내전형 연축성 발성장애의 비유창성 및 VOT 특성
Characteristics of the Disfluency and VOT in Adductor type Spasmodic Dysphonia
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초록
본 연구의 목적은 내전형 연축성 발성장애 환자들과 발달성 말더듬을 가진 환자들 간의 비유창성 발성 및 VOT 특성에 있어서 분광사진을 통한 분석 방법이 질환의 차이를 구별하는데 어떠한 유용성이 있는지 알아보고자 하였다. ADSD로 진단받은 여성 10명을 대상으로 하였다. 대상군의 연령분포는 20세에서 54세로 평균연령은 37세였으며, 유병기간은 평균 1.5년이었다. 대조군은 동일연령대의 발달성 말더듬을 가진 남성 7명과 여성 3명을 대상으로 하였다. 대상자들의 비유창성 형태는 파라다이스 유창성검사(P-FA)에서 제시한 정상적인 비유창성(normal disfluency, ND)과 병리적인 비유창성(abnormal disfluency, AD)의 항목을 사용하여 비교 분석하였다. VOT는 녹음된 음성샘플 가운데 한국어 파열음 중 기식음 구간이 가장 길고, 명확한 기식음 /ph/ 산출된 검사어로 측정하였으며, VOT의 분석은 CSL 프로그램의 oscillogram과 spectrogram을 동시에 이용하여 측정하였다. 연구 결과, 말더듬 그룹은 비정상적 간투사, 단어부분반복이 나타났으며, ADSD그룹은 긴장과 막힘을 동반한 DPB 소견이 나타났다. 이는 ADSD가 말더듬과 다른 비유창성 형태를 가지고 있음을 보여준 결과로 해석된다. 또한 ADSD 그룹의 VOT가 말더듬 그룹에 비해 통계학적으로 유의미하게 짧은 것으로 나타났다. 이는 두 질환을 감별하는데 스펙트로그램 분석이 매우 유용하다는 것을 보여주는 결과로 사료된다.
Abstract
The purpose of this study was to investigate the usefulness of spectroscopic analysis on the characteristics of non-fluency vocalization and VOT between patients with adductor spasmodic dysphonia and patients with developmental stuttering. Ten women diagnosed with ADSD were enrolled. The age distribution of the target group ranged from 20 to 54 years, with an average age of 37 years and an average duration of disease of 1.5 years. The control group included 7 males and 3 females with developmental stuttering in the same age group. The types of non-fluency were compared and analyzed using the items of normal disfluency (ND) and pathological disfluency (AD) presented in the Paradise Fluency Test (P-FA). VOT was measured as a test word for which the amorphous sound /ph/ was calculated among the recorded voice samples. VOT was measured using the oscillogram and spectrogram of the CSL program. As a result of the study, the stuttering group had abnormal interjection and partial word repetition, and the ADSD group had DPB findings with tension and block. These results are interpreted to show that ADSD has a form of non-fluency different from stuttering. In addition, the VOT of the ADSD group was statistically significantly shorter than that of the stuttering group. This is thought to be a result showing that spectrogram analysis is very useful in discriminating between two diseases.
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