For generations, the evaluation of speech abnormalities in neurodegenerative disorders such as Parkinson's disease (PD) has been limited to perceptual tests or user-controlled laboratory analysis based upon rather small samples of human vocalizations. Our study introduces a fully automated method that yields significant features related to respiratory deficits, dysphonia, imprecise articulation and dysrhythmia from acoustic microphone data of natural connected speech for predicting early and distinctive patterns of neurodegeneration. We compared speech recordings of 50 subjects with rapid eye movement sleep behaviour disorder (RBD), 30 newly diagnosed, untreated PD patients and 50 healthy controls, and showed that subliminal parkinsonian speech deficits can be reliably captured even in RBD patients, which are at high risk of developing PD or other synucleinopathies. Thus, automated vocal analysis should soon be able to contribute to screening and diagnostic procedures for prodromal parkinsonian neurodegeneration in natural environments.

Charles University Prague 1st Faculty of Medicine Department of Neurology and Centre of Clinical Neuroscience Kateřinská 30 120 00 Prague 2 Czech Republic

Czech Technical University Prague Faculty of Electrical Engineering Department of Circuit Theory Technická 2 166 27 Prague 6 Czech Republic

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Kent RD, Kent JF, Weismer G, Duffy JR. What dysarthrias can tell us about the neural control of speech. J. Phonetics. 2000;28:273–302. doi: 10.1006/jpho.2000.0122. DOI

Graber S, Hertrich I, Daum I, Spieker S, Ackermann H. Speech perception deficits in Parkinson’s disease: Underestimation of time intervals compromises identification of durational phonetic contrasts. Brain Lang. 2002;82:65–74. doi: 10.1016/S0093-934X(02)00002-0. PubMed DOI

Ho AK, Bradshaw J, Iansek R, Alfredson R. Speech volume regulation in Parkinson’s disease: Effects of implicit cues and explicit instructions. Neuropsychologia. 1999;37:1453–1460. doi: 10.1016/S0028-3932(99)00067-6. PubMed DOI

Ho AK, Iansek R, Marigliani C, Bradshaw JL, Gates S. Speech impairment in a large sample of patients with Parkinson’s disease. Behav. Neurol. 1998;11:131–137. doi: 10.1155/1999/327643. PubMed DOI

Duffy, J. R. Motor Speech Disorders: Substrates, Differential Diagnosis and Management, 3rd ed., Mosby, St. Louis (2013).

Rusz J, et al. Quantitative assessment of motor speech abnormalities in idiopathic REM sleep behaviour disorder. Sleep Med. 2016;19:141–147. doi: 10.1016/j.sleep.2015.07.030. PubMed DOI

Postuma RB, Lang AE, Gagnon JF, Pelletier A, Montplaisir JY. How does Parkinsonism start? Prodromal Parkinsonism motor changes in idiopathic REM sleep behaviour disorder. Brain. 2012;135:1860–1870. doi: 10.1093/brain/aws093. PubMed DOI

Schenck CH, et al. Rapid eye movement sleep behaviour disorder: devising controlled active treatment studies for symptomatic and neuroprotective therapy-a consensus statement from the International Rapid Eye Movement Sleep Behaviour Disorder Study Group. Sleep Med. 2013;14:795–806. doi: 10.1016/j.sleep.2013.02.016. PubMed DOI PMC

Postuma RB, et al. Identifying prodromal Parkinson’s disease: Pre‐Motor disorders in Parkinson’s disease. Mov. Disord. 2012;27:617–626. doi: 10.1002/mds.24996. PubMed DOI

Darley FL, Aronson AE, Brown JR. Differential diagnostic patterns of dysarthria. J. Speech Lang. Hear. Res. 1969;12:47–57. PubMed

Sussman JE, Tjaden K. Perceptual measures of speech from individuals with Parkinson’s disease and multiple sclerosis: Intelligibility and beyond. J. Speech Lang. Hear. Res. 2012;55:1208–1219. doi: 10.1044/1092-4388(2011/11-0048). PubMed DOI PMC

Skodda, S., Grönheit, W., Mancinelli, N. & Schlegel, U. Progression of voice and speech impairment in the course of Parkinson’s disease: a longitudinal study. Parkinsons Dis.389195 (2013). PubMed PMC

Little MA, McSharry PE, Hunter EJ, Spielman J, Ramig LO. Suitability of dysphonia measurement for telemonitoring of Parkinson’s disease. IEEE T. Biomed. Eng. 2009;56:1015–1022. doi: 10.1109/TBME.2008.2005954. PubMed DOI PMC

Novotný M, Rusz J, Čmejla R, Růžička E. Automatic evaluation of articulatory disorders in Parkinson’s disease. IEEE/ACM T. Audio Speech Lang. Proces. 2014;22:1366–1378. doi: 10.1109/TASLP.2014.2329734. DOI

Stebbins GT, Goetz CG. Factor structure of the Unified Parkinson’s Disease Rating Scale: motor examination section. Mov. Disord. 1998;13:633–636. doi: 10.1002/mds.870130404. PubMed DOI

Boersma P. Praat, a system for doing phonetics by computer. Glot International. 2001;5:341–345.

Rosen K, et al. Automatic method of pause measurement for normal and dysarthric speech. Clin. Linguist. Phonet. 2010;24:141–154. doi: 10.3109/02699200903440983. PubMed DOI

International Telecommunication Union. Standardization Sector of ITU. ITU-T G.729, WTSC-96, Geneva, 1–39 (1996).

Rusz J, Čmejla R, Růžičková H, Růžička E. Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson’s disease. J. Acoust. Soc. Am. 2011;129:350–367. doi: 10.1121/1.3514381. PubMed DOI

Postuma RB, Gagnon JF, Bertrand JA, Marchand DG, Montplaisir JY. Parkinson risk in idiopathic REM sleep behavior disorder Preparing for neuroprotective trials. Neurology. 2015;84:1104–1113. doi: 10.1212/WNL.0000000000001364. PubMed DOI PMC

Benecke J, Rothwell C, Dick PJR, Day PL, Marsden CD. Disturbance of sequential movements in patients with Parkinson’s disease. Brain. 1987;110:361–379. doi: 10.1093/brain/110.2.361. PubMed DOI

Spencer KA, Rogers MA. Speech motor programming in hypokinetic and ataxic dysarthria. Brain Lang. 2005;94:347–366. doi: 10.1016/j.bandl.2005.01.008. PubMed DOI

Hammen VL, Yorkston KM. Speech and pause characteristics following speech rate reduction in hypokinetic dysarthria. J. Commun. Disord. 1996;29:429–445. doi: 10.1016/0021-9924(95)00037-2. PubMed DOI

Weismer, G. & McNeil, M. Articulatory characteristics of Parkinsonian dysarthria: Segmental and phrase-level timing, spirantization, and glottal-supraglottal coordination. The dysarthrias: Physiology, acoustics, perception, management, College-Hill Press, San Diego 101–130 (1984).

Romenets SR, et al. Rapid eye movement sleep behavior disorder and subtypes of Parkinson’s disease. Mov. Disord. 2012;27:996–1003. doi: 10.1002/mds.25086. PubMed DOI

Gong Y, et al. Clinical manifestations of Parkinson disease and the onset of rapid eye movement sleep behavior disorder. Sleep Med. 2014;15:647–653. doi: 10.1016/j.sleep.2013.12.021. PubMed DOI

Sapir S. Multiple factors are involved in the dysarthria associated with Parkinson’s disease: a review with implications for clinical practice and research. J. Speech Lang. Hear. Res. 2014;57:1330–1343. doi: 10.1044/2014_JSLHR-S-13-0039. PubMed DOI

Levelt WJM. Speaking: From Intention to Articulation. A Bradford Book. Cambridge (Massachusetts)–London (England): The MIT Press; 1989. pp. 1–545.

Skodda S, Schlegel U. Speech rate and rhythm in Parkinson’s disease. Mov. Disord. 2008;23:985–992. doi: 10.1002/mds.21996. PubMed DOI

Ramus F, Nespor M, Mehler J. Correlates of linguistic rhythm in the speech signal. Cognition. 1999;73:265–292. doi: 10.1016/S0010-0277(99)00058-X. PubMed DOI

Hertrich I, Ackermann H. Gender-specific vocal dysfunctions in Parkinson’s disease: electroglottographic and acoustic analyses. Ann. Oto. Rhinol. Laryn. 1995;104:197–202. doi: 10.1177/000348949510400304. PubMed DOI

de Lau LM, Breteler MM. Epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5:525–535. doi: 10.1016/S1474-4422(06)70471-9. PubMed DOI

Trotti LM. REM sleep behaviour disorder in older individuals. Drugs Aging. 2010;27:457–470. doi: 10.2165/11536260-000000000-00000. PubMed DOI PMC

Rolinski M, et al. Basal ganglia dysfunction in idiopathic REM sleep behaviour disorder parallels that in early Parkinson’s disease. Brain. 2016;139:2224–2234. doi: 10.1093/brain/aww124. PubMed DOI PMC

Berg D, et al. MDS research criteria for prodromal Parkinson’s disease. Mov Disord. 2015;30:1600–1611. doi: 10.1002/mds.26431. PubMed DOI

Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods. 2007;39:175–191. doi: 10.3758/BF03193146. PubMed DOI

Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J. Neurol. Neurosurg. Psychiatry. 1992;55:181–184. doi: 10.1136/jnnp.55.3.181. PubMed DOI PMC

American Academy of Sleep Medicine. International Classification of Sleep Disorders, Third Edition: Diagnostic and Coding Manual, Westchester, Illinois: American Academy of Sleep Medicine (2014).

Buskova, J., Ibarburu, V., Sonka, K. & Ruzicka, E. Screening for REM sleep behavior disorder in the general population. Sleep Med.24, 147 (2016). PubMed

Fischer E, Goberman AM. Voice onset time in Parkinson disease. J. Commun. Disord. 2010;43:21–34. doi: 10.1016/j.jcomdis.2009.07.004. PubMed DOI

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Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder

Distinctive speech signature in cerebellar and parkinsonian subtypes of multiple system atrophy

Accuracy of Rating Scales and Clinical Measures for Screening of Rapid Eye Movement Sleep Behavior Disorder and for Predicting Conversion to Parkinson's Disease and Other Synucleinopathies