Nejvíce citovaný článek - PubMed ID 36732902
Speech biomarkers in Huntington's disease: A cross-sectional study in pre-symptomatic, prodromal and early manifest stages
Speech abnormalities in Parkinson's disease (PD) are heterogeneous and often considered resistant to levodopa. However, human hearing may miss subtle treatment-related speech changes. Digital speech biomarkers offer a sensitive alternative to measure such changes objectively. Speech was recorded in 51 PD patients during ON and OFF medication states and compared to 43 healthy controls matched for language and gender. Acute levodopa effects were significant in prosodic (F0 standard deviation, p = 0.03, effect size = 0.47), respiratory (intensity slope, p = 0.02, effect size = 0.49), and spectral domains (LTAS mean, p = 0.01, effect size = 0.35). Stepwise backward regression identified 8 biomarkers reflecting hypokinetic symptoms, 6 for dyskinetic symptoms, and 7 for medication-state transitions. Hypokinetic compound score correlated strongly with MDS-UPDRS-III changes (r = 0.70; MAE = 6.06/92), and the dyskinetic compound score with dyskinesia ratings (r = 0.50; MAE = 1.81/12). Medication-state transitions were detected with AUC = 0.86. This study highlights the potential of digital speech biomarkers to objectively measure levodopa-induced changes in PD symptoms and medication states.
- Publikační typ
- časopisecké články MeSH
Head tremor is a common symptom in both essential tremor (ET) and cervical dystonia (CD). Distinguishing between these two conditions can be challenging in clinical practice, particularly when head tremor is the dominant feature. Our goal was to explore the potential of speech assessment in recognizing the mechanisms of head tremor in patients with ET and CD. Objective acoustic vocal assessments of oral diadochokinesis, phonatory stability, vocal tremor, and speech timing were performed. Of the 93 patients assessed, 39 had cervical dystonia (CD) with head tremor, 38 had ET with head tremor (ET-HT), and 16 had ET with no head tremor (ET-nHT). Compared to both CD and ET-nHT, ET-HT showed irregular sequential motion rate, excessive pitch fluctuations, increased noise, and higher extent of vocal vibrato. Compared to CD, ET-HT also demonstrated slower sequential motion rate, prolonged pauses, and a slower articulation rate. Additionally, ET-HT had more pronounced vocal tremolo compared to ET-nHT. Speech assessment provided discrimination between the CD and ET-HT groups with an area under curve of 0.80. This study underscores the promising potential of speech analysis in recognizing mechanisms of head tremor in patients with ET or CD, revealing more severe and distinct speech impairments in ET-HT patients compared to those with CD.
- Klíčová slova
- Acoustic analysis, Cervical dystonia, Dysarthria, Essential tremor, Speech disorder,
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Dysarthria, a motor speech disorder caused by muscle weakness or paralysis, severely impacts speech intelligibility and quality of life. The condition is prevalent in motor speech disorders such as Parkinson's disease (PD), atypical parkinsonism such as progressive supranuclear palsy (PSP), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS). Improving intelligibility is not only an outcome that matters to patients but can also play a critical role as an endpoint in clinical research and drug development. This study validates a digital measure for speech intelligibility, the ki: SB-M intelligibility score, across various motor speech disorders and languages following the Digital Medicine Society (DiMe) V3 framework. METHODS: The study used four datasets: healthy controls (HCs) and patients with PD, HD, PSP, and ALS from Czech, Colombian, and German populations. Participants' speech intelligibility was assessed using the ki: SB-M intelligibility score, which is derived from automatic speech recognition (ASR) systems. Verification with inter-ASR reliability and temporal consistency, analytical validation with correlations to gold standard clinical dysarthria scores in each disease, and clinical validation with group comparisons between HCs and patients were performed. RESULTS: Verification showed good to excellent inter-rater reliability between ASR systems and fair to good consistency. Analytical validation revealed significant correlations between the SB-M intelligibility score and established clinical measures for speech impairments across all patient groups and languages. Clinical validation demonstrated significant differences in intelligibility scores between pathological groups and healthy controls, indicating the measure's discriminative capability. DISCUSSION: The ki: SB-M intelligibility score is a reliable, valid, and clinically relevant tool for assessing speech intelligibility in motor speech disorders. It holds promise for improving clinical trials through automated, objective, and scalable assessments. Future studies should explore its utility in monitoring disease progression and therapeutic efficacy as well as add data from further dysarthrias to the validation.
