Publications by authors named "Lynda Feenaughty"

10 Publications

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Dual-task speech performance in multiple sclerosis.

Authors:
Lynda Feenaughty

Mult Scler Relat Disord 2021 Jun 10;53:103077. Epub 2021 Jun 10.

School of Communication Sciences and Disorders, University of Memphis, 4055 North Park Loop, Memphis, TN 38152, United States. Electronic address:

Background: Although extant dual-task studies suggest cognitive-motor interference may magnify existing non-speech motor impairments in multiple sclerosis (MS), cognitive-speech motor interference in MS has not been studied. This study evaluated the presence of cognitive-speech motor interference in MS and explored within subject differences in speech measures from the single-to dual-task condition for individuals with MS with co-occurring dysarthria and impaired cognition.

Methods: In this dual-task study, 21 individuals with MS and 21 controls read aloud a sentence (single-task) and completed a cognitive-linguistic task while simultaneously reading aloud a sentence (dual-task). Speech measures included speech and articulation rate, silent pause frequency and duration, and total sentence duration.

Results: Both groups had significantly slower speech in the dual-task condition. Relative to participants with dysarthria, speech rate and sentence duration difference scores approached significance or were significantly greater for participants with MS with dysarthria and cognitive impairment. These difference scores were associated with executive function and processing speed deficits and fewer years of education.

Conclusion: Significant negative compounding effects for speech rate and sentence duration suggest that the dual-task paradigm shows promise for identifying individuals with MS with cognitive impairment and dysarthria at increased risk of problems with effective communication. Further research is warranted to replicate this work and evaluate the consequences of these speech aberrancies on communication effectiveness that ultimately may affect employment, social relationships, and quality of life.
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http://dx.doi.org/10.1016/j.msard.2021.103077DOI Listing
June 2021

Speech timing changes accompany speech entrainment in aphasia.

J Commun Disord 2021 Mar-Apr;90:106090. Epub 2021 Feb 11.

Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, 29208, USA. Electronic address:

Background: Prior speech entrainment studies, where individuals with non-fluent aphasia mimic an audio-visual model, suggest speech entrainment improves speech fluency, as indexed by various linguistic measures (e.g., the total number of different words produced per minute). Here, more precise speech timing adjustments accompanying entrained speech were studied and compared to spontaneous speech to determine how these temporal variables relate to the fluency inducing effects of speech entrainment in aphasia.

Methods: Thirty-one left hemisphere stroke survivors classified with fluent or non-fluent speech were audio-video recorded as they described a picture and during speech entrainment. Speech fluency was documented using the Western Aphasia Battery-Revised. Acoustic measures of speech timing included total number of syllables, speech rate, articulatory rate, silent pause frequency and duration. Standard descriptive statistics and a two-factor mixed model analysis of variance were used to investigate group, task, and 'group x task' interaction effects.

Findings: All acoustic measures of speech timing differentiated the fluent and nonfluent groups except for silent pause frequency. Differences between speech entrainment and spontaneous speech were found for most acoustic measures of speech timing and speaker groups, yet the direction of the effect varied. Stroke survivors classified with non-fluent aphasia improved speech fluency such that speech entrainment elicited pause adjustments facilitating more typical speech timing in comparison to spontaneous speech.

Conclusion: Overall, findings provide further evidence of the impact of speech entrainment on measures of speech timing to help individuals with non-fluent aphasia to practice speaking more fluently. Practicing speaking more fluently may ultimately impact perceptual judgments of speech naturalness and social acceptance for persons with aphasia.
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http://dx.doi.org/10.1016/j.jcomdis.2021.106090DOI Listing
February 2021

Impact of Cognitive Impairment and Dysarthria on Spoken Language in Multiple Sclerosis.

J Int Neuropsychol Soc 2021 05 16;27(5):450-460. Epub 2020 Nov 16.

Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY 14214, USA.

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.
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http://dx.doi.org/10.1017/S1355617720001113DOI Listing
May 2021

Separate and Combined Influence of Cognitive Impairment and Dysarthria on Functional Communication in Multiple Sclerosis.

Am J Speech Lang Pathol 2018 08;27(3):1051-1065

Department of Neurology, University at Buffalo, New York.

Purpose: Dysarthria is a consequence of multiple sclerosis (MS) that can co-occur with cognitive impairment. Clinical management thus requires understanding the separate and combined effects of dysarthria and cognitive impairment on functional communication in MS. This study compared perceptual measures of intelligibility and speech severity that capture functional communication deficits for 4 operationally defined groups with MS. The relationship between communication participation and perceptual measures was also examined.

Method: Forty-eight adults with MS and 12 healthy controls participated. Cognitive testing and dysarthria diagnosis determined group assignment: (a) MS with cognitive impairment (MSCI), (b) MS with a diagnosis of dysarthria and no cognitive impairment (MSDYS), (c) MS with dysarthria and cognitive impairment (MSDYS + CI), and (d) MS without dysarthria or cognitive impairment (MS). Sentence Intelligibility Test scores, scaled speech severity obtained from the "Grandfather Passage," and Communication Participation Item Bank (CPIB) scores were analyzed.

Results: Sentence Intelligibility Test scores approached 100% for all groups. Speech severity was greater for the MSDYS + CI and MSDYS groups versus controls. CPIB scores were greatest for the MSDYS + CI group and were not significantly correlated with either perceptual measure.

Conclusions: The CPIB and speech severity were sensitive to aspects of communication problems for some groups with MS not reflected in a measure of sentence intelligibility. Findings suggest the importance of employing a variety of measures to capture functional communication problems experienced by persons with MS.
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http://dx.doi.org/10.1044/2018_AJSLP-17-0174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195026PMC
August 2018

A Multivariate Analytic Approach to the Differential Diagnosis of Apraxia of Speech.

J Speech Lang Hear Res 2017 12;60(12):3378-3392

Department of Communication Sciences & Disorders, University of South Carolina, Columbia.

Purpose: Apraxia of speech (AOS) is a consequence of stroke that frequently co-occurs with aphasia. Its study is limited by difficulties with its perceptual evaluation and dissociation from co-occurring impairments. This study examined the classification accuracy of several acoustic measures for the differential diagnosis of AOS in a sample of stroke survivors.

Method: Fifty-seven individuals were included (mean age = 60.8 ± 10.4 years; 21 women, 36 men; mean months poststroke = 54.7 ± 46). Participants were grouped on the basis of speech/language testing as follows: AOS-Aphasia (n = 20), Aphasia Only (n = 24), and Stroke Control (n = 13). Normalized Pairwise Variability Index, proportion of distortion errors, voice onset time variability, and amplitude envelope modulation spectrum variables were obtained from connected speech samples. Measures were analyzed for group differences and entered into a linear discriminant analysis to predict diagnostic classification.

Results: Out-of-sample classification accuracy of all measures was over 90%. The envelope modulation spectrum variables had the greatest impact on classification when all measures were analyzed together.

Conclusions: This study contributes to efforts to identify objective acoustic measures that can facilitate the differential diagnosis of AOS. Results suggest that further study of these measures is warranted to determine the best predictors of AOS diagnosis.

Supplemental Materials: https://doi.org/10.23641/asha.5611309.
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http://dx.doi.org/10.1044/2017_JSLHR-S-16-0443DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111519PMC
December 2017

Non-fluent speech following stroke is caused by impaired efference copy.

Cogn Neuropsychol 2017 09 17;34(6):333-346. Epub 2017 Nov 17.

b Department of Communication Sciences and Disorders , University of South Carolina , Columbia , SC , USA.

Efference copy is a cognitive mechanism argued to be critical for initiating and monitoring speech: however, the extent to which breakdown of efference copy mechanisms impact speech production is unclear. This study examined the best mechanistic predictors of non-fluent speech among 88 stroke survivors. Objective speech fluency measures were subjected to a principal component analysis (PCA). The primary PCA factor was then entered into a multiple stepwise linear regression analysis as the dependent variable, with a set of independent mechanistic variables. Participants' ability to mimic audio-visual speech ("speech entrainment response") was the best independent predictor of non-fluent speech. We suggest that this "speech entrainment" factor reflects integrity of internal monitoring (i.e., efference copy) of speech production, which affects speech initiation and maintenance. Results support models of normal speech production and suggest that therapy focused on speech initiation and maintenance may improve speech fluency for individuals with chronic non-fluent aphasia post stroke.
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http://dx.doi.org/10.1080/02643294.2017.1394834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834304PMC
September 2017

Chronic post-stroke aphasia severity is determined by fragmentation of residual white matter networks.

Sci Rep 2017 08 15;7(1):8188. Epub 2017 Aug 15.

Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.

Many stroke survivors with aphasia in the acute period experience spontaneous recovery within the first six months after the stroke. However, approximately 30-40% sustain permanent aphasia and the factors determining incomplete recovery are unclear. Suboptimal recovery may be influenced by disruption of areas seemingly spared by the stroke due to loss of white matter connectivity and network integrity. We reconstructed individual anatomical whole-brain connectomes from 90 left hemisphere stroke survivors using diffusion MR images. We measured the modularity of the residual white matter network organization, the probability of brain regions clustering together, and the degree of fragmentation of left hemisphere networks. Greater post-stroke left hemisphere network fragmentation and higher modularity index were associated with more severe chronic aphasia, controlling for the size of the stroke lesion. Even when the left hemisphere was relatively spared, subjects with disorganized community structure had significantly worse aphasia, particularly when key temporal lobe regions were isolated into segregated modules. These results suggest that white matter integrity and disorganization of neuronal networks could be important determinants of chronic aphasia severity. Connectome white matter organization measured through modularity and other topological features could be used as a personalized variable for clinical staging and aphasia treatment planning.
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http://dx.doi.org/10.1038/s41598-017-07607-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558035PMC
August 2017

Relationship between acoustic measures and judgments of intelligibility in Parkinson's disease: a within-speaker approach.

Clin Linguist Phon 2014 Nov 29;28(11):857-78. Epub 2014 May 29.

Department of Communicative Disorders & Sciences, University at Buffalo , Buffalo, NY , USA.

This study investigated the acoustic basis of within-speaker, across-utterance variation in sentence intelligibility for 12 speakers with dysarthria secondary to Parkinson's disease (PD). Acoustic measures were also obtained for 12 healthy controls for comparison to speakers with PD. Speakers read sentences using their typical speech style. Acoustic measures of speech rate, articulatory rate, fundamental frequency, sound pressure level and F2 interquartile range (F2 IQR) were obtained. A group of listeners judged sentence intelligibility using a computerized visual-analog scale. Relationships between judgments of intelligibility and acoustic measures were determined for individual speakers with PD. Relationships among acoustic measures were also quantified. Although considerable variability was noted, articulatory rate, fundamental frequency and F2 IQR were most frequently associated with within-speaker variation in sentence intelligibility. Results suggest that diversity among speakers with PD should be considered when interpreting results from group analyses.
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http://dx.doi.org/10.3109/02699206.2014.921839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558195PMC
November 2014

Speech and pause characteristics in multiple sclerosis: a preliminary study of speakers with high and low neuropsychological test performance.

Clin Linguist Phon 2013 Feb;27(2):134-51

Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY 14214, USA.

This preliminary study investigated how cognitive-linguistic status in multiple sclerosis (MS) is reflected in two speech tasks (i.e. oral reading, narrative) that differ in cognitive-linguistic demand. Twenty individuals with MS were selected to comprise High and Low performance groups based on clinical tests of executive function and information processing speed and efficiency. Ten healthy controls were included for comparison. Speech samples were audio-recorded and measures of global speech timing were obtained. Results indicated predicted differences in global speech timing (i.e. speech rate and pause characteristics) for speech tasks differing in cognitive-linguistic demand, but the magnitude of these task-related differences was similar for all speaker groups. Findings suggest that assumptions concerning the cognitive-linguistic demands of reading aloud as compared to spontaneous speech may need to be re-considered for individuals with cognitive impairment. Qualitative trends suggest that additional studies investigating the association between cognitive-linguistic and speech motor variables in MS are warranted.
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http://dx.doi.org/10.3109/02699206.2012.751624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5554953PMC
February 2013

Influence of cognitive function on speech and articulation rate in multiple sclerosis.

J Int Neuropsychol Soc 2013 Feb 12;19(2):173-80. Epub 2012 Oct 12.

Jacobs Neurological Institute, Buffalo, NY, USA.

We examined cognitive predictors of speech and articulation rate in 50 individuals with multiple sclerosis (MS) and 23 healthy controls. We measured speech and articulation rate from audio-recordings of participants reading aloud and talking extemporaneously on a topic of their choice (i.e., self-generated speech). Articulation rate was calculated for each speech sample by removing lexically irrelevant vocalizations and pauses of >200 ms. Speech rate was similarly calculated including pauses. Concurrently, the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery, as well as standardized tests of sentence intelligibility and syllable repetition were administered. Analysis of variance showed that MS patients were slower on three of the four rate measures. Greater variance in rate measures was accounted for by cognitive variables for the MS group than controls. An information processing speed composite, as measured by the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT), was the strongest predictor among cognitive tests. A composite of memory tests related to self-generated speech, above and beyond information processing speed, but not to oral reading. Self-generated speech, in this study, was not found to relate more strongly to cognitive tests than simple reading. Implications for further research are discussed.
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http://dx.doi.org/10.1017/S1355617712001166DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564302PMC
February 2013
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