This thesis is about design and implementation of application for computing speech parameters on people with Parkinson disease. At the beginning is generaly described Parkinson disease and Hypokinetic dysarthria and how it affects the speech and speech parameters when it occurs. Mainly there are described areas of speech like phonation, prosody, articulation and fluent speech. As a part of next topic this thesis describes specific speech parameters with bigger meaning during diagnosis Parkinson disease and it's progress over the time. There are also mentioned few significant studies dealing with examination of speech of the subjects with diagnoses of Parkinson disease and computing some speech parameters in order to analyze their speech impairments. Part of the thesis is description of implemented standalone application for calculating, exporting and visualizing of speech parameters from selected sound records.

One of the key features of the hypokinetic dysarthria associated with Parkinson disease is dysprosody. While there has been ample research into the global characterization of speech in Parkinson disease, little is known about how people with Parkinson disease mark lexical stress. This study aimed to determine how people with Parkinson disease modulate pitch, intensity, duration, and vowel space to differentiate between two common lexical stress patterns in English: trochees (strong-weak pattern) and iambs (weak-strong pattern), in two syllable words. Twelve participants with mild to moderate idiopathic Parkinson disease and twelve age- and sex-matched controls completed a series of speech tasks designed to elicit token words of interest in prosodically-relevant speech tasks (picture identification (in isolation and lists) and giving directions (spontaneous speech). Results revealed that people with Parkinson disease produced a higher overall pitch and a smaller vowel space as compared to controls, though most lexical marking features were not significantly different. Importantly, the elicitation task had a significant effect on most dependent measures. Although lexical stress is not significantly impacted by Parkinson disease, we recommend that future research and clinical practice focus more on the use of spontaneous speech tasks rather than isolated words or lists of words due to the differences in the marking of lexical stress in the latter tasks, making them less useful as ecologically-valid assessments of prosody in everyday communication.

Die Progressive Supranukleäre Blickparese (PSP) ist eine sporadisch auftretende neurodegenerative Erkrankung im Rahmen der atypischen Parkinson-Syndrome (APS), die im frühen Verlauf häufig mit dem Idiopathischen Parkinson-Syndrom (IPS) verwechselt wird. Dabei ist die Dysarthrie als eine erworbene, zentral bedingte sprechmotorische Störung ein häufiges und früh auftretendes Symptom bei PSP. Bislang spricht man von einer eher unspezifischen „gemischten“ Dysarthrie aus hypokinetischen, spastischen und auch ataktischen Komponenten. Im Rahmen einer explorativen Querschnittsstudie am „Fachkrankenhaus für Bewegungsstörungen und Parkinson“ Beelitz-Heilstätten in Kooperation mit der „Entwicklungsgruppe Klinische Neuropsychologie“ München (EKN) sowie der „Interdisziplinären Ambulanz für Bewegungsstörungen“ am Klinikum München-Großhadern wurden 50 Patienten dahingehend untersucht, ob sich für die Progressive Supranukleäre Blickparese (PSP) eine spezielle, frühzeitig zu diagnostizierende und differentialdiagnostisch relevante Dysarthrie beschreiben ließe. In diesem Zusammenhang soll geklärt werden, ob es sich um phänotypische Ausprägungen im Rahmen eines Störungsspektrums handelt oder ob sich differenzierbare Subtypen der Krankheit, insbesondere ein „klassischer“ PSP-Typ (PSP-RS) und ein „atypischer“ PSP-Typ (PSP-P), auch im Bereich der Dysarthrie zeigen. Im Rahmen der Untersuchungen wurde der Schweregrad der Erkrankung mittels der „PSP-sensitiven Ratingskala (PSPRS)“ gemessen. Die Dysarthriediagnostik erfolgte anhand der „Bogenhausener Dysarthrieskalen (BoDyS)“ zur Beschreibung der Art und Ausprägung der Dysarthrie bei PSP. Die Verständlichkeit wurde mithilfe des „Münchner Verständlichkeits-Profils (MVP)" sowie eines weiteren Transkriptionsverfahrens ermittelt, wobei Ausschnitte aus den Tests zum Lesen und Nachsprechen der BoDyS zugrunde lagen. Weiterhin erfolgte eine Einschätzung der Natürlichkeit des Sprechens. Die Ergebnisse hinsichtlich des Einflusses von Natürlichkeit und Verständlichkeit des Sprechens auf den Schweregrad der Dysarthrie zeigten, dass dieser modalitätenübergreifend mit beiden Schweregradaspekten korreliert, wenngleich es offenbar die Natürlichkeit des Sprechens ist, die bei PSP bereits frühzeitig beeinträchtigt ist und somit als das entscheidende differentialdiagnostische Kriterium zur Differenzierung zwischen beiden PSP-Subtypen zu beurteilen ist, möglicherweise auch gegenüber anderen Parkinson-Syndromen. Anhand statistisch valider Ergebnisse konnten spezifische Störungsmerkmale der Dysarthrie extrahiert werden, die eine signifikante Trennung von PSP-RS und PSP-P ermöglichen: eine leise und behaucht-heisere Stimme sowie ein verlangsamtes Sprechtempo und Hypernasalität. Damit können für die hier fokussierten Subtypen der PSP zwei unterschiedliche Dysarthrietypen postuliert werden. Danach wird dem Subtyp PSP-RS eine spastisch betonte Dysarthrie mit ausgeprägter Verlangsamung des Sprechtempos zugeordnet, dem Subtyp PSP-P hingegen eine hypokinetische Dysarthrie mit behaucht-heiserer Hypophonie. Desweiteren konnte ein „Dysarthrie-Schwellenwert“ als Zusatzkriterium für eine zeitliche Differenzierung beider PSP-Subtypen ermittelt werden. Anhand der Daten zeigte sich die Dysarthrie bei dem Subtyp PSP-RS gleich zu Beginn der Erkrankung, jedoch spätestens 24 Monate danach. Hingegen konnte die Dysarthrie beim Subtyp PSP-P frühestens 24 Monate nach Erkrankungsbeginn festgestellt werden. Die Daten dieser Studie verdeutlichen, dass der Frage nach einer subtypenspezifischen Ausprägung der Dysarthrie bei PSP eine Längsschnittsstudie folgen sollte, um die ermittelten Ergebnisse zu konsolidieren. / Progressive Supranuclear Palsy (PSP) is an atypical Parkinsonian syndrome characterized by gait ataxia, slowing or inability to generate vertical saccadic eye movements, axial rigidity, cognitive disorders and a progressive dysarthria. The dysarthria may include abnormalities in strength, speed, range, tone or accuracy of speech movements. As the disease progresses, important functional components of speech including respiration, phonation, resonance, articulation and prosody are affected. The question is what kind of dysarthria do we find in PSP? Until now it remains unclear, if the dysarthric characteristics of PSP vary in way as described by Williams et al. (2005) who found clinically distinct symptom patterns of a Parkinsonian form of PSP (PSP-P) distinct from a classical form (Richardson Syndrome). The aim of the cross-sectional multi center study was to investigate the specific dysarthric symptoms in patients with PSP. Until now it remains unclear, whether there are two different points on a continuous spectrum of speech disturbances or if there exist distinct „profiles“ of dysarthria according to the proposed Richardson Syndrome (PSP-RS) with early onset of postural instability and falls, vertical gaze palsy and cognitive dysfunctions and the PSP with Parkinsonism (PSP-P) with asymmetric onset, tremor, early bradykinesia, non-axial dystonia and response to levodopa medications in the beginning. „Bogenhausener Dysarthrieskalen“ (BoDys) was used as base-line dysarthria scale: pitch pattern, loudness range, voice quality, respiration and resonance capacities, prosody and articulation were rated. Furthermore, the intelligibility is a most important index of functional impairment in dysarthria. Therefore, the „Munich Intelligibility Profile (MVP)“, a computer-based method for the assessment of the intelligibility of dysarthric patients, was used to describe the intelligibility of the patients. The PSP-P-group, at the beginning frequently confused with patients with PD, showed rigide-hypokinetic dysarthric features with hypophonia as cardinal symptom. In contrast the patients with the “classical” PSP-RS-Type show severe speech impairments in terms of a very effortful speak with a progressive loss of intelligibility. They show spastic components of dysarthria, like a very strained-strangled voice with breaks and voice stoppages, harshness and reduced pitch and loudness variability. Their loudness often is inadequate in terms of the so called “lions voice”. Further they show a hypernasality, the articulation is imprecise, the vowels are distorted. Concerning the prosody there is a very slow and strained rate of speech with equal or excess stress. The results show that the patients with PSP-RS generally suffer from severe and more progressive speech impairments beginning early after disease onset, whereas the PSP-P-group shows rather moderate symptoms. The dysarthria in PSP is subtype-specific. The hypothesis of different dysarthric profiles for the proposed clinical subtypes "Richardson Syndrome" (PSP-RS) and "PSP with parkinsonism" (PSP-P) was confirmed and based on a discriminant analysis that identified distinctive dysarthric features for both subgroups.

The onset of a progressive, fatal illness such as Motor Neuron Disease (MND) inevitably results in physical and communication disabilities that impinge on the individuals’ ability to remain functionally independent. The loss of speech as a result of dysarthria, a motor speech disorder, is one of the most profound changes that the person with MND will experience. The decline in the individuals’ speech intelligibility, that negatively influences communication effectiveness, implies that in 80% of cases alternative and augmentative communication (AAC) strategies are required to support the daily communication needs of individuals with MND. The dyadic nature of chronic illness implies that multiple aspects of one of the most important adult relationships, marriage, will be affected. Roles and responsibilities performed by each member of the couple will continually change as the disease progresses. The emotional trauma of adjusting to the unavoidable alteration in their relationship elicits strong emotions such as guilt, anger and frustration. Communication is one of the most constructive ways of dealing with these emotions. The ability of spouses to convey their innermost thoughts, feelings and intimacy through communicative interaction is vitally important in marital communication. The aim of this study was to compare how persons with MND and their spouses perceive changes in their marital communication in relation to the deteriorating speech of persons with MND. Fourteen couples divided into two participant groups, persons with MND and spouses, participated in this non-experimental correlational research study. Data was collected during three visits at six-monthly intervals over a 12 month period. At each of these visits both participant groups completed a variety of objective and subjective measures, of which twenty percent were interrated by independent raters. Results confirmed the inevitable decline in speech intelligibility of persons with MND across the disease progression. The persons with MND did not report a change in their perception of marital communication although their spouses indicated a statistically significant decrease between the first and last visits. Interestingly, there was no statistically significant relationship between the deteriorating speech of persons with MND and the couples’ perception of marital communication, confirming that marital communication was not influenced by decreased speech intelligibility. / Thesis (PhD)--University of Pretoria, 2010. / Centre for Augmentative and Alternative Communication (CAAC) / unrestricted

L’intelligibilité de la parole est un véritable enjeu dans la prise en charge des personnes présentant un trouble de la production de la parole pathologique (TPPP). L’usage de ce terme, avec un sens commun recouvrant le domaine de la compréhension, et un sens restreint répondant à la mesure du transfert d’information linguistique dans un contexte de test, entretient une ambigüité ; ambigüité qui entrave le développement des concepts de prise en charge. L’objectif de ce travail de thèse est, à travers trois groupes d’expériences autour de la notion d’intelligibilité, de proposer un cadre conceptuel pouvant servir à organiser la prise en charge des TPPP et à identifier les questions de recherche fondamentale impliquées dans la problématique de l’intelligibilité dans les TPPP.L’objectif principal du premier groupe d’expériences est d’étudier la place de l’intelligibilité dans les stratégies cognitives sous-jacentes à la perception de la parole pathologique. La méthode utilisée est une catégorisation libre..La deuxième série d’expériences est consacrée à la manière dont un groupe d’experts réalise une tâche de jugement de sévérité comparée à une tâche de jugement d’intelligibilité. Le troisième groupe d’expériences cherche à déterminer les cibles les plus efficaces dans la prise en charge des TPPP. Elle repose sur l’hypothèse suivante : la conservation d’une perception juste d’un phonème ou d’une syllabe malgré sa distorsion pathologique permet de déterminer sa contribution à l’intelligibilité et participe à la définition de la notion de robustesse perceptive. Pour tester cette hypothèse, une méthode d’analyse du taux de perception obtenu par un jury d’auditeurs, en fonction du degré de vraisemblance issu d’un système automatique de reconnaissance a été formalisée. Les résultats de ces expériences, interprétées sous l’éclairage croisé des théories sur la perception et de la production de la parole et des modèles de santé, nous ont permis de proposer une définition des différents concepts dans la perspective de la classification internationale du fonctionnement. / The intelligibility of speech is a real challenge for the management of speech disorders. The use of this word, with a common meaning of comprehension and, a specific meaning in a context of test, of measurement of the information transfer, carries some ambiguity, which could hinder the concept of management.The purpose of this work is to propose a conceptual framework for the management of pathological speech production (PSP) through three kinds of experiments. The aim of the first set of experiments is to study the place of the intelligibility within the underlying cognitive strategies of the perception of pathological speech.A free classification method is used with a corpus of sentences read by 33 speakers: 20 patients with speech disorders (a pathological speech production due to neurological diseases or sequellae of cancer or malformative lesions) and 13 normal subjects. The second set of experiments studies the way an expert group performs evaluation of severity compared to evaluation of intelligibility. During an off line experiment, the corpus of the previous study filled by a corpus of different sentences by speaker, was presented to 5 judges (logopedists and phoniatriciansThe third group of experiments looks for the most efficient targets for managing speech disorders. It‘s based on the following assumption: the preservation of a correct perception of a phoneme or a syllable, despite its pathological distortion, allows to determine its contribution to intelligibility and participates to the notion of perceptive robustness. For testing this assumption, was proposed a method of analysis by the identification score (obtained by a jury of listeners) function of the degree of” plausibility (obtained by an automatic system for speech recognition). The outcome of these experiments, adopting the points of view of some perception theories of SD mixed with health models allow us to precise the definition of the main concepts in the prospect of the international classification of functioning.

This diploma thesis focuses on the automated diagnosis of hypokinetic dysarthria in the multilingual speech corpus, which is a motor speech disorder that occurs in patients with neurodegenerative diseases such as Parkinson’s disease. The automatic speech recognition approach to diagnosis is based on the acoustic analysis of speech and subsequent use of mathematical models. The popularity of this method is on the rise due to its objectivity and the possibility of working simultaneously on different languages. The aim of this work is to find out which acoustic parameters have high discriminative power and are universal for multiple languages. To achieve this, a statistical analysis of parameterized speech tasks and subsequent modelling by machine learning methods was used. The analyses were performed for Czech, American English, Hungarian and all languages together. It was found that only some parameters enable the diagnosis of the hypokinetic disorder and are, at the same time, universal for multiple languages. The relF2SD parameter shows the best results, followed by the NST parameter. When classifying speakers of all the languages together, the model achieves accuracy of 59 % and sensitivity of 72 %.

This master´s thesis deals with the calculation of parameters that would be able to differentiate healthy speech and speech impaired by hypokinetic dysarthria. There was staged hypokinetic dysarthria, which is a motoric disorder of speech and vocal tract. Were studied speech signal processing methods. Further parameters were studied, which could well differentiate healthy and diseased speech. Subsequently, these parameters were programmed in Python programming language. The next step was to create a web application in Django framework, which is used for the analysis of the dyzartic speech.

The diploma thesis is focused on the issue of acquired dysarthric and swallowing disorders in amyotrophic lateral sclerosis and on multidisciplinary care provided to patients with this disease. Theoretical part of the thesis is divided into three chapters. The introductory chapter presents a summary of current knowledge about amyotrophic lateral sclerosis (ALS). The following two chapters are dedicated to dysarthria and dysphagia and their specifics in ALS. The practical part of the diploma thesis is represented by the fourth chapter which incorporates a research survey focused on multidisciplinary care provided to patients with ALS. The primary aim of the research is to evaluate the multidisciplinary care provided to two selected patients with ALS with a focus on speech and swallowing disorders. The secondary objectives of the research relate to the evaluation of the extent of acquired dysarthric and swallowing disorders of these patients, providing a comprehensive overview of the course and content of the provided care and gathering information to create information brochure for patients with ALS and caregivers. The research approach to achieve the determined objectives of the research survey is creation of case studies using qualitative methods of data collection, which is a structured interview...

The speech of individuals with Parkinson's disease (PD) is typically characterized as lacking in proper prosody because of its monopitch and monoloud quality, in addition to its reduced intensity. These qualities make it difficult for others to understand speakers with PD. The purpose of the current study was to identify what individuals with PD would do vocally, if anything at all, to improve speech production following a simulated misunderstanding of what they had just said. The study evaluated the performance of 5 individuals with PD and compared their performance to 5 age- and sex-matched controls. Specifically, measures of vocal intensity (loudness), fundamental frequency (pitch), and utterance duration were made for repetitions of a ‘misheard’ phrase. In one experimental condition noise was presented through headphones to induce the Lombard effect. Both individuals with PD and controls used increased duration as a means of enhancing clarity in a repetition. Fundamental frequency (F0) and sound pressure level (SPL) were not consistently modified in repetitions for clarification. Under most speaking conditions, individuals with PD and controls had similar F0 and SPL. Individuals with PD, like the controls, responded to the presentation of masking noise by increasing their fundamental frequency and their intensity. Therefore, not all individuals with PD exhibit difficulty using prosody.

Les ataxies héréditaires sont des désordres neuro-dégénératifs qui causent une ataxie comme symptôme primaire; soit une perte de coordination des mouvements volontaires, un sens de l’équilibre déficient et un trouble à la motricité. Elles forment un groupe cliniquement et génétiquement hétérogène. De ce fait, de nombreuses classifications existent basées sur différents critères. Cependant, le consensus actuel veut que le mode de transmission soit le critère premier de classement. On estime la prévalence mondiale des ataxies héréditaires à 6/100 000 bien que ce nombre diffère entre régions. C’est le cas du Québec où la structuration historique du bassin génétique canadien-français a menée à des effets fondateurs régionaux, ce qui a eu comme conséquence de hausser la prévalence régionale de certaines maladies. L’Acadie est également une région canadienne-française avec des effets fondateurs où le taux de prévalence de certaines ataxies héréditaires est plus élevé. Nous avons recruté huit familles canadiennes-françaises provenant de diverses régions du Québec, ayant un lien génétique plus ou moins rapproché avec l’Acadie, dans lesquelles nous avons observé dix cas d’une forme d’ataxie spastique autosomique récessive relativement légère qui a résistée à l’analyse des gènes d’ataxies connues. Nous avons émis l’hypothèse d’être en présence d’une nouvelle forme d’ataxie à effet fondateur pour la population canadienne-française. Afin d’identifier le gène muté responsable de cette ataxie, un criblage génomique des marqueurs SNP pour les individus recrutés fut effectué. Puis, par cartographie de l’homozygotie, une région de 2,5 Mb fut identifiée sur le chromosome 17p13 dans une famille. Une revue de la littérature nous a permis de constater, qu’en 2007, quatre familles nord-africaines atteintes d’une ataxie dénommée SPAX2 qui présentaient des manifestations cliniques semblables avaient déjà été liées au même locus sur le chromosome 17. Afin de supporter notre hypothèse que les malades étaient porteurs de deux copies de la même mutation fondatrice et de cartographier plus finement notre région d’intérêt, les haplotypes de tous les atteints de nos huit familles furent étudiés. Nous avons établie qu’un intervalle de 200 kb (70 SNP), soit du marqueur rs9900036 à rs7222052, était partagé par tous nos participants. Les deux gènes les plus prometteurs des 18 se trouvant dans la région furent séquencés. Aucune mutation ne fut trouvée dans les gènes SLC25A11 et KIF1C. Par la suite, une analyse de liaison génétique stricte avec calcul de LOD score nous a permis d’exclure ce locus de 200 kb comme étant celui porteur du gène muté causant l’ataxie dans la majorité de nos familles. Nous avons donc conclus que malgré qu’une famille soit homozygote pour une grande région du chromosome 17, l’absence d’Informativité des marqueurs SNP dans la région de 200 kb fut responsable de l’apparent partage d’haplotype homozygote. Le travail reste donc entier afin d’identifier les mutations géniques responsables de la présentation ataxique chez nos participants de souche acadienne. / Hereditary ataxias are neurodegenerative disorders which share ataxia as common feature is manifested by a decrease in limb coordination, imbalance and an unsteady gait. They consist in a clinically and genetically heterogeneous group. Many ataxia classifications have been proposed, however, the current consensus is to first characterize them according to their mode of transmission. Hereditary ataxias as a whole have a prevalence of 6/100 000, with variable estimation between country and region. In the Province of Quebec where the French Canadian genetic pool can be seen has a mosaic of regional gene pools there is clear differences in local variation in the prevalence of different ataxias. Acadia is also a French Canadian region with a history of many founder effects and a higher prevalence for certain hereditary ataxias. We recruit 8 French Canadian families from Quebec and with genealogical links with Acadia in which 10 cases manifest a presumably relatively mild autosomal recessive spastic ataxia of unknown etiology. The shared phenotype and Acadian background raised the possibility that they suffered from a new form of ataxia with a founder effect. To identify the mutated gene causing this ataxia, the individuals recruited were genotyped. By homozygosity mapping, a region of 2,5 Mb was identified in one family on chromosome 17p13. A literature review established that in 2007 four North Africans families segregating also a mild spastic ataxia were linked to the same locus on chromosome 17. To support our hypothesis that our patients were carrier of the same founder mutation we look closer at their haplotype in the region. We defined an interval of 200kb (70 SNP) between markers rs9900036 and rs7222052 shared by all affected cases. The two most promising gene in the interval were sequenced. No mutation was found in SLC25A11 and KIF1C. Thereafter a linkage analysis by LOD score excluded the candidate interval of 200 kb in the majority of our families. We conclude that even if in one family exists a large homozygous region on chromosome 17, the lack of informative SNP in the 200 kb region was responsible for the apparent sharing rather than they shared a common mutation. Further work will be necessary to identify the mutate gene causing the ataxia presentation in these cases of mild spastic ataxia.