Objective: To identify if intelligibility or social repercussions of dysarthria determined quality of life in patients with different kinds of movement disorders.

Background: Dysarthria in neurological affections is much often assessed by the impairment of speech intelligibility. However, speech production is a privileged way of communication, and its alteration provokes a psychosocial impact that has to be assessed, from the speaker’s perspective, to detect patients with disabling repercussions from this impairment.

Methods: We studied 49 patients with different kinds of movement disorders inducing dysarthria (Ataxia, Parkinson’s disease [PD], Huntington’s disease[HD], Amyotrophic Lateral Sclerosis [ALS]), and 13 healthy controls. We used a protocol that included the administration of self-questionnaires: Dysarthria Impact Profile (DIP) for the assessment of psychosocial consequences of dysarthria, the Voice Handicap Index (VHI) for the degree of voice impairment perceived by the patient, and the 36-Item Short Form Health Survey for quality of life (QoL). Speech intelligibility was also evaluated by means of the Frenchay Dysarthria Assessment (intelligibility section only).

Results: First, only the DIP scores explained significantly the reduction of QoL (R2=0.18; p=0.001), when both the VHI and speech intelligibility were not correlated. Second, we found that the degree of QoL decrease was equal for all diseases. Oppositely, we observed that ALS patients presented the most impaired profile. In comparison to PD patients, it was worse for speech intelligibility (p<0.001), the VHI (p=0.002) and the DIP (p=0.003); in comparison to patients with ataxia, it was worse only for speech intelligibility (p=0.001).

Conclusions: In general, we reported that intelligibility is not the most effective measure of dysarthria repercussions. This point is particularly important because the large part of dysarthria assessment is focused on the physician’s point of view. To integrate the speaker’s perspective will allow to improve the patient orientation to an appropriate speech therapy. Also, our results allowed to identify a gradient of dysarthria consequences, from Parkinson’s disease to Amyotrophic Lateral Sclerosis, by cerebellar ataxia and Huntington chorea.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/psychosocial-impact-of-dysarthria-is-speech-intelligibility-an-effective-measure-outcome/