Highlights
- •Motor speech disorders in multiple sclerosis (MS) are poorly understood.
- •The prevalence of generally mild spastic-ataxic dysarthria in MS cohort was 56%.
- •Speech impairment reflected subclinical motor impairment in MS.
- •Speech disorder severity was related to the severity of neurological involvement.
- •Dysarthria reflected underlying pyramidal-cerebellar pathophysiology in MS.
Abstract
Background
Motor speech disorders in multiple sclerosis (MS) are poorly understood and their
quantitative, objective acoustic characterization remains limited. Additionally, little
data regarding relationships between the severity of speech disorders and neurological
involvement in MS, as well as the contribution of pyramidal and cerebellar functional
systems on speech phenotypes, is available.
Methods
Speech data were acquired from 141 MS patients with Expanded Disability Status Scale
(EDSS) ranging from 1 to 6.5 and 70 matched healthy controls. Objective acoustic speech
assessment including subtests on phonation, oral diadochokinesis, articulation and
prosody was performed.
Results
The prevalence of dysarthria in our MS cohort was 56% while the severity was generally
mild and primarily consisted of a combination of spastic and ataxic components. Prosodic-articulatory
disorder presenting with monopitch, articulatory decay, excess loudness variations
and slow rate was the most salient. Speech disorders reflected subclinical motor impairment
with 78% accuracy in discriminating between a subgroup of asymptomatic MS (EDSS <
2.0) and control speakers. Speech disorder severity was related to the severity of
neurological involvement. Decreased articulation rate was moderately correlated to
EDSS as well as all subtests of the multiple sclerosis functional composite. The strongest
correlation was observed between irregular oral diadochokinesis and the 9-Hole Peg
Test (r = − 0.65, p < 0.001). Irregular oral diadochokinesis and excess loudness variations significantly
separated pure pyramidal and mixed pyramidal-cerebellar MS subgroups.
Conclusions
Automated speech analyses may provide valuable biomarkers of disease progression in
MS as dysarthria represents common and early manifestation that reflects disease disability
and underlying pyramidal-cerebellar pathophysiology.
Keywords
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Article info
Publication history
Published online: November 08, 2017
Accepted:
November 7,
2017
Received:
October 5,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
