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Speech-based characterization of dopamine replacement therapy in people with Parkinson's disease.

ABSTRACT: People with Parkinson's (PWP) disease are under constant tension with respect to their dopamine replacement therapy (DRT) regimen. Waiting too long between doses results in more prominent symptoms, loss of motor function, and greater risk of falling per step. Shortened pill cycles can lead to accelerated habituation and faster development of disabling dyskinesias. The Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is the gold standard for monitoring Parkinson's disease progression but requires a neurologist to administer and therefore is not an ideal instrument to continuously evaluate short-term disease fluctuations. We investigated the feasibility of using speech to detect changes in medication states, based on expectations of subtle changes in voice and content related to dopaminergic levels. We calculated acoustic and prosodic features for three speech tasks (picture description, reverse counting, and diadochokinetic rate) for 25 PWP, each evaluated "ON" and "OFF" DRT. Additionally, we generated semantic features for the picture description task. Classification of ON/OFF medication states using features generated from picture description, reverse counting and diadochokinetic rate tasks resulted in cross-validated accuracy rates of 0.89, 0.84, and 0.60, respectively. The most discriminating task was picture description which provided evidence that participants are more likely to use action words in ON than in OFF state. We also found that speech tempo was modified by DRT. Our results suggest that automatic speech assessment can capture changes associated with the DRT cycle. Given the ease of acquiring speech data, this method shows promise to remotely monitor DRT effects.

SUBMITTER: Norel R

PROVIDER: S-EPMC7293295 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Speech-based characterization of dopamine replacement therapy in people with Parkinson's disease.

Norel R R Agurto C C Heisig S S Rice J J JJ Zhang H H Ostrand R R Wacnik P W PW Ho B K BK Ramos V L VL Cecchi G A GA

NPJ Parkinson's disease 20200612

People with Parkinson's (PWP) disease are under constant tension with respect to their dopamine replacement therapy (DRT) regimen. Waiting too long between doses results in more prominent symptoms, loss of motor function, and greater risk of falling per step. Shortened pill cycles can lead to accelerated habituation and faster development of disabling dyskinesias. The Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is the gold standard for monitoring Parkinson's disease progression but requ ...[more]

PMID: 32566741

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Project description:Introduction Anxiety and depression are among the most common non-motor PD symptoms. People with PD have experienced additional stress and social isolation during the COVID-19 pandemic. Caregivers of people with PD may experience significant caregiver burden. MBCT can prevent the relapse of depression and improve anxiety symptoms. Few studies have explored its benefits for people with PD; none have included caregivers. This study aimed to investigate the feasibility and effectiveness of a mindfulness-based cognitive therapy (MBCT) intervention in reducing anxiety and/or depression in people with Parkinson's disease (PD) and their caregivers. The study was registered on ClinicalTrials.gov (NCT04469049) and it was conducted entirely online. Methods Peoplewith PD or parkinsonism and mild-to-moderate anxiety and/or depressive symptoms and caregivers of people with PD were recruited from neurology clinics, support groups, and online. 3 MBCT groups were conducted in Zoom from November 2020 to June 2021, using a previously adapted MBCT protocol, further modified for online delivery during the pandemic. Caregivers could also enter MBCT groups or complete pre- and post- surveys without joining groups. Data collected included demographic and clinical variables, pre- and post-MBCT behavioral measures (GAD-7, PHQ-9, Five Facet Mindfulness Questionnaire: FFMQ-15), home practice time, and satisfaction surveys. Descriptive statistics were used to summarize participant characteristics, home practice time, and satisfaction survey responses. Pre- and post-MBCT behavioral measure scores were compared using mixed-effect models. Results See attached tables. All 27 participants who entered MBCT groups completed the intervention, except for one man with PD (n = 22 people with PD/parkinsonism, n = 4 caregivers). Attendance and participant satisfaction were high. MBCT completers had significant anxiety (GAD-7) and depression (PHQ-9) score reductions and FFMQ-15 total and Observing and Non-reactivity subscale score increases (all p’s < 0.05). Completers with PD/parkinsonism and anxiety (n = 14) had a significant GAD-7 score reduction; those with PD/parkinsonism and depression (n = 13) had a significant PHQ-9 score reduction (both p’s < 0.05). Completers with PD/parkinsonism also had a significant FFMQ-15 Observing subscale score increase (p < 0.05). The caregiver sample was too small to be analyzed. Conclusions Online MBCT is feasible and may be effective in reducing anxiety and/or depression in people with PD. Results should be replicated in studies with larger samples and control groups. Please note, this study built on the previous pilot trial presented in poster #1101 at the 2021 AAGP Virtual Annual Meeting. This was a different study and it also included caregivers. This research was funded by This study was supported by the Mount Zion Health Fund.

Dataset Information

Speech-based characterization of dopamine replacement therapy in people with Parkinson's disease.

Publications

Speech-based characterization of dopamine replacement therapy in people with Parkinson's disease.

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