The purpose of this study is to investigate the speech rate characteristics (whole speech rate, articulation speech rate, and articulation percentage) and the pause characteristics (pause duration, pause frequency, and pause percentage) of Korean-speaking patients with idiopathic Parkinson's disease...
The purpose of this study is to investigate the speech rate characteristics (whole speech rate, articulation speech rate, and articulation percentage) and the pause characteristics (pause duration, pause frequency, and pause percentage) of Korean-speaking patients with idiopathic Parkinson's disease (referred to as IPD hereafter). The study aims first to examine the differences between the patient group with IPD and the other group without IPD concerning those measurements, and secondly to investigate the relevant measurements of the two groups following the sentence length changes. There were two groups of subjects in this study. The first group consisted of 7 subjects between the ages of 50 and 60 who were diagnosed as IPD with mild severity, and the second group consisted of 13 subjects without IPD who matched the age and gender of those in the first group. Those two groups were asked to read 8 different sentences in length at habitual speed. Speech rate and pause characteristics of the two groups were measured and compared each other. The followings results were observed. First, in a study of speech rate characteristics, the whole speech rate and the articulation speech rate of the patient group scored within the normal range, which is same as the group without IPD. On the other hand, with regard to the pause characteristics, differences between two groups were shown; the patient group had shorter pause duration, lower pause frequency, lower pause percentage, and higher articulation percentage. Secondly, in a study of relevant measurements following the sentence length, both groups showed a tendency for whole speech rate and articulation rate to increase as the length of the sentence increased, but the result of pause characteristics showed a difference between two groups. While the group without IPD showed a longer pause duration, higher pause frequency, and higher pause percentage as the length of sentences increases, no differences were shown among the patient group concerning the length of sentences. This study suggests a result that the patients with IPD of mild severity retained a normal speech rate and examined pause characteristics of the patient group which showed a different result from the group without IPD in terms of quality. Future studies on the speech rate and pause characteristics of Korean-speaking patients with IPD in various severities.
The purpose of this study is to investigate the speech rate characteristics (whole speech rate, articulation speech rate, and articulation percentage) and the pause characteristics (pause duration, pause frequency, and pause percentage) of Korean-speaking patients with idiopathic Parkinson's disease (referred to as IPD hereafter). The study aims first to examine the differences between the patient group with IPD and the other group without IPD concerning those measurements, and secondly to investigate the relevant measurements of the two groups following the sentence length changes. There were two groups of subjects in this study. The first group consisted of 7 subjects between the ages of 50 and 60 who were diagnosed as IPD with mild severity, and the second group consisted of 13 subjects without IPD who matched the age and gender of those in the first group. Those two groups were asked to read 8 different sentences in length at habitual speed. Speech rate and pause characteristics of the two groups were measured and compared each other. The followings results were observed. First, in a study of speech rate characteristics, the whole speech rate and the articulation speech rate of the patient group scored within the normal range, which is same as the group without IPD. On the other hand, with regard to the pause characteristics, differences between two groups were shown; the patient group had shorter pause duration, lower pause frequency, lower pause percentage, and higher articulation percentage. Secondly, in a study of relevant measurements following the sentence length, both groups showed a tendency for whole speech rate and articulation rate to increase as the length of the sentence increased, but the result of pause characteristics showed a difference between two groups. While the group without IPD showed a longer pause duration, higher pause frequency, and higher pause percentage as the length of sentences increases, no differences were shown among the patient group concerning the length of sentences. This study suggests a result that the patients with IPD of mild severity retained a normal speech rate and examined pause characteristics of the patient group which showed a different result from the group without IPD in terms of quality. Future studies on the speech rate and pause characteristics of Korean-speaking patients with IPD in various severities.
파킨슨병 환자의 말 속도가 정상 범주 내에 속한다는 연구 보고도 있고[4], 정상 속도보다 느리거나 빠르다는 연구도 있다[1],[5]. 파킨슨병 환자의 빠른 말 속도의 원인은 말 분절(speech segment)이 짧아지고 [6], 소리를 동반하지 않는 쉼(silent pause)이 증가하기 때문이라고 한다[7],[8]. 또한 근육 조직의 강직으로 인해 조음 시 정확한 위치에 도달하기 전에 조음 동작이 끝나버리는 현상(articulation undershoot)이 원인이라고 언급한 연구도 있다[9].
피로는 파킨슨병 환자에게 어떤 영향을 끼치는가?
마지막으로, 파킨슨병 환자들은 피로에 민감하다. 피로는 효능개시-종료 현상과 같이 파킨슨병 환자의 증상에 대한 변동을 악화시킬 수 있고[40], 이는 말 속도와 쉼 특성에 영향을 미칠 수 있다.
파킨슨병 환자의 말 속도와 쉼 특성은 약물치료에 의해 어떤 영향을 받는가?
네 번째 요인으로 약물 치료를 들 수 있다. 약 복용 기간이 길어짐에 따라 약에 반응을 하지 않거나 불수의적 움직임이 나타나는 등의 부작용이 관찰되기도 하고, 증상의 호전과 악화가 예측 불가능하게 나타나는 효능 개시-종료 현상(on-off effect)도 관찰되기도 한다[28]. 항파킨슨제(anti-par kinsonan medicine)의 일종인 레보도파(L-dopa)의 경우, 약물 치료를 처음 시작할 때는 일반적으로 파킨슨병 환자의 증상이 줄어드나[28],[29], 2~5년 정도의 ‘레보도파 허니문(levodopa honeymoon)’ 기간이 지나면 운동측면에서 변동(fluctuation)이 나타나게 된다. 약 50%의 환자가 5년 후에 이러한 변동을 경험하게 되고, 10년 후에는 100%의 환자들에게 나타난다는 연구 결과도 있다[30]. 항파킨슨제의 장기 복용으로 인한 변동의 일반적인 유형 중 하나인 효능개시-종료 현상은 말 산출 측면에서도 나타날 수 있어, 항파킨슨제를 복용한 직후보다 시간이 경과한 후 다음 약을 복용하기 직전에 결함이 지각되었다는 보고도 있다[31]. 즉, 약 복용 후 경과 시간에 따라 환자의 발화에 청지 각적 차이가 나타나는 것이다. 또한 약 복용 후에 성대 부피(vocal fold stiffness)는 감소하고, 후두의 안정성(laryngeal stability)은 증가하여 속도 지수(speed quotient), 강도, 강도 변동률(shimmer)이 줄어들었다는 결과도 있다[32],[33].
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