Automated speech analytics in ALS: higher sensitivity of digital articulatory precision over the ALSFRS-R.

Objective: Although studies have shown that digital measures of speech detected ALS speech impairment and correlated with the ALSFRS-R speech item, no study has yet compared their performance in detecting speech changes. In this study, we compared the performances of the ALSFRS-R speech item and an algorithmic speech measure in detecting clinically important changes in speech. Importantly, the study was part of a FDA submission which received the breakthrough device designation for monitoring ALS; we provide this paper as a roadmap for validating other speech measures for monitoring disease progression. Methods: We obtained ALSFRS-R speech subscores and speech samples from participants with ALS. We computed the minimum detectable change (MDC) of both measures; using clinician-reported listener effort and a perceptual ratings of severity, we calculated the minimal clinically important difference (MCID) of each measure with respect to both sets of clinical ratings. Results: For articulatory precision, the MDC (.85) was lower than both MCID measures (2.74 and 2.28), and for the ALSFRS-R speech item, MDC (.86) was greater than both MCID measures (.82 and .72), indicating that while the articulatory precision measure detected minimal clinically important differences in speech, the ALSFRS-R speech item did not. Conclusion: The results demonstrate that the digital measure of articulatory precision effectively detects clinically important differences in speech ratings, outperforming the ALSFRS-R speech item. Taken together, the results herein suggest that this speech outcome is a clinically meaningful measure of speech change.

A speech-based prognostic model for dysarthria progression in ALS.

Objective: We demonstrated that it was possible to predict ALS patients' degree of future speech impairment based on past data. We used longitudinal data from two ALS studies where participants recorded their speech on a daily or weekly basis and provided ALSFRS-R speech subscores on a weekly or quarterly basis (quarter-annually). Methods: Using their speech recordings, we measured articulatory precision (a measure of the crispness of pronunciation) using an algorithm that analyzed the acoustic signal of each phoneme in the words produced. First, we established the analytical and clinical validity of the measure of articulatory precision, showing that the measure correlated with perceptual ratings of articulatory precision (r = .9). Second, using articulatory precision from speech samples from each participant collected over a 45-90 day model calibration period, we showed it was possible to predict articulatory precision 30-90 days after the last day of the model calibration period. Finally, we showed that the predicted articulatory precision scores mapped onto ALSFRS-R speech subscores. Results: the mean absolute error was as low as 4% for articulatory precision and 14% for ALSFRS-R speech subscores relative to the total range of their respective scales. Conclusion: Our results demonstrated that a subject-specific prognostic model for speech predicts future articulatory precision and ALSFRS-R speech values accurately.

Articulatory-acoustic relations in the production of alveolar and palatal lateral sounds in Brazilian Portuguese.

Lateral approximant speech sounds are notoriously difficult to measure and describe due to their complex articulation and acoustics. This has prevented researchers from reaching a unifying description of the articulatory and acoustic characteristics of laterals. This paper examines articulatory and acoustic properties of Brazilian Portuguese alveolar and palatal lateral approximants (/l/ and /ʎ/) produced by six native speakers. The methodology for obtaining vocal tract area functions was based on three-dimensional/four-dimensional (3D/4D) ultrasound recordings and 3D digitized palatal impressions with simultaneously recorded audio signals. Area functions were used to calculate transfer function spectra, and predicted formant and anti-resonance frequencies were compared with the acoustic recordings. Mean absolute error in formant frequency prediction was 4% with a Pearson correlation of r = 0.987. Findings suggest anti-resonances from the interdental channels are less important than a prominent anti-resonance from the supralingual cavity but can become important in asymmetrical articulations. The use of 3D/4D ultrasound to study articulatory-acoustic relations is promising, but significant limitations remain and future work is needed to make better use of 3D/4D ultrasound data, e.g., by combining it with magnetic resonance imaging.

The relation between tongue shape and pitch in clarinet playing using ultrasound measurements.

Tongue shapes during clarinet performances of chromatic scale, portamento and pitch bending exercises were imaged using an ultrasound machine while audio and video were recorded synchronously. Analysis of the data from four participants revealed that tongue position varies non-monotically with note frequency in the lowest register (up to ≈ 440 Hz) and then descends monotonically as note frequencies rise through the upper registers. The descent of the tongue results in an expansion of the vocal tract's posterior oral cavity, resulting in a vocal tract input impedance maximum tuned to high frequency. Portamento and pitch bending were found to involve a raising of the tongue and concomitant contraction of the posterior oral cavity. The degree of contraction was similar in both portamento and pitch bending, suggesting a common acoustic mechanism.