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Dysprosody Differentiate Between Parkinson's Disease, Progressive See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/319184906 Dysprosody Differentiate Between Parkinson’s Disease, Progressive Supranuclear Palsy, and Multiple System Atrophy Conference Paper · August 2017 DOI: 10.21437/Interspeech.2017-762 CITATIONS READS 0 31 6 authors, including: Tereza Tykalová Jiri Klempir Czech Technical University in Prague Charles University in Prague 22 PUBLICATIONS 102 CITATIONS 46 PUBLICATIONS 283 CITATIONS SEE PROFILE SEE PROFILE Evžen Růžička Jan Rusz Charles University in Prague Czech Technical University in Prague 304 PUBLICATIONS 2,979 CITATIONS 69 PUBLICATIONS 480 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: Role of mitochondria in Huntington's disease View project All content following this page was uploaded by Jan Hlavnička on 26 September 2017. The user has requested enhancement of the downloaded file. INTERSPEECH 2017 August 20–24, 2017, Stockholm, Sweden Dysprosody differentiate between Parkinson’s disease, progressive supranuclear palsy, and multiple system atrophy Jan Hlavnička1, Tereza Tykalová1, Roman Čmejla1, Jiří Klempíř2, Evžen Růžička2, Jan Rusz1,2 1 Czech Technical University in Prague, Faculty of Electrical Engineering, Department of Circuit Theory, Technická 2, 166 27, Prague 6, Czech Republic 2 Charles University in Prague, First Faculty of Medicine, Department of Neurology and Centre of Clinical Neuroscience, Kateřinská 30, 120 00, Prague 2, Czech Republic [email protected], [email protected] silences and rushes of speech [4]. PSP and MSA typically Abstract manifested mixed dysarthria including various combinations of Parkinson’s disease (PD), progressive supranuclear palsy hypokinetic, spastic, and ataxic components [5, 6] due to (PSP), and multiple system atrophy (MSA) are distinctive different involvement of the basal ganglia, corticobulbar neurodegenerative disorders, which manifest similar motor pathways, and the cerebellum. Excess pitch, reduced speech features. Their differentiation is crucial but difficult. rate, reduced maximum phonation time, reduced intonation Dysfunctional speech, especially dysprosody, is a common variability and substantial prolongation of pauses is typical for symptom accompanying PD, PSP, and MSA from early stages. speech impairment in PSP [7-9]. Slow, effortful speech and We hypothesized that automated analysis of monologue could strained-strangled vocal quality characterize speech in MSA provide speech patterns distinguishing PD, PSP, and MSA. We [10]. analyzed speech recordings of 16 patients with PSP, 20 patients Various speech tasks have been used to examine with MSA, and 23 patients with PD. Our findings revealed that hypokinetic dysarthria. These speech tasks including prolonged deviant pause production differentiated between PSP, MSA, phonation of isolated vowel, articulatory pattern of rapid and PD. In addition, PSP showed greater deficits in speech syllables repetition, and rhythmic pattern of syllable repetition respiration when compared to MSA and PD. Automated in steady pace endeavour to isolate specific aspect of dysarthria. analysis of connected speech is easy to administer and could Prosody comprehensively includes all dimensions of speech provide valuable information about underlying pathology for and is commonly quantified upon text reading or spontaneous differentiation between PSP, MSA, and PD. speech such as monologue that require coordination of all Index Terms: automated acoustic analysis, speech disorder, subsystems of speech. These tasks offer the most natural way dysprosody, atypical parkinsonian syndromes, Parkinson’s to seek characteristics of speech. Especially, the spontaneous disease, progressive supranuclear palsy, multiple system speech seems to represent the purest condition of speech, as it atrophy is conducted by speaker itself nor by his disposition to read. The previous study considered spontaneous speech as the most 1. Introduction sensitive marker of true deficits in PD speech [11]. Prosody describes utterance of speech in Parkinson’s disease (PD) is an idiopathic neurodegenerative suprasegmental terms of factors such as intonation, tone, stress, disorder characterized by progressive loss of dopaminergic rhythm, and spectrum. Prosody, in general, may reflect the neurons in substantia nigra. Bradykinesia, rigidity, tremor, and emotional state of the speaker; however, dysprosody in PD is postural instability represent the clinical symptoms of PD. related to a combination of respiratory, phonatory, articulatory, Atypical parkinsonian syndromes (APS) such as progressive and rhythmic disturbances associated with hypokinetic supranuclear palsy (PSP) and multiple system atrophy (MSA) dysarthria [4, 12, 13]. Dysprosody of hypokinetic dysarthria are distinctive neurodegenerative disorders that involve various may exhibit monopitch and monoloudness but particularly neuronal systems in addition to substantia nigra and progress speech-timing disturbances. more rapidly than PD. APS manifest characteristic clinical Rhythm characteristics of speech in PD are signs together with shared parkinsonian features. Because of constrained by the timing pattern of spoken language, this overlap in symptoms, patients with PSP, MSA, and PD are hypokinetic movements of speech apparatus, and self-pacing. frequently misdiagnosed [1]. The accurate diagnosis plays an Impaired self-pace rhythm with a tendency to accelerate is important role in deciding upon drug therapy, monitoring frequent in hypokinetic dysarthria [12, 14]. Consequently, response to therapy and determining prognosis of the disease. rhythm can either be abnormally accelerated or slowed as PD Previous studies have shown that motor speech progresses. An accelerated rhythm is considered to be a salient impairment, called hypokinetic dysarthria, is a common feature of hypokinetic dysarthria [13]. symptom for approximately 70%-90% of PD patients [2, 3]. The tempo of speech is defined as a number of speech Hypokinetic dysarthria is a multidimensional impairment units per time. Most authors express the tempo of speech as the affecting all aspects of speech including respiration, phonation, articulation rate, i.e., the number of words or syllables per time articulation, and prosody [4]. Speech in PD is mainly typically measured for a standardized speech sentence. Because characterized by imprecise articulation of consonants and the flow of a syllable stream is phrased by pauses, the number vowels, monopitch, monoloudness, reduced vocal loudness, and duration of pauses have a considerable impact on the harsh voice, breathy voice quality, dysrhythmia, inappropriate perceived tempo of speech. In general, tempo is strictly related Copyright © 2017 ISCA 1844 http://dx.doi.org/10.21437/Interspeech.2017-762 to pause characteristics. For healthy speech, it has been for the automated measurement of basic temporal and suggested that the number of pauses increases as overall phonatory characteristics of the short standardized sentence. speaking tempo decreases, whereas articulatory speech tempo The automatic evaluation of rhythm and respiratory remains relatively stable [15, 16]. As pauses tend to vary more characteristics based on continuous speech has not been freely than phonemes, overall changes in tempo are mostly available until now [37]. Thus, a complex investigation of dependent on changes in pauses [17]. dysprosodic patterns in PSP and MSA through continuous In hypokinetic dysarthria, the suggested mechanism speech with respect to all subsystems of speech has never been of tempo execution may be affected by articulatory performed. The aim of the present study was to explore “undershoots” and slurring of stop consonants [12, 18]. Indeed, dysprosody in PSP, MSA and PD using fully automated PD speakers compensate for hypokinetic movement of analysis. articulators by reducing the amplitude of movement to achieve a higher articulatory rate [14]. Reduced amplitude of 2. Materials and methods articulators’ movement causes imprecise articulation of phonemes. In particular, stop consonants tend to have a fricative 2.1. Subjects character with insufficient oral closure [19, 20]. The majority of patients for this study was originally recruited Correctly articulated speech also requires well-timed for the previous study [38]. Data were obtained from a total of voicing. PD causes disturbances in the coordination of 79 subjects, 16 of which were diagnosed with PSP (10 men, 6 laryngeal and supralaryngeal musculature, rigid laryngeal women; 14 Richardson’s syndrome, 2 PSP-parkinsonism), and musculature, increased the stiffness of vocal folds and reduction 20 with MSA (9 men, 11 women; 17 parkinsonian type, 3 in vocal fold opening [21-23]. As a result of voicing deficits in cerebellar type). Additionally, 23 PD (12 men, 11 women) were PD, voice onset time may be prolonged or shortened, initial recruited to match the PSP and MSA groups in terms of age and consonants may be omitted, and voicing may interfere with disease duration estimated from the self-reported occurrence of voiceless consonants or may be continuous within utterance first symptoms. The group of 20 healthy controls (HC) with no containing voiceless consonants [21-24]. history of neurological or communication disorder consisted of Respiration abnormalities are quintessentially 10 men and 10 women with mean age of 63.6 years ± 6.4 responsible for common loudness impairments and dysprosody standard
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