Primary progressive apraxia of speech: clinical features and acoustic and neurologic correlates

Joseph R Duffy, Edythe A Strand, Heather Clark, Mary Machulda, Jennifer L Whitwell, Keith A Josephs, Joseph R Duffy, Edythe A Strand, Heather Clark, Mary Machulda, Jennifer L Whitwell, Keith A Josephs

Abstract

Purpose: This study summarizes 2 illustrative cases of a neurodegenerative speech disorder, primary progressive apraxia of speech (AOS), as a vehicle for providing an overview of the disorder and an approach to describing and quantifying its perceptual features and some of its temporal acoustic attributes.

Method: Two individuals with primary progressive AOS underwent speech-language and neurologic evaluations on 2 occasions, ranging from 2.0 to 7.5 years postonset. Performance on several tests, tasks, and rating scales, as well as several acoustic measures, were compared over time within and between cases. Acoustic measures were compared with performance of control speakers.

Results: Both patients initially presented with AOS as the only or predominant sign of disease and without aphasia or dysarthria. The presenting features and temporal progression were captured in an AOS Rating Scale, an Articulation Error Score, and temporal acoustic measures of utterance duration, syllable rates per second, rates of speechlike alternating motion and sequential motion, and a pairwise variability index measure.

Conclusions: AOS can be the predominant manifestation of neurodegenerative disease. Clinical ratings of its attributes and acoustic measures of some of its temporal characteristics can support its diagnosis and help quantify its salient characteristics and progression over time.

Figures

Figure 1.
Figure 1.
Mean word durations for control participants (vertical bar and shading represents range of durations) and AOS1 and AOS2 at two points in time.
Figure 2.
Figure 2.
Syllable rate per second for words of increasing length, sentence, and speech sequential motion rates and alternating motion rates for control participants (vertical bar and shading represents range of durations) and AOS1 and AOS2 at two points in time.

References

    1. Ackermann H., Scharf G., Hertrich I., & Daum I. (1997). Articulatory disorders in primary progressive aphasia. Aphasiology, 11, 1017–1030.
    1. Ash S., Moore P., Vesely L., Gunawardena D., McMillan C., Anderson C., … Grossman M. (2009). Nonfluent speech in frontotemporal lobar degeneration. Journal of Neurolinguistics, 22, 1–14.
    1. Ballard K. J., Savage S., Leyton C. E., Vogel A. P., Hornberger M., & Hodges J. R. (2014). Logopenic and nonfluent variants of primary progressive aphasia are differentiated by acoustic measures of speech production. PLOS ONE, 9(2), e89864, . 1–14. doi:10.1371/journal.pone.0089864
    1. Botha H., Duffy J. R., Strand E. A., Machulda M. M., Whitwell J. L., & Josephs K. A. (2014). Nonverbal oral apraxia in primary progressive aphasia and apraxia of speech. Neurology, 82, 1729–1735.
    1. Boersma P., & Weenink D. (2014). Praat: Doing phonetics by computer (Version 5.3.63) [Computer software]. Amsterdam, the Netherlands: Institute of Phonetic Sciences; Retrieved from
    1. Clark H. C., Duffy J. R., Strand E. A., Ahlskog J. E., Sorenson E. J., & Josephs K. A. (2013). Clinical and imaging characterization of progressive spastic dysarthria. European Journal of Neurology, 21, 368–376.
    1. Code C., Ball M., Tree J., & Dawe K. (2013). The effects of initiation, termination and inhibition impairments on speech rate in a case of progressive nonfluent aphasia with progressive apraxia of speech with frontotemporal degeneration. Journal of Neurolinguistics, 26, 602–618.
    1. Croot K., Ballard K., Leyton C. E., & Hodges J. R. (2012). Apraxia of speech and phonological errors in the diagnosis of nonfluent/agrammatic and logopenic variants of primary progressive aphasia. Journal of Speech, Language, and Hearing Research, 55(Suppl.), S1562–S1572.
    1. Deramecourt V., Lebert F., Debachy B., Mackowiak-Cordoliani M. A., Bombois S., Kerdraon. O., … Pasquier F. (2010). Prediction of pathology in primary progressive language and speech disorders. Neurology, 74, 42–49.
    1. De Renzi E., & Vignolo L. A. (1962). The Token Test: A sensitive test to detect receptive disturbances in aphasics. Brain, 85, 665–678.
    1. Didic M., Ceccaldi M., & Poncet M. (1998). Progressive loss of speech: A neuropsychological profile of premotor dysfunction. European Neurology, 39, 90–96.
    1. Duffy J. R. (2006). Apraxia of speech in degenerative neurologic disease. Aphasiology, 20, 511–527.
    1. Duffy J. R. (2013). Motor speech disorders: Substrates, differential diagnosis, and management (3rd ed.). St. Louis, MO: Elsevier.
    1. Duffy J. R., & Josephs K. A. (2012). The diagnosis and understanding of apraxia of speech: Why including neurodegenerative etiologies may be important. Journal of Speech, Language, and Hearing Research, 55, S1518–S1522.
    1. Duffy J. R., & McNeil M. R. (2008). Primary progressive aphasia and apraxia of speech. In Chapey R. (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (pp. 543–563). Philadelphia, PA: Lippincott, Williams & Wilkins.
    1. Duffy J. R., Strand E. A., & Josephs K. A. (2014). Motor speech disorders associated with primary progressive aphasia. Aphasiology, 28, 1004–1017. doi:10.1080/02687038.2013.869307
    1. Folstein M. F., Folstein S. E., & McHugh P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.
    1. Frattali C., Duffy J. R., Litvan I., Patsalides A. D., & Grafman J. (2003). Yes/no reversals as neurobehavioral sequela: A disorder of language, praxis, or inhibitory control? European Journal of Neurology, 10, 103–106.
    1. Gorno-Tempini M. L., Hillis A. E., Weintraub S., Kertesz A., Mendez M., Cappa S. F., … Grossman M. (2011). Classification of primary progressive aphasia and its variants. Neurology, 15, 1006–1014.
    1. Haley K. L., Jacks A., de Riesthal M., Abou-Khlil R., & Roth H. L. (2012). Toward a quantitative basis for assessment and diagnosis of apraxia of speech. Journal of Speech, Language, and Hearing Research, 55, S1502–S1517.
    1. Haley K. L., & Overton H. B. (2001). Word length and vowel duration in apraxia of speech: The use of relative measures. Brain and Language, 79, 397–406.
    1. Josephs J. R., Boeve B. F., Duffy J. R., Smith G. E., Knopman D. S., Parisi J. E., … Dickson D. W. (2005). Atypical progressive supranuclear palsy underlying progressive apraxia of speech and nonfluent aphasia. Neurocase, 11, 283–296.
    1. Josephs K. A., Duffy J. R., Fossett T., Strand E. A., Classen D. O., Whitwell J. L., & Peller P. J. (2010). Fluorodeoxyglucose F18 positron emission tomography in progressive apraxia of speech and primary progressive aphasia variants. Archives of Neurology, 67, 596–605.
    1. Josephs K. A., Duffy J. R., Strand E. A., Machulda M. M., Senjem M. L., Gunter C. G., … Whitwell J. L. (2014). The evolution of primary progressive apraxia of speech. Brain, 137, 2783–2795.
    1. Josephs K. A., Duffy J. R., Strand E. A., Machulda M. M., Senjem M. L., Lowe V. J., … Whitwell J. L. (2013). Syndromes dominated by apraxia of speech show distinct characteristics from agPPA. Neurology, 81, 337–345.
    1. Josephs K. A., Duffy J. R., Strand E. A., Machulda M. M., Senjem M. L., Master A. V., … Whitwell J. L. (2012). Characterizing a neurodegenerative syndrome: Primary progressive apraxia of speech. Brain, 135, 1522–1536.
    1. Josephs K. A., Duffy J. R., Strand E. A., Whitwell J. L., Layton K. F., Parisi J. E., … Petersen R. C. (2006). Clinicopathological and imaging correlates of progressive aphasia and apraxia of speech. Brain, 129, 1385–1398.
    1. Kent R., & Rosenbek J. (1983). Acoustic patterns of apraxia of speech. Journal of Speech and Hearing Research, 26, 231–249.
    1. Kertesz A. (2007). Western Aphasia Battery (Revised). San Antonio, TX: The Psychological Corporation.
    1. Knibb J. A., Woollams A. M., Hodges J. R., & Patterson K. (2009). Making sense of progressive non-fluent aphasia: An analysis of conversational speech. Brain, 132, 2734–2746.
    1. Laganaro M., Croisier M., Bagou O., & Assal F. (2012). Progressive apraxia of speech as a window into the study of speech planning processes. Cortex, 48, 963–971.
    1. Lansing A. E., Ivnik R. J., Cullum C. M., & Randolph C. (1999). An empirically derived short form of the Boston Naming Test. Archives of Clinical Neuropsychology, 14, 481–487.
    1. Liss J. M., & Weismer G. (1994). Selected acoustic characteristics of contrastive stress production in control geriatric, apraxic, and ataxic speakers. Clinical Linguistics & Phonetics, 8, 45–66.
    1. McNeil M. R., Caliguiri M., Weismer G., & Rosenbek J. (1986). Labio-mandibular kinematic durations, velocities, and dysmetrias in apraxic adults. Clinical Aphasiology, 17, 173–193.
    1. McNeil M. R., Robin D. A., & Schmidt R. A. (2009). Apraxia of speech: Definition, differentiation, and treatment. In McNeil M. R. (Ed.), Clinical management of sensorimotor speech disorders (2nd ed., pp. 249–268). New York, NY: Thieme.
    1. Odell K., McNeil M. R., Rosenbek J. C., & Hunter L. (1991). Perceptual characteristics of vowel and prosody production in apraxic, aphasic, and dysarthric speakers. Journal of Speech and Hearing Research, 34, 67–80.
    1. Petroi D., Duffy J. R., Strand E. A., & Josephs K. A. (2014). Phonologic errors in the logopenic variant of primary progressive aphasia. Aphasiology, 28, 1223–1243. doi:10.1080/02687038.2014.910591
    1. Ricci M., Magarelli M., Todino V., Bianchini A., Calandriello E., & Tramutoli R. (2008). Progressive apraxia of speech presenting as isolated disorder of speech articulation and prosody: A case report. Neurocase, 14, 162–168.
    1. Rogers M. A. (1997). The vowel lengthening exaggeration effect in speakers with apraxia of speech: Compensation, artifact, or primary deficit? Aphasiology, 11, 433–445.
    1. Strand E. A., Duffy J. R., Clark H., & Josephs K. A. (2014). The Apraxia of Speech Rating Scale: A new tool for diagnosis and description of AOS. Journal of Communication Disorders, 51, 43–50.
    1. Strand E. A., & McNeil M. R. (1996). Effects of length and linguistic complexity on temporal acoustic measures in apraxia of speech. Journal of Speech and Hearing Research, 39, 1018–1033.
    1. Vergis M. K., Ballard K. J., Duffy J. R., McNeil M. R., Scholl D., & Layfield C. (2014). An acoustic measure of lexical stress differentiates aphasia and aphasia plus apraxia of speech after stroke. Aphasiology, 28, 554–575.
    1. Wambaugh J. L., Duffy J. R., McNeil M. R., Robin D. A., & Rogers M. A. (2006). Treatment guidelines for acquired apraxia of speech: A synthesis and evaluation of the evidence. Journal of Medical Speech-Language Pathology, 14(2), xv–xxxiii.
    1. Yorkston K., Strand E. A., Miller R., & Hillel A. (1993). Speech deterioration in amyotrophic lateral sclerosis: Implications for timing of intervention. Journal of Medical Speech-Language Pathology, 1, 35–46.
    1. Ziegler W. (2002). Task-related factors in oral motor control: Speech and oral diadokokinesis in dysarthria and apraxia of speech. Brain and Language, 80, 556–575.
    1. Ziegler W., Aichert I., & Staiger A. (2012). Apraxia of speech: Concepts and controversies. Journal of Speech, Language, and Hearing Research, 55(Suppl.), S1485–S1501.
    1. Ziegler W., & Wessel K. (1996). Speech timing in ataxic disorders: Sentence production and rapid repetitive articulation, Neurology, 47, 208–214.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren