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Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation

Despite signs of facial nerve recovery within a few months following face transplantation, speech deficits persist for years. Behavioral speech modifications (e.g., slower-than-normal speaking rate and increased loudness) have shown promising potential to enhance speech intelligibility in population...

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Autores principales: Eshghi, Marziye, Perry, Bridget J., Richburg, Brian, Ventresca, Hayden M., Pomahac, Bohdan, Green, Jordan R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815523/
https://www.ncbi.nlm.nih.gov/pubmed/33488496
http://dx.doi.org/10.3389/fneur.2020.593153
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author Eshghi, Marziye
Perry, Bridget J.
Richburg, Brian
Ventresca, Hayden M.
Pomahac, Bohdan
Green, Jordan R.
author_facet Eshghi, Marziye
Perry, Bridget J.
Richburg, Brian
Ventresca, Hayden M.
Pomahac, Bohdan
Green, Jordan R.
author_sort Eshghi, Marziye
collection PubMed
description Despite signs of facial nerve recovery within a few months following face transplantation, speech deficits persist for years. Behavioral speech modifications (e.g., slower-than-normal speaking rate and increased loudness) have shown promising potential to enhance speech intelligibility in populations with dysarthric speech. However, such evidence-based practice approach is lacking in clinical management of speech in individuals with facial transplantation. Because facial transplantation involves complex craniofacial reconstruction and facial nerve coaptation, it is unknown to what extent individuals with face transplant are capable of adapting their motor system to task-specific articulatory demands. The purpose of this study was to identify the underlying articulatory mechanisms employed by individuals with face transplantation in response to speech modification cues at early and late stages of neuromotor recovery. In addition, we aimed to identify speech modifications that conferred improved speech clarity. Participants were seven individuals who underwent full or partial facial vascularized composite allografts that included lips and muscles of facial animation and were in early (~2 months) or late (~42 months) stages of recovery. Participants produced repetitions of the sentence “Buy Bobby a puppy” in normal, fast, loud, and slow speech modifications. Articulatory movement traces were recorded using a 3D optical motion capture system. Kinematic measures of average speed (mm/s) and range of movement (mm(3)) were extracted from the lower lip (± jaw) marker. Two speech language pathologists rated speech clarity for each speaker using a visual analog scale (VAS) approach. Results demonstrated that facial motor capacity increased from early to late stages of recovery. While individuals in the early group exhibited restricted capabilities to adjust their motor system based on the articulatory demands of each speech modification, individuals in the late group demonstrated faster speed and larger-than-normal range of movement for loud speech, and slower speed and larger-than-normal range of movement for slow speech. In addition, subjects in both groups showed overreliance on jaw rather than lip articulatory function across all speech modifications, perhaps as a compensatory strategy to optimize articulatory stability and maximize speech function. Finally, improved speech clarity was associated with loud speech in both stages of recovery.
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spelling pubmed-78155232021-01-21 Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation Eshghi, Marziye Perry, Bridget J. Richburg, Brian Ventresca, Hayden M. Pomahac, Bohdan Green, Jordan R. Front Neurol Neurology Despite signs of facial nerve recovery within a few months following face transplantation, speech deficits persist for years. Behavioral speech modifications (e.g., slower-than-normal speaking rate and increased loudness) have shown promising potential to enhance speech intelligibility in populations with dysarthric speech. However, such evidence-based practice approach is lacking in clinical management of speech in individuals with facial transplantation. Because facial transplantation involves complex craniofacial reconstruction and facial nerve coaptation, it is unknown to what extent individuals with face transplant are capable of adapting their motor system to task-specific articulatory demands. The purpose of this study was to identify the underlying articulatory mechanisms employed by individuals with face transplantation in response to speech modification cues at early and late stages of neuromotor recovery. In addition, we aimed to identify speech modifications that conferred improved speech clarity. Participants were seven individuals who underwent full or partial facial vascularized composite allografts that included lips and muscles of facial animation and were in early (~2 months) or late (~42 months) stages of recovery. Participants produced repetitions of the sentence “Buy Bobby a puppy” in normal, fast, loud, and slow speech modifications. Articulatory movement traces were recorded using a 3D optical motion capture system. Kinematic measures of average speed (mm/s) and range of movement (mm(3)) were extracted from the lower lip (± jaw) marker. Two speech language pathologists rated speech clarity for each speaker using a visual analog scale (VAS) approach. Results demonstrated that facial motor capacity increased from early to late stages of recovery. While individuals in the early group exhibited restricted capabilities to adjust their motor system based on the articulatory demands of each speech modification, individuals in the late group demonstrated faster speed and larger-than-normal range of movement for loud speech, and slower speed and larger-than-normal range of movement for slow speech. In addition, subjects in both groups showed overreliance on jaw rather than lip articulatory function across all speech modifications, perhaps as a compensatory strategy to optimize articulatory stability and maximize speech function. Finally, improved speech clarity was associated with loud speech in both stages of recovery. Frontiers Media S.A. 2021-01-06 /pmc/articles/PMC7815523/ /pubmed/33488496 http://dx.doi.org/10.3389/fneur.2020.593153 Text en Copyright © 2021 Eshghi, Perry, Richburg, Ventresca, Pomahac and Green. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Eshghi, Marziye
Perry, Bridget J.
Richburg, Brian
Ventresca, Hayden M.
Pomahac, Bohdan
Green, Jordan R.
Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation
title Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation
title_full Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation
title_fullStr Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation
title_full_unstemmed Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation
title_short Neuromotor Speech Recovery Across Different Behavioral Speech Modifications in Individuals Following Facial Transplantation
title_sort neuromotor speech recovery across different behavioral speech modifications in individuals following facial transplantation
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815523/
https://www.ncbi.nlm.nih.gov/pubmed/33488496
http://dx.doi.org/10.3389/fneur.2020.593153
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