What is already known on this subject Dysarthria is a common symptom in myotonic dystrophy type 1 (DM1). Research has focused on articulatory accuracy and SR. Cognitive decline in patients with DM1 is known to reduce illness insight in approximately half of the cases. However, its impact on self-awareness of dysarthria, and how this compares to perceptions of relatives and speech therapists, had not been investigated prior to this study. The combination of acoustic and perceptual speech measures with patients' own perspectives provides new knowledge of speech monitoring in DM1. What this study adds to existing knowledge This is the first study to investigate speech in patients with DM1 using both acoustic and perceptual analyses, while simultaneously examining the relationship with patients' self-awareness of their speech impairments. The results of this study show a relationship between increasing perceptual dysarthria severity and decreasing acoustic speech performance. Patients often rate their own speech more optimistically than relatives and speech therapists, which suggests a possible role of neuropsychological impairment in reduced self-awareness of speech deficits in DM1, warranting further research. What are the potential or actual clinical implications of this study? The integration of acoustic and perceptual speech assessment allows an objective and accurate diagnosis of dysarthria in DM1. Speech therapy should focus on improving speech clarity and intelligibility by developing exercises for articulatory precision and respiratory control. The discrepancy between how patients perceive their own speech and the opinion of clinicians and relatives suggests that speech therapists may need to focus on raising awareness of the dysarthria and actively involve relatives in the therapeutic process.
Hellemond et al. (2026) studied this question.