4.3 Article

Speech and language abnormalities in myotonic dystrophy: An overview

Journal

JOURNAL OF CLINICAL NEUROSCIENCE
Volume 96, Issue -, Pages 212-220

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2021.10.031

Keywords

Myotonic dystrophy; Myotonic dystrophy type 1; Myotonic dystrophy type 2; Speech; Language; Speech abnormality; Myotonia

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Myotonic dystrophy (DM) is a neuromuscular disease that can cause speech and language abnormalities related to cognitive dysfunction, muscle weakness, and myotonia. Understanding these abnormalities can provide markers for disease characterization and evaluation.
Myotonic dystrophy (DM) is an autosomal dominant neuromuscular and multisystem disease that is divided into two types, DM1 and DM2, according to mutations in DMPK and CNBP genes, respectively. DM patients may manifest with various speech and language abnormalities. In this review, we had an overview on speech and language abnormalities in both DM1 and DM2. Our literature search highlights that irrespective of age, all DM patients (i.e. congenital, juvenile, and adult onset DM1 as well as DM2 patients) exhibit various degrees of speech impairments. These problems are related to both cognitive dysfunction (e.g. difficulties in written and spoken language) and bulbar/vocal muscles weakness and myotonia. DM1 adult patients have also a significant decrease in speech rate and performance due to myotonia and flaccid dysarthria, which can improve with warming up. Weakness, tiredness, and hypotonia of oral and velopharyngeal muscles can cause flaccid dysarthria. Hearing impairment also plays a role in affecting speech recognition in DM2. A better understanding of different aspects of speech and language abnormalities in DM patients may provide better characterization of these abnormalities as markers that can be potentially used as outcome measures in natural history studies or clinical trials. (c) 2021 Elsevier Ltd. All rights reserved.

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