Objective: The aim of this study was to characterize speech impairment in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) with a standardized approach, in order to detect specific speech parameters which might discriminate these conditions.

Background: Speech disorders represent an early and prominent clinical manifestation of PSP and MSA. Unlike PD, characterized by a predominant hypokinetic dysarthria, speech disorders in atypical parkinsonism typically evolve into a condition of “mixed” dysarthria, expression of corticobulbar and cerebellar involvement.

Methods: 15 patients with probable or possible PSP, 15 patients with probable or possible MSA and 15 healthy controls (HC) were enrolled. Each participant was asked to read a short story and a list of words (used to assess global intelligibility) and perform the following speech tasks: spontaneous monologue, sustained phonation and fast syllable repetition. Acoustic analysis was performed using PRAAT software, evaluating 24 parameters correlated to hypokinetic, ataxic and spastic dysarthria. Perceptual assessment comprises 24 different speech dimensions grouped into 3 major groups: articulation, phonation and prosody. The disease severity was assessed using the Hoehn and Yahr staging and the natural history and neuroprotection in Parkinson plus syndromes–Parkinson plus scale (NNIPPS). ANOVA and logistic regression analyses were performed as appropriate.

Results: Compared to HC, PSP and MSA patients showed greater alteration of global perceptual quality of spontaneous speech and abnormally slow syllable articulation rate. Perceptual global and single words intelligibility resulted significant impaired in PSP compared to HC. Mean speech intensity of spontaneous speech was statistically lower in PSP compared to both HC and MSA patients (HC:70,7±4,6 dB, PSP:57,3±7,0, MSA:63,7±6,5, p=0.02). Univariate and multivariate logistic regression analyses confirmed the role of speech intensity in differentiate PSP from MSA.

Conclusions: Our data suggest that respect to MSA, PSP patients show a greater global deterioration of speech particularly regarding the intelligibility of words and spontaneous speech. We found that mean speech intensity of spontaneous speech is able to differentiate PSP from MSA. This finding may be related to the different neurodegenerative involvement of basal ganglia and midbrain structures in PSP versus MSA.

References:

• Skodda S, Visser W, Schlegel U. Acoustical analysis of speech in progressive supranuclear palsy. J Voice. 2011;25(6):725-731. 

• Rusz J, Bonnet C, Klempíř J, Tykalová T, Baborová E, Novotný M, Rulseh A, Růžička E. Speech disorders reflect differing pathophysiology in Parkinson’s disease, progressive supranuclear palsy and multiple system atrophy. J Neurol. 2015;262(4):992-1001.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/perceptual-and-acoustical-analysis-of-speech-in-multiple-system-atrophy-and-progressive-supranuclear-palsy/