What speech can tell us: A systematic review of dysarthria characteristics in Multiple Sclerosis

Abstract

IMPORTANCE: Multiple sclerosis produces neurological impairments that are variable in duration, severity and quality. Speech is frequently impaired, resulting in decreased communication skills and quality of life. Advancements in technology now makes it possible to use quantitative acoustic assessment of speech as biomarkers of disease progression. OBSERVATIONS: Four domains of speech have been identified: articulation (slow articulation and imprecise consonants), voice (pitch and loudness instability), respiration (decreased phonatory time and expiratory pressure) and prosody (longer and frequent pauses, deficient loudness control). Studies also explored predictive models for diagnosis of MS and ataxia through speech assessment, the relationship of dysarthria with cognition and very few studies correlated neuroimaging with dysarthria. We could not identify longitudinal studies of speech or dysarthria in Multiple Sclerosis. CONCLUSION AND RELEVANCE: Refinement of objective measures of speech has enhanced our understanding of Multiple Sclerosis-related deficits in cross-sectional analysis while both integrative and longitudinal studies are identified as major gaps. This review highlights the potential for using quantitative acoustic assessments as clinical endpoints for diagnosing, monitoring progression and treatment in disease modifying trials.

Otolaryngologic Symptoms in Multiple Sclerosis: A Review

“…Nearly 40% of subjects with a diagnosis of MS have speech disorders such as dysphonia and dysarthria and, at a lesser extent, comprehension disorders 105,106 .…”

Speech metrics, general disability, brain imaging and quality of life in multiple sclerosis

“…Dysarthria (impairment of speech execution), affects approximately 50% of people with multiple sclerosis (MS) at some stage of their illness [1,2]. Studies using standardized assessments by trained raters, herein perceptual analysis, highlighted that dysarthria in people with MS (pwMS) is often characterized by slow speech rate, increased frequency of pauses and poor respiratory support [3]. The degree of impairment is typically mild, and intelligibility is marginally affected [3].…”

Biomarker potential of real-world voice signals to predict abnormal blood glucose levels

“…For example, it has been shown that thyroid hormone imbalance caused the hoarseness of voice, and affected larynx development 2 . Unstable pitch and loudness were observed in patients with multiple sclerosis 3 . Other recent studies also demonstrated distinct voice characteristics that were associated with various pathological, neurological, and psychiatric disorders, such as congestive heart failure 4 , Parkinson’s disease 5 , Alzheimer’s disease 6 , post-traumatic stress disorder 7 , and autism spectrum disorder 8 .…”