Effects of cognitive impairment on prosodic parameters of speech production planning in multiple sclerosis

Abstract

Cognitive impairment (CI) affects 40-65% of patients with multiple sclerosis (MS). CI can have a negative impact on a patient's everyday activities, such as engaging in conversations. Speech production planning ability is crucial for successful verbal interactions and thus for preserving social and occupational skills. This study investigates the effect of cognitive-linguistic demand and CI on speech production planning in MS, as reflected in speech prosody. A secondary aim is to explore the clinical potential of prosodic features for the prediction of an individual's cognitive status in MS. A total of 45 subjects, that is 22 healthy controls (HC) and 23 patients in early stages of relapsing-remitting MS, underwent neuropsychological tests probing specific cognitive processes involved in speech production planning. All subjects also performed a read speech task, in which they had to read isolated sentences manipulated as for phonological length. Results show that the speech of MS patients with CI is mainly affected at the temporal level (articulation and speech rate, pause duration). Regression analyses further indicate that rate measures are correlated with working memory scores. In addition, linear discriminant analysis shows the ROC AUC of identifying MS patients with CI is 0.70 (95% confidence interval: 0.68-0.73). Our findings indicate that prosodic planning is deficient in patients with MS-CI and that the scope of planning depends on patients' cognitive abilities. We discuss how speech-based approaches could be used as an ecological method for the assessment and monitoring of CI in MS.

Changes in temporal features of speech in secondary progressive multiple sclerosis (SPMS) – case studies

“…Similar changes in temporal features of speech have been observed in other neurodegenerative diseases, e.g., mild cognitive impairment (Tóth et al 2018), Alzheimer's disease (Hoffmann et al, 2010;Meilán et al, 2014;Weiner, Neubecker, Mary, & Hynan, 2008), Parkinson's disease (Rektorova et al, 2016;Tjaden & Wilding, 2011), and Huntington's disease (Azambuja et al, 2012). Temporal characteristics of speech in MS are less described issues (DeLooze et al, 2017;Feenaugthy et al, 2013;Rodgers, Tjaden, Feenaughty, Weinstock-Guttman, & Benedict, 2013;Tjaden & Wilding, 2011).…”

“…The higher cognitive and linguistic demand and the time-limited or time-measured tasks require higher mental effort which might cause slower speech rate as well as more and longer silent and filled pauses (Arnett et al, 2008;DeLooze et al, 2017;Swets, Jacovina, & Gerrig, 2013). DeLooze et al (2017) found that MS patients with cognitive impairments produced more dysfluencies, slower speech rate, more silent pauses compared to MS patients without cognitive impairments. Feenaugthy et al (2013) measured slower speech rate and faster articulation rate, longer pauses and increased pause frequency both in cognitively impaired and non-impaired MS patients.…”

“…Many patients report some inconveniencies in their daily communication routine due to their articulation deficits, word finding difficulties, or other language symptoms. Although speech and language processes are strongly related to other cognitive processes, their relation and interaction in MS are relatively less studied (Kujala et al 1996;DeLooze et al, 2017;Feenaugthy, Tjaden, Benedict, & Weinstock-Guttman, 2013;Yorkston et al, 2003). The communicative processes and speech tasks require complex reasoning, the ability of flexible attentional switching, complex memory processes, and fast real-time information processing.…”

Impact of Cognitive Impairment and Dysarthria on Spoken Language in Multiple Sclerosis

“…Pause time has been interpreted to reflect cognitive-linguistic planning demands (Feenaughty et al, 2013;De Looze et al, 2017;Svindt, Bona, & Hoffmann, 2020) or the demand to generate an internal motor plan free of linguistic context required for spontaneous speech (Sidtis & Sidtis, 2017). Thus, it could be speculated that speakers in the MSDYS þ CI group demonstrated significantly longer silent pauses to allow more time for language formulation or to generate an internal motor plan for the spontaneous speech task, as an external printed script or verbal model of the desired speech output was not provided.…”

Multiple Sclerosis and Evaluation of Vitamin D Effect

“…With disease progression, swallowing problems can ultimately endanger patients 'lives. Interrupted speech, inability to make sentences, slowing or altering speech and swallowing disorder may be other MS symptoms [7].…”