Physiologic Deficits in the Orofacial System Underlying Dysarthria in Amyotrophic Lateral Sclerosis The purpose of this study was to delineate some of the physiological deficits in the orofacial musculature of patients with dysarthria associated with amyotrophic lateral sclerosis (ALS) and to relate the physiologic deficits to perceived severity of dysarthria. Strain gauge force transducers placed on the lower lip, jaw, and tongue ... Research Article
Research Article  |   February 01, 1994
Physiologic Deficits in the Orofacial System Underlying Dysarthria in Amyotrophic Lateral Sclerosis
 
Author Affiliations & Notes
  • Susan E. Langmore
    Department of Veterans Affairs Medical Center Ann Arbor, MI
  • Mark E. Lehman
    Central Michigan University Mt. Pleasant
  • Contact author: Susan E. Langmore, PhD, Audiology and Speech Pathology (126), Department of Veterans Affairs Medical Center, 2215 Fuller Road, Ann Arbor, Ml 48105.
Article Information
Speech, Voice & Prosodic Disorders / Dysarthria / Special Populations / Speech / Research Articles
Research Article   |   February 01, 1994
Physiologic Deficits in the Orofacial System Underlying Dysarthria in Amyotrophic Lateral Sclerosis
Journal of Speech, Language, and Hearing Research, February 1994, Vol. 37, 28-37. doi:10.1044/jshr.3701.28
History: Received January 2, 1992 , Accepted August 9, 1993
 
Journal of Speech, Language, and Hearing Research, February 1994, Vol. 37, 28-37. doi:10.1044/jshr.3701.28
History: Received January 2, 1992; Accepted August 9, 1993

The purpose of this study was to delineate some of the physiological deficits in the orofacial musculature of patients with dysarthria associated with amyotrophic lateral sclerosis (ALS) and to relate the physiologic deficits to perceived severity of dysarthria. Strain gauge force transducers placed on the lower lip, jaw, and tongue tip were used to measure maximum strength and maximum rate of repeated contractions. Diadochokinetic rates for repeated /p/ and /t/ were also determined. Fourteen ALS patients and 15 normal subjects were tested. It was found that the ALS patients with dysarthria were impaired in all tasks compared to the normal subjects, and that some measures revealed impairment even in those ALS patients who were not yet dysarthric. Bulbar ALS patients were generally more severely affected than the corticobulbar or spinal ALS patients, and the tongue was generally the most affected structure in all ALS groups. Perceived severity of dysarthria was more highly correlated with the measures of repeated contraction rate than with the measures of strength, suggesting that more severe dysarthria may be largely due to slower movement of the orofacial structures until substantial muscle strength has been lost.

Acknowledgments
This research was supported by a DVA Merit Review grant (001), Department of Medicine and Surgery. The authors wish to thank Kenneth Casey, Chief, Neurology Service, VAMC, for examining the ALS patients and classifying them into the appropriate ALS group. We also wish to acknowledge Rick Konopacki, who provided the force transducers used for this study. Finally, we are grateful for the help and encouragement of James Abbs, who guided the design of the project and provided ongoing assistance through its completion.
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