Authors: Jan Rusz Marika Megrelishvili Cecilia Bonnet Michael Okujava Hana Brožová Irine Khatiashvili Madona Sekhniashvili Marina Janelidze Eduardo Tolosa Evžen Růžička
Publish Date: 2014/01/21
Volume: 121, Issue: 6, Pages: 655-664
Abstract
A distinctive alteration of speech has been reported in patients suffering from ephedroneinduced 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 agematched healthy controls Speech examination brain MRI and NNIPPSParkinson 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 ephedroneinduced 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 = −054 p 001 articulation r = 040 p 005 and timing r = −053 p 001 In ephedroneinduced 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 nigraWe are grateful to H E Ivan Jestrab the Czech Ambassador in Georgia for his personal support to Nina Mikeladze for neuropsychological testing of patients to Prof Jonas Bergquist for testing the manganese content of patient hair to Prof Giorgi Menabde for his support and to Aaron Rulseh MD for his thoughtful English corrections This study was supported by the Czech Science Foundation GACR 102/12/2230 Czech Ministry of Health NT/122885 and NT/141813 and Charles University in Prague PRVOUKP26/LF1/4 and GA UK 441611 MRI examination in the Research Institute of Clinical Medicine in Tbilisi was enabled by the grant from the Czech Development Agency JSC Bank Republic Tbilisi supported customs expenses
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