RT Journal Article
SR Electronic
T1 Lexical and Acoustic Speech Features Relating to Alzheimer Disease Pathology
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 10.1212/WNL.0000000000200581
DO 10.1212/WNL.0000000000200581
A1 Cho, Sunghye
A1 Quilico Cousins, Katheryn Alexandra
A1 Shellikeri, Sanjana
A1 Ash, Sharon
A1 Irwin, David John
A1 Liberman, Mark Yoffe
A1 Grossman, Murray
A1 Nevler, Naomi
YR 2022
UL http://n.neurology.org/content/early/2022/04/29/WNL.0000000000200581.abstract
AB Background and Objectives: We compared digital speech and language features of patients with amnestic Alzheimer’s disease (aAD) or logopenic variant primary progressive aphasia (lvPPA) in a biologically confirmed cohort and related these features to neuropsychiatric test scores and CSF analytes.Methods: We included patients with aAD or lvPPA with cerebrospinal fluid (CSF) (phosphorylated Tau (p-Tau)/Aβ≥ 0.09 and total Tau/Aβ≥ 0.34) or autopsy confirmation of AD pathology and age-matched healthy controls (HC) recruited at the Frontotemporal Degeneration Center of the University of Pennsylvania for a cross-sectional study. We extracted speech and language variables with automated lexical and acoustic pipelines from participants’ oral picture descriptions. We compared the groups and correlated distinct features with clinical ratings and CSF p-Tau levels.Results: We examined patients with aAD (n=44; 62±8 years; 24 females; Mini-Mental State Exam (MMSE)=21.1±4.8) or lvPPA (n=21; 64.1±8.2 years; 11 females; MMSE=23.0±4.2), and healthy controls (HC) (n=28; 65.9±5.9 years, 15 females; MMSE=29±1). Patients with lvPPA produced fewer verbs (10.5±2.3; p=0.001), adjectives (2.7±1.3, p=0.019), and more fillers (7.4±3.9; p=0.022) with lower lexical diversity (0.84±0.1; p=0.05) and higher pause rate (54.2±19.2; p=0.015) than aAD (verbs: 12.5±2; adjectives: 3.8±2; fillers: 4.9±4.5; lexical diversity: 0.87±0.1; pause rate: 45.3±12.8). Both groups showed some shared language impairments compared with HC. Word frequency (MMSE: β=-1.6, p=0.009, BNT: β=-4.36, p<0.001), adverbs (MMSE: β=-1.9, p=0.003, BNT: β=-2.41, p=0.041), pause rate (MMSE: β=-1.21, p=0.041, BNT: β=-2.09, p=0.041), and word length (MMSE: β=1.75, p=0.001, BNT: β=2.94, p=0.003) were significantly correlated with both MMSE and BNT, but other measures were not correlated with MMSE and/or BNT. Prepositions (r=-0.36, p=0.019), nouns (r=-0.31, p=0.047), speech segment duration (r=-0.33, p=0.032), word frequency (r=0.33, p=0.036), and pause rate (r=0.34, p=0.026) were correlated with patients’ CSF p-Tau levels.Discussion: Our measures captured language and speech differences between the two phenotypes that traditional language-based clinical assessments failed to identify. This work demonstrates the potential of natural speech in reflecting underlying variants with AD pathology.