Longitudinal objective assessment of speech in Multiple Sclerosis.

Autor: Noffs G; Department of Audiology and Speech Pathology, University of Melbourne, Australia; Department of Neuroscience, School of Translational Medicine, Monash University, Australia. Electronic address: gustavo.noffs@monash.edu., Perera T; The Bionics Institute, Australia; Department of Medical Bionics, University of Melbourne, Australia., Butzkueven H; Department of Neuroscience, School of Translational Medicine, Monash University, Australia., Kolbe SC; Department of Neuroscience, School of Translational Medicine, Monash University, Australia., Boonstra FMC; Department of Neuroscience, School of Translational Medicine, Monash University, Australia., Vogel AP; Department of Audiology and Speech Pathology, University of Melbourne, Australia; Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany; Redenlab, Australia., van der Walt A; Department of Neuroscience, School of Translational Medicine, Monash University, Australia.
Jazyk: angličtina
Zdroj: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2024 Nov; Vol. 91, pp. 105891. Date of Electronic Publication: 2024 Sep 18.
DOI: 10.1016/j.msard.2024.105891
Abstrakt: Background: Remote objective tests may supplement in-clinic examination to better inform treatment decisions. Previous cross-sectional studies presented objective speech metrics as potential markers of Multiple Sclerosis (MS) disease progression.
Objective: To examine the short-term stability and long-term sensitivity of speech metrics to MS progression.
Methods: We prospectively recorded speech from people with MS at baseline, six, twelve weeks, and at ten months or longer after baseline (1y+). Only people with a definite diagnosis of MS and without other potential causes of dysarthria were included. Speech tasks comprehended 1) a sustained vowel /a/, 2) saying the days of the week, 3) repeating the non-word pa-ta-ka multiple times as fast as possible, 4) reading the Grandfather Passage, and 5) telling a personal story. We selected speech metrics of interest according to their association with MS presence, correlation with general disability, and short-term metric stability in the absence of disease progression. Selected speech metrics were analysed for short- versus long-term changes in the whole MS cohort and in the clinically stable versus progression subgroups at 1y+.
Results: Sixty-nine people with MS participated (76.8 % female, age mean 47.5 ± 11.1 SD, EDSS median 3.5, interquartile range 3.5). Twenty-six unique speech metrics satisfied the suitability criteria. On average, reading rate improved 3.5 % for all people with MS and 6.5 % for slow readers with MS from baseline to the six-week, driven by a reduction in pauses. At 1y+, participants showed a 3.1 % average reduction in vocalization time during the reading task, which was similar in the progression (n = 29) and non-progression (n = 40) groups and thus unrelated to disease progression. Both findings are in the opposite direction of what would be generally expected for deterioration in speech performance and might be attributable to familiarity and training effects. Other speech metrics showed either negligible change or a similar variability between short-term and long-term differences.
Conclusion: Most individual long-term changes were small and within short-term variability intervals, irrespective of clinical disease progression. Familiarity and practice effects might have blunted the measurement of change. The present lack of longitudinal sensitivity of speech in MS contradicts previous cross-sectional findings and requires further investigation.
Competing Interests: Declaration of competing interest Adam Vogel is Chief Science Officer of Redenlab Inc. Anneke van der Walt served on advisory boards and receives unrestricted research grants from Novartis, Biogen, Merck and Roche She has received speaker's honoraria and travel support from Novartis, Roche, and Merck. She receives grant support from the National Health and Medical Research Council of Australia and MS Research Australia. Frederique Boonstra has nothing to disclose. Gustavo Noffs works in scientific development for Redenlab Inc. Helmut Butzkueven has received institutional (Monash University) funding from Biogen, F. Hoffmann-La Roche Ltd, Merck, Alexion, CSL, and Novartis; has carried out contracted research for Novartis, Merck, F. Hoffmann-La Roche Ltd and Biogen; has taken part in speakers’ bureaus for Biogen, Genzyme, UCB, Novartis, F. Hoffmann-La Roche Ltd and Merck; has received personal compensation from Oxford Health Policy Forum for the Brain Health Steering Committee. Scott Kolbe receives grant income from the National Health and Medical Research Council of Australia and has received honoraria from Novartis, Biogen and Merck Thushara Perera has nothing to disclose.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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