hypokinetic dysarthria
caused by any process that damages basal ganglia (extrapyramidal system)
speech characteristics of hypokinetic dysarthria
harsh vocal quality, reduced stress, monoloudness, imprecise consonants
hypokinetic dysarthria will only be seen in
parksinson’s disease, parkinsonism
parkinsonism
know the etiology
parkinson’s disease
etiology is unknown
hypo and hyper refer to
range of movement
neurologic basis of hypokinetic dysarthria
unique as only dysarthria with increased rate of system, mainly one causative factor, symptoms caused by dysfunction to basal ganglia or to basal ganglia’a neural connections to other parts of CNS
characteristics of parkinsonism
resting tremor, bradykinesia, rigidity, spasticity, akinesia, postural reflexes
resting tremor
males more effected than females; hands are shaking without doing anything
bradykinesia
slow, reduced range of movement
rigidity
tight muscle tone from start to finish
akinesia
delay in initation of movements
causes of parkinsonism
caused by dysfunction in basal ganglia
dopamine
inhibitory
acetylcholine
excitatory
causes of hypokinetic dysarthria
-parkinsonism: collective term for different disorders sharing many similar symptoms
-idiopathic PD
neuroleptic-induced parkinsonism
postencephalitic parkinsonism
traumatic head injury
toxic metal posioning
stroke
speech characteristics of hypokinetic dysarthria
most notable errors: prosody and articulation
speech characteristics prosody
monopitch, reduced stress, and monloudness, festinating speech
speech characteristics artic.
imprecise consonants, repeated phonemes, palilalia
speech characteristics phontion
harsh/breathy quality, aphonia, low pitch
speech characteristics respiration
sometimes noted
speech characteristics resonance
if present, mild hypernasality
key evaluation tasks for hypokinetic dysarthria
conversational speech and reading, speech alternate motion rates (AMRs), vowel prolongations
treatment of hypokinetic dysarthria
pharmacologic, surgical, behavioral
pharmalogic treatments
replacing dopamine in striatum; L-Dopa; correct neurotransmitter imbalance by decreasing acetylcholine activity in striatum
surgical treatments for parkinsonism
complicated and invasive, used when patient incapacitated and medications ineffective, two general types
stem-cell implantation
stem cells unique as can transform themselves into different types of cells, found naturally in embryos and can be grown in labs, significant amount of research concentrated on using stem cells to treat parkinsonism
behavioral treatments
speech-therapy
artic. treatment
compounded by increased rate, treatment types; rate reduction, stretching, taditional artic. tasks
phonation
adduct VFs on partially or have harsh or breathy vocal quality; pushing and pulling procedure, hard glottal attack, voice amplifiers, instrumental biofeedbacks, Lee Silverman Voice Treatment
respiration
shallow breath support can cause shortened phrases and decreased loudness; speaking immediately on exhalation, cueing for complete inhalation, slow and controlled exhalation, stop phonation early
prosody
improved by slowing rate; intonation profiles, contrastive stress drills, chunking utterances ino syntactic units
