3
|
Vogel AP, Magee M, Torres-Vega R, Medrano-Montero J, Cyngler MP, Kruse M, Rojas S, Cubillos SC, Canento T, Maldonado F, Vazquez-Mojena Y, Ilg W, Rodríguez-Labrada R, Velázquez-Pérez L, Synofzik M. Features of speech and swallowing dysfunction in pre-ataxic spinocerebellar ataxia type 2. Neurology 2020; 95:e194-e205. [PMID: 32527970 DOI: 10.1212/wnl.0000000000009776] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/17/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To determine whether objective and quantitative assessment of dysarthria and dysphagia in spinocerebellar ataxia type 2 (SCA2), specifically at pre-ataxic and early disease phases, can act as sensitive disease markers. METHODS Forty-six individuals (16 with pre-ataxic SCA2, 14 with early-stage ataxic SCA2, and 16 healthy controls) were recruited in Holguin, Cuba. All participants underwent a comprehensive battery of assessments including objective acoustic analysis, clinician-derived ratings of speech function and swallowing, and quality of life assessments of swallowing. RESULTS Reduced speech agility manifest at the pre-ataxic stage was observed during diadochokinetic tasks, with the magnitude of speech deficit augmented in the early ataxic stage. Speech rate was slower in early-stage ataxic SCA2 compared with pre-ataxic SCA2 and healthy controls. Reduced speech agility and speech rate correlated with disease severity and time to ataxia onset, verifying that speech deficits occur prior to ataxia onset and increase in severity as the disease progresses. Whereas dysphagia was observed in both pre-ataxic and ataxic SCA2, it was not associated with swallowing-related quality of life, disease severity, or time to ataxia onset. CONCLUSIONS Speech and swallowing deficits appear sensitive to disease progression in early-stage SCA2, with syllabic rate a viable marker. Findings provide insight into mechanisms of disease progression in early-stage SCA2, signaling an opportunity for stratifying early-stage SCA2 and identifying salient markers of disease onset as well as outcome measures in future early-stage therapeutic studies.
Collapse
Affiliation(s)
- Adam P Vogel
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany.
| | - Michelle Magee
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Reidenis Torres-Vega
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Jacqueline Medrano-Montero
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Melissa P Cyngler
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Megan Kruse
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Sandra Rojas
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Sebastian Contreras Cubillos
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Tamara Canento
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Fernanda Maldonado
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Yaimee Vazquez-Mojena
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Winfried Ilg
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Roberto Rodríguez-Labrada
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Luis Velázquez-Pérez
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| | - Matthis Synofzik
- From the Centre for Neuroscience of Speech (A.P.V., M.M., M.P.C., M.K., S.R., T.C., F.M.), The University of Melbourne, Victoria, Australia; Department of Neurodegeneration (A.P.V., M.S.), Hertie Institute for Clinical Brain Research, University of Tübingen; Center for Neurology (A.P.V., W.I., M.S.), University Hospital Tübingen, Germany; Redenlab (A.P.V.), Melbourne, Australia; Center for Research and Rehabilitation of Hereditary Ataxias (CIRAH) (R.T.-V., J.M.-M., Y.V.-M., R.R.-L., L.V.-P.), Holguin, Cuba; Escuela de Fonoaudiologia (S.C.C.), Facultad de Salud, Universidad Santo Tomas, Talca; Physical Medicine & Rehabilitation Service, Speech Therapy Unit (S.C.C.), Hospital of Curico, Chile; and German Center for Neurodegenerative Diseases (DZNE) (M.S.), Tübingen, Germany
| |
Collapse
|