Objective: We assessed whether baseline speech prosodic parameters, alone or in combination with other predominantly non-dopaminergic symptoms may predict global cognitive decline as measured by the Addenbrooke’s cognitive examination (ACE-R) and/or worsening of cognitive status as assessed by a detailed neuropsychological examination.

Background: Impairment of speech prosody is characteristic for PD and does not respond well to dopaminergic treatment.

Methods: Fifty consecutive non-depressed PD patients underwent clinical and cognitive testing, and perceptual and acoustic voice analysis at baseline and at the two-year follow-up. Influence of speech and other clinical parameters on worsening of the ACE-R and of the cognitive status was analyzed using linear and logistic regression.

Results: The cognitive status (classified as normal cognition, mild cognitive impairment and dementia) deteriorated in 25% of patients during the follow-up. The multivariate linear regression model consisted of the variation in range of the fundamental voice frequency (F0VR) and the REM sleep Behavioral Disorder Screening Questionnaire (RBDSQ). These parameters explained 37.2% of the variability of the change in ACE-R. The most significant predictors in the univariate logistic regression were the speech index of rhythmicity (SPIR; p=0.012), faciokinesis (p=0.049), disease duration (p=0.019), and the RBDSQ (p=0.032). The multivariate regression analysis revealed that combining faciokinesis with RBDSQ led to 81.8% accuracy in predicting a change in cognitive status. The SPIR alone predicted a cognitive status change with 73.2% accuracy.

Conclusions: Impairment of speech prosody and faciokinesis together with symptoms of RBD predict rapid cognitive decline and worsening of PD cognitive status during a two-year period.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/speech-prosody-impairment-predicts-cognitive-decline-in-parkinsons-disease/