Martina Mrackova

Robust and complex approach of pathological speech signal analysis

This paper presents a study of the approaches in the state-of-the-art in the field of pathological speech signal analysis with a special focus on parametrization techniques. It provides a description of 92 speech features where some of them are already widely used in this field of science and some of them have not been tried yet (they come from different areas of speech signal processing like speech recognition or coding). As an original contribution, this work introduces 36 completely new pathological voice measures based on modulation spectra, inferior colliculus coefficients, bicepstrum, sample and approximate entropy and empirical mode decomposition. The significance of these features was tested on 3 (English, Spanish and Czech) pathological voice databases with respect to classification accuracy, sensitivity and specificity. To our best knowledge the introduced approach based on complex feature extraction and robust testing outperformed all works that have been published already in this field. The results (accuracy, sensitivity and specificity equal to 100.0 ? 0.0 % ) are discussable in the case of Massachusetts Eye and Ear Infirmary (MEEI) database because of its limitation related to a length of sustained vowels, however in the case of Principe de Asturias (PdA) Hospital in Alcala de Henares of Madrid database we made improvements in classification accuracy ( 82.1 ? 3.3 % ) and specificity ( 83.8 ? 5.1 % ) when considering a single-classifier approach. Hopefully, large improvements may be achieved in the case of Czech Parkinsonian Speech Database (PARCZ), which are discussed in this work as well. All the features introduced in this work were identified by Mann-Whitney U test as significant ( p < 0.05 ) when processing at least one of the mentioned databases. The largest discriminative power from these proposed features has a cepstral peak prominence extracted from the first intrinsic mode function ( p = 6.9443 i? 10 - 32 ) which means, that among all newly designed features those that quantify especially hoarseness or breathiness are good candidates for pathological speech identification. The paper also mentions some ideas for the future work in the field of pathological speech signal analysis that can be valuable especially under the clinical point of view.

Prosodic analysis of neutral, stress-modified and rhymed speech in patients with Parkinson's disease

BACKGROUND AND OBJECTIVE Hypokinetic dysarthria (HD) is a frequent speech disorder associated with idiopathic Parkinsons disease (PD). It affects all dimensions of speech production. One of the most common features of HD is dysprosody that is characterized by alterations of rhythm and speech rate, flat speech melody, and impairment of speech intensity control. Dysprosody has a detrimental impact on speech naturalness and intelligibility. METHODS This paper deals with quantitative prosodic analysis of neutral, stress-modified and rhymed speech in patients with PD. The analysis of prosody is based on quantification of monopitch, monoloudness, and speech rate abnormalities. Experimental dataset consists of 98 patients with PD and 51 healthy speakers. For the purpose of HD identification, sequential floating feature selection algorithm and random forests classifier is used. In this paper, we also introduce a concept of permutation test applied in the field of acoustic analysis of dysarthric speech. RESULTS Prosodic features obtained from stress-modified reading task provided higher classification accuracies compared to the ones extracted from reading task with neutral emotion demonstrating the importance of stress in speech prosody. Features calculated from poem recitation task outperformed both reading tasks in the case of gender-undifferentiated analysis showing that rhythmical demands can in general lead to more precise identification of HD. Additionally, some gender-related patterns of dysprosody has been observed. CONCLUSIONS This paper confirms reduced variation of fundamental frequency in PD patients with HD. Interestingly, increased variability of speech intensity compared to healthy speakers has been detected. Regarding speech rate disturbances, our results does not report any particular pattern. We conclude further development of prosodic features quantifying the relationship between monopitch, monoloudness and speech rate disruptions in HD can have a great potential in future PD analysis.

Addenbrooke's Cognitive Examination and Individual Domain Cut-Off Scores for Discriminating between Different Cognitive Subtypes of Parkinson's Disease

Objective. The main aim of this study was to verify the sensitivity and specificity of Addenbrookes Cognitive Examination-Revised (ACE-R) in discriminating between Parkinsons disease (PD) with normal cognition (PD-NC) and PD with mild cognitive impairment (PD-MCI) and between PD-MCI and PD with dementia (PD-D). We also evaluated how ACE-R correlates with neuropsychological cognitive tests in PD. Methods. We examined three age-matched groups of PD patients diagnosed according to the Movement Disorder Society Task Force criteria: PD-NC, PD-MCI, and PD-D. ROC analysis was used to establish specific cut-off scores of ACE-R and its domains. Correlation analyses were performed between ACE-R and its subtests with relevant neuropsychological tests. Results. Statistically significant differences between groups were demonstrated in global ACE-R scores and subscores, except in the language domain. ACE-R cut-off score of 88.5 points discriminated best between PD-MCI and PD-NC (sensitivity 0.68, specificity 0.91); ACE-R of 82.5 points distinguished best between PD-MCI and PD-D (sensitivity 0.70, specificity 0.73). The verbal fluency domain of ACE-R demonstrated the best discrimination between PD-NC and PD-MCI (cut-off score 11.5; sensitivity 0.70, specificity 0.73) while the orientation/attention subscore was best between PD-MCI and PD-D (cut-off score 15.5; sensitivity 0.90, specificity 0.97). ACE-R scores except for ACE-R language correlated with specific cognitive tests of interest.

Assessing progress of Parkinson's disease using acoustic analysis of phonation

This paper deals with a complex acoustic analysis of phonation in patients with Parkinsons disease (PD) with a special focus on estimation of disease progress that is described by 7 different clinical scales (e. g. Unified Parkinsons disease rating scale or Beck depression inventory). The analysis is based on parametrization of 5 Czech vowels pronounced by 84 PD patients. Using classification and regression trees we estimated all clinical scores with maximal error lower or equal to 13 %. Best estimation was observed in the case of Mini-mental state examination (MAE = 0.77, estimation error 5.50 %). Finally, we proposed a binary classification based on random forests that is able to identify Parkinsons disease with sensitivity SEN = 92.86% (SPE = 85.71 %). The parametrization process was based on extraction of 107 speech features quantifying different clinical signs of hypokinetic dysarthria present in PD.

Impact of Parkinson's disease and levodopa on resting state functional connectivity related to speech prosody control

BACKGROUND Impaired speech prosody is common in Parkinsons disease (PD). We assessed the impact of PD and levodopa on MRI resting-state functional connectivity (rs-FC) underlying speech prosody control. METHODS We studied 19 PD patients in the OFF and ON dopaminergic conditions and 15 age-matched healthy controls using functional MRI and seed partial least squares correlation (PLSC) analysis. In the PD group, we also correlated levodopa-induced rs-FC changes with the results of acoustic analysis. RESULTS The PLCS analysis revealed a significant impact of PD but not of medication on the rs-FC strength of spatial correlation maps seeded by the anterior cingulate (p = 0.006), the right orofacial primary sensorimotor cortex (OF_SM1; p = 0.025) and the right caudate head (CN; p = 0.047). In the PD group, levodopa-induced changes in the CN and OF_SM1 connectivity strengths were related to changes in speech prosody. CONCLUSIONS We demonstrated an impact of PD but not of levodopa on rs-FC within the brain networks related to speech prosody control. When only the PD patients were taken into account, the association between treatment-induced changes in speech prosody and changes in rs-FC within the associative striato-prefrontal and motor speech networks was found.

Quantitative Analysis of Relationship Between Hypokinetic Dysarthria and the Freezing of Gait in Parkinson’s Disease

Hypokinetic dysarthria (HD) and freezing of gait (FOG) are both axial symptoms that occur in patients with Parkinson’s disease (PD). It is assumed they have some common pathophysiological mechanisms and therefore that speech disorders in PD can predict FOG deficits within the horizon of some years. The aim of this study is to employ a complex quantitative analysis of the phonation, articulation and prosody in PD patients in order to identify the relationship between HD and FOG, and establish a mathematical model that would predict FOG deficits using acoustic analysis at baseline. We enrolled 75 PD patients who were assessed by 6 clinical scales including the Freezing of Gait Questionnaire (FOG–Q). We subsequently extracted 19 acoustic measures quantifying speech disorders in the fields of phonation, articulation and prosody. To identify the relationship between HD and FOG, we performed a partial correlation analysis. Finally, based on the selected acoustic measures, we trained regression models to predict the change in FOG during a 2-year follow-up. We identified significant correlations between FOG–Q scores and the acoustic measures based on formant frequencies (quantifying the movement of the tongue and jaw) and speech rate. Using the regression models, we were able to predict a change in particular FOG–Q scores with an error of between 7.4 and 17.0 %. This study is suggesting that FOG in patients with PD is mainly linked to improper articulation, a disturbed speech rate and to intelligibility. We have also proved that the acoustic analysis of HD at the baseline can be used as a predictor of the FOG deficit during 2 years of follow-up. This knowledge enables researchers to introduce new cognitive systems that predict gait difficulties in PD patients.

Identification of hypokinetic dysarthria using acoustic analysis of poem recitation

Up to 90% of patients with Parkinsons disease (PD) suffer from hypokinetic dysarthria (HD). In this work, we analysed the power of conventional speech features quantifying imprecise articulation, dysprosody, speech dysfluency and speech quality deterioration extracted from a specialized poem recitation task to discriminate dysarthric and healthy speech. For this purpose, 152 speakers (53 healthy speakers, 99 PD patients) were examined. Only mildly strong correlation between speech features and clinical status of the speakers was observed. In case of univariate classification analysis, sensitivity of 62.63 % (imprecise articulation), 61.62% (dysprosody), 71.72% (speech dysfluency) and 59.60% (speech quality deterioration) was achieved. Multivariate classification analysis improved the classification performance. Sensitivity of 83.42% using only two features describing imprecise articulation and speech quality deterioration in HD was achieved. We showed the promising potential of the selected speech features and especially the use of poem recitation task to quantify and identify HD in PD.

Assessing freezing of gait in parkinson's disease using analysis of hypokinetic dysarthria

Hypokinetic dysarthria (HD) and freezing of gait (FOG) are frequent symptoms of Parkinsons disease (PD). The aim of this work is to reveal pathological mechanisms common for HD and FOG, and use acoustic analysis of dysarthric speech to assess the gait difficulties in PD. We used a correlation analysis to investigate a relationship between speech features and FOG evaluated by freezing of gait questionnaire (FOG-Q). We found speech features quantifying reduced mobility of the articulatory organs significantly correlated with all parts of the questionnaire. Next, we built multivariate regression models to estimate the FOG-Q total score. With this approach, mean estimation error rate of 14.71% was achieved. We confirmed the previous findings of a close relationship between HD and FOG in PD. Furthermore, we showed it is possible to accurately (with the error of approximately 0.5 points) estimate FOG-Q using a reasonable number of conventional speech features.