Comprehensive assessment of speech physiology and acoustics in Parkinson's disease progression

项目摘要 帕金森病(PD)是一种进行性神经系统疾病，影响多达1%的老年人，超过90% 有语言障碍的人。这些言语问题导致生活质量的下降，由 以患者为中心的沟通参与结果(PCO)、语言可理解性和自然性， 随着疾病的发展进一步下降。PCOS的减少可归因于潜在的 语言的生理机制(即呼吸、喉咙和发音子系统)，但 语音生理变化对多囊卵巢综合征的相对贡献尚不清楚。如果没有这些知识，宝贵的 治疗时间可能被浪费在处理与患者体验无关的生理变化上。 明确语言生理学和多囊卵巢综合征之间的关系将使临床医生能够专注于生理学 对病人来说很重要的变化。此外，由于许多临床机构没有资源 为了实施生理措施，需要进行研究，以确定临床上可以获得的声学 评估与推动多囊卵巢综合征变化的言语生理的个体化变化有关。我们 建议在大样本中对多囊卵巢综合征、生理学和声学进行全面、纵向的研究， 应该为临床翻译提供新的结果。在目标1中，我们将比较多囊卵巢综合征的纵向变化 帕金森病与伴随的言语生理学改变有关。不管我们是否看到组级别的变化，这 AIM将在研究期间下降的个体中提供与多囊卵巢综合征相关的生理指标。 在目标2中，我们将开发和评估一组精细化的帕金森病言语衰退的声学相关性，基于 它们与呼吸、喉和关节生理学的关系。最后，在目标3中，我们将 心理计量学评估语音、生理和声学指标对变化的敏感性 相互关联。衡量标准能够适当地反映随时间变化的能力是一个关键的特征，是必不可少的 用于临床或研究应用的措施。为了全面评估对变化的敏感性， 我们将检查减少(由于疾病进展)和增加(由于以下方面的改善 行为提示-清晰语音)功能。我们的研究结果将为未来的循证研究提供路线图 治疗。根据生理学或声学评估，临床医生将能够针对特定的语音 改善PCOS的子系统。这项工作将指导未来个性化治疗的发展 帕金森病患者。

Project Summary Parkinson’s disease (PD) is a progressive neurological condition affecting up to 1% of older adults, over 90% of whom experience speech problems. These speech problems cause reductions in quality of life, as measured by patient-centered outcomes (PCOs) of communicative participation, speech intelligibility, and naturalness, with further declines as the disease progresses. Decrements in PCOs can be attributed to changes in underlying physiological mechanisms of speech (i.e., the respiratory, laryngeal, and articulatory subsystems), yet the relative contributions of changes in speech physiology to PCOs are unknown. Without this knowledge, precious therapy time may be wasted on addressing physiological changes that do not matter to the patient experience. Defining the relationships between speech physiology and PCOs would allow clinicians to focus on physiological changes that are important to the patient. Furthermore, since many clinical settings do not have the resources to implement physiological measures, research is needed to determine which clinically accessible acoustic assessments are related to the individualized changes in speech physiology that drive changes in PCOs. We propose a comprehensive, longitudinal study of PCOs, physiology, and acoustics in a large sample, which should provide novel outcomes for clinical translation. In Aim 1, we will compare longitudinal changes in PCOs in PD to concomitant changes in speech physiology. Regardless of whether we see group-level changes, this aim will provide physiological targets that are tied to PCOs in the individuals who decline during the study period. In Aim 2, we will develop and evaluate a refined set of acoustic correlates of speech decline in PD based on their relationships with respiratory, laryngeal, and articulatory physiology. Finally, in Aim 3, we will psychometrically assess the sensitivity to change of the measures of speech physiology and the acoustic correlates. The ability of a measure to appropriately reflect change over time is a critical characteristic, essential for measures to be used for clinical or research applications. To comprehensively assess sensitivity to change, we will examine both decreasing (due to disease progression) and increasing (due to improvement with behavioral cueing – clear speech) function. Our results will provide a roadmap for future evidence-based treatment. Based on a physiological or acoustic evaluation, clinicians will be able to target specific speech subsystems to improve PCOs. This work will guide the future development of personalized treatment for individuals with PD.