Using Voice Change as an Indicator of Dysphagia: A Systematic Review

Santos, Karoline Weber dos; Rodrigues, Esther da Cunha; Rech, Rafaela Soares; Wendland, Eliana Márcia; Neves, Matheus; Hugo, Fernando Neves; Hilgert, Juliana Balbinot

doi:10.1007/s00455-021-10319-y

Cited by 11 publications

(4 citation statements)

References 27 publications

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“…For example, wrist-worn devices can monitor sleep profiles and irregular motor movements, and, if tied to a health-related app that surveys other parameters (eg, olfactory), might serve as an early alert. Commercially available smartwatches with three-axis ballistographic sensors and photoplethysmography technologies (eg, Apple iPhone) are currently able to capture signals relevant to PD ( Figure 1 , blue text) and the potential exists for patients who are diagnosed to switch from passive to active monitoring, allowing surveillance of other signals (eg, voice-based signals, which might detect the severity of dysphagia and fatigue) [ 16 ].…”

Section: Disease Progression and Managementmentioning

confidence: 99%

Toward Personalized Medicine Approaches for Parkinson Disease Using Digital Technologies

Khanna,

Jones

2023

JMIR Form Res

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Parkinson disease (PD) is a complex neurodegenerative disorder that afflicts over 10 million people worldwide, resulting in debilitating motor and cognitive impairment. In the United States alone (with approximately 1 million cases), the economic burden for treating and caring for persons with PD exceeds US $50 billion and myriad therapeutic approaches are under development, including both symptomatic- and disease-modifying agents. The challenges presented in addressing PD are compounded by observations that numerous, statistically distinct patient phenotypes present with a wide variety of motor and nonmotor symptomatic profiles, varying responses to current standard-of-care symptom-alleviating medications (L-DOPA and dopaminergic agonists), and different disease trajectories. The existence of these differing phenotypes highlights the opportunities in personalized approaches to symptom management and disease control. The prodromal period of PD can span across several decades, allowing the potential to leverage the unique array of composite symptoms presented to trigger early interventions. This may be especially beneficial as disease progression in PD (alongside Alzheimer disease and Huntington disease) may be influenced by biological processes such as oxidative stress, offering the potential for individual lifestyle factors to be tailored to delay disease onset. In this viewpoint, we offer potential scenarios where emerging diagnostic and monitoring strategies might be tailored to the individual patient under the tenets of P4 medicine (predict, prevent, personalize, and participate). These approaches may be especially relevant as the causative factors and biochemical pathways responsible for the observed neurodegeneration in patients with PD remain areas of fluid debate. The numerous observational patient cohorts established globally offer an excellent opportunity to test and refine approaches to detect, characterize, control, modify the course, and ultimately stop progression of this debilitating disease. Such approaches may also help development of parallel interventive strategies in other diseases such as Alzheimer disease and Huntington disease, which share common traits and etiologies with PD. In this overview, we highlight near-term opportunities to apply P4 medicine principles for patients with PD and introduce the concept of composite orthogonal patient monitoring.

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Section: Disease Progression and Managementmentioning

confidence: 99%

Toward Personalized Medicine Approaches for Parkinson Disease Using Digital Technologies

Khanna,

Jones

2023

JMIR Form Res

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“…Dysphonia also affects rehabilitation treatment compliance in patients who have suffered an ischemic stroke and may cause poor functional outcomes [ 6 ]. Dysphonia has also been reported to be associated with swallowing dysfunction and is known as a predictor of aspiration risk [ 7 , 8 ]. Aspiration pneumonia is a risk factor that increases mortality in patients who have suffered an ischemic stroke [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Biomarkers as Predictors of Dysphonia Severity in Patients with Ischemic Stroke

2023

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Dysphonia and malnutrition are major problems in patients who have suffered an ischemic stroke. Tools to assess dysphonia severity include the dysphonia severity index (DSI) and maximum phonation time (MPT). This study aimed to investigate whether the nutritional biomarkers transferrin, albumin, and prealbumin could be predictors of dysphonia severity. A retrospective analysis was conducted between January 2018 and October 2022. A total of 180 patients who had suffered an ischemic stroke were included. Serum transferrin, albumin, and prealbumin levels were significantly correlated with DSI and MPT levels. In a multiple regression analysis, prealbumin and transferrin were significant predictors of DSI, whereas only prealbumin was a significant predictor of MPT. Serum transferrin, albumin, and prealbumin levels in patients who have suffered an ischemic stroke may correlate with dysphonia severity as assessed using DSI and MPT. These results may provide objective evidence that nutritional biomarkers affect dysphonia severity.

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“…wet voice) is unclear [ 38 , 41 ]. Besides, a systematic review reported that it is not possible to obtain a consensus regarding the use of vocal quality as an indicator of swallowing impairment [ 42 ]. Indeed, standardized methods and consensual protocols regarding voice investigation in the framework of dysphagia are lacking because no acoustic voice features of reasonable evidence of dysphagia have been found, although some studies have reported that an aspiration risk may be correlated with acoustic features such as vocal jitter (relative average perturbation of the glottal cycle lengths) and harmonics-to-noise ratio [ 40 , 43 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of radio(chemo)therapy-related dysphagia in head and neck cancer patients based on cough-related acoustic features: a prospective phase II national clinical trial (ACCOUGH-P/A trial)

Mootassim-Billah,

Van Nuffelen,

Schoentgen

et al. 2023

Trials

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Background Radiation-associated dysphagia is defined as impaired swallowing efficiency/safety following (chemo)radiotherapy in head and neck cancer patients. In a dysphagia framework, impaired coughing may lead to lung aspiration and fatal lung infection. Although cough efficacy is a predictor of the risk of aspiration, cough investigation is minimal in patients with radiation-associated dysphagia. Because cough is a transient signal, existing software for speech analysis are not appropriate. The goal of our project is to develop an assessment method using acoustic features related to voluntary and reflexive coughs as biomarkers of the risk of penetration/aspiration in patients with radiation-associated dysphagia. Methods Healthy subjects and head and neck cancer patients with and without dysphagia will produce voluntary coughs, throat clearings and reflexive coughs. Recordings will be made using an acoustic microphone and a throat microphone. The recorded signals will be manually segmented and subsequently analysed with a software under development. Automatic final segmentation enables to measure cough duration. The first method of analysis includes temporal features: the amplitude contour, the sample entropy and the kurtosis. These features report respectively the strength, the unpredictability (turbulence noise due to the air jet) and the impulsive quality (burst) of the signal. The second method of analysis consists of a spectral decomposition of the relative cough signal energy into several frequency bands (0–400 Hz, 400–800 Hz, 800–1600 Hz, 1600–3200 Hz, > 3200 Hz). The primary outcome of this exploratory research project is the identification of a set of descriptive acoustic cough features in healthy subjects as reference data (ACCOUGH). The secondary outcome of this research in head and neck cancer patients with radiation-associated dysphagia includes the identification of (1) a set of descriptive acoustic cough features as biomarkers of penetration-aspiration (ACCOUGH-P/A), (2) swallowing scores, (3) voice features and (4) aerodynamic cough features. Discussion This study is expected to develop methods of acoustic cough analysis to enhance the assessment of radiation-associated dysphagia in head and neck cancer patients following (chemo)radiation. Trial registration International Standard Randomized Controlled Trials Number (ISRCTN) registry ISRCTN16540497. Accepted on 23 June 2023.

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Using Voice Change as an Indicator of Dysphagia: A Systematic Review

Cited by 11 publications

References 27 publications

Toward Personalized Medicine Approaches for Parkinson Disease Using Digital Technologies

Toward Personalized Medicine Approaches for Parkinson Disease Using Digital Technologies

Nutritional Biomarkers as Predictors of Dysphonia Severity in Patients with Ischemic Stroke

Assessment of radio(chemo)therapy-related dysphagia in head and neck cancer patients based on cough-related acoustic features: a prospective phase II national clinical trial (ACCOUGH-P/A trial)

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