A distinct variant of mixed dysarthria reflects parkinsonism and dystonia due to ephedrone abuse.
A distinctive alteration of speech has been reported in patients suffering from ephedrone-induced parkinsonism. However, an objective assessment of dysarthria has not been performed in ephedrone users. We studied 28 young Caucasian men from Georgia with a previous history of ephedrone abuse and compared them to 25 age-matched healthy controls. Speech examination, brain MRI, and NNIPPS-Parkinson plus scale were performed in all patients. The accurate differential diagnosis of dysarthria subtypes was based on the quantitative acoustic analyses of 15 speech dimensions. We revealed a distinct variant of mixed dysarthria with a combination of hyperkinetic and hypokinetic components representing the altered motor programming of dystonia and bradykinesia in ephedrone-induced parkinsonism. According to acoustic analyses, all patients presented at least one affected speech dimension, whereas dysarthria was moderate in 43% and severe in 36% of patients. Further findings indicated relationships between motor subscores of dystonia and bradykinesia and speech components of loudness (r = -0.54, p < 0.01), articulation (r = 0.40, p < 0.05), and timing (r = -0.53, p < 0.01). In ephedrone-induced parkinsonism a prominent mixed hyperkinetic-hypokinetic dysarthria occurs that appears related to marked dystonia and bradykinesia and probably reflects manganese induced toxic and neurodegenerative damage to the globus pallidus internus and substantia nigra.
Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
Jan
J
Rusz
Marika
M
Megrelishvili
Cecilia
C
Bonnet
Michael
M
Okujava
Hana
H
Brožová
Irine
I
Khatiashvili
Madona
M
Sekhniashvili
Marina
M
Janelidze
Eduardo
E
Tolosa
Evžen
E
Růžička
D000162:Acoustics; D000328:Adult; D000704:Analysis of Variance; D000978:Antiparkinson Agents / Q000627:therapeutic use; D004401:Dysarthria / Q000209:etiology*; D004421:Dystonia / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000188:drug therapy / Q000209:etiology*; D011427:Propiophenones / Q000009:adverse effects*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000150:complications*
D000978:Antiparkinson Agents; D011427:Propiophenones; C047806:monomethylpropion