Dysprosody - symptoms, causes and treatment

This type of speech disturbance can be expressed in two different ways.

Dysprosody is an alteration in the pronunciation and intonation of words, the cause of which has been linked to significant neurological damage.The cause of dysprosody has been linked to significant neurological damage. It is one of the manifestations of the Foreign Accent Syndrome, although it also occurs in people with Parkinson's disease, among other conditions. It is also an alteration that has allowed the study of the relationship between language, affective state, emotional processing and communication.

Next we will see what is the dysprosody and which are its main characteristics.

What is dysprosody?

The term "dysprosody" is composed, on the one hand, of the word "dys" which means separation, divergence or difficulty. And on the other hand, it is composed of the word "prosody", which in grammar is the branch in charge of teaching the correct pronunciation and accentuation of words.

In phonology prosody studies the phonic features that affect the meter, such as rhythm or structure.For example, rhythm or verse structure, but especially accents and intonation.

Thus, dysprosody is the difficulty in pronouncing or intoning words properly.. It is characterized by alterations in the intensity, pauses, rhythm, cadence and intonation of words. As such, the person with dysprosody can understand the language and vocalize the desired responses, however, they find it difficult to control the way in which they enunciate these responses.

Dysprosody and Foreign Accent Syndrome

One of the most studied conditions in relation to this is the foreign accent syndrome, which consists of a sudden pronunciation with unusual pitch and accentuation.

In fact, the first studies in dysprosody are also the first studies conducted with this syndrome. At the beginning of the 20th century, the French neurologist Pierre Marie studied the case of a woman who, after suffering a Cardiovascular accident, suddenly and drastically modified her intonation..

Although there have been few, since then similar cases have been reported, which have led to the study of the relationship between hemiplegia and altered speech patterns.

Other conditions in which dysprosody may manifest itself are Parkinson's disease (in this case it has in fact been extensively studied), Autism Spectrum Disorder, in some types of depression and schizophrenia..

Difference between dysprosody and prosodic impairment.

When manifesting itself as a significant change in intonation and pronunciation, dysprosody may be mistaken for the expression of a particular mood or even a difficulty in processing or even a difficulty in processing emotional information. However, this is not necessarily the case.

Important terms have emerged to differentiate between dysprosody and affective processing. One of these is "prosodic impairment."

While dysprosody refers to the absence of physical and/or linguistic means to indicate affective state through intonation; prosodic impairment refers to the opposite phenomenon: a previous "affective deficit" may be reflected through schizophrenia. may be reflected through atypical prosodic schemes (Gallardo and Moreno, 2010).

Causes

The causes of dysprosody have been mainly attributed to severe neurological damage. The most studied have been tumors and brain trauma, generally caused by cerebrovascular accidents, although in some cases it has also been related to cerebral and/or cranial trauma.

However, there have also cases of dysprosody have also been reported after laryngeal surgery, which may indicate that dysprosody may not necessarily be the result of a brain or head injury.This may indicate that there is not necessarily a solely neurological etiology.

Recently, dysprosody has been explained by cognitive-affective functions related to cortical areas of the right cerebral hemisphere. Even more recently, the involvement of subcortical structure and the relationship of prosody to communication and emotional processing have begun to be investigated in various syndromes.

Types of dysprosody

From the above, two main types of dysprosody have emerged, with also differential symptoms, linguistic dysprosody and emotional dysprosody. Each of these types refers to modifications in the individual person's speech, and far from being mutually exclusive, both types of dysprosody are far from being exclusive manifestations, both types are often closely related..

1. Dysprosody of the linguistic type

This is an alteration in speech intentionmainly due to verbal variations. For example, it may be difficult for the person to state a question differently from a statement, which makes it difficult to communicate with other people. Likewise, he/she has difficulty emphasizing certain words or revealing the intention of an expression.

2. Emotional dysprosody

It is characterized by a difficulty in conveying or expressing emotions through speech.Emotional dysprosody can sometimes include difficulties in understanding the emotions conveyed in other people's speech, precisely because of the significant changes in intonation and the difficulty in controlling them.

The severity of emotional dysprosody can vary according to the neurological damage, and as mentioned above, it does not mean that the person has lost the ability to experience emotions, but that there is a difficulty in expressing and/or understanding them. The latter has been especially important in the understanding of different psychiatric or neurological diagnoses such as those we have mentioned throughout this text.

Treatment

Dysprosody, especially of the linguistic type, is usually evaluated and treated with speech therapy.. Mostly including exercises to identify prosodic cues in natural situations, i.e. practicing everyday conversations.

Although its effects on emotional dysprosody are less promising, there are also strategies to improve the expression of emotions that complement speech therapies.

Bibliographical references:

• Caekebeke, J.F., Schinkel-Jennekens, A., van der Linder, M.E., Bruruma, O.J., and Ross, R.A. (1991). The interpretation of dysprosody in patients with Parkinson's disease. Journal Neurologycal, Neurosurgery & Psychiatry, 54(2): 145-148.
• Gallardo, B. and Moreno, V. (Eds.). (2010). Studies in clinical linguistics. Volume 5. Clinical Applications. Universitat de Valencia: Valencia.
• Sidtis, J. J. and Van Lancker, D. (2003). A Neurobehavioral Approach to Dysprosody. Seminars in Speech and Language, 24(2): 93-105.
• Pell, M. (1999). Fundamental Frequency Encoding of Linguistic and Emotional Prosody by Right Hemisphere-Damaged Speakers. Brain and Language. 69 (2): 161-92.