[Could speech rate of Wilson's disease dysarthric patient be improved in dual task condition?]. / Le débit de parole du patient wilsonien dysarthrique peut-il être amélioré en condition de double tâche?

INTRODUCTION: Dysarthria is one of the first sign of neurological Wilson's disease and is often characterized by a decreased speech rate. The aim of this study is to determine the abilities of Wilson's disease dysarthric patients to control their speech rate. We examined the impact of dual-tasking on the speech rate of patients as compared to healthy control speakers and in relation with their ability to accelerate speech rate when instructed to do so. METHODS: Twenty-six patients and twenty-six age- and sex-matched healthy controls repeated a sentence during 20 seconds at a comfortable speech rate used as reference. They were then asked to perform the same repetition task but in dual task conditions, in which sentence repetition was done while performing three types of executive grapho-motor tasks. Finally, the ability to control speech rate was tested by asking the speakers to perform the sentence repetition task alone but at a fast rate of speech. RESULTS: A significantly slower speech rate was observed for all patients as compared to controls. In the dual-task conditions, while the speech rate of healthy speakers accelerated significantly, two behaviors are found for the patients. Forty-two percent of the patients reproduced the control pattern with a significant increased in speech rate, while the other group significantly decreased their speech rate. Comparison of the ability of the two groups to intentionally modulate speech rate, when instructed to accelerate, shows that significantly better acceleration was achieved by speakers in the former group compared with the latter. CONCLUSIONS: This study supports the finding that patients with Wilson's disease exhibit an impaired speech rate and also impaired control of speech rate. Indirect assessment of speech rate modulation with the help of a dual-task paradigm has proven to be useful to distinguish patient behaviors. This paradigm could also be envisioned as a tool for rehabilitation.

[Vocal and behavioral adaptations of program sellers in work situation]. / Adaptations vocales et comportementales chez les vendeurs de programme en situation de travail.

Are program sellers at the Parisian Operas at risk of developing vocal problems? What are the adaptations they use to be heard and understood in this loud environment? Six program sellers were recorded and observed at work. The methodology applied included a questionnaire, acoustic analysis of the records, a videolaryngostroboscopic examination, analysis of objective and subjective measures of vocal function. The results confirmed the existence of voice risk factors and symptoms of vocal fatigue that may justify a preventive intervention. The adaptations that program sellers carry out follow the characteristics of what is called "Lombard Speech". In addition, announces reveal common and individual specificities such as prosodic and acoustic types.

[Reverse phonation: pathological and therapeutic aspects. Study of a clinical case]. / La phonation inversée: aspects pathologiques et thérapeutiques. Etude d'un cas clinique.

If the phenomenon of reverse voice is well known as a transitional phenomenon occurring during normal phonation, it is less known as a pathological entity. In this connection it seemed interesting to get a fix on this type of phonation. We will illustrate our discussion with one of our patients for which the reverse voice was continuously used instead of the usual blown voice. We will present all clinical and functional investigations conducted with this patient. We also focused on the particular psycho-dysfunctional context this patient was struggling with. Instrumental investigations concerning the fundamental frequency and the laryngeal aspect allowed us to find the same results as the literature ones. We will then talk about speech therapy, its difficulties and the means proposed to patient in order for him to accept his blown exhalation voice.

[The ultra-rapid cinematography of the larynx, its contributions in speech pathology]. / La cinématographie ultra rapide du larynx, ses apports en phoniatrie.

The development in the medical field of high speed cinematography and its dissemination in the field of speech pathology will probably change the way we view the larynx and diagnose its disorders. So far only the stroboscope could inform us about the appearance of vocal cord vibration but with certain limitations. Indeed the wave motion of the vocal cords is really only apparent motion. It is made possible through the phenomenon of retinal persistence of images and light intermittent vocal folds set to the frequency of the voice and out of phase by a few Hertz. This technique has several disadvantages: The need for the voice to trigger the strobe light; a low number of frames per second (25 fps) recorded; frame loss for the period between unlit two flashes; limitation in the study of the upper voice spectrum (gearing). The ultra-rapid cinematography brings a big difference in design since the digital recording can shoot up to 4000 frames per second with permanent lighting of the larynx. The slow reading of short sequences permits us to view the actual movement of vibrating structures, and to analyze the behavior of the vibrator during the transitional phases of the attack, depreciation and termination of sound. The footage in high resolution permits a detailed analysis of the movements of opening and closing of the vocal cords in phonation and respiration, and the diagnosis of lesions.

[New therapeutical possibility in a geriatric practice (author's transl)]. / Nouvelle possibilité thérapeutique en pratique gériatrique.

Thirty four patients whose ages ranged for 60 to 101 were treated with "tiapride" in a geriatric hospital. The patients' tolerance of the drug was excellent even the very elderly whose circulatory or respiratory state was often rather poor. The results obtained were good for the cases of acute or chronic agitation. They were satisfactory as regards a certain number of abnormal movements and some painful syndromes. However the number of these cases was too small for the results to be considered significant.