Relevance of Aerodynamic Evaluation in Parkinsonian Dysarthria

Résumé En Fr

Parkinsonian dysarthria is generally known under the name of hypokinetic dysarthria. Dysarthria, according to Darley et al (1969), is characterized by all speech disorders related to disturbances of muscular control of the speech organs, whose origin is a central or peripheral nervous system injury. So we must understand by dysarthria all failures related to either different levels of speech production (respiratory, phonatory, articulatory and even prosodic). Parkinsonian dysarthria, meanwhile, is mainly based on rigidity and hypokinesia. That's why it is considered as « hypokinetic » (Darley et al., 1975; Gentil et al., 1995). This term refers not only to reduction of articulatory movements but also to decreasing of speech prosody modulation described as monotonic (Viallet & Teston, 2007). Parkinsonian dysarthria arises, like other signs of Parkinson's disease, the depletion of dopamine in charge of phonatory incompetence by muscular hypokinesia. It is a major handicap factor that may compromise in long-term oral communication of the patient, as worsening over the course of the disease, responding less well to treatment and thereby posing additional difficulties in support. So we thought to better assess this dysarthria in order to gain a better understanding and improve management. This assessment can be done by perceptual analysis. She could also be done by various instrumental methods (acoustic and physiological) focusing on one of the speech production levels mentioned above. Such studies are numerous in literature and we will report some examples in this chapter. What is more rare in literature is assessment of parkinsonian dysarthria in study combined several levels as might allow, for example, the dual approach appealing to physiology of speech production with firstly an aerodynamic component related to pneumophonic coordination (respiratory and phonatory levels) and, secondly, an acoustic component in relation to phonoarticulatory coordination (phonatory and articulatory levels). Through this chapter we want show that it is possible to assess appropriately parkinsonian dysarthria by using aerodynamic parameters that combine respiratory and phonatory levels, so such an experiment that we report in this chapter after having reviewed main methods of evaluation.

Ce travail met en évidence l'intérêt des mesures aérodynamiques pour l'évaluation de la dysrthrie parkinsonienne.