Author Of 2 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.
P0582 - High resolution functional mapping of upper and lower limb sensorimotor function in minimally disabled people with multiple sclerosis using 7T MRI (ID 1050)
Abstract
Background
In multiple sclerosis (MS) upper and lower limbs can be affected, but impairments only moderately relate to each other. Previous motor task studies have focussed predominantly on imaging hand function at clinical field strengths, preventing the detection of subtle changes and differentiation of mechanisms underlying subtle motor impairment.
Objectives
To investigate functional brain changes related to upper and/or lower limb motor task performance in minimally disabled MS patients using ultra-high field MRI.
Methods
Twenty-eight MS patients and seventeen healthy controls underwent visually-guided force-matching fMRI tasks using either hand or foot. Task performance (force error and lag) and activation level during upper and lower limb movements were compared between groups. Correlations were assessed between task activation and behavioural performance.
Results
During lower limb force tracking, MS patients showed significantly (p<0.01) longer lag, higher force error, higher primary motor and premotor cortex activation and lower cerebellar Crus I/II activation, compared to controls. No differences were seen in upper limb performance or activation. Upper and lower limb task performance was related to the level of activation in cerebellar, visual and motor areas in MS patients.
Conclusions
Altered lower limb movements and brain activation with preserved upper limb function and activation in minimally disabled patients suggests partially divergent functional mechanisms underlying upper and lower limb disability.