Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function

Background: Speech production is a possible way to monitor bulbar and respiratory functions in patients with amyotrophic lateral sclerosis (ALS). Moreover, the emergence of smartphone-based data collection offers a promising approach to reduce frequent hospital visits and enhance patient outcomes. H...

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Main Authors: Pedro Santos Rocha, Nuno Bento, Hanna Svärd, Diana Monteiro Lopes, Sandra Hespanhol, Duarte Folgado, André Valério Carreiro, Mamede de Carvalho, Bruno Miranda
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/14/11/1082
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author Pedro Santos Rocha
Nuno Bento
Hanna Svärd
Diana Monteiro Lopes
Sandra Hespanhol
Duarte Folgado
André Valério Carreiro
Mamede de Carvalho
Bruno Miranda
author_facet Pedro Santos Rocha
Nuno Bento
Hanna Svärd
Diana Monteiro Lopes
Sandra Hespanhol
Duarte Folgado
André Valério Carreiro
Mamede de Carvalho
Bruno Miranda
author_sort Pedro Santos Rocha
collection DOAJ
description Background: Speech production is a possible way to monitor bulbar and respiratory functions in patients with amyotrophic lateral sclerosis (ALS). Moreover, the emergence of smartphone-based data collection offers a promising approach to reduce frequent hospital visits and enhance patient outcomes. Here, we studied the relationship between bulbar and respiratory functions with voice characteristics of ALS patients, alongside a speech therapist’s evaluation, at the convenience of using a simple smartphone. Methods: For voice assessment, we considered a speech therapist’s standardized tool—consensus auditory-perceptual evaluation of voice (CAPE-V); and an acoustic analysis toolbox. The bulbar sub-score of the revised ALS functional rating scale (ALSFRS-R) was used, and pulmonary function measurements included forced vital capacity (FVC%), maximum expiratory pressure (MEP%), and maximum inspiratory pressure (MIP%). Correlation coefficients and both linear and logistic regression models were applied. Results: A total of 27 ALS patients (12 males; 61 years mean age; 28 months median disease duration) were included. Patients with significant bulbar dysfunction revealed greater CAPE-V scores in overall severity, roughness, strain, pitch, and loudness. They also presented slower speaking rates, longer pauses, and higher jitter values in acoustic analysis (all <i>p</i> < 0.05). The CAPE-V’s overall severity and sub-scores for pitch and loudness demonstrated significant correlations with MIP% and MEP% (all <i>p</i> < 0.05). In contrast, acoustic metrics (speaking rate, absolute energy, shimmer, and harmonic-to-noise ratio) significantly correlated with FVC% (all <i>p</i> < 0.05). Conclusions: The results provide supporting evidence for the use of smartphone-based recordings in ALS patients for CAPE-V and acoustic analysis as reliable correlates of bulbar and respiratory function.
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spelling doaj-art-fb4828adaac64237b50adaf265af5d6d2025-08-20T02:08:13ZengMDPI AGBrain Sciences2076-34252024-10-011411108210.3390/brainsci14111082Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory FunctionPedro Santos Rocha0Nuno Bento1Hanna Svärd2Diana Monteiro Lopes3Sandra Hespanhol4Duarte Folgado5André Valério Carreiro6Mamede de Carvalho7Bruno Miranda8Department of Physiology, Institute of Molecular Medicine, Lisbon School of Medicine, Av. Prof. Egas Moniz, 1649-028 Lisbon, PortugalFraunhofer Portugal AICOS, 1649-003 Lisbon, PortugalFaculty of Medicine and Health Sciences, Linkoping University, 581-83 Linkoping, SwedenDepartment of Physiology, Institute of Molecular Medicine, Lisbon School of Medicine, Av. Prof. Egas Moniz, 1649-028 Lisbon, PortugalHospital da Luz—Torres de Lisboa, 1600-209 Lisbon, PortugalFraunhofer Portugal AICOS, 1649-003 Lisbon, PortugalFraunhofer Portugal AICOS, 1649-003 Lisbon, PortugalDepartment of Physiology, Institute of Molecular Medicine, Lisbon School of Medicine, Av. Prof. Egas Moniz, 1649-028 Lisbon, PortugalDepartment of Physiology, Institute of Molecular Medicine, Lisbon School of Medicine, Av. Prof. Egas Moniz, 1649-028 Lisbon, PortugalBackground: Speech production is a possible way to monitor bulbar and respiratory functions in patients with amyotrophic lateral sclerosis (ALS). Moreover, the emergence of smartphone-based data collection offers a promising approach to reduce frequent hospital visits and enhance patient outcomes. Here, we studied the relationship between bulbar and respiratory functions with voice characteristics of ALS patients, alongside a speech therapist’s evaluation, at the convenience of using a simple smartphone. Methods: For voice assessment, we considered a speech therapist’s standardized tool—consensus auditory-perceptual evaluation of voice (CAPE-V); and an acoustic analysis toolbox. The bulbar sub-score of the revised ALS functional rating scale (ALSFRS-R) was used, and pulmonary function measurements included forced vital capacity (FVC%), maximum expiratory pressure (MEP%), and maximum inspiratory pressure (MIP%). Correlation coefficients and both linear and logistic regression models were applied. Results: A total of 27 ALS patients (12 males; 61 years mean age; 28 months median disease duration) were included. Patients with significant bulbar dysfunction revealed greater CAPE-V scores in overall severity, roughness, strain, pitch, and loudness. They also presented slower speaking rates, longer pauses, and higher jitter values in acoustic analysis (all <i>p</i> < 0.05). The CAPE-V’s overall severity and sub-scores for pitch and loudness demonstrated significant correlations with MIP% and MEP% (all <i>p</i> < 0.05). In contrast, acoustic metrics (speaking rate, absolute energy, shimmer, and harmonic-to-noise ratio) significantly correlated with FVC% (all <i>p</i> < 0.05). Conclusions: The results provide supporting evidence for the use of smartphone-based recordings in ALS patients for CAPE-V and acoustic analysis as reliable correlates of bulbar and respiratory function.https://www.mdpi.com/2076-3425/14/11/1082ALSacoustic analysispersonalized medicinedigital health
spellingShingle Pedro Santos Rocha
Nuno Bento
Hanna Svärd
Diana Monteiro Lopes
Sandra Hespanhol
Duarte Folgado
André Valério Carreiro
Mamede de Carvalho
Bruno Miranda
Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function
Brain Sciences
ALS
acoustic analysis
personalized medicine
digital health
title Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function
title_full Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function
title_fullStr Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function
title_full_unstemmed Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function
title_short Voice Assessment in Patients with Amyotrophic Lateral Sclerosis: An Exploratory Study on Associations with Bulbar and Respiratory Function
title_sort voice assessment in patients with amyotrophic lateral sclerosis an exploratory study on associations with bulbar and respiratory function
topic ALS
acoustic analysis
personalized medicine
digital health
url https://www.mdpi.com/2076-3425/14/11/1082
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