BACKGROUND: Impairments of olfactory and speech function are likely early prodromal symptoms of α-synucleinopathy. OBJECTIVE: The aim of this study is to assess whether dysprosody is present in isolated rapid eye movement sleep behavior disorder (iRBD) with hyposmia/anosmia and a normal nigrostriatal system. METHODS: Pitch variability during speech was investigated in 17 iRBD subjects with normal olfactory function (iRBD-NOF), 30 iRBD subjects with abnormal olfactory function (iRBD-AOF), and 50 healthy controls. iRBD subjects were evaluated using the University of Pennsylvania Smell Identification Test and [123I]-2ß-carbomethoxy-3ß-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane dopamine transporter single-photon emission computed tomography (DAT-SPECT). All iRBD subjects completed the 24-month follow-up with DAT-SPECT, speech, and olfactory testing. RESULTS: At baseline, only iRBD-AOF showed monopitch when compared to iRBD-NOF (P = 0.04) and controls (P = 0.03), with no difference between iRBD-NOF and controls (P = 1). At follow-up, dysprosody progressed only in iRBD-AOF with abnormal DAT-SPECT (P = 0.03). CONCLUSION: Prosody is impaired in hyposmic but not in normosmic iRBD subjects before the nigrostriatal dopaminergic transmission is affected (Braak stage 2). © 2021 International Parkinson and Movement Disorder Society.

Department of Circuit Theory Faculty of Electrical Engineering Czech Technical University Prague Prague Czech Republic

Department of Neurology and Centre of Clinical Neuroscience 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

Department of Neurology Philipps University Marburg Marburg Germany

Institute of Nuclear Medicine 1st Faculty of Medicine Charles University and General University Hospital Prague Czechia

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Postuma RB, Iranzo A, Hu M, et al. Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain 2019;142:744-759.

Miglis MG, Adler CH, Antelmi E, et al. Biomarkers of conversion to α-synucleinopathy in isolated rapid-eye-movement sleep behaviour disorder. Lancet Neurol 2021;20:671-684.

Rusz J, Hlavnicka J, Tykalova T, et al. Smartphone allows capture of speech abnormalities associated with high risk of developing Parkinson's disease. IEEE Trans Neural Syst Rehabil Eng 2018;26:1495-1507.

Rusz J, Hlavnicka J, Novotny M, et al. Speech biomarkers in rapid eye movement sleep behaviour disorder and Parkinson's disease. Ann Neurol 2021;90:62-75.

Barber TR, Lawton M, Rolinski M, et al. Prodromal parkinsonism and neurodegenerative risk stratification in REM sleep behavior disorder. Sleep 2017;40(8):zsx071

Fereshtehnejad SM, Yao C, Pelletier A, Montplaisir JY, Gagnon JF, Postuma RB. Evolution of prodromal Parkinson's disease and dementia with Lewy bodies: a prospective study. Brain 2019;142:2051-2067.

Dusek P, Ibarburu V, Bezdicek O, et al. Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder. Sci Rep 2019;9:15463

Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson's disease. Neurobiol Aging 2003;24:197-211.

American Academy of Sleep Medicine. International Classification of Sleep Disorders, Third Edition: Diagnostic and Coding Manual. Westchester, IL: American Academy of Sleep Medicine; 2014.

Doty RL, Shaman P, Kimmelman CP, Dann MS. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 1984;94:176-178.

Goetz CG, Fahn S, Martinez-Martin P, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord 2007;22:41-47.

Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53:695-699.

Visser M, Marinus J, Stiggelbout A, Van Hilten JJV. Assessment of autonomic dysfuntion in Parkinson's disease: the SCOPA-AUT. Mov Disord 2004;19:1306-1312.

Darcourt J, Booij J, Tatsch K, et al. EANM procedure guidelines for brain neurotransmission SPECT using (123)I-labelled dopamine transporter ligands, version 2. Eur J Nucl Med Mol Imaging 2010;37:443-450.

Calvini P, Rodriguez G, Inguglia F, Mignone A, Guerra UP, Nobili F. The basal ganglia matching tools package for striatal uptake semi-quantification: description and validation. Eur J Nucl Med Mol Imaging 2007;34:1240-1253.

Rusz J, Tykalova T, Ramig LO, Tripoliti E. Guidelines for speech recording and acoustic analyses in dysarthrias of movement disorders. Mov Disord 2021;36:803-814.

Hlavnicka J, Cmejla R, Klempir J, Ruzicka E, Rusz J. Acoustic tracking of pitch, modal and subharmonic vibrations of vocal folds in Parkinson's disease and Parkinsonism. IEEE Access 2019;7:150339-150354.

Hlavnicka J. Automated analysis of speech disorders in neurodegenerative diseases. PhD Thesis, Faculty of Electrical Engineering, Czech Technical University, Prague, Czechia 2018.

Schulz GM, Varga M, Jeffires K, Ludlow CL, Braun AR. Functional neuroanatomy of human vocalization: an H215O PET study. Cereb Cortex 2005;15:1835-1847.

Davis PJ, Zhang SP, Winkworth A, Bandler R. Neural control of vocalization: respiratory and emotional influences. J Voice 1996;10:23-38.

Zhang SP, Bandler R, Davis PJ. Brain stem integration of vocalization: role of the nucleus retroambigualis. J Neurophysiol 1995;74:2500-2512.

Rusz J, Tykalova T, Novotny M, et al. Defining speech subtypes in de-novo Parkinson's disease: response to long-term levodopa therapy. Neurology 2021;97:e2124-e2135.

Horsager J, Andersen KB, Knudsen K, et al. Brain-first versus body-first Parkinson's disease: a multimodal imaging case-control study. Brain 2020;143:3077-3088.

Articulatory undershoot of vowels in isolated REM sleep behavior disorder and early Parkinson's disease