Objective: To test the applicability of “the dysarthria analyzer” in a levodopa challenge test to determine short term effects of levodopa on acoustic speech parameters.

Background: The dysarthria analyzer [1] is a tool for an automated analysis of speech motor disorders that runs in MATLAB [2]. So far, it has been used to capture characteristics of speech dysfunctions in various motor disorders [3-5], effects of speech therapy in cerebellar ataxia [6], longitudinal effects of dopaminergic treatment in Parkinson’s disease (PD) [7,8], and effects of pallidal deep brain stimulation in dystonia [9,10]. To date, no study has examined short-term effects of levodopa by means of the dysarthria analyzer.

Method: Acoustic speech data were recorded from 65 people with PD (39 m, 26 f), aged between 47 and 80 (M = 62 years), considering the speech tasks given by the protocol of the dysarthria analyzer, i.e. vowel phonation of /a/ and /i/, reading, storytelling, rhythmic repetition of the syllable /pa/, and fast repetitions of the sequence /pataka/. All participants were recorded in medication-OFF (withdraw of PD medication for 12h) and medication-ON (200 mg of soluble levodopa). Speech parameters were automatically extracted with the given algorithm [1] and further analyzed in R [11].

Results: Results indicate that the voice quality improved under levodopa during the phonation of the vowel /a/, as hoarseness (HNR, p < .001) and voice tremor (FF0T, p = .04) were reduced. Fluency improved (RST, p = .045) and pitch variation increased (stdF0, p = .004) in the reading task. In the story telling, fewer difficulties in initiating speech and an omission of short pauses occurred (DPI, p = .04). Additionally, an increased coordination of the laryngeal and supralaryngeal system (VOT, p = .007) and reduced loudness variation (stdPWR, p = .04) were produced during fast syllable repetitions of /pataka/. No changes were found for parameters linked with vowel phonation /i/ and rhythm task. Overall, no changes were discovered related to speech or articulation rate, vowel duration, resonance, and loudness.

Conclusion: The dysarthria analyzer might be a useful tool to capture short-term effects of levodopa on speech in PD, as acute levodopa intake affects speech coordination in terms of increased laryngeal and supralaryngeal control, improved initiation of speech, and more stable speech production.

References: [1] Hlavnička, Jan. “Automated Analysis of speech disorders in neurodegenerative diseases.” Doctoral Thesis, Dept. of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague. 2018.
[2] The MathWorks, Inc. (2021). MATLAB version: 9.13.0 (R2021b).
[3] Rusz, J., Tykalova, T., Salerno, G., Bancone, S., Scarpelli, J. and Pellecchia, M. T. “Distinctive speech signature in cerebellar and parkinsonian subtypes of multiple system atrophy”, Journal of Neurology, 266, pp. 1394-1404, 2019.
[4] Rusz, J., Beňová, B., Růžičková, H., Novotný, M., Tykalová, T., Hlavnička, J., Uher, T., Vaněčková, M., Andělová, M., Novotná, K., Kadrnožková, L., and Horáková, D. (2018). “Characteristics of motor speech phenotypes in multiple sclerosis”, Multiple sclerosis and related disorders, 19, pp. 62-69, 2018.
[5] Rusz, J., Hlavnička, J., Tykalová, T., Busková, J., Ulmanová, O., Růžička, E., and Šonka, K. “Quantitative assessment of motor speech abnormalities in idiopathic rapid eye movement sleep behavior disorder”, Sleep medicine, 19, pp. 141-147, 2015.
[6] Tykalova, T., Pospisilova, M., Cmejla, R., Jerabek, J., Mares, P. and Rusz, J. “Speech changes after coordinative training in patients with cerebellar ataxia: A pilot study”, Neurological Sciences, 37, pp. 293-296, 2016.
[7] Rusz, J., Tykalova, T., Klempir, J., Cmejla, R. and Ruzicka, E. “Effects of dopaminergic replacement therapy on motor speech disorders in Parkinson’s disease: a longitudinal follow-up study on previously untreated patients”, Journal of Neural Transmission, 123, pp. 379-387, 2016.
[8] Tykalova, T., Rusz, J., Cmejla, R., Klempir, J., Ruzickova, H., Roth, J. and E. Ruzicka. “Effect of dopaminergic medication on speech dysfluency in Parkinson’s disease: a longitudinal study”, Journal of Neural Transmission, 122, pp. 1135-1142, 2015.
[9] Rusz, J., Fecikova, A., Tykalova, T. and Jech, R. “Effect of pallidal deep-brain stimulation on articulation rate in dystonia”, Neurological Sciences, 40, pp. 869–873, 2019.
[10] Rusz, J., Tykalova, T., Fecikova, A., Stastna, D., Urgosik, D. and Jech, R. “Dualistic effect of pallidal deep brain stimulation on motor speech disorders in dystonia”, Brain Stimulation, 11, pp. 896-903, 2018.
[11] R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; 2018. http://www.r-project.org/

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MDS Abstracts - https://www.mdsabstracts.org/abstract/testing-the-applicability-of-the-dysarthria-analyzer-to-detect-levodopa-effects-on-speech-in-a-german-cohort-of-people-with-parkinsons-disease/