Automatic extraction of abnormal lip movement features from the alternating motion rate task in amyotrophic lateral sclerosis

Rong, Panying; Yunusova, Yana; Richburg, Brian; Green, Jordan R.

doi:10.1080/17549507.2018.1485739

Cited by 44 publications

(49 citation statements)

References 37 publications

(72 reference statements)

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“…However, FDA was not specifically developed for ALS, and the evaluation of its measurement properties in ALS is lacking. DDK, which is included in CNE, FDA and perceptual dysarthria assessments, is commonly used to track disease progression, and has shown high sensitivity but low specificity for detecting bulbar signs in the prodromal phase of bulbar ALS (61, 62). With further optimization, DDK may have a diagnostic potential, particularly if certain performance constrains are imposed or its complexity is increased (63, 64).…”

Section: Tools For Diagnosing and Screening For Bulbar Alsmentioning

confidence: 99%

Clinical Measures of Bulbar Dysfunction in ALS

et al. 2019

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Bulbar impairment represents a hallmark feature of Amyotrophic Lateral Sclerosis (ALS) that significantly impacts survival and quality of life. Speech and swallowing dysfunction are key contributors to the clinical heterogeneity of ALS and require well-timed and carefully coordinated interventions. The accurate clinical, radiological and electrophysiological assessment of bulbar dysfunction in ALS is one of the most multidisciplinary aspects of ALS care, requiring expert input from speech-language pathologists (SLPs), neurologists, otolaryngologists, augmentative alternative communication (AAC) specialists, dieticians, and electrophysiologists—each with their own evaluation strategies and assessment tools. The need to systematically evaluate the comparative advantages and drawbacks of various bulbar assessment instruments and to develop integrated assessment protocols is increasingly recognized. In this review, we provide a comprehensive appraisal of the most commonly utilized clinical tools for assessing and monitoring bulbar dysfunction in ALS based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) evaluation framework. Despite a plethora of assessment tools, considerable geographical differences exist in bulbar assessment practices and individual instruments exhibit considerable limitations. The gaps identified in the literature offer unique opportunities for the optimization of existing and development of new tools both for clinical and research applications. The multicenter validation and standardization of these instruments will be essential for guideline development and best practice recommendations.

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Section: Tools For Diagnosing and Screening For Bulbar Alsmentioning

confidence: 99%

Clinical Measures of Bulbar Dysfunction in ALS

et al. 2019

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“…Movements of the articulators during the AMR tasks were captured using a 3D electromagnetic articulograph (Wave; Northern Digital, Inc.). Following procedures described by [11], the 3D Euclidean distance between the upper and lower lip was derived during each of the AMR tasks. This was low-pass filtered at 15 Hz.…”

Section: Kinematic Recordingsmentioning

confidence: 99%

“…Kinematic data were analyzed using a semi-automatic MATLAB algorithm developed by Rong et al [11]. The algorithm automatically segmented the opening and closing phases of the lip distance traces and identified cycles with large deviations from the average pattern for manual inclusion or exclusion of the deviant cycles.…”

Section: Extraction Of Kinematic Featuresmentioning

confidence: 99%

Reduced Task Adaptation in Alternating Motion Rate Tasks as an Early Marker of Bulbar Involvement in Amyotrophic Lateral Sclerosis

et al. 2019

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The identification of robust biomarkers to detect the onset of amyotrophic lateral sclerosis (ALS) has been an ongoing challenge. Recent evidence from multiple studies suggests that speech changes are a reliable early indicator of ALS particularly during physically demanding speaking tasks such as alternating motion rate (AMR). However, it has also been found that individuals make various behavioral adaptations to meet the maximum rate requirement in AMR. In this study, we explored the extent to which persons with early-stage ALS are capable of adapting to challenging speech-like tasks. Speech motor performance of 14 healthy controls was compared to that of 18 patients at the early stage of ALS during standard (unconstrained) and fixed-target (constrained) AMR tasks. Fixed-target tasks were designed to impose high demands on the speech motor system. Although habitual speaking rate was maintained within normal limits, findings revealed that task adaptation was reduced at the early stage of ALS. Furthermore, the difference between the number of cycles in the fixed-target task and standard task showed higher sensitivity than habitual speaking rate to detect early decline in bulbar function. The inability to adapt to the fixed-target task was a good early indicator of bulbar motor involvement due to ALS.

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“…Third, widely-published normative data for AMR tasks across the life-span provide a rich empirical basis for identifying impaired oromotor function (10). Finally, AMR tasks are highly responsive to neuromotor impairments and have previously been used to study neurological disorders such as amyotrophic lateral sclerosis (ALS) (11, 12), multiple sclerosis (13), Parkinson's disease (14–16), and traumatic brain injury (17).…”

Section: Introductionmentioning

confidence: 99%

Assessing Oromotor Capacity in ALS: The Effect of a Fixed-Target Task on Lip Biomechanics

et al. 2019

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Alternating motion rate (AMR) is a standard measure often included in neurological examinations to assess orofacial neuromuscular integrity. AMR is typically derived from recordings of patients producing repetitions of a single syllable as fast and clear as possible on one breath. Because the task places high demands on oromotor performance, particularly articulatory speed, AMRs are widely considered to be tests of maximum performance and, therefore, likely to reveal underlying neurologic deficits. Despite decades of widespread use, biomechanical studies have shown that speakers often circumvent the presumed speed challenge of the standard AMR task. Specifically, speakers are likely to manipulate their displacements (movement amplitude) instead of speed because this strategy requires less motor effort. The current study examined the effectiveness of a novel fixed-target paradigm for minimizing the truncation of articulatory excursions and maximizing motor effort. We compared the standard AMR task to that of a fixed-target AMR task and focused specifically on the tasks' potential to detect decrements in lip motor performance in persons with dysarthria due to amyotrophic lateral sclerosis (ALS). Our participants were 14 healthy controls and 17 individuals with ALS. For the standard AMR task, participants were instructed to produce the syllable /bα/ as quickly and accurately as possible on one breath. For the fixed-target AMR task, participants were given the same instructions, but were also required to strike a physical target placed under the jaw during the opening phase of each syllable. Lip kinematic data were obtained using 3D electromagnetic articulography. 16 kinematic features were extracted using an algorithmic approach. Findings revealed that compared to the standard task, the fixed-target AMR task placed increased motor demands on the oromotor system by eliciting larger excursions, faster speeds, and greater spatiotemporal variability. In addition, participants with ALS exhibited limited ability to adapt to the higher articulatory demands of the fixed-target task. Between the two AMR tasks, the maximum speed during the fixed-target task showed a moderate association with the ALSFRS-R bulbar subscore. Employment of both standard and fixed-target AMR tasks is, however, needed for comprehensive assessment of oromotor function and for elucidating profiles of task adaptation.

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Automatic extraction of abnormal lip movement features from the alternating motion rate task in amyotrophic lateral sclerosis

Cited by 44 publications

References 37 publications

Clinical Measures of Bulbar Dysfunction in ALS

Clinical Measures of Bulbar Dysfunction in ALS

Reduced Task Adaptation in Alternating Motion Rate Tasks as an Early Marker of Bulbar Involvement in Amyotrophic Lateral Sclerosis

Assessing Oromotor Capacity in ALS: The Effect of a Fixed-Target Task on Lip Biomechanics

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