AIM: To investigate the presence and relationship of temporal speech and gait parameters in patients with postural instability/gait disorder (PIGD) and tremor-dominant (TD) motor subtypes of Parkinson's disease (PD). METHODS: Speech samples and instrumented walkway system assessments were acquired from a total of 60 de-novo PD patients (40 in TD and 20 in PIGD subtype) and 40 matched healthy controls. Objective acoustic vocal assessment of seven distinct speech timing dimensions was related to instrumental gait measures including velocity, cadence, and stride length. RESULTS: Compared to controls, PIGD subtype showed greater consonant timing abnormalities by prolonged voice onset time (VOT) while also shorter stride length during both normal walking and dual task, while decreased velocity and cadence only during dual task. Speaking rate was faster in PIGD than TD subtype. In PIGD subtype, prolonged VOT correlated with slower gait velocity (r = -0.56, p = 0.01) and shorter stride length (r = -0.59, p = 0.008) during normal walking, whereas relationships were also found between decreased cadence in dual task and irregular alternating motion rates (r = -0.48, p = 0.04) and prolonged pauses (r = -0.50, p = 0.03). No correlation between speech and gait was detected in TD subtype. CONCLUSION: Our findings suggest that speech and gait rhythm disorder share similar underlying pathomechanisms specific for PIGD subtype.

Department of Anthropology and Human Genetics Faculty of Science Charles University Prague Czechia

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

Department of Neurology and ARTORG Center Inselspital Bern University Hospital University of Bern Bern Switzerland

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

Department of Radiology 1st Faculty of Medicine Charles University and General University Hospital Prague Czechia

Faculty of Biomedical Engineering Czech Technical University Prague Prague Czechia

Zobrazit více v PubMed

Poewe W, Seppi K, Tanner CM, et al. Parkinson Disease. Nat Rev Dis Primers. 2017;23:17013. PubMed

Rusz J, Hlavnička J, Novotný M, et al. Speech biomarkers in rapid eye movement sleep behavior disorder and Parkinson disease. Ann Neurol. 2021;90:62‐75. PubMed PMC

Del Din S, Yarnall AJ, Barber TR, et al. Continuous real‐world gait monitoring in idiopathic REM sleep behavior disorder. J Parkinsons Dis. 2020;10:283‐299. PubMed

Skodda S, Schlegel U. Speech rate and rhythm in Parkinson's disease. Mov Disord. 2008;23:985‐992. PubMed

Hlavnička J, Čmejla R, Tykalová T, Šonka K, Růžička E, Rusz J. Automated analysis of connected speech reveals early biomarkers of Parkinson's disease in patients with rapid eye movement sleep behaviour disorder. Sci Rep. 2017;7:12. PubMed PMC

Mirelman A, Bonato P, Camicioli R, et al. Gait impairments in Parkinson's disease. Lancet Neurol. 2019;18:697‐708. PubMed

Park HK, Yoo JY, Kwon M, et al. Gait freezing and speech disturbance in Parkinson's disease. Neurol Sci. 2014;35:357‐363. PubMed

Ricciardi L, Ebreo M, Graziosi A, et al. Speech and gait in Parkinson's disease: when rhythm matters. Parkinsonism Relat Disord. 2016;32:42‐47. PubMed

Mekyska J, Galaz Z, Kiska T, et al. Quantitative analysis of relationship between hypokinetic dysarthria and the freezing of gait in Parkinson's disease. Cognit Comput. 2018;10:1006‐1018. PubMed PMC

Moreau C, Ozsancak C, Blatt JL, Derambure P, Destee A, Defebvre L. Oral festination in Parkinson's disease: biomechanical analysis and correlation with festination and freezing of gait. Mov Disord. 2007;22:1503‐1506. PubMed

Cantiniaux S, Vaugoyeau M, Robert D, et al. Comparative analysis of gait and speech in Parkinson's disease: hypokinetic or dysrhythmic disorders? J Neurol Neurosurg Psychiatry. 2010;81:177‐184. PubMed

Curtze C, Nutt JG, Carlson‐Kuhta P, Mancini M, Horak FB. Levodopa is a double‐edged sword for balance and gait in people with Parkinson's disease. Mov Disord. 2015;30:1361‐1370. PubMed PMC

Rusz J, Tykalova T, Novotny M, et al. Defining speech subtypes in de novo Parkinson disease: response to long‐term levodopa therapy. Neurology. 2021;97:e2124‐e2135. PubMed

Fereshtehnejad SM, Zeighami Y, Dagher A, Postuma RB. Clinical criteria for subtyping Parkinson's disease: biomarkers and longitudinal progression. Brain. 2017;140:1959‐1976. PubMed

Thenganatt MA, Jankovic J. Parkinson Disease Subtypes. JAMA Neurol. 2014;71:499‐504. PubMed

Tykalová T, Rusz J, Švihlík J, Bancone S, Spezia A, Pellecchia MT. Speech disorder and vocal tremor in postural instability/gait difficulty and tremor dominant subtypes of Parkinson's disease. J Neural Transm. 2020;127(9):1295‐1304. PubMed

Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord. 2015;30:1591‐1601. PubMed

Dušek P, Bezdíček O, Brožová H, et al. Clinical characteristics of newly diagnosed Parkinson's disease patients included in the longitudinal BIO‐PD study. Cesk Slov Neurol Neurochir. 2020;83(116):633‐639.

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. PubMed

Kopecek M, Stepankova H, Lukavsky J, Ripova D, Nikolai T, Bezdicek O. Montreal cognitive assessment (MoCA): normative data for old and very old Czech adults. Appl Neuropsychol Adult. 2017;24:23‐29. PubMed

Stebbins GT, Goetz CG, Burn DJ, Jankovic J, Khoo TK, Tilley BC. How to identify tremor dominant and postural instability/gait difficulty groups with the movement disorder society unified Parkinson's disease rating scale: comparison with the unified Parkinson's disease rating scale. Mov Disord. 2013;28:668‐670. PubMed

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. PubMed

Hlavnicka J. Automated Analysis of Speech disorders in neurodegenerative diseases. PhD thesis, Faculty of Electrical Engineering, Czech Technical University, Prague, Czechia, 2018.

Rusz J, Hlavnička J, Čmejla R, Růžička E. Automatic evaluation of speech rhythm instability and acceleration in Dysarthrias associated with basal ganglia dysfunction. Front Bioeng Biotechnol. 2015;3:104. PubMed PMC

Faul F, Erdfelder E, Lang AG, 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. PubMed

Herman T, Weiss A, Brozgol M, Giladi N, Hausdorff JM. Gait and balance in Parkinson's disease subtypes: objective measures and classification considerations. J Neurol. 2014;261:2401‐2410. PubMed

Kent R, Kim Y. Toward an acoustic typology of motor speech disorders. Clin Linquist Phonetics. 2003;17:427‐445. PubMed

Skodda S, Flasskamp A, Schlegel U. Instability of syllable repetition as a model for impaired motor processing: is Parkinson's disease a "rhythm disorder"? J Neural Transm. 2010;117:605‐612. PubMed

Arie L, Herman T, Shema‐Shiratzky S, Giladi N, Hausdorff JM. Do cognition and other non‐motor symptoms decline similarly among patients with Parkinson's disease motor subtypes? Findings from a 5‐year prospective study. J Neurol. 2017;264:2149‐2157. PubMed

Alves G, Larsen JP, Emre M, Wentzel‐Larsen T, Aarsland D. Changes in motor subtype and risk for incident dementia in Parkinson's disease. Mov Disord. 2006;21:1123‐1130. PubMed

Rosenberg‐Katz K, Herman T, Jacob Y, Giladi N, Hendler T, Hausdorff JM. Gray matter atrophy distinguishes between Parkinson disease motor subtypes. Neurology. 2013;80:1467‐1484. PubMed PMC

Richardson JD, Fillmore P, Rorden C, Lapointe LL, Fridriksson J. Reestablishing Broca's initial findings. Brain Lang. 2012;123:125‐130. PubMed PMC

Delval A, Rambour M, Tard C, et al. Freezing/festination during motor tasks in early‐stage Parkinson's disease: a prospective study. Mov Disord. 2016;31:1837‐1845. PubMed

Tykalová T, Rusz J, Čmejla R, et al. Effect of dopaminergic medication on speech dysfluency in Parkinson's disease: a longitudinal study. J Neural Transm. 2015;122:1135‐1142. PubMed

Illes J, Metter EJ, Hanso WR, Iritani S. Parkinson's disease: acoustic and linguistic considerations. Brain Lang. 1988;33:146‐160. PubMed

Skodda S. Aspects of speech rate and regularity in Parkinson's disease. J Neurol Sci. 2011;310:231‐236. PubMed

Barbagallo G, Caligiuri ME, Arabia G, et al. Structural connectivity differences in motor network between tremor‐dominant and nontremor Parkinson's disease. Hum Brain Mapp. 2017;38:4716‐4729. PubMed PMC

Boonstra JT, Michielse S, Temel Y, Hoogland G, Jahanshahi A. Neuroimaging detectable differences between Parkinson's disease motor subtypes: a systematic review. Mov Disord Clin Pract. 2020;8:175‐192. PubMed PMC

Basaia S, Agosta F, Francia A, et al. Cerebro‐cerebellar motor networks in clinical subtypes of Parkinson's disease. NPJ Parkinsons Dis. 2022;8(1):113. PubMed PMC

Rusz J, Vaneckova M, Benova B, et al. Brain volumetric correlates of dysarthria in multiple sclerosis. Brain Lang. 2019;194:58‐64. PubMed

Spencer KA, Rogers MA. Speech motor programming in hypokinetic and ataxic dysarthria. Brain Lang. 2005;94:347‐366. PubMed

Riecker A, Mathiak K, Wildgruber D, et al. fMRI reveals two distinct cerebral networks subserving speech motor control. Neurology. 2005;64:700‐706. PubMed

Lee JW, Song YS, Kim H, Ku BD, Lee WW. Alteration of tremor dominant and postural instability gait difficulty subtypes during the progression of Parkinson's disease: analysis of the PPMI cohort. Front Neurol. 2019;7(10):471. PubMed PMC

Automated analysis of spoken language differentiates multiple system atrophy from Parkinson's disease

Acoustic assessment in mandarin-speaking Parkinson's disease patients and disease progression monitoring and brain impairment within the speech subsystem