Q88483990
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This study presents an automated, objective method for eyelid movement assessment in de-novo Parkinson's disease(PD) using a one-dimensional camera setup during monologue. These measurements were related to Dopamine Transporter Single Photon Emission Tomography and clinical scores. State-of-the-art computer-vision technologies and deep-learning neural networks were utilized to measure fourteen eyelid movement markers describing blinking and eyelid kinematics. Video-recordings were collected from a total of 120 de-novo patients with PD and 55 healthy controls. Abnormal blinking was present in 38% of PD, indicated by a reduced blink rate (p < 0.001), an increased inter-blink interval (p < 0.001), and an increased rigidity of the palpebral aperture (p < 0.001). The classification experiment reached an area under the curve of 0.81 on a blinded test set. The blink rate correlated with the loss of nigral dopaminergic neurons (r = 0.35, p < 0.001). These findings suggest eyelid movement markers as strong reflections of striatal dopaminergic activity levels, underscoring the method's potential as a reliable early PD biomarker.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Research on the possible influence of lateralised basal ganglia dysfunction on speech in Parkinson's disease is scarce. This study aimed to compare speech in de-novo, drug-naive patients with Parkinson's disease (PD) with asymmetric nigral dopaminergic dysfunction, predominantly in either the right or left hemisphere. METHODS: Acoustic analyses of reading passages were performed. Asymmetry of nigral dysfunction was defined using dopamine transporter-single-photon emission CT (DAT-SPECT). RESULTS: From a total of 135 de novo patients with PD assessed, 47 patients had a lower right and 36 lower left DAT availability in putamen based on DAT-SPECT. Patients with PD with lower left DAT availability had higher dysarthria severity via composite dysarthria index compared with patients with lower right DAT availability (p=0.01). CONCLUSION: Our data support the crucial role of DAT availability in the left putamen in speech. This finding might provide important clues for managing speech following deep brain stimulation.
- MeSH
- bazální ganglia * patofyziologie diagnostické zobrazování MeSH
- dysartrie patofyziologie diagnostické zobrazování etiologie MeSH
- funkční lateralita * fyziologie MeSH
- jednofotonová emisní výpočetní tomografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- Parkinsonova nemoc * patofyziologie diagnostické zobrazování komplikace MeSH
- proteiny přenášející dopamin přes plazmatickou membránu metabolismus MeSH
- putamen diagnostické zobrazování metabolismus patofyziologie MeSH
- řeč * fyziologie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The effect of dopaminergic medication on speech has rarely been examined in early-stage Parkinson's disease (PD) and the respective literature is inconclusive and limited by inappropriate design with lack of PD control group. The study aims to examine the short-term effect of dopaminergic medication on speech in PD using patients with good motor responsiveness to levodopa challenge compared to a control group of PD patients with poor motor responsiveness. A total of 60 early-stage PD patients were investigated before (OFF) and after (ON) acute levodopa challenge and compared to 30 age-matched healthy controls. PD patients were categorised into two clinical subgroups (PD responders vs. PD nonresponders) according to the comparison of their motor performance based on movement disorder society-unified Parkinson's disease rating scale, part III. Seven distinctive parameters of hypokinetic dysarthria were examined using quantitative acoustic analysis. We observed increased monopitch (p > 0.01), aggravated monoloudness (p > 0.05) and longer duration of stop consonants (p > 0.05) in PD compared to healthy controls, confirming the presence of hypokinetic dysarthria in early PD. No speech alterations from OFF to ON state were revealed in any of the two PD groups and speech dimensions investigated including monopitch, monoloudness, imprecise consonants, harsh voice, slow sequential motion rates, articulation rate, or inappropriate silences, although a subgroup of PD responders manifested obvious improvement in motor function after levodopa intake (p > 0.001). Since the short-term usage of levodopa does not easily affect voice and speech performance in PD, speech assessment may provide a medication state-independent motor biomarker of PD.
- Publikační typ
- časopisecké články MeSH
BACKGROUND AND OBJECTIVES: Patterns of speech disorder in Parkinson disease (PD), which are highly variable across individual patients, have not been systematically studied. Our aim was to identify speech subtypes in treatment-naive patients with PD and to examine their response to long-term dopaminergic therapy. METHODS: We recorded speech data from a total of 111 participants with de novo PD; 83 of the participants completed the 12-month follow-up (69 patients with PD on stable dopaminergic medication and 14 untreated controls with PD). Unsupervised k-means cluster analysis was performed on 8 distinctive parameters of hypokinetic dysarthria examined with quantitative acoustic analysis. RESULTS: Three distinct speech subtypes with similar prevalence, symptom duration, and motor severity were detected: prosodic, phonatory-prosodic, and articulatory-prosodic. Besides monopitch and monoloudness, which were common in each subtype, speech impairment was more severe in the phonatory-prosodic subtype with predominant dysphonia and the articulatory-prosodic subtype with predominant imprecise consonant articulation than in the prosodic subtype. Clinically, the prosodic subtype was characterized by a prevalence of women and younger age, while articulatory-prosodic subtype was characterized by the prevalence of men, older age, greater severity of axial gait symptoms, and poorer cognitive performance. The phonatory-prosodic subtype clinically represented intermediate status in age with mostly men and preserved cognitive performance. While speech of untreated controls with PD deteriorated over 1 year (p = 0.02), long-term dopaminergic medication maintained stable speech impairment severity in the prosodic and articulatory-prosodic subtypes and improved speech performance in patients with the phonatory-prosodic subtype (p = 0.002). DISCUSSION: Distinct speech phenotypes in de novo PD reflect divergent underlying mechanisms and allow prediction of response of speech impairment to levodopa therapy. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, in patients with newly diagnosed PD with speech impairment, speech phenotype is associated with levodopa responsiveness.
Evaluation of precision of consonant articulation is commonly used metric in assessment of pathological speech. However, up to date most of the research on consonant characteristics was performed on English while there are obvious language-specific differences. The aim of the current study was therefore to investigate the patterns of consonant articulation in Czech across 6 stop consonants with respect to age and gender. The database used consisted of 30 female and 30 male healthy participants (mean age 51.0 years, standard deviation 18.0 years and range from 20 to 79 years). Four acoustic variables including voice onset time (VOT), VOT ratio and two spectral moments were analyzed. The Czech plosives /p/, /t/ and /k/ were found to be characterized by short voicing lag (average VOT ranged from 14 to 32 ms) while voiced plosives /b/, /d/ and /g/ by long voicing lead (average VOT ranged from -79 to -91 ms). Furthermore, we observed significantly longer duration of both VOT (p < 0.05) and VOT ratio (p < 0.01) of voiceless plosives in female compared to male gender. Finally, we revealed a significant negative correlation between age and duration of voiceless (r = -0.36, p < 0.05) as well as voiced VOT (r = -0.45, p = 0.01) in female but not in male participants.
Evaluation of precision of consonant articulation is commonly used metric in assessment of pathological speech. However, up to date most of the research on consonant characteristics was performed on English while there are obvious language-specific differences. The aim of the current study was therefore to investigate the patterns of consonant articulation in Czech across 6 stop consonants with respect to age and gender. The database used consisted of 30 female and 30 male healthy participants (mean age 51.0 years, standard deviation 18.0 years and range from 20 to 79 years). Four acoustic variables including voice onset time (VOT), VOT ratio and two spectral moments were analyzed. The Czech plosives /p/, /t/ and /k/ were found to be characterized by short voicing lag (average VOT ranged from 14 to 32 ms) while voiced plosives /b/, /d/ and /g/ by long voicing lead (average VOT ranged from -79 to -91 ms). Furthermore, we observed significantly longer duration of both VOT (p < 0.05) and VOT ratio (p < 0.01) of voiceless plosives in female compared to male gender. Finally, we revealed a significant negative correlation between age and duration of voiceless (r = -0.36, p < 0.05) as well as voiced VOT (r = -0.45, p = 0.01) in female but not in male participants.
- Klíčová slova
- akustická analýza,
- MeSH
- hlas MeSH
- kvalita hlasu * MeSH
- lidé MeSH
- poruchy artikulace MeSH
- věkové faktory MeSH
- výzkum MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Although dysarthria is a common pattern in multiple sclerosis (MS), the contribution of specific brain areas to key factors of dysarthria remains unknown. Speech data were acquired from 123 MS patients with Expanded Disability Status Scale (EDSS) ranging from 1 to 6.5 and 60 matched healthy controls. Results of computerized acoustic analyses of subtests on spastic and ataxic aspects of dysarthria were correlated with MRI-based brain volume measurements. Slow articulation rate during reading was associated with bilateral white and grey matter loss whereas reduced maximum speed during oral diadochokinesis was related to greater cerebellar involvement. Articulation rate showed similar correlation to whole brain atrophy (r = 0.46, p < 0.001) as the standard clinical scales such as EDSS (r = -0.45, p < 0.001). Our results support the critical role of the pyramidal tract and cerebellum in the modification of motor speech timing in MS.
- MeSH
- atrofie diagnostické zobrazování MeSH
- čtení MeSH
- dospělí MeSH
- dysartrie diagnostické zobrazování etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozek diagnostické zobrazování patologie MeSH
- roztroušená skleróza komplikace diagnostické zobrazování MeSH
- šedá hmota diagnostické zobrazování patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Although smartphone technology provides new opportunities for the recording of speech samples in everyday life, its ability to capture prodromal speech impairment in persons with a high risk of developing Parkinson's disease (PD) has never been investigated. Speech data were acquired through a smartphone as well as a professional microphone with a linear frequency response from 50 participants with a rapid eye movement sleep behavior disorder that are at a high risk of developing PD and related neurodegenerative disorders. Additionally, recordings of 30 newly diagnosed, untreated PD patients and 30 healthy participants were evaluated. Acoustic assessment of 11 speech dimensions representing the key aspects of hypokinetic dysarthria in the early stages of PD was performed. Smartphone allowed the detection of speech abnormalities in participants with a high risk of developing PD. Acoustic measurements related to fundamental frequency variability, duration of pause intervals, and rate of speech timing extracted from spontaneous speech were sufficiently sensitive to significantly separate groups (area under curve of 0.85 between PD and controls) and showed very strong correlation and reliability between the professional microphone and the smartphone. Speech-based biomarkers collected through smartphones may have the potential to revolutionize the diagnostic process in neurodegenerative diseases and improve stratification for future neuroprotective therapy in PD.
- MeSH
- chytrý telefon * MeSH
- dysartrie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- Parkinsonova nemoc * diagnóza komplikace MeSH
- poruchy řeči * diagnóza etiologie MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- software pro rozpoznávání řeči MeSH
- zdraví dobrovolníci pro lékařské studie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
Background: Although increased nasality can originate from basal ganglia dysfunction, data regarding hypernasality in Parkinson's disease (PD) and Huntington's disease (HD) are very sparse. The aim of the current study was to analyze acoustic and perceptual correlates of velopharyngeal seal closure in 37 PD and 37 HD participants in comparison to 37 healthy control speakers. Methods: Acoustical analysis was based on sustained phonation of the vowel /i/ and perceptual analysis was based on monologue. Perceptual analysis was performed by 10 raters using The Great Ormond Street Speech Assessment '98. Acoustic parameters related to changes in a 1/3-octave band centered on 1 kHz were proposed to reflect nasality level and behavior through utterance. Results: Perceptual analysis showed the occurrence of mild to moderate hypernasality in 65% of PD, 89% of HD and 22% of control speakers. Based on acoustic analyses, 27% of PD, 54% of HD and 19% of control speakers showed an increased occurrence of hypernasality. In addition, 78% of HD patients demonstrated a high occurrence of intermittent hypernasality. Further results indicated relationships between the acoustic parameter representing fluctuation of nasality and perceptual assessment (r = 0.51, p < 0.001) as well as the Unified Huntington Disease Rating Scale chorea composite subscore (r = 0.42, p = 0.01). Conclusions: In conclusion the acoustic assessment showed that abnormal nasality was not a common feature of PD, whereas patients with HD manifested intermittent hypernasality associated with chorea.
- MeSH
- akustika řeči MeSH
- Huntingtonova nemoc diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci bazálních ganglií diagnóza MeSH
- Parkinsonova nemoc diagnóza MeSH
- poruchy artikulace * MeSH
- senioři MeSH
- testy artikulace MeSH
- velofaryngální nedostatečnost diagnóza MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
- srovnávací studie MeSH
Although speech disorder is frequently an early and prominent clinical feature of Parkinson's disease (PD) as well as atypical parkinsonian syndromes (APS) such as progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), there is a lack of objective and quantitative evidence to verify whether any specific speech characteristics allow differentiation between PD, PSP and MSA. Speech samples were acquired from 77 subjects including 15 PD, 12 PSP, 13 MSA and 37 healthy controls. The accurate differential diagnosis of dysarthria subtypes was based on the quantitative acoustic analysis of 16 speech dimensions. Dysarthria was uniformly present in all parkinsonian patients but was more severe in PSP and MSA than in PD. Whilst PD speakers manifested pure hypokinetic dysarthria, ataxic components were more affected in MSA whilst PSP subjects demonstrated severe deficits in hypokinetic and spastic elements of dysarthria. Dysarthria in PSP was dominated by increased dysfluency, decreased slow rate, inappropriate silences, deficits in vowel articulation and harsh voice quality whereas MSA by pitch fluctuations, excess intensity variations, prolonged phonemes, vocal tremor and strained-strangled voice quality. Objective speech measurements were able to discriminate between APS and PD with 95% accuracy and between PSP and MSA with 75% accuracy. Dysarthria severity in APS was related to overall disease severity (r = 0.54, p = 0.006). Dysarthria with various combinations of hypokinetic, spastic and ataxic components reflects differing pathophysiology in PD, PSP and MSA. Thus, motor speech examination may provide useful information in the evaluation of these diseases with similar manifestations.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- multisystémová atrofie komplikace MeSH
- Parkinsonova nemoc komplikace MeSH
- poruchy řeči klasifikace diagnóza etiologie MeSH
- progresivní supranukleární obrna komplikace MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
