Longitudinal Changes to Speech in Parkinson's Disease Phenotypes

帕金森病表型中言语的纵向变化

• 批准号: 10153450
• 负责人: Defne Abur
• 金额: $ 3.47万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10153450
• 关键词: Acoustics; Address; Affect; Articular Range of Motion; Articulation; Clinical assessments; Communication; Data; Databases; Deterioration; Development; Diagnosis; Dysarthria; Future; Gait; Heterogeneity; Impairment; Incidence; Individual; Laryngeal muscle structure; Longitudinal Studies; Loudness; Measures; Motor; Movement; Movement Disorder Society Unified Parkinson' s Disease Rating Scale; Movement Disorders; Muscle Rigidity; Neurodegenerative Disorders; Outcome; Parkinson Disease; Pattern; Phenotype; Population; Posture; Preparation; Production; Quality of life; Reading; Recommendation; Reporting; Research; Severities; Societies; Speech; Speech Acoustics; Speech Disorders; Speech Intelligibility; Speech Therapy; Stress; Symptoms; Testing; Time; TimeLine; Training; Tremor; Visual; Voice; Voice Quality; Work; analog; career; disease diagnosis; disease phenotype; experience; follow-up; human old age (65+); individual variation; insight; motor control; motor disorder; motor impairment; motor symptom; posture instability

Project Summary Approximately 90% of individuals with Parkinson's disease (PD) experience speech symptoms that can drastically reduce quality of life, as well as the ability to maintain effective communication abilities. Therefore, these speech changes in PD are vital to understand and address. Yet the associations between the progression of PD (years since diagnosis), specific motor impairments, and the development of specific speech difficulties are not well understood. The progression of PD does not appear to correlate with speech symptom severity: overall motor severity via clinical assessments and the years since PD diagnosis are not always associated with a decline in functional speech outcomes (i.e., speech intelligibility and naturalness) or acoustic measures of speech. In particular, the association appears to differ by speech subsystem: articulatory features of speech relate to the progression of PD, whereas measures of voice do not. However, it is not clear if these findings are due to different underlying causes or because of high individual variability in PD motor symptoms. In fact, recent work suggests that there are two distinct motor phenotypes of PD: postural insufficiency and gait dominant (PIGD) and tremor dominant (TD). A higher incidence of communication difficulties and worse speech scores are found in speakers with PIGD compared to TD, which may be a result of increased laryngeal muscle rigidity. Thus, it is critical to understand how speech symptoms progress within an individual by speech subsystem, and moreover, how speech changes relate to specific motor symptoms in PD. Functional speech outcomes may also show differences across PD phenotype since speech intelligibility and naturalness are affected by articulatory precision and voice quality. No studies have yet completed a robust acoustic characterization of speech changes and measures of functional speech outcomes within the same speakers with PD over time. Therefore, this proposal will comprehensively examine how longitudinal changes in acoustic features of speech production relate to motor phenotype and functional speech outcomes of speech intelligibility and naturalness in the same speakers with PD. Speech data will be collected in 44 speakers with PD (with an even PIGD-to-TD motor- phenotype ratio) at two time points, leveraging a previous database as the first time point. Aim 1 will evaluate longitudinal changes in acoustic measures of articulation and voice to provide insight into how different speech impairments progress in within speakers with PD over time by motor phenotype. Aim 2 will determine how longitudinal changes in acoustic measures of speech are related to functional speech outcomes in PD. The results of Aim 2 will elucidate which specific acoustic measures are tied to functional speech outcomes in PD and enhance the ability to objectively track the most critical features of communication in PD. This work will clarify the relationship between PD motor phenotypes and progression of speech symptoms as well as provide meaningful objective measures for future treatment studies in PD.

项目摘要 大约90%的帕金森病（PD）患者会出现语言症状， 大大降低生活质量，以及保持有效沟通能力的能力。因此，我们认为， PD中的这些言语变化对于理解和解决是至关重要的。然而， PD（自诊断以来的年数）、特定运动障碍和特定语言困难的发展 并没有得到很好的理解。PD的进展似乎与言语症状的严重程度无关： 通过临床评估的总体运动严重程度和自PD诊断以来的年数并不总是与 功能性言语结果的下降（即，语音清晰度和自然度）或声学测量 演讲特别是，该协会似乎不同的语音子系统：发音特点的讲话 与PD的进展有关，而语音测量则不相关。然而，目前尚不清楚这些发现是否 由于不同的潜在原因或由于PD运动症状的高度个体差异。事实上，最近 研究表明，PD有两种不同的运动表型：姿势功能不全和步态优势 （PIGD）和震颤显性（TD）。沟通困难的发生率更高，语言成绩更差 与TD相比，PIGD的扬声器中发现了，这可能是喉部肌肉僵硬增加的结果。 因此，了解言语子系统如何在个体内发展言语症状是至关重要的， 此外，如何言语变化与特定的运动症状在PD。功能性言语结果也可能 显示了PD表型之间的差异，因为语音清晰度和自然度受发音的影响。 精确度和语音质量。还没有研究完成了语音变化的强大声学表征 以及随着时间的推移，同一说话者的功能性语音结果的测量。因此本 该提案将全面研究语音产生的声学特征的纵向变化 涉及运动表型和功能性语音结果的语音清晰度和自然度， 演讲者PD将在44名患有PD的说话者中收集语音数据（具有均匀的PIGD到TD运动， 表型比率），利用先前的数据库作为第一时间点。目标1将评估 发音和声音的声学测量的纵向变化，以提供对不同语音 运动表型的PD说话者内的损伤随时间进展。目标2将决定如何 语音声学测量的纵向变化与PD的功能性语音结果有关。的 目标2的结果将阐明哪些特定的声学测量与PD的功能性语音结果相关 并增强客观跟踪PD中最关键的通信特征的能力。这项工作将 阐明PD运动表型与言语症状进展之间的关系，并提供 对于未来PD治疗研究有意义的客观指标。