Medicine (Austin & Northern Health) - Research Publications

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Type: Abstract × Start date: 2016 × End date: 2019 × Author: Vogel, Adam ×

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    Acoustic monitoring of speech impairment in motor neuron disease associated with frontotemporal dementia: a case series
    VOGEL, A ; Poole, M ; Darby, D ; Brodtmann, A (European Journal of Neurology, 2016)
    Frontotemporal dementia is the second most common form of younger onset dementia. A subset of people with this disorder develop motor neuron disease (MND) with associated speech impairment (dysarthria). Here, we aim to measure the progression of dysarthria in a case of FTD-MND with acoustic analysis. Four individuals with FTD (one developing concomitant MND) were longitudinally assessed over two years. Two acoustic measures demonstrated capacity to objectively monitor dysarthria in FTD-MND. These preliminary data highlight potential for the clinical use of these methods to identify the initial signs of bulbar onset motor neuron disease. Index terms: acoustics, disease monitoring, dysarthria, frontotemporal dementia, motor neuron disease.
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    Quantification of motor speech in primary progressive aphasia and frontotemporal dementia
    Poole, M ; Brodtmann, A ; Darby, D ; Vogel, A (WILEY-BLACKWELL, 2016-08-01)
    Frontotemporal dementia (FTD) and primary progressive aphasia (PPA) are two groups of related disorders which are classified into the behavioural (bvFTD), semantic (svPPA), nonfluent/agrammatic (nfvPPA) and logopaenic (lvPPA) variants. Each variant presents with characteristic impairments of communication or behaviour, and the defining features of the syndromes are under ongoing debate in the literature. Researchers and clinicians usually assess speech with listener-based rating scales, which pose a challenge for identifying subtle changes to speech. Objective measures of speech may therefore improve characterisation of speech impairments in the literature and assist in clinical diagnosis and management. In this study, speech samples were taken from 43 people with PPA or FTD (8 svPPA, 4 nfvPPA, 9 lvPPA, 22 bvFTD) and 24 healthy controls. Speech was analysed perceptually using a 5-point rating scale across all speech subsystems. Speech was objectively quantified with measures of lexical stress (the pairwise variability index, PVI), vowel production, timing, voice quality and diadochokinetic (DDK) speech rate. The ability of speech measures to predict regions of neurodegeneration was assessed by comparison of speech to calculations of cortical thickness and subcortical volume derived from participants’ clinical magnetic resonance imaging (MRI) scans. Longitudinal speech investigations were conducted for a subgroup of participants to investigate the capacity of the measures to track disease progression. Group comparisons indicated that several speech measures differentiate pathological groups from controls, including measures of speech timing, DDK rate, and PVI. PVI and DDK also differentiated the nfvPPA group from other subtypes. Case studies of longitudinal data highlight measures which reflect motor speech changes in a case of bvFTD progressing to motor neurone disease (MND), and in two cases of nfvPPA. Findings add to the documentation of speech production in PPA and FTD by establishing acoustic correlates which differ from the healthy population. Longitudinal case studies demonstrate the potential for these measures to be used clinically to improve monitoring of disease progression.