Contributions
Abstract: P902
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
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.
Disclosure:
- Gustavo Noffs has nothing to declare
- Frederique Boonstra has nothing to declare
- Thushara Perera has nothing to declare
- Camille Shanahan has nothing to declare
- Adam Vogel has received consulting fees from Cogstate and Takeda.
- Andrew Evans has received honoraria from Novartis for giving presentations and providing consultancy services. He has participated in scientific advisory board meetings for Novartis, UCB Pharma, Allergan, and Boehringer Ingelheim. He has received conference travel support from Boehringer Ingelheim.
- Helmut Butzkeuven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme
- Anneke van der Walt has received travel support from Biogen Idec, Novartis, Teva, Merck and serves on several advisory boards
- Scott Kolbe receives grant income from the National Health and Medical Research Council of Australia and has received honoraria from Novartis
Abstract: P902
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
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.
Disclosure:
- Gustavo Noffs has nothing to declare
- Frederique Boonstra has nothing to declare
- Thushara Perera has nothing to declare
- Camille Shanahan has nothing to declare
- Adam Vogel has received consulting fees from Cogstate and Takeda.
- Andrew Evans has received honoraria from Novartis for giving presentations and providing consultancy services. He has participated in scientific advisory board meetings for Novartis, UCB Pharma, Allergan, and Boehringer Ingelheim. He has received conference travel support from Boehringer Ingelheim.
- Helmut Butzkeuven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme
- Anneke van der Walt has received travel support from Biogen Idec, Novartis, Teva, Merck and serves on several advisory boards
- Scott Kolbe receives grant income from the National Health and Medical Research Council of Australia and has received honoraria from Novartis