#CMSC16 – MS Patients’ Speech Limitations and Difficulty in Swallowing May Be Measured Through Phoneme Rate Production

Researchers from Mount Sinai Rehabilitation Hospital found that patients with multiple sclerosis (MS) who complain of speech limitations or difficulty in swallowing cannot produce specific phonemes, which may be a helpful way of objectively quantifying these symptoms in MS patients.

The findings were recently reported in an oral presentation titled “Rate of Production of Individual Phonemes of the Diadochokinetic Rate in Persons with Multiple Sclerosis Both With and Without Complaints of Speech Production or Swallowing Difficulty,” at the 2016 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) June 1-4 in National Harbor, Maryland.

Patients with MS often experience difficulty with speaking or swallowing. Although these patients are evaluated by skilled speech-language pathologists, the variability of symptoms characteristic of MS make it difficult to assess the severity of the symptoms and to design a course of treatment based only on what patients report.

To identify an objective measure that supported patient complaints, Lori A. Kostich determined whether the diadochokinetic (DDK) rate differed between MS patients with speech or swallowing complaints from patients that did not report any of those difficulties. DDK rate measures how quickly a person can repeat a series of rapid, alternating phonetic sounds, and it is used to assess, diagnose, and treat speech malfunctions.

The research team reviewed medical records of evaluations of MS patients completed between November 1, 2013, and October 31, 2014. Among the 232 records examined, only 161 had objective measurements of the individual components of the DDK rate. These patients were then divided into four groups: patients complaining from speech difficulties, patients without speech problems, patients with difficulty in swallowing, and patients without difficulty in swallowing.

Results showed that the group of patients who complained from either speech or swallowing difficulties, had a higher percentage of patients that did not reach the minimal acceptable DDK rate, compared to patients who did not have those symptoms. The phoneme /k/ especially showed the greatest difference between the groups with speech or swallowing problems, and the groups without complaints.

According to the team, further studies are required with larger cohorts of patients to determine if the differences between groups in terms of DDK rate are significant.