• 제목/요약/키워드: Dysarthria

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파킨슨병 환자의 교대운동속도 과제에서 관찰된 '말 뭉침'의 음향학적 특성 (Acoustic Characteristics of 'Short Rushes of Speech' using Alternate Motion Rates in Patients with Parkinson's Disease)

  • 김선우;윤지혜;이승진
    • 말소리와 음성과학
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    • 제7권2호
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    • pp.55-62
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    • 2015
  • It is widely accepted that Parkinson's disease(PD) is the most common cause of hypokinetic dysarthria, and its characteristics of 'short rushes of speech' have become more evident along with the severity of motor disorders. Speech alternate motion rates (AMRs) are particularly useful for observing not only rate abnormalities but also deviant speech. However, relatively little is known about the characteristics of 'short rushes of speech' in terms of AMRs of PD except for the perceptual characteristics. The purpose of this study was to examine which acoustic features of 'short rushes of speech' in terms of AMRs are a robust indicator of Parkinsonian speech. Numbers of syllabic repetitions (/pə/, /tə/, /kə/) in AMR tasks were analyzed through acoustic methods observing a spectrogram of the Computerized Speech Lab in 9 patients with PD. Acoustically, we found three characteristics of 'short rushes of speech': 1) Vocalized consonants without closure duration(VC) 76.3%; 2) No consonant segmentation(NC) 18.6%; 3) No vowel formant frequency(NV) 5.1%. Based on these results, 'short rushes of speech' may affect the failure to reach and maintain the phonatory targets. In order to best achieve the therapeutic goals, and to make the treatment most efficacious, it is important to incorporate training methods which are based on both phonation and articulation.

기저핵 뇌경색 환자의 편마비 한방치료 1례 (The Effect of Korean Medicine Treatment on Left Basal Ganglia Infarction with Hemiplegia Symptoms: Case Report)

  • 김홍경;김재익;정소연;김정호;김영일
    • 혜화의학회지
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    • 제27권2호
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    • pp.21-29
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    • 2018
  • Objectives : The purpose of this study was to report the effect of Korean medical treatment on left basal ganglia infarction. Methods : We performed acupuncture and administered herbal medicine to one patient to alleviate symptoms of hemiplegia such as motor disorder, facial palsy, and dysarthria. Manual Muscle Test(MMT), Hand Grip Test(HGT), Gait Level(GL), and Dysarthria grade were used to evaluate status of the patient. Results & Conclusions : The results of this research showed that overall symptoms of hemiplegia in the patient were improved. According to the results, the Korean medical treatment is considered to be effective on patients of left basal ganglia infarction to treat symptoms of hemiplegia. Further studies with larger sample sizes are needed to examine this issue.

특발성 파킨슨병의 시상밑부핵 심부뇌자극술 관련 말 평가 과제에 대한 문헌연구 (Speech Evaluation Tasks Related to Subthalamic Nucleus Deep Brain Stimulation in Idiopathic Parkinson's Disease: A Review)

  • 김선우;김향희
    • 재활복지
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    • 제18권4호
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    • pp.237-255
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    • 2014
  • 특발성 파킨슨병(idiopathic Parkinson disease, IPD)은 알 수 없는 원인으로 인해 중뇌의 흑질신경세포가 손실되는 대표적인 퇴행성 신경계 질환이다. IPD 환자는 신체 운동 이상을 주로 호소하지만 이들 중 70~90%가 운동저하형 마비말장애(hypokinetic dysarthria)를 동반하는 것으로 알려져 있다. 진행된 심도의 IPD 환자의 운동 증상 호전에 가장 효과적인 치료 방법으로 알려진 시상밑부핵 심부뇌자극술(subthalamic nucleus deep brain stimulation, STN-DBS)은 말 산출에서는 그 효과가 일관되지 않게 보고된다. 이에 본 연구에서는 STN-DBS가 말 산출에 미치는 영향을 살펴보고, 연구에서 어떠한 말 평가 과제가 사용되었는지를 조사하기 위하여 medline을 통해 2012까지 이루어진 연구 논문을 수집하였다. 총 32편 중, 연구대상자들에서 술 후 말 상태의'호전'이 관찰된 논문은 42%,'악화'는 29%,'엇갈리는 결과'는 26%,'변화 없음'은 3%로 확인되었다. 말 효과 간에는 문맥발화(contextual speech)가 연구에 사용된 비중이 높을수록 술 후 말 상태는 부정적인 결과로 보고되었으며, 말 산출 단계 중 일부 단계(예: 호흡 및 발성만, 혹은 조음만)만이 반영된 평가 과제가 연구마다 선택적으로 사용되었음을 확인하였다. 이에 본 연구는 STN-DBS를 받은 IPD 환자의 말 평가는 말 산출 하부 단계를 모두 반영하는 문맥발화 과제를 통일적으로 사용할 것을 제안한다.

음질, 운율, 발음 특징을 이용한 마비말장애 중증도 자동 분류 (Automatic severity classification of dysarthria using voice quality, prosody, and pronunciation features)

  • 여은정;김선희;정민화
    • 말소리와 음성과학
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    • 제13권2호
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    • pp.57-66
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    • 2021
  • 본 논문은 말 명료도 기준의 마비말장애 중증도 자동 분류 문제에 초점을 둔다. 말 명료도는 호흡, 발성, 공명, 조음, 운율 등 다양한 말 기능 특징의 영향을 받는다. 그러나 대부분의 선행연구는 한 개의 말 기능 특징만을 중증도 자동분류에 사용하였다. 본 논문에서는 음성의 장애 특성을 효과적으로 포착하기 위해 마비말장애 중증도 자동 분류에서 음질, 운율, 발음의 다양한 말 기능 특징을 반영하고자 하였다. 음질은 jitter, shimmer, HNR, voice breaks 개수, voice breaks 정도로 구성된다. 운율은 발화 속도(전체 길이, 말 길이, 말 속도, 조음 속도), 음높이(F0 평균, 표준편차, 최솟값, 최댓값, 중간값, 25 사분위값, 75 사분위값), 그리고 리듬(% V, deltas, Varcos, rPVIs, nPVIs)을 포함한다. 발음에는 음소 정확도(자음 정확도, 모음 정확도, 전체 음소 정확도)와 모음 왜곡도[VSA(vowel space area), FCR (formant centralized ratio), VAI(vowel articulatory index), F2 비율]가 있다. 본 논문에서는 다양한 특징 조합을 사용하여 중증도 자동 분류를 시행하였다. 실험 결과, 음질, 운율, 발음 특징 세 가지 말 기능 특징 모두를 분류에 사용했을 때 F1-score 80.15%로 가장 높은 성능이 나타났다. 이는 마비말장애 중증도 자동 분류에는 음질, 운율, 발음 특징이 모두 함께 고려되어야 함을 시사한다.

중풍 후 언어 장애에 대한 ☐☐의부집성(醫部集成)☐☐의 침구치료 고찰 (A Literatual Study on the Acupuncture and Moxibustion for Dysarthria of Stroke in Euibujipsung)

  • 정동원;민인규;문상관;나병조;홍진우;박성욱;정우상;박정미;고창남;조기호;배형섭;김영석
    • 대한중풍순환신경학회지
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    • 제8권1호
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    • pp.28-33
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    • 2007
  • Objectives and methods : The Euibujipsung is one of the huge-scale encyclopedias about Oriental Medicine. To search the most frequently used aupoints for dysarthria after stroke, we used Euibujipsung CD-ROM database with several chinese character keyword concerned with vernal function(語, 言, 音, 啞, 瘖, etc). Results : We found four popular acupoints(PC5, GV20, GV16, TE6), and five meridians (Governor vessel, Gall Bladder, Heart, Large Intestine and Triple Energizer). We also found that the extra meridians were used more frequently than other type of meridians. Conclusion : We think that these findings can give further ideas to clinical practice and research fields for stroke rehabilitation in Oriental medicine.

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심근경색후 발생한 좌심실류의 외과적 치료 (Surgical Treatment of Postmyocardial Infarct LV Aneurysm - A case report -)

  • 유환국
    • Journal of Chest Surgery
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    • 제22권6호
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    • pp.1078-1083
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    • 1989
  • We experienced one case of the left ventricular aneurysm. The patient was 44 years old male, who complained of dysarthria and dysphagia due to right cerebellar infarction EKG revealed antero-lateral myocardial infarction, so checked 2-D echo-cardiogram showed the left ventricular aneurysm with the mural thrombus. Aneurysmectomy with removal of thrombi was made for preventing further propagation of the systemic embolization. But CABG was impossible due to fine coronary artery at the portion of myocardial infarction. Mild LCOS was noted but postop course was smooth. During 12 months follow-up period, he lives in good physical activity [MYHA F.C. II /IV] and absence of chest pain.

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페니토인 사용에 따른 소뇌 위축 사례 (A case of phenytoin-induced cerebellar atrophy)

  • 김재현
    • 한국콘텐츠학회:학술대회논문집
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    • 한국콘텐츠학회 2016년도 춘계 종합학술대회 논문집
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    • pp.433-434
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    • 2016
  • Cerebellar atrophy was found that a patient was taking oral phenytoin for 3 years. 53 years old female patient with General tonic clonic(GTC) type seizure was prescribed phenytoin. In the process, she developed ataxic gate, dysarthria. Brain magnetic resonance imaging(MRI) finding was revealed differential diagnosis cerebellar atrophy. She was prescribed epileptol instead of phenytoin. But leukopenia, thrombocytopenia occurred. As a result, phenytoin restarted. Development of medical state decreased abuse of anticonvulsants. Considering various convulsive disorders, we must give attention to using anticonvulsants.

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청심연자탕 가감방으로 호전된 교뇌 출혈 이후 발생한 양측 반신부전마비, 연하곤란, 언어장애 치험 1례 (A Case Study of Chengsimyeonja-tang-gamibang Treatment of a Patient with a Pontine Hemorrhage, with Quadriparesis, Dysarthria, and Dysphagia)

  • 양지연;정택수;전경륭;옥소윤;선종주
    • 대한한방내과학회지
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    • 제38권2호
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    • pp.217-225
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    • 2017
  • Objectives: This case study evaluated the effectiveness of Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) in a patient with a pontine hemorrhage and quadriparesis, dysarthria, and dysphagia. Methods: A patient diagnosed with a pontine hemorrhage was treated with Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) acupuncture, and moxibustion. The manual muscle test (MMT), modified Barthel index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Mini Mental State Examination-Korea (MMSE-K), and Articulatory Functional Ability of Achievement Scale were administered. Results: Improvements in the MMT, MBI, NIHSS, mRS, and K-MMSE were observed after the treatment. The MMT grade increased from Rt. 3/3- and Lt. 3/3- pretreatment to Rt. 4/4 and Lt. 4+/4+ post-treatment. The MBI increased from 10 to 50 post-treatment. The NIHSS decreased from 24 to 6 post-treatment, and the mRS fell from 5 to 4 post-treatment. Finally, the MMSE-K increased from 0 to 24 post-treatment. The Articulatory Functional Ability of Achievement Scale also improved. Conclusion: This study shows that Chengsimyeonja-tang-gamibang can be used to treat the symptoms of patients with a pontine hemorrhage.

서산 지역에서의 중풍에 대한 임상적 고찰 (A Clinical Study on Stroke patients(CVA) in Seosan province)

  • 이근동;서종은;한성수
    • 대한한방내과학회지
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    • 제21권5호
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    • pp.715-721
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    • 2000
  • Objective : The purpose of this study is about stroke patients in Seosan. Method : The subjects of this study were 45 patients who were admitted to Hanseo University Oriental Hospital because of stroke. Each patients was diagnosed with Brain CT, sasang constitutional analysis. Results : 1. The rates in CVA was 58% on cerebral infarction, and 42% on cerebral hemorrhage. 2. The sites of cerebral infarction were Basal ganglia, MCA, Internal. External capsule. Thalamus, ect. Sites of cerebral hemorrhage were Thalamus, Basal ganglia, Cerebellum. 3. The ratio of left and right hemiplegia in cerebral infarction was 1:1.6, and in cerebral hemorrhage it was 1:2. 4. The most chief complaints in cerebral infarction, were hemiplegia, dysarthria, facial palsy, headache. In cerebral hemorrhage, their were hemiplegia, dysarthria, headache, dizziness, and facial palsy. 5. Classification of human corporal constitution in cerebral hemorrhage, the most was Taeumin, Soyangin, Soeumin. And in cerebral infarction, the most was Soyangin, Taeumin, Soyumin. 6. The ratio between male and female was 1.25:2 in cerebral hemorrhage, 2.5:5 in cerebral infarction. 7. The most prevalent age groups in cerebral hemorrhage was fifties to sixties. and in cerebral infarction was fifties to sixties. 8. The most common preceding disease in cerebral hemorrhage was HTN, DM. 9. The recurrence rate of cerebral hemorrhage was 16%, and cerebral infarction was 8%. 10. The ratio of recovery in cerebral hemorrhage was 84%, in cerebral infarction 58%. Conclusion : From this study, in cerebral hemorrhage most patients were Taeumin, in their fifties to sixties. And in cerebral infarction most patients were Soyangin, in their sixties to eighties. In both stroke patients, there were more female than male patients.

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Functional Independence Measure를 이용한 뇌졸중(腦卒中) 환자의 임상적 관찰 (A Clinical Observation of the Stroke Patients : Using Functional Independence Measure)

  • 김민석;정승현;신길조;이원철
    • 대한한방내과학회지
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    • 제19권1호
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    • pp.97-113
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    • 1998
  • BACKGROUND The purpose of this study was to investigate disability of the patients after stroke, clinical applicability and usefulness of the FIM in evaluating the functional abilities and to assess the characteristics of the patients after stroke. And this study examined difference by predictive factors on the treatment outcome. METHOD The study was composed of 31 stroke patients who were within 1 week after stroke and had been treated in hospital more than 4 weeks. Improving rate was measured by using the Functional Independence Measure(FIM), and the correlation was analyzed between Motor FIM and Cognitive FIM. We analyzed significant meaning statistically in the mean value of FIM. RESULT 1. There was no significant meaning statistically in the mean value of FIM that was between both at admission and after 2 weeks. But there was proportional correlation between both at admission and after 4 weeks, and significant meaning statistically. 2. There was proportional correlation between both FIM and Motor FIM, and significant meaning statistically. But there was no significant meaning statistically between both FIM and Cognitive FIM. 3. There was no significant meaning statistically between both FIM and sex, age, side of weakness, stroke subtype, hypertension, hypercholesterolemia, diabetes mellitus, heart disease, starting point of rehabilitation therapy and past history of cerebral vascular accident. While dysarthria affected functional recovery in stroke patients, and significant meaning statistically. CONCLUSION 1. FIM appeared to be a valid and reliable method to measure the functional abilities of the patients after stroke. 2. Only one thing between Motor FIM and score didn't influence FIM score. 3. Dysarthria affected functional recovery in stroke patients, and it is the statistically significant factor.

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