigated the auditory perceptual features in 62 consecutive patients with dysarthria due to a single, non-space-occupying cerebral infarction confirmed by MRI. Standardized speech samples of all patients were stored within 72 h after stroke onset using a digital tape recorder. Speech samples were assessed independently by two experienced speech therapists, who were unaware of the clinical and neuroradiological findings, using an interval scale ranging from 0 to 6. Separately assessed were features of articulation, phonation, prosody, and the global severity for a total of 31 items. Extracerebellar infarctions (85.5%) were located in the lower motor cortex (14.5%), striatocapsular region (46.8%) and base of the pons (24.2%). Isolated cerebellar infarctions were present in 14.5% of patients. There was a strong correlation between the findings of both examiners, showing identical scores, or only minor differences (<1 on the assessment scale) for 80% of all items. The average severity of dysarthria was 2.9 ± 1.3. Articulatory abnormalities were the predominant deviation characteristics, affecting in particular the production of consonants. However, phonatory and prosodic abnormalities were also frequently observed speech characteristics. As revealed by factor analysis of speech characteristics the total severity of dysarthria was mainly influenced by the impairment of articulation. Speech parameters describing characteristics of articulation and prosody showed significant side-to-side and area differences, while this effect was lacking for any voice parameter. Left cerebral lesions showed a more severe overall impairment of speech and articulation, independent of lesion topography. Thirty-eight of 62 patients were available for follow-up. Speech evaluation showed normal speech within weeks in 15 out of 38 patients (39.5%). In the other 23 patients overall severity of dysarthria was mild. This is the first prospective study which describes speech characteristics of dysarthria due to acute unilateral cerebral infarctions. We could demonstrate that dysarthria in extracerebellar infarctions was more frequently caused by left-sided lesions and that the severity of dysarthria was more pronounced in left-sided lesions independent from lesion topography. All extracerebellar lesions were located along the course of the cortico-bulbar tract fibres. Compatible with a common pathophysiological basis of dysarthria in these patients, none of the 31 speech items differed significantly between subcortical and brainstem lesions.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Articulation Disorders - etiology</subject><subject>Biological and medical sciences</subject><subject>Brain Mapping - methods</subject><subject>Cerebral Infarction - complications</subject><subject>Cerebral Infarction - pathology</subject><subject>cerebral ischaemia</subject><subject>dysarthria</subject><subject>Dysarthria - etiology</subject><subject>Dysarthria - pathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Functional Laterality</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>lesion topography</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Speech Perception</subject><subject>Speech Production Measurement</subject><subject>stroke</subject><subject>Tomography, X-Ray Computed</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><subject>Voice Quality</subject><issn>0006-8950</issn><issn>1460-2156</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>7T9</sourceid><recordid>eNqFkUFvFCEYhonR2LV682yIiZ4c-wEDM3gzm2qNa7xoYnohDPORoc7OrMBo118vdjc28dILkPDwhvd7CHnK4DUDLc66aMN0Zn8NDbT3yIrVCirOpLpPVgCgqlZLOCGPUroCYLXg6iE5YapmLWthRfYb9LkacBvSbsAYHO3nbZjs5JD6OVIbc3DLaHOYpzfU0l2c0w5dDj-Rprz0ezpP1LolIw3JDbYElYh9Ku-GGCy1mfbBe4w4ZTrOzo7h901YekweeDsmfHLcT8nXd-df1hfV5vP7D-u3m8pJCbkSqLGVnei41rKxQtVc6k7X3pVjJ32jpe97gbXmfct9pxwgYllBW-BaiFPy8pBbvv5jwZRN6epwHO2E85JMK5XQjLV3gqpRsoHmbpAVE4zzuoDP_wOv5iVOpa1hWtZ1q4AV6NUBcmW0KaI3uxi2Nu4NA_PXsLkxbA6GC_7smLl0W-xv4aPSArw4AjaVcftYXIZ0yzWyaQTjhasOXEgZr__d2_i9NBWNNBffLg2spfp4-QmMFn8Ax3_Ahg</recordid><startdate>20060301</startdate><enddate>20060301</enddate><creator>Urban, P. P.</creator><creator>Rolke, R.</creator><creator>Wicht, S.</creator><creator>Keilmann, A.</creator><creator>Stoeter, P.</creator><creator>Hopf, H. C.</creator><creator>Dieterich, M.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>7T9</scope></search><sort><creationdate>20060301</creationdate><title>Left-hemispheric dominance for articulation: a prospective study on acute ischaemic dysarthria at different localizations</title><author>Urban, P. P. ; Rolke, R. ; Wicht, S. ; Keilmann, A. ; Stoeter, P. ; Hopf, H. 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Cerebral palsy</topic><topic>Humans</topic><topic>lesion topography</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Speech Perception</topic><topic>Speech Production Measurement</topic><topic>stroke</topic><topic>Tomography, X-Ray Computed</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><topic>Voice Quality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Urban, P. P.</creatorcontrib><creatorcontrib>Rolke, R.</creatorcontrib><creatorcontrib>Wicht, S.</creatorcontrib><creatorcontrib>Keilmann, A.</creatorcontrib><creatorcontrib>Stoeter, P.</creatorcontrib><creatorcontrib>Hopf, H. 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P.</au><au>Rolke, R.</au><au>Wicht, S.</au><au>Keilmann, A.</au><au>Stoeter, P.</au><au>Hopf, H. C.</au><au>Dieterich, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left-hemispheric dominance for articulation: a prospective study on acute ischaemic dysarthria at different localizations</atitle><jtitle>Brain (London, England : 1878)</jtitle><addtitle>Brain</addtitle><date>2006-03-01</date><risdate>2006</risdate><volume>129</volume><issue>3</issue><spage>767</spage><epage>777</epage><pages>767-777</pages><issn>0006-8950</issn><eissn>1460-2156</eissn><coden>BRAIAK</coden><abstract>Dysarthria is a frequent symptom in cerebral ischaemia. However, speech characteristics of these patients have not previously been investigated in relation to lesion site in a prospective study. We investigated the auditory perceptual features in 62 consecutive patients with dysarthria due to a single, non-space-occupying cerebral infarction confirmed by MRI. Standardized speech samples of all patients were stored within 72 h after stroke onset using a digital tape recorder. Speech samples were assessed independently by two experienced speech therapists, who were unaware of the clinical and neuroradiological findings, using an interval scale ranging from 0 to 6. Separately assessed were features of articulation, phonation, prosody, and the global severity for a total of 31 items. Extracerebellar infarctions (85.5%) were located in the lower motor cortex (14.5%), striatocapsular region (46.8%) and base of the pons (24.2%). Isolated cerebellar infarctions were present in 14.5% of patients. There was a strong correlation between the findings of both examiners, showing identical scores, or only minor differences (<1 on the assessment scale) for 80% of all items. The average severity of dysarthria was 2.9 ± 1.3. Articulatory abnormalities were the predominant deviation characteristics, affecting in particular the production of consonants. However, phonatory and prosodic abnormalities were also frequently observed speech characteristics. As revealed by factor analysis of speech characteristics the total severity of dysarthria was mainly influenced by the impairment of articulation. Speech parameters describing characteristics of articulation and prosody showed significant side-to-side and area differences, while this effect was lacking for any voice parameter. Left cerebral lesions showed a more severe overall impairment of speech and articulation, independent of lesion topography. Thirty-eight of 62 patients were available for follow-up. Speech evaluation showed normal speech within weeks in 15 out of 38 patients (39.5%). In the other 23 patients overall severity of dysarthria was mild. This is the first prospective study which describes speech characteristics of dysarthria due to acute unilateral cerebral infarctions. We could demonstrate that dysarthria in extracerebellar infarctions was more frequently caused by left-sided lesions and that the severity of dysarthria was more pronounced in left-sided lesions independent from lesion topography. All extracerebellar lesions were located along the course of the cortico-bulbar tract fibres. Compatible with a common pathophysiological basis of dysarthria in these patients, none of the 31 speech items differed significantly between subcortical and brainstem lesions.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16418180</pmid><doi>10.1093/brain/awh708</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Brain (London, England : 1878), 2006-03, Vol.129 (3), p.767-777 |
| issn | 0006-8950 1460-2156 |
| language | eng |
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| source | Oxford Journals Online; Linguistics and Language Behavior Abstracts (LLBA) |
| subjects | Acute Disease Adult Aged Aged, 80 and over Articulation Disorders - etiology Biological and medical sciences Brain Mapping - methods Cerebral Infarction - complications Cerebral Infarction - pathology cerebral ischaemia dysarthria Dysarthria - etiology Dysarthria - pathology Female Follow-Up Studies Functional Laterality Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans lesion topography Magnetic Resonance Imaging Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Prospective Studies Severity of Illness Index Speech Perception Speech Production Measurement stroke Tomography, X-Ray Computed Vascular diseases and vascular malformations of the nervous system Voice Quality |
| title | Left-hemispheric dominance for articulation: a prospective study on acute ischaemic dysarthria at different localizations |
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