- Medicine (RMH) - Research Publications
Medicine (RMH) - Research Publications
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ItemNo Preview AvailablePathophysiology of MS tremor: an fMRI studyBoonstra, FMC ; Noffs, G ; Perera, T ; Shanahan, CJ ; Vogel, AP ; Evans, A ; Butzkueven, H ; van der Walt, A ; Kolbe, SC (SAGE PUBLICATIONS LTD, 2017-10)
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ItemNo Preview AvailableSubclinical speech signs correlate with MS disease severity and differentiates patients with and without clinical cerebellar dysfunctionNoffs, G ; Boonstra, F ; Perera, T ; Kolbe, S ; Shanahan, C ; Evans, A ; Butzkueven, H ; Vogel, A ; van der Walt, A (SAGE PUBLICATIONS LTD, 2017-10-01)Background: Dysarthria is highly prevalent in Multiple Sclerosis (MS). The relationship between dysarthria, MS disease severity and other cerebellar manifestations (such as tremor) is poorly understood. Aim: To examine the relationship between objective markers of speech, disease severity and upper limb tremor in relapsing-remitting and secondary progressive MS. Method: An experienced neurologist determined A) the presence of upper limb tremor, B) the Expanded Disability Status Scale (EDSS) score and C) the degree of dysarthria (from 0, no disturbance to 4, unintelligible). We used acoustic analysis to investigate 4 speech domains: 1) stability of vocal pitch, in sustained utterance of the vowel /a/; 2) stability of loudness, in the same sustained vowel; 3) diadochokinetic speed, in fast repetition of the meaningless word /pa/ta/ka/ and 4) maximum speed of vocal tract movement (i.e. change in pharynx and mouth cavity shape), measured through change in the second formant frequency in the word “always”, from reading of the “Grandfather Passage”. After adjustment for multiple comparisons, a p< 0.0125 was considered for statistical significance. Results: We assessed 24 MS patients with upper limb tremor (47.2±12.3years, 75% female, EDSS=3.7±1.6) and 24 matched patients without tremor (51.2±10.7years, 75% female, EDSS=3.6±1.7). Clinical dysarthria (median=0, mean=0.375±0.76) moderately correlated with EDSS scores (Spearman's rho =.586, p< .001) and with syllable repetition rates (/pa/ta/ka/ rho=.561, p< .001), marginally correlated with speed of tract movement (rho=.363, p=.012), pitch stability (rho=.37, p=.011), loudness stability (rho=.37, p=.01) but not with upper limb tremor presence (p=.039). Only /pa/ta/ka/ rate correlated with EDSS (rho=.529, p< .001) and speed of tract movement differentiated tremor and non-tremor groups (2-tailed t-test p=0.002, rho=.418). Conclusion: Acoustic speech measurements correlate with MS disease severity and can differentiate overt cerebellar dysfunction. Further study is needed to understand the significance of this relationship longitudinally.
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ItemNo Preview AvailablePathophysiology of MS tremor: an fMRI studyBoonstra, F ; Noffs, G ; Perera, T ; Shanahan, C ; Vogel, A ; Evans, A ; Butzkueven, H ; van der Walt, A ; Kolbe, S (SAGE PUBLICATIONS LTD, 2017-11)
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ItemNo Preview AvailableA comparison of human and digital speech analysis to describe and monitor cerebellar dysfunction and disease severity in multiple sclerosis.Noffs, G ; Boonstra, F ; Maldonado, F ; Perera, T ; Kolbe, S ; Evans, A ; Butzkeuven, H ; Vogel, A ; van der Walt, A (SAGE PUBLICATIONS LTD, 2018-10)
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ItemNo Preview AvailableFunctional neuroplasticity in response to cerebello-thalamic injury underpins the clinical presentation of tremor in multiple sclerosisBoonstra, FMC ; Noffs, G ; Perera, T ; Jokubaitis, VG ; Vogel, AP ; Moffat, BA ; Butzkueven, H ; Evans, A ; van der Walt, A ; Kolbe, SC (SAGE PUBLICATIONS LTD, 2020-05)