Adam Vogel

Acoustic changes in the production of lexical stress during Lombard speech

Publisher: SAGE Publications

Date: 16-08-2014

DOI: 10.1177/0023830913495652

Abstract: The Lombard effect describes the phenomenon of in iduals increasing their vocal intensity when speaking in the presence of background noise. Here, we conducted an investigation of the production of lexical stress during Lombard speech. Participants ( N= 27) produced the same sentences in three conditions: one quiet condition and two noise conditions at 70 dB (white noise multi-talker babble). Manual acoustic analyses (syllable duration, vowel intensity, and vowel fundamental frequency) were completed for repeated productions of two trisyllabic words with opposing patterns of lexical stress (weak–strong strong–weak) in each of the three conditions. In total, 324 productions were analysed (12 utterances per participant). Results revealed that, rather than increasing vocal intensity equally across syllables, participants alter the degree of stress contrastivity when speaking in noise. This was especially evident in the production of strong–weak lexical stress where there was an increase in contrastivity across syllables in terms of intensity and fundamental frequency. This preliminary study paves the way for further research that is needed to establish these findings using a larger set of multisyllabic stimuli.

Letter to the editor

Publisher: SAGE Publications

Date: 17-03-2021

DOI: 10.1177/1751143721999947

Consensus clinical management guidelines for Friedreich ataxia

Publisher: Springer Science and Business Media LLC

Date: 30-11-2014

DOI: 10.1186/S13023-014-0184-7

Dysarthria in Friedreich's ataxia: A perceptual analysis

Publisher: S. Karger AG

Date: 2010

DOI: 10.1159/000287207

Abstract: The aims of this study were to: (1) evaluate the perceptual speech dimensions, speech intelligibility and dysarthria severity of a group of in iduals diagnosed with Friedreich’s ataxia (FRDA) (2) determine the presence of subgroups within FRDA dysarthria (3) investigate the relationship between the speech outcome and the clinical factors of disease progression. The study included 38 in iduals (21 female, 17 male) with a confirmed diagnosis of FRDA. A group of 20 non-neurologically impaired in iduals served as controls. Perceptual analysis, investigating 30 different dimensions of speech, was conducted on a speech s le obtained from each participant. In addition, the Assessment of Intelligibility of Dysarthria Speech was administered. All FRDA participants presented with dysarthria with severities ranging from mild to moderate. Cluster analysis revealed 3 subgroups, the first presenting with mild dysarthric symptoms, the second with increased velopharyngeal involvement and the third characterized by increased laryngeal dysfunction. Dysarthria severity showed a significant correlation to disease duration but to no other clinical measure. The findings support the notion of subgroups in FRDA dysarthria, representing distinct impairments of the speech mechanism and perhaps reflective of differing evolutions beyond the cerebellum.

Speech and language deficits are central to SETBP1 haploinsufficiency disorder

Publisher: Springer Science and Business Media LLC

Date: 27-04-2021

DOI: 10.1038/S41431-021-00894-X

Comparison of voice acquisition methodologies in speech research

Publisher: Springer Science and Business Media LLC

Date: 11-2008

DOI: 10.3758/BRM.40.4.982

Use of illicit amphetamines is associated with long-lasting changes in hand circuitry and control

Publisher: Elsevier BV

Date: 05-2019

DOI: 10.1016/J.CLINPH.2019.02.005

Abstract: The study aim was to determine if use of illicit hetamines or ecstasy is associated with abnormal excitability of the corticomotoneuronal pathway and manipulation of novel objects with the hand. Three groups of adults aged 18-50 years were investigated: in iduals with a history of illicit hetamine use, in iduals with a history of ecstasy use but minimal use of other stimulants, and non-drug users. Transcranial magnetic stimulation was delivered to the motor cortex and the electromyographic response (motor evoked potential MEP) was recorded from a contralateral hand muscle. Participants also gripped and lifted a novel experimental object consisting of two strain gauges and an accelerometer. Resting MEP litude was larger in the hetamine group (6M, 6F) than the non-drug and ecstasy groups (p < 0.005) in males but not females. Overestimation of grip force during manipulation of a novel object was observed in the hetamine group (p = 0.020) but not the ecstasy group. History of illicit hetamine use, in particular meth hetamine, is associated with abnormal motor cortical and/or corticomotoneuronal excitability in males and abnormal manipulation of novel objects in both males and females. Abnormal excitability and hand function is evident months to years after cessation of illicit hetamine use.

Standardization of pitch-range settings in voice acoustic analysis

Publisher: Springer Science and Business Media LLC

Date: 05-2009

DOI: 10.3758/BRM.41.2.318

Health care utilisation following hospitalisation for transport-related injury

Publisher: Elsevier BV

Date: 09-2012

DOI: 10.1016/J.INJURY.2011.03.011

Abstract: Transport injuries are a substantial cause of disability and death internationally. There is little published information regarding patterns of healthcare utilisation following transport injury. To investigate patterns of in-hospital and post-discharge healthcare use following transport injury. Analysis of all accepted adult claims from the database of the transport accident compensation regulator in Victoria, Australia between 1995 and 2008. The analyses focused on injuries resulting in hospitalisation. Indicators of in-hospital and post-discharge healthcare utilisation (e.g. number of services per practitioner group) within the first 12-months were summarised. More than a third (33.6%, n = 68,639) of all accepted compensable transport injuries resulted in admission to an acute care facility within 28 days of injury. In this group, the compensation authority paid for a total of 4.5 million healthcare services in the 12 months post-discharge (median of 19 services per claim). Services provided by medical practitioners were accessed by nearly all claimants (95.7%) at a median of 11 (5-26) per claimant. Less than half of claimants (46.7%) accessed paramedical or allied health services but the median number of services accessed was higher at 29 (9-82) per claimant. Transport-related injury cases require a substantial interaction with multiple components of the healthcare system in the year following hospital discharge. Compensation system data may provide a detailed understanding of healthcare utilisation, a key element of injury burden.

Dysphagia and swallowing-related quality of life in Friedreich ataxia

Publisher: Springer Science and Business Media LLC

Date: 27-12-2013

DOI: 10.1007/S00415-013-7208-4

Abstract: Dysphagia in Friedreich ataxia (FRDA) and its impact on quality of life is not adequately understood. The objective of this study was to characterise dysphagia in FRDA and to determine the impact of swallowing dysfunction on activities, participation, and sense of well-being. Thirty-six in iduals with a confirmed diagnosis of FRDA were assessed via a clinical bedside examination (CBE), the Royal Brisbane Hospital outcome measure for swallowing, an oral-motor examination and the Australian therapy outcome measures for speech and swallowing (AusTOMS). Data on swallowing function, diet modification and swallowing strategies were collated. Thirty-three (91.67 %) participants exhibited clinical signs of dysphagia according to the CBE, and all participants received ratings indicating swallowing difficulties on at least one other measure. Dysphagia in FRDA is characterised by oral and pharyngeal stage impairment relating to incoordination, weakness and spasticity. A significant positive correlation was found between the severity of impairment, activity, participation and distress/well-being on the AusTOMS, suggesting that swallowing function decreases with overall reductions in quality of life. A significant correlation was found between activity on the AusTOMS and disease duration (r = -0.283, p = 0.012). No significant correlations were found between dysphagia severity and GAA repeat length, age of onset or disease severity. Participants employing diet modification and swallowing strategies demonstrated higher dysphagia severity, activity limitations and participation restrictions. These data advocate a holistic approach to dysphagia management in FRDA. Early detection of swallowing impairment and consideration of the potential impact dysphagia has on quality of life should be key aspects in disease management.

Automatic method of pause measurement for normal and dysarthric speech

Publisher: Informa UK Limited

Date: 25-01-2010

DOI: 10.3109/02699200903440983

Abstract: This study proposes an automatic method for the detection of pauses and identification of pause types in conversational speech for the purpose of measuring the effects of Friedreich's Ataxia (FRDA) on speech. Speech s les of approximately 3 minutes were recorded from 13 speakers with FRDA and 18 healthy controls. Pauses were measured from the intensity contour and fit with bimodal lognormal distributions using the Expectation-Maximization algorithm in Matlab. In the speakers with FRDA, both modes in the pause distributions had significantly larger means, with disproportionately fewer pauses associated with the first mode. From this preliminary study, it is concluded that distributional analysis of pause duration holds promise as a useful method of measuring the effects of FRDA on functional speech.

Evaluation of cerebellar function scores in relation to cerebellar axonal loss in multiple sclerosis

Publisher: Cold Spring Harbor Laboratory

Date: 16-05-2020

DOI: 10.1101/2020.05.15.094938

Abstract: Cerebellar damage is common in people with multiple sclerosis (pwMS) and is associated with worse progression and relapse recovery. Studies into the importance of the cerebellum in pwMS are h ered by limited understanding of cerebellar damage and its relation to cerebellar function in pwMS. Examine axonal loss, as a primary driver of progressive neurological decline, in the cerebellum using advanced diffusion MRI and compare axonal loss with cerebellar dysfunction in pwMS We recruited 55 pwMS and 14 healthy controls. Clinical assessments included scale for the assessment and rating of ataxia (SARA), and Bain tremor ratings. Subjects underwent FLAIR, T1-weighted and diffusion MRI. Cerebellar grey and white matter and lesion volume were calculated. Cerebellar axonal loss was examined with fibre-specific markers. Fibre density and cross-section (FDC) accounts for microscopic and macroscopic changes in a fibre bundle. Loss of cerebellar FDC was associated with increased SARA (r=-0.42, p .01) and tremor severity (rho=-0.35, p=0.01). Cerebellar lesion volume correlated with SARA (r=0.49, p .01) and tremor severity (rho=0.41, p=0.01). Fibre-specific measures of cerebellar pathology could provide a functionally relevant marker of cerebellar damage in MS. Future trials using fibre-specific markers are needed to further characterize cerebellar pathology in pwMS and understand its significance in disease progression.

Friedreich ataxia

Publisher: BMJ

Date: 03-12-2013

DOI: 10.1136/BMJ.F7062

Speech outcomes in Parkinson's disease after subthalamic nucleus deep brain stimulation: A systematic review.

Publisher: Elsevier BV

Date: 12-2016

DOI: 10.1016/J.PARKRELDIS.2016.09.022

Abstract: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is effective in reducing motor symptoms for many in iduals with Parkinson's disease (PD). However, STN DBS does not appear to influence speech in the same way, and may result in a variety of negative outcomes for people with PD (PWP). A high degree of inter-in idual variability amongst PWP regarding speech outcomes following STN DBS is evident in many studies. Furthermore, speech studies in PWP following STN DBS have employed a wide variety of designs and methodologies, which complicate comparison and interpretation of outcome data amongst studies within this growing body of research. An analysis of published evidence regarding speech outcomes in PWP following STN DBS, according to design and quality, is missing. This systematic review aimed to analyse and coalesce all of the current evidence reported within observational and experimental studies investigating the effects of STN DBS on speech. It will strengthen understanding of the relationship between STN DBS and speech, and inform future research by highlighting methodological limitations of current evidence.

Adults with a history of recreational cannabis use have altered speech production

Publisher: Elsevier BV

Date: 10-2021

DOI: 10.1016/J.DRUGALCDEP.2021.108963

Evaluation of communication assessment practices during the acute stages post stroke

Publisher: Wiley

Date: 12-2010

DOI: 10.1111/J.1365-2753.2009.01291.X

Abstract: Early detection of communication impairment post stroke is an important prognostic indicator and promotes the use of in idualized treatment protocols. Therefore, the methods for speech and language assessment used by communication experts in acute settings following stroke were investigated. A survey was conducted among 254 speech and language pathologists providing acute care for patients following stroke in all states and territories across Australia and New Zealand. Respondent attitudes and practices in speech and language assessment post stroke were recorded with a standardized questionnaire collected online. A total of 174 (68.5%) speech and language pathologists responded. Over 70% of participants assessed language and 80% assessed speech using their own clinical assessments. Respondents identified limited test repeatability and poor sensitivity to change over acute periods as key areas of concern for currently available standardized assessments. Subjective and/or un-standardized assessments were the most commonly used measures of communication during the acute phases post stroke. These results highlight a critical need for the development of population-specific communication assessments that build on existing clinician derived techniques and expertise while considering the acute time demands and transient nature of patient's communicative functioning.

Can a smartphone-based chatbot engage older community group members? The impact of specialised content

Publisher: Wiley

Date: 07-2016

DOI: 10.1016/J.JALZ.2016.06.2070

Clinical assessment of dysphagia in neurodegeneration (CADN): development, validity and reliability of a bedside tool for dysphagia assessment

Publisher: Springer Science and Business Media LLC

Date: 03-05-2017

DOI: 10.1007/S00415-017-8499-7

Abstract: Screening assessments for dysphagia are essential in neurodegenerative disease. Yet there are no purpose-built tools to quantify swallowing deficits at bedside or in clinical trials. A quantifiable, brief, easy to administer assessment that measures the impact of dysphagia and predicts the presence or absence of aspiration is needed. The Clinical Assessment of Dysphagia in Neurodegeneration (CADN) was designed by a multidisciplinary team (neurology, neuropsychology, speech pathology) validated against strict methodological criteria in two neurodegenerative diseases, Parkinson's disease (PD) and degenerative ataxia (DA). CADN comprises two parts, an anamnesis (part one) and consumption (part two). Two-thirds of patients were assessed using reference tests, the SWAL-QOL symptoms subscale (part one) and videofluoroscopic assessment of swallowing (part two). CADN has 11 items and can be administered and scored in an average of 7 min. Test-retest reliability was established using correlation and Bland-Altman plots. 125 patients with a neurodegenerative disease were recruited 60 PD and 65 DA. Validity was established using ROC graphs and correlations. CADN has sensitivity of 79 and 84% and specificity 71 and 69% for parts one and two, respectively. Significant correlations with disease severity were also observed (p < 0.001) for PD with small to large associations between disease severity and CADN scores for DA. Cutoff scores were identified that signal the presence of clinically meaningful dysphagia symptomatology and risk of aspiration. The CADN is a reliable, valid, brief, quantifiable, and easily deployed assessment of swallowing in neurodegenerative disease. It is thus ideally suited for both clinical bedside assessment and future multicentre clinical trials in neurodegenerative disease.

Speech in prodromal and symptomatic Huntington's disease as a model of measuring onset and progression in dominantly inherited neurodegenerative diseases

Publisher: Elsevier BV

Date: 12-2019

DOI: 10.1016/J.NEUBIOREV.2019.08.009

Abstract: Subtle motor and cognitive changes can manifest prior to diagnosis in many progressive neurological disorders. Most people with Huntington's disease (HD) develop dysarthria. Yet, how speech evolves, how the brain regulates speech in HD, and the clinical implications of these changes remain unclear. We reviewed existing literature on speech production in premanifest (PreHD) to symptomatic HD. A search of databases yielded 12 eligible studies. Nine of the twelve studies were included in the meta-analysis. Data suggest that speech in PreHD is characterized by impaired speech agility, phonatory function and speech rate. Over the disease course, speech gradually deteriorates across all subsystems of speech. Our findings indicate subtle changes in speech appear prior to a clinical diagnosis of HD. However, distinct patterns of decline and the magnitude of these deficits require further investigation. Our current understanding of speech impairment in HD relies on small cohort studies. Natural history studies documenting changes from premanifest to end stage may facilitate the development of speech as a marker of disease onset and treatment response.

Speech as a reliable marker of alertness and performance impairment under conditions of acute sleep deprivation

Publisher: Oxford University Press (OUP)

Date: 28-04-2017

DOI: 10.1093/SLEEPJ/ZSX050.184

Response to the Letter to the Editor From Marcotte (2019) Regarding The History of Stuttering by 7 Years: Follow-Up of a Prospective Community Cohort by Kefalianos et al. (2017)

Publisher: American Speech Language Hearing Association

Date: 21-05-2019

DOI: 10.1044/2019_JSLHR-S-17-0476

Abstract: The purpose of this letter is to respond to Marcotte's (2019) letter to the editor, “The Influence of Treatment on Children's Recovery from Stuttering: Comments on Kefalianos et al. (2017) and Leech et al. (2017),” published by the Journal of Speech, Language, and Hearing Research .

The effects of Huntington’s disease and task difficulty on dual-task performance

Publisher: Wiley

Date: 21-08-2011

DOI: 10.1111/J.1399-0004.2011.01737.X

Acoustic analysis of the effects of sustained wakefulness on speech

Publisher: Acoustical Society of America (ASA)

Date: 12-2010

DOI: 10.1121/1.3506349

Abstract: Exposing healthy adults to extended periods of wakefulness is known to induce changes in psychomotor functioning [Maruff et al. (2005). J. Sleep Res. 14, 21–27]. The effect of fatigue on speech is less well understood. To date, no studies have examined the pitch and timing of neurologically healthy in iduals over 24 h of sustained wakefulness. Therefore, speech s les were systematically acquired (e.g., every 4 h) from 18 healthy adults over 24 h. Stimuli included automated and extemporaneous speech tasks, sustained vowel, and a read passage. Measures of timing, frequency and spectral energy were derived acoustically using PRAAT and significant changes were observed on all tasks. The effect of fatigue on speech was found to be strongest just before dawn (after 22 h). Specifically, total speech time, mean pause length, and total signal time all increased as a function of increasing levels of fatigue on the reading tasks percentage pause and mean pause length decreased on the counting task F4 variation decreased on the sustained vowel tasks /a:/ and alpha ratio increased on the extemporaneous speech tasks. These findings suggest that acoustic methodologies provide objective data on central nervous system functioning and that changes in speech production occur in healthy adults after just 24 h of sustained wakefulness.

Development, feasibility testing, and preliminary evaluation of the Communication with an Artificial airway Tool (CAT): Results of the Crit-CAT pilot study

Publisher: Elsevier BV

Date: 10-2023

DOI: 10.1016/J.AUCC.2023.09.007

Mobile instrumental assessment of swallowing in residential aged care homes

Publisher: Cold Spring Harbor Laboratory

Date: 04-08-2023

DOI: 10.1101/2023.07.28.23293296

Abstract: Adults living in residential-aged-care-homes (RACHs) with oropharyngeal dysphagia may not have timely access to instrumental swallowing assessment due to barriers, including the need to travel off-site for assessment. This study describes the feasibility, utility, and acceptability of mobile Flexible-Endoscopic-Swallowing-Assessment (mFEES) in Australian residential-aged-care-homes (RACHs). Residents with dysphagia living in RACHs were assessed using onsite mFEES. Feasibility, utility, and acceptability were measured at institutional, resident, and implementation levels. Healthcare professionals and medical decision makers reported that mFEES facilitated a better understanding of residents’ swallowing function/dysphagia management and was beneficial over off-site services. Self-rated discomfort during mFEES was low and most residents presented with no or minimal anxiety about the procedure. Costs of mobile assessments are documented. mFEES was a safe, well tolerated, and practical service that offered opportunity to enhance person-centered clinical care in older adults living with dysphagia in RACHs.

The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort.

Publisher: American Speech Language Hearing Association

Date: 17-10-2017

DOI: 10.1044/2017_JSLHR-S-16-0205

Abstract: For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and environmental measures and first-degree relative history of stuttering. Comorbidities examined at 7 years included temperament, language, nonverbal cognition, and health-related quality of life. The recovery rate by the age of 7 years was 65%. Girls with stronger communication skills at the age of 2 years had higher odds of recovery (adjusted OR = 7.1, 95% CI [1.3, 37.9], p = .02), but similar effects were not evident for boys (adjusted OR = 0.5, 95% CI [0.3, 1.1], p = .10). At the age of 7 years, children who had recovered from stuttering were more likely to have stronger language skills than children whose stuttering persisted ( p = .05). No evident differences were identified on other outcomes including nonverbal cognition, temperament, and parent-reported quality of life. Overall, findings suggested that there may be associations between language ability and recovery from stuttering. Subsequent research is needed to explore the directionality of this relationship.

Using the Concept of Health Literacy to Understand How People Living with Motor Neurone Disease and Carers Engage in Healthcare: A Longitudinal Qualitative Study

Publisher: MDPI AG

Date: 24-07-2022

DOI: 10.3390/HEALTHCARE10081371

Abstract: The growing body of information-seeking and decision-making literature in motor neurone disease (MND) has not yet explored the impact of health literacy. Health literacy relates to the skills people have to access, understand, and use health information and is influenced by motivation to engage with healthcare. We aimed to better understand how people affected by MND engage in healthcare by examining longitudinal interview data using the construct of health literacy. Semi-structured interviews were conducted with 19 persons living with MND and 15 carers recruited from a specialist MND clinic using maximum variation s ling. Transcripts were deductively coded using a framework of health literacy behaviours. The analysis used a matrix-based approach for thematic analysis of longitudinal data. People living with MND and carers sought nuanced information dependent on their priorities and attitudes. Information uptake was influenced by perceived relevancy and changed over time. Time allowed opportunity to reflect on and understand the significance of information provided. The findings indicate that persons living with MND and carers benefit when information and consultations are adapted to meet their communication needs. The results highlight the potential benefits of gaining an early understanding of and accommodating the communication needs, personal preferences, and emotional readiness for information for persons living with MND and their carers.

Dysphagia in spinocerebellar ataxia and multiple system atrophy - cerebellar

Publisher: Informa UK Limited

Date: 22-09-2015

DOI: 10.1179/2050572814Y.0000000047

The feasibility of using acoustic markers of speech for optimizing patient outcomes during randomized amplitude variation in deep brain stimulation: A proof of principle methods study

Publisher: Frontiers Media SA

Date: 14-07-2015

DOI: 10.3389/FBIOE.2015.00098

Clinically meaningful metrics of speech in neurodegenerative disease: Quantification of speech intelligibility and naturalness in ataxia

Publisher: Cold Spring Harbor Laboratory

Date: 29-03-2023

DOI: 10.1101/2023.03.28.23287878

Abstract: Digital biomarkers continue to make headway in the clinic and clinical trials for neurological conditions. Speech is a domain with great promise. Using Friedreich ataxia (FRDA) as an exemplar population, we aimed to align objective measures of speech with markers of disease severity, speech related quality of life and subjective judgements of speech using supervised machine learning techniques. 132 participants with genetically confirmed diagnosis of FRDA were assessed using digital speech tests, disease severity scores (Friedreich Ataxia Rating Scale, FARS) and speech related quality of life ratings over a 10-year period. Speech was analyzed perceptually by expert listeners for intelligibility (ability to be understood) and naturalness (deviance from healthy norm) and acoustically across 344 features. Features were selected and presented into a random forest and a support vector machine classifier in a standard supervised learning setup designed to replicate expert-produced scores. We demonstrate a subset of measures are strongly associated with all four clinical scales. Objective speech data replicated experts’ assessments of naturalness and intelligibility. These scores represent a lower level of variability than observed between subjective listener ratings. Findings provide evidence there are specific objective markers of speech that change over time and reflect clinical aspects of the disease. The use of a large dataset yielded a speech assay capable of accurately approximating expert listener ratings of key clinical aspects of dysarthria severity. Distinct but complementary subsets align with disease severity and speech related quality of life.

Intervention for childhood apraxia of speech

Publisher: Wiley

Date: 16-07-2008

DOI: 10.1002/14651858.CD006278.PUB2

A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration

Publisher: S. Karger AG

Date: 2018

DOI: 10.1159/000494210

Abstract: b i Background: /i /b Frontotemporal lobar degeneration (FTLD) can result in a decline in behavior, language, and motor function. Mealtime disturbances are a common and significant outcome of FTLD. Disturbances during mealtimes can arise from dysphagia or may occur secondary to behavioral changes such as rapid eating, mealtime rigidity, and altered diet preferences. b i Summary: /i /b Few studies have comprehensively evaluated eating behavior or dysphagia in in iduals presenting with FTLD pathology despite the potential impact on medical safety and in idual quality of life. Dysphagia is reported in the late stages of frontotemporal dementia and early in the motor subtypes of FTLD. The identification of dysphagia can alert in iduals and medical teams to disease progression and provide insight into the nature and spread of the underlying neuropathology. Improved understanding of eating behaviors can improve in idual care and may enhance diagnostic accuracy. b i Key Message: /i /b Aberrant eating behavior and swallowing difficulties are reported in the conditions associated with FTLD neuropathology. The consequences of mealtime disturbances include health risks associated with an increased BMI and aspiration, reduction of an in idual’s independence, and an increase in caregiver stress and burden. Here we review and summarize the literature on eating behavior and swallow impairments (dysphagia) in each of the syndromes caused by FTLD.

Articulatory kinematics in the dysarthria associated with Friedreich's ataxia

Publisher: Human Kinetics

Date: 07-2011

DOI: 10.1123/MCJ.15.3.376

Abstract: Electromagnetic articulography (EMA) was used to investigate the tongue kinematics in the dysarthria associated with Friedreich’s ataxia (FRDA). The subject group consisted of four in iduals diagnosed with FRDA. Five nonneurologically impaired in iduals, matched for age and gender, served as controls. Each participant was assessed using the AG-200 EMA system during six repetitions of the tongue tip sentence Tess told Dan to stay fit and the tongue back sentence Karl got a croaking frog . Results revealed reduced speed measures (i.e., maximum acceleration / deceleration / velocity), greater movement durations and increased articulatory distances for the approach phases of consonant productions. The approach phase, involving movement up to the palate, was more affected than the release phase. It is suggested that deviant lingual kinematics could be the outcome of disturbances to cerebellar function, or possibly in combination with disturbances to upper motor neuron systems.

Speech and swallowing abnormalities in adults with POLG associated ataxia (POLG-A)

Publisher: Elsevier BV

Date: 11-2017

DOI: 10.1016/J.MITO.2017.06.002

Abstract: Mutations in the nuclear-encoded mitochondrial DNA polymerase gamma (POLG) can result in a wide spectrum of neurological deficits. A common presentation is progressive ataxia (POLG-A) which includes impaired speech and swallowing. The nature, severity and impact of these deficits in POLG-A is not known. A comprehensive quantitative and qualitative characterization of dysarthria and dysphagia in this recurrent ataxia disorder will assist in diagnostics, provide insights into the underlying pathology, and establish the foundation for future therapy trials. 14 consecutive patients with POLG (9 females, mean age=50.1y, SD=11.2) and 34 healthy controls were enrolled. Comprehensive assessments of motor speech and swallowing function, acoustic analysis of speech, videofluoroscopy and measures of quality of life were conducted. The speech profile of in iduals with POLG-A was characterized by poor control of pitch and strain-strangled voice quality, reduced rate of speech and longer variable silences between words, and articulatory breakdown including imprecise consonants and vowel distortions. Swallowing deficits included slower initiation of the swallow reflex, poor control of bolus and late epiglottic closure. Speech and swallowing related quality of life was worse than healthy controls. The dysarthria and dysphagia profiles in POLG-A are largely symptomatic of impaired timing, indicating a mainly spinocerebellar deficit. Dysarthria and dysphagia contribute to a significant impairment in functional quality of life, and progress distinctly from other POLG-A dysfunctions like ataxia or cognitive impairment. Our assessments establish meaningful patient focused outcome measures that will be suitable for use in natural history studies and clinical trials.

In-depth characterisation of a cohort of individuals with missense and loss-of-function variants disruptingFOXP2

Publisher: BMJ

Date: 03-11-2022

DOI: 10.1136/JMG-2022-108734

Abstract: Heterozygous disruptions of FOXP2 were the first identified molecular cause for severe speech disorder: childhood apraxia of speech (CAS), and yet few cases have been reported, limiting knowledge of the condition. Here we phenotyped 28 in iduals from 17 families with pathogenic FOXP2 -only variants (12 loss-of-function, five missense variants 14 males aged 2 to 62 years). Health and development (cognitive, motor, social domains) were examined, including speech and language outcomes with the first cross-linguistic analysis of English and German. Speech disorders were prevalent (23/25, 92%) and CAS was most common (22/25, 88%), with similar speech presentations across English and German. Speech was still impaired in adulthood, and some speech sounds (eg, ‘th’, ‘r’, ‘ch’, ‘j’) were never acquired. Language impairments (21/25, 84%) ranged from mild to severe. Comorbidities included feeding difficulties in infancy (10/26, 38%), fine (13/26, 50%) and gross (13/26, 50%) motor impairment, anxiety (5/27, 19%), depression (6/27, 22%) and sleep disturbance (10/24, 42%). Physical features were common (22/27, 81%) but with no consistent pattern. Cognition ranged from average to mildly impaired and was incongruent with language ability for ex le, seven participants with severe language disorder had average non-verbal cognition. Although we identify an increased prevalence of conditions like anxiety, depression and sleep disturbance, we confirm that the consequences of FOXP2 dysfunction remain relatively specific to speech disorder, as compared with other recently identified monogenic conditions associated with CAS. Thus, our findings reinforce that FOXP2 provides a valuable entry point for examining the neurobiological bases of speech disorder.

Objective measures of efficacy of Deep Brain Stimulation for treatment of tremor

Publisher: Frontiers Media SA

Date: 2012

DOI: 10.3389/CONF.FNHUM.2012.208.00067

ParkinSong: A Controlled Trial of Singing-Based Therapy for Parkinson’s Disease

Publisher: SAGE Publications

Date: 12-05-2019

DOI: 10.1177/1545968319847948

Abstract: Background. Communication impairment is one of the most common symptoms of Parkinson’s disease (PD), significantly affecting quality of life. Singing shares many of the neural networks and structural mechanisms used during speech and, thus, has potential for therapeutic application to address speech disorders. Objective. To explore the effects of an interdisciplinary singing-based therapeutic intervention (ParkinSong) on voice and communication in people with PD. Methods. A controlled trial compared the effects of the ParkinSong intervention with an active control condition at 2 dosage levels (weekly vs monthly) over 3 months, on voice, speech, respiratory strength, and voice-related quality-of-life outcomes for 75 people living with PD. The interdisciplinary ParkinSong model comprised high-effort vocal and respiratory tasks, speech exercises, group singing, and social communication opportunities. Results. ParkinSong intervention participants demonstrated significant improvements in vocal intensity ( P = .018), maximum expiratory pressure ( P = .032), and voice-related quality of life ( P = .043) in comparison to controls. Weekly ParkinSong participants increased vocal intensity more than monthly participants ( P = .011). Vocal intensity declined in nontreatment control groups. No statistical differences between groups on maximum phonation length or maximum inspiratory pressure were observed at 3 months. Conclusions. ParkinSong is an engaging intervention with the potential to increase loudness and respiratory function in people with mild to moderately severe PD.

Treatment for dysphagia (swallowing difficulties) in hereditary ataxia syndromes (Protocol)

Publisher: John Wiley & Sons, Ltd

Date: 17-10-2012

DOI: 10.1002/14651858.CD010169

Speech and oral motor profile after childhood hemispherectomy

Publisher: Elsevier BV

Date: 08-2010

DOI: 10.1016/J.BANDL.2009.12.004

Abstract: Hemispherectomy (disconnection or removal of an entire cerebral hemisphere) is a rare surgical procedure used for the relief of drug-resistant epilepsy in children. After hemispherectomy, contralateral hemiplegia persists whereas gross expressive and receptive language functions can be remarkably spared. Motor speech deficits have rarely been examined systematically, thus limiting the accuracy of postoperative prognosis. We describe the speech profiles of hemispherectomized participants characterizing their intelligibility, articulation, phonological speech errors, dysarthric features, and execution and sequencing of orofacial speech and non-speech movements. Thirteen participants who had undergone hemispherectomy (six left, seven right nine with congenital, four with acquired hemiplegia operated between four months and 13 years) were investigated. Results showed that all participants were intelligible but showed a mild dysarthric profile characterized by neuromuscular asymmetry and reduced quality and coordination of movements, features that are characteristic of adult-onset unilateral upper motor neuron dysarthria, flaccid-ataxic variant. In addition, one left and four right hemispherectomy cases presented with impaired production of speech and non-speech sequences. No participant showed evidence of verbal or oral dyspraxia. It is concluded that mild dysarthria is persistent after left or right hemispherectomy, irrespective of age at onset of hemiplegia. These results indicate incomplete functional re-organization for the control of fine speech motor movements throughout childhood, and provide no evidence of hemispheric differences.

A Tutorial Review on Clinical Acoustic Markers in Speech Science

Publisher: American Speech Language Hearing Association

Date: 12-09-2022

DOI: 10.1044/2022_JSLHR-21-00647

Abstract: The human voice changes with the progression of neurological disease and the onset of diseases that affect articulators, often decreasing the effectiveness of communication. These changes can be objectively measured using signal processing techniques that extract acoustic features. When measuring acoustic features, there are often several steps and assumptions that might be known to experts in acoustics and phonetics, but are less transparent for other disciplines (e.g., clinical medicine, speech pathology, engineering, and data science). This tutorial describes these signal processing techniques, explicitly outlines the underlying steps for accurate measurement, and discusses the implications of clinical acoustic markers. We establish a vocabulary using straightforward terms, provide visualizations to achieve common ground, and guide understanding for those outside the domains of acoustics and auditory signal processing. Where possible, we highlight the best practices for measuring clinical acoustic markers and suggest resources for obtaining and further understanding these measures.

Optimising speech outcomes in deep brain stimulation for essential tremor

Publisher: Frontiers Media SA

Date: 2012

DOI: 10.3389/CONF.FNHUM.2012.208.00108

A predictive model for diagnosing stroke-related apraxia of speech

Publisher: Elsevier BV

Date: 2016

DOI: 10.1016/J.NEUROPSYCHOLOGIA.2015.12.010

Abstract: Diagnosis of the speech motor planning rogramming disorder, apraxia of speech (AOS), has proven challenging, largely due to its common co-occurrence with the language-based impairment of aphasia. Currently, diagnosis is based on perceptually identifying and rating the severity of several speech features. It is not known whether all, or a subset of the features, are required for a positive diagnosis. The purpose of this study was to assess predictor variables for the presence of AOS after left-hemisphere stroke, with the goal of increasing diagnostic objectivity and efficiency. This population-based case-control study involved a s le of 72 cases, using the outcome measure of expert judgment on presence of AOS and including a large number of independently collected candidate predictors representing behavioral measures of linguistic, cognitive, nonspeech oral motor, and speech motor ability. We constructed a predictive model using multiple imputation to deal with missing data the Least Absolute Shrinkage and Selection Operator (Lasso) technique for variable selection to define the most relevant predictors, and bootstrapping to check the model stability and quantify the optimism of the developed model. Two measures were sufficient to distinguish between participants with AOS plus aphasia and those with aphasia alone, (1) a measure of speech errors with words of increasing length and (2) a measure of relative vowel duration in three-syllable words with weak-strong stress pattern (e.g., banana, potato). The model has high discriminative ability to distinguish between cases with and without AOS (c-index=0.93) and good agreement between observed and predicted probabilities (calibration slope=0.94). Some caution is warranted, given the relatively small s le specific to left-hemisphere stroke, and the limitations of imputing missing data. These two speech measures are straightforward to collect and analyse, facilitating use in research and clinical settings.

Reliability, stability, and sensitivity to change and impairment in acoustic measures of timing and frequency

Publisher: Elsevier BV

Date: 03-2011

DOI: 10.1016/J.JVOICE.2009.09.003

Abstract: Assessment of the voice for supporting classifications of central nervous system (CNS) impairment requires a different practical, methodological, and statistical framework compared with assessment of the voice to guide decisions about change in the CNS. In experimental terms, an understanding of the stability and sensitivity to change of an assessment protocol is required to guide decisions about CNS change. Five experiments (N = 70) were conducted using a set of commonly used stimuli (eg, sustained vowel, reading, extemporaneous speech) and easily acquired measures (eg, f₀-f₄, percent pause). Stability of these measures was examined through their repeated application in healthy adults over brief and intermediate retest intervals (ie, 30 seconds, 2 hours, and 1 week). Those measures found to be stable were then challenged using an experimental model that reliably changes voice acoustic properties (ie, the Lombard effect). Finally, adults with an established CNS-related motor speech disorder (dysarthria) were compared with healthy controls. Of the 61 acoustic variables studied, 36 showed good stability over all three stability experiments (eg, number of pauses, total speech time, speech rate, f₀-f₄. Of the measures with good stability, a number of frequency measures showed a change in response to increased vocal effort resulting from the Lombard effect challenge. Furthermore, several timing measures significantly separated the control and motor speech impairment groups. Measures with high levels of stability within healthy adults, and those that show sensitivity to change and impairment may prove effective for monitoring changes in CNS functioning.

Speech treatment improves dysarthria in multisystemic ataxia: a rater-blinded, controlled pilot-study in ARSACS

Publisher: Springer Science and Business Media LLC

Date: 06-03-2019

DOI: 10.1007/S00415-019-09258-4

Abstract: We aimed to provide proof-of-principle evidence that intensive home-based speech treatment can improve dysarthria in complex multisystemic degenerative ataxias, exemplified by autosomal recessive spastic ataxia Charlevoix-Saguenay (ARSACS). Feasibility and piloting efficacy of speech training specifically tailored to cerebellar dysarthria was examined through a 4-week program in seven patients with rater-blinded assessment of intelligibility (primary outcome) and naturalness and acoustic measures of speech (secondary outcomes) performed 4 weeks before, immediately prior to, and directly after training (intrain idual control design). Speech intelligibility and naturalness improved post treatment. This provides piloting evidence that ataxia-tailored speech treatment might be effective in degenerative cerebellar disease.

Quantifying ultrasonic mouse vocalizations using acoustic analysis in a supervised statistical machine learning framework

Publisher: Springer Science and Business Media LLC

Date: 30-05-2019

DOI: 10.1038/S41598-019-44221-3

Abstract: Examination of rodent vocalizations in experimental conditions can yield valuable insights into how disease manifests and progresses over time. It can also be used as an index of social interest, motivation, emotional development or motor function depending on the animal model under investigation. Most mouse communication is produced in ultrasonic frequencies beyond human hearing. These ultrasonic vocalizations (USV) are typically described and evaluated using expert defined classification of the spectrographic appearance or simplistic acoustic metrics resulting in nine call types. In this study, we aimed to replicate the standard expert-defined call types of communicative vocal behavior in mice by using acoustic analysis to characterize USVs and a principled supervised learning setup. We used four feature selection algorithms to select parsimonious subsets with maximum predictive accuracy, which are then presented into support vector machines (SVM) and random forests (RF). We assessed the resulting models using 10-fold cross-validation with 100 repetitions for statistical confidence and found that a parsimonious subset of 8 acoustic measures presented to RF led to 85% correct out-of-s le classification, replicating the experts’ labels. Acoustic measures can be used by labs to describe USVs and compare data between groups, and provide insight into vocal-behavioral patterns of mice by automating the process on matching the experts’ call types.

Intervention for dysarthria associated with acquired brain injury in children and adolescents

Publisher: Wiley

Date: 16-07-2008

DOI: 10.1002/14651858.CD006279.PUB2

The Feasibility, Utility, and Safety of Communication Interventions With Mechanically Ventilated Intensive Care Unit Patients: A Systematic Review

Publisher: American Speech Language Hearing Association

Date: 09-08-2019

DOI: 10.1044/2019_AJSLP-19-0001

Abstract: The aim of this study was to conduct a systematic review of the literature relating to the feasibility, utility, and safety of augmentative and alternative communication (AAC) interventions and tracheostomy-related communication interventions with mechanically ventilated adult patients in the intensive care unit (ICU). MEDLINE, Embase, and PsycINFO databases were searched for relevant articles. Studies were included if (a) they were performed in the ICU, (b) they involved participants 18 years of age, (c) 85% of participants were mechanically ventilated, and (d) they reported on content that related to the feasibility and/or utility and/or safety of AAC intervention and/or tracheostomy-related communication intervention. Studies were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The levels of evidence for included studies were assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Forty-eight studies met the inclusion criteria. Different communication interventions relating to intubated and tracheostomized mechanically ventilated patients were reviewed, including (a) communication boards, (b) electrolarynx, (c) high-technology AAC devices, (d) tracheostomy tubes with communication-enabling features, (e) one-way valve in line with the ventilator, (f) ventilator-adjusted leak speech, (g) ventilator adjustments and one-way valve, and (h) multiple interventions. Forty-seven of 48 studies examined the feasibility and utility of the interventions. Sixteen studies examined the safety of the interventions. The included studies were composed of randomized controlled trials ( n = 2), quasi-experimental studies ( n = 7), cohort studies ( n = 8), case–control ( n = 1), case series ( n = 23), and case reports ( n = 7). The levels of evidence varied and ranged from high ( n = 2), moderate ( n = 7), low ( n = 9), and very low ( n = 30). There is developing evidence that communication interventions with mechanically ventilated ICU patients are feasible, have utility, and are safe. Further research is warranted to guide speech pathologist–directed intervention to improve patient outcomes and the patient experience in the ICU.

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

Publisher: Wiley

Date: 22-10-2020

DOI: 10.1111/ENE.14523

Abstract: Objective measurement of speech has shown promising results to monitor disease state in multiple sclerosis. In this study, we characterize the relationship between disease severity and speech metrics through perceptual (listener based) and objective acoustic analysis. We further look at deviations of acoustic metrics in people with no perceivable dysarthria. Correlations and regression were calculated between speech measurements and disability scores, brain volume, lesion load and quality of life. Speech measurements were further compared between three subgroups of increasing overall neurological disability: mild (as rated by the Expanded Disability Status Scale ≤2.5), moderate (≥3 and ≤5.5) and severe (≥6). Clinical speech impairment occurred majorly in people with severe disability. An experimental acoustic composite score differentiated mild from moderate ( P 0.001) and moderate from severe subgroups ( P = 0.003), and correlated with overall neurological disability ( r = 0.6, P 0.001), quality of life ( r = 0.5, P 0.001), white matter volume ( r = 0.3, P = 0.007) and lesion load ( r = 0.3, P = 0.008). Acoustic metrics also correlated with disability scores in people with no perceivable dysarthria. Acoustic analysis offers a valuable insight into the development of speech impairment in multiple sclerosis. These results highlight the potential of automated analysis of speech to assist in monitoring disease progression and treatment response.

Is age or culture important for the use of speech as a marker of depression?

Publisher: Frontiers Media SA

Date: 2012

DOI: 10.3389/CONF.FNHUM.2012.208.00109

Recovery Within Injury Compensation Schemes

Publisher: Springer Science and Business Media LLC

Date: 03-2019

DOI: 10.1007/S10926-018-9764-Z

Abstract: Purpose Many industrialised nations have systems of injury compensation and rehabilitation that are designed to support injury recovery and return to work. Despite their intention, there is now substantial evidence that injured people, employers and healthcare providers can experience those systems as difficult to navigate, and that this can affect injury recovery. This study sought to characterise the relationships and interactions occurring between actors in three Australian injury compensation systems, to identify the range of factors that impact on injury recovery, and the interactions and inter-relationships between these factors. Methods This study uses data collected directly from injured workers and their family members via qualitative interviews, analysed for major themes and interactions between themes, and then mapped to a system level model. Results Multiple factors across multiple system levels were reported by participants as influencing injury recovery. Factors at the level of the injured person's immediate environment, the organisations and personnel involved in rehabilitation and compensation processes were more commonly cited than governmental or societal factors as influencing physical function, psychological function and work participation. Conclusions The study demonstrates that injury recovery is a complex process influenced by the decisions and actions of organisations and in iduals operating across multiple levels of the compensation system. Changes occurring 'upstream', for instance at the level of governmental or organisational policy, can impact injury recovery through both direct and diffuse pathways.

Outcome measurement tools for communication, voice and speech intelligibility in the ICU and their clinimetric properties: A systematic review

Publisher: SAGE Publications

Date: 02-11-2020

DOI: 10.1177/1751143720963757

Abstract: To identify outcome measurement tools used to evaluate communication, voice and speech intelligibility in the mechanically ventilated ICU population. Secondly, to evaluate, synthesise and compare the clinimetric properties of the tools identified. A systematic review of articles was undertaken via electronic databases in two parts. Eligibility criteria for selection: part one – quantitative or mixed methods studies which assessed communication, voice or speech intelligibility part two – studies which evaluated a clinimetric property for one of the tools identified in part one. Two independent reviewers assessed articles for inclusion and used the consensus-based standards for health status measurement instruments (COSMIN) risk of bias checklist. The part one search yielded five included studies comprised of eight outcome measurement tools. The part two search yielded 22 included studies comprised of nine tools. Few studies had adequate reliability and measurement error properties. No studies established responsiveness. A notable proportion of studies utilised tools that have no clinimetric properties. There is a relatively small number of studies which have established clinimetric properties for outcome measurement tools that evaluate communication, voice and/or speech intelligibility, and a fewer number which have done so in the mechanically ventilated ICU population.

ParkinSong Online: Protocol for a telehealth feasibility study of therapeutic group singing for people with Parkinson's disease

Publisher: BMJ

Date: 12-2021

DOI: 10.1136/BMJOPEN-2021-058953

Abstract: Parkinson’s disease can be associated with speech deterioration and low communication confidence which in turn compromises social interaction. Therapeutic singing is an engaging method for combatting speech decline however, face-to-face delivery can limit access to group singing. The aim of this study is to test the feasibility and acceptability of an online mode of delivery for a Parkinson’s singing intervention (ParkinSong) as well as remote data collection procedures. This ParkinSong Online feasibility trial is a single-arm, pre–post study of online singing delivery and remote data collection for 30 people living with Parkinson’s. The primary outcome measure is feasibility: recruitment, retention, attendance, safety, intervention fidelity, acceptability and associated costs. Secondary outcomes are speech (loudness, intelligibility, quality, communication-related quality of life) and wellbeing (apathy, depression, anxiety, stress, health-related quality of life). This mode of delivery aims to increase the accessibility of singing interventions. Ethics approval was obtained from The University of Melbourne Human Research Ethics Committee (2021-14465-16053-3) and the trial has been prospectively registered. Results will be presented at national and international conferences, published in a peer-reviewed journal, and disseminated to the Parkinson’s community, researchers and policymakers. ACTRN12621000940875.

Speech is a Sensitive Marker of Neuropsychiatric and Neurodegenerative Conditions (in the Right Context)

Publisher: Elsevier BV

Date: 05-2021

DOI: 10.1016/J.BIOPSYCH.2021.02.069

Interventions to Mitigate Cognitive Biases in the Decision Making of Eye Care Professionals: A Systematic Review

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 29-10-2019

DOI: 10.1097/OPX.0000000000001445

Abstract: Cognitive biases, systematic errors in thinking that impact a person's choices and judgments, can influence decision making at various points during patient care provision. These biases can potentially result in misdiagnoses, delayed clinical care, and/or patient mismanagement. A range of interventions exists to mitigate cognitive biases. There is a need to understand the relative efficacy of these interventions within the context of eye care practice. The aim of this systematic review was to synthesize the evidence relating to interventions for mitigating cognitive biases associated with clinical decision making by eye care professionals. Electronic databases (including Ovid MEDLINE, Embase, Scopus, PsycINFO) were searched from inception to October 2017 for studies investigating interventions intended to mitigate cognitive biases in the clinical decision making of eye care professionals. This review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. To ensure inclusion of all relevant literature, a wide range of study designs was eligible for inclusion, such as randomized controlled trials, nonrandomized trials, interrupted time series and repeated measures, controlled before-after studies, and qualitative studies that were a component of any of these quantitative study designs. Two review authors independently screened titles, abstracts, and full-text articles in duplicate, applying a priori eligibility criteria. After screening 2759 nonduplicate records, including full-text screening of 201 articles, no relevant studies were identified. Given that cognitive biases can significantly impact the accuracy of clinical decision making and thus can have major effects on clinical care and patient health outcomes, the lack of studies identified in this systematic review indicates a critical need for research within the area of cognitive bias mitigation for decision making within eye care practice.

Two different phenomena in basic motor speech performance in premanifest Huntington disease

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 21-11-2016

DOI: 10.1212/WNL.0000000000003392

Quantitative Speech Assessment in Ataxia—Consensus Recommendations by the Ataxia Global Initiative Working Group on Digital-Motor Markers

Publisher: Springer Science and Business Media LLC

Date: 28-10-2023

DOI: 10.1007/S12311-023-01623-4

Automated Detection of Speech Timing Alterations in Autopsy-Confirmed Nonfluent/Agrammatic Variant Primary Progressive Aphasia

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 02-08-2022

DOI: 10.1212/WNL.0000000000200750

Abstract: Motor speech function, including speech timing, is a key domain for diagnosing nonfluent/agrammatic variant primary progressive aphasia (nfvPPA). Yet, standard assessments use subjective, specialist-dependent evaluations, undermining reliability and scalability. Moreover, few studies have examined relevant anatomo-clinical alterations in patients with pathologically confirmed diagnoses. This study overcomes such caveats using automated speech timing analyses in a unique cohort of autopsy-proven cases. In a cross-sectional study, we administered an overt reading task and quantified articulation rate, mean syllable and pause duration, and syllable and pause duration variability. Neuroanatomical disruptions were assessed using cortical thickness and white matter (WM) atrophy analysis. We evaluated 22 persons with nfvPPA (mean age: 67.3 years 13 female patients) and confirmed underlying 4-repeat tauopathy, 15 persons with semantic variant primary progressive aphasia (svPPA mean age: 66.5 years 8 female patients), and 10 healthy controls (HCs 70 years 5 female patients). All 5 speech timing measures revealed alterations in persons with nfvPPA relative to both the HC and svPPA groups, controlling for dementia severity. The articulation rate robustly discriminated in iduals with nfvPPA from HCs (area under the ROC curve [AUC] = 0.95), outperforming specialist-dependent perceptual measures of dysarthria and apraxia of speech severity. Patients with nfvPPA exhibited structural abnormalities in left precentral and middle frontal as well as bilateral superior frontal regions, including their underlying WM. The articulation rate correlated with atrophy of the left pars opercularis and supplementary resupplementary motor areas. Secondary analyses showed that, controlling for dementia severity, all measures yielded greater deficits in patients with nfvPPA and corticobasal degeneration (nfvPPA-CBD, n = 12) than in those with progressive supranuclear palsy pathology (nfvPPA-PSP, n = 10). The articulation rate robustly discriminated between in iduals in each subgroup (AUC = 0.82). More widespread cortical thinning was observed for the nfvPPA-CBD than the nfvPPA-PSP group across frontal regions. Automated speech timing analyses can capture specific markers of nfvPPA while potentially discriminating between patients with different tauopathies. Thanks to its objectivity and scalability this approach could support standard speech assessments. This study provides Class III evidence that automated speech analysis can accurately differentiate patients with nonfluent PPA from normal controls and patients with semantic variant PPA.

Perceptual and Acoustic Analysis of Speech in Spinocerebellar ataxia Type 1

Publisher: Springer Science and Business Media LLC

Date: 12-01-2023

DOI: 10.1007/S12311-023-01513-9

Abstract: This study characterizes the speech phenotype of spinocerebellar ataxia type 1 (SCA1) using both perceptual and objective acoustic analysis of speech in a cohort of SCA1 patients. Twenty-seven symptomatic SCA1 patients in various disease stages (SARA score range: 3–32 points) and 18 sex and age matched healthy controls underwent a clinical assessment addressing ataxia severity, non-ataxia signs, cognitive functioning, and speech. Speech s les were perceptually rated by trained speech therapists, and acoustic metrics representing speech timing, vocal control, and voice quality were extracted. Perceptual analysis revealed reduced intelligibility and naturalness in speech s les of SCA1 patients. Acoustically, SCA1 patients presented with slower speech rate and diadochokinetic rate as well as longer syllable duration compared to healthy controls. No distinct abnormalities in voice quality in the acoustic analysis were detected at group level. Both the affected perceptual and acoustic variables correlated with ataxia severity. Longitudinal assessment of speech is needed to place changes in speech in the context of disease progression and potential response to treatment.

A Cross-sectional Study of Perceptual and Acoustic Voice Characteristics in Healthy Aging.

Publisher: Elsevier BV

Date: 07-2021

DOI: 10.1016/J.JVOICE.2021.06.007

Longitudinal change in dysarthria associated with Friedreich ataxia: A potential clinical endpoint

Publisher: Springer Science and Business Media LLC

Date: 06-06-2012

DOI: 10.1007/S00415-012-6547-X

Abstract: CNS functions that show change across short periods of time are particularly useful clinical endpoints for Friedreich ataxia. This study determined whether there is measurable acoustical change in the dysarthria associated with Friedreich ataxia across yearly intervals. A total of 29 participants diagnosed with Friedreich ataxia were recorded across 4 years at yearly intervals. A repeated measures ANOVA was used to determine which acoustic measures differed across time, and pairwise t tests were used to assess the consistency of the change across the time intervals. The relationship between the identified measures with perceptual severity was assessed with stepwise regression. Significant longitudinal change was observed with four measures that relate to the utterance duration and spectral changes in utterances. The spectral measures consistently detected change across time intervals of two or more years. The four measures combined moderately predicted perceptual severity. Together, the results implicate longitudinal change in speaking rate and utterance duration. Changes in speech associated with Friedreich ataxia can be measured across intervals of 2 years and therefore show rich potential for monitoring disease progression and therapy outcomes.

Features of speech and swallowing dysfunction in pre-ataxic spinocerebellar ataxia type 2

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 11-06-2020

DOI: 10.1212/WNL.0000000000009776

Abstract: To determine whether objective and quantitative assessment of dysarthria and dysphagia in spinocerebellar ataxia type 2 (SCA2), specifically at pre-ataxic and early disease phases, can act as sensitive disease markers. Forty-six in iduals (16 with pre-ataxic SCA2, 14 with early-stage ataxic SCA2, and 16 healthy controls) were recruited in Holguin, Cuba. All participants underwent a comprehensive battery of assessments including objective acoustic analysis, clinician-derived ratings of speech function and swallowing, and quality of life assessments of swallowing. Reduced speech agility manifest at the pre-ataxic stage was observed during diadochokinetic tasks, with the magnitude of speech deficit augmented in the early ataxic stage. Speech rate was slower in early-stage ataxic SCA2 compared with pre-ataxic SCA2 and healthy controls. Reduced speech agility and speech rate correlated with disease severity and time to ataxia onset, verifying that speech deficits occur prior to ataxia onset and increase in severity as the disease progresses. Whereas dysphagia was observed in both pre-ataxic and ataxic SCA2, it was not associated with swallowing-related quality of life, disease severity, or time to ataxia onset. Speech and swallowing deficits appear sensitive to disease progression in early-stage SCA2, with syllabic rate a viable marker. Findings provide insight into mechanisms of disease progression in early-stage SCA2, signaling an opportunity for stratifying early-stage SCA2 and identifying salient markers of disease onset as well as outcome measures in future early-stage therapeutic studies.

Deep brain stimulation wash-in and wash-out times for tremor and speech

Publisher: Elsevier BV

Date: 03-2015

DOI: 10.1016/J.BRS.2015.01.156

Development of precise tremor assessment software to aid deep brain stimulation parameter optimization

Publisher: Elsevier BV

Date: 03-2015

DOI: 10.1016/J.BRS.2015.01.155

Characterization of Dysphagia and Longitudinal Changes in Swallowing Function in Adults with Niemann-Pick Disease Type C Treated with Miglustat

Publisher: Springer Science and Business Media LLC

Date: 19-06-2020

DOI: 10.1007/S00455-020-10145-8

Plug-and-play microphones for recording speech and voice with smart devices

Publisher: Cold Spring Harbor Laboratory

Date: 02-10-2023

DOI: 10.1101/2023.09.30.23296391

Acoustic Speech Analytics Are Predictive of Cerebellar Dysfunction in Multiple Sclerosis

Publisher: Springer Science and Business Media LLC

Date: 18-06-2020

DOI: 10.1007/S12311-020-01151-5

Language, meaning, and localization: Last year's words, next year's words.

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 08-02-2017

DOI: 10.1212/WNL.0000000000003705

Treatment for dysphagia (swallowing difficulties) in hereditary ataxia

Publisher: Wiley

Date: 13-11-2015

DOI: 10.1002/14651858.CD010169.PUB2

Automated and objective analysis of speech in premanifest and early-stage Huntington’s disease

Publisher: Cold Spring Harbor Laboratory

Date: 30-10-2022

DOI: 10.1101/2022.10.27.22281625

Abstract: Clinical markers that show change in performance in people with Huntington’s disease (HD) during the presymptomatic and prodromal stages remain a target of investigation in clinical medicine. Alongside genetic and neuroimaging initiatives, digital speech analytics has shown promise as a sensitive clinical marker of premanifest HD. To investigate the sensitivity of digital speech measures for detecting subtle cognitive-linguistic and fine motor features in people carrying the expanded HD gene, with and without symptoms. Speech data were acquired from 110 participants (55 people with the expanded HD gene including 16 presymptomatic HD 16 prodromal HD 14 early-stage HD 9 mid-stage HD and 55 matched healthy controls). Objective digital speech measures were derived from speech tasks that fit along a continuum of motor and cognitive complexity. Acoustic features quantified speakers’ articulatory agility, voice quality and speech-timing. Subjects also completed the tests of cognition and upper limb motor function. Some presymptomatic HD (furthest from disease onset) differed to healthy controls on timing measures derived from the syllable repetition and monologue. Prodromal HD presented with reduced articulatory agility, reduced speech rate and longer and variable pauses. Speech agility correlated with poorer performance on the upper limb motor test. Tasks with a mix of cognitive and motor demands differentiated prodromal HD from their matched control groups. Motor speech tasks alone did not differentiate groups until participants were relatively closer to disease onset or symptomatic. Data demonstrated how ubiquitous behaviors like speech, when analyzed objectively, provide insight into disease related change.

Functional neuroplasticity in response to cerebello-thalamic injury underpins the clinical presentation of tremor in multiple sclerosis

Publisher: SAGE Publications

Date: 25-03-2019

DOI: 10.1177/1352458519837706

Abstract: Tremor is present in almost half of multiple sclerosis (MS) patients. The lack of understanding of its pathophysiology is h ering progress in development of treatments. To clarify the structural and functional brain changes associated with the clinical phenotype of upper limb tremor in people with MS. Fifteen healthy controls (46.1 ± 15.4 years), 27 MS participants without tremor (46.7 ± 11.6 years) and 42 with tremor (46.6 ± 11.5 years) were included. Tremor was quantified using the Bain score (0–10) for overall severity, handwriting and Archimedes spiral drawing. Functional magnetic resonance imaging activations were compared between participants groups during performance of a joystick task designed to isolate tremulous movement. Inflammation and atrophy of cerebello-thalamo-cortical brain structures were quantified. Tremor participants were found to have atrophy of the cerebellum and thalamus, and higher ipsilateral cerebellar lesion load compared to participants without tremor ( p 0.020). We found higher ipsilateral activation in the inferior parietal lobule, the premotor cortex and supplementary motor area in MS tremor participants compared to MS participants without tremor during the joystick task. Finally, stronger activation in those areas was associated with lower tremor severity. Subcortical neurodegeneration and inflammation along the cerebello-thalamo-cortical and cortical functional neuroplasticity contribute to the severity of tremor in MS.

Verbal Fluency, Semantics, Context and Symptom Complexes in Schizophrenia

Publisher: Springer Science and Business Media LLC

Date: 04-03-2009

DOI: 10.1007/S10936-009-9100-Z

Abstract: Lexical-semantic access and retrieval was examined in 15 adults diagnosed with schizophrenia and matched controls. This study extends the literature through the inclusion of multiple examinations of lexical-semantic production within the same patient group and through correlating performance on these tasks with various positive and negative clinical symptoms. On tasks of verbal fluency, meaning generation, sentence production using contextual information and confrontation naming, participants with schizophrenia made significantly more semantic errors on naming tasks produced fewer meanings for homophones produced fewer items on semantic, phonological, cued and switching fluency tasks and produced more errors on sentence production tasks when compared to healthy controls. Significant correlations were also observed between ratings of psychomotor poverty and measures of semantic production and mental inflexibility. This study has provided additional evidence for deficits in lexical-semantic retrieval which are not due to underlying semantic store degradation, do not involve phonological based retrieval, and at the level of sentence generation appear to vary as a function of the contextual constraints provided.

Swallowing function in people with Friedreich's ataxia

Publisher: Unpublished

Date: 2013

DOI: 10.13140/2.1.3227.9040

Dysphagia in Friedreich Ataxia

Publisher: Springer Science and Business Media LLC

Date: 04-05-2017

DOI: 10.1007/S00455-017-9804-4

Abstract: The objective of the study was to comprehensively characterise dysphagia in Friedreich ataxia (FRDA) and identify predictors of penetration/aspiration during swallowing. We also investigated the psychosocial impact of dysphagia on in iduals with FRDA. Sixty participants with FRDA were screened for dysphagia using a swallowing quality of life questionnaire (Swal-QOL) and case history. In iduals reporting dysphagia underwent a standardised oromotor assessment (Frenchay Dysarthria Assessment, 2, FDA-2) and videofluoroscopic study of swallowing (VFSS). Data were correlated with disease parameters (age at symptom onset, age at assessment, disease duration, FXN intron 1 GAA repeat sizes, and Friedreich Ataxia Rating Scale (FARS) score). Predictors of airway penetration/aspiration were explored using logistic regression analysis. Ninety-eight percent (59/60) of participants reported dysphagia, of whom 35 (58.3%) underwent FDA-2 assessment, and 38 (63.3%) underwent VFSS. Laryngeal, respiratory, and tongue dysfunction was observed on the FDA-2. A Penetration-Aspiration Scale score above 3 (deemed significant airway compromise based on non-clinical groups) was observed on at least one consistency in 13/38 (34.2%) participants. All of those who aspirated (10/38, 26.3%) did so silently, with no overt signs of airway entry such as reflexive cough. Significant correlations were observed between dysphagic symptoms and disease duration and severity. No reliable predictors of penetration or aspiration were identified. Oropharyngeal dysphagia is commonly present in in iduals with FRDA and worsens with disease duration and severity. In iduals with FRDA are at risk of aspiration at any stage of the disease and should be reviewed regularly. Instrumental analysis remains the only reliable method to detect aspiration in this population. Dysphagia significantly affects the quality of life of in iduals with FRDA.

Speech-Language Pathology Guidance for Tracheostomy During the COVID-19 Pandemic: An International Multidisciplinary Perspective

Publisher: American Speech Language Hearing Association

Date: 04-08-2020

DOI: 10.1044/2020_AJSLP-20-00089

Abstract: As the COVID-19 pandemic has unfolded, there has been growing recognition of risks to frontline health care workers. When caring for patients with tracheostomy, speech-language pathologists have significant exposure to mucosal surfaces, secretions, and aerosols that may harbor the SARS-CoV-2 virus. This tutorial provides guidance on practices for safely performing patient evaluation and procedures, thereby reducing risk of infection. Data were collated through review of literature, guidelines, and consensus statements relating to COVID-19 and similar high-consequent infections, with a focus on mitigating risk of transmission to health care workers. Particular emphasis was placed on speech-language pathologists, nurses, and other allied health professionals. A multinational interdisciplinary team then analyzed findings, arriving at recommendations through consensus via electronic communications and video conference. Reports of transmission of infection to health care workers in the current COVID-19 pandemic and previous outbreaks substantiate the need for safe practices. Many procedures routinely performed by speech-language pathologists have a significant risk of infection due to aerosol generation. COVID-19 testing can inform level of protective equipment, and meticulous hygiene can stem spread of nosocomial infection. Modifications to standard clinical practice in tracheostomy are often required. Personal protective equipment, including either powered air-purifying respirator or N95 mask, gloves, goggles, and gown, are needed when performing aerosol-generating procedures in patients with known or suspected COVID-19 infection. Speech-language pathologists are often called on to assist in the care of patients with tracheostomy and known or suspected COVID-19 infection. Appropriate care of these patients is predicated on maintaining the health and safety of the health care team. Careful adherence to best practices can significantly reduce risk of infectious transmission.

Diagnosis and Differential Diagnosis of Developmental Disorders of Speech and Language

Publisher: Springer Berlin Heidelberg

Date: 05-12-2020

DOI: 10.1007/978-3-662-46780-0_11

What is return to work? An investigation into the quantification of return to work

Publisher: Springer Science and Business Media LLC

Date: 15-05-2011

DOI: 10.1007/S00420-011-0644-5

Abstract: To describe and demonstrate issues with return to work (RTW) outcome metrics in common use among clinical researchers and injury compensation organisations. We also aim to describe a framework on which to capture relevant RTW information including current employment status and data on participation and maintenance. Structured telephone interviews discussing participant health and vocational status were conducted following compensable transport-related injury. Participants who were working at the time of injury and took time off work because of their injuries (N = 414) were asked questions relating to their work participation and maintenance, including length of continuous employment, hours worked and duties performed before and after injury. A series of RTW metrics was developed and applied to survey data. Rates of RTW according to each metric were calculated. Eighty-four per cent of participants had achieved some employment since their injury, and 74% were working at the time of the survey. In contrast, only 58% of participants were working the same hours as prior to their injury and had been doing so for at least 3 months. These data show that different impressions of rehabilitative success can be obtained depending on the criterion used to define RTW suggesting that reliance on a single RTW index (e.g. 'are you currently working?') will not represent important characteristics of employment. A multi-layered approach to measuring RTW that includes data on reasons for not working, length of continuous employment, hours and duties performed after injury provides greater insight into the vocational status of injured in iduals compared to single metrics or outcomes that fail to capture key detail on motives and participation. This information can assist clinicians to more accurately monitor the progress of rehabilitation following injury and compensation schemes to more effectively monitor their performance.

Perception of Cantonese Lexical Tones by Pediatric Cochlear Implant Users

Publisher: American Speech Language Hearing Association

Date: 22-01-2018

DOI: 10.1044/2017_JSLHR-H-17-0027

Abstract: The purpose of this study is to assess Cantonese word recognition and the discrimination of Cantonese tones with manipulated contours by child and adolescent cochlear implant (CI) users and a group of peers with normal hearing (NH). It was hypothesized that the CI users would perform more poorly than their counterparts with NH in both tasks and that CI users implanted before 2 years of age would perform better than those implanted after 2 years. Forty-one participants were recruited from hospitals, schools, and kindergartens in Hong Kong: Ten CI users implanted at or before 2 years of age (“early” CI group), 13 CI users implanted after 2 years of age (“late” CI group), and 18 in iduals with NH. The mean age at implantation of the early CI group was 1.5 years ( SD = 0.3), and for the late CI group, it was 4.3 years ( SD = 2.1). Participants were a mean of 13.3 years of age ( SD = 3.7) at time of testing. Participants completed a Cantonese word recognition test and a discrimination task using Cantonese tones with modified fundamental frequency trajectories. Both CI user groups obtained significantly lower scores than the group with NH on the word recognition test. Mean percent correct scores for the word recognition test were 79% for the early CI group, 69% for the late CI group, and 97% for the group with NH. The group with NH consistently achieved higher scores than the CI user groups when discriminating manipulated Cantonese tones. Increasing the acoustic difference between tones improved discrimination performance for CI users for level tone contrasts only. CI users implanted at or before 2 years of age obtained higher scores than those implanted later. The results of this study add further evidence that children using CIs do not perform as well as peers in perceiving Cantonese tones. Modification of tones to increase pitch range did not consistently improve the ability of children with implants to perceive the difference between tones. Further research is required to fully assess potential benefits of early implantation for speakers of tonal languages. 0.23641/asha.5782209

Cantonese Tone Perception for Children Who Use a Hearing Aid and a Cochlear Implant in Opposite Ears

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 11-2017

DOI: 10.1097/AUD.0000000000000453

Abstract: The ability to recognize tones is vital for speech perception in tonal languages. Cantonese has six tones, which are differentiated almost exclusively by pitch cues (tones 1 to 6). The differences in pitch contours among the tones are subtle, making Cantonese a challenging language for cochlear implant users. The addition of a hearing aid has been shown to improve speech perception in nontonal languages and in Mandarin Chinese. This study (1) investigates the Cantonese tone perception ability of children who use a cochlear implant and a hearing aid in opposite ears (2) evaluates the effect of varying pitch height and pitch contour cues on Cantonese tone perception for these children and (3) compares the Cantonese tone perception ability for using a hearing aid and a cochlear implant together versus an implant alone. Eight native Cantonese speaking children using a cochlear implant and a hearing aid in opposite ears were assessed for tone perception and word identification. The tone perception test involved discriminating and ranking tone pairs from natural and artificially manipulated Cantonese tones with various pitch heights and/or pitch contours. The word identification test involved identifying Cantonese words in a four-alternative forced-choice task. All tests were performed in two device conditions: (1) cochlear implant and hearing aid together and (2) implant alone. Seven of the 8 subjects performed significantly above chance in both tests using the cochlear implant alone. Results showed that both pitch height and/or pitch direction were important perceptual cues for implant users. Perception for some tones was improved by increasing the pitch height differences between the tones. The ability to discriminate and rank the tone 2/tone 5 contrast and the tone 4/tone 6 contrast was poor, as the tones in these contrasts are similar in pitch contours and onset frequencies. No significant improvement was observed after artificially increasing the pitch offset differences between the tones in the tone 2/tone 5 and the tone 4/tone 6 contrasts. Tone perception results were significantly better with the addition of the hearing aid in the nonimplanted ear compared with using the implant alone however, word identification results were not significantly different between using the implant alone and using both the hearing aid and the implant together. None of the subjects performed worse in tone perception or in word identification when the hearing aid was added. Reduced ability to perceive pitch contour cues, even when artificially exaggerated, may explain some of the difficulties in Cantonese word recognition for implant users. The addition of a contralateral hearing aid could be beneficial for Cantonese tone perception for some in iduals with a unilateral implant. The results encouraged Cantonese speakers to trial a hearing aid in the nonimplanted ear when using a cochlear implant.

Poster Presentations

Publisher: Wiley

Date: 05-2014

DOI: 10.1002/MDS.25914

Changes detected in swallowing function in Friedreich ataxia over 12 months

Publisher: Elsevier BV

Date: 10-2018

DOI: 10.1016/J.NMD.2019.08.013

Abstract: Friedreich ataxia (FRDA) is a multisystem neurodegenerative disorder and the most common hereditary ataxia. Dysphagia (swallowing impairment) is present in 98% of in iduals with FRDA and is characterized by lingual and pharyngeal dysfunction (manifesting in impaired bolus preparation and transfer, and post-swallow residue in the mouth and pharynx), delayed swallow initiation, and entry of material into the airway (penetration/aspiration). Dysphagia severity correlates with disease severity and duration however no longitudinal studies describe changes in function in FRDA. The aim of this study was to investigate the progression of dysphagia in FRDA over one year. Fifty-nine in iduals with FRDA and confirmed dysphagia were recruited and 23 of them underwent a second assessment 12 months later. Assessments of swallowing related quality of life, oral motor function (Frenchay Dysarthria Assessment 2nd Ed [FDA-2]) and functional swallowing via videofluoroscopy were conducted. Trials of thin liquid, puree and biscuit were interpreted using the Bethlehem Assessment Scale and the Penetration-Aspiration Scale by two blinded raters. Data from the videofluoroscopy revealed a decline in tongue function, pharyngeal clearance and cricopharyngeal function on solid food. However, severity of penetration/aspiration did not increase. Swallowing-related quality of life and oral-motor function remained stable. A decline in function was observed at three anatomical sites considered important for safe and effective swallowing (tongue, pharyngeal, and cricopharyngeal). However, these deficits did not translate into any meaningful functional decline in swallowing related health over 12 months for in iduals with FRDA.

How people living with motor neurone disease and their carers experience healthcare decision making: a qualitative exploration

Publisher: Informa UK Limited

Date: 09-12-2020

DOI: 10.1080/09638288.2020.1855261

Abstract: Healthcare decision making in motor neurone disease (MND) focuses on symptom management and quality of life. Decision making may be affected by personal approach to receiving information, decision making style, and disease symptoms. This study explored decision making from the perspectives of people living with motor neurone disease (plwMND). The issues impacting engagement and involvement in healthcare decisions were investigated. Semi-structured interviews were conducted with 19 plwMND and 15 carers. Interview data was inductively analysed to identify and describe patterns and themes. Data analysis identified six overarching themes: Dimensions of decision making Window of opportunity for choice Intrinsic influences on decision making Extrinsic influences impacting decision making Planning in uncertainty and, Communication is core. Many participants did not identify a process of "decision-making" except if considering early gastrostomy placement. Information provision requires a balance between ensuring patients are informed but not overwhelmed. Communication impairment impacts involvement. Healthcare professionals' communication style influences engagement in decision making. PlwMND perceive a lack of clinical decisions to make because disease symptoms and clinical phenotypes dictate necessary interventions. PlwMND describe communication impairment as a barrier to involvement in decision making and extra support is required to ensure they maintain engagement.IMPLICATIONS FOR REHABILITATIONPeople living with MND (plwMND) perceive they have few clinical decisions to make and viewed this process as "accepting a recommendation", rather than "making a decision" although early gastrostomy placement is the exception with considerable deliberation evident.Specialist multidisciplinary clinic advice is especially helpful for plwMND without dysphagia (swallowing problems) when considering early gastrostomy placement.Communication impairment may be a barrier to involvement in healthcare decisions and extra support to remain engaged is required.Some plwMND choose not to involve others in their decisions, and patients/families with medical or scientific backgrounds are more likely to collaborate with each other outside the context of clinic appointments.

Communication and cognitive impairments and health care decision making in MND: A narrative review

Publisher: Wiley

Date: 08-07-2019

DOI: 10.1111/JEP.13219

Abstract: Motor neurone disease (MND) is a neurodegenerative disease presenting with progressive weakness of voluntary muscles. For any condition, person-centred health care relies on the sharing of information and a mutual understanding of the person's needs and preferences. Decision making in MND becomes more complex as there is no cure and a high prevalence of co-morbid communication and/or cognitive difficulties. To identify the reported impact of communication and/or cognitive impairment on patient and carer involvement in health care decision making in MND. A review and synthesis of studies addressing issues of communication impairment and/or cognitive impairment in relation to decision making focussed on MND was conducted. Articles were excluded if they were reviews, case studies, conference papers, or commentaries. To be included studies needed to address issues of communication impairment or cognitive impairment specifically in relation to decision making. Relevant data were extracted verbatim and subjected to content analysis to support the narrative summary. Seventy-six articles were identified, and 35 articles screened. Six articles met inclusion criteria each describing ex les of decision making in MND. There was limited data related to communication and/or cognitive impairment, and the impact these impairments may have on decision making despite recognition that many people with MND may lose verbal communication or develop subtle cognitive impairments. The literature is primarily from the perspective of others. This review highlights that the current body of literature exploring decision making within the MND population presents us with extremely limited insights into the impact of communication and/or cognitive impairments on health care decision making. Extant literature focuses on interventions (namely, ventilation and gastrostomy), the broad process of decision making, or cognitive assessment of decision-making ability. Whilst most studies acknowledge that deficits in communication or cognition impact the decision-making process, this issue is not the focus of any study.

Feasibility of a Telerehabilitation Adaptation of the Be Clear Speech Treatment Program for Non-Progressive Dysarthria

Publisher: MDPI AG

Date: 31-01-2022

DOI: 10.3390/BRAINSCI12020197

Abstract: This study evaluated the feasibility and outcomes of a telerehabilitation adaptation of the Be Clear speech treatment program for adults with non-progressive dysarthria to determine clinical delivery viability and future research directions. Treatment effects on speech clarity, intelligibility, communication effectiveness, and participation, as well as psychosocial outcomes in 15 participants with non-progressive dysarthria, were explored. Intervention involved daily 1-h online sessions (4 days per week for 4 weeks, totalling 16 sessions) and daily home practice. Outcome measures were obtained at baseline (PRE), post-treatment (POST), and 12 weeks following treatment (FUP). Feasibility measures targeting participant satisfaction, treatment adherence and fidelity, and technical viability were also employed. The programme was feasible concerning technical viability and implementation, treatment adherence and fidelity. High levels of participant satisfaction were reported. Increases in overall ratings of communication participation and effectiveness were identified at POST and FUP. Reductions in speech rate were identified at FUP. Improvements in aspects of lingual and laryngeal function were also noted after treatment. Over time, improvements relating to the negative impact of dysarthria were identified. Naïve listeners perceived negligible changes in speech clarity following treatment. Online delivery of the Be Clear speech treatment program was feasible, and some positive speech benefits were observed. Due to the small s le size included in this research, statistically significant findings related to speech outcomes must be interpreted with caution. An adequately powered randomised controlled trial of Be Clear online is warranted to evaluate treatment efficacy.

A Systematic Review of Self-reported Swallowing Assessments in Progressive Neurological Disorders

Publisher: Springer Science and Business Media LLC

Date: 04-10-2015

DOI: 10.1007/S00455-014-9579-9

Abstract: Dysphagia experienced as a consequence of neurodegenerative disease can have severe consequences on a patient's health and well-being. Regular assessment of swallowing function can assist to achieve adequate nutrition and hydration. Here we review subjective swallowing assessments currently available are suitable for use in people with neurodegenerative disease. Measurement properties were reviewed for each tool and coverage of the World Health Organization's International Classification of Functioning, Disability and Health (WHO ICF) was considered. Assessments were identified following a review of the published literature Instruments were reviewed on the basis of reliability and validity, as well as administrative properties, such an interpretability, acceptability, and feasibility. Tools were also evaluated according to the WHO ICF framework. In total, 19 studies were identified for full-text review from 13,315 abstracts. Nine self-reported dysphagia assessment tools suitable for use in progressive neurological disorders were identified. The Swallowing Quality of Life Questionnaire (SWAL-QOL) yields the strongest combination of reliability (including internal consistency and test-retest reliability) and convergent validity while simultaneously covering all WHO ICF domains. Lengthy administration time was identified as a limitation of the SWAL-QOL. The review highlights a relative lack of well-validated self-report questionnaires in dysphagia for people with progressive neurological disease. Additional validation and evaluation of the clinical utility of the tools currently available is required to further promote an informed selection of available assessments.

Intervention for developmental apraxia of speech

Publisher: John Wiley & Sons, Ltd

Date: 18-10-2006

DOI: 10.1002/14651858.CD006278

How does our voice change as we age? A systematic review and meta-analysis of acoustic and perceptual voice data from healthy adults over 50 years of age

Publisher: American Speech Language Hearing Association

Date: 26-02-2020

DOI: 10.1044/2019_JSLHR-19-00099

Abstract: Approximately 30% of adults over the age of 50 years present with altered vocal function. Our understanding of how these changes manifest acoustically and perceptually is derived from relatively modest-sized studies using a ersity of tools. Voice changes can arise from the onset of disease or disorder, but also age-related physiological changes, which may not reflect pathology as such. Here, we bring together data on acoustic, perceptual, and instrumental assessments (electroglottography), with the aim of gaining a better understanding of the changes occurring across these measurement domains. We consider these changes in the context of different acoustic features, software programs, and perceptual protocols. Studies of voice function in healthy older adults over the age of 50 years were sought. Literature was systematically searched with 746 abstracts reviewed. Forty-seven studies were included in the review. A meta-analysis of included studies compared voice acoustic parameters between sex and age. Sixteen acoustic parameters collected from 1,475 participants were analyzed in the meta-analysis. These included some previously unpublished analyses using data provided by authors of included studies. Data from the systematic review suggest that older in iduals are perceived to present with higher overall scores of dysphonia and roughness, breathiness, strain, and instability. Acoustically, males have significantly higher scores on measures of perturbation, including noise-to-harmonic ratio and absolute jitter. The meta-analysis outcomes suggest that participants aged 80–89 years produce significantly higher fundamental frequency, jitter percent, shimmer percent, and shimmer in decibels compared to participants aged 60–69 years and a significant increase in relative average perturbation, jitter percent, and shimmer in decibels compared to participants aged 70–79 years. Limited data were available comparing acoustic measures using the same acoustic software. Variations in fundamental frequency and frequency and litude perturbation increase as healthy adults age. It was difficult to draw definitive conclusions based on existing literature due to variability in hardware used, limited descriptions of study cohorts, or missing data from statistical analysis. 0.23641/asha.11868663

Intervention for dysarthria associated with acquired brain injury in children and adolescents

Publisher: John Wiley & Sons, Ltd

Date: 18-10-2006

DOI: 10.1002/14651858.CD006279

Kinematic analysis of lingual movements during consonant productions in dysarthric speakers with Friedreich's ataxia: A case-by-case analysis

Publisher: Informa UK Limited

Date: 08-10-2011

DOI: 10.3109/02699206.2010.511760

Abstract: Articulatory kinematics were investigated using electromagnetic articulography (EMA) in four dysarthric speakers with Friedreich's ataxia (FRDA). Specifically, tongue-tip and tongue-back movements were recorded by the AG-200 EMA system during production of the consonants /t/ and /k/ as produced within a sentence utterance and during a rapid syllable repetition task. The results obtained for each of the participants with FRDA were in idually compared to those obtained by a control group (n = 10). Results revealed significantly greater movement durations and increased articulatory distances, most predominantly during the approach phase of consonant production. A task difference was observed with lingual kinematics more disturbed during the syllable repetition task than during the sentence utterance. Despite expectations of slowed articulatory movements in FRDA dysarthria, the EMA data indicated that the observed prolongation of consonant phase durations was generally associated with greater articulatory distances, rather than slowed movement execution.

Spectral measures of the effects of Friedreich's ataxia on speech

Publisher: Informa UK Limited

Date: 09-11-2011

DOI: 10.3109/17549507.2011.529940

Abstract: This study identifies two measures of the effects of Friedreich's ataxia (FRDA) on speech motor control. Speech s les of 17 healthy controls and 37 speakers with dysarthria associated with FRDA were recorded during one structured and one unstructured speaking task. Two measures of spectral variation were used that relate to the rate and range of changes that occur in the spectral envelope. Linear mixed models revealed significant effects of GROUP, TASK, and GROUP*TASK. FRDA speech s les had slower rate of spectral change and reduced spectral range. Healthy speakers produced faster rates of spectral change in read text compared to conversation, but speakers with dysarthria did not. The results suggest that structured speaking tasks which demand large spectral variation may be particularly useful in assessing the dysarthria. It is concluded that the rate of spectral change is a useful measure of dysarthria associated with FRDA.

Interventions to Mitigate Bias in Social Work Decision-Making: A Systematic Review

Publisher: SAGE Publications

Date: 23-12-2018

DOI: 10.1177/1049731518819160

Abstract: This systematic review synthesized evidence supporting interventions aimed at mitigating cognitive bias associated with the decision-making of social work professionals. A systematic search was conducted within 10 social services and health-care databases. Review authors independently screened studies in duplicate against prespecified inclusion criteria, and two review authors undertook data extraction and quality assessment. Four relevant studies were identified. Because these studies were too heterogeneous to conduct meta-analyses, results are reported narratively. Three studies focused on diagnostic decisions within mental health and one considered family reunification decisions. Two strategies were reportedly effective in mitigating error: a nomogram tool and a specially designed online training course. One study assessing a consider-the-opposite approach reported no effect on decision outcomes. Cognitive bias can impact the accuracy of clinical reasoning. This review highlights the need for research into cognitive bias mitigation within the context of social work practice decision-making.

Comparability of Modern Recording Devices for Speech Analysis: Smartphone, Landline, Laptop, and Hard Disc Recorder

Publisher: S. Karger AG

Date: 2014

DOI: 10.1159/000368227

Abstract: b i Background: /i /b Large-scale multi-site experimental and clinical speech protocols require high-fidelity, easy-to-use speech recording technologies. However, little is known about the reliability and comparability of affordable, portable and commonly used technologies with traditional well-validated devices (e.g., a hard disc recorder with a high-quality microphone). b i Objective: /i /b To examine the comparability of speech and voice s les acquired from protocols involving high- and low-quality devices. b i Methods: /i /b Speech s les were acquired simultaneously from 15 healthy adults using four devices and analyzed acoustically for measures of timing and voice quality. For the purpose of making initial comparisons, methods were deemed comparable if the resultant acoustic data yielded root mean squared error values ≤10% and statistically significant Spearman's correlation coefficients. b i Results: /i /b The data suggest that there is significant and widespread variability in the quality and reliability between different acquisition methods for voice and speech recording. Not one method provided statistically similar data to the protocol using the benchmark device (i.e., a high-quality recorder coupled with a condenser microphone). Acoustic analysis cannot be assumed to be comparable if different recording methods are used to record speech. b i Conclusions: /i /b Findings have implications for researchers and clinicians hoping to make comparisons between labs or, where lower-quality devices are suggested, to offer equal fidelity.

Feasibility of automated speech sample collection with stuttering children using interactive voice response (IVR) technology

Publisher: Informa UK Limited

Date: 14-07-2014

DOI: 10.3109/17549507.2014.923511

Abstract: To investigate the feasibility of adopting automated interactive voice response (IVR) technology for remotely capturing standardized speech s les from stuttering children. Participants were 10 6-year-old stuttering children. Their parents called a toll-free number from their homes and were prompted to elicit speech from their children using a standard protocol involving conversation, picture description and games. The automated IVR system was implemented using an off-the-shelf telephony software program and delivered by a standard desktop computer. The software infrastructure utilizes voice over internet protocol. Speech s les were automatically recorded during the calls. Video recordings were simultaneously acquired in the home at the time of the call to evaluate the fidelity of the telephone collected s les. Key outcome measures included syllables spoken, percentage of syllables stuttered and an overall rating of stuttering severity using a 10-point scale. Data revealed a high level of relative reliability in terms of intra-class correlation between the video and telephone acquired s les on all outcome measures during the conversation task. Findings were less consistent for speech s les during picture description and games. Results suggest that IVR technology can be used successfully to automate remote capture of child speech s les.

Adults with a history of illicit amphetamine use exhibit abnormal substantia nigra morphology and parkinsonism

Publisher: Elsevier BV

Date: 04-2016

DOI: 10.1016/J.PARKRELDIS.2016.02.019

Abstract: The sonographic appearance of the substantia nigra is abnormally bright and enlarged (hyperechogenic) in young adults with a history of illicit stimulant use. The abnormality is a risk factor for Parkinson's disease. The aim of the current study was to identify the type of illicit stimulant drug associated with substantia nigra hyperechogenicity and to determine if in iduals with a history of illicit stimulant use exhibit clinical signs of parkinsonism. We hypothesised that use of hetamines (primarily meth hetamine) is associated with substantia nigra hyperechogenicity and clinical signs of parkinsonism. The area of echogenic signal in the substantia nigra was measured in abstinent human hetamine users (n = 27 33 ± 8 years) and in three control groups comprising a) 'ecstasy' users (n = 19 23 ± 3 years), b) cannabis users (n = 30 26 ± 8 years), and c) non-drug users (n = 37 25 ± 7 years). A subset of subjects (n = 55) also underwent a neurological examination comprising the third and fifth part of the Unified Parkinson's Disease Rating Scale. Area of substantia nigra echogenicity was significantly larger in the hetamine group (0.276 ± 0.080 cm(2)) than in the control groups (0.200 ± 0.075, 0.190 ± 0.049, 0.191 ± 0.055 cm(2), respectively P < 0.002). The score on the clinical rating scale was also significantly higher in the hetamine group (8.4 ± 8.1) than in pooled controls (3.3 ± 2.8 P = 0.002). Illicit use of hetamines is associated with abnormal substantia nigra morphology and subtle clinical signs of parkinsonism. The results support epidemiological findings linking use of hetamines, particularly meth hetamine, with increased risk of developing Parkinson's disease later in life.

Proportionate research funding based on relative burden of conditions of communication and swallowing

Publisher: AMPCo

Date: 04-2014

DOI: 10.5694/MJA13.00244

The classification of neurodegenerative disease from acoustic speech data

Publisher: Research Square Platform LLC

Date: 30-11-2021

DOI: 10.21203/RS.3.RS-1029846/V1

Abstract: Neurodegenerative diseases often affect speech. Speech acoustics can be used as objective clinical markers of pathology. Previous investigations of pathological speech have primarily compared controls with one specific condition and excluded comorbidities. We broaden the utility of speech markers by examining how multiple acoustic features can delineate diseases. We used supervised machine learning with gradient boosting (CatBoost) to differentiate healthy speech and speech from people with multiple sclerosis or Friedreich ataxia. Participants performed a diadochokinetic task where they repeated alternating syllables. We extracted 74 spectral and temporal prosodic features from the speech recordings, which were subjected to machine learning. Results showed that Friedreich ataxia, multiple sclerosis and healthy controls were all identified with high accuracy (over 82%). Twenty-one acoustic features were strong markers of neurodegenerative diseases, falling under the categories of spectral qualia, spectral power, and speech rate. We demonstrated that speech markers can delineate neurodegenerative diseases and distinguish healthy speech from pathological speech with high accuracy. Findings emphasize the importance of examining speech outcomes when assessing indicators of neurodegenerative disease. We propose large-scale initiatives to broaden the scope for differentiating other neurological diseases and affective disorders.

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

Publisher: Elsevier BV

Date: 12-2018

DOI: 10.1016/J.AUTREV.2018.06.010

Abstract: 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. 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 I) predictive models for diagnosis of MS and of ataxia using speech variables, II) the relationship of dysarthria with cognition and III) very few studies correlated neuroimaging with dysarthria. We could not identify longitudinal studies of speech or dysarthria in Multiple Sclerosis. 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.

Instrumental swallowing assessment in adults in residential aged care homes: Practice patterns and opportunities

Publisher: Wiley

Date: 08-08-2023

DOI: 10.1111/AJAG.13122

Abstract: To describe practice patterns in the use of instrumental swallowing assessment (ISA) for older adults in residential aged care homes (RACHs). A retrospective audit of medical records of residents living in RACHs in Melbourne, Australia to extract data on speech‐language pathologist (SLP) involvement, indications for ISA and ISA practice patterns. Medical files of 323 residents across four Melbourne facilities were reviewed. 36% ( n = 115) of residents were referred to SLP for swallowing assessment. Referral to SLP was related to length of stay ( U = 7393.00, p 0.001), dementia status ( χ 2 [1] = 7.06, p = 0.008), texture modification ( χ 2 [1] = 93.34, p 0.001) and an existing dysphagia diagnosis ( χ 2 [1] = 112.89, p 0.001). There were no referrals for ISA and no instances of ISA being used. Among 115 residents who were referred to SLP for swallowing assessment, there were 33 instances where ISA might be clinically relevant according to ISA indicators. Instrumental swallowing assessment is not being used for the management of swallowing in RACHs in Australia despite a clinical need for ISA and a potential role for ISA to improve swallowing care quality. Lack of timely ISA may fail to meet the complex health‐care needs of older adults living with dysphagia in RACHs, increasing their vulnerability to complications of dysphagia and its management.

Home‐based biofeedback speech treatment improves dysarthria in repeat‐expansion SCAs

Publisher: Wiley

Date: 21-06-2022

DOI: 10.1002/ACN3.51613

Abstract: CAG repeat‐expansion spinocerebellar ataxias (CAG‐SCAs) are genetically defined multisystemic degenerative diseases, resulting in motor symptoms including dysarthria with a substantial impact on daily living. Whilst speech therapy is widely recommended in ataxia, very limited evidence exists for its use. We evaluated the efficacy of a home‐delivered, ataxia‐tailored biofeedback‐driven speech therapy in CAG‐SCA in 16 in iduals with SCA1, 2, 3, or 6. Treatment was delivered intensively over 20 days. Efficacy was evaluated by blinded ratings of intelligibility (primary) and acoustic measures (secondary) leveraging an intra‐in idual control design. Intelligibility improved post‐treatment (Z = −3.18, p = 0.004) whilst remaining stable prior to treatment (Z = 0.53, p = 1.00).

Clinical management guidelines for Friedreich ataxia: best practice in rare diseases

Publisher: Springer Science and Business Media LLC

Date: 12-11-2022

DOI: 10.1186/S13023-022-02568-3

Abstract: In iduals with Friedreich ataxia (FRDA) can find it difficult to access specialized clinical care. To facilitate best practice in delivering healthcare for FRDA, clinical management guidelines (CMGs) were developed in 2014. However, the lack of high-certainty evidence and the inadequacy of accepted metrics to measure health status continues to present challenges in FRDA and other rare diseases. To overcome these challenges, the Grading of Recommendations Assessment and Evaluation (GRADE) framework for rare diseases developed by the RARE-Bestpractices Working Group was adopted to update the clinical guidelines for FRDA. This approach incorporates additional strategies to the GRADE framework to support the strength of recommendations, such as review of literature in similar conditions, the systematic collection of expert opinion and patient perceptions, and use of natural history data. A panel representing international clinical experts, stakeholders and consumer groups provided oversight to guideline development within the GRADE framework. Invited expert authors generated the Patient, Intervention, Comparison, Outcome (PICO) questions to guide the literature search (2014 to June 2020). Evidence profiles in tandem with feedback from in iduals living with FRDA, natural history registry data and expert clinical observations contributed to the final recommendations. Authors also developed best practice statements for clinical care points that were considered self-evident or were not amenable to the GRADE process. Seventy clinical experts contributed to fifteen topic-specific chapters with clinical recommendations and/or best practice statements. New topics since 2014 include emergency medicine, digital and assistive technologies and a stand-alone section on mental health. Evidence was evaluated according to GRADE criteria and 130 new recommendations and 95 best practice statements were generated. Evidence-based CMGs are required to ensure the best clinical care for people with FRDA. Adopting the GRADE rare-disease framework enabled the development of higher quality CMGs for FRDA and allows in idual topics to be updated as new evidence emerges. While the primary goal of these guidelines is better outcomes for people living with FRDA, the process of developing the guidelines may also help inform the development of clinical guidelines in other rare diseases.

Validation and Psychometric Properties of the German Version of the SWAL-QOL

Publisher: Springer Science and Business Media LLC

Date: 08-01-2018

DOI: 10.1007/S00455-017-9872-5

Abstract: The SWAL-QOL questionnaire is a common tool for evaluating patients' dysphagia-specific quality of life. A validated German version is not available. This study aimed to establish a German version of the SWAL-QOL (G-SWAL-QOL) using a standardized translation procedure and to systematically evaluate its psychometric properties. The original SWAL-QOL was translated into German following international translation guidelines. A pilot study (45 subjects) confirmed comprehensibility of the G-SWAL-QOL. A consecutive series of 158 subjects (103 patients with dysphagia 55 healthy controls) was then recruited to assess validity and reliability of the G-SWAL-QOL. Construct validity was analyzed through a correlation analysis with both (i) the Anderson Dysphagia Inventory (ADI-D) and (ii) the Short Form 36 (SF-36). Internal consistency and test-retest reliability were evaluated to determine reliability. All questions of the G-SWAL-QOL were comprehensible, except one which was subsequently revised. Construct validity of the G-SWAL-QOL was demonstrated by moderate to high correlations with the ADI-D (Spearman's rho 0.36 - 0.88). The G-SWAL-QOL was able to differentiate between patients with dysphagia and healthy controls (p 0.7 for all domains, except eating desire [α = 0.69]) and test-retest reliability (Spearman's rho ≥ 0.68 for all domains ICC > 0.8 for all domains). The G-SWAL-QOL is a valid and reliable measuring tool for dysphagia-specific quality of life in German-speaking persons.

Looking to the Future: Speech, Language, and Academic Outcomes in an Adolescent with Childhood Apraxia of Speech

Publisher: S. Karger AG

Date: 2019

DOI: 10.1159/000500554

Abstract: b i Objective: /i /b The clinical course of childhood apraxia of speech (CAS) is poorly understood. Of the few longitudinal studies in the field, only one has examined adolescent outcomes in speech, language, and literacy. This study is the first to report long-term speech, language, and academic outcomes in an adolescent, Liam, with CAS. b i Methods: /i /b Speech, language, literacy, and academic outcome data were collected, including 3 research-based assessments. Overall, data were available at 17 time points from 3 to 15 years. b i Results: /i /b Liam had moderate-to-severe expressive language impairment and poor reading, writing, and spelling up to 10 years. His numeracy was at or above the national average from 8 to 14 years. He made gains in preadolescence, with average expressive language at 11 years and above average reading and writing at 14 years. Nonword reading, reading comprehension, and spelling remained areas of weakness. Receptive language impairment was evident at 13 years, which was an unexpected finding. b i Conclusion: /i /b Findings from single cases can be hypothesis generating but require verification in larger cohorts. This case shows that at least some children with CAS may gain ground in adolescence, relative to same age peers, in expressive language and academic areas such as reading and writing.

Hand function is altered in individuals with a history of illicit stimulant use

Publisher: Public Library of Science (PLoS)

Date: 29-12-2014

DOI: 10.1371/JOURNAL.PONE.0115771

Decision making biases in the allied health professions: A systematic scoping review

Publisher: Public Library of Science (PLoS)

Date: 20-10-2020

DOI: 10.1371/JOURNAL.PONE.0240716

A Comparative Study of Two Acoustic Measures of Hypernasality

Publisher: American Speech Language Hearing Association

Date: 12-2009

DOI: 10.1044/1092-4388(2009/08-0161)

Abstract: This study aimed to compare 2 quantitative acoustic measures of nasality in children with cleft lip and palate (CLP) and healthy controls using formalized perceptual assessment as a guide. Fifty participants (23 children with CLP and 27 age- and gender-matched healthy controls) aged between 4 and 12 years produced a variety of high and low vowels that allowed perceptual ratings of nasal resonance severity as well as acoustic analysis of spectral changes. Two objective measures of nasality were used: 1/3 octave spectra analysis and the voice low tone high tone ratio. Each respective technique has been evaluated in previous research, and their potential as an effective means of detecting changes in nasal resonance has been demonstrated. Only 1/3 octave spectra analysis differentiated between participants with hypernasal speech and those perceived to have normal nasal resonance. Significant differences were also observed between varying levels of perceived severity on vowels within nonnasalized phonemic environments ( i t/, /t i p/). Perceptual judgment remains the primary means of evaluating levels of nasality in children with CLP. However, the development and validation of easy-to-use objective techniques remains an important goal for effective clinical and empirical practice.

Measures of spectral change and their application to habitual, slow, and clear speaking modes

Publisher: Informa UK Limited

Date: 08-11-2011

DOI: 10.3109/17549507.2011.529939

Abstract: Spectral measures are sensitive to dysarthric speech. However, it is unclear whether the spectral differences in dysarthric and healthy speech are due to slow articulation rate or reflect other qualitative changes in speech. Spectral measures were used to detect differences between habitual, slow, and "clear" speaking modes in 12 healthy speakers. Matched t-tests were used to determine differences in the rate and degree of spectral change between the speaking modes. Pearson's correlation coefficients were calculated to assess how well rate of spectral change predicts articulation rate (syllables per second). Clear speech had a significantly higher degree of spectral change than habitual speech, and slow speech had a significantly slower rate of spectral change than habitual and clear speaking modes. These differences occurred in all 12 speakers. The rate of spectral change was correlated with articulation rate across all speakers (range of r = .8-.9 within in idual speaking modes) and therefore is a gross predictor of articulation rate. These results suggest that measures of the degree and rate of spectral change together can be used to detect changes between clear, slow, and habitual speaking modes, and hold potential as performance measures.

OnabotulinumtoxinA treatment for MS-tremor modifies fMRI tremor response in central sensory-motor integration areas

Publisher: Elsevier BV

Date: 05-2020

DOI: 10.1016/J.MSARD.2020.101984

Best practices for supervised machine learning when examining biomarkers in clinical populations

Publisher: Elsevier

Date: 2021

DOI: 10.1016/B978-0-12-822884-5.00013-1

Consensus Paper: Neurophysiological Assessments of Ataxias in Daily Practice

Publisher: Springer Science and Business Media LLC

Date: 14-04-2018

DOI: 10.1007/S12311-018-0937-2

Abstract: The purpose of this consensus paper is to review electrophysiological abnormalities and to provide a guideline of neurophysiological assessments in cerebellar ataxias. All authors agree that standard electrophysiological methods should be systematically applied in all cases of ataxia to reveal accompanying peripheral neuropathy, the involvement of the dorsal columns, pyramidal tracts and the brainstem. Electroencephalography should also be considered, although findings are frequently non-specific. Electrophysiology helps define the neuronal systems affected by the disease in an in idual patient and to understand the phenotypes of the different types of ataxia on a more general level. As yet, there is no established electrophysiological measure which is sensitive and specific of cerebellar dysfunction in ataxias. The authors agree that cerebellar brain inhibition (CBI), which is based on a paired-pulse transcranial magnetic stimulation (TMS) paradigm assessing cerebellar-cortical connectivity, is likely a useful measure of cerebellar function. Although its role in the investigation and diagnoses of different types of ataxias is unclear, it will be of interest to study its utility in this type of conditions. The authors agree that detailed clinical examination reveals core features of ataxia (i.e., dysarthria, truncal, gait and limb ataxia, oculomotor dysfunction) and is sufficient for formulating a differential diagnosis. Clinical assessment of oculomotor function, especially saccades and the vestibulo-ocular reflex (VOR) which are most easily examined both at the bedside and with quantitative testing techniques, is of particular help for differential diagnosis in many cases. Pure clinical measures, however, are not sensitive enough to reveal minute fluctuations or early treatment response as most relevant for pre-clinical stages of disease which might be amenable to study in future intervention trials. The authors agree that quantitative measures of ataxia are desirable as biomarkers. Methods are discussed that allow quantification of ataxia in laboratory as well as in clinical and real-life settings, for instance at the patients' home. Future studies are needed to demonstrate their usefulness as biomarkers in pharmaceutical or rehabilitation trials.

Optimising verbal fluency analysis in neurological patients with dysarthria: examples from Parkinson’s disease and hereditary ataxia

Publisher: Informa UK Limited

Date: 09-2023

DOI: 10.1080/13803395.2023.2249172

Effects of face masks on acoustic analysis and speech perception: Implications for peri-pandemic protocols

Publisher: Acoustical Society of America (ASA)

Date: 12-2020

DOI: 10.1121/10.0002873

Abstract: Wearing face masks (alongside physical distancing) provides some protection against infection from COVID-19. Face masks can also change how people communicate and subsequently affect speech signal quality. This study investigated how three common face mask types (N95, surgical, and cloth) affected acoustic analysis of speech and perceived intelligibility in healthy subjects. Acoustic measures of timing, frequency, perturbation, and power spectral density were measured. Speech intelligibility and word and sentence accuracy were also examined using the Assessment of Intelligibility of Dysarthric Speech. Mask type impacted the power distribution in frequencies above 3 kHz for the N95 mask, and above 5 kHz in surgical and cloth masks. Measures of timing and spectral tilt mainly differed with N95 mask use. Cepstral and harmonics to noise ratios remained unchanged across mask type. No differences were observed across conditions for word or sentence intelligibility measures however, accuracy of word and sentence translations were affected by all masks. Data presented in this study show that face masks change the speech signal, but some specific acoustic features remain largely unaffected (e.g., measures of voice quality) irrespective of mask type. Outcomes have bearing on how future speech studies are run when personal protective equipment is worn.

Factors affecting the quality of sound recording for speech and voice analysis

Publisher: Informa UK Limited

Date: 2009

DOI: 10.3109/17549500902822189

Abstract: The importance and utility of objective evidence-based measurement of the voice is well documented. Therefore, greater consideration needs to be given to the factors that influence the quality of voice and speech recordings. This manuscript aims to bring together the many features that affect acoustically acquired voice and speech. Specifically, the paper considers the practical requirements of in idual speech acquisition configurations through examining issues relating to hardware, software and microphone selection, the impact of environmental noise, analogue to digital conversion and file format as well as the acoustic measures resulting from varying levels of signal integrity. The type of recording environment required by a user is often dictated by a variety of clinical and experimental needs, including: the acoustic measures being investigated portability of equipment an in idual's budget and the expertise of the user. As the quality of recorded signals is influenced by many factors, awareness of these issues is essential. This paper aims to highlight the importance of these methodological considerations to those previously uninitiated with voice and speech acoustics. With current technology, the highest quality recording would be made using a stand-alone hard disc recorder, an independent mixer to attenuate the incoming signal, and insulated wiring combined with a high quality microphone in an anechoic chamber or sound treated room.

The impact of task automaticity on speech in noise

Publisher: Elsevier BV

Date: 11-2014

DOI: 10.1016/J.SPECOM.2014.05.002

Fiberoptic endoscopic evaluation of swallowing and videofluoroscopy swallowing assessment of adults in residential care facilities

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 03-2019

DOI: 10.11124/JBISRIR-D-19-00015

Is age or culture important for the use of speech as a marker of depression?

Publisher: No publisher found

Date: 2012

DOI: 10.3389/CONF.FNHUM.2012.208.00109 

Instrumental Swallowing Assessment in Adults in Residential Aged Care Homes: A Scoping Review

Publisher: Elsevier BV

Date: 02-2021

DOI: 10.1016/J.JAMDA.2020.08.028

A review of ultrasonic vocalizations in mice and how they relate to human speech

Publisher: Acoustical Society of America (ASA)

Date: 08-2023

DOI: 10.1121/10.0020544

Abstract: Mice communicate through audible vocalizations, which are within the human hearing range, and ultrasonic vocalizations (USVs), which are above the upper limit of human hearing. USVs are produced by rodents in social contexts including pup separation, territorial, and courting assays. Like birdsong, an established model for human speech, USVs in mice have been used as a model for understanding human communication. Their utility as a model of social communication is illustrated in neurodevelopmental conditions with a genetic basis, like autism spectrum disorders and Rett syndrome. As mice do not exhibit clear visual cues when they vocalize, the source of vocalization is often assumed. Therefore, there is potential to better discern the true vocal contribution of in idual mice if the upper limit of human hearing were to be extended. Currently, there are efforts to increase the precision of sound-localizing technology, which will develop our understanding of communication in mice and other animal models.

Differentiating profiles of speech impairments in Friedreich's ataxia: A perceptual and instrumental approach

Publisher: Wiley

Date: 19-08-2012

DOI: 10.1111/J.1460-6984.2011.00078.X

Abstract: The speech disorder associated with Friedreich's ataxia (FRDA) is classically described as ataxic dysarthria. However, variable neuropathology beyond the cerebellum, which may include the corticospinal and corticobulbar tracts, means that the dysarthria can be mixed rather than a pure ataxic dysarthria. To characterize physiological features of the dysarthria associated with FRDA and identify differential patterns of deviation that may occur across the subsystems of the speech-production mechanism in a series of seven case studies. The assessment battery included a perceptual analysis of a speech s le using an interval rating scale, and a range of instrumental measures to investigate the respiratory, laryngeal, velopharyngeal and articulatory systems. The results demonstrated the variability that exists in the dysarthria associated with FRDA, highlighting the existence of differential profiles of speech impairment. A particular distinction was observed between the presence of hypernasality and phonatory dysfunction, as evidenced by the instrumental results. The distinct profiles of dysarthria associated with FRDA indicate that approaches that address multiple subsystems are necessary for the accurate characterization and quantification of the motor speech disorder. Further research is required to investigate the decline in speech function as the disease progresses, as changes in speech function over time may be a good indicator of neurological decline in FRDA.

Differentiating impairment levels in temporal versus spatial aspects of linguopalatal contacts in Friedreich's ataxia

Publisher: Human Kinetics

Date: 10-2010

DOI: 10.1123/MCJ.14.4.490

Abstract: Electropalatography (EPG) was used to describe the pattern of linguopalatal contact and the consonant phase durations exhibited by a group of seven in iduals with dysarthria associated with Friedreich’s ataxia (FRDA). A group of 14 non-neurologically impaired in iduals served as controls. The Reading Electropalatograph (EPG3) system was used to record linguopalatal contact during production of the target consonants (/t/, /l/, /s/, /k/) elicited in five words of CV and CVC construction, with the target consonants in word initial position. These words were embedded into short sentences and repeated five times by each participant. The FRDA group exhibited significantly increased consonant durations compared with the controls while maintaining normal linguopalatal contact patterns. These findings suggest that the articulatory impairment in FRDA manifests as a temporal rather than spatial disturbance.

Mandarin Lexical Tone Acquisition in Cochlear Implant Users With Prelingual Deafness: A Review

Publisher: American Speech Language Hearing Association

Date: 09-2016

DOI: 10.1044/2016_AJA-15-0069

Abstract: The purpose of this review article is to synthesize evidence from the fields of developmental linguistics and cochlear implant technology relevant to the production and perception of Mandarin lexical tone in cochlear implant users with prelingual deafness. The aim of this review was to identify potential factors that determine outcomes for tonal-language speaking cochlear implant users and possible directions for further research. A computerized database search of MEDLINE, CINAHL, Academic Search Premier, Web of Science, and Google Scholar was undertaken in June and July 2014. Search terms used were lexical tone AND tonal language, speech development AND/OR speech production AND/OR speech perception AND cochlear implants, and pitch perception AND cochlear implants, anywhere in the title or abstract. Despite the demonstrated limitations of pitch perception in cochlear implant users, there is some evidence that typical production and perception of lexical tone is possible by cochlear implant users with prelingual deafness. Further studies are required to determine the factors that contribute to better outcomes to inform rehabilitation processes for cochlear implant users in tonal-language environments.

10^th International Conference on Frontotemporal Dementias Munich/Germany; August 31‐September 2, 2016

Publisher: Wiley

Date: 18-07-2016

DOI: 10.1111/JNC.13692

Treatment for speech disorder in Friedreich ataxia and other hereditary ataxia syndromes (Protocol)

Publisher: John Wiley & Sons, Ltd

Date: 19-01-2011

DOI: 10.1002/14651858.CD008953

Effects of face masks on acoustic analysis and speech perception: Implications for peri-pandemic protocols

Publisher: Cold Spring Harbor Laboratory

Date: 08-10-2020

DOI: 10.1101/2020.10.06.327452

Abstract: Wearing face masks (alongside physical distancing) provides some protection against infection from COVID-19. Face masks can also change how we communicate and subsequently affect speech signal quality. Here we investigated how three face mask types (N95, surgical and cloth) affect acoustic analysis of speech and perceived intelligibility in healthy subjects. We compared speech produced with and without the different masks on acoustic measures of timing, frequency, perturbation and power spectral density. Speech clarity was also examined using a standardized intelligibility tool by blinded raters. Mask type impacted the power distribution in frequencies above 3kHz for both the N95 and surgical masks. Measures of timing and spectral tilt also differed across mask conditions. Cepstral and harmonics to noise ratios remained flat across mask type. No differences were observed across conditions for word or sentence intelligibility measures. Our data show that face masks change the speech signal, but some specific acoustic features remain largely unaffected (e.g., measures of voice quality) irrespective of mask type. Outcomes have bearing on how future speech studies are run when personal protective equipment is worn.

Tracheostomy clinical practices and patient outcomes in three tertiary metropolitan hospitals in Australia

Publisher: Elsevier BV

Date: 05-2023

DOI: 10.1016/J.AUCC.2022.03.002

Coordination and timing deficits in speech and swallowing in autosomal recessive spastic ataxia of Charlevoix–Saguenay (ARSACS)

Publisher: Springer Science and Business Media LLC

Date: 02-07-2018

DOI: 10.1007/S00415-018-8950-4

Abstract: Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare early onset neurodegenerative disease that typically results in ataxia, upper motor neuron dysfunction and sensorimotor peripheral neuropathy. Dysarthria and dysphagia are anecdotally described as key features of ARSACS but the nature, severity and impact of these deficits in ARSACS are not known. A comprehensive quantitative and qualitative characterization of speech and swallowing function will support diagnostics, provide insights into the underlying pathology, and guide day-to-day clinical management. 11 consecutive non-Quebec ARSACS patients were recruited, and compared to healthy participants from several published and unpublished cohorts. A comprehensive behavioural assessment including objective acoustic analysis and expert perceptual ratings of motor speech, the Clinical Assessment of Dysphagia in Neurodegeneration (CADN), videofluoroscopy and standardized tests of dysarthria and swallowing related quality of life was conducted. Speech in this ARSACS cohort is characterized by pitch breaks, prosodic deficits including reduced rate and prolonged intervals, and articulatory deficits. The swallowing profile was characterized by delayed initiation of the swallowing reflex and late epiglottic closure. Four out of ten patients were observed aspirating thin liquids on videofluoroscopy. Patients report that they regularly cough or choke on thin liquids and solids during mealtimes. Swallowing and speech-related quality of life was worse than healthy controls on all domains except sleep. The dysphagia and dysarthria profile of this ARSACS cohort reflects impaired coordination and timing. Dysphagia contributes to a significant impairment in functional quality of life in ARSACS, and appears to manifest distinctly from other ARSACS dysfunctions such as ataxia or spasticity.

History of cannabis use is associated with altered gait

Publisher: Elsevier BV

Date: 09-2017

DOI: 10.1016/J.DRUGALCDEP.2017.05.017

Abstract: Despite evidence that cannabinoid receptors are located in movement-related brain regions (e.g., basal ganglia, cerebral cortex, and cerebellum), and that chronic cannabis use is associated with structural and functional brain changes, little is known about the long-term effect of cannabis use on human movement. The aim of the current study was to investigate balance and walking gait in adults with a history of cannabis use. We hypothesised that cannabis use is associated with subtle changes in gait and balance that are insufficient in magnitude for detection in a clinical setting. Cannabis users (n=22, 24±6years) and non-drug using controls (n=22, 25±8years) completed screening tests, a gait and balance test (with a motion capture system and in-built force platforms), and a clinical neurological examination of movement. Compared to controls, cannabis users exhibited significantly greater peak angular velocity of the knee (396±30 versus 426±50°/second, P=0.039), greater peak elbow flexion (53±12 versus 57±7°, P=0.038) and elbow range of motion (33±13 versus 36±10°, P=0.044), and reduced shoulder flexion (41±19 versus 26±16°, P=0.007) during walking gait. However, balance and neurological parameters did not significantly differ between the groups. The results suggest that history of cannabis use is associated with long-lasting changes in open-chain elements of walking gait, but the magnitude of change is not clinically detectable. Further research is required to investigate if the subtle gait changes observed in this population become more apparent with aging and increased cannabis use.

Assessment of impairment or monitoring change in Friedreich ataxia

Publisher: Wiley

Date: 30-06-2010

DOI: 10.1002/MDS.23103

Stability, reliability, and sensitivity of acoustic measures of vowel space: A comparison of vowel space area, formant centralization ratio, and vowel articulation index

Publisher: Acoustical Society of America (ASA)

Date: 09-2020

DOI: 10.1121/10.0001931

Abstract: Vowel space (VS) measurements can provide objective information on formant distribution and act as a proxy for vowel production. There are a number of proposed ways to quantify vowel production clinically, including vowel space area, formant centralization ratio, and vowel articulation index (VAI). The stability, reliability, and sensitivity of three VS measurements were investigated in two experiments. Stability was explored across three inter-recording intervals and challenged in two sensitivity conditions. Data suggest that VAI is the most stable measure across 30 s, 2 h, and 4 h inter-recording intervals. VAI appears the most sensitive metric of the three measures in conditions of fatigue and noise. These analyses highlight the need for stability and sensitivity analysis when developing and validating acoustic metrics, and underscore the potential of the VAI for vowel analysis.

Novel Functional MRI Task for Studying the Neural Correlates of Upper Limb Tremor.

Publisher: Frontiers Media SA

Date: 02-07-2018

DOI: 10.3389/FNEUR.2018.00513

Is the bilateral cochlear implantation necessary for avoidance of auditory deprivation in deaf children?

Publisher: Elsevier BV

Date: 11-2003

DOI: 10.1016/S0531-5131(03)00965-8

Disease Delineation for Multiple Sclerosis, Friedreich Ataxia, and Healthy Controls Using Supervised Machine Learning on Speech Acoustics

Publisher: Institute of Electrical and Electronics Engineers (IEEE)

Date: 2023

DOI: 10.1109/TNSRE.2023.3321874

Monitoring change requires a rethink of assessment practices in voice and speech

Publisher: Informa UK Limited

Date: 05-03-2013

DOI: 10.3109/14015439.2013.775332

Abstract: Assessment for the purpose of monitoring change over time requires a different practical and statistical approach to that of assessment for diagnosing impairment. Sophisticated methods exist for identifying strengths and weaknesses in a patient's voice/speech profile, yet our understanding of the impact of repeated assessment is limited. Monitoring change necessitates that stimuli are stable in the absence of any true change in functioning, while remaining sensitive to influences that are considered to alter functioning (degeneration, therapy). The current paper discusses the issues relating to stimuli selection, identifying error within the s le and appropriate statistical models for identifying intra-in idual change in the context of clinical and experimental speech or voice examinations.

The Role of Instrumental Swallowing Assessment in Adults in Residential Aged Care Homes: A National Modified Delphi Survey Examining Beliefs and Practices

Publisher: Springer Science and Business Media LLC

Date: 09-04-2021

DOI: 10.1007/S00455-021-10296-2

Abstract: Many adults in residential aged care homes (RACHs) live with oropharyngeal dysphagia (OD) and its physiological, psychosocial, and economic sequalae. Timely, evidence-based assessment of OD can help healthcare teams to create OD management plans that optimize consumer health and minimize healthcare costs. Instrumental swallowing assessment (ISA), specifically flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing studies (VFSS), is generally accepted to be an important component of dysphagia assessment and management in older adults. However, its role in RACHs has not been empirically examined. This study aimed to explore the role and use of ISA in adults in RACHs from the perspective of speech-language-pathologists (SLPs) experienced in a RACH setting and/or FEES and VFSS. A three-round electronic Delphi study was conducted to guide 58 SLPs in Australia towards consensus using a combination of multiple-choice questions, statements with five-point Likert scale agreement options, and open-ended questions. Participants' responses were analyzed using descriptive statistics and content analysis after each survey round. Feedback about group responses was provided before subsequent surveys. Consensus was defined as 70% or greater agreement. Participants reached consensus about obstacles and facilitators to the use of ISA in RACHs. Participants agreed that FEES was a valuable tool in RACHs and that a mobile service model may have advantages over standard off-site assessment. SLPs believed that appropriate governance processes, infrastructure and education were necessary to develop a safe, high-quality service. These views support equitable access to ISA across settings, aligning with person-centered care, re-ablement, and care-in-place.

Role of cerebellum in fine speech control in childhood: Persistent dysarthria after surgical treatment for posterior fossa tumour

Publisher: Elsevier BV

Date: 05-2011

DOI: 10.1016/J.BANDL.2011.01.002

Abstract: Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen long-term after surgical treatment for childhood PFT, unselected for the presence of post-operative mutism (mean time post-surgery=6y10m, range 1 -12 years, two had post-operative mutism), and examine factors affecting outcome. Twenty-six age- and sex- matched healthy controls were recruited for comparison. Participants in both groups had speech assessments using detailed perceptual and acoustic methods. Over two-thirds of the group (69%) with removal of PFT had a profile of typically mild dysarthria. Prominent speech deficits included consonant imprecision, reduced rate, monopitch and monoloudness. We conclude that speech deficits may persist even up to 10 years post-surgery in participants who have not shown mutism in the acute phase. Of cases with unilateral lesions, poorer outcomes were associated with right cerebellar tumours compared to left, consistent with the notion based on adult data that speech is controlled by reciprocal right cerebellar/left frontal interactions. These results confirm the important role of the cerebellum in the control of fine speech movements in children.

Automatic speech recognition in neurodegenerative disease

Publisher: Springer Science and Business Media LLC

Date: 04-05-2021

DOI: 10.1007/S10772-021-09836-W

Abstract: Automatic speech recognition (ASR) could potentially improve communication by providing transcriptions of speech in real time. ASR is particularly useful for people with progressive disorders that lead to reduced speech intelligibility or difficulties performing motor tasks. ASR services are usually trained on healthy speech and may not be optimized for impaired speech, creating a barrier for accessing augmented assistance devices. We tested the performance of three state-of-the-art ASR platforms on two groups of people with neurodegenerative disease and healthy controls. We further examined in idual differences that may explain errors in ASR services within groups, such as age and sex. Speakers were recorded while reading a standard text. Speech was elicited from in iduals with multiple sclerosis, Friedreich’s ataxia, and healthy controls. Recordings were manually transcribed and compared to ASR transcriptions using Amazon Web Services, Google Cloud, and IBM Watson. Accuracy was measured as the proportion of words that were correctly classified. ASR accuracy was higher for controls than clinical groups, and higher for multiple sclerosis compared to Friedreich’s ataxia for all ASR services. Amazon Web Services and Google Cloud yielded higher accuracy than IBM Watson. ASR accuracy decreased with increased disease duration. Age and sex did not significantly affect ASR accuracy. ASR faces challenges for people with neuromuscular disorders. Until improvements are made in recognizing less intelligible speech, the true value of ASR for people requiring augmented assistance devices and alternative communication remains unrealized. We suggest potential methods to improve ASR for those with impaired speech.

Speech acoustic markers of early stage and prodromal Huntington's disease: a marker of disease onset?

Publisher: Elsevier BV

Date: 12-2012

DOI: 10.1016/J.NEUROPSYCHOLOGIA.2012.09.011

Abstract: Speech disturbances (e.g., altered prosody) have been described in symptomatic Huntington's Disease (HD) in iduals, however, the extent to which speech changes in gene positive pre-manifest (PreHD) in iduals is largely unknown. The speech of in iduals carrying the mutant HTT gene is a behavioural/motor/cognitive marker demonstrating some potential as an objective indicator of early HD onset and disease progression. Speech s les were acquired from 30 in iduals carrying the mutant HTT gene (13 PreHD, 17 early stage HD) and 15 matched controls. Participants read a passage, produced a monologue and said the days of the week. Data were analysed acoustically for measures of timing, frequency and intensity. There was a clear effect of group across most acoustic measures, so that speech performance differed in-line with disease progression. Comparisons across groups revealed significant differences between the control and the early stage HD group on measures of timing (e.g., speech rate). Participants carrying the mutant HTT gene presented with slower rates of speech, took longer to say words and produced greater silences between and within words compared to healthy controls. Importantly, speech rate showed a significant correlation to burden of disease scores. The speech of early stage HD differed significantly from controls. The speech of PreHD, although not reaching significance, tended to lie between the performance of controls and early stage HD. This suggests that changes in speech production appear to be developing prior to diagnosis.

Logopenic and Nonfluent Variants of Primary Progressive Aphasia Are Differentiated by Acoustic Measures of Speech Production

Publisher: Public Library of Science (PLoS)

Date: 28-02-2014

DOI: 10.1371/JOURNAL.PONE.0089864

Motor speech and non-motor language endophenotypes of Parkinson’s disease

Publisher: Informa UK Limited

Date: 08-08-2019

DOI: 10.1080/14737175.2019.1649142

The influence of rate of stimulation and pulse duration on efficacy of deep brain stimulation for Essential Tremor.

Publisher: Elsevier BV

Date: 03-2015

DOI: 10.1016/J.BRS.2015.01.073

Vocal acoustic biomarkers of depression severity and treatment response

Publisher: Elsevier BV

Date: 10-2012

DOI: 10.1016/J.BIOPSYCH.2012.03.015

Validation of a precision tremor measurement system for multiple sclerosis.

Publisher: Elsevier BV

Date: 2018

DOI: 10.1016/J.JNEUMETH.2018.09.022

Abstract: Tremor is a debilitating symptom of Multiple Sclerosis (MS). Little is known about its pathophysiology and treatments are limited. Clinical trials investigating new interventions often rely on subjective clinical rating scales to provide supporting evidence of efficacy. We present a novel instrument (TREMBAL) which uses electromagnetic motion capture technology to quantify MS tremor. We aim to validate TREMBAL by comparison to clinical ratings using regression modelling with 310 s les of tremor captured from 13 MS participants who performed five different hand exercises during several follow-up visits. Minimum detectable change (MDC) and test-retest reliability were calculated and comparisons were made between MS tremor and data from 12 healthy volunteers. Velocity of the index finger was most congruent with clinical observation. Regression modelling combining different features, sensor configurations, and labelling exercises did not improve results. TREMBAL MDC was 84% of its initial measurement compared to 91% for the clinical rating. Intra-class correlations for test-retest reliability were 0.781 for TREMBAL and 0.703 for clinical ratings. Tremor was lower (p = 0.002) in healthy subjects. Subjective scales have low sensitivity, suffer from ceiling effects, and mitigation against inter-rater variability is challenging. Inertial sensors are ubiquitous, however, their output is nonlinearly related to tremor frequency, compensation is required for gravitational artefacts, and their raw data cannot be intuitively comprehended. TREMBAL, compared with clinical ratings, gave measures in agreement with clinical observation, had marginally lower MDC, and similar test-retest reliability.

Voice in Friedreich Ataxia

Publisher: Elsevier BV

Date: 03-2017

DOI: 10.1016/J.JVOICE.2016.04.015

Abstract: Friedreich Ataxia (FRDA) is the most common hereditary ataxia, with dysarthria as one of its key clinical signs. To describe the voice profile of in iduals with FRDA to inform outcome marker development and goals of speech therapy. Thirty-six in iduals with FRDA and 30 age-matched controls provided sustained vowel and connected speech s les. Speech and voice s les were analyzed acoustically using the Analysis of Dysphonia in Speech and Voice program and perceptually using the Consensus Auditory-Perceptual Evaluation of Voice form. Correlations between dysphonia and overall dysarthria severity, demographic, clinical, and genetic information were explored. In iduals with FRDA presented with mild dysphonia characterized by hoarseness (combined roughness and breathiness), increased strain, and altered pitch variability (increased in vowel productions slightly decreased on reading s les). Acoustically, in iduals with FRDA had significantly higher scores on the Cepstral Spectral Index of Dysphonia during vowel production. A combination of perceptual and acoustic measures of dysphonia used in this study was quite effective in categorizing the FRDA versus control participants, with >80% overall accuracy. Although dysphonia severity in FRDA did not correlate significantly with overall disease severity, speaking rate and syllabic duration significantly correlated with age at disease onset and disease duration, and also have an effect on listener perception of dysphonia. The relationship between dysphonia and dysarthria in FRDA suggests that reducing overall dysphonia severity via therapeutic techniques that improve phonatory stability and increase speaking rate is a viable target for speech therapy.

The impacts of injury at the individual, community and societal levels: A systematic meta-review

Publisher: Elsevier BV

Date: 07-2014

DOI: 10.1016/J.PUHE.2014.04.004

Abstract: Injury is a major public health problem. While the impacts of injury on the injured person are well documented, there is relatively little knowledge about the impacts of injury on those in iduals and groups in the community connected to the injured person. This study seeks to describe this breadth of research using a meta-review methodology. Systematic meta-review. To gain a better understanding of the known impacts of injury on family, community and society, a systematic meta-review of injury outcomes research literature was conducted. Seventy-eight peer-reviewed published literature reviews were included in the meta-review. Of these, 70 reported outcomes at the level of the injured person including mortality, body functions, activity and participation limitations. Nine reviews reported impacts at the level of the community including impacts on family members, work colleagues and carers. Six studies reported impacts at the societal level including economic, health system and injury compensation system impacts. In summary, the meta-review identified a substantial body of knowledge at the in idual level outcomes of injury, and a relative lack of information regarding the community and societal impacts of injury. An injury outcome framework is proposed on the basis of the findings of the meta-review to guide future research activity, particularly with regard to injury outcome domains where there is currently limited evidence. A comprehensive framework that takes account of all levels of impact is necessary for effective policies, systems and strategies to support recovery following injury.

Prevalence of self-reported movement dysfunction among young adults with a history of ecstasy and methamphetamine use

Publisher: Elsevier BV

Date: 12-2019

DOI: 10.1016/J.DRUGALCDEP.2019.107595

Abstract: Illicit stimulant use is associated with long-lasting changes in movement and movement-related brain regions. The aim of our study was to investigate the prevalence of movement dysfunction in this population. We hypothesized that prevalence of self-reported movement dysfunction is higher among stimulant users than non-stimulant users. Three groups of adults completed a survey containing questions about demographics, health, drug use, and movement. The groups consisted of ecstasy users with no history of meth hetamine use (ecstasy group, n = 190, 20 ± 3 yrs.), meth hetamine users (meth hetamine group, n = 331, 23 ± 5 yrs.), and non-stimulant users (control group, n = 228, 25 ± 8 yrs.). Movement data was analyzed with logistic regression. In the unadjusted logistic regression model, group had a significant effect on fine hand control, tremor, and voice/speech questions, but not on other movement domain questions. The prevalence of tremor and abnormal fine hand control was significantly higher in the ecstasy and meth hetamine groups than in the control group (p < 0.018), and changes in voice/speech was more prevalent in the ecstasy group than in the control group (p = 0.015). Age and use of cannabis and hallucinogens were confounding variables. However, inspection of chi-square tables suggests that the effect of these parameters on the movement data is likely to be minor. The prevalence of self-reported tremor and changes in fine hand control and voice/speech is significantly higher in stimulant users than in non-stimulant users. Inclusion of these common and noticeable changes in body function may aid public health c aigns that target prevention or harm minimization.

University Of Queensland

Location: Australia

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University Of Melbourne

Location: Australia

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Redenlab

Location: Australia

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Eberhard Karls Universität Tübingen Hertie Institut Für Klinische Hirnforschung Allgemeine Neurologie

Location: Germany

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Sleep And Speech: Objectively Monitoring The Residual Effects Of Sleep Promoting Compounds

Start Date: 2012

End Date: 2015

Funder: Australian Research Council

Optimising Speech Assessment And Treatment In Frontotemporal Dementia

Start Date: 2017

End Date: 2021

Funder: National Health and Medical Research Council

Building And Commercialising A Digital Speech Tool (ADAAPT)

Start Date: 2019

End Date: 2014

Funder: National Health and Medical Research Council

Detecting And Tracking Alertness Using Speech Biometrics

Start Date: 2023

End Date: 2026

Funder: Australian Research Council

Determining The Individual, Community And Societal Impacts Of Compensable Injury In Australia

Start Date: 2011

End Date: 2014

Funder: Australian Research Council

Stuttering In Childhood: Patterns Of Recovery And Persistence

Start Date: 2009

End Date: 2011

Funder: Australian Research Council

Linkage Projects - Grant ID: LP120200223

Start Date: 06-2013

End Date: 06-2016

Amount: $120,349.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP130101900

Start Date: 08-2013

End Date: 12-2017

Amount: $185,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP130100026

Start Date: 06-2014

End Date: 12-2018

Amount: $266,087.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP110200119

Start Date: 09-2011

End Date: 06-2016

Amount: $298,719.00

Funder: Australian Research Council

ARC Future Fellowships - Grant ID: FT220100253

Start Date: 2023

End Date: 12-2026

Amount: $1,050,872.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP0984833

Start Date: 2009

End Date: 12-2012

Amount: $334,000.00

Funder: Australian Research Council