TY - JOUR
T1 - Motor speech disorders and communication limitations in progressive supranuclear palsy
AU - Clark, Heather M.
AU - Utianski, Rene L.
AU - Ali, Farwa
AU - Botha, Hugo
AU - Whitwell, Jennifer L.
AU - Josephs, Keith A.
N1 - Funding Information:
This work was supported by funding from National Institutes of Health Grants R01-DC12519 (PI: J. L. Whitwell) and R01-NS 89757 (PI: K. A. Josephs). The authors thank Peter Martin, who contributed to the development visualization of the data for Figure 3. The authors also express their gratitude to the patients and families who generously gave their time for this research.
Publisher Copyright:
© 2021 American Speech-Language-Hearing Association.
PY - 2021/6
Y1 - 2021/6
N2 - Purpose: This study describes motor speech disorders and associated communication limitations in six variants of progressive supranuclear palsy (PSP). Method: The presence, nature, and severity of dysarthria and apraxia of speech (AOS) were documented, along with scores on the Apraxia of Speech Rating Scale–Version 3 (ASRS-3) for 77 (40 male and 37 female) patients with PSP. Clinician-estimated and patient-estimated communication limitations were rated using the Motor Speech Disorders Severity Rating (MSDSR) Scale and the Communicative Effectiveness Survey (CES), respectively. Descriptive statistics were calculated for each of these dependent variables. One-tailed t tests were conducted to test mean differences in ASRS-3 and CES between participants with and without AOS and between participants with and without dysarthria. Spearman rank correlations were calculated between ASRS-3 scores and clinical judgments of AOS and dysarthria severity and between MSDSR and CES ratings. Results: Nine participants (12%) had normal speech. Eighty-seven percent exhibited dysarthria; hypokinetic and mixed hypokinetic–spastic dysarthria were observed most frequently. AOS was observed in 19.5% of participants across all variants, but in only 10% exclusive of the PSP speech and language variant. Nearly half presented with AOS in which neither phonetic nor prosodic features clearly predominated. The mean ASRS-3 score for participants with AOS was significantly higher than for those without and correlated strongly with clinician judgment of AOS severity. Mean ASRS-3 was higher for participants with dysarthria than for those without but correlated weakly with dysarthria severity. Mean MSDSR and CES ratings were lower in participants with AOS compared to those without and moderately correlated with each other. Conclusions: Motor speech disorders that negatively impact communicative effectiveness are common in PSP and occur in many variants. This is the first description of motor speech disorders across PSP variants, setting the stage for future research characterizing neuroanatomical correlates, progression of motor speech disorders, and benefits of targeted interventions. Supplemental Material: https://doi.org/10.23641/asha. 14111837.
AB - Purpose: This study describes motor speech disorders and associated communication limitations in six variants of progressive supranuclear palsy (PSP). Method: The presence, nature, and severity of dysarthria and apraxia of speech (AOS) were documented, along with scores on the Apraxia of Speech Rating Scale–Version 3 (ASRS-3) for 77 (40 male and 37 female) patients with PSP. Clinician-estimated and patient-estimated communication limitations were rated using the Motor Speech Disorders Severity Rating (MSDSR) Scale and the Communicative Effectiveness Survey (CES), respectively. Descriptive statistics were calculated for each of these dependent variables. One-tailed t tests were conducted to test mean differences in ASRS-3 and CES between participants with and without AOS and between participants with and without dysarthria. Spearman rank correlations were calculated between ASRS-3 scores and clinical judgments of AOS and dysarthria severity and between MSDSR and CES ratings. Results: Nine participants (12%) had normal speech. Eighty-seven percent exhibited dysarthria; hypokinetic and mixed hypokinetic–spastic dysarthria were observed most frequently. AOS was observed in 19.5% of participants across all variants, but in only 10% exclusive of the PSP speech and language variant. Nearly half presented with AOS in which neither phonetic nor prosodic features clearly predominated. The mean ASRS-3 score for participants with AOS was significantly higher than for those without and correlated strongly with clinician judgment of AOS severity. Mean ASRS-3 was higher for participants with dysarthria than for those without but correlated weakly with dysarthria severity. Mean MSDSR and CES ratings were lower in participants with AOS compared to those without and moderately correlated with each other. Conclusions: Motor speech disorders that negatively impact communicative effectiveness are common in PSP and occur in many variants. This is the first description of motor speech disorders across PSP variants, setting the stage for future research characterizing neuroanatomical correlates, progression of motor speech disorders, and benefits of targeted interventions. Supplemental Material: https://doi.org/10.23641/asha. 14111837.
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U2 - 10.1044/2020_AJSLP-20-00126
DO - 10.1044/2020_AJSLP-20-00126
M3 - Article
C2 - 33719524
AN - SCOPUS:85108742325
SN - 1058-0360
VL - 30
SP - 1361
EP - 1372
JO - American Journal of Speech-Language Pathology
JF - American Journal of Speech-Language Pathology
IS - 3s
ER -