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Dysarthria in multiple system atrophy
Author(s) -
GARRATT HELEN,
WENNING GREGOR,
QUINN NIALL
Publication year - 1995
Publication title -
international journal of language and communication disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.101
H-Index - 67
eISSN - 1460-6984
pISSN - 1368-2822
DOI - 10.1111/j.1460-6984.1995.tb01724.x
Subject(s) - dysarthria , olivopontocerebellar atrophy , psychology , parkinsonism , atrophy , audiology , degenerative disease , spastic , central nervous system disease , phonation , parkinson's disease , medicine , disease , neuroscience , pathology , cerebral palsy , psychiatry
Multiple system atrophy (MSA) is a degenerative neurological condition involving multiple areas of the nervous system. This may result in combinations of parkinsonism, cerebellar, pyramidal and autonomic symptoms. Early in the course of the disease patients may present with similar symptoms to patients with idiopathic Parkinson's disease (IPD) and, in the past, this has led to people being diagnosed incorrectly as having IPD. The type of dysarthria present in MSA may be spastic, hypokinetic or cerebellar, or any combination of these, depending on the site of neurological damage. The literature has commented on the laryngeal element in the dysarthria, noting the early presentation of phonatory disorders and the greater impairment of laryngeal features when compared to IPD subjects. This study was undertaken to examine the dysarthria in MSA and, in particular, its phonatory component. Six subjects with MSA were entered into the study. Five presented with striatonigral degeneration (predominant Parkinsonian features) and one with olivopontocerebellar atrophy (predominant cerebellar features). Following the initial study the data were compared with three matched subjects with IPD. The subjects' speech was assessed by use of the Frenchay Dysarthria Assessment (FDA) and the Laryngograph PCLX systems. The dysarthria of these subjects was described as slurred, hypophonic and hoarse. Examination of the results of ‘all subject’ data from the FDA indicated that laryngeal function was the most impaired parameter. Results of the PCLX analysis shed more light on the nature of this laryngeal impairment. The Dx plot showed irregularities at low and high frequencies. Dx plots for IPD subjects reading the same passage showed much less low‐ and high‐frequency irregularity. This equates with the perceived nature of the phonatory disturbances in IPD as hypophonic but without hoarseness in the MSA subjects. The study confirms previous findings of a noticeable phonatory element of the dysarthria in MSA and also provides some further description of this in the results of the PCLX analysis. This finding should be further investigated and may provide additional information helpful in the diagnosis of MSA and its dysarthria.