The dysarthrias: Speech-voice profiles, related dysfunctions, and neuropathology

The dysarthrias are important for several reasons, but principally because of their diagnostic value in neurology and speech-language pathology and because of their effect on the quality of life of those affected. At least in the United States, the rating and classification system introduced by Darley, Aronson, and Brown (1969a, 1969b) continues to be frequently used clinically and is central to the contemporary understanding of the dysarthrias. This review article emphasizes articles published within the last 10 years and thereby complements previous reviews. The classification system introduced by Darley et al. is used as the skeleton of discussion, which includes summaries of the following for each of seven major types of dysarthria: (1) auditory-perceptual characteristics, (2) instrumental (acoustic and physiologic) data, (3) descriptions of individual variations and subtypes, (4) related dysfunctions such as dysphagia and neuropsychological deficits, and (5) recent hypotheses on neuropathologies. The discussion includes issues related to the rating and classification of the dysarthrias. A general conclusion is that the dysarthrias constitute a complex set of disorders, with large variations seen among individual patients in each classification and with possible subtypes that have been only partially and tentatively described.