Wolfram Ziegler - Profile on Academia.edu (original) (raw)
Papers by Wolfram Ziegler
The Impact of Dysarthria on Laypersons’ Attitudes towards Adults with Cerebral Palsy
Folia Phoniatrica Et Logopaedica, 2019
Objective: This study investigated laypersons’ attitudes towards adults with dysarthria due to ce... more Objective: This study investigated laypersons’ attitudes towards adults with dysarthria due to cerebral palsy (CP). We aimed to explore the impact of the overall severity and of specific symptoms of dysarthria on laypersons’ evaluations. Patients and Methods: Eighteen adults with dysarthria due to CP and 6 nondysarthric controls participated as speakers. The individuals with CP underwent dysarthria assessment based on a standardized tool. The results were compared to those of a listening experiment with 20 laypersons. A text passage spoken by all speakers was presented to the listeners, who provided their evaluations using rating scales specifically developed for this study. The tool addressed 3 dimensions of attitudes: (1) estimation of a speaker’s cognitive-linguistic abilities; (2) attribution of personality and social characteristics, and (3) listeners’ emotions and behavioral tendencies towards the speaker. Results: Severity of dysarthria was strongly correlated with the overall attitudes. Regression analyses identified different symptoms as predictors of the listeners’ judgements. Conclusion: Severity of dysarthria seems to have a major impact on laypersons’ attitudes. Results suggest that speech symptoms may have a very specific influence on laypersons’ evaluations. This may be important for clinical care, since symptoms with the most negative impact should be focused on in treatment.
Mutismus bei zentralmotorischen Störungen - Eine Literaturübersicht
Fortschritte Der Neurologie Psychiatrie, Sep 1, 1994
Mutism can be defined as "a condition in which there is no, or very little, oral-verbal expr... more Mutism can be defined as "a condition in which there is no, or very little, oral-verbal expression, whereas comprehension of speech ... is normal or at least at a considerably higher level" (Lebrun, 1990). Benson (1979) enumerates five neuroanatomical correlates of mutism: (a) damage to the Broca region, (b) lesion of the supplementary motor area of the dominant hemisphere, (c) dysfunction of the mesencephalic reticular system, (d) thalamotomy, and (e) bilateral pathology of cortical and subcortical motor structures. The last item refers to syndromes of mutism resulting from central motor disorders. Depending on location and size of the lesion this pathophysiological interpretation should hold true for the fourth point as well. In mutism due to central motor disturbances lacking verbal expression represents the most severe degree of dysarthria, i.e. anarthria. The present review provides a detailed description of mutism following corticobulbar, striatal, and cerebellar dysfunctions.
Dysarthria in bilateral thalamic infarction A case study
Journal of Neurology, 1993
A patient suffering from bilateral thalamic infarction in the region supplied by the paramedian a... more A patient suffering from bilateral thalamic infarction in the region supplied by the paramedian arteries sparing the internal capsules underwent acoustic analysis of sentence utterances. The results were compared with the findings obtained in parkinsonian subjects, in patients with upper motor neuron lesions, and in normal subjects. Acoustic measurements revealed increased pitch, monotonous speech, rough voice quality, and normal speech tempo concomitant with articulatory impreciseness in terms of incomplete closure productions. This constellation resembled parkinsonian dysarthria. Damage to the thalamic projection area of the pallidal efferents, therefore, seems to be the most probable cause of the patient's speech disorders. In parkinsonian subjects stereotactical lesions of this structure ameliorate rigor, but not akinesia. Thus, our patient's speech deficits, and by analogy the corresponding parkinsonian dysarthric disturbances, may be considered akinetic signs.
A “Birdsong Perspective” on Human Speech Production
The MIT Press eBooks, Mar 22, 2013
Higher-Faster-Farther: Maximum Performance Tests in the Assessment of Neurogenic Speech Impairment
Folia Phoniatrica Et Logopaedica, 2019
Background: Maximum performance tests are widely used in dysarthria assessment. From a theoretica... more Background: Maximum performance tests are widely used in dysarthria assessment. From a theoretical perspective, the motor demands of such tasks differ from those of speaking. Therefore, their validity as measures of dysarthric impairment needs to be established empirically. Patients and Methods: Maximum phonation time (MPT) and maximum syllable repetition rate (MRR) were compared with sentence reading/repetition tasks. In study 1, 130 patients with neurologic movement disorders and 130 healthy control participants were examined. Presence/severity of dysarthria was measured using psychometrically standardized auditory scales. In study 2, 16 healthy volunteers participated in an experiment designed to examine the intraspeaker variability of MPT, MRR, and sentence repetition across eight trials. Results: Study 1: MPT made no reasonable contribution to the diagnosis of dysarthria or of any specific dimension of perceived speech impairment. MRR correlated with overall speech impairment but turned out to be an insensitive and highly unspecific statistical marker, afflicted with aetiology-specific errors. Study 2: compared with sentence repetition, both MPT and MRR demonstrated highly increased within-subject inconsistencies. Conclusion: The validity of MPT and MRR tasks as measures of dysarthria is still unsettled.
Journal of Neurology, Neurosurgery, and Psychiatry, Jun 1, 1989
Apraxia of Speech: Concepts and Controversies
Journal of Speech Language and Hearing Research, Oct 1, 2012
Purpose This article was written as an editorial to a collection of original articles on apraxia ... more Purpose This article was written as an editorial to a collection of original articles on apraxia of speech (AOS) in which some of the more recent advancements in the understanding of this syndrome are discussed. It covers controversial issues concerning the theoretical foundations of AOS. Our approach was motivated by a change of perspective on motor speech that has taken place in neurobiology, neurolinguistics, phonology, and phonetics during the past few decades. Method The literature on AOS is reviewed from 3 different but overlapping perspectives—that is, a disconnection, a motor memory, and a fine motor skill perspective. Separate sections are devoted to the delimitations of AOS from oral facial apraxia, dysarthria, and phonological impairment. Conclusions We conclude that many of the still unresolved conceptual issues about AOS arise from an underspecification of existing models of spoken language production. We suggest that phonological and motor impairments of sound production should be studied by an integrated approach.
Journal of Motor Behavior, Dec 9, 2016
Measures of performance rates in speech-like or volitional nonspeech oral motor tasks are frequen... more Measures of performance rates in speech-like or volitional nonspeech oral motor tasks are frequently used to draw inferences about articulation rate abnormalities in patients with neurologic movement disorders. The study objective was to investigate the structural relationship between rate measures of speech and of oral motor behaviors different from speech. A total of 130 patients with neurologic movement disorders and 130 healthy subjects participated in the study. Rate data was collected for oral reading (speech), rapid syllable repetition (speech-like), and rapid single articulator movements (nonspeech). The authors used factor analysis to determine whether the different rate variables reflect the same or distinct constructs. The behavioral data were most appropriately captured by a measurement model in which the different task types loaded onto separate latent variables. The data on oral motor performance rates show that speech tasks and oral motor tasks such as rapid syllable repetition or repetitive single articulator movements measure separate traits.
The Cerebellum, Jan 13, 2013
Friedreich ataxia (FRDA) is the most frequent recessive ataxia in the Western world. Dysarthria i... more Friedreich ataxia (FRDA) is the most frequent recessive ataxia in the Western world. Dysarthria is a cardinal feature of FRDA, often leading to severe impairments in daily functioning, but its exact characteristics are only poorly understood so far. We performed a comprehensive evaluation of dysarthria severity and the profile of speech motor deficits in 20 patients with a genetic diagnosis of FRDA based on a carefully selected battery of speaking tasks and two widely used paraspeech tasks, i.e., oral diadochokinesis and sustained vowel productions. Perceptual ratings of the speech samples identified respiration, voice quality, voice instability, articulation, and tempo as the most affected speech dimensions. Whereas vocal instability predicted ataxia severity, tempo turned out as a significant correlate of disease duration. Furthermore, articulation predicted the overall intelligibility score as determined by a systematic speech pathology assessment tool. In contrast, neurologists' ratings of intelligibility-a component of the "Scale for the Assessment and Rating of Ataxia"-were found to be related to perceived speech tempo. Obviously, clinicians are more sensitive to slowness of speech than to any other feature of spoken language during dysarthria evaluation. Our results suggest that different components of speech production and trunk/limb motor functions are differentially susceptible to FRDA pathology. Furthermore, evidence emerged that paraspeech tasks do not allow for an adequate scaling of speech deficits in FRDA.
Fortschritte Der Neurologie Psychiatrie, Feb 1, 1995
Akinetic Mutism -A Review Cairns and coworkers (1941) introduced the term "akinetic mutism" to de... more Akinetic Mutism -A Review Cairns and coworkers (1941) introduced the term "akinetic mutism" to denote a syndrome characterised by lack of responsiveness in the presence of apparently preserved vigilance. Tbe present paper reviews clinical data as weil as results of animal experimentation to outline the functionalneuroanatomie basis of this constellation. Tbe c1inical literature following the original publication of Cairns et al. (1941) reported syndromes of "akinetic mutism" in bilateral mesodiencephalic or frontal lesions of various aetiology. At least two pathomechanisms of akinetic mutism can be differentiated: (a) reduced "arousal" of cortical functions due to lesions at or rostral to the mesodiencephalic junction; (b) impaired activation of the motor system following bilateral damage to the frontal lobes. Since perceptual and cognitive functions are disturbed as weil in mesodiencephalic akinetic mutism, the latter notion does not seem to be adequate. The terms "apallic syndrome" or "vegetative state" are rather more appropriate in these instances. Tbe label "akinetic mutism" can then be restricted to a pathophysiologically distinct syndrome, i. e. reduced motor activation following bilateral frontal damage.
From phonology to articulation
Routledge eBooks, Apr 27, 2023
Symptomatik
Springer eBooks, 2020
Sprechmotorische Störungen bei primär progredienter Aphasie
Sprache-stimme-gehor, Nov 30, 2021
Beispiel eines Therapieverlaufs
Im Folgenden wird exemplarisch der Therapieverlauf einer Patientin mit schwerer Sprechapraxie und... more Im Folgenden wird exemplarisch der Therapieverlauf einer Patientin mit schwerer Sprechapraxie und schwerer Aphasie beschrieben. Ausgehend vom sprachtherapeutischen Befund erfolgen die Zielerstellung und die Beschreibung des therapeutischen Vorgehens in der Therapie.
Sprechapraxie – eine Herausforderung
Sprechen ist ein Vorgang, dem gesunde Erwachsene keine besondere Aufmerksamkeit schenken mussen: ... more Sprechen ist ein Vorgang, dem gesunde Erwachsene keine besondere Aufmerksamkeit schenken mussen: Zunge, Lippen und Kehlkopf bewegen sich wie von selbst, wenn wir im Gesprach Worter und Satze formulieren, jemandem etwas zurufen, aus einem Buch vorlesen oder eine Geschichte erzahlen. Die ganze Aufmerksamkeit wahrend des Sprechens gehort den Inhalten, den Argumenten, den Reaktionen der Gesprachspartner, dem kommunikativen Austausch. Die Sprechorgane und ihre Bewegungen sind dabei nicht mehr als ein Instrument, das wir muhelos beherrschen.
Sprechapraxie: Klinik und Modelle
Springer eBooks, 2020
Dieser Abschnitt fuhrt in das Storungsbild der Sprechapraxie ein. Er beginnt mit einer modellbezo... more Dieser Abschnitt fuhrt in das Storungsbild der Sprechapraxie ein. Er beginnt mit einer modellbezogenen und einer symptombezogenen Definition und skizziert dann die Einordnung der Sprechapraxie zwischen den Dysarthrien einerseits und den aphasisch-phonologischen Storungen andererseits. Am Ende folgt eine Liste von Charakterisierungen des sprechapraktischen Storungsmechanismus.
Brain Mechanisms Underlying Speech Motor Control
Brain Stimulation, Sep 1, 2015
Background: Globus pallidus internus deep brain stimulation (GPi-DBS) can be an effective treatme... more Background: Globus pallidus internus deep brain stimulation (GPi-DBS) can be an effective treatment for primary dystonia. However, speech disorders have previously been reported as a common possible side effect of the treatment. Objectives: To study possible deterioration of speech after GPi-DBS and describe this in different dimensions. Methods: Speech was systematically evaluated in 15 patients with predominant torticollis and GPi-DBS. Each patient was tested twice within one day in two stimulation conditions: ON-DBS vs. OFF-DBS. Speech analyses comprised both function-oriented (perceptual scales, acoustic analyses) and communication-related measures (intelligibility, naturalness). A control sample of 15 healthy speakers underwent the same speech assessment. Results: On the group level, patients with dystonia showed mild but significant impairment on the overall dysarthria scale, the intelligibility score, and the naturalness ratings in both stimulation conditions (ManneWhitney, P < .05). No stimulation-induced deterioration was found. A slight increase in articulation rate was measured in the ON condition. On the single-case level, effects of GPi-DBS on speech were heterogenous. In one patient we observed a deterioration of speech (dysarthria), in a second patient with a history of childhood stuttering we found an aggravation of dysfluency. Impressive benefits could be documented in another patient who also suffered from spasmodic dysphonia. The study provides evidence that speech impairment is not a necessary side-effect of GPi-DBS in primary dystonia. Both, recurring of stuttering and a worsening of dysarthria may be seen in individual patients. The positive effects of GPi-DBS on the symptoms of spasmodic dysphonia merits further research as DBS is not commonly applied in this population.
Acoustic Analysis of Vocal Instability in Cerebellar Dysfunctions
Annals of Otology, Rhinology, and Laryngology, Feb 1, 1994
Acoustic analysis of vocal instability during the production of isolated vowels, including comput... more Acoustic analysis of vocal instability during the production of isolated vowels, including computation of mean fundamental frequency (F0), period-to-period variability (jitter), pitch fluctuations, and between-trial variation of F0, was performed in 20 patients with cerebellar cortical dysfunction. Eleven subjects suffered from purely cerebellar atrophy (CA). In the remaining 9 patients olivopontocerebellar atrophy (OPCA) had been diagnosed. A subgroup of both the CA and OPCA subjects presented with enlarged pitch fluctuations and/or increased jitter values. It is conceivable that asymmetrically distributed motor deficits at the laryngeal level and altered gain settings of laryngeal and/or respiratory reflexes account for the observed phonatory instability. Moreover, 5 of the 20 cerebellar patients had a pitch level exceeding the upper limit of the normal range. Presumably, this deviation reflects increased vocal effort.
Motor Control, 2011
The present study combines functional magnetic resonance imaging (fMRI) and reaction time (RT) me... more The present study combines functional magnetic resonance imaging (fMRI) and reaction time (RT) measurements to further elucidate the influence of syllable frequency and complexity on speech motor control processes, i.e., overt reading of pseudowords. Tying in with a recent fMRI-study of our group we focused on the concept of a mental syllabary housing syllable sized ready-made motor plans for high- (HF), but not low-frequency (LF) syllables. The RT-analysis disclosed a frequency effect weakened by a simultaneous complexity effect for HF-syllables. In contrast, the fMRI data revealed no effect of syllable frequency, but point to an impact of syllable structure: Compared with CV-items, syllables with a complex onset (CCV) yielded higher hemodynamic activation in motor “execution” areas (left sensorimotor cortex, right inferior cerebellum), which is at least partially compatible with our previous study. We discuss the role of the syllable in speech motor control.
The Impact of Dysarthria on Laypersons’ Attitudes towards Adults with Cerebral Palsy
Folia Phoniatrica Et Logopaedica, 2019
Objective: This study investigated laypersons’ attitudes towards adults with dysarthria due to ce... more Objective: This study investigated laypersons’ attitudes towards adults with dysarthria due to cerebral palsy (CP). We aimed to explore the impact of the overall severity and of specific symptoms of dysarthria on laypersons’ evaluations. Patients and Methods: Eighteen adults with dysarthria due to CP and 6 nondysarthric controls participated as speakers. The individuals with CP underwent dysarthria assessment based on a standardized tool. The results were compared to those of a listening experiment with 20 laypersons. A text passage spoken by all speakers was presented to the listeners, who provided their evaluations using rating scales specifically developed for this study. The tool addressed 3 dimensions of attitudes: (1) estimation of a speaker’s cognitive-linguistic abilities; (2) attribution of personality and social characteristics, and (3) listeners’ emotions and behavioral tendencies towards the speaker. Results: Severity of dysarthria was strongly correlated with the overall attitudes. Regression analyses identified different symptoms as predictors of the listeners’ judgements. Conclusion: Severity of dysarthria seems to have a major impact on laypersons’ attitudes. Results suggest that speech symptoms may have a very specific influence on laypersons’ evaluations. This may be important for clinical care, since symptoms with the most negative impact should be focused on in treatment.
Mutismus bei zentralmotorischen Störungen - Eine Literaturübersicht
Fortschritte Der Neurologie Psychiatrie, Sep 1, 1994
Mutism can be defined as "a condition in which there is no, or very little, oral-verbal expr... more Mutism can be defined as "a condition in which there is no, or very little, oral-verbal expression, whereas comprehension of speech ... is normal or at least at a considerably higher level" (Lebrun, 1990). Benson (1979) enumerates five neuroanatomical correlates of mutism: (a) damage to the Broca region, (b) lesion of the supplementary motor area of the dominant hemisphere, (c) dysfunction of the mesencephalic reticular system, (d) thalamotomy, and (e) bilateral pathology of cortical and subcortical motor structures. The last item refers to syndromes of mutism resulting from central motor disorders. Depending on location and size of the lesion this pathophysiological interpretation should hold true for the fourth point as well. In mutism due to central motor disturbances lacking verbal expression represents the most severe degree of dysarthria, i.e. anarthria. The present review provides a detailed description of mutism following corticobulbar, striatal, and cerebellar dysfunctions.
Dysarthria in bilateral thalamic infarction A case study
Journal of Neurology, 1993
A patient suffering from bilateral thalamic infarction in the region supplied by the paramedian a... more A patient suffering from bilateral thalamic infarction in the region supplied by the paramedian arteries sparing the internal capsules underwent acoustic analysis of sentence utterances. The results were compared with the findings obtained in parkinsonian subjects, in patients with upper motor neuron lesions, and in normal subjects. Acoustic measurements revealed increased pitch, monotonous speech, rough voice quality, and normal speech tempo concomitant with articulatory impreciseness in terms of incomplete closure productions. This constellation resembled parkinsonian dysarthria. Damage to the thalamic projection area of the pallidal efferents, therefore, seems to be the most probable cause of the patient's speech disorders. In parkinsonian subjects stereotactical lesions of this structure ameliorate rigor, but not akinesia. Thus, our patient's speech deficits, and by analogy the corresponding parkinsonian dysarthric disturbances, may be considered akinetic signs.
A “Birdsong Perspective” on Human Speech Production
The MIT Press eBooks, Mar 22, 2013
Higher-Faster-Farther: Maximum Performance Tests in the Assessment of Neurogenic Speech Impairment
Folia Phoniatrica Et Logopaedica, 2019
Background: Maximum performance tests are widely used in dysarthria assessment. From a theoretica... more Background: Maximum performance tests are widely used in dysarthria assessment. From a theoretical perspective, the motor demands of such tasks differ from those of speaking. Therefore, their validity as measures of dysarthric impairment needs to be established empirically. Patients and Methods: Maximum phonation time (MPT) and maximum syllable repetition rate (MRR) were compared with sentence reading/repetition tasks. In study 1, 130 patients with neurologic movement disorders and 130 healthy control participants were examined. Presence/severity of dysarthria was measured using psychometrically standardized auditory scales. In study 2, 16 healthy volunteers participated in an experiment designed to examine the intraspeaker variability of MPT, MRR, and sentence repetition across eight trials. Results: Study 1: MPT made no reasonable contribution to the diagnosis of dysarthria or of any specific dimension of perceived speech impairment. MRR correlated with overall speech impairment but turned out to be an insensitive and highly unspecific statistical marker, afflicted with aetiology-specific errors. Study 2: compared with sentence repetition, both MPT and MRR demonstrated highly increased within-subject inconsistencies. Conclusion: The validity of MPT and MRR tasks as measures of dysarthria is still unsettled.
Journal of Neurology, Neurosurgery, and Psychiatry, Jun 1, 1989
Apraxia of Speech: Concepts and Controversies
Journal of Speech Language and Hearing Research, Oct 1, 2012
Purpose This article was written as an editorial to a collection of original articles on apraxia ... more Purpose This article was written as an editorial to a collection of original articles on apraxia of speech (AOS) in which some of the more recent advancements in the understanding of this syndrome are discussed. It covers controversial issues concerning the theoretical foundations of AOS. Our approach was motivated by a change of perspective on motor speech that has taken place in neurobiology, neurolinguistics, phonology, and phonetics during the past few decades. Method The literature on AOS is reviewed from 3 different but overlapping perspectives—that is, a disconnection, a motor memory, and a fine motor skill perspective. Separate sections are devoted to the delimitations of AOS from oral facial apraxia, dysarthria, and phonological impairment. Conclusions We conclude that many of the still unresolved conceptual issues about AOS arise from an underspecification of existing models of spoken language production. We suggest that phonological and motor impairments of sound production should be studied by an integrated approach.
Journal of Motor Behavior, Dec 9, 2016
Measures of performance rates in speech-like or volitional nonspeech oral motor tasks are frequen... more Measures of performance rates in speech-like or volitional nonspeech oral motor tasks are frequently used to draw inferences about articulation rate abnormalities in patients with neurologic movement disorders. The study objective was to investigate the structural relationship between rate measures of speech and of oral motor behaviors different from speech. A total of 130 patients with neurologic movement disorders and 130 healthy subjects participated in the study. Rate data was collected for oral reading (speech), rapid syllable repetition (speech-like), and rapid single articulator movements (nonspeech). The authors used factor analysis to determine whether the different rate variables reflect the same or distinct constructs. The behavioral data were most appropriately captured by a measurement model in which the different task types loaded onto separate latent variables. The data on oral motor performance rates show that speech tasks and oral motor tasks such as rapid syllable repetition or repetitive single articulator movements measure separate traits.
The Cerebellum, Jan 13, 2013
Friedreich ataxia (FRDA) is the most frequent recessive ataxia in the Western world. Dysarthria i... more Friedreich ataxia (FRDA) is the most frequent recessive ataxia in the Western world. Dysarthria is a cardinal feature of FRDA, often leading to severe impairments in daily functioning, but its exact characteristics are only poorly understood so far. We performed a comprehensive evaluation of dysarthria severity and the profile of speech motor deficits in 20 patients with a genetic diagnosis of FRDA based on a carefully selected battery of speaking tasks and two widely used paraspeech tasks, i.e., oral diadochokinesis and sustained vowel productions. Perceptual ratings of the speech samples identified respiration, voice quality, voice instability, articulation, and tempo as the most affected speech dimensions. Whereas vocal instability predicted ataxia severity, tempo turned out as a significant correlate of disease duration. Furthermore, articulation predicted the overall intelligibility score as determined by a systematic speech pathology assessment tool. In contrast, neurologists' ratings of intelligibility-a component of the "Scale for the Assessment and Rating of Ataxia"-were found to be related to perceived speech tempo. Obviously, clinicians are more sensitive to slowness of speech than to any other feature of spoken language during dysarthria evaluation. Our results suggest that different components of speech production and trunk/limb motor functions are differentially susceptible to FRDA pathology. Furthermore, evidence emerged that paraspeech tasks do not allow for an adequate scaling of speech deficits in FRDA.
Fortschritte Der Neurologie Psychiatrie, Feb 1, 1995
Akinetic Mutism -A Review Cairns and coworkers (1941) introduced the term "akinetic mutism" to de... more Akinetic Mutism -A Review Cairns and coworkers (1941) introduced the term "akinetic mutism" to denote a syndrome characterised by lack of responsiveness in the presence of apparently preserved vigilance. Tbe present paper reviews clinical data as weil as results of animal experimentation to outline the functionalneuroanatomie basis of this constellation. Tbe c1inical literature following the original publication of Cairns et al. (1941) reported syndromes of "akinetic mutism" in bilateral mesodiencephalic or frontal lesions of various aetiology. At least two pathomechanisms of akinetic mutism can be differentiated: (a) reduced "arousal" of cortical functions due to lesions at or rostral to the mesodiencephalic junction; (b) impaired activation of the motor system following bilateral damage to the frontal lobes. Since perceptual and cognitive functions are disturbed as weil in mesodiencephalic akinetic mutism, the latter notion does not seem to be adequate. The terms "apallic syndrome" or "vegetative state" are rather more appropriate in these instances. Tbe label "akinetic mutism" can then be restricted to a pathophysiologically distinct syndrome, i. e. reduced motor activation following bilateral frontal damage.
From phonology to articulation
Routledge eBooks, Apr 27, 2023
Symptomatik
Springer eBooks, 2020
Sprechmotorische Störungen bei primär progredienter Aphasie
Sprache-stimme-gehor, Nov 30, 2021
Beispiel eines Therapieverlaufs
Im Folgenden wird exemplarisch der Therapieverlauf einer Patientin mit schwerer Sprechapraxie und... more Im Folgenden wird exemplarisch der Therapieverlauf einer Patientin mit schwerer Sprechapraxie und schwerer Aphasie beschrieben. Ausgehend vom sprachtherapeutischen Befund erfolgen die Zielerstellung und die Beschreibung des therapeutischen Vorgehens in der Therapie.
Sprechapraxie – eine Herausforderung
Sprechen ist ein Vorgang, dem gesunde Erwachsene keine besondere Aufmerksamkeit schenken mussen: ... more Sprechen ist ein Vorgang, dem gesunde Erwachsene keine besondere Aufmerksamkeit schenken mussen: Zunge, Lippen und Kehlkopf bewegen sich wie von selbst, wenn wir im Gesprach Worter und Satze formulieren, jemandem etwas zurufen, aus einem Buch vorlesen oder eine Geschichte erzahlen. Die ganze Aufmerksamkeit wahrend des Sprechens gehort den Inhalten, den Argumenten, den Reaktionen der Gesprachspartner, dem kommunikativen Austausch. Die Sprechorgane und ihre Bewegungen sind dabei nicht mehr als ein Instrument, das wir muhelos beherrschen.
Sprechapraxie: Klinik und Modelle
Springer eBooks, 2020
Dieser Abschnitt fuhrt in das Storungsbild der Sprechapraxie ein. Er beginnt mit einer modellbezo... more Dieser Abschnitt fuhrt in das Storungsbild der Sprechapraxie ein. Er beginnt mit einer modellbezogenen und einer symptombezogenen Definition und skizziert dann die Einordnung der Sprechapraxie zwischen den Dysarthrien einerseits und den aphasisch-phonologischen Storungen andererseits. Am Ende folgt eine Liste von Charakterisierungen des sprechapraktischen Storungsmechanismus.
Brain Mechanisms Underlying Speech Motor Control
Brain Stimulation, Sep 1, 2015
Background: Globus pallidus internus deep brain stimulation (GPi-DBS) can be an effective treatme... more Background: Globus pallidus internus deep brain stimulation (GPi-DBS) can be an effective treatment for primary dystonia. However, speech disorders have previously been reported as a common possible side effect of the treatment. Objectives: To study possible deterioration of speech after GPi-DBS and describe this in different dimensions. Methods: Speech was systematically evaluated in 15 patients with predominant torticollis and GPi-DBS. Each patient was tested twice within one day in two stimulation conditions: ON-DBS vs. OFF-DBS. Speech analyses comprised both function-oriented (perceptual scales, acoustic analyses) and communication-related measures (intelligibility, naturalness). A control sample of 15 healthy speakers underwent the same speech assessment. Results: On the group level, patients with dystonia showed mild but significant impairment on the overall dysarthria scale, the intelligibility score, and the naturalness ratings in both stimulation conditions (ManneWhitney, P < .05). No stimulation-induced deterioration was found. A slight increase in articulation rate was measured in the ON condition. On the single-case level, effects of GPi-DBS on speech were heterogenous. In one patient we observed a deterioration of speech (dysarthria), in a second patient with a history of childhood stuttering we found an aggravation of dysfluency. Impressive benefits could be documented in another patient who also suffered from spasmodic dysphonia. The study provides evidence that speech impairment is not a necessary side-effect of GPi-DBS in primary dystonia. Both, recurring of stuttering and a worsening of dysarthria may be seen in individual patients. The positive effects of GPi-DBS on the symptoms of spasmodic dysphonia merits further research as DBS is not commonly applied in this population.
Acoustic Analysis of Vocal Instability in Cerebellar Dysfunctions
Annals of Otology, Rhinology, and Laryngology, Feb 1, 1994
Acoustic analysis of vocal instability during the production of isolated vowels, including comput... more Acoustic analysis of vocal instability during the production of isolated vowels, including computation of mean fundamental frequency (F0), period-to-period variability (jitter), pitch fluctuations, and between-trial variation of F0, was performed in 20 patients with cerebellar cortical dysfunction. Eleven subjects suffered from purely cerebellar atrophy (CA). In the remaining 9 patients olivopontocerebellar atrophy (OPCA) had been diagnosed. A subgroup of both the CA and OPCA subjects presented with enlarged pitch fluctuations and/or increased jitter values. It is conceivable that asymmetrically distributed motor deficits at the laryngeal level and altered gain settings of laryngeal and/or respiratory reflexes account for the observed phonatory instability. Moreover, 5 of the 20 cerebellar patients had a pitch level exceeding the upper limit of the normal range. Presumably, this deviation reflects increased vocal effort.
Motor Control, 2011
The present study combines functional magnetic resonance imaging (fMRI) and reaction time (RT) me... more The present study combines functional magnetic resonance imaging (fMRI) and reaction time (RT) measurements to further elucidate the influence of syllable frequency and complexity on speech motor control processes, i.e., overt reading of pseudowords. Tying in with a recent fMRI-study of our group we focused on the concept of a mental syllabary housing syllable sized ready-made motor plans for high- (HF), but not low-frequency (LF) syllables. The RT-analysis disclosed a frequency effect weakened by a simultaneous complexity effect for HF-syllables. In contrast, the fMRI data revealed no effect of syllable frequency, but point to an impact of syllable structure: Compared with CV-items, syllables with a complex onset (CCV) yielded higher hemodynamic activation in motor “execution” areas (left sensorimotor cortex, right inferior cerebellum), which is at least partially compatible with our previous study. We discuss the role of the syllable in speech motor control.