Articulatory Range of Movement in Individuals With Dysarthria Secondary to Amyotrophic Lateral Sclerosis

• DOI: 10.1044/2018_ajslp-17-0064
• Publication Date: 2018-05-24T19:30:32Z
• Authors: Jimin Lee; Michael Bell
• Keywords: Adult; Aged, 80 and over; Male; Dysarthria; Amyotrophic Lateral Sclerosis; Speech Intelligibility; Middle Aged; Severity of Illness Index; Lip; Speech Acoustics; Biomechanical Phenomena; Judgment; 03 medical and health sciences; Jaw; Case-Control Studies; Speech Perception; Humans; Female; Range of Motion, Articular; 0305 other medical science; Electromagnetic Phenomena; Aged

Purpose The current study examined overall articulatory range of movement (ROM) in individuals with amyotrophic lateral sclerosis (ALS). Differential involvement of articulators was also tested using articulatory working space in individuals with varying degrees of dysarthria severity and in typically aging individuals. A strong association between overall articulatory ROM and severity measures among individuals with ALS was hypothesized. In addition, it was hypothesized that differential involvement of articulators would be detected using overall articulatory ROM measures.

Method Twenty-two speakers with dysarthria secondary to ALS and 22 typically aging speakers participated. Speech intelligibility and speaking rate were used as indices of severity. Movement range and overall articulatory working space area (convex hull) of the tongue, lower lip, and jaw were each measured by electromagnetic articulography while the speakers produced the Rainbow Passage.

Results Tongue convex hull size was significantly correlated with both indices of severity. A significant interaction between articulators and groups was observed. Individuals with severe dysarthria had reduced tongue convex hull size and exaggerated lower lip convex hull size. ROM in the anterior–posterior dimension showed a more notable differential involvement pattern than ROM in the superior–inferior dimension. Results in the area under a receiver operating characteristic curve analysis revealed group-specific ROM sensitivity.

Conclusions The findings indicate that tongue ROM is reduced in individuals with more severe dysarthria when estimated using a standardized paragraph containing all American English phonemes. The articulatory working space measure could be useful for estimating speech dysfunction in ALS. ROM of the tongue decreases, but ROM of the lower lip and jaw each increase in individuals with severe dysarthria. Differential involvement of the articulators in the anterior–posterior dimension needs to be further investigated.