Objective:To investigate the impact of cognitive impairment on spoken language produced by speakers with multiple sclerosis (MS) with and without dysarthria.Method:Sixty speakers comprised operationally defined groups. Speakers produced a spontaneous speech sample to obtain speech timing measures of speech rate, articulation rate, and silent pause frequency and duration. Twenty listeners judged the overall perceptual severity of the samples using a visual analog scale that ranged from no impairment to severe impairment (speech severity). A 2 × 2 factorial design examined main and interaction effects of dysarthria and cognitive impairment on speech timing measures and speech severity in individuals with MS. Each speaker group with MS was further compared to a healthy control group. Exploratory regression analyses examined relationships between cognitive and biopsychosocial variables and speech timing measures and perceptual judgments of speech severity, for speakers with MS.Results:Speech timing was significantly slower for speakers with dysarthria compared to speakers with MS without dysarthria. Silent pause durations also significantly differed for speakers with both dysarthria and cognitive impairment compared to MS speakers without either impairment. Significant interactions between dysarthria and cognitive factors revealed comorbid dysarthria and cognitive impairment contributed to slowed speech rates in MS, whereas dysarthria alone impacted perceptual judgments of speech severity. Speech severity was strongly related to pause duration.Conclusions:The findings suggest the nature in which dysarthria and cognitive symptoms manifest in objective, acoustic measures of speech timing and perceptual judgments of severity is complex.

中文翻译：

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认知障碍和构音障碍对多发性硬化症患者口语的影响


目的：调查认知障碍对患有或不患有构音障碍的多发性硬化症 (MS) 说话者所产生的口语的影响。方法：60 名说话者组成可操作定义的组。说话者制作自发语音样本，以获得语速、发音速率、无声停顿频率和持续时间的语音计时测量。二十名听众使用视觉模拟量表来判断样本的整体感知严重程度，范围从无损伤到严重损伤（言语严重程度）。 2 × 2 析因设计检查了构音障碍和认知障碍对多发性硬化症患者言语计时测量和言语严重程度的主要影响和相互作用。每个患有多发性硬化症的说话者组都与健康对照组进行了进一步比较。探索性回归分析检查了患有 MS 的说话者的认知和生物心理社会变量与言语计时测量和言语严重程度的感知判断之间的关系。结果：与患有 MS 且无构音障碍的说话者相比，患有构音障碍的说话者的言语计时明显较慢。与没有任何障碍的多发性硬化症说话者相比，患有构音障碍和认知障碍的说话者的无声停顿持续时间也存在显着差异。构音障碍和认知因素之间的显着相互作用表明，构音障碍和认知障碍共存导致多发性硬化症患者语速减慢，而构音障碍单独影响对言语严重程度的感知判断。言语严重程度与停顿持续时间密切相关。结论：研究结果表明，构音障碍和认知症状在言语计时的客观声学测量和严重程度的感知判断中表现出来的性质是复杂的。