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Background: The presence of naming difficulties in Parkinson’s Disease (PD), especially object naming difficulties, as well as the associated cognitive difficulties, remains a controversial topic.A...

Resumen Introduccion En este estudio se explora la forma en que el envejecimiento afecta a la produccion del habla. Indudablemente, son muchos los cambios que se producen a edades avanzadas en los procesos de control motor, asi como en la integridad de los musculos laringeos y supralaringeos, y que pueden afectar a la produccion del habla. Sin embargo, hay pocos trabajos que examinen estas capacidades en el marco del envejecimiento saludable, especialmente en personas de habla francesa. Material y metodos Nos hemos centrado en el voice onset time (VOT) o tiempo de inicio de la sonoridad, una pista del habla especialmente relevante para el estudio de la coordinacion temporal y espacial entre los gestos laringeos y supralaringeos. Han participado cuatro grupos de personas francofonas de las siguientes franjas de edad: 40-49, 50-59, 60-69 y 70-79. Se les propuso una tarea de repeticion de pseudopalabras, que incluia las seis oclusivas sonoras y sordas que existen en frances: /p, t, k, b, d, g/. Resultados Los resultados arrojan una mayor duracion de las pseudopalabras, a partir de los 70 anos, F(3,847) = 3,52, p = 0,02, probablemente debido a la ralentizacion de los movimientos del habla. En la franja etaria 70-79, se detectaron problemas adicionales al iniciar y mantener la sonoridad durante la oclusion. Esto tuvo como consecuencia un VOT mas breve (presonoridad retrasada), F(3,848) = 5,23, p = 0,001, asi como una sonoridad incompleta (interrupcion de la sonoridad antes de la apertura) de una oclusiva sonora a inicio de palabra /b, d, g/, F(3,422) = 3,01, p = 0,03, lo cual, a su vez, conlleva una diferencia menor en cuanto al VOT entre las categorias fonologicas sonora y sorda. Discusion Estos resultados apuntan a dificultades en la coordinacion de los movimientos articulatorios que podrian indicar un declive en el control motor del habla asociado con la edad.

International audience; Introduction: To explore the prevalence of dysphonia in European patients with mild-to-moderate COVID-19 and the clinical features of dysphonic patients.Methods: The clinical and epidemiological data of 702 patients with mild-to-moderate COVID-19 were collected from 19 European Hospitals. The following data were extracted: age, sex, ethnicity, tobacco consumption, comorbidities, general, and otolaryngological symptoms. Dysphonia and otolaryngological symptoms were self-assessed through a 4-point scale. The prevalence of dysphonia, as part of the COVID-19 symptoms, was assessed. The outcomes were compared between dysphonic and nondysphonic patients. The association between dysphonia severity and outcomes was studied through Bayesian analysis.Results: A total of 188 patients were dysphonic, accounting for 26.8% of cases. Females developed more frequently dysphonia than males (P = 0.022). The proportion of smokers was significantly higher in the dysphonic group (P = 0.042). The prevalence of the following symptoms was higher in dysphonic patients compared with nondysphonic patients: cough, chest pain, sticky sputum, arthralgia, diarrhea, headache, fatigue, nausea, and vomiting. The severity of dyspnea, dysphagia, ear pain, face pain, throat pain, and nasal obstruction was higher in dysphonic group compared with nondysphonic group. There were significant associations between the severity of dysphonia, dysphagia, and cough.Conclusion: Dysphonia may be encountered in a quarter of patients with mild-to-moderate COVID-19 and should be considered as a symptom list of the infection. Dysphonic COVID-19 patients are more symptomatic than nondysphonic individuals. Future studies are needed to investigate the relevance of dysphonia in the COVID-19 clinical presentation.

International audience; The aim of this preliminary study is to better understand the effects of transparent, surgical, cloth, KN95 (FFP2), and singer’s face masks on speech and singing in French. A survey gathered self-perception, and a local and global acoustic analysis of conversational, loud spoken and sung productions by the same individual were conducted. According to the 303 subjects surveyed, plosive consonants seem to be produced with the greatest difficulty. Consonants requiring lip involvement seem to be the most affected. The transparent and KN95 (FFP2) masks attenuate the intensity of all the consonants and spoken utterances as a whole, unlike the singer’s mask analysed in this case study.; L'objectif de cette étude préliminaire est de mieux comprendre les effets des masques transparents, chirurgicaux, en tissu, KN95 (FFP2) et des masques pour chanteurs sur la parole et le chant en français. Une enquête recueillant l'auto-perception (ressenti), ainsi qu'une analyse acoustique locale et globale de productions conversationnelles, parlées à haute voix et chantées par un même individu ont été réalisées. Selon les 303 sujets interrogés, les consonnes occlusives semblent être produites avec le plus de difficulté. Les consonnes nécessitant une implication des lèvres semblent être les plus touchées. Les masques transparent et KN95 (FFP2) atténuent l'intensité de l'ensemble des consonnes et des énoncés parlés, contrairement au masque pour chanteur analysé dans cette étude de cas.

Objective: To develop clinical tools assessing the refluxogenic potential of foods and beverages (F&B) consumed by patients with laryngopharyngeal reflux (LPR). Methods: European experts of the LPR Study group of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological societies were invited to identify the components of Western European F&B that would be associated with the development of LPR. Based on the list generated by experts, four authors conducted a systematic review to identify the F&B involved in the development of esophageal sphincter and motility dysfunctions, both mechanisms involved in the development of gastroesophageal reflux disease and LPR. Regarding the F&B components and the characteristics identified as important in the development of reflux, experts developed three rational scores for the assessment of the refluxogenic potential of F&B, a dish, or the overall diet of the patient. Results: Twenty-six European experts participated to the study and identified the following components of F&B as important in the development of LPR: pH; lipid, carbohydrate, protein composition; fiber composition of vegetables; alcohol degree; caffeine/theine composition; and high osmolality of beverage. A total of 72 relevant studies have contributed to identifying the Western European F&B that are highly susceptible to be involved in the development of reflux. The F&B characteristics were considered for developing a Refluxogenic Diet Score (REDS), allowing a categorization of F&B into five categories ranging from 1 (low refluxogenic F&B) to 5 (high refluxogenic F&B). From REDS, experts developed the Refluxogenic Score of a Dish (RESDI) and the Global Refluxogenic Diet Score (GRES), which allow the assessment of the refluxogenic potential of dish and the overall diet of the LPR patient, respectively. Conclusion: REDS, RESDI and GRES are proposed as objective scores for assessing the refluxogenic potential of F&B composing a dish or the overall diet of LPR patients. Future studies are needed to study the correlation between these scores and the development of LPR according to impedance–pH study.

Summary Introduction Sixty to 90% of patients with idiopathic Parkinson disease (IPD) developed early dysphonia and subtle speech impairment, which is usually related to orofacial muscular dysfunctions. The aim of this preliminary study is to assess the usefulness of voice quality and orofacial strength (involved in speech) as outcome of levodopa challenge test used for the IPD diagnosis. Material and Methods A total of 20 patients with early IPD were recruited and evaluated for clinical findings (Hoehn and Yahr scale), voice handicap index, maximal phonation time, phonation quotient, percent jitter, percent shimmer, noise-to-harmonic ratio, and orofacial muscular strength (Iowa Oral Performance Instrument) at baseline, throughout the levodopa challenge test and after therapeutic stabilization. Results The intake of a standardized dose of levodopa (levodopa challenge test) significantly improved phonation quotient and percent shimmer. We did not find similar improvement after medical stabilization of patients (based on levodopa medication) despite an improvement of Hoehn and Yahr mean score. The intake of levodopa significantly improved cheeks and lips strength involved in speech quality both along the challenge test and after the therapeutic stabilization. Conclusions These preliminary findings support a differential impact of levodopa on voice and speech functions in early diagnosed IPD and a mismatch between the clinical examination, orofacial strength, and voice quality improvements once the patient is medically stabilized.

To develop a French version of the Eating Assessment Tool (Fr EAT-10) and to assess its internal consistency, reliability and clinical validity. Fifty-six patients referred in the Swallowing Clinics of CHU Saint-Pierre Hospital (Brussels) and EpiCURA hospital (Ath, Belgium) for dysphagia were enrolled and completed fiberoptic endoscopic evaluation of swallowing and videofluoroscopy. Seventy-three asymptomatic subjects were included in the study. To assess reliability, Fr-EAT-10 was completed twice within a 7-day period. Validity was assessed by comparing Fr-EAT-10 scores with the scores of dysphagia handicap index (DHI) in all individuals. Normative value of EAT-10 was calculated and the receiver operating characteristic (ROC) curve was used to determine the best Fr-EAT-10 threshold associated with aspiration. Fifty-two patients completed the study. Cronbach’s alpha was 0.95 indicating a high internal consistency. Test–retest reliability was high in the entire cohort (rs = 0.921). The correlation between Fr-EAT-10 total scores and DHI was high (rs = 0.827) indicating a high external validity. Patients had a significant higher score of Fr-EAT-10 than the controls (p 3 should be considered as abnormal. The correlation between Fr-EAT-10 and the occurrence of aspiration is significant (rs = 0.327, p

Summary Objectives To analyze pre to posttreatment voice changes regarding the type of reflux in patients with acid, weakly acid or alkaline laryngopharyngeal reflux (LPR). Methods Patients with LPR, diagnosed using hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH), were prospectively recruited from three University Hospitals. Patients were treated with a combination of diet, proton pump inhibitors, magaldrate and alginate for 3 months. The following clinical and voice quality outcomes were studied pre to posttreatment according to the type of reflux (acid, weakly acid, nonacid): HEMII-pH, gastrointestinal endoscopy features, reflux symptom score (RSS), reflux sign assessment (RSA), voice handicap index (VHI), perceptual voice assessment (grade of dysphonia and roughness), aerodynamic and acoustic measurements. Results From December 2018 to March 2021, 160 patients completed the evaluations, accounting for 60 acid, 52 weakly acid, and 48 alkaline cases of LPR. There were no baseline differences in clinical and voice quality outcomes between groups. RSS and RSA significantly improved from pre to posttreatment in the entire cohort and in all patient groups. VHI, dysphonia and roughness, maximum phonation time, Jitter, Shimmer and noise to harmonic ratio significantly improved from pre to posttreatment. Individuals with alkaline reflux reported better voice quality improvements as compared to acid and weakly acid reflux patients. Conclusion Patients with acid and alkaline reflux reported better posttreatment voice quality outcomes as compared to weakly acid reflux patients. Future basic science and clinical studies are needed to better understand the histological changes of the vocal folds due to reflux of varying pH types and gastroduodenal enzyme content.

International audience; Objective To develop and validate a short version of the Reflux Symptom Score—the 12-question Reflux Symptom Score–12 (RSS-12)—for patients with laryngopharyngeal reflux disease (LPR). Study Design Prospective study. Setting Multicenter academic hospitals. Methods Patients with LPR diagnosed via multichannel intraluminal impedance pH monitoring were enrolled from 3 European hospitals. Healthy individuals completed the study. Individuals completed the Reflux Symptom Score, Reflux Symptom Index (RSI), and Voice Handicap Index (VHI) at baseline and 3 months posttreatment. The Reflux Symptom Score was completed twice within a 7-day period to assess test-retest reliability. Cronbach’s α was used for assessing internal consistency. The RSS-12 was developed and validity assessed through a comparison of the RSS-12, RSI, and VHI. Responsiveness to change was evaluated through the pre- to posttreatment evolution of the RSS-12 total score. Receiver operating characteristic analysis was used to determine the RSS-12 threshold that is suggestive of LPR. Results The RSS-12 was characterized by high test-retest reliability ( r s = 0.956) and adequate internal consistency reliability (α = 0.739). The RSS-12 was significantly correlated with the RSI ( r s = 0.845), suggesting high external validity. The RSS-12 total and item scores were significantly higher in patients with LPR as compared with healthy individuals ( P = .001), supporting high internal validity. RSS-12, VHI, and RSI significantly improved throughout treatment. Regarding the receiver operating characteristic curve, an RSS-12 score >11 is suggestive of LPR, exhibiting a sensitivity of 94.5% and a specificity of 86.2%. Conclusion The RSS-12 is a shorter, reliable, and valid self-administered patient-reported outcome measure questionnaire that can be used in the outpatient setting to suggest and monitor LPR.

This study examined whether the atypical speech style that is frequently reported in autistic adults is underpinned by an inflexible production of phonetic targets. In a first task, 20 male autistic adults and 20 neuro-typicals had to read and produce native vowels. To assess the extent to which phonetic inflexibility is due to an overall fine-grained control of phonetic behavior or to a lack of flexibility in the realization of one's phonological repertoire, the second task asked participants to reproduce artificial vowel-like sounds. Results confirmed the presence of a greater articulatory stability in the production of native vowels in autistic adults. When instructed to imitate artificial vowel-like sounds, the autistic group did not better approximate the targets' acoustic properties relative to neuro-typicals but their performance at reproducing artificial vowels was less variable and influenced to a greater extent by the articulatory properties of their own vocalic space. These findings suggest that the greater articulatory stability observed in autistic adults arises from a lack of flexibility in the production of their own native vowels. The two phonetic tasks are devoid of any pragmatic constraint, which indicates that phonetic inflexibility in autism is partly independent of register selection. Lay Summary: Autistic and neuro-typical adults took part in two tasks: one in which they produced vowels from French, their native tongue, and the other where they imitated unfamiliar vowels. Autistic adults displayed significantly less variation in their production of different French vowels. In imitating unfamiliar vowels, they were more influenced by the way they pronounce French vowels. These results suggest that the atypical speech style, frequently attested in autistic individuals, could stem from an unusually stable pronunciation of speech sounds., SCOPUS: ar.j, info:eu-repo/semantics/published

Objectives To identify the instruments for evaluating the clinical findings (ICFs) of laryngopharyngeal reflux (LPR) designed for use with regard to diagnosis and treatment effectiveness. Methods The PubMed, Scopus, and Cochrane databases were used to search for subject headings following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Three investigators retrieved relevant studies published between 1990 and 2018 describing the evolution of laryngopharyngeal findings throughout LPR treatment. Issues of clinical relevance, that is, LPR diagnosis, treatments, and signs assessed for diagnosis or as therapeutic outcomes, were assessed. The investigators also evaluated the psychometric properties (conceptual model, content validity, consistency, reliability, concordance, convergent validity, known-groups validity, responsiveness to change, and interpretability) of the ICF. The risk of bias was assessed with the tool of the Clarity Group and Evidence Partners. Results The search identified 1,227 publications with a total of 4,735 LPR patients; of these studies, 53 met the inclusion criteria. Of these 53 studies, we identified 10 unvalidated and six validated ICFs. None of the validated ICFs included all the psychometric properties. The main identified deficiencies related to ICF psychometric validation included variable construct validity, disparate and uncertain reliabilities, and a lack of interpretability. The lack of consideration of certain LPR laryngeal and extralaryngeal signs is the main weakness of ICFs, biasing content, and construct validities. Conclusion The low specificity of LPR signs, the lack of consideration of many findings, and the absence of a gold standard for diagnosis constitute barriers to the further validation of these ICFs. Additional studies are needed to develop complete and reliable ICFs. Laryngoscope, 129:720-736, 2019.

Objective To assess the usefulness of voice quality measurements as a treatment outcome in patients with laryngopharyngeal reflux (LPR)-related symptoms. Design Prospective uncontrolled multi-centre study. Material and methods A total of 80 clinically diagnosed LPR patients with a reflux finding score (RFS)>7 and a reflux symptom index (RSI)>13 were treated with pantoprazole and diet recommendations during 3 or 6 months, according to their evolution. RSI; RFS; blinded Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI) and aerodynamic and acoustic measurements were evaluated at baseline, 3 months (n = 80), and 6 months (n = 41) post-treatment. We conducted a correlation analysis between the adherence to the diet, and the evolution of both signs and symptoms and between videolaryngostroboscopic signs and acoustic measurements. Results Reflux symptom index, RFS, perceptual voice quality evaluations (dysphonia, roughness, strain and instability), and aerodynamic and acoustic measurements (ie, percent jitter and percent shimmer) were significantly improved at 3 months post-treatment but not at 6 months. Percent jitter was the most useful outcome for evaluating the clinical evolution of patients throughout the treatment course. A significant relationship between globus sensation and posterior commissure hypertrophy was documented; both seemed to significantly improve from 3 to 6 months. The correlation analysis revealed correlations between adherence to diet recommendations and the improvement of symptoms and between posterior commissure granulation severity and acoustic measurement impairments. Conclusion Voice quality improved in a manner similar to both signs and symptoms throughout a 6-month empirical treatment with better improvement the 3 first months. Voice quality assessments can be used as indicators of treatment effectiveness in patients with LPR-related symptoms.

To investigate the voice quality impairments in patients with laryngopharyngeal reflux (LPR) according to the gender. Controlled multi-center study. 80 LPR patients (40 males and 40 females) with reflux finding score (RFS) > 7 and reflux symptom index (RSI) > 13 were included and clinically compared according to gender. To be considered as LPR patients, subjects responded to an empiric therapeutic trial based on pantoprazole intake and diet recommendations for 3 months or had positive pH/Impedance metry. Voice Handicap Index (VHI); Short Form Healthy Survey 36 (SF36), blinded Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI); aerodynamic and acoustic measurements were assessed in all patients and compared with 80 healthy controls (40 males and 40 females) according to gender. The most common reasons for the consultation were, respectively, globus sensation in males (22.5%) and dysphonia (27.5%) in female who complained more of breathing difficulties and choking episodes related to LPR than males (p = 0.024). From a quality of life standpoint, female had increased significant impact of LPR disease on vitality and mental health than male. Compared to healthy subjects, both LPR male and female patients had stronger values of G, R, B, S, I, VHI, percent jitter, percent shimmer, and soft palate index than controls. In addition, LPR female had stronger values of lowest fundamental frequency and all aerodynamic measurements than controls. As showed in many other laryngeal conditions, voice quality of female could be more impaired by LPR than male. Some anatomical, histological and functional factors can be suspected and need additional future researches.

Objective: To study the differences in perceptual ratings of mild and moderate dysphonia related to the speech task, and their impact on intrarater and interrater reliabilities. Patients and Methods: Voice recordings of 15 outpatients with mild or moderate dysphonia related to laryngopharyngeal reflux were presented to 6 female experienced judges blinded to the clinical state of the patients. From these, the GRBASI (Grade, Roughness, Breathiness, Asthenia, Strain, and Instability) evaluations were performed on connected speech and sustained vowel of the pretreatment voice recordings and absolute agreement, and both intrarater and interrater reliabilities were assessed. Results: The average GRBASI scores were significantly worse when performed on sustained vowel. Intrarater reliability substantially varied according to the judge and the task. Good interrater reliability was broadly found for the evaluations of all GRBASI components irrespective of the speech task. Concerning agreement, we only found absolute agreement between judges for G and R items assessed on text. Conclusion: Average grade of perceptual voice impairment, intrarater reliability, and agreement vary according to the speech task.

The objective is to assess the differences in the severity of symptoms, signs, voice quality, and quality of life before and after treatment according to age in suspected laryngopharyngeal reflux (LPR) patients. The design used in this paper is prospective multi-center study. Eighty clinically diagnosed LPR patients with a reflux finding score (RFS) >7 and a reflux symptom index (RSI) >13 were treated with pantoprazole and diet recommendations for 3 months. Patients were subdivided into three groups according their age: group 1 (18-39 years, N = 21), group 2 (40-59 years, N = 31), and group 3 (≥60 years, N = 28). RSI, RFS, Voice Handicap Index (VHI), Short Form 36 questionnaire (SF36), aerodynamic, and acoustic measurements were evaluated at baseline and after treatment. The response to the empiric treatment was also assessed. Significant improvements in RSI, RFS, and VHI were found in all patient groups. The elderly patients showed a significantly lower RSI score than younger subjects (p = 0.035) without RFS difference among groups. At baseline, the SF36 score was better in group 3 with respect to social functioning (p = 0.049). At the 3-month follow-up, we found significant improvement of acoustic parameters only in the younger age groups (group 1 and group 2). The rate of resistant patients to the empiric treatment was higher in the younger group than in the elderly patient group (42.9 versus 28.6%). Age appears to reduce the subjective LPR symptom perception, leading to a lower rate of uncured patients. The utilization of acoustic parameters as an indicator of treatment effectiveness seems less useful for elderly subjects, probably due to an overlap between an aging voice and LPR.