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PLoS One. 2016 Jan 20;11(1):e0147573. doi: 10.1371/journal.pone.0147573. eCollection 2016.

Profiling Speech and Pausing in Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Dementia (FTD).

Author information

1
Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.
2
Sunnybrook Research Institute, Toronto, Ontario, Canada.
3
University Health Network-Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
4
Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.
5
Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
6
Rotman Research Institute, Toronto, Ontario, Canada.
7
L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
8
Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
9
MGH Institute of Health Professions, Boston, Massachusetts, United States of America.

Abstract

OBJECTIVE:

This study examines reading aloud in patients with amyotrophic lateral sclerosis (ALS) and those with frontotemporal dementia (FTD) in order to determine whether differences in patterns of speaking and pausing exist between patients with primary motor vs. primary cognitive-linguistic deficits, and in contrast to healthy controls.

DESIGN:

136 participants were included in the study: 33 controls, 85 patients with ALS, and 18 patients with either the behavioural variant of FTD (FTD-BV) or progressive nonfluent aphasia (FTD-PNFA). Participants with ALS were further divided into 4 non-overlapping subgroups--mild, respiratory, bulbar (with oral-motor deficit) and bulbar-respiratory--based on the presence and severity of motor bulbar or respiratory signs. All participants read a passage aloud. Custom-made software was used to perform speech and pause analyses, and this provided measures of speaking and articulatory rates, duration of speech, and number and duration of pauses. These measures were statistically compared in different subgroups of patients.

RESULTS:

The results revealed clear differences between patient groups and healthy controls on the passage reading task. A speech-based motor function measure (i.e., articulatory rate) was able to distinguish patients with bulbar ALS or FTD-PNFA from those with respiratory ALS or FTD-BV. Distinguishing the disordered groups proved challenging based on the pausing measures.

CONCLUSIONS AND RELEVANCE:

This study demonstrated the use of speech measures in the identification of those with an oral-motor deficit, and showed the usefulness of performing a relatively simple reading test to assess speech versus pause behaviors across the ALS-FTD disease continuum. The findings also suggest that motor speech assessment should be performed as part of the diagnostic workup for patients with FTD.

PMID:
26789001
PMCID:
PMC4720472
DOI:
10.1371/journal.pone.0147573
[Indexed for MEDLINE]
Free PMC Article

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