title: Profiling Speech and Pausing in Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Dementia (FTD).
abstract: OBJECTIVE
  This study examines reading aloud in patients with amyotrophic lateral sclerosis (ALS) and those with frontotemporal dementia (FTD) in order to determine whether differences in patterns of speaking and pausing exist between patients with primary motor vs. primary cognitive-linguistic deficits, and in contrast to healthy controls.
  
  
  METHODS
  136 participants were included in the study: 33 controls, 85 patients with ALS, and 18 patients with either the behavioural variant of FTD (FTD-BV) or progressive nonfluent aphasia (FTD-PNFA). Participants with ALS were further divided into 4 non-overlapping subgroups--mild, respiratory, bulbar (with oral-motor deficit) and bulbar-respiratory--based on the presence and severity of motor bulbar or respiratory signs. All participants read a passage aloud. Custom-made software was used to perform speech and pause analyses, and this provided measures of speaking and articulatory rates, duration of speech, and number and duration of pauses. These measures were statistically compared in different subgroups of patients.
  
  
  RESULTS
  The results revealed clear differences between patient groups and healthy controls on the passage reading task. A speech-based motor function measure (i.e., articulatory rate) was able to distinguish patients with bulbar ALS or FTD-PNFA from those with respiratory ALS or FTD-BV. Distinguishing the disordered groups proved challenging based on the pausing measures.
  
  
  CONCLUSIONS
  This study demonstrated the use of speech measures in the identification of those with an oral-motor deficit, and showed the usefulness of performing a relatively simple reading test to assess speech versus pause behaviors across the ALS-FTD disease continuum. The findings also suggest that motor speech assessment should be performed as part of the diagnostic workup for patients with FTD.
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.|Sunnybrook Research Institute, Toronto, Ontario, Canada.|University Health Network-Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
authors.forename: Yana
authors.initials: Y
authors.lastname: Yunusova
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.|University Health Network-Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
authors.forename: Naida L
authors.initials: NL
authors.lastname: Graham
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sanjana
authors.initials: S
authors.lastname: Shellikeri
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kent
authors.initials: K
authors.lastname: Phuong
authors.affiliation: Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Madhura
authors.initials: M
authors.lastname: Kulkarni
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.|University Health Network-Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rochon
authors.affiliation: Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.|Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: David F
authors.initials: DF
authors.lastname: Tang-Wai
authors.affiliation: Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.|Rotman Research Institute, Toronto, Ontario, Canada.
authors.forename: Tiffany W
authors.initials: TW
authors.lastname: Chow
authors.affiliation: Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.|L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.|Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Black
authors.affiliation: Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.|Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Lorne H
authors.initials: LH
authors.lastname: Zinman
authors.affiliation: MGH Institute of Health Professions, Boston, Massachusetts, United States of America.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Green
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D057180:Frontotemporal Dementia / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D057178:Primary Progressive Nonfluent Aphasia / Q000503:physiopathology*; D011379:Prognosis; D013060:Speech / Q000502:physiology*; D013068:Speech Production Measurement