Department of Psychiatry, University of Szeged, Szeged, Hungary.
MTA-SZTE Research Group on Artificial Intelligence, Szeged, Hungary.
PLoS One. 2024 Aug 20;19(8):e0308409. doi: 10.1371/journal.pone.0308409. eCollection 2024.
Our aim was to find out whether speech-related temporal parameters (SRTPs) are sensitive indicators of the clinical outcome in acetylcholinesterase (AChE) inhibitor therapy with donepezil, compared to the standard cognitive Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) used in clinical trials. In this 24-week-long, naturalistic, self-control, open-labeled, prospective pilot study with 10 mg donepezil on 20 mild AD patients, cognitive functions were evaluated using 15 different SRTPs analyzed by automatic speech recognition in the Speech-Gap Test® compared to ADAS-Cog test results. Among the SRTPs, the filled pause duration ratio significantly improved after 12 weeks of donepezil treatment. During the 24-week follow-up, additional SRTPs such as the filled pause count ratio and the filled pause frequency showed significant benefits. ADAS-Cog total scores showed a slight but not significant improvement compared to baseline after 12 and 24 weeks of donepezil treatment. Among the ADAS-Cog subtests, only orientation improved significantly after 24 weeks of donepezil treatment. Our results indicate that subtle changes in SRTPs measured by the Speech-Gap Test® could be considered as sensitive indicators of the efficacy of the pharmacotherapy in mild AD. According to our data, other cognitive domains did not show improvement in response to donepezil therapy rating by ADAS-Cog. Based on all of this, it is likely that examining and evaluating speech parameters may play an important role in determining the effects of pharmacological treatment of mild AD. The novelty of our study is that it applies the measurement of linguistic parameters as primary outcomes during a drug trial of mild AD in scientific research for the first time.
我们的目的是确定在与临床试验中使用的标准认知阿尔茨海默病评估量表-认知子量表（ADAS-Cog）相比，与言语相关的时间参数（SRTPs）是否可以作为多奈哌齐乙酰胆碱酯酶抑制剂治疗的临床疗效的敏感指标。在这项为期 24 周、自然、自我控制、开放性、前瞻性试验研究中，20 例轻度 AD 患者使用 10mg 多奈哌齐，通过自动言语识别分析 Speech-Gap Test®中的 15 种不同的 SRTP，与 ADAS-Cog 测试结果进行比较。在这些 SRTP 中，填充停顿时间比在多奈哌齐治疗 12 周后显著改善。在 24 周的随访中，其他 SRTP，如填充停顿计数比和填充停顿频率也显示出显著的益处。与多奈哌齐治疗 12 周和 24 周后的基线相比，ADAS-Cog 总分略有改善，但无统计学意义。在 ADAS-Cog 子测试中，只有定向在多奈哌齐治疗 24 周后显著改善。我们的结果表明，Speech-Gap Test®测量的 SRTP 中的细微变化可以被认为是轻度 AD 药物治疗疗效的敏感指标。根据我们的数据，其他认知领域在多奈哌齐治疗后没有显示出改善，ADAS-Cog 评分也没有改善。基于所有这些，检查和评估言语参数可能在确定轻度 AD 药物治疗效果方面发挥重要作用。我们的研究的新颖之处在于，它首次将语言参数的测量作为轻度 AD 药物试验的主要结果应用于科学研究。
