parkinson's disease; dysarthria; early detection; acoustic analyses; vowel production
Abstract :
[en] Objectives: Our aim is to detect early, subclinical speech biomarkers of dysarthria in Parkinson’s disease (PD), i.e., systematic atypicalities in speech that remain subtle, are not easily detectible by the clinician, so that the patient is labeled “nondysarthric.” Based on promising exploratory work, we examine here whether vowel articulation, as assessed by three acoustic metrics, can be used as early indicator of speech difficulties associated with Parkinson’s disease. Study design: This is a prospective case–control study.
Methods: Sixty-three individuals with PD and 35 without PD (healthy controls-HC) participated in this study. Out of 63 PD patients, 43 had been diagnosed with dysarthria (DPD) and 20 had not (NDPD). Sustained vowels were recorded for each speaker and formant frequencies were measured. The analyses focus on three acoustic metrics: individual vowel triangle areas (tVSA), vowel articulation index (VAI) and the Phi index.
Results: tVSA were found to be significantly smaller for DPD speakers than for HC. The VAI showed significant differences between these two groups, indicating greater centralization and lower vowel contrasts in the DPD speakers with dysarhtria. In addition, DPD and NDPD speakers had lower Phi values, indicating a lower organization of their vowel system compared to the HC. Results also showed that the VAI index was the most efficient to distinguish between DPD and NDPD whereas the Phi index was the best acoustic metric to discriminate NDPD and HC. Conclusion: This acoustic study identified potential subclinical vowel-related speech biomarkers of dysarthria in speakers with Parkinson’s disease who have not been diagnosed with dysarthria.
Disciplines :
Social & behavioral sciences, psychology: Multidisciplinary, general & others
Author, co-author :
Roland, Virginie ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Education > Service de Métrologie et Sciences du langage
Huet, Kathy ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Education > Service de Métrologie et Sciences du langage
Harmegnies, Bernard ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Educatio > Service du Doyen de la Faulté de Psychologie et des Sciences de l'Education
Piccaluga, Myriam ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Educatio > Service de Métrologie et Sciences du langage
Verhaegen, Clémence ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Education > Service de Métrologie et Sciences du langage
Delvaux, Véronique ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Educatio > Service de Métrologie et Sciences du langage
Language :
English
Title :
Vowel production: a potential speech biomarker for early detection of dysarthria in Parkinson's Disease
Publication date :
2023
Journal title :
Frontiers in Psychology
eISSN :
1664-1078
Publisher :
Frontiers Media S.A., Switzerland
Special issue title :
Linguistic Biomarkers of Neurological, Cognitive, and Psychiatric Disorders: Verification, Analytical Validation, Clinical Validation, and Machine Learning
Volume :
14
Pages :
01-09
Peer reviewed :
Peer Reviewed verified by ORBi
Research unit :
P362 - Métrologie et Sciences du langage
Research institute :
Research Institute for Language Science and Technology
Ackermann H. Hertrich I. Hehr T. (1995). Oral diadochokinesis in neurological dysarthrias. Folia Phoniatrica et Logoaedica. 47, 15–23. doi: 10.1159/000266338
Ackermann H. Ziegler W. (1991). Articulatory deficits in parkinsonian dysarthria: an acoustic analysis. J. Neurol. Neurosurg. Psychiatry 54, 1093–1098. doi: 10.1136/jnnp.54.12.1093, PMID: 1783924
Agüera-Ortiz L. García-Ramos R. Grandas Pérez F. J. López-Álvarez J. Montes Rodríguez J. M. Olazarán Rodríguez F. J. et al. (2021). Depression in Alzheimer's disease: a Delphi consensus on etiology, risk factors, and clinical management. Front. Psych. 12:638651. doi: 10.3389/fpsyt.2021.638651
American Speech-Language-Hearing Association. (2004). Preferred practice patterns for the profession of speech-language pathology [preferred practice patterns]. Available at: https://www.asha.org/policy/pp2004-00191/ (Accessed December 22, 2022).
Audibert N. Fougeron C. (2012). Distorsions de l’espace vocalique: quelles mesures? Application à la dysarthrie. Actes de la conférence conjointe JEP-TALN-RECITAL 2012, 1, 217–224. Grenoble.
Auquier P. Sapin C. Ziegler M. Tison F. Destée A. Dubois B. et al. (2002). Validation en langue française d'un questionnaire de qualité de vie dans la maladie de Parkinson: le Parkinson's Disease Questionnaire-PDQ-39. Rev. Neurol. 158, 41–50. PMID: 11938321
Beck AT Steer RA Brown GK. (1996). BDI-II Manual. London: The Psychological Corporation.
Caverlé M. W. J. Vogel A. P. (2020). Stability, reliability, and sensitivity of acoustic measures of vowel space: a comparison of vowel space area, formant centralization ratio, and vowel articulation index. J. Acoust. Soc. Am. 148, 1436–1444. doi: 10.1121/10.0001931, PMID: 33003843
Daoudi K. Das B. de Saint M. Victor S. Foubert-Samier A. Fabbri M. et al. (2022). A comparative study on vowel articulation in Parkinson’s disease and multiple system atrophy. Interspeech, 2248–2252. doi: 10.21437/Interspeech.2022-845
Delvaux V. Roland V. Huet K. Piccaluga M. Haelewyck M. C. Harmegnies B. (2016). The production of intervocalic glides in non Dysarthric parkinsonian speech. Proc. Interspeech, 253–256. doi: 10.21437/Interspeech.2016-349
Dias A. E. Barbosa M. T. Limongi J. C. P. Barbosa E. R. (2016). Speech disorders did not correlate with age at onset of Parkinson’s disease. Arq. Neuropsiquiatr. 74, 117–121. doi: 10.1590/0004-282X20160008
Duez D. Ghio A. Viallet F. (2020). Perception des consonnes dans la dysarthrie parkinsonienne: Effets du contexte phonémique, prosodique et lexical. 6e conférence conjointe Journées d’Études sur la Parole (JEP, 33e édition), Traitement Automatique des Langues Naturelles (TALN, 27e édition), Rencontre des Étudiants Chercheurs en Informatique pour le Traitement Automatique des Langues (RÉCITAL, 22e édition), 10
Duffy J. R. (2019). Motor speech disorders: Substrates, differential diagnosis and management (4th). St Louis, MO: Mosby.
Fougeron C. Smith C. L. (1999). Handbook of the international phonetic association: A guide to the use of the international phonetic alphabet (French). Cambridge University Press, England.
Gentilhomme A. Tir M. Renard A. (2020). Dysarthrie dans la maladie de Parkinson. Quelle est la sévérité de la dysarthrie au moment de la première évaluation en orthophonie pour prise en soin? Neurologies 23:213.
Goberman A. Coelho C. Robb M. (2002). Phonatory characteristics of parkinsonian speech before and after morning medication: the ON and OFF states. J. Commun. Disord. 35, 217–239. doi: 10.1016/S0021-9924(01)00072-7, PMID: 12064785
Goetz C. G. Tilley B. C. Shaftman S. R. Stebbins G. T. Fahn S. Martinez-Martin P. et al. (2008). Movement Disorder Society-sponsored revision of the Uni-fied Parkinson’s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov. Disord. 23, 2129–2170. doi: 10.1002/mds.22340
Hartelius L. Svensson P. (1994). Speech and swallowing symptoms associated with Parkinson’s disease and multiple sclerosis: a survey. Folia Phoniatr. Logop. 46, 9–17. doi: 10.1159/000266286
Hlavnička J. Čmejla R. Tykalová T. Šonka K. Růžička E. Rusz J. (2017). Automated analysis of connected speech reveals early biomarkers of Parkinson’s disease in patients with rapid eye movement sleep behaviour disorder. Sci. Rep. 7:12. doi: 10.1038/s41598-017-00047-5, PMID: 28144037
Hoehn M. M. Yahr M. D. (1967). Parkinsonism: onset, progression, and mortality. Neurology 17, 427–442. doi: 10.1212/WNL.17.5.427
Huet K. Harmegnies B. (2000). Contribution à la quantification du degré d’organisation des systèmes vocaliques. XXIIIèmes Journées d’Etude sur la Parole 1, 225–228. Aussois
Kalf H. de Swart B. Bonnier-Baars M. Kanters J. Hofman M. Kocken J., … Munneke M. (2011). Guidelines for speech-language therapy in parkinson’s disease. Nijmegen (The Netherlands)/Miami (USA): National Parkinson Foundation.
Karan B. Sahu S. S. Orozco-Arroyave J. R. (2022). An investigation about the relationship between dysarthria level of speech and the neurological state of Parkinson’s patients. Biocybernetics and Biomed. Eng. 42, 710–726. doi: 10.1016/j.bbe.2022.04.003
Karlsson F. Hartelius L. (2019). How well does Diadochokinetic task performance predict articulatory imprecision? Differentiating individuals with Parkinson’s disease from control subjects. Folia Phoniatr Logop 71, 251–260. doi: 10.1159/000498851, PMID: 31117108
Kent R. D. Kim Y.-J. (2003). Toward an acoustic typology of motor speech disorders. Clin. Linguist. Phon. 17, 427–445. doi: 10.1080/0269920031000086248
Kent R. D. Vorperian H. K. (2018). Static measurements of vowel formant frequencies and bandwidths: a review. J. Commun. Disord. 74, 74–97. doi: 10.1016/j.jcomdis.2018.05.004, PMID: 29891085
Kuo C. Berry J. (2023). The relationship between acoustic and kinematic vowel space areas with and without normalization for speakers with and without dysarthria. Am. J. Speech Lang. Pathol. 1-15, 1–15. doi: 10.1044/2023_AJSLP-22-00158, PMID: 37105919
Laganaro M. Fougeron C. Pernon M. Levêque N. Borel S. Fornet M. et al. (2021). Sensitivity and specificity of an acoustic- and perceptual-based tool for assessing motor speech disorders in French: the MonPaGe-screening protocol. Clin. Linguist. Phon. 35, 1060–1075. doi: 10.1080/02699206.2020.1865460, PMID: 33478251
Martel-Sauvageau V. Roy J.-P. Cantin L. Prud’Homme M. Langlois M. Macoir J. (2015). Articulatory changes in vowel production following STN DBS and levodopa intake in Parkinson’s disease. Parkinsons Dis 2015, 1–7. doi: 10.1155/2015/382320, PMID: 26558134
Martel-Sauvageau V. Tjaden K. (2017). Vocalic transitions as markers of speech acoustic changes with STN-DBS in Parkinson’s disease. J. Commun. Disord. 70, 1–11. doi: 10.1016/j.jcomdis.2017.10.001, PMID: 29032347
McAuliffe M. J. Ward E. C. Murdoch B. E. (2006). Speech production in Parkinson’s disease: I. an electropalatographic investigation of tongue-palate contact patterns. Clin. Linguist. Phon. 20, 1–18. doi: 10.1080/02699200400001044, PMID: 16393795
McRae P. Tjaden K. (1998). Spectral properties of fricatives in Parkinson’s disease. Am. J. Speech Lang. Pathol. 104:1854. doi: 10.1121/1.424480
Miller N. Deane K. H. O. Jones D. Noble E. Gibb C. (2011). National survey of speech and language therapy provision for people with Parkinson’s disease in the United Kingdom: therapists’ practices. Int. J. Lang. Commun. Disord. 46, 189–201. doi: 10.3109/13682822.2010.484849, PMID: 21401817
Mollaei F. Shiller D. M. Baum S. R. Gracco V. L. (2016). Sensorimotor control of vocal pitch and formant frequencies in Parkinson’s disease. Brain Res. 1646, 269–277. doi: 10.1016/j.brainres.2016.06.013, PMID: 27288701
Nasreddine Z. S. Phillips N. A. Bédirian V. Charbonneau S. Whitehead V. Collin I. et al. (2005). The Montreal cognitive assessment, MoCA: a Brief screening tool for mild cognitive impairment: MOCA: a BRIEF SCREENING TOOL FOR MCI. J. Am. Geriatr. Soc. 53, 695–699. doi: 10.1111/j.1532-5415.2005.53221.x, PMID: 15817019
Neel A. T. (2008). Vowel space characteristics and vowel identification accuracy. J. Speech Lang. Hear. Res. 51, 574–585. doi: 10.1044/1092-4388(2008/041), PMID: 18506036
Postuma R. B. Berg D. Stern M. Poewe W. Olanow C. W. Oertel W. et al. (2015). MDS clinical diagnostic criteria for Parkinson’s disease: MDS-PD clinical diagnostic criteria. Mov. Disord. 30, 1591–1601. doi: 10.1002/mds.26424
Rountrey C. Molett M. (2020). Vowel articulation index and conversational spontaneous speech intelligibility in parkinson's disease. Parkinsonism Related Dis. 79:e123. doi: 10.1016/j.parkreldis.2020.06.444
Roy N. Nissen S. L. Dromey C. Sapir S. (2009). Articulatory changes in muscle tension dysphonia: evidence of vowel space expansion following manual circumlaryngeal therapy. J. Commun. Disord. 42, 124–135. doi: 10.1016/j.jcomdis.2008.10.001, PMID: 19054525
Rusz J. Cmejla R. Tykalova T. Ruzickova H. Klempir J. Majerova V. et al. (2013). Imprecise vowel articulation as a potential early marker of Parkinson's disease: effect of speaking task. J. Acoust. Soc. Am. 134, 2171–2181. doi: 10.1121/1.4816541
Rusz J. Hlavnička J. Novotný M. Tykalová T. Pelletier A. Montplaisir J. et al. (2021). Speech biomarkers in rapid eye movement sleep behavior disorder and Parkinson disease. Ann. Neurol. 90, 62–75. doi: 10.1002/ana.26085, PMID: 33856074
Sapir S. (2014). Multiple factors are involved in the dysarthria associated with Parkinson’s disease: a review with implications for clinical practice and research. J. Speech Lang. Hear. Res. 57, 1330–1343. doi: 10.1044/2014_JSLHR-S-13-0039, PMID: 24686571
Sapir S. Ramig L. O. Spielman J. L. Fox C. (2010). Formant centralization ratio: a proposal for a new acoustic measure of dysarthric speech. J. Speech. Lang. Hear. Res. 53:114. doi: 10.1044/1092-4388(2009/08-0184)
Sapir S. Ramig L. O. Spielman J. Fox C. (2011). “Acoustic metrics of vowel articulation in parkinson’s disease: Vowel space area (VSA) vs. vowel articulation index (VAI),” in Models of Analysis of Vocal Emissions for Biomedical Applications: 7th International Workshop. Florence, Italy: Firenze University Press, 173–5.
Sapir S. Spielman J. L. Ramig L. O. Story B. H. Fox C. (2007). Effects of intensive voice treatment (the Lee Silverman voice treatment [LSVT]) on vowel articulation in Dysarthric individuals with idiopathic Parkinson disease: acoustic and perceptual findings. J. Speech Lang. Hear. Res. 50, 899–912. doi: 10.1044/1092-4388(2007/064)
Schalling E. Johansson K. Hartelius L. (2017). Speech and communication changes reported by people with Parkinson’s disease. Folia Phoniatr. Logop. 69, 131–141. doi: 10.1159/000479927
Skodda S. Grönheit W. Schlegel U. (2012). Impairment of vowel articulation as a possible marker of disease progression in Parkinson’s disease. PLoS One 7:e32132. doi: 10.1371/journal.pone.0032132, PMID: 22389682
Skodda S. Visser W. Schlegel U. (2011). Vowel articulation in Parkinson’s disease. J. Voice 25, 467–472. doi: 10.1016/j.jvoice.2010.01.009
Sunwoo M. K. Hong J. Y. Lee J. E. Lee H. S. Lee P. H. Sohn Y. H. (2014). Depression and voice handicap in Parkinson disease. J. Neurol. Sci. 346, 112–115. doi: 10.1016/j.jns.2014.08.003, PMID: 25172195
Walsh B. Smith A. (2012). Basic parameters of articulatory movements and acoustics in individuals with Parkinson's disease. Mov. Disord. 27, 843–850. doi: 10.1002/mds.24888, PMID: 22729986
Wong M. N. Murdoch B. E. Whelan B.-M. (2011). Lingual kinematics in Dysarthric and Nondysarthric speakers with Parkinson's disease. Parkinson’s Dis 2011, 1–8. doi: 10.4061/2011/352838, PMID: 22007341
