Oral motor functions, speech and communication before a definitive diagnosis of amyotrophic lateral sclerosis.
The aim of this study was to explore the cranial nerve symptoms, speech disorders and communicative effectiveness of Finnish patients with diagnosed or possible amyotrophic lateral sclerosis (ALS) at their first assessment by a speech-language pathologist. The group studied consisted of 30 participants who had clinical signs of bulbar deterioration at the beginning of the study. They underwent a thorough clinical speech and communication examination. The cranial nerve symptoms and ability to communicate were compared in 14 participants with probable or definitive ALS and in 16 participants with suspected or possible ALS. The initial type of ALS was also assessed. More deterioration in soft palate function was found in participants with possible ALS than with diagnosed ALS. Likewise, a slower speech rate combined with more severe dysarthria was observed in possible ALS. In both groups, there was some deterioration in communicative effectiveness. In the possible ALS group the diagnostic delay was longer and speech therapy intervention actualized later. The participants with ALS showed multidimensional decline in communication at their first visit to the speech-language pathologist, but impairments and activity limitations were more severe in suspected or possible ALS. The majority of persons with bulbar-onset ALS in this study were in the latter diagnostic group. This suggests that they are more susceptible to delayed diagnosis and delayed speech therapy assessment. It is important to start speech therapy intervention during the diagnostic processes particularly if the person already shows bulbar symptoms.
Department of Neurology and Rehabilitation, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland. Electronic address: makkonen.tanja.e@student.uta.fi.
Tanja
T
Makkonen
School of Social Sciences and Humanities, University of Tampere, Yhteiskunta-ja kulttuuritieteiden yksikkö, Linna, P.O. Box 33014, Tampereen yliopisto, Finland. Electronic address: anna-maija.korpijaakko-huuhka@uta.fi.
Anna-Maija
AM
Korpijaakko-Huuhka
Department of Neurology and Rehabilitation, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland. Electronic address: hanna.ruottinen@pshp.fi.
Hanna
H
Ruottinen
Department of Neurology and Rehabilitation, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland. Electronic address: riitta.puhto@tampere.fi.
Riitta
R
Puhto
Department of Neurology and Rehabilitation, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland. Electronic address: kirsi.hollo@tampere.fi.
Kirsi
K
Hollo
Department of Neurological Sciences, University of Helsinki, Helsinki, Finland; Department of Neurology, Helsinki University Central Hospital, P.O. Box 302, 00029 HUS Helsinki, Finland. Electronic address: aarne.ylinen@hus.fi.
Aarne
A
Ylinen
Neuromuscular Research Center, University of Tampere and Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland. Electronic address: johanna.palmio@uta.fi.
Johanna
J
Palmio
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000145:classification / Q000175:diagnosis*; D003142:Communication; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders; D013066:Speech-Language Pathology / Q000379:methods
Amyotrophic lateral sclerosis; Bulbar symptoms; Communication; Dysarthria; Speech