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https://revistacefac.org.br/article/doi/10.1590/1982-0216/20232564723
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Original Articles

Use of the diadochokinetic index DDKCCVP% in the detection of articulatory inaccuracies in Parkinson’s disease: a preliminary exploratory study

Utilidad del índice diadococinético DDKCVP% para la detección  de imprecisiones articulatorias en enfermedad de Parkinson:  estudio exploratorio preliminar

Marcela Sanhueza-Garrido; Carlos Rojas-Zepeda; Virginia García-Flores

http://dx.doi.org/10.1590/1982-0216/20232564723 Revista CEFAC, vol.25, n6, e4723, 2023
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Abstract

Purpose: to explore whether the diadochokinetic index of syllable production variability (DDKcvp%) is useful for the detection of articulatory inaccuracies in different stages of Parkinson's disease (PD).

Methods: a diadochokinetic speech task of the consonant-vowel type [pa-pa-pa] was applied to 18 people with PD (classified in stages of progression from 1 to 5 according to the Hoehn & Yahr scale) to determine their diadochokinetic performance. Records of the study group were compared to a reference value obtained from a control group made up of 40 subjects.

Results: 77.78% of the study group showed articulatory inaccuracies. The DDKcvp% index allowed to detect articulatory difficulties from stage 1 of PD, and its variation showed that articulatory deficits were permanent from stage 2 onwards. A significant and direct correlation was obtained between the increase in the DDKcvp% index and the increase in the stage of evolution of the participants.

Conclusion: DDKcvp% index evaluated by means of a simple and fast consonant-vowel diadochokinetic task [pa-pa-pa], could be useful to determine articulatory inaccuracies in different stages of PD, although it is suggested that investigation of this index in larger sample sizes be conducted.

Keywords

Parkinson Disease; Speech; Articulation Disorders; Dysarthria

Resumen

Objetivo: explorar si el índice diadococinético de variabilidad de la producción silábica (DDKcvp%) es útil para la detección de imprecisiones articulatorias en distintos estadios de la Enfermedad de Parkinson (EP).

Métodos: se aplicó una tarea diadococinética de habla del tipo consonante-vocal [pa-pa-pa] a 18 personas con EP (clasificadas en estadios de evolución del 1 al 5 según la escala Hoehn & Yahr) para determinar su rendimiento diadococinético. Los registros del grupo de estudio fueron comparados con un valor de referencia obtenido de un grupo control compuesto por 40 personas. 

Resultados: el 77,78% del grupo de estudio evidenció imprecisiones articulatorias. Además, el índice DDKcvp% permitió pesquisar dificultades articulatorias desde el estadio 1 de la EP, y su variación evidenció que los déficits articulatorios son permanentes desde el estadio 2 en adelante. También, se obtuvo una correlación significativa y directa entre el aumento del índice DDKcvp% con el incremento del estadio de evolución en el que se encontraban los participantes. 

Conclusión: el índice DDKcvp%, evaluado mediante una tarea diadococinética simple y rápida tipo consonante-vocal [pa-pa-pa], podría presentar una correcta utilidad para determinar imprecisiones articulatorias en distintos estadios de la EP, aunque se sugiere continuar investigando este índice en tamaños muestrales más amplios.

Palabras clave

Enfermedad de Parkinson; Habla; Trastornos de la Articulación; Disartria

Referencias

1. Ray Dorsey E, Elbaz A, Nichols E, Abd-Allah F, Abdelalim A, Adsuar JC et al. Global, regional, and national burden of Parkinson's disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17(11):939-53. https://doi.org/10.1016/S1474-4422(18)30295-3PMID: 30287051.

2. Fahn S. Description of Parkinson's disease as a clinical syndrome. Vol. 991, Ann. N.Y. Acad. Sci. New York; 2003.

3. Dashtipour K, Tafreshi A, Lee J, Crawley B. Speech disorders in Parkinson's disease: pathophysiology, medical management and surgical approaches. Vol. 8, Neurodegenr Dis Manag. 2018;8(5):337-48. https://doi.org/10.2217/nmt-2018-0021PMID: 30223711.

4. Ramig L, Halpern A, Spielman J, Fox C, Freeman K. Speech treatment in Parkinson's disease: Randomized Controlled Trial (RCT). Mov Disord. 2018;33(11):1777-91. https://doi.org/10.1002/mds.27460PMID: 30264896.

5. Skodda S, Visser W, Schlegel U. Vowel articulation in parkinson's disease. J Voice. 2011;25(4):467-72. https://doi.org/10.1016/j.jvoice.2010.01.009 PMID: 20434876.

6. Tykalova T, Rusz J, Klempir J, Cmejla R, Ruzicka E. Distinct patterns of imprecise consonant articulation among Parkinson's disease, progressive supranuclear palsy and multiple system atrophy. Brain Lang. 2017 Feb 1;165:1-9. https://doi.org/10.1016/j.bandl.2016.11.005 PMID: 27894006.

7. Freed D. Motor speech disorder diagnosis and treatment. 3th ed. San Diego (CA): Plural Publishing; 2020.

8. Aviñó Farret C, Maneiro Chouza M, Clemente Benaiges I. Neurorrehabilitación en la enfermedad de Parkinson. Neurol Supl. 2007;3(7):22-9.

9. Montaña D, Campos-Roca Y, Pérez CJ. A diadochokinesis-based expert system considering articulatory features of plosive consonants for early detection of Parkinson's disease. Comput Methods Programs Biomed. 2018 Feb 1;154:89-97. https://doi.org/10.1016/j.cmpb.2017.11.010 PMID: 29249350.

10. Munner Altaher A. A report of assesment tools for individuals with dysarthria. Open Public Health J. 2019;12:384-6. https://doi.org/ 10.2174/1874944501912010384

11. Pommée T, Balaguer M, Mauclair J, Pinquier J, Woisard V. Assessment of adult speech disorders: current situation and needs in French-speaking clinical practice. Logoped Phoniatr Vocol. 2021;47(2):1-17. https://doi.org/10.1080/14015439.2020.1870245 PMID: 33423572.

12. Rumbach AF, Finch E, Stevenson G. What are the usual assessment practices in adult non-progressive dysarthria rehabilitation? A survey of Australian dysarthria practice patterns. J Commun Disord. 2019 May 1;79:46-57. https://doi.org/10.1016/j.jcomdis.2019.03.002 PMID: 30875615.

13. Jankovic J. Parkinson's disease: clinical features and diagnosis. Journal of Neurology, Neurosurgery and Psychiatry. BMJ Publishing Group; 2008;79:368-76. https://doi.org/10.1136/jnnp.2007.131045PMID: 18344392.

14. Karlsson F, Schalling E, Laakso K, Johansson K, Hartelius L. Assessment of speech impairment in patients with Parkinson's disease from acoustic quantifications of oral diadochokinetic sequences. J Acoust Soc Am. 2020;147(2):839-51. https://doi.org/10.1121/10.0000581 PMID: 32113309.

15. Kent R, Kim H, Weismer G, Kent J, Rosenbek B. Laryngeal dysfunction in neurological disease: amyotrophic lateral sclerosis, Parkinson disease, and stroke. J Med Speech-Lang Pathol. 1994;2:157-75.

16. Pérez H, Fernández R, Oliva C. Valores normativos para el programa de análisis acústico del habla Motor Speech Profile en hablantes de español de Chile. Rev Chil Fonoaudiol. 2015;14:4-14. https://doi.org/10.5354/rcdf.v14i0.37608

17. John J, Ganapathy K, John S, Rajashekhar B. Normative for motor speech profile in kannada-speaking adults. J Voice. 2014;28(1):7-13. https://doi.org/10.1016/j.jvoice.2013.06.009 PMID: 24176300.

18. Rusz J, Cmejla R, Ruzickova H, Ruzicka E. Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson's disease. J Acoust Soc Am. 2011;129(1):35-67. https://doi.org/10.1121/1.3514381 PMID: 21303016.

19. Karlsson F, Hartelius L. How well does diadochokinetic task performance predict articulatory imprecision? Differentiating individuals with Parkinson's disease from control subjects. Folia Phoniatr Logop. 2019;71(5-6):251-60. https://doi.org/10.1159/000498851 PMID: 31117108.

20. Pawlukowska W, Szylińska A, Kotlęga D, Rotter I, Nowacki P. Differences between subjective and objective assessment of speech deficiency in Parkinson disease. J Voice. 2018;32(6):715-22. https://doi.org/10.1016/j.jvoice.2017.08.018 PMID: 29122413.

21. Gaballah A, Parsa V, Andreetta M, Adams S. Objective and subjective speech quality assessment of amplification devices for patients with Parkinson's disease. IEEE Trans Neural Syst Rehabil Eng. 2019;27(6):1226-35. https://doi.org/10.1109/TNSRE.2019.2915172 PMID: 31071046.

22. Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology. 1967;17(5):427-42. https://doi.org/10.1212/wnl.17.5.427 PMID: 6067254.

23. Eklund E, Qvist J, Sandström L, Viklund F, van Doorn J, Karlsson F. Perceived articulatory precision in patients with Parkinson's disease after deep brain stimulation of subthalamic nucleus and caudal zona incerta. Clin Linguist Phon. 2015;29(2):150-66. https://doi.org/10.3109/02699206.2014.971192 PMID: 25333411.

24. Skodda S, Flasskamp A, Schlegel U. Instability of syllable repetition in Parkinson's disease-Influence of levodopa and deep brain stimulation. Movement Disorders. 2011;26(4):728-30. https://doi.org/10.1002/mds.23439 PMID: 21506151.

25. Rusz J, Čmejla R, Růžičková H, Klempíř J, Majerová V, Picmausová J et al. Evaluation of speech impairment in early stages of Parkinson's disease: a prospective study with the role of pharmacotherapy. J Neural Transm. 2013;120(2):319-29. https://doi.org/10.1007/s00702-012-0853-4 PMID: 22772465.

26. Godino-Llorente JI, Shattuck-Hufnagel S, Choi JY, Moro-Velázquez L, Gómez-García JA. Towards the identification of Idiopathic Parkinson's Disease from the speech. New articulatory kinetic biomarkers. PloS One. 2017;12(12):1-35. https://doi.org/10.1371/journal.pone.0189583 PMID: 29240814.

27. Novotný M, Rusz J, Čmejla R, Růžička E. Automatic evaluation of articulatory disorders in Parkinson's disease. IEEE Trans Audio Speech Lang Process. 2014;22(9):1366-78. https://doi.org/10.1109/TASLP.2014.2329734

28. Tjaden K, Watling E. Characteristics of diadochokinesis in multiple sclerosis and Parkinson's disease. Folia Phoniatr logop. 2003;55:241-59. https://doi.org/10.1159/000072155 PMID: 12931058.

29. Ackermann H, Ziegler W. Articulatory deficits in Parkinsonian dysarthria: an acoustic analysis. J Neurol Neurosurg Psychiatry. 1991;54(12):1093-8. https://doi.org/10.1136/jnnp.54.12.1093 PMID: 1783924.

30. Fabbri M, Guimarães I, Cardoso R, Coelho M, Guedes LC, Rosa MM et al. Speech and voice response to a levodopa challenge in late-stage Parkinson's disease. Front Neurol. 2017 Aug 22;8(AUG). https://doi.org/10.3389/fneur.2017.00432 PMID: 28878734.

31. Skodda S, Lorenz J, Schlegel U. Instability of syllable repetition in Parkinson's disease-Impairment of automated speech performance? Basal Ganglia. 2013;3(1):33-7. https://doi.org/10.1016/j.baga.2012.11.002

32. Steurer H, Schalling E, Franzén E, Albrecht F. Characterization of mild and moderate dysarthria in Parkinson's disease: behavioral measures and neural correlates. Front Aging Neurosci. 2022; May 16;14. https://doi.org/10.3389/fnagi.2022.870998. PMID: 35651530.

33. Walsh B, Smith A. Basic parameters of articulatory movements and acoustics in individuals with Parkinson's disease. Movement Disorders. 2012;27(7):843-50. https://doi.org/10.1002/mds.24888 PMID: 22729986.

34. Kent RD, Vorperian HK, Kent JF, Duffy JR. Voice dysfunction in dysarthria: Application of the Multi-Dimensional Voice ProgramTM. J Commun Disord. 2003;36(4):281-306. https://doi.org/10.1016/S0021-9924(03)00016-9 PMID: 12837587.

35. Ma A, Lau KK, Thyagarajan D. Voice changes in Parkinson's disease: what are they telling us? J Clin Neurosci. 2020;7(2):7. https://doi.org/10.1016/j.jocn.2019.12.029 PMID: 31952969.

36. Silbergleit AK, Schultz L, Hamilton K, Lewitt PA, Sidiropoulos C. Self-perception of voice and swallowing handicap in Parkinson's disease. J Parkinsons Dis. 2021;11(4):2027-34. https://doi.org/10.3233/JPD-212621 PMID: 34366369.

37. Skodda S. Steadiness of syllable repetition in early motor stages of Parkinson's disease. Biomed Signal Process Control. 2015;17:55-9. https://doi.org/10.1016/j.bspc.2014.04.009

38. Rusz J, Hlavnička J, Tykalová T, Bušková J, Ulmanová O, Růžička E et al. Quantitative assessment of motor speech abnormalities in idiopathic rapid eye movement sleep behaviour disorder. Sleep Med. 2016 Mar 1;19:141-7. https://doi.org/10.1016/j.sleep.2015.07.030 PMID: 26459688.

39. Estevo Dias A, Tonidandel Barbosa M, Papaterra Limongi JC, Reis Barbosa E. Speech disorders did not correlate with age at onset of Parkinson's disease. Arq Neuropsiquiatr. 2016;74(2):117-21. https://doi.org/10.1590/0004-282X20160008 PMID: 26982988.

40. Tracy J, Özkanca Y, Atkins D, Hosseini R. Investigating voice as a biomarker: deep phenotyping methods for early detection of Parkinson's disease. J. Biomed. Inform. 2020;104:103362. https://doi.org/10.1016/j.jbi.2019.103362 PMID: 31866434.

41. Moro L, Gómez JA, Arias JD, Dehak N, Godino JI. Advances in Parkinson's disease detection and assessment using voice and speech: A review of the articulatory and phonatory aspects. Biomed. Signal Process. Control. 2021;66:102418. https://doi.org/10.1016/j.bspc.2021.102418

42. Narendra NP, Schuller B, Alku P. The detection of Parkinson's disease from speech using voice source information. IEEE/ACM Trans. Audio Speech Lang. 2021;29:1925-36. https://doi.org/10.1109/TASLP.2021.3078364

43. Rueda A, Vásquez JC, Orozco-Arroyave JR, Nöth E, Krishnan S. Empirical mode decomposition articulation feature extraction on Parkinson's diadochokinesia. Comput. Speech Lang. 2022;72:101322. https://doi.org/10.1016/j.csl.2021.101322

44. Kumar S, Kar P, Singh D, Sharma M. Analysis of diadochokinesis in persons with Parkinson's disease. J. Datta Meghe Inst. Med. Sci. Univ. 2018;13(3):140-2. https://doi.org/10.4103/jdmimsu.jdmimsu_66_18

45. Karan B, Sahu SS, Orozco-Arroyave JR. An investigation about the relationship between dysarthria level of speech and the neurological state of Parkinson's patients. Biocybern. Biomed. Eng. 2022;42(2):710-26. https://doi.org/10.1016/j.bbe.2022.04.003

46. Lowit A, Marchetti A, Corson S, Kuschmann A. Rhythmic performance in hypokinetic dysarthria: relationship between reading, spontaneous speech and diadochokinetic tasks. J Commun Disord. 2018;72:26-39. https://doi.org/10.1016/j.jcomdis.2018.02.005 PMID: 29471176.
 

Submitted date:
04/09/2023

Accepted date:
04/10/2023

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