title: Objective acoustic quantification of phonatory dysfunction in Huntington's disease.
abstract: OBJECTIVE
  Although speech motor changes are reported as a common sign of Huntington's disease (HD), the most prominent signs of voice dysfunction remain unknown. The aim of the current study was to explore specific changes in phonatory function in subjects with HD.
  
  
  METHODS
  34 subjects with HD and 34 age- and sex-matched healthy controls were examined. Participants performed sustained vowel phonation for subsequent analyses of airflow insufficiency, aperiodicity, irregular vibrations of vocal folds, signal perturbations, increased noise, and articulation deficiency. In total, 272 phonations were collected and 12 voice parameters were extracted. Subsequently, a predictive model was built to find the most salient patterns of voice disorders in HD. The results were also correlated with disease severity according to the Unified HD Rating Scale (UHDRS) motor score.
  
  
  RESULTS
  Subjects with HD showed deterioration in all investigated phonatory functions. Irregular pitch fluctuations, sudden phonation interruption, increased noise, and misplacement of articulators were found to be most significant patterns of phonatory dysfunction in HD (p<0.001). The combination of these four dysphonia aspects contributed to the best classification performance of 94.1% (sensitivity: 95.1%; specificity: 93.2%) in the separation of HD patients from healthy participants. Our results further indicated stronger associations between sudden phonation interruption and voluntary components of the UHDRS (r = -0.48, p<0.01) and between misplacement of articulators and involuntary components of the UHDRS (r = 0.52, p<0.01).
  
  
  CONCLUSIONS
  Our configuration of phonatory features can detect subtle voice abnormalities in subjects with HD. As impairment of phonatory function in HD was found to parallel increasing motor involvement, a qualitative description of voice dysfunction may be helpful to gain better insight into the pathophysiology of the vocal mechanism.
authors.affiliation: Department of Circuit Theory, Czech Technical University in Prague, Faculty of Electrical Engineering, Prague, Czech Republic. ruszjan@fel.cvut.cz
authors.forename: Jan
authors.initials: J
authors.lastname: Rusz
authors.forename: Jiří
authors.initials: J
authors.lastname: Klempíř
authors.forename: Eva
authors.initials: E
authors.lastname: Baborová
authors.forename: Tereza
authors.initials: T
authors.lastname: Tykalová
authors.forename: Veronika
authors.initials: V
authors.lastname: Majerová
authors.forename: Roman
authors.initials: R
authors.lastname: Cmejla
authors.forename: Evžen
authors.initials: E
authors.lastname: Růžička
authors.forename: Jan
authors.initials: J
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010699:Phonation; D013061:Speech Acoustics; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology*; D055815:Young Adult