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Fournet M, Chiuvé SC, Laganaro M. Attentional Demand of Motor Speech Encoding: Evidence From Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3758-3775. [PMID: 36201164 DOI: 10.1044/2022_jslhr-22-00096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE While the involvement of attention in utterance planning is well established at the conceptual and lexical levels, the attentional demands of postlexical processes are still debated. This study investigates the involvement of attentional resources on motor speech encoding during utterance production in the context of Parkinson's disease (PD), a population allowing to assess if the attentional demands observed in a dual-task paradigm (the dual-task costs [DTCs]) are explained by postlexical difficulties and not solely by executive impairment. METHOD Speech production was analyzed in a dual-task paradigm with 30 participants presenting with motor speech disorders due to hypokinetic dysarthria in the context of PD. The dual-task comprised an automatic speech task in which participants recited the days of the week and two nonverbal tasks evaluating processing speed and inhibition. The severity of dysarthria and performance in several executive tests (inhibition, verbal fluency, and cognitive shifting) were used as potential predictors of the DTCs. RESULTS Individuals with PD exhibited a DTC on the nonverbal tasks and on the speech task when the secondary task was inhibition (the most difficult one). Additionally, the severity of dysarthria and a poorer performance in cognitive shifting predicted a more severe DTC on speech rate. Finally, modulation of the magnitude of the DTCs was observed, depending on the difficulty of the nonverbal secondary task. CONCLUSION The results suggest that, in PD, postlexical processes require attentional resources and cognitive shifting is related to dual-task performance in speech. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21265893.
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Affiliation(s)
- Maryll Fournet
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
- Department of Neurorehabilitation, Geneva University Hospitals, Switzerland
| | | | - Marina Laganaro
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
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Rogalski Y, Key-DeLyria SE, Hazamy A, Altmann LJP. Global Coherence and Cognition in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2962-2977. [PMID: 35930682 PMCID: PMC9911095 DOI: 10.1044/2022_jslhr-21-00442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/31/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study compared global coherence (GC) in individuals with Parkinson's disease (PD) to a healthy older adult (HOA) group during single (sitting) and dual (stationary cycling) tasks. Additionally, it explored the relationship between GC and cognition in PD. METHOD Thirty-seven individuals with PD and 19 HOAs participated in the prospective, cross-sectional study. Participants completed discourse monologues elicited using published prompts while seated and while pedaling a stationary bicycle. Four rating levels of GC were analyzed (GC1 = no relationship to the topic, GC2 = remote relationship, GC3 = conditional relationship, and GC4 = complete relationship) using a published protocol with good interrater reliability and test-retest stability. Participants completed a battery of cognitive tasks, from which four latent factors were extracted: processing speed, working memory, inhibition, and updating. RESULTS Linear mixed modeling identified significant effects of GC level and GC level interactions with group, processing speed, and inhibition. The Group × GC Level interaction reflected that the PD group had a higher proportion of GC2 and GC1 utterances and fewer GC4 utterances than the HOA group. No differences between single and dual task conditions were found. Faster speed of processing predicted more GC4 utterances, whereas slower speed of processing predicted more G1 utterances. Better inhibition predicted fewer GC2 utterances. Group also predicted GC4 and GC2 proportions. CONCLUSIONS Individuals with PD experienced greater difficulties with GC than HOAs. Processing speed and inhibition contributed significantly to GC across groups. Analysis of GC should be considered an informative addition to assessment of communicative effectiveness in PD. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20416056.
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Affiliation(s)
- Yvonne Rogalski
- Department of Speech-Language Pathology and Audiology, Ithaca College, NY
| | | | - Audrey Hazamy
- Department of Communication Arts, Sciences, and Disorders, Brooklyn College, NY
| | - Lori J P Altmann
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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García AM, Arias-Vergara T, C Vasquez-Correa J, Nöth E, Schuster M, Welch AE, Bocanegra Y, Baena A, Orozco-Arroyave JR. Cognitive Determinants of Dysarthria in Parkinson's Disease: An Automated Machine Learning Approach. Mov Disord 2021; 36:2862-2873. [PMID: 34390508 DOI: 10.1002/mds.28751] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Dysarthric symptoms in Parkinson's disease (PD) vary greatly across cohorts. Abundant research suggests that such heterogeneity could reflect subject-level and task-related cognitive factors. However, the interplay of these variables during motor speech remains underexplored, let alone by administering validated materials to carefully matched samples with varying cognitive profiles and combining automated tools with machine learning methods. OBJECTIVE We aimed to identify which speech dimensions best identify patients with PD in cognitively heterogeneous, cognitively preserved, and cognitively impaired groups through tasks with low (reading) and high (retelling) processing demands. METHODS We used support vector machines to analyze prosodic, articulatory, and phonemic identifiability features. Patient groups were compared with healthy control subjects and against each other in both tasks, using each measure separately and in combination. RESULTS Relative to control subjects, patients in cognitively heterogeneous and cognitively preserved groups were best discriminated by combined dysarthric signs during reading (accuracy = 84% and 80.2%). Conversely, patients with cognitive impairment were maximally discriminated from control subjects when considering phonemic identifiability during retelling (accuracy = 86.9%). This same pattern maximally distinguished between cognitively spared and impaired patients (accuracy = 72.1%). Also, cognitive (executive) symptom severity was predicted by prosody in cognitively preserved patients and by phonemic identifiability in cognitively heterogeneous and impaired groups. No measure predicted overall motor dysfunction in any group. CONCLUSIONS Predominant dysarthric symptoms appear to be best captured through undemanding tasks in cognitively heterogeneous and preserved cohorts and through cognitively loaded tasks in patients with cognitive impairment. Further applications of this framework could enhance dysarthria assessments in PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Adolfo M García
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.,Global Brain Health Institute, University of California, San Francisco, California, USA
| | - Tomás Arias-Vergara
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University, Munich, Germany
| | - Juan C Vasquez-Correa
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany
| | - Elmar Nöth
- Friedrich-Alexander University Erlangen-Nuremberg
| | - Maria Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University, Munich, Germany
| | - Ariane E Welch
- Memory and Aging Center, University of California, San Francisco, California, USA
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan R Orozco-Arroyave
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany
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Urell C, Zetterberg L, Hellström K, Anens E. Factors explaining physical activity level in Parkinson´s disease: A gender focus. Physiother Theory Pract 2019; 37:507-516. [PMID: 31387476 DOI: 10.1080/09593985.2019.1630875] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: To analyze the multivariate associations between self-rated level of physical activity and demographic characteristics, self-efficacy for physical activity, fall-related self-efficacy, fear of falling, enjoyment from participation in physical activity, social support, fatigue, and health-related quality of life in persons with PD with a focus on gender.Method: Participants were persons with PD (n = 285, mean age 69.1 ± 7 years). Self-reported scales measuring level of physical activity (Physical Activity Disability Survey-Revised), enjoyment of physical activity (study- specific questions), self-efficacy for physical activity (Exercise Self-Efficacy Scale), fall-related self-efficacy (Falls Efficacy Scale), social support (Social Influences on Physical Activity), fatigue (Fatigue Severity Scale) and health-related quality of life (Parkinson's Disease Questionnaire-39) were used. The response rate was 58.2%.Results: Multiple regression analyses showed that 54.5% of the level of physical activity was explained by low-degree limitations in mobility and activities of daily life (ADL), being younger, higher self-efficacy for physical activity, communication limitations, bodily discomfort, social support and shorter time since diagnosis. Enjoyment of physical activity explained the level of physical activity for women, whereas self-efficacy for physical activity explained the level of physical activity for men.Conclusion: Implementing strategies to increase functional mobility, self-efficacy for physical activity, social support, and enjoyment of physical activity might facilitate persons with PD beginning and/or maintain different physical activities.
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Affiliation(s)
- Charlotte Urell
- Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
| | - Lena Zetterberg
- Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
| | - Karin Hellström
- Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
| | - Elisabeth Anens
- Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
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Whitfield JA, Kriegel Z, Fullenkamp AM, Mehta DD. Effects of Concurrent Manual Task Performance on Connected Speech Acoustics in Individuals With Parkinson Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:2099-2117. [PMID: 31306612 DOI: 10.1044/2019_jslhr-s-msc18-18-0190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Prior investigations suggest that simultaneous performance of more than 1 motor-oriented task may exacerbate speech motor deficits in individuals with Parkinson disease (PD). The purpose of the current investigation was to examine the extent to which performing a low-demand manual task affected the connected speech in individuals with and without PD. Method Individuals with PD and neurologically healthy controls performed speech tasks (reading and extemporaneous speech tasks) and an oscillatory manual task (a counterclockwise circle-drawing task) in isolation (single-task condition) and concurrently (dual-task condition). Results Relative to speech task performance, no changes in speech acoustics were observed for either group when the low-demand motor task was performed with the concurrent reading tasks. Speakers with PD exhibited a significant decrease in pause duration between the single-task (speech only) and dual-task conditions for the extemporaneous speech task, whereas control participants did not exhibit changes in any speech production variable between the single- and dual-task conditions. Conclusions Overall, there were little to no changes in speech production when a low-demand oscillatory motor task was performed with concurrent reading. For the extemporaneous task, however, individuals with PD exhibited significant changes when the speech and manual tasks were performed concurrently, a pattern that was not observed for control speakers. Supplemental Material https://doi.org/10.23641/asha.8637008.
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Affiliation(s)
- Jason A Whitfield
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
| | - Zoe Kriegel
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
| | - Adam M Fullenkamp
- School of Human Movement, Sport, & Leisure Studies, Bowling Green State University, OH
| | - Daryush D Mehta
- Center for Laryngeal Surgery and Voice Rehabilitation, Department of Surgery, Massachusetts General Hospital-Harvard Medical School, Boston
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Mekyska J, Galaz Z, Kiska T, Zvoncak V, Mucha J, Smekal Z, Eliasova I, Kostalova M, Mrackova M, Fiedorova D, Faundez-Zanuy M, Solé-Casals J, Gomez-Vilda P, Rektorova I. Quantitative Analysis of Relationship Between Hypokinetic Dysarthria and the Freezing of Gait in Parkinson's Disease. Cognit Comput 2018; 10:1006-1018. [PMID: 30595758 PMCID: PMC6294819 DOI: 10.1007/s12559-018-9575-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 06/13/2018] [Indexed: 12/27/2022]
Abstract
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.
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Affiliation(s)
- Jiri Mekyska
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Zoltan Galaz
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Tomas Kiska
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Vojtech Zvoncak
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Jan Mucha
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Zdenek Smekal
- Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic
| | - Ilona Eliasova
- First Department of Neurology, St. Anne’s University Hospital, Pekarska 53, 656 91 Brno, Czech Republic
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic
| | - Milena Kostalova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic
- Department of Neurology, Faculty Hospital and Masaryk University, Jihlavska 20, 63900 Brno, Czech Republic
| | - Martina Mrackova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic
| | - Dagmar Fiedorova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic
| | - Marcos Faundez-Zanuy
- Escola Superior Politecnica, Tecnocampus, Avda. Ernest Lluch 32, 08302 Mataro, Barcelona Spain
| | - Jordi Solé-Casals
- Data and Signal Processing Research Group, University of Vic – Central University of Catalonia, Perot Rocaguinarda 17, 08500 Vic, Catalonia Spain
| | - Pedro Gomez-Vilda
- Neuromorphic Processing Laboratory (NeuVox Lab), Center for Biomedical Technology, Universidad Politécnica de Madrid Campus de Montegancedo, s/n, 28223, Pozuelo de Alarcón, Madrid Spain
| | - Irena Rektorova
- First Department of Neurology, St. Anne’s University Hospital, Pekarska 53, 656 91 Brno, Czech Republic
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic
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Reynolds H, Miller N, Walker R. Drooling in Parkinson's Disease: Evidence of a Role for Divided Attention. Dysphagia 2018; 33:809-817. [PMID: 29785679 DOI: 10.1007/s00455-018-9906-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/03/2018] [Indexed: 02/08/2023]
Abstract
Drooling is a frequently reported symptom in Parkinson's Disease (PD) with significant psychosocial impact and negative health consequences including silent aspiration of saliva with the associated risk of respiratory infections. It is suggested that in PD drooling is associated with inefficient oropharyngeal swallowing which reduces the effective clearance of saliva rather than hyper-salivation. This is compounded by unintended mouth opening and flexed posture increasing anterior loss of saliva. It is reported to occur most frequently during cognitively distracting concurrent tasks suggesting an impact from divided attention in a dual-task situation. However, this supposition has not been systematically examined. This study assessed whether frequency of saliva swallows reduced, and drooling severity and frequency increased, when people with PD engaged in a cognitively distracting task. 18 patients with idiopathic PD reporting daytime drooling on the Unified Parkinson's Disease Rating Scale (UPDRS) were recruited. They completed the Radboud Oral Motor Inventory for PD saliva questionnaire and the Montreal Cognitive Assessment. UPDRS drooling score, disease stage, duration, gender, and age were recorded. Swallow frequency and drooling severity and frequency were measured at rest and during a distracting computer-based language task. There was no significant difference between drooling severity at rest and during distraction (Wilcoxon signed rank test z = - 1.724, p = 0.085). There was a significant difference between at rest and distraction conditions for both drooling frequency (Wilcoxon signed rank test z = - 2.041, p = 0.041) and swallow frequency (Wilcoxon signed rank test z = - 3.054, p = 0.002). Participants swallowed less frequently and drooled more often during the distraction task. The frequency of saliva swallows and drooling are affected by divided attention in a dual-task paradigm. Further studies are needed to explore the exact role of attention in saliva management and the clinical applications in assessment and treatment.
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Affiliation(s)
- Hannah Reynolds
- South Tyneside NHS Foundation Trust, Department of Speech and Language Therapy, Queen Elizabeth Hospital, Sheriff Hill, Gateshead, NE9 6SX, UK.
| | - Nick Miller
- Newcastle University Institute for Ageing, Newcastle University, Speech and Language Sciences, George VI Building, Newcastle upon Tyne, NE1 7RU, UK
| | - Richard Walker
- Northumbria Health NHS Foundation Trust, North Tyneside District Hospital, Rake Lane, North Shields, Tyne and Wear, NE29 8NH, UK.,Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
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