Phonetics and Speech Sciences (말소리와 음성과학)

Korean Society of Speech Sciences (한국음성학회)
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Characteristics of accurate token and all token diadochokinesis in patients with normal pressure hydrocephalus

정상압 수두증 환자와 정상 노인의 조음교대운동 수행력 비교

  • Seong Hee Yoon (Department of Speech and Language Pathology, Graduate School of Rehabilitation, Daegu University) ;
  • Ki-Su Park (Department of Neurosurgery, School of Medicine, Kyungpook National University) ;
  • Kyunghun Kang (Department of Neurology, School of Medicine, Kyungpook National University) ;
  • Janghyeok Yoon (Neopons Inc.) ;
  • Ji-Wan Ha (Department of Speech and Language Pathology, Graduate School of Rehabilitation, Daegu University)
  • 윤성희 (대구대학교 대학원 재활과학과) ;
  • 박기수 (경북대학교 의과대학 신경외과) ;
  • 강경훈 (경북대학교 의과대학 신경과학교실) ;
  • 윤장혁 (네오폰스(주)) ;
  • 하지완 (대구대학교 대학원 재활과학과)
  • Received : 2024.02.18
  • Accepted : 2024.03.06
  • Published : 2024.03.31
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Abstract

Normal pressure hydrocephalus (NPH) is a condition wherein the cerebrospinal pressure in the brain is within the normal range, but the cerebrospinal fluid increases above the normal level, causing ventriculomegaly. In patients with NPH, the articulatory system exhibits reduced mobility and range, which may affect diadochokinesis (DDK) and speech intelligibility. In this study, we investigated the characteristics of DDK, including accurate-token DDK and all-token DDK including inaccurate tokens, in patients with NPH and healthy elderly adults (HE). We also examined the classification accuracy of DDK between the two groups. Finally, we investigated whether there was a correlation between speech intelligibility and DDKs in the NPH group. The results showed that NPH and HE groups differed significantly in both accurate-token DDK and all-token DDK, and their classification accuracy was relatively high. However, there was no correlation between speech intelligibility and DDK. The findings suggest that the DDK is a useful method for sensitively assessing speech motor performance in patients with NPH.

정상압 수두증(normal pressure hydrocephalus, NPH)은 뇌의 뇌척수압은 정상 범위에 있지만 뇌척수액이 정상 수준보다 증가해 뇌실확장증을 유발하는 질환으로, 조음기관의 운동성과 범위가 감소해 조음교대운동(diadochokinesis, DDK)과 말명료도에 영향을 줄 수 있다. 본 연구에서는 NPH 환자 38명과 정상 노인 38명을 대상으로 /파/, /타/, /카/ 및 /파타카/에 대한 DDK 과제를 실시한 후, 정확한 산출만 측정한 DDK(accurate token-DDK)와 부정확한 산출 포함, 모든 산출시도를 측정한 DDK(all token-DDK)의 두 방법을 모두 사용해 그 결과를 비교하였다. 또한 DDK가 NPH와 정상 노인의 두 집단을 얼마나 정확하게 분류 가능한지, 그리고 DDK와 말명료도 간 상관관계는 어떠한지에 대해서도 알아보았다. 연구결과, NPH 집단과 정상 노인 집단 간에는 accurate token-DDK와 all token-DDK 모두에서 유의한 차이가 있었고, 집단 분류정확도는 accurate token-DDK의 경우 75.0%, all token-DDK의 경우 77.6%로 비교적 높았다. 그러나 NPH 집단에서 DDK 속도와 말명료도 측정값 간에는 유의한 상관관계가 없었다. 본 연구는 NPH 환자의 말운동능력을 민감하게 평가하는 데에 DDK가 유용한 방법임을 시사한다.

Keywords

Acknowledgement

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2022S1A3A2A03089435).

References

  1. Boscato, N., Hayakawa, H., Iida, T., Costa, Y. M., Kothari, S. F., Kothari, M., & Svensson, P. (2022). Impact of oral motor task training on corticomotor pathways and diadochokinetic rates in young healthy participants. Journal of Oral Rehabilitation, 49(9), 924-934. https://doi.org/10.1111/joor.13349
  2. Bradley, W. G. (2000). Normal pressure hydrocephalus: New concepts on etiology and diagnosis. American Journal of Neuroradiology, 21(9), 1586-1590.
  3. Chankaew, E., Srirabheebhat, P., Manochiopinig, S., Witthiwej, T., & Benjamin, I. (2016). Bulbar dysfunction in normal pressure hydrocephalus: A prospective study. Neurosurgical Focus, 41(3), E15.
  4. Cho Y. J., Park, K. S. Kang, K. H., & Ha, J. W. (in press). Effects of audio-visual and contextual conditions on auditory word recognition. Communication Sciences & Disorders, in press. doi: 10.12963/csd.231017
  5. Choe, J., & Han, J. S. (1998). Diadochokinetic rate of normal children and adults: A preliminary study. Communication Sciences & Disorders, 3(1), 183-194.
  6. Chung, E. H. (2018). Deficits of language and speech in idiopathic normal pressure hydrocephalus (Doctoral dissertation). Harvard Medical School, Boston, MA.
  7. Chung, O. R. (1994). Daegu diagnostic aphasia examination. Daegu, Korea: Korean Speech-Language & Hearing Association.
  8. Cohen, W., & Waters, D. (1999, August). Measuring speech motor skills in normally developing and phonologically disordered pre-school children. Proceedings of the XIVth International Congress of Phonetic Sciences (pp. 789-792). San Francisco, CA.
  9. Cordella, C., Quimby, M., Touroutoglou, A., Brickhouse, M., Dickerson, B. C., & Green, J. R. (2019). Quantification of motor speech impairment and its anatomic basis in primary progressive aphasia. Neurology, 92(17):e1992-e2004.
  10. Duffy, J. R. (2005). Motor speech disorders: Substrates, differential diagnosis, and management (2nd ed.). St. Louis, MO: Elsevier Mosby.
  11. Duffy, J. R. (2013). Motor speech disorders: Substrates, differential diagnosis, and management (3rd ed.). St. Louis, MO: Elsevier Mosby.
  12. Gallia, G. L., Rigamonti, D., & Williams, M. A. (2006). The diagnosis and treatment of idiopathic normal pressure hydrocephalus. Nature Clinical Practice Neurology, 2(7), 375-381. https://doi.org/10.1038/ncpneuro0237
  13. Graff-Radford, N. R. (2007). Normal pressure hydrocephalus. Neurologic Clinics, 25(3), 809-832. https://doi.org/10.1016/j.ncl.2007.03.004
  14. Jung, E. Y., Cho, S. R., Kim, Y. J., & Kim, H. H. (2011). Characteristics of diadochokinesis in hypokinetic dysarthria: Rate and regularity. Communication Sciences & Disorders, 16(1), 74-82.
  15. Ha, S. (2023). Oral diadochokinetic production in children with typical speech development and speech-sound disorders. International Journal of Language & Communication Disorders, 58(5), 1783-1798. https://doi.org/10.1111/1460-6984.12908
  16. Kang, K., Seo, S. D., Hwang, S. K., Seo, J. G., Park, J. S., Park, S. P., & Lee, H. W. (2014). Idiopathic normal-pressure hydrocephalus patient with an ataxic gait as the predominant presenting manifestation. Journal of the Korean Neurological Association, 32(3), 198-201.
  17. Kent, R. D., Kent, J. F., & Rosenbek, J. C. (1987). Maximum performance tests of speech production. Journal of Speech and Hearing Disorders, 52(4), 367-387. https://doi.org/10.1044/jshd.5204.367
  18. Kim, S. Y. (2008). Maximum phonation time and diadochokinetic rate in normal Korean children (Doctoral dissertation). Yonsei University, Seoul, Korea.
  19. Lee, C. H. (2022). The social changes and food situation in the late period of Joseon. Food Science and Industry, 55(2), 203-217. https://doi.org/10.23093/FSI.2022.55.2.203
  20. Lee, S. E. (2010). Auditory-perceptual evaluation of the speech of hearing-impaired adults: Based on suprasegmental factors, speech intelligibility, and speech acceptability (Doctoral dissertation). Yonsei University, Seoul, Korea.
  21. Ministry of Health and Welfare (2015). 70 years of health and welfare: From an era of poverty to a welfare society. Seoul, Koera: Ministry of Health and Welfare.
  22. Park, K. E. (2013). The effect of speech intelligibility of patients with Parkinson's disease on quality of communication life (Master's thesis). Yonsei University, Seoul, Korea.
  23. Shprecher, D., Schwalb, J., & Kurlan, R. (2008). Normal pressure hydrocephalus: Diagnosis and treatment. Current Neurology and Neuroscience Reports, 8(5), 371-376. https://doi.org/10.1007/s11910-008-0058-2
  24. Song, H. N. (2012). Consonant accuracy and speech intelligibility of paralyzed speech impaired people according to articulation complexity and articulation severity (Master's thesis) Ewha Womans University, Seoul, Korea.
  25. Tjaden, K., & Watling, E. (2003). Characteristics of diadochokinesis in multiple sclerosis and Parkinson's disease. Folia Phoniatrica et Logopaedica, 55(5), 241-259. https://doi.org/10.1159/000072155
  26. Wang, Y. T., Kent, R. D., Duffy, J. R., & Thomas, J. E. (2009). Analysis of diadochokinesis in ataxic dysarthria using the Motor Speech Profile ProgramTM. Folia Phoniatrica et Logopaedica, 61(1), 1-11. https://doi.org/10.1159/000184539