Speech-based characterization of dopamine replacement therapy in people with Parkinson’s disease

Abstract

People with Parkinson’s (PWP) disease are under constant tension with respect to their dopamine replacement therapy (DRT) regimen. Waiting too long between doses results in more prominent symptoms, loss of motor function, and greater risk of falling per step. Shortened pill cycles can lead to accelerated habituation and faster development of disabling dyskinesias. The Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) is the gold standard for monitoring Parkinson’s disease progression but requires a neurologist to administer and therefore is not an ideal instrument to continuously evaluate short-term disease fluctuations. We investigated the feasibility of using speech to detect changes in medication states, based on expectations of subtle changes in voice and content related to dopaminergic levels. We calculated acoustic and prosodic features for three speech tasks (picture description, reverse counting, and diadochokinetic rate) for 25 PWP, each evaluated “ON” and “OFF” DRT. Additionally, we generated semantic features for the picture description task. Classification of ON/OFF medication states using features generated from picture description, reverse counting and diadochokinetic rate tasks resulted in cross-validated accuracy rates of 0.89, 0.84, and 0.60, respectively. The most discriminating task was picture description which provided evidence that participants are more likely to use action words in ON than in OFF state. We also found that speech tempo was modified by DRT. Our results suggest that automatic speech assessment can capture changes associated with the DRT cycle. Given the ease of acquiring speech data, this method shows promise to remotely monitor DRT effects.

Automated text‐level semantic markers of Alzheimer's disease

“…Yet, while we targeted PD patients on levodopa, as in previous works, 25 semantic alterations in this disease are sensitive to medication status. 44 New studies should explore whether the deficits observed in ADD remain specific when considering PD patients with varying levels of dopamine bioavailability. Still, our findings suggest that theoretically informed semantic measures may prove useful not only to identify specific brain diseases, but also to discriminate among them.…”

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

“…Attention and memory impairments in PD are risk factors for dysarthric manifestations, 29 which, in turn, can predict cognitive decline 16,23 . Because MCI is present in 25%–57% of cases, 48‐50 the diversity of speech disturbances might partly reflect cognitive heterogeneity.…”

Rekindling Action Language: A Neuromodulatory Study on Parkinson’s Disease Patients

“…Action-semantic alterations are paramount among the communicative profile of PD patients [13,16,17] and they constitute candidate cognitive markers for early PD [6,17]. Intake of levodopa or dopamine agonists seems to favor verbal action fluency [12,106] and action description in spontaneous speech [13], but such pharmacological interventions may have undesirable side effects. Promisingly, atDCS might circumvent some of such consequences and last for substantial time periods [36,57,[107][108][109][110].…”