- •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.
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.
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.
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Multiple Sclerosis and Related Disorders
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Speech rate and rhythm in cerebellar dysarthria: an acoustic analysis of syllabic timing.Folia Phoniatr. Logop. 1994; 46: 70-78
- Oralmotor slowing in multiple sclerosis: relationship to neuropsychological tasks requiring an oral response.J. Int. Neuropsychol. Soc. 2008; 14: 454-462
- Subjective and perceptual analysis of voice quality and relationship with neurological dysfunction in multiple sclerosis patients.Clin. Neurol. Neurosurg. 2013; 115: S17-S20
- Expressive communication disorders in persons with multiple sclerosis: a survey.Arch. Phys. Med. Rehabil. 1985; 66: 675-677
- PRAAT, a system for doing phonetics by computer.Glot Int. 2001; 5: 341-345
- Development of a multiple sclerosis functional composite as a clinical trial outcome measure.Brain. 1999; 122: 871-882
- Dysarthria in multiple sclerosis.J. Speech Hear. Res. 1972; 15: 229-245
- Motor Speech Disorders: Substrates, Differential Diagnosis and Management.3rd ed. Mosby, St. Louis2013
- Acoustic analysis of voice in multiple sclerosis patients.J. Voice. 2004; 18: 341-347
- Multiple sclerosis: associated speech and language disorders.Aust. J. Hum. Commun. Disord. 1987; 15: 15-33
- Long-term phonatory instability in individuals with multiple sclerosis.J. Speech Lang. Hear Res. 1997; 40: 1056-1072
- Prevalence and characteristics of dysarthria in multiple-sclerosis incidence cohort: relation to neurologic data.Folia Phoniatr. Logop. 2000; 52: 160-177
- Temporal speech characteristics of individuals with multiple sclerosis and ataxic dysarthria: scanning speech revisited.Folia Phoniatr. Logop. 2000; 52: 228-238
- Lip and tongue function differently affected in individuals with multiple sclerosis.Folia Phoniatr. Logop. 2003; 55: 1-9
- Automated analysis of connected speech reveals early biomarkers of Parkinson's disease in patients with rapid eye movement sleep behavior disorder.Sci. Rep. 2017; 7: 12
- Gait characteristics according to pyramidal, sensory and cerebellar EDSS subcategories in people with multiple sclerosis.J. Neurol. 2016; 263: 1796-1801
- A speaking task analysis of the dysarthria in cerebellar disease.Folia Phoniatr. Logop. 1997; 49: 63-82
- The existence of phonatory instability in multiple sclerosis: an acoustic and electroglottographic study.Neurol. Sci. 2010; 31: 259-268
- Rating neurologic impairment in multiple sclerosis: and Expanded Disability Status Scale (EDSS).Neurology. 1983; 33: 1444-1452
- Speech-language pathology and dysphagia in multiple sclerosis.Phys. Med. Rehabil. Clin. N. Am. 1998; 9: 631-641
- Automatic evaluation of articulatory disorders in Parkinson's disease.IEEE/ACM Trans. Audio Speech Lang. Process. 2014; 22: 1366-1378
- Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.Ann. Neurol. 2011; 69: 292-302
- Influence of cognitive function on speech and articulation rate in multiple sclerosis.J. Int. Neuropsychol. Soc. 2013; 19: 173-180
- Quantitative acoustic assessment of speech and voice disorders in early untreated Parkinson's disease.J. Acoust. Soc. Am. 2011; 129: 350-367
- A distinct variant of mixed dysarthria reflects parkinsonism and dystonia due to ephedrone abuse.J. Neural Transm. 2014; 121: 655-664
- Speech disorders reflect differing pathophysiology in Parkinson's disease, progressive supranuclear palsy and multiple system atrophy.J. Neurol. 2015; 262: 992-1001
- Quantitative assessment of motor speech abnormalities in idiopathic rapid eye movement sleep behaviour disorder.Sleep. Med. 2016; 19: 141-147
- Perceptual and acoustic analysis of speech in individuals with spinocerebellar ataxia (SCA).Logop. Phoniatr. Vocol. 2009; 32: 31-46
- Speech motor programming in hypokinetic and ataxic dysarthria.Brain Lang. 2005; 94: 347-366
- Characteristics of diadochokinesis in multiple sclerosis and Parkinson's disease.Folia Phoniatr. Logop. 2003; 55: 241-259
- The natural history of multiple sclerosis.Neurol. Clin. 1995; 13: 119-146
- Vocal symptoms and acoustic changes in relation to the expanded disability status scale, duration and stage of disease in patients with multiple sclerosis.Eur. Arch. Oto-Rhino-L. 2009; 266: 1759-1765
- Characteristics of multiple sclerosis as a function of the severity of speech disorders.J. Med. Speech Lang. Pathol. 2003; 11: 73-84
Published online: November 08, 2017
Accepted: November 7, 2017
Received: October 5, 2017
© 2017 Elsevier B.V. All rights reserved.