Hypokinetic dysarthria (HD) and freezing of gait (FOG) are both axial symptoms that occur in patients with Parkinson’s disease (PD). It is assumed they have some common pathophysiological mechanisms and therefore that speech disorders in PD can predict FOG deficits within the horizon of some years. The aim of this study is to employ a complex quantitative analysis of the phonation, articulation and prosody in PD patients in order to identify the relationship between HD and FOG, and establish a mathematical model that would predict FOG deficits using acoustic analysis at baseline. We enrolled 75 PD patients who were assessed by 6 clinical scales including the Freezing of Gait Questionnaire (FOG–Q). We subsequently extracted 19 acoustic measures quantifying speech disorders in the fields of phonation, articulation and prosody. To identify the relationship between HD and FOG, we performed a partial correlation analysis. Finally, based on the selected acoustic measures, we trained regression models to predict the change in FOG during a 2-year follow-up. We identified significant correlations between FOG–Q scores and the acoustic measures based on formant frequencies (quantifying the movement of the tongue and jaw) and speech rate. Using the regression models, we were able to predict a change in particular FOG–Q scores with an error of between 7.4 and 17.0 %. This study is suggesting that FOG in patients with PD is mainly linked to improper articulation, a disturbed speech rate and to intelligibility. We have also proved that the acoustic analysis of HD at the baseline can be used as a predictor of the FOG deficit during 2 years of follow-up. This knowledge enables researchers to introduce new cognitive systems that predict gait difficulties in PD patients.

Introduction:Cognitive deficit after stroke is common, and beginning cognitive rehabilitation as soon as possible is important to minimize the consequences of the impairment. The aim of this study was to use Addenbrooke's Cognitive Examination to compare cognitive function in nondemented and nondepressed stroke patients, 3-6 months after the stroke, with sex-and age-matched controls. Materials and Methods:A total of 156 participants were included (72 controls: 19 men, mean age 64.5 ± 12.4 years; 84 patients after stroke: 54 men, mean age 62.2 ± 9.0 years).Results: Statistically significant differences were identified between controls and stroke patients in total Addenbrooke's score (stroke patients, 86.2 points vs controls, 91.2 points; p<0.01), Verbal Production domain (stroke patients, 9.8 points vs controls, 11.5 points; p<0.01), and Memory domain (stroke patients, 19.5 points vs controls, 21.7 points; p<0.01). The difference was also statistically significant between subgroups of stroke patients and controls: patients with a right-sided brain lesion differed from controls in total scores (88.3 vs 91.3 points, respectively; p<0.05) and Verbal Production domain scores (9.9 vs 11.5 points, p<0.01), as did patients with left-sided brain lesions in total score (83.9 vs 91.3 points; p<0.01) and Memory (18.6 vs 21.7 points; p<0.01) and Verbal Production (9.6 vs 11.5 points; p<0.01) domains. Conclusion:This study shows the usability of Addenbrooke's Cognitive Examination 3-6 months after a stroke to detect mild cognitive decline, providing a basis for initiating cognitive rehabilitation as soon as possible.