Speech prosody impairment predicts cognitive decline in Parkinson’s disease

Rektorová, Irena; Mekyska, Jiří; Janoušová, Eva; Košťálová, Milena; Eliasova, Ilona; Mračková, Martina; Beránková, Dagmar; Nečasová, Tereza; Smékal, Zdeněk; Mareček, Radek

doi:10.1016/j.parkreldis.2016.05.018

Cited by 47 publications

(43 citation statements)

References 28 publications

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“…In our previous works, we proved that HD shares some pathophysiological mechanisms with other motor/non-motor features of PD. For instance, based on a combination of acoustic analysis and machine learning approaches, it is possible to predict cognitive deficits or gait disorders [44,56]. Although in the frame of this research we explored only the field of phonation, our results confirm the ability of acoustic HD analysis to predict the progress of PD.…”

Section: Discussionsupporting

confidence: 62%

“…Furthermore, even though we used six clinical rating scales when describing the dataset (see Section 2.1), only four of these scales were used for the analysis, specifically: UPDRS III, UPDRS IV, RBDSQ, and FOG-Q. The reason is that previous studies have already shown that non-motor manifestations of PD are not linked with the phonatory aspects of HD, but rather with the impairments of prosody and articulation [44] that are commonly being quantified using a sentence reading task, free speech (monologue), etc. Since this study is focused on the phonatory aspects of HD, clinical rating scales describing only motor symptoms of PD were used.…”

Section: Discussionmentioning

confidence: 99%

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Changes in Phonation and Their Relations with Progress of Parkinson’s Disease

et al. 2018

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Hypokinetic dysarthria, which is associated with Parkinson's disease (PD), affects several speech dimensions, including phonation. Although the scientific community has dealt with a quantitative analysis of phonation in PD patients, a complex research revealing probable relations between phonatory features and progress of PD is missing. Therefore, the aim of this study is to explore these relations and model them mathematically to be able to estimate progress of PD during a two-year follow-up. We enrolled 51 PD patients who were assessed by three commonly used clinical scales. In addition, we quantified eight possible phonatory disorders in five vowels. To identify the relationship between baseline phonatory features and changes in clinical scores, we performed a partial correlation analysis. Finally, we trained XGBoost models to predict the changes in clinical scores during a two-year follow-up. For two years, the patients' voices became more aperiodic with increased microperturbations of frequency and amplitude. Next, the XGBoost models were able to predict changes in clinical scores with an error in range 11-26%. Although we identified some significant correlations between changes in phonatory features and clinical scores, they are less interpretable. This study suggests that it is possible to predict the progress of PD based on the acoustic analysis of phonation. Moreover, it recommends utilizing the sustained vowel /i/ instead of /a/.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Changes in Phonation and Their Relations with Progress of Parkinson’s Disease

et al. 2018

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“…For the task data, standard deviations (SD) in the scans of individual subjects were calculated. The scans were identified as outliers based on inner fence criterion as shown in equations (1) and (2).…”

Section: Fmri Data Analysismentioning

confidence: 99%

“…Hypokinetic dysarthria (HD) in PD is a multidimensional speech disorder characterized by monopitch and monoloudness, reduced stress, imprecise consonants, airflow insufficiency, microperturbations in frequency/amplitude, impaired speech rate and rhythm etc. [1][2][3]. The pathophysiology of HD is not fully understood, and dopaminergic and surgical treatments have only limited effects on motor-speech dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive stimulation of the auditory feedback area for improved articulation in Parkinson's disease

Brabenec

Klobušiaková

Bartoň

et al. 2019

Parkinsonism & Related Disorders

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Introduction: Hypokinetic dysarthria (HD) is a common symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated acute effects of repetitive transcranial magnetic stimulation (rTMS) of the motor and auditory feedback area on HD in PD using acoustic analysis of speech. Methods: We used 10 Hz and 1 Hz stimulation protocols and applied rTMS over the left orofacial primary motor area, the right superior temporal gyrus (STG), and over the vertex (a control stimulation site) in 16 PD patients with HD. A cross-over design was used. Stimulation sites and protocols were randomised across subjects and sessions. Acoustic analysis of a sentence reading task performed inside the MR scanner was used to evaluate rTMS-induced effects on motor speech. Acute fMRI changes due to rTMS were also analysed. Results: The 1 Hz STG stimulation produced significant increases of the relative standard deviation of the 2nd formant (p = 0.019), i.e. an acoustic parameter describing the tongue and jaw movements. The effects were superior to the control site stimulation and were accompanied by increased resting state functional connectivity between the stimulated region and the right parahippocampal gyrus. The rTMS-induced acoustic changes were correlated with the reading task-related BOLD signal increases of the stimulated area (R = 0.654, p = 0.029). Conclusion: Our results demonstrate for the first time that low-frequency stimulation of the temporal auditory feedback area may improve articulation in PD and enhance functional connectivity between the STG and the cortical region involved in an overt speech control.

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“…Structural and functional imaging studies support this notion [139][140][141][142][143][144][145]. Other clinical risk factors include higher age, family history of PDD, lower education, lower socioeconomic status, disease severity and duration, motor subtype with postural instability and gait difficulty, presence of REM sleep behavioral disorder, changes in speech rhythmicity and prosody, autonomic symptoms, and specific genetic abnormalities (particularly SNCA gene duplication/triplication, glucocerebrosidase gene mutation, H1 tau haplotypes, and APOE4 allelic variants) [146][147][148]. Biomarkers of cognitive decline in PD have been studied extensively, see e.g.…”

Section: Cognitive Impairment and Dementiamentioning

confidence: 90%

Current treatment of behavioral and cognitive symptoms of Parkinson's disease

Rektorová

2019

Parkinsonism & Related Disorders

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Cognitive and behavioral symptoms are common in Parkinson's disease, may occur even in the prodromal stages of the disease, worsen with disease progression, and surpass motor symptoms as the major factors affecting patient quality of life and caregiver burden. The symptoms may be caused by the disease pathology or they may represent adverse effects of treatment, or both etiological factors may contribute. Although many of these symptoms are related to dopaminergic dysfunction or dopaminergic medication, other neurotransmitters are involved as well. Behavioral symptoms including impulse control disorders, apathy, psychosis, as well as mild cognitive impairment and dementia are reviewed with a special focus on current treatment approaches.

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Speech prosody impairment predicts cognitive decline in Parkinson’s disease

Cited by 47 publications

References 28 publications

Changes in Phonation and Their Relations with Progress of Parkinson’s Disease

Changes in Phonation and Their Relations with Progress of Parkinson’s Disease

Non-invasive stimulation of the auditory feedback area for improved articulation in Parkinson's disease

Current treatment of behavioral and cognitive symptoms of Parkinson's disease

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