Objective: A systematic review and a meta-analysis were performed to identify the main characteristics of voice disturbances in bulbar amyotrophic lateral sclerosis.Materials and Methods: Literature searches with the keywords: "amyotrophic lateral sclerosis" and "dysarthria" and "intelligibility" were conducted in PubMed, EMBASE, Cochrane Library and Web of Science to perform the systematic review about the articulatory disorders and with the keyword "amyotrophic lateral sclerosis" and "voice" to conduct the meta-analysis about the phonetic changes in patients with bulbar ALS.Results: Seven publications met the inclusion criteria and were included in the meta-analysis, twenty-six publications were included in the systematic review. The data within the meta-analysis revealed that several voice parameters including Jitter, Shimmer, Noise to Harmonic Ratio discriminated best between bulbar amyotrophic lateral sclerosis and healthy controls. On the other hand, significant variations of fundamental frequency were not observed.Conclusion: Acoustic analysis of voice and articulatory analysis contributes to identification of the earliest signs of bulbar degeneration and allows the identification of changes in voice parameters for an early detection, for predicting bulbar involvement and the worsening of disease, for targeting specific intervention. Among the voice parameters, Jitter and Shimmer discriminated better bulbar involvement, they are significantly increased in the patients, on the contrary maximum phonation time is significantly worsened. The careful monitoring of speech symptoms improves diagnostic accuracy and the close cooperation of a multidisciplinary team (physicians as otolaryngologist and physiatrist, speech and language therapists, physiotherapist, dietitians, caregivers, the patients, and their relatives) could be essential.

Acoustic analysis of voice in bulbar amyotrophic lateral sclerosis: a systematic review and meta-analysis of studies.

Purpose The clinical assessment of intelligibility must be based on a large repository and extensive variation of test materials, to render test stimuli unpredictable and thereby avoid expectancies and familiarity effects in the listeners. At the same time, it is essential that test materials are systematically controlled for factors influencing intelligibility. This study investigated the impact of lexical and articulatory characteristics of quasirandomly selected target words on intelligibility in a large sample of dysarthric speakers under clinical examination conditions. Method Using the clinical assessment tool KommPaS, a total of 2,700 sentence-embedded target words, quasirandomly drawn from a large corpus, were spoken by a group of 100 dysarthric patients and later transcribed by listeners recruited via online crowdsourcing. Transcription accuracy was analyzed for influences of lexical frequency, phonological neighborhood structure, articulatory complexity, lexical familiarity, word class, stimulus length, and embedding position. Classification and regression analyses were performed using random forests and generalized linear mixed models. Results Across all degrees of severity, target words with higher frequency, fewer and less frequent phonological neighbors, higher articulatory complexity, and higher lexical familiarity received significantly higher intelligibility scores. In addition, target words were more challenging sentence-initially than in medial or final position. Stimulus length had mixed effects; word length and word class had no effect. Conclusions In a large-scale clinical examination of intelligibility in speakers with dysarthria, several well-established influences of lexical and articulatory parameters could be replicated, and the roles of new factors were discussed. This study provides clues about how experimental rigor can be combined with clinical requirements in the diagnostics of communication impairment in patients with dysarthria.

The Impact of Lexical and Articulatory Factors in the Automatic Selection of Test Materials for a Web-Based Assessment of Intelligibility in Dysarthria.

Purpose This retrospective analysis examined group differences in error rate across 4 contextual variables (clusters vs. singletons, syllable position, number of syllables, and articulatory phoneti...

Perceptual Characteristics of Consonant Production in Apraxia of Speech and Aphasia

Purpose This study sought to determine the feasibility of using phonetic complexity manipulations as a way to systematically assess articulatory deficits in talkers with progressive dysarthria due to Parkinson's disease (PD) Method Articulatory kinematics were recorded using three-dimensional electromagnetic articulography from 15 talkers with PD (58-84 years old) and 15 healthy controls (55-80 years old) while they produced target words embedded in a carrier phrase Majority of the talkers with PD exhibited a relatively mild dysarthria For stimuli selection, phonetic complexity was calculated for a variety of words using the framework proposed by Kent (1992), and six words representative of low, medium, and high phonetic complexity were selected as targets Jaw, posterior tongue, and anterior tongue kinematic measures that were used to test for phonetic complexity effects included movement speed, cumulative path distance, movement range, movement duration, and spatiotemporal variability Results Significantly smaller movements and slower movement speeds were evident in talkers with PD, predominantly for words with high phonetic complexity The effect sizes of between-groups differences were larger for several jaw kinematic measures than those of the tongue Discussion and Conclusion Findings suggest that systematic manipulations of phonetic complexity can support the detection of articulatory deficits in talkers with PD Phonetic complexity should therefore be leveraged for the assessment of articulatory performance in talkers with progressive dysarthria Future work will be directed toward linking speech kinematic and auditory-perceptual measures to determine the clinical significance of the current findings

Detection of Articulatory Deficits in Parkinson's Disease: Can Systematic Manipulations of Phonetic Complexity Help?


 
 
 To be effective for clinical and research purposes, materials for eliciting speech should have phonetic coverage of a language, which necessarily includes both
 phonemic
 coverage (including all phonemes) and
 allophonic
 coverage (including positional contexts). The purpose of this work was to quantify allophonic coverage in widely used standard passages.
 
 
 
 
 
 A total of 466 allowable contexts for 24 consonants in English were determined by taking into account positional contexts in terms of word positions, lexical stress, and proximity to other phonemes.
 The Caterpillar, The Grandfather Passage
 , and
 The Rainbow Passage
 were analyzed with respect to their phonetic coverage of these allowable contexts.
 
 
 
 
 
 The standard passages achieved phonemic coverage, but their phonetic coverage was minimal: 24.89% in
 The Caterpillar
 , 27.25% in
 The Grandfather Passage
 , and 35.84% in
 The Rainbow Passage
 .
 
 
 
 
 Our analysis of three standard passages suggests the need for new speech materials that provide not only phonemic but also allophonic coverage so that production and perception of consonants can be examined as a function of their positional contexts.


Examination of Consonantal Phonetic Coverage in Standard Reading Passages

Purpose This study describes a phonetic complexity-based approach for speech intelligibility and articulatory precision testing using preliminary data from talkers with amyotrophic lateral sclerosi

/pdf/a-phonetic-complexity-based-approach-for-intelligibility-and-nbrrsr03wt.pdf

A Phonetic Complexity-Based Approach for Intelligibility and Articulatory Precision Testing: A Preliminary Study on Talkers With Amyotrophic Lateral Sclerosis.

Claire Custer

Papers

A Phonetic Complexity-Based Approach for Intelligibility and Articulatory Precision Testing: A Preliminary Study on Talkers With Amyotrophic Lateral Sclerosis.