title: Predicting Speech Intelligibility Decline in Amyotrophic Lateral Sclerosis Based on the Deterioration of Individual Speech Subsystems.
abstract: To determine the mechanisms of speech intelligibility impairment due to neurologic impairments, intelligibility decline was modeled as a function of co-occurring changes in the articulatory, resonatory, phonatory, and respiratory subsystems.
  
  
  
  Sixty-six individuals diagnosed with amyotrophic lateral sclerosis (ALS) were studied longitudinally. The disease-related changes in articulatory, resonatory, phonatory, and respiratory subsystems were quantified using multiple instrumental measures, which were subjected to a principal component analysis and mixed effects models to derive a set of speech subsystem predictors. A stepwise approach was used to select the best set of subsystem predictors to model the overall decline in intelligibility.
  
  
  
  Intelligibility was modeled as a function of five predictors that corresponded to velocities of lip and jaw movements (articulatory), number of syllable repetitions in the alternating motion rate task (articulatory), nasal airflow (resonatory), maximum fundamental frequency (phonatory), and speech pauses (respiratory). The model accounted for 95.6% of the variance in intelligibility, among which the articulatory predictors showed the most substantial independent contribution (57.7%).
  
  
  
  Articulatory impairments characterized by reduced velocities of lip and jaw movements and resonatory impairments characterized by increased nasal airflow served as the subsystem predictors of the longitudinal decline of speech intelligibility in ALS. Declines in maximum performance tasks such as the alternating motion rate preceded declines in intelligibility, thus serving as early predictors of bulbar dysfunction. Following the rapid decline in speech intelligibility, a precipitous decline in maximum performance tasks subsequently occurred.
authors.affiliation: Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, United States of America.
authors.forename: Panying
authors.identifier: 0000-0001-7067-0083
authors.initials: P
authors.lastname: Rong
authors.affiliation: Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.
authors.forename: Yana
authors.initials: Y
authors.lastname: Yunusova
authors.affiliation: Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, United States of America.|Callier Center for Communication Disorders, University of Texas at Dallas, Richardson, Texas, United States of America.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Lorne
authors.initials: L
authors.lastname: Zinman
authors.affiliation: Neurology Associates, P.C., Lincoln, Nebraska, United States of America.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Pattee
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: James D
authors.initials: JD
authors.lastname: Berry
authors.affiliation: Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, United States of America.
authors.forename: Bridget
authors.initials: B
authors.lastname: Perry
authors.affiliation: Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts, United States of America.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Green
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D010699:Phonation / Q000502:physiology; D012119:Respiration; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000503:physiopathology*; D013065:Speech Intelligibility / Q000502:physiology*