Author Of 3 Presentations
P0121 - Objective measurement of speech correlates with disease status and quality of life in people with MS without dysarthria (ID 1681)
Abstract
Background
Objective measurement of speech has shown promising results to monitor disease state in Multiple Sclerosis (MS). Yet, it is not clear if changes in speech can be detected before overt dysarthria.
Objectives
In this study, we characterize the relationship between disease severity and objective speech metrics exclusively in people with no perceivable dysarthria.
Methods
An acoustic composite score was calculated using regression modelling of speech data from 119 people with MS (pwMS, 75% female), irrespective of dysarthria presence. That score was then tested in pwMS without dysarthria, as determined by blinded perceptual rating, for correlations with the Expanded Disability Status Scale (EDSS), brain volume and lesion load from magnetic resonance imaging, and quality of life scores from the Multiple Sclerosis Impact Scale (MSIS-29) .
Results
PwMS without dysarthria (n=77) were more likely to be female (82% vs 62%, p=0.017), were on average 5.7 years younger (age mean ± standard deviation 53.5±11.4, p=0.009), had MS for 2.5 years shorter (11±8.5 years, p=0.034) and scored EDSS 1.7 step lower (2.7±1.9, p<0.001) than pwMS with dysarthria (n=42). The acoustic composite score correlated with EDSS scores (r=0.45, p<0.001) and quality of life (r=0.4, p=0.01) in pwMS without perceivable dysarthria, but not with brain volume or lesion load.
Conclusions
Acoustic analysis offers a valuable insight into the subclinical development of speech impairment in MS. These results highlight the potential of automated analysis of speech to assist in monitoring disease progression and treatment response.
P0572 - Evaluation of cerebellar function scores in relation to cerebellar axonal loss in multiple sclerosis. (ID 933)
Abstract
Background
Damage to the cerebellum is common in people with multiple sclerosis (pwMS) and associated with a worse prognosis and, cerebellar relapses are associated with poorer recovery and earlier onset of progressive disease. Studies examining the importance of the cerebellum are hampered by incomplete characterisation of cerebellar damage and its relation to cerebellar function.
Objectives
We aim to examine axonal loss in the cerebellum using diffusion imaging and compare the degree of cerebellar axonal loss with cerebellar dysfunction in pwMS.
Methods
We prospectively recruited 55 pwMS and 14 healthy controls (HC). Clinical assessments included scale for the assessment and rating of ataxia (SARA) and Bain tremor ratings. Subjects underwent 3-tesla volumetric, lesion and diffusion magnetic resonance imaging. Cerebellar axonal loss was examined with fibre-specific markers. Fibre density and cross-section (FDC) accounts for microscopic and macroscopic changes in a fibre bundle.
Results
Significant loss of cerebellar FDC was found in pwMS compared to HC (p=0.03). Lower FDC was associated with increased SARA (r=-0.42, p<0.01) and tremor severity (rho=-0.35, p=0.01). Cerebellar lesion volume correlated with SARA (r=0.49, p<0.01) and tremor severity (rho=0.41, p=0.01). Cerebellar volume showed no correlation with cerebellar clinical assessments.
Conclusions
Fibre-specific measures of cerebellar pathology could provide a functionally relevant marker of cerebellar damage in pwMS. Future trials using fibre-specific markers are needed to further characterise cerebellar pathology and understand its significance in disease progression.
P0803 - Discriminating Spatialised Speech in Complex Environments in Multiple Sclerosis (ID 1538)
Abstract
Background
Multiple Sclerosis (MS) is a multi-component disease where inflammatory and neurodegenerative processes disrupt wide-ranging cerebral systems, including auditory networks. Although cochlear hearing loss is uncommon, people with MS (pwMS) frequently report deficits in binaural hearing, which involves integration of sound inputs to both ears, for using acoustic spatial localization and disambiguating important signals from competing sounds. Spatial processing deficits have been described in pwMS using localization tasks of simple tones presented in silence but have yet to be evaluated in realistic listening situations, such as speech emanating from various spatial locations within a noisy environment.
Objectives
To investigate how pwMS discriminate speech appearing to emanate from different spatial positions, in background competing conversation.
Methods
Pre-recorded everyday sentences from a standard list (Bamford-Kowal-Bench sentences) were presented via headphones with virtual acoustic techniques used to simulate as if they originated from 0⁰, 20⁰ and 50⁰ on the azimuth plane around the listener. Simultaneous eight talker babble was presented as if emanating from 0⁰. Controls (n=20) and age-matched pwMS with mild (Expanded Disability Status Scale (EDSS) score < 2; n = 23), moderate (EDSS 2.5 – 4.5; n = 16) and advanced disability (EDSS 5 – 7; n = 8) were required to repeat the target sentence. Mild pwMS also completed the Paced Serial Addition Test (PASAT) and a basic three alternative forced-choice spatial task of detecting interaural time differences (a binaural spatial cue) in noise bursts. All participants passed a standard hearing evaluation.
Results
Sentence intelligibility increased for all listeners when speech was spatially separated from noise at 20⁰ and 50⁰ azimuth compared to when stimuli was colocalized at 0⁰ with the noise. A mixed-effects model confirmed that a one-unit increase in spatial separation increased the odds of discriminating the correct sentence for controls by 5%, but only 3% for moderate and advanced pwMS. Spatial processing in mild pwMS was comparable to controls in both the complex babble environment and the basic three-alternative noise burst task. PASAT scores moderately correlated with discrimination scores in colocalized conditions (0⁰) (r = 0.5, p < 0.01) and strongly in the largest separated condition (50⁰) (r = 0.7, p < 0.0001).
Conclusions
Knowing the spatial location of a sound is particularly critical in a complex noisy environment, as spatial cues help to group ambiguous sound elements into coherent streams. Although pwMS were able to use spatial cues, those with moderate and advanced disability did not receive the same spatial release from noise as controls. As spatial perception has largely been studied only in the visual domain, this is the first study to investigate how pwMS navigate their acoustic surroundings and communicate in noisy social environments.