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Cognitive Neuroscience > Dysarthria and Motor Speech Disorders > Flashcards

Dysarthria and Motor Speech Disorders Flashcards

1
Q

Motor speech disorders

A

Resulting from neurological impairments affecting the motor planning, programming or execution of speech

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2
Q

Apraxia of Speech

A

Impacts the retrieval, activation and sequencing of motor plans for speech

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3
Q

Dysarthria

A

Impacts the execution of movements for speech

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4
Q

Motor Skills involved in Speech Production

A 
Phonation - phonatory system
Resonation - velar-pharyngeal system
Articulation - articulatory system
Respiration - respiratory system
Controlled by the cerebral cortex (primary motor cortex), other control centres (cerebellum, basal ganglia)
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5
Q

3 Levels of the Motor System

A

Strategy - cerebral cortex and basal ganglia
Tactics - Motor cortex and cerebellum
Execution - brainstem and spinal cord

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6
Q

Use of sensory info

A

important for determining starting position of the muscles

Sensory info during = important for adapting planning and execution of movement

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7
Q

Frontal lobes in Motor Planning

A

Prefrontal Cortex - planning of movements
Premotor cortex - organises motor sequences
Primary motor cortex - produces specific movements

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8
Q

Motor Cortex Representation

A

Part of the body to be moved
Spatial location where the movement is directed
Movement’s function

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9
Q

Corticospinal motor pathway

A

(30% of fibres)
- travels from cortex to spine
- controls voluntary movements of the skeletal muscles
- activates spinal motor neurons
Originate from the upper 2/3 of PMC, premotor cortex, sensory cortex

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10
Q

Corticobulbar motor pathway

A

(70% of fibres)
- travels from cortex to brainstem
- controls the facial and associated muscles
- activates cranial nerve nuclei in brainstem (UMN)
Originate from the lower 1/3 of the PMC and adjacent area
Controls the skeletal muscles of head and face via cranial nerve

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11
Q

Corticospinal Tract

A

Motor cortex - contralateral organisation to output and input
Majority of corticospinal axons cross midline in the medulla to innervate contralateral spinal output nuclei

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12
Q

Upper Motor Neuron Damage

A

Weakness, increased tone, hyperreflexia (overactive reflexes)

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13
Q

Lower Motor Neuron Damage

A

Flaccidity, severe weakness, atrophy of muscle, hyporeflexia (underactive/absent), fasciculations (twitch)

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14
Q

Cranial Nerve Nuclei

A

Found in the brainstem
Can be connected to several related nerves
LMN nuclei - innervated by the UMN of the corticobulbar tracts
Majority receive bilateral innervation (safety)
- Both L and R nerves in pair are innervated by crainal nerves in L and R hem; except lower facial nerve (VII), hypoglossal nerve (XII)

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15
Q

Cranial Nerves Specific for Speech/Swallowing

A 
CN V - Trigeminal 
CN VII - Facial 
CN IX - Glossopharyngeal 
CN X - Vagus
CN XII - Hypoglossal
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16
Q

Testing Muscle Function

A 
Symmetry 
Muscle bulk (signs of wasting, atrophy) 
Muscle tone
- hypotonia 
- hypertonia 
Muscle strength
Reflexes - hyper/hyporeflexia 
Coordination
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17
Q

Ipsilateral

A

innervates the same side

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18
Q

Contralateral

A

Innervates the opposite side

19
Q

Unilateral

A

Innervates one side only

20
Q

Bilateral

A

Innervates both sides

21
Q

Decussation - Corticospinal tract

A

Majority decussate midline in medulla to innervate contralateral spinal output nuclei
Become two lateral corticospinal tracts to innervate contralateral side
Nerves that don’t cross = anterior corticospinal tracts, innervate ipsilateral side

22
Q

Decussation - Corticobulbar Tract

A

Do no decussate
except:
CN I - optic nerve & CN IV - trocholear
CN VII - facial & CN XII - hypoglossal

23
Q

Basal Ganglia

A

Collection of subcortical nuclei within forebrain
Receives input from cortex (neocortex, limbic cortex), midbrain (substatia nigra)
Sends output to motor cortex and substantia nigra

24
Q

Basal Ganglia Structure

A
  1. Caudate nucleus
  2. Putamen
  3. Globus Pallidua
    Subthalamic nucleus, substatia nigra and red nucleus are functionally related to BG
25
Circuitry of Basal Ganglia
Caudate and putamen - major input nuclei to basal ganglia; integrates sensorimotor info Caudate and putament connect with the substantia nigra Substantia nigra and globus pallidus are the major output nuclei
26
Volume hypothesis
Internal globus pallidus = volume dial | Projects into thalamus, projects into motor cortex
27
Direct pathway into Basal Ganglia
Amplifies force of movement Increases cortical activity - can see abnormal, violent, involuntary movements - hyperkinetic
28
Indirect Pathway into Basal Ganglia
Reduces force of movement Reduces cortical activity - diminished, reduced, small, slow movements - hypokinetic
29
Basal Ganglia Function - Speech
Roles in speech execution and motor programming (between formulator and articulator) Involved in the specification of individual movements - sets force, range, rate of movement - involved in specifying volume, speed, stress etc involved in motor program dependent on context/communicative intent
30
Impairments - Basal Ganglia
Hyperkinetic symptoms - excessive involuntary movements (Huntington's Disease) Hypokinetic symptoms - paucity of movement (Parkinson's Disease)
31
Parkinson's Disease - Symptoms
Motor tremors, rigidity, loss of balance/coordination, difficulty moving Resting tremor Bradykinesia (slowness in initiating/performing movement) Reduced postural reflexes Hypokinetic dysarthria Decrease in non-verbal communication
32
Parkinson's Disease - Pathology
Destruction of neurons that produce dopamine in substatia nigra
33
Parkinson's Disease - Executive Function
20% will develop frank dementia Often associated with Lewy Body dementia Subtle cognitive impairments common (esp executive difficulties)
34
Huntington's Disease - Symptoms
Involuntary movements - chorea (writhing of body, facial grimacing) Cognitive decline Psychiatric features
35
Huntington's Disease - Pathology
Cell loss in the caudate nucleus - lesser degree in putament, globus pallidus and cortex Autosomal dominant condition
36
Huntington's Disease - Speech
Hyperkinetic dysarthria - inappropriate silences, intermittent breathiness, hypernasality, loudness variations and imprecise articulations; lingual chorea (vocal tics)
37
Huntington's Disease - Cognitive and Language
``` Impaired delayed recall of info Impaired memory Poor cognitive flexibility and abstration Impaired attention and concentration Slowed thought process ``` Language difficulties could be a result of more general cognitive difficulties; loss of convo initiative reduced syntactic structure reduced verbal fluency
38
Cerebellum
Sequencing, timing, fine motor control of movement
39
Cerebellar Lesions
Ataxia - uncoordinated and inaccurate movements | Dysmetria - overshoot/undershoot target
40
Cerebellum Structure
``` Separated into two hemispheres by the vermis Lobes: - Vestibulocerebellum - Spinocerebellum - Cerebrocerebellum ```
41
Cerebellum - Motor Functions
Regulation of motor planning and control of movements (reaching and acquiring targets) Refinement and amplification of movement online Motor programming role - parameters for executrion
42
Cerebellum - planning
Receives info from the motor cortex about intended movement - determines order of muscular contractions, timing, ranges and force - info from vestibular system to maintain posture, balance, refine movement Info is sent back to primary motor cortex after modification
43
Cerebellar Damage
``` Ipsilateral signs Incoordination of the limbs Ataxia Reduced fine motor control Wide based gait Dysarthria Difficulty performing rapid alternating movements incoordination of thought ```
44
Ataxia - Articulation
Breakdown in motor organisation and control | = slowness and inaccuracy in range, force, timing, direction of articulatory movements

Cognitive Neuroscience (11 decks)

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