Comprehensive assessment of speech physiology and acoustics in Parkinson's disease progression

帕金森病进展中言语生理学和声学的综合评估

• 批准号: 10602958
• 负责人: Daryush Dinyar Mehta
• 金额: $ 72.01万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-02 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10602958
• 关键词: Acoustics; Address; Affect; Air Movements; Articulation; Behavioral; Characteristics; Clinical; Clinical Trials; Cognition; Cues; Data; Development; Disease Progression; Elderly; Electromagnetics; Evaluation; Evidence based treatment; Future; Goals; Heterogeneity; Impairment; Individual; Intervention; Knowledge; Language; Larynx; Life; Link; Longitudinal Studies; Measures; Mental Depression; Methods; Neurologic; Oral; Outcome; Outcome Measure; Parkinson Disease; Patient-Focused Outcomes; Patients; Persons; Physiological; Physiology; Predictive Value; Production; Progressive Disease; Psychometrics; Quality of life; Rehabilitation therapy; Research; Resources; Sampling; Specificity; Speech; Speech Acoustics; Speech Disorders; Speech Intelligibility; Speech Therapy; Symptoms; Testing; Time; Visit; Work; algorithm development; base; clear speech; clinical decision-making; clinical translation; clinically actionable; expectation; experience; improved; improved outcome; instrumentation; kinematics; knowledge translation; novel; personalized medicine; pressure; respiratory; therapeutic target; wasting

Project Summary Parkinson’s disease (PD) is a progressive neurological condition affecting up to 1% of older adults, over 90% of whom experience speech problems. These speech problems cause reductions in quality of life, as measured by patient-centered outcomes (PCOs) of communicative participation, speech intelligibility, and naturalness, with further declines as the disease progresses. Decrements in PCOs can be attributed to changes in underlying physiological mechanisms of speech (i.e., the respiratory, laryngeal, and articulatory subsystems), yet the relative contributions of changes in speech physiology to PCOs are unknown. Without this knowledge, precious therapy time may be wasted on addressing physiological changes that do not matter to the patient experience. Defining the relationships between speech physiology and PCOs would allow clinicians to focus on physiological changes that are important to the patient. Furthermore, since many clinical settings do not have the resources to implement physiological measures, research is needed to determine which clinically accessible acoustic assessments are related to the individualized changes in speech physiology that drive changes in PCOs. We propose a comprehensive, longitudinal study of PCOs, physiology, and acoustics in a large sample, which should provide novel outcomes for clinical translation. In Aim 1, we will compare longitudinal changes in PCOs in PD to concomitant changes in speech physiology. Regardless of whether we see group-level changes, this aim will provide physiological targets that are tied to PCOs in the individuals who decline during the study period. In Aim 2, we will develop and evaluate a refined set of acoustic correlates of speech decline in PD based on their relationships with respiratory, laryngeal, and articulatory physiology. Finally, in Aim 3, we will psychometrically assess the sensitivity to change of the measures of speech physiology and the acoustic correlates. The ability of a measure to appropriately reflect change over time is a critical characteristic, essential for measures to be used for clinical or research applications. To comprehensively assess sensitivity to change, we will examine both decreasing (due to disease progression) and increasing (due to improvement with behavioral cueing – clear speech) function. Our results will provide a roadmap for future evidence-based treatment. Based on a physiological or acoustic evaluation, clinicians will be able to target specific speech subsystems to improve PCOs. This work will guide the future development of personalized treatment for individuals with PD.

项目摘要 帕金森氏病（PD）是一种进行性神经系统疾病，影响多达1％的老年人，超过90％ 遇到语音问题的人。这些语音问题导致生活质量的降低，如 以患者为中心的沟通参与，语音清晰度和自然性的结果（PCOS）， 随着疾病的进展，进一步下降。 PCOS的减小可以归因于基础的变化 语音的生理机制（即呼吸道，喉和发音子系统），但 语音生理变化对PCOS的相对贡献尚不清楚。没有这些知识，宝贵 治疗时间可能会浪费在解决与患者体验无关紧要的身体变化方面。 定义语音生理学与PCOS之间的关系将使临床医生能够专注于生理 对患者很重要的变化。此外，由于许多临床环境没有资源 要实施身体措施，需要进行研究以确定哪些临床上可及的声学 评估与驱动PCOS变化的语音生理学的个性化变化有关。我们 在大型样本中对PCOS，生理学和声学的全面，纵向研究，该研究 应为临床翻译提供新的结果。在AIM 1中，我们将比较PCOS的纵向变化 在PD中伴随语音生理的变化。不管我们是否看到小组级变化， AIM将提供与在研究期间下降的个体中与PCOS相关的身体目标。 在AIM 2中，我们将基于PD的一组精致的声音下降的声学相关性 他们与呼吸道，喉和发音生理的关系。最后，在AIM 3中，我们将 从心理上评估改变语音生理测量和声学的敏感性 相关。措施适当反映随着时间的变化的能力是关键的特征，必不可少的 用于用于临床或研究应用的测量。为了全面评估对改变的敏感性， 我们将检查既下降（由于疾病的进展）和增加 行为提示 - 清晰的语音）功能。我们的结果将为以后的循证提供路线图 治疗。基于物理或声学评估，临床医生将能够针对特定的语音 子系统改善PCOS。这项工作将指导未来的个性化治疗 患有PD的人。