Vocal Effort and Acoustic Analysis of Gargle Phonation Versus Water Swallow in Patients With Muscle Tension Dysphonia: A Clinical Trial.

PURPOSE: To determine the effects of gargle phonation (GP) on self-perceived vocal improvement, vocal effort, acoustic parameters, and speech rate in patients with muscle tension dysphonia (MTD). We hypothesized that GP would improve voice, reduce phonatory effort, and alter acoustic and speech measures. STUDY DESIGN: Prospective randomized, single-blind cross-over clinical trial METHODS: Thirty-four participants (26 females, 8 males; average age 53 years) who were diagnosed with MTD completed the Voice Handicap Index-10 (VHI-10) and were assigned three study conditions: Baseline (B), GP, and Water Swallow (WS; sham), presented in one of two counterbalanced orders B-WS-GP (WS1st) or B-GP-WS (GP1st). Participants recorded stimuli from the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and rated their perceived vocal effort and vocal improvement. F0, vocal intensity, cepstral peak prominence (CPP), and speaking rate were measured. RESULTS: Average VHI-10 scores by group were 16 (min/max 2-29) for WS1st and 15 (min/max 3-40) for GP1st. About 73.5% reported more vocal improvement after GP, 17.65% after WS, and 8.8% noted no difference between conditions. Reduced effort was reported after GP, compared to B (P < 0.001) and WS (P = 0.005). Lower effort was also reported after the WS condition, compared to B (P = 0.011). Key acoustic findings included an increase in F0 after GP for sustained /i/ for females. CPP was significantly higher for females reading CAPE-V sentences after GP, when GP preceded WS, compared to B (P = 0.004) and WS (P = 0.003). Speech rate was faster for females after GP versus B (P = 0.029). CONCLUSIONS: GP may be beneficial in the treatment of MTD. CPP may be a useful marker for vocal improvement after GP for women with mild MTD. Further studies would benefit from having more male participants and those with moderate and severe MTD.

Landmark-based analysis of speech differentiates conversational from clear speech in speakers with muscle tension dysphonia.

This study evaluated the feasibility of differentiating conversational and clear speech produced by individuals with muscle tension dysphonia (MTD) using landmark-based analysis of speech (LMBAS). Thirty-four adult speakers with MTD recorded conversational and clear speech, with 27 of them able to produce clear speech. The recordings of these individuals were analyzed with the open-source LMBAS program, SpeechMark®, matlab Toolbox version 1.1.2. The results indicated that glottal landmarks, burst onset landmarks, and the duration between glottal landmarks differentiated conversational speech from clear speech. LMBAS shows potential as an approach for detecting the difference between conversational and clear speech in dysphonic individuals.

Analyzing acoustic and prosodic fluctuations in free speech to predict psychosis onset in high-risk youths.

The diagnosis and treatment of psychiatric disorders depends on the analysis of behavior through language by a clinical specialist. This analysis is subjective in nature and could benefit from automated, objective acoustic and linguistic processing methods. This integrated approach would convey a richer representation of patient speech, particularly for expression of emotion. In this work, we explore the potential of acoustic and prosodic metrics to infer clinical variables and predict psychosis, a condition which produces measurable derailment and tangentiality in patient language. To that purpose, we analyzed the recordings of 32 young patients at high risk of developing clinical psychosis. The subjects were evaluated using the Structured Interview for Prodromal Syndromes/Scale of Prodromal Symptoms (SIPS/SOPS) criteria. To analyze the recordings, we examined the variation of different acoustic and prosodic metrics across time. This preliminary analysis shows that these features can infer negative symptom severity ratings (i.e., SIPS-Btotal), obtaining a Pearson correlation of 0.77 for all the subjects after cross-validated evaluation. In addition, these features can predict development of psychosis with high accuracy above 90%, outperforming classification using clinical variables only. This improved predictive power ultimately can help provide early treatment and improve quality of life for those at risk for developing psychosis.

Analyzing progression of motor and speech impairment in ALS.

Amyotrophic lateral sclerosis (ALS) is a degenerative disease which causes death of neurons controlling voluntary muscles. It is currently assessed with subjective clinical measurements, but it would benefit from alternative surrogate biomarkers that can better estimate disease progression. This work analyzes speech and fine motor coordination of subjects recruited by the Answer ALS foundation using data from a mobile app. In addition, clinical variables such as speech, writing and total ALSFRS-R scores are also acquired along with forced and slow vital capacity. Cross-sectional and longitudinal analyses were performed using speech and fine motor features. Results show that both types of features are useful to infer clinical variables especially for males (R2=0.79 for ALSFRS-R total score), but their initial values are not helpful to predict speech and motor decline. However, we found that longitudinal progression for bulbar and spinal ALS onset are different and they can be identified with high accuracy by the extracted features.

SPEECH MARKERS FOR CLINICAL ASSESSMENT OF COCAINE USERS.

One of the main foci of addiction research is the delineation of markers that track the propensity of relapse. Speech analysis can provide an unbiased assessment that can be deployed outside the lab, enabling objective measurements and relapse susceptibility tracking. This work is the first attempt to study unscripted speech markers in cocaine users. We analyzed 23 subjects performing two tasks: describing the positive consequences (PC) of abstinence and the negative consequences (NC) of using cocaine. We perform two main experiments: first, we analyzed whether acoustic and semantic features can infer clinical variables such as the Cocaine Selective Severity Assessment; then, we analyzed the main problem of interest: to see if these features are powerful enough to infer if the subjects remains abstinent. Our results show that speech features have potential to be used as a proxy to monitor cocaine users under treatment to recover from their addiction.

Acoustic correlates for perceived effort levels in male and female acted voices.

The best actors, particularly classic Shakespearian actors, are experts at vocal expression. With prosodic inflection, change of voice quality, and non-textual utterances, they communicate emotion, emphasize ideas, create drama, and form a complementary language which works with the text to tell the story in the script. To begin to study selected elements of vocal expression in acted speech, corpora were curated from male actors' Hamlet and female actresses' Lady Macbeth soliloquy performances. L1 speakers of American English on Mechanical Turk listened to excerpts from the corpora, and provided descriptions of the speaker's vocal expression. In this exploratory, open-ended, mixed-methods study, approximately 60% of all responses described emotion, and the remainder of responses split evenly between voice quality (including effort levels) and prosody. Also, significant differences were found in the kind and quantity of descriptors applied to male and female speech. Perception-grounded male and female acoustic feature sets which tracked the actors' expressive effort levels through the continuum of whispered, breathy, modal, and resonant speech are presented and validated via multiple models. The best results in applying these features to simple, un-optimized, four-way decision tree classifiers yielded 76% accuracy for male and 73% accuracy for female expressive, acted speech.