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Biomedical subjects

D E Hartman

Publications and source records attributed to D E Hartman.

At least 19 recordsLinked to original sources
PubMed1992

Dysarthria associated with focal unilateral upper motor neuron lesion.

Speech motor changes in six patients with focal unilateral upper motor neuron (UUMN) lesions were characterised using a variety of techniques including listener judgements, speech acoustic analyses, electromyographic and strength measures. Listener judgements of speech understand-ability, intelligibility and dysarthric features indicated mild dysarthria. Diadochokinesis, electromyographic and strength measures corroborated these observations. The findings of this study delineate the characteristics of the dysarthria associated with unilateral upper motor neuron lesions and have important implications for identifying potential upper motor neuron components of other neurogenic disorders of speech and language.

Aged↗
PubMed1989

A case of superior laryngeal nerve paresis and psychogenic dysphonia.

A psychogenic voice disorder co-occurred or evolved with the symptoms and signs of unilateral superior laryngeal nerve paresis. We speculated that the former was a manifestation of a musculoskeletal tension or conversion reaction disorder, whereas the latter was a sequela to a self-limiting inflammatory process. Voice therapy proved effective for alleviating the psychogenic dysphonia after the signs of the neuropathy had resolved, whereas psychotherapy offered strategies for stress management. A multidisciplinary approach to this patient provided for differential diagnosis and efficacious treatment.

Adult↗
PubMed1988

Neuropsychology and the neurochemical lesion: evolution, applications and extensions.

The evolution of neuropsychology into a method for neurotoxic damage detection is reviewed. When neuropsychology is transformed into "neuropsychological toxicology", fundamental philosophical assumptions of the field are altered; the search for brain-behavior relationships must extend from structural damage into the analysis of neurochemical systems. The complementary relationship of human neuropsychology to basic toxicological and animal research is discussed. The great numbers of human "natural experiments" whose employment, medical history or substance abuse subjects them to contact with neurotoxic substances, suggest that there is a great need for expanded human investigations involving neuropsychological testing procedures in the service of research and clinical identification of neurotoxic syndromes. Further, it is argued that neurobehavioral procedures originally developed to detect industrial neurotoxic exposure will prove additionally useful assessing other brain-behavior disruptions mediated by neurochemistry or neurotoxicity rather than structural lesion. These frontiers include physical or emotional illness, substance abuse, effects of abused or prescription drugs as well as little-researched areas deserving of closer study, e.g., allergens or biotoxic exposure.

Behavior↗
PubMed1988

Dysarthrias of movement disorders.

Following the seminal works of Canter (152) and Darley, et al. (1) concerning differential diagnosis and classification of dysarthria, considerable strides have been made with regard to characterizing the features of speech that occur with disorders of movement. Research should continue to address the neurophysiologic substrates of the dysarthrias of movement disorders, and most importantly, efficacious means of treating these impairments of speech.

Athetosis↗
PubMed1987

Orofacial motor control impairment in Parkinson's disease.

Motor impairments in lip, jaw, and tongue muscles in patients with idiopathic Parkinson's disease (PD) were quantified. These orofacial muscle groups are nonuniformly endowed with muscle afferents, thus permitting evaluation of the hypothesis that certain PD motor symptoms are due to aberrations in muscle afferent function. Tongue muscles, devoid of stretch reflexes, were most impaired, while jaw-closing muscles, with numerous spindles and a monosynaptic stretch reflex, manifested the least impairment. Seemingly, PD motor impairments are independent of fusimotor or muscle afferent dysfunctions.

Facial Muscles↗
PubMed1985

Cautions in alternate-form presentation of aural test material: Speech Sounds Perception Test.

86 college students were administered the standard Speech Sounds Perception Test and an alternate recording. Although reliability between the two recordings was moderate (r = .68) when the standard was given first, but only .36 when the alternate form was given first, differences in performance were consistent with differences in attack and decay found in voice-print tracings. Results suggest caution in using an alternate form of a neuro-psychological test, particularly one using auditory stimuli, until cross-validation confirms the reliability coefficient and the level of performance.

Adult↗
PubMed1985

Dysgraphia after right hemisphere stroke.

Acquired dysgraphia has been described as a disorder of graphemic selection and spatial temporal disorganization which can exist in isolation or as a component of a broader language or cognitive syndrome. There is little agreement on the locus of writing centers, although select areas within the left hemisphere have been suggested. We describe a patient who had dysgraphia after a right hemispheric stroke. He had no demonstrable signs of limb apraxia or visual field deficit, and only subtle signs of language impairment other than the writing disturbance. Treatment emphasized progressively more complex writing tasks which included the following: (1) written responses to picture/word stimuli, (2) word and sentence dictation, and (3) self-generated sentences and functional writing tasks. At discharge from the hospital the patient's writing was within normal limits. Our findings were similar to those described for a patient with a left hemispheric stroke who was primarily dysgraphic. We conclude that our patient's dysgraphia was a component of a subtle aphasia as well as a spatial temporal disorganization disorder.

Aged↗
PubMed1984

Spastic dysphonia and essential (voice) tremor treated with primidone.

Primidone has been reported to be effective in reducing tremor in patients with benign essential tremor. There is at least one report that suggests that the medication may reduce voice tremor, a frequent component of the essential tremor syndrome. Three patients with spastic dysphonia of essential (voice) tremor and one with more typical essential (voice) tremor were treated with primidone and experienced no alleviation in the voice signs. The side effects experienced by all patients were consistent with those noted in previous reports. Primidone does not seem to be effective in treating essential voice tremor or spastic dysphonia of essential voice tremor.

Aged↗
PubMed1983

Psychogenic aphonia masking mutational falsetto.

Aphonia, originally due to laryngeal inflammation, became psychogenic and superimposed on the unstable pitch of adolescent voice change. We presumed that the aphonia was adopted as a means of dealing with peer pressure to maintain a high preadolescent pitch as well. Voice therapy was effective in alleviating both the aphonia and mutational falsetto. Clinicians should be alert to underlying mutational falsetto when confronted with an aphonic or dysphonic adolescent patient with no organic laryngeal pathologic condition.

Adolescent↗
PubMed1982

A case of vocal cord nodules masking essential (voice) tremor.

Essential tremor is a progressive, potentially debilitating disorder that may be manifested in the voice only. In the case we report, the signs occurred concurrently with the voice characteristics of vocal cord nodules but were subtle. The mildness of the voice tremor precluded treatment at this time, although the results of medical management for the disorder have not been impressive. It is probable that some patients with severe essential (voice) tremor have undergone recurrent laryngeal nerve resection for the disorder.

Diagnosis, Differential↗
PubMed1981

Adductor spastic dysphonia as a sign of essential (voice) tremor.

Adductor spastic dysphonia may not be one disorder but a voice sign of several different neurologic and psychiatric syndromes. This study evaluates whether rhythmic voice arrests, often components of "spastic dysphonia," are signs of essential tremor, a neurologic disorder. Data on 22 patients originally diagnosed as having spastic dysphonia, who had tremor-like or rhythmic voice arrests, were compared with data on two groups of patients who had essential (voice) tremor. The frequency of voice arrest on vowel prolongation in the group labeled spastic dysphonia was compared with the frequency of voice tremor in the groups with essential tremor. The median frequencies of 5.7, 5.0, and 5.5 Hz were not significantly different among the three groups. Patients in all three groups had tremor in other parts of the body, other scattered neurologic signs, and histories of life stress associated with the onset of their voice disorders. Although the results do not prove conclusively that the patients diagnosed as having spastic dysphonia in this study actually had essential tremor, the similarities to that disorder strongly suggest a linkage.

Adult↗
PubMed1981

Clinical investigations of intermittent breathy dysphonia.

Case history and voice data for 17 patients who presented with intermittent moments of breathy dysphonia (IBD) in contextual speech were analyzed. From recorded samples of vowel prolongation four variants of phonation were identified. Of 13 patients examined neurologically, 10 (77%) had positive neurologic signs. Psychiatric and physical illnesses were often associated with onset of the voice disorder. Sex ratio of the patients in this study was nearly the same as that for adductor spastic dysphonia. Age at onset was similar to that which has been described for "functional" voice disorders. Different therapies were generally ineffective in alleviating the disorder. Although not conclusive, patients presenting with IBD in connected speech may have an underlying neurologic or psychologic disorders.

Adolescent↗