Dysprosody after severe closed head injury: an acoustic analysis
a Service de Rééducation
Neurologique, Hôpital Raymond Poincaré (AP-HP), Université Paris
V, Garches, France, b Service d'ORL, Hôpital
Tenon, Paris, France, c Fédération de
Neurologie, Hôpital de la Salpétrière, Paris, France
Correspondence to: Dr Christiane Samuel, Department of Neurological Rehabilitation, Raymond Poincaré Hospital, 92380 Garches, France.
Received 6 May 1997 and in revised form 9 September 1997;
Accepted 17 September 1997
OBJECTIVES
Neurological speech disorders
(dysarthria and dysprosody) are known to be frequent sequelae after
severe closed head injury. These disorders may dramatically alter
communicative intent and accentuate social isolation. The aim was to
provide an instrumental evaluation for prosodic production in a group
of patients with severe closed head injury and to
determine the correlations between prosodic production and
neurobehavioural status.
METHODSFifteen patients, at the subacute stage
after severe closed head injury, were studied and compared
with 11 controls, matched for age, sex, and duration of education. Each
subject was required to read aloud a French sentence "Je m'en vais
samedi matin" (I am leaving saturday morning) under six different
prosodic intonations (neutral, affirmation, interrogation, happiness,
sadness, anger). The recorded sentences were analysed using a sound
signal analysis software (Signalyse) allowing the measurement of signal
intensity and fundamental frequency. Statistical analyses were carried
out using repeated measures analysis of variance (ANOVA).
RESULTSPatients with closed head
injury were significantly less able than controls to modulate speech
output (pitch and intensity) according to prosodic context. This
deficit was particularly pronounced for the intonation feature of
anger, question, and statement. No consistent correlations could be
found between prosodic production and cognitive or behavioural data.
CONCLUSIONSAcoustic analysis of pitch and
intensity may show impairments of prosodic production after
severe closed head injury, which may be useful in
rehabilitation planning. This impairment does not seem to reflect the
eventual cognitive and behavioural deficits of the patients, but rather
a specific disorder of modulation of speech output.
© 1998 by Journal of Neurology, Neurosurgery, and Psychiatry
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