Attention/Memory Complaint is Correlated with Motor Speech Disorder in Parkinson’s Disease

Abstract

Background The mechanisms underlying the online modulation of motor speech in Parkinson’s disease (PD) have not been determined. Moreover, medical and rehabilitation interventions for PD-associated motor speech disorder (MSD) have a poor long-term prognosis.Methods To compare risk factors in PD patients with MSD to those without MSD (non-MSD) and determine predictive independent risk factors correlated with the MSD phenotype, we enrolled 314 PD patients, including 250 with and 64 without MSD. We compared demographic, characteristic data, as well as PD-associated evaluations between the MSD group and non-MSD group.Results Univariate analysis showed that demographic characteristics, including occupation, educational level, monthly income and speaking background; clinical characteristics, including lesions in the frontal and temporal lobes, and concurrent dysphagia; and PD-associated evaluations, including the activity of daily living (ADL) score, non-motor symptoms scale (NMSS) domain 4 score (perceptual problem), and NMSS domain 5 score (attention/memory) were all significantly different between the MSD and non-MSD group (all P < 0.05). Multivariate logistic regression analysis showed that educational level, frontal lesions, and NMSS domain 5 score (attention/memory) were independent risk factors for PD-associated MSD (all P < 0.005).Conclusions We determined an association between MSD phenotype and cognitive impairment, reflected by low-level education and related clinical profiles. Moreover, attention and memory dysfunction may play key roles in the progression of MSD in PD patients. Further studies are required to detail the mechanism underlying abnormal speech motor modulation in PD patients. Early cognitive intervention may enhance rehabilitation management and motor speech function in patients with PD-associated MSD.

Cognitive Determinants of Dysarthria in Parkinson's Disease: An Automated Machine Learning Approach

“…Here, maximal discrimination (≈87%) was yielded by phonemic identifiability during retelling, even outranking fusion results. This accuracy surpassed the best one for PD‐nMCI, corroborating that dysarthric profiles are linked to cognitive deterioration 17,28,29 . Spontaneous production typically poses greater demands on attention and memory than reading, 13,25,32 and these domains are key determinants of both MCI 48‐51 and dysarthric symptoms 29 in PD.…”

“…Arguably, such interactions reflect the shared reliance of linguistic and other cognitive functions on common neural substrates affected early on 43 . The same rationale might explain the relation between dysarthria and cognitive variables 29 …”

“…This may partly reflect caveats of previous reports, including all‐male samples, 13 age‐related confounds, 20 unmatched texts for different tasks, 21 and use of the same participants in training and testing sets 22 . More particularly, such diversity may be influenced by cognitive factors 13,17,21,25,28‐32 . However, no study has examined this hypothesis by manipulating both task‐related and subject‐level cognitive variables, let alone while circumventing earlier shortcomings.…”

“…22 More particularly, such diversity may be influenced by cognitive factors. 13,17,21,25,[28][29][30][31][32] However, no study has examined this hypothesis by manipulating both task-related and subject-level cognitive variables, let alone while circumventing earlier shortcomings. Here, we assessed speech tasks with divergent demands in a cognitively heterogeneous PD cohort and subgroups with and without mild cognitive impairment (PD-MCI and PD-nMCI, respectively).…”

“…Although all these dimensions prove relevant, they are unevenly affected across studies, [23][24][25][26] limiting their clinical applicability. Such variability could reflect subject-level 17,28,29 and task-related 13,21,25,[30][31][32] cognitive factors. Both factors impinge on linguistic domains in PD.…”