SPEECH as Biomarker for Emotion, Movement and cOgnition in Parkinson's Disease

Study Overview
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Brief Summary
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With this study, the investigators want to investigate whether computerized speech analysis can be used to reliably and objectively detect motor, emotional, and cognitive fluctuations in Parkinson's disease patients.

Detailed Description
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Parkinson's disease (PD) affects mobility (motor function), thought processes (cognition) and mood (emotion). The language is one of the most complex programs in humans. It contains information about mobility, thinking and mood at the same time. These three levels of agility, thinking and mood are subject to spontaneous fluctuations and can be influenced by external stimuli such as pictures that induce emotions. In addition, these three levels are influenced on the one hand by Parkinson's disease itself, and on the other hand by its treatment with medication or with deep brain stimulation (DBS). For this reason, the investigators would like to investigate language in Parkinson's disease patients in a very detailed computerized way for motor, cognitive and emotional elements for better management of therapies. With this study, the investigators want to investigate whether computerized speech analysis can be used to reliably and objectively detect fluctuations in motor, mood, and thinking in Parkinson's disease patients. Even in healthy subjects, speech changes in a situational manner, due to which the investigators will also include healthy subjects as a control group.

Official Title
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SPEECH as Biomarker for Emotion, Movement and cOgnition in Parkinson's Disease

Conditions
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Parkinson Disease

Intervention / Treatment
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* Other: Dopaminergic OFF drug state
* Other: DBS OFF state
* Other: Dopaminergic ON drug state
* Other: DBS ON state


Participation Criteria
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Eligibility Criteria
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Patients with Parkinson's Disease Inclusion Criteria: Written informed consent Idiopathic PD according to the Movement Disorders Society Criteria; Age of participants > 30 and ≤ 75 years; Treatment with or without bilateral deep brain stimulation in the subthalamic nucleus; Fluent in German or French Exclusion Criteria: Dysarthria caused in addition by a condition other than PD (e.g. stroke, myasthenia); Clinical diagnosis of aphasia; Brain disease other than Parkinson's disease (e.g. atypical Parkinsonism, Alzheimer's disease, vascular dementia, multiple sclerosis, stroke, traumatic brain injury, epilepsy, etc.). Cognitive impairment (Montreal Cognitive Assessment (MoCa) < 24/30 points); Depression with acute suicidal ideation Healthy Controls Inclusion Criteria: Written informed consent Adults from 50-70 years old; Fluent in German or French Exclusion Criteria: Diagnosis of Parkinson's disease; Cognitive impairment (Montreal Cognitive Assessment (MoCa) < 24/30 points); Suffering from brain disease (e.g. atypical Parkinsonism, Alzheimer's disease, vascular dementia, multiple sclerosis, stroke, traumatic brain injury, epilepsy, etc.); Clinical diagnosis of aphasia, dysarthria, and stuttering; Suffering from or diagnosed with psychiatric illnesses according to DSM-V criteria

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Parkinson's disease patients with DBS<br>All Parkinson's disease patients with bilateral deep brain stimulation (DBS) in the subthalamic nucleus | Other: Dopaminergic OFF drug state<br>* Experiment will be performed without dopaminergic medication<br>Other: DBS OFF state<br>* Turning off the stimulation during experiment<br>Other: Dopaminergic ON drug state<br>* Experiment will be performed with dopaminergic medication<br>Other: DBS ON state<br>* Experiment will be performed with stimulation (ON condition)<br>|
| Experimental: Parkinson's disease patients without DBS<br>All Parkinson's disease patients without bilateral deep brain stimulation (DBS) in the subthalamic nucleus | Other: Dopaminergic OFF drug state<br>* Experiment will be performed without dopaminergic medication<br>Other: Dopaminergic ON drug state<br>* Experiment will be performed with dopaminergic medication<br>|
| No Intervention: Healthy Controls<br>All healthy volunteers | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Part I: Changes from baseline in best acoustic speech variables to detect changes of dopaminergic and stimulation motor effect in Parkinson's disease patients | A speech analyser software will allow extraction of basic motor acoustic speech features. The extracted variables that better index the dopaminergic medication or stimulation motor effect assessed with Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III - motor score [0-132 pts.] will be used as primary outcomes in this part. Higher scores in MDS-UPDRS part III means more severe motor symptoms. | Visit 2 (< 3 months) | 
| Part II: Changes from baseline in best acoustic and linguistic speech variables to detect changes of dopaminergic and stimulation neuropsychological effect in Parkinson's disease patients | A speech analyser software will allow extraction of basic acoustic speech features. For the linguistic domain several natural language variables will be extracted covering domains such as linguistic sense, coherence, and emotionality. The extracted variables that better index the dopaminergic medication or stimulation emotional effect assessed with Neuropsychiatric fluctuations scale (NFS) [0-60 pts.] will be used as primary outcomes in this part. Higher scores in NFS means more severe neuropsychiatric fluctuations. | Visit 2 (< 3 months) | 
| Part III: Changes from baseline in best acoustic and linguistic speech variables to detect changes of dopaminergic and stimulation cognitive effect in Parkinson's disease patients | A speech analyser software will allow extraction of basic acoustic speech features. For the linguistic domain several natural language variables will be extracted covering domains such as linguistic sense, coherence, and emotionality. The extracted variables that better index the dopaminergic medication or stimulation cognitive effect assessed with verbal fluency task will be used as primary outcomes in this part. Higher scores in Fluency task means better outcome. | Visit 2 (< 3 months) | 
| Part III: Changes from baseline in best acoustic and linguistic speech variables to detect changes of dopaminergic and stimulation cognitive effect in Parkinson's disease patients | A speech analyser software will allow extraction of basic acoustic speech features. For the linguistic domain several natural language variables will be extracted covering domains such as linguistic sense, coherence, and emotionality. The extracted variables that better index the dopaminergic medication or stimulation cognitive effect assessed with Stroop test will be used as primary outcomes in this part. Higher scores in Stroop test means worse outcome. | Visit 2 (< 3 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dyskinesia severity | Score on Marconi dyskinesia rating scale [0-28 pts.]. Higher scores in Marconi dyskinesia rating scale means more severe dyskinesia. | At visit 1 (baseline) and visit 2 (< 3 months) | 
| Momentary mood state | Score on Visual Analogue Mood Scale (VAMS) [0-100 pts.]. Higher scores in VAMS means better mood. | At visit 1 (baseline) and visit 2 (< 3 months) | 
| Momentary anxiety state | Score on Visual Analogue Anxiety Scale (VAAS) [0-100 pts.]. Higher scores in VAAS means more anxiety. | At visit 1 (baseline) and visit 2 (< 3 months) | 
| Bradyphrenia assessment | Score on Bradyphrenia scale [0-72 pts.]. Higher scores in Bradyphrenia scale means more severe bradyphrenia. | At visit 1 (baseline) and visit 2 (< 3 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Speech, Emotion, Movement, Cognition, Biomarker, Automated speech analysis