Background: Dysarthria in neurological disorders can have psychosocial consequences. The dysarthric speaker’s perspective towards the disorder’s psychosocial impact is essential in its global assessment and management. For such purposes, assessment tools such as the Dysarthria Impact Profile (DIP) are indispensable. Objective: We aimed to confirm the relevance of using the DIP to quantify the psychosocial consequences of dysarthria in neurological diseases. Methods: We studied 120 participants, 15 healthy controls and 105 patients with different kinds of dysarthria induced by several neurological disorders (Parkinson’s disease [PD], Huntington’s disease, dystonia, cerebellar ataxia, progressive supranuclear palsy [PSP], multiple system atrophy, lateral amyotrophic sclerosis). All participants underwent a cognitive evaluation and a speech intelligibility assessment and completed three self-reported questionnaires: the 36-Item Short Form Health Survey, the Voice Handicap Index (VHI), and the DIP. Results: The psychometric properties of the DIP were confirmed, including internal consistency (α = 0.93), concurrent validity (correlation with the VHI: r = –0.77), and discriminant validity (accuracy = 0.93). Psychosocial impact of dysarthria was revealed by the DIP for all patients. Intelligibility loss was found strongly correlated with the psychosocial impact of dysarthria: for a similar level of intelligibility impairment, the DIP total score was similar regardless of the pathological group. However, our findings suggest that the psychosocial impact measured by the DIP could be partially independent from the severity of dysarthria (indirectly addressed here via speech intelligibility): the DIP was able to detect patients without any intelligibility impairment, but with a psychosocial impact. Conclusions: All patients reported a communication complaint, attested by the DIP scores, despite the fact that not all patients, notably PD, ataxic, and PSP patients, had an intelligibility deficit. The DIP should be used in clinical practice to contribute to a holistic evaluation and management of functional communication in patients with dysarthria.

The aim of this study was to rank vocal exercises using semi-occluded vocal tracts (SOVT) as a function of their effect on subglottal pressure (SGP) and on transglottal pressure (TGP). Direct measurements were performed in two healthy females. The correct realization of vocal exercises was controlled by maintaining a constant airflow at the phonation onset. TGP varied from 1.8 to 5.9 hPa among SOVT, in the same range as phonation threshold pressure values. SGP varied among subjects from 19.4 for 2-mm straw to 3.2 hPa for closed vowel. SOVT could be ranked in voice rehabilitation from the greatest to the smallest effects on SGP as following: 1) 2-mm straw; 2) 5-mm straw and fricative /v/; 3) 8-mm straw and nasals /m/ and /n/; 4) vowel /i/.

Objectives Phonation threshold pressure (PTP) and phonation threshold flow (PTF) are useful aerodynamic parameters, but each is sensitive to different disorders. A single comprehensive aerodynamic parameter sensitive to a variety of disorders might be beneficial in quantitative voice assessment. We performed the first study of phonation threshold power (PTW) in human subjects. Methods PTP and PTF were measured in 100 normal subjects, 19 subjects with vocal fold immobility, and 94 subjects with a benign mass lesion. PTW was calculated from these two parameters. In 41 subjects with a polyp, measurements were obtained before and after excision. Receiver operating characteristic (ROC) analysis was used to determine the ability of the three parameters to distinguish between controls and disordered groups. Results The PTW (p < 0.001), PTP (p < 0.001), and PTF (p < 0.001) were different among the three groups. All parameters decreased after polyp excision. PTW had the highest area under the ROC curve for all analyses. Conclusions PTW is sensitive to the presence of mass lesions and vocal fold mobility disorders. Additionally, changes in PTW can be observed after excision of mass lesions. PTW could be a useful parameter to describe the aerodynamic inputs to voice production.

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