👤 Ouarda Metref

Assessment and treatment practices for hypokinetic dysarthria in people with Parkinson's disease (PwPD) remain largely inaccessible and understudied in African and Arabic countries. This study investigates clinical practices of Algerian speech-language therapists (SLTs) in assessing and treating dysarthria in PwPD. A cross-sectional online survey of Algerian SLTs was conducted between December 2024 and January 2025. Thirty-six SLTs completed the proposed questionnaire (88.8% women; mean age 32.7 ± 8.9 years). Data on demographics, assessment tools, treatment methods, and perceived challenges of the answers were analysed using descriptive statistics and chi-square tests (α = 0.05). Most SLTs who completed the questionnaire were based in the northern region of the country (66.6%). They reported leaning on informal assessments (63.8%), prioritizing articulation (61.1%), self-assessment and speech rating (61.1%). Formal tools, such as acoustic analysis, appeared underused (36.1%). Non-evidence-based therapy dominated practice: articulatory muscle strengthening (77.7%), respiratory training (69.4%), and rehabilitation with a straw (61.1%). In contrast, evidence-based methods like the Lee Silverman Voice Treatment (LSVT) were rarely used (8.3% frequent use). SLTs with PhD degrees significantly favoured formal assessments (χ Our findings underline the crucial need for structured training programmes, integration of evidence-based therapies, and improvement of the work environment in terms of different tools. This study emphasizes the significant gaps that remain to be addressed in the provision of SLTs services to PwPD in Algeria. What is already known on this subject Existing studies from high-income countries highlight variability in assessment and treatment practices of hypokinetic dysarthria in PwPD among SLTs, with underutilization of standardized tools. However, no data existed on clinical practices in Africa and Arabic-speaking contexts, where linguistic and resource constraints may uniquely shape rehabilitation approaches. What this paper adds to the existing knowledge This study reveals that Algerian SLTs predominantly rely on informal assessments (63.8%) and non-evidence-based therapy (e.g., articulatory muscle strengthening, 77.7%), while evidence-based methods like LSVT are rarely used (8.3%). Systemic barriers, including inadequate training (83.3%), lack of dedicated tools (88.8%), and limited workplace resources (55.5%), may explain these disparities. This is the first study to document Arabic-language challenges in dysarthria management in PwPD, advocating for linguistically adapted tools. What are the potential or actual clinical implications of this study? These findings urge action to enhance SLTs training programmes in Algeria, by integrating evidence-based methods like LSVT into curricula and develop standardized Arabic-language assessment tools. Show less

This study aimed to investigate correlations between acoustic voice quality index (AVQI) parameters, self-reported voice handicap (VHI-30), and auditory-perceptual assessments (GRBAS) in Algerian Arabic-speaking individuals with Parkinson's disease (IwPD), while identifying key predictors of voice-related handicap. Cross-sectional observational study. Forty-four native Algerian Arabic dialect speakers with idiopathic PD underwent voice assessments, including audio recordings of sustained vowel phonation and continuous speech tasks. Acoustic analysis was performed using the six AVQI v03.01 parameters via Praat® (version 6.4.06). Self-reported and auditory-perceptual assessments were assessed, respectively, using the VHI-30 and the GRBAS scale (G-score). Statistical analyses included Spearman's rank-order correlations and multiple linear regressions to identify key predictors of voice-related handicap in this cohort of patients. Significant correlations were observed between individual AVQI parameters and VHI-30 scores, with CPPs demonstrating the strongest inverse correlation with the total VHI-30 score (r This pilot study highlights the multidimensional nature of voice impairment in a cohort of Algerian Arabic-speaking PD patients. The regression model substantially advances the understanding of key predictors of voice-related handicap in this cohort of patients. Collectively, acoustic, perceptual, and self-reported outcome measures merit systematic integration into comprehensive voice assessment protocols, as they hold potential utility for refining therapeutic decision-making and optimizing clinical management strategies for voice-related disorders in PD. Show less

Liver glucose metabolism plays a central role in glucose homeostasis and may also regulate feeding and energy expenditure. Here we assessed the impact of glucose transporter 2 (Glut2) gene inactivation in adult mouse liver (LG2KO mice). Loss of Glut2 suppressed hepatic glucose uptake but not glucose output. In the fasted state, expression of carbohydrate-responsive element-binding protein (ChREBP) and its glycolytic and lipogenic target genes was abnormally elevated. Feeding, energy expenditure, and insulin sensitivity were identical in LG2KO and control mice. Glucose tolerance was initially normal after Glut2 inactivation, but LG2KO mice exhibited progressive impairment of glucose-stimulated insulin secretion even though β cell mass and insulin content remained normal. Liver transcript profiling revealed a coordinated downregulation of cholesterol biosynthesis genes in LG2KO mice that was associated with reduced hepatic cholesterol in fasted mice and reduced bile acids (BAs) in feces, with a similar trend in plasma. We showed that chronic BAs or farnesoid X receptor (FXR) agonist treatment of primary islets increases glucose-stimulated insulin secretion, an effect not seen in islets from Fxr(-/-) mice. Collectively, our data show that glucose sensing by the liver controls β cell glucose competence and suggest BAs as a potential mechanistic link. Show less