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Skibińska J, Hosek J. Computerized analysis of hypomimia and hypokinetic dysarthria for improved diagnosis of Parkinson's disease. Heliyon 2023; 9:e21175. [PMID: 37908703 PMCID: PMC10613914 DOI: 10.1016/j.heliyon.2023.e21175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/07/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Background and Objective An aging society requires easy-to-use approaches for diagnosis and monitoring of neurodegenerative disorders, such as Parkinson's disease (PD), so that clinicians can effectively adjust a treatment policy and improve patients' quality of life. Current methods of PD diagnosis and monitoring usually require the patients to come to a hospital, where they undergo several neurological and neuropsychological examinations. These examinations are usually time-consuming, expensive, and performed just a few times per year. Hence, this study explores the possibility of fusing computerized analysis of hypomimia and hypokinetic dysarthria (two motor symptoms manifested in the majority of PD patients) with the goal of proposing a new methodology of PD diagnosis that could be easily integrated into mHealth systems. Methods We enrolled 73 PD patients and 46 age- and gender-matched healthy controls, who performed several speech/voice tasks while recorded by a microphone and a camera. Acoustic signals were parametrized in the fields of phonation, articulation and prosody. Video recordings of a face were analyzed in terms of facial landmarks movement. Both modalities were consequently modeled by the XGBoost algorithm. Results The acoustic analysis enabled diagnosis of PD with 77% balanced accuracy, while in the case of the facial analysis, we observed 81% balanced accuracy. The fusion of both modalities increased the balanced accuracy to 83% (88% sensitivity and 78% specificity). The most informative speech exercise in the multimodality system turned out to be a tongue twister. Additionally, we identified muscle movements that are characteristic of hypomimia. Conclusions The introduced methodology, which is based on the myriad of speech exercises likewise audio and video modality, allows for the detection of PD with an accuracy of up to 83%. The speech exercise - tongue twisters occurred to be the most valuable from the clinical point of view. Additionally, the clinical interpretation of the created models is illustrated. The presented computer-supported methodology could serve as an extra tool for neurologists in PD detection and the proposed potential solution of mHealth will facilitate the patient's and doctor's life.
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Affiliation(s)
- Justyna Skibińska
- Faculty of Electrical Engineering and Communication, Brno University of Technology, Technicka 12, Brno, 61600, Czechia
- Unit of Electrical Engineering, Tampere University, Kalevantie 4, Tampere, 33100, Finland
| | - Jiri Hosek
- Faculty of Electrical Engineering and Communication, Brno University of Technology, Technicka 12, Brno, 61600, Czechia
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2
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Hireš M, Drotár P, Pah ND, Ngo QC, Kumar DK. On the inter-dataset generalization of machine learning approaches to Parkinson's disease detection from voice. Int J Med Inform 2023; 179:105237. [PMID: 37801807 DOI: 10.1016/j.ijmedinf.2023.105237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/20/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Parkinson's disease is the second-most-common neurodegenerative disorder that affects motor skills, cognitive processes, mood, and everyday tasks such as speaking and walking. The voices of people with Parkinson's disease may become weak, breathy, or hoarse and may sound emotionless, with slurred words and mumbling. Algorithms for computerized voice analysis have been proposed and have shown highly accurate results. However, these algorithms were developed on single, limited datasets, with participants possessing similar demographics. Such models are prone to overfitting and are unsuitable for generalization, which is essential in real-world applications. METHODS We evaluated the computerized Parkinson's disease diagnosis performance of various machine learning models and showed that these models degraded rapidly when used on different datasets. We evaluated two mainstream state-of-the-art approaches, one based on deep convolutional neural networks and another based on voice feature extraction followed by a shallow classifier (i.e., extreme gradient boosting (XGBoost)). RESULTS An investigation with four datasets (CzechPD, PC-GITA, ITA, and RMIT-PD) proved that even if the algorithms yielded excellent performance on a single dataset, the results obtained on new data or even a mix of datasets were very unsatisfactory. CONCLUSIONS More work needs to be done to make computerized voice analysis methods for Parkinson's disease diagnosis suitable for real-world applications.
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Affiliation(s)
- Máté Hireš
- Intelligent Information Systems Lab, Technical University of Kosice, Letna 9, 42001 Kosice, Slovakia
| | - Peter Drotár
- Intelligent Information Systems Lab, Technical University of Kosice, Letna 9, 42001 Kosice, Slovakia.
| | - Nemuel Daniel Pah
- Biosignals Lab, RMIT University, Melbourne, Australia; Universitas Surabaya, Surabaya, Indonesia
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Moret-Tatay C, Iborra-Marmolejo I, Jorques-Infante MJ, Bernabé-Valero G, Beneyto-Arrojo MJ, Irigaray TQ. A pilot screening for cognitive impairment through voice technology (WAY2AGE). BMC Psychol 2023; 11:170. [PMID: 37221628 PMCID: PMC10204663 DOI: 10.1186/s40359-023-01212-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/17/2023] [Indexed: 05/25/2023] Open
Abstract
Voice technology has grown exponentially, offering an opportunity to different fields, such as the health area. Considering that language can be a sign of cognitive impairment and most screening tools are based on speech measures, these devices are of interest. The aim of this work was to examine a screening tool for Mild Cognitive Impairment (MCI) through voice technology. For this reason, the WAY2AGE voice Bot was tested across Mini-Mental (MMSE) scores. The main results depict a strong relationship between MMSE and WAY2AGE scores, as well as a good AUC value to discriminate between no cognitive impairment (NCI) and MCI groups. However, a relationship between age and WAY2AGE scores, but not between age and MMSE scores, was found. This would indicate that, even if WAY2AGE seems sensitive to detect MCI, the voice tool is age-sensitive and not as robust as the traditional MMSE scale. Future lines of research should look more deeply into parameters that distinguish developmental changes. As a screening tool, these results are of interest for the health area and for at-risk older adults.
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Affiliation(s)
- Carmen Moret-Tatay
- Faculty of Psychology, Valencia Catholic University Saint Vincent Martyr (UCV), Burjassot, Valencia, Spain.
| | - Isabel Iborra-Marmolejo
- Faculty of Psychology, Valencia Catholic University Saint Vincent Martyr (UCV), Burjassot, Valencia, Spain
| | - María José Jorques-Infante
- Faculty of Psychology, Valencia Catholic University Saint Vincent Martyr (UCV), Burjassot, Valencia, Spain
| | - Gloria Bernabé-Valero
- Faculty of Psychology, Valencia Catholic University Saint Vincent Martyr (UCV), Burjassot, Valencia, Spain
| | - María José Beneyto-Arrojo
- Faculty of Psychology, Valencia Catholic University Saint Vincent Martyr (UCV), Burjassot, Valencia, Spain
| | - Tatiana Quarti Irigaray
- Department of Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Rio Grande do Sul, Brazil
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Rusz J, Krupička R, Vítečková S, Tykalová T, Novotný M, Novák J, Dušek P, Růžička E. Speech and gait abnormalities in motor subtypes of de-novo Parkinson's disease. CNS Neurosci Ther 2023. [PMID: 36942517 DOI: 10.1111/cns.14158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/23/2023] Open
Abstract
AIM To investigate the presence and relationship of temporal speech and gait parameters in patients with postural instability/gait disorder (PIGD) and tremor-dominant (TD) motor subtypes of Parkinson's disease (PD). METHODS Speech samples and instrumented walkway system assessments were acquired from a total of 60 de-novo PD patients (40 in TD and 20 in PIGD subtype) and 40 matched healthy controls. Objective acoustic vocal assessment of seven distinct speech timing dimensions was related to instrumental gait measures including velocity, cadence, and stride length. RESULTS Compared to controls, PIGD subtype showed greater consonant timing abnormalities by prolonged voice onset time (VOT) while also shorter stride length during both normal walking and dual task, while decreased velocity and cadence only during dual task. Speaking rate was faster in PIGD than TD subtype. In PIGD subtype, prolonged VOT correlated with slower gait velocity (r = -0.56, p = 0.01) and shorter stride length (r = -0.59, p = 0.008) during normal walking, whereas relationships were also found between decreased cadence in dual task and irregular alternating motion rates (r = -0.48, p = 0.04) and prolonged pauses (r = -0.50, p = 0.03). No correlation between speech and gait was detected in TD subtype. CONCLUSION Our findings suggest that speech and gait rhythm disorder share similar underlying pathomechanisms specific for PIGD subtype.
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Affiliation(s)
- Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
- Department of Neurology & ARTORG Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Radim Krupička
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Slávka Vítečková
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Tereza Tykalová
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Michal Novotný
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Jan Novák
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czechia
| | - Petr Dušek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
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Karan B, Sahu SS, Orozco-Arroyave JR. An investigation about the relationship between dysarthria level of speech and the neurological state of Parkinson’s patients. Biocybern Biomed Eng 2022. [DOI: 10.1016/j.bbe.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Yu Q, Zou X, Quan F, Dong Z, Yin H, Liu J, Zuo H, Xu J, Han Y, Zou D, Li Y, Cheng O. Parkinson's disease patients with freezing of gait have more severe voice impairment than non-freezers during "ON state". J Neural Transm (Vienna) 2022; 129:277-286. [PMID: 34989833 DOI: 10.1007/s00702-021-02458-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/26/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Speech disorders and freezing of gait (FOG) in Parkinson's disease (PD) may have some common pathological mechanisms. The purpose of this study was to compare the acoustic parameters of PD patients with dopamine-responsive FOG (PD-FOG) and without FOG (PD-nFOG) during "ON state" and explore the ability of "ON state" voice features in distinguishing PD-FOG from PD-nFOG. METHODS A total of 120 subjects, including 40 PD patients with dopamine-responsive FOG, 40 PD-nFOG, and 40 healthy controls (HCs) were recruited. All subjects underwent neuropsychological tests. Speech samples were recorded through the sustained vowel pronunciation tasks during the "ON state" and then analyzed by the Praat software. A set of 27 voice features was extracted from each sample for comparison. Support vector machine (SVM) was used to build mathematical models to classify PD-FOG and PD-nFOG. RESULTS Compared with PD-nFOG, the jitter, the standard deviation of fundamental frequency (F0SD), the standard deviation of pulse period (pulse period SD) and the noise-homophonic-ratio (NHR) were increased, and the maximum phonation time (MPT) was decreased in PD-FOG. The above voice features were correlated with the freezing of gait questionnaire (FOGQ). The average accuracy, specificity, and sensitivity of SVM models based on 27 voice features for classifying PD-FOG and PD-nFOG were 73.57%, 75.71%, and 71.43%, respectively. CONCLUSIONS PD-FOG have more severe voice impairment than PD-nFOG during "ON state".
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Affiliation(s)
- Qian Yu
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Xiaoya Zou
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Fengying Quan
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Zhaoying Dong
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Huimei Yin
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Jinjing Liu
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Hongzhou Zuo
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Jiaman Xu
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Yu Han
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Dezhi Zou
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Yongming Li
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing, 400030, China
| | - Oumei Cheng
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China.
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7
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García AM, Arias-Vergara T, C Vasquez-Correa J, Nöth E, Schuster M, Welch AE, Bocanegra Y, Baena A, Orozco-Arroyave JR. Cognitive Determinants of Dysarthria in Parkinson's Disease: An Automated Machine Learning Approach. Mov Disord 2021; 36:2862-2873. [PMID: 34390508 DOI: 10.1002/mds.28751] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Dysarthric symptoms in Parkinson's disease (PD) vary greatly across cohorts. Abundant research suggests that such heterogeneity could reflect subject-level and task-related cognitive factors. However, the interplay of these variables during motor speech remains underexplored, let alone by administering validated materials to carefully matched samples with varying cognitive profiles and combining automated tools with machine learning methods. OBJECTIVE We aimed to identify which speech dimensions best identify patients with PD in cognitively heterogeneous, cognitively preserved, and cognitively impaired groups through tasks with low (reading) and high (retelling) processing demands. METHODS We used support vector machines to analyze prosodic, articulatory, and phonemic identifiability features. Patient groups were compared with healthy control subjects and against each other in both tasks, using each measure separately and in combination. RESULTS Relative to control subjects, patients in cognitively heterogeneous and cognitively preserved groups were best discriminated by combined dysarthric signs during reading (accuracy = 84% and 80.2%). Conversely, patients with cognitive impairment were maximally discriminated from control subjects when considering phonemic identifiability during retelling (accuracy = 86.9%). This same pattern maximally distinguished between cognitively spared and impaired patients (accuracy = 72.1%). Also, cognitive (executive) symptom severity was predicted by prosody in cognitively preserved patients and by phonemic identifiability in cognitively heterogeneous and impaired groups. No measure predicted overall motor dysfunction in any group. CONCLUSIONS Predominant dysarthric symptoms appear to be best captured through undemanding tasks in cognitively heterogeneous and preserved cohorts and through cognitively loaded tasks in patients with cognitive impairment. Further applications of this framework could enhance dysarthria assessments in PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Adolfo M García
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.,Global Brain Health Institute, University of California, San Francisco, California, USA
| | - Tomás Arias-Vergara
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University, Munich, Germany
| | - Juan C Vasquez-Correa
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany
| | - Elmar Nöth
- Friedrich-Alexander University Erlangen-Nuremberg
| | - Maria Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University, Munich, Germany
| | - Ariane E Welch
- Memory and Aging Center, University of California, San Francisco, California, USA
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan R Orozco-Arroyave
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany
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8
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Jadczyk T, Wojakowski W, Tendera M, Henry TD, Egnaczyk G, Shreenivas S. Artificial Intelligence Can Improve Patient Management at the Time of a Pandemic: The Role of Voice Technology. J Med Internet Res 2021; 23:e22959. [PMID: 33999834 PMCID: PMC8153030 DOI: 10.2196/22959] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/20/2021] [Accepted: 03/21/2021] [Indexed: 12/24/2022] Open
Abstract
Artificial intelligence–driven voice technology deployed on mobile phones and smart speakers has the potential to improve patient management and organizational workflow. Voice chatbots have been already implemented in health care–leveraging innovative telehealth solutions during the COVID-19 pandemic. They allow for automatic acute care triaging and chronic disease management, including remote monitoring, preventive care, patient intake, and referral assistance. This paper focuses on the current clinical needs and applications of artificial intelligence–driven voice chatbots to drive operational effectiveness and improve patient experience and outcomes.
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Affiliation(s)
- Tomasz Jadczyk
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.,Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Michal Tendera
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Timothy D Henry
- The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, United States
| | - Gregory Egnaczyk
- The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, United States
| | - Satya Shreenivas
- The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, United States
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9
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Online Arabic and French handwriting of Parkinson’s disease: The impact of segmentation techniques on the classification results. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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10
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Klobusiakova P, Mekyska J, Brabenec L, Galaz Z, Zvoncak V, Mucha J, Rapcsak SZ, Rektorova I. Articulatory network reorganization in Parkinson's disease as assessed by multimodal MRI and acoustic measures. Parkinsonism Relat Disord 2021; 84:122-128. [PMID: 33609963 DOI: 10.1016/j.parkreldis.2021.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/28/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Hypokinetic dysarthria (HD) is common in Parkinson's disease (PD). Our objective was to evaluate articulatory networks and their reorganization due to PD pathology in individuals without overt speech impairment using a multimodal MRI protocol and acoustic analysis of speech. METHODS A total of 34 PD patients with no subjective HD complaints and 25 age-matched healthy controls (HC) underwent speech task recordings, structural MRI, and reading task-induced and resting-state fMRI. Grey matter probability maps, task-induced activations, and resting-state functional connectivity within the regions engaged in speech production (ROIs) were assessed and compared between groups. Correlation with acoustic parameters was also performed. RESULTS PD patients as compared Tto HC displayed temporal decreases in speech loudness which were related to BOLD signal increases in the right-sided regions of the dorsal language pathway/articulatory network. Among those regions, activation of the right anterior cingulate was increased in PD as compared to HC. We also found bilateral posterior superior temporal gyrus (STG) GM loss in PD as compared to HC that was strongly associated with diadochokinetic (DDK) irregularity in the PD group. Task-induced activations of the left STG were increased in PD as compared to HC and were related to the DDK rate control. CONCLUSIONS The results provide insight into the neural correlates of speech production control and distinct articulatory network reorganization in PD apparent already in patients without subjective speech impairment.
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Affiliation(s)
- Patricia Klobusiakova
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic; Surgeon General Office of the Slovak Armed Forces, Ružomberok, Slovak Republic
| | - Jiri Mekyska
- Department of Telecommunications, Brno University of Technology, Brno, Czech Republic
| | - Lubos Brabenec
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic
| | - Zoltan Galaz
- Department of Telecommunications, Brno University of Technology, Brno, Czech Republic
| | - Vojtech Zvoncak
- Department of Telecommunications, Brno University of Technology, Brno, Czech Republic
| | - Jan Mucha
- Department of Telecommunications, Brno University of Technology, Brno, Czech Republic
| | - Steven Z Rapcsak
- Department of Neurology, College of Medicine, University of Arizona, Tucson, USA
| | - Irena Rektorova
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic; First Department of Neurology, Faculty of Medicine and St. Anne's University Hospital, Masaryk University, Brno, Czech Republic.
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11
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Tsanas A, Little MA, Ramig LO. Remote Assessment of Parkinson's Disease Symptom Severity Using the Simulated Cellular Mobile Telephone Network. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2021; 9:11024-11036. [PMID: 33495722 PMCID: PMC7821632 DOI: 10.1109/access.2021.3050524] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 12/25/2020] [Indexed: 06/12/2023]
Abstract
Telemonitoring of Parkinson's Disease (PD) has attracted considerable research interest because of its potential to make a lasting, positive impact on the life of patients and their carers. Purpose-built devices have been developed that record various signals which can be associated with average PD symptom severity, as quantified on standard clinical metrics such as the Unified Parkinson's Disease Rating Scale (UPDRS). Speech signals are particularly promising in this regard, because they can be easily recorded without the use of expensive, dedicated hardware. Previous studies have demonstrated replication of UPDRS to within less than 2 points of a clinical raters' assessment of symptom severity, using high-quality speech signals collected using dedicated telemonitoring hardware. Here, we investigate the potential of using the standard voice-over-GSM (2G) or UMTS (3G) cellular mobile telephone networks for PD telemonitoring, networks that, together, have greater than 5 billion subscribers worldwide. We test the robustness of this approach using a simulated noisy mobile communication network over which speech signals are transmitted, and approximately 6000 recordings from 42 PD subjects. We show that UPDRS can be estimated to within less than 3.5 points difference from the clinical raters' assessment, which is clinically useful given that the inter-rater variability for UPDRS can be as high as 4-5 UPDRS points. This provides compelling evidence that the existing voice telephone network has potential towards facilitating inexpensive, mass-scale PD symptom telemonitoring applications.
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Affiliation(s)
- Athanasios Tsanas
- Edinburgh Medical SchoolUsher Institute, The University of EdinburghEdinburghEH16 4UXU.K.
| | - Max A. Little
- School of Computer ScienceUniversity of BirminghamBirminghamB15 2TTU.K.
| | - Lorraine O. Ramig
- Department of Speech, Language, and Hearing ScienceUniversity of Colorado BoulderBoulderCO80309USA
- National Center for Voice and SpeechDenverCO80014USA
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Ieracitano C, Mammone N, Hussain A, Morabito FC. A novel multi-modal machine learning based approach for automatic classification of EEG recordings in dementia. Neural Netw 2020; 123:176-190. [DOI: 10.1016/j.neunet.2019.12.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 12/27/2022]
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13
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Changes in Phonation and Their Relations with Progress of Parkinson’s Disease. APPLIED SCIENCES-BASEL 2018. [DOI: 10.3390/app8122339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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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