Objective: Speech disturbances have been described in premanifest Huntington’s Disease (HD). Yet a recent systematic review and meta-analysis highlighted disagreement in the literature regarding the nature and size of these deficits.

Background: Drawing on measures known to be sensitive to pathology, we explored the utility of objective analysis of diadochokinesis (DDK) and speech timing measures to describe four distinct HD groups.

Method: Speech samples were acquired from 55 people carrying the expanded HD gene (14 presymptomatic, PreHD-A; 18 prodromal, PreHD-B; 14 early, and 9 middle stage HD) and 55 matched controls. Participants repeated syllable sequences, read a passage and produced a monologue. Data on syllable repetition and connected speech tasks were analysed acoustically.

Results: Speech performance did not differ between the control group and people with presymptomatic HD (PreHD-A). Results indicated significant differences between people with prodromal HD (PreHD-B) and controls on measures of syllabic duration and rate. Similar differences were observed on the connected speech tasks. Individuals in the prodromal HD group presented with a slower rate of speech in reading with greater pauses and silences compared to controls, possibly due to cognitive and motor changes in the premanifest period. Results also revealed significant changes in the temporal pattern of spontaneous speech in prodromal HD (e.g. higher degree of silences). Overall, speech agility and timing appear to gradually deteriorate as the disease progresses.

Conclusion: These data suggest that it is possible to detect changes in speech motor control and speech timing more than a decade prior to disease onset.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/speech-impairment-as-a-marker-of-clinical-changes-in-premanifest-huntingtons-disease/