Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
Ann Neurol. 2021 Jul;90(1):62-75. doi: 10.1002/ana.26085. Epub 2021 May 7.
This multilanguage study used simple speech recording and high-end pattern analysis to provide sensitive and reliable noninvasive biomarkers of prodromal versus manifest α-synucleinopathy in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) and early-stage Parkinson disease (PD).
We performed a multicenter study across the Czech, English, German, French, and Italian languages at 7 centers in Europe and North America. A total of 448 participants (337 males), including 150 with iRBD (mean duration of iRBD across language groups 0.5-3.4 years), 149 with PD (mean duration of disease across language groups 1.7-2.5 years), and 149 healthy controls were recorded; 350 of the participants completed the 12-month follow-up. We developed a fully automated acoustic quantitative assessment approach for the 7 distinctive patterns of hypokinetic dysarthria.
No differences in language that impacted clinical parkinsonian phenotypes were found. Compared with the controls, we found significant abnormalities of an overall acoustic speech severity measure via composite dysarthria index for both iRBD (p = 0.002) and PD (p < 0.001). However, only PD (p < 0.001) was perceptually distinct in a blinded subjective analysis. We found significant group differences between PD and controls for monopitch (p < 0.001), prolonged pauses (p < 0.001), and imprecise consonants (p = 0.03); only monopitch was able to differentiate iRBD patients from controls (p = 0.004). At the 12-month follow-up, a slight progression of overall acoustic speech impairment was noted for the iRBD (p = 0.04) and PD (p = 0.03) groups.
Automated speech analysis might provide a useful additional biomarker of parkinsonism for the assessment of disease progression and therapeutic interventions. ANN NEUROL 2021;90:62-75.
本多语言研究采用简单的语音记录和高端模式分析，为特发性快速眼动睡眠行为障碍（iRBD）和早期帕金森病（PD）患者的前驱期与显性α-突触核蛋白病提供敏感且可靠的非侵入性生物标志物。
我们在欧洲和北美 7 个中心进行了一项跨捷克语、英语、德语、法语和意大利语的多中心研究。共有 448 名参与者（337 名男性），包括 150 名 iRBD（语言组的 iRBD 平均持续时间为 0.5-3.4 年）、149 名 PD（语言组的疾病平均持续时间为 1.7-2.5 年）和 149 名健康对照者被记录下来；其中 350 名参与者完成了 12 个月的随访。我们开发了一种全自动声学定量评估方法，用于 7 种不同的运动障碍性构音障碍模式。
未发现影响临床帕金森表型的语言差异。与对照组相比，我们发现 iRBD（p=0.002）和 PD（p<0.001）的整体语音严重程度测量的复合构音障碍指数均存在显著异常。然而，只有 PD（p<0.001）在盲法主观分析中具有明显的可辨别性。我们发现 PD 与对照组之间在单音（p<0.001）、延长停顿（p<0.001）和不准确辅音（p=0.03）方面存在显著的组间差异；只有单音能够将 iRBD 患者与对照组区分开来（p=0.004）。在 12 个月的随访中，iRBD（p=0.04）和 PD（p=0.03）组的整体语音损伤略有进展。
自动语音分析可能为评估疾病进展和治疗干预提供有用的帕金森病附加生物标志物。
