BACKGROUND AND OBJECTIVE: An aging society requires easy-to-use approaches for diagnosis and monitoring of neurodegenerative disorders, such as Parkinson's disease (PD), so that clinicians can effectively adjust a treatment policy and improve patients' quality of life. Current methods of PD diagnosis and monitoring usually require the patients to come to a hospital, where they undergo several neurological and neuropsychological examinations. These examinations are usually time-consuming, expensive, and performed just a few times per year. Hence, this study explores the possibility of fusing computerized analysis of hypomimia and hypokinetic dysarthria (two motor symptoms manifested in the majority of PD patients) with the goal of proposing a new methodology of PD diagnosis that could be easily integrated into mHealth systems. METHODS: We enrolled 73 PD patients and 46 age- and gender-matched healthy controls, who performed several speech/voice tasks while recorded by a microphone and a camera. Acoustic signals were parametrized in the fields of phonation, articulation and prosody. Video recordings of a face were analyzed in terms of facial landmarks movement. Both modalities were consequently modeled by the XGBoost algorithm. RESULTS: The acoustic analysis enabled diagnosis of PD with 77% balanced accuracy, while in the case of the facial analysis, we observed 81% balanced accuracy. The fusion of both modalities increased the balanced accuracy to 83% (88% sensitivity and 78% specificity). The most informative speech exercise in the multimodality system turned out to be a tongue twister. Additionally, we identified muscle movements that are characteristic of hypomimia. CONCLUSIONS: The introduced methodology, which is based on the myriad of speech exercises likewise audio and video modality, allows for the detection of PD with an accuracy of up to 83%. The speech exercise - tongue twisters occurred to be the most valuable from the clinical point of view. Additionally, the clinical interpretation of the created models is illustrated. The presented computer-supported methodology could serve as an extra tool for neurologists in PD detection and the proposed potential solution of mHealth will facilitate the patient's and doctor's life.

• Klíčová slova
• Acoustic analysis, Facial analysis, Hypokinetic dysarthria, Hypomimia, Machine learning, Parkinson's disease,
• Publikační typ
• časopisecké články MeSH

Hypokinetic dysarthria (HD) and freezing of gait (FOG) are both axial symptoms that occur in patients with Parkinson's disease (PD). It is assumed they have some common pathophysiological mechanisms and therefore that speech disorders in PD can predict FOG deficits within the horizon of some years. The aim of this study is to employ a complex quantitative analysis of the phonation, articulation and prosody in PD patients in order to identify the relationship between HD and FOG, and establish a mathematical model that would predict FOG deficits using acoustic analysis at baseline. We enrolled 75 PD patients who were assessed by 6 clinical scales including the Freezing of Gait Questionnaire (FOG-Q). We subsequently extracted 19 acoustic measures quantifying speech disorders in the fields of phonation, articulation and prosody. To identify the relationship between HD and FOG, we performed a partial correlation analysis. Finally, based on the selected acoustic measures, we trained regression models to predict the change in FOG during a 2-year follow-up. We identified significant correlations between FOG-Q scores and the acoustic measures based on formant frequencies (quantifying the movement of the tongue and jaw) and speech rate. Using the regression models, we were able to predict a change in particular FOG-Q scores with an error of between 7.4 and 17.0 %. This study is suggesting that FOG in patients with PD is mainly linked to improper articulation, a disturbed speech rate and to intelligibility. We have also proved that the acoustic analysis of HD at the baseline can be used as a predictor of the FOG deficit during 2 years of follow-up. This knowledge enables researchers to introduce new cognitive systems that predict gait difficulties in PD patients.

• Klíčová slova
• Acoustic analysis, Freezing of gait, Hypokinetic dysarthria, Parkinson’s disease, Quantitative analysis,
• Publikační typ
• časopisecké články MeSH

Visual processing difficulties are often present in Alzheimer's disease (AD), even in its pre-dementia phase (i.e. in mild cognitive impairment, MCI). The default mode network (DMN) modulates the brain connectivity depending on the specific cognitive demand, including visual processes. The aim of the present study was to analyze specific changes in connectivity of the posterior DMN node (i.e. the posterior cingulate cortex and precuneus, PCC/P) associated with visual processing in 17 MCI patients and 15 AD patients as compared to 18 healthy controls (HC) using functional magnetic resonance imaging. We used psychophysiological interaction (PPI) analysis to detect specific alterations in PCC connectivity associated with visual processing while controlling for brain atrophy. In the HC group, we observed physiological changes in PCC connectivity in ventral visual stream areas and with PCC/P during the visual task, reflecting the successful involvement of these regions in visual processing. In the MCI group, the PCC connectivity changes were disturbed and remained significant only with the anterior precuneus. In between-group comparison, we observed significant PPI effects in the right superior temporal gyrus in both MCI and AD as compared to HC. This change in connectivity may reflect ineffective "compensatory" mechanism present in the early pre-dementia stages of AD or abnormal modulation of brain connectivity due to the disease pathology. With the disease progression, these changes become more evident but less efficient in terms of compensation. This approach can separate the MCI from HC with 77% sensitivity and 89% specificity.

• Klíčová slova
• Dementia, Posterior cingulate, Precuneus, Psychophysiological interactions, Visual pathways, fMRI,
• MeSH
• Alzheimerova nemoc komplikace   MeSH
• kognitivní dysfunkce diagnostické zobrazování   etiologie   patologie   MeSH
• kyslík krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• modely neurologické MeSH
• mozek patologie   MeSH
• nervové dráhy diagnostické zobrazování   patofyziologie   MeSH
• počítačové zpracování obrazu MeSH
• psychofyzika MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stárnutí * MeSH
• světelná stimulace MeSH
• zraková percepce fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• kyslík MeSH

While previous studies suggested that perfusion abnormalities in Parkinson's disease (PD) are driven by dementia, our study aimed to identify perfusion underpinning of cognitive alteration in non-demented PD patients. Cerebral blood flow was measured using arterial spin labelling (ASL) in 28 PD patients (age 65 years ± 9.9 SD) and 16 age-matched healthy controls (HC) (age 65 years ± 7.8 SD), who also underwent neurological and cognitive testing. The 3D pseudocontinuous ASL and T2-weighted scans from 22 PD patients and 16 HC were analysed in a voxel-wise manner using SPM8 software. Associations between the ASL values in volumes of interest (VOIs) and behavioural and cognitive measures were assessed by Spearman correlation analysis. Posterior cortical hypoperfusion was found in PD patients compared to HC in the left supramarginal gyrus/superior temporal gyrus (VOI1) and left posterior cingulate/precuneus (VOI2). Positive correlation was revealed between perfusion in the VOI2 and Addenbrooke's Cognitive Examination Revised (ACE-R) scores after filtering out the effect of age, levodopa equivalent dose (LED), and total intracranial volume (TIV) (R = 0.51, p = 0.04). Conversely, negative correlation between VOI1 and ACE-R was detected (R = -0.62, p = 0.01) after regressing out the effects of motor impairment, age, LED, and TIV. In non-demented subjects with PD, blood flow abnormalities in precuneus/posterior cingulate were linked to the level of motor impairment and global cognitive performance. Oppositely, perfusion abnormalities in supramarginal gyrus might serve as a compensatory mechanism for brain degeneration and decreased cognitive performance.

• Klíčová slova
• Arterial spin labelling, Cognitive performance, Parkinson’s disease, Perfusion,
• MeSH
• cerebrovaskulární poruchy diagnostické zobrazování   patofyziologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• mozková kůra diagnostické zobrazování   patofyziologie   MeSH
• mozkový krevní oběh fyziologie   MeSH
• Parkinsonova nemoc diagnostické zobrazování   patofyziologie   psychologie   MeSH
• počítačové zpracování obrazu MeSH
• pohybová aktivita MeSH
• průřezové studie MeSH
• senioři MeSH
• spinové značení MeSH
• stupeň závažnosti nemoci MeSH
• zobrazování trojrozměrné MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• spinové značení MeSH