Objective: To assess the usefulness and metric properties of a transcribed version of the Frenchay Dysarthria Assessment 2 (FDA-2) for speech evaluation in a cohort of patients with Parkinson’s disease (PD) in comparison to age-matched controls.

Background: Speech and voice impairments are very frequent symptoms of PD, affecting about 70% of patients in the course of the disease. Although several rating scales for dysarthria are available, structured evaluations of their usefulness for the assessment of speech and voice abnormalities in PD patients are lacking.

Methods: We performed a single-center, prospective, cross-sectional study in 60 participants (40 PD patients with mild to severe dysarthria, 20 age-matched controls) using a comprehensive test battery consisting of scales for motor and non-motor symptoms, with particular emphasis on speech. In order to evaluate the usefulness of the FDA-2 for quantitative speech assessments in PD, we applied a transcribed, metric version of the FDA-2, in which we assigned scores ranging from 0 (no function) to 8 (full function) for all scale items and domains. The total FDA-2 score was calculated by adding the mean scores of its 7 domains (reflexes, respiration, lips, palate, laryngeal, tongue, intelligibility).

Results: PD patients showed significantly lower FDA-2 total scores (mean 49.1, SD 4.2) compared to age-matched controls (mean 54.5, SD 1.1) (p<0.001). Neither floor nor ceiling effect were observed on the FDA-2 total score. Mean Cronbach’s alpha for domains was 0.763, with item-total correlation coefficients ranging from 0.36 to 0.66, indicating acceptable internal consistency of the transcribed scale. FDA-2 total scores in patients correlated significantly with the Radboud Oral Motor Inventory for PD (r_S=-0.51) and with those scales measuring related constructs (r_S=-0.38 through r_S=-0.49). Conversely, we found no significant correlations between the FDA-2 total score and cognition and depression scores. FDA-2 total scores decreased with increasing Hoehn and Yahr stages (p=0.013), overall demonstrating good validity of the scale.

Conclusions: Our study suggests that the transcribed version of the FDA-2 comprises a useful tool for quantitative assessment of dysarthria in PD patients, but does not obviate the need for the development of a scale focusing on disease-specific speech impairments in PD, in particular voice abnormalities.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/speech-evaluation-in-parkinsons-disease-using-a-transcribed-version-of-the-frenchay-dysarthria-assessment/