title: Speech prosody impairment predicts cognitive decline in Parkinson's disease.
abstract: Impairment of speech prosody is characteristic for Parkinson's disease (PD) and does not respond well to dopaminergic treatment.
  
  
  
  We assessed whether baseline acoustic parameters, alone or in combination with other predominantly non-dopaminergic symptoms may predict global cognitive decline as measured by the Addenbrooke's cognitive examination (ACE-R) and/or worsening of cognitive status as assessed by a detailed neuropsychological examination.
  
  
  
  Forty-four consecutive non-depressed PD patients underwent clinical and cognitive testing, and acoustic voice analysis at baseline and at the two-year follow-up. Influence of speech and other clinical parameters on worsening of the ACE-R and of the cognitive status was analyzed using linear and logistic regression.
  
  
  
  The cognitive status (classified as normal cognition, mild cognitive impairment and dementia) deteriorated in 25% of patients during the follow-up. The multivariate linear regression model consisted of the variation in range of the fundamental voice frequency (F0VR) and the REM Sleep Behavioral Disorder Screening Questionnaire (RBDSQ). These parameters explained 37.2% of the variability of the change in ACE-R. The most significant predictors in the univariate logistic regression were the speech index of rhythmicity (SPIR; p = 0.012), disease duration (p = 0.019), and the RBDSQ (p = 0.032). The multivariate regression analysis revealed that SPIR alone led to 73.2% accuracy in predicting a change in cognitive status. Combining SPIR with RBDSQ improved the prediction accuracy of SPIR alone by 7.3%.
  
  
  
  Impairment of speech prosody together with symptoms of RBD predicted rapid cognitive decline and worsening of PD cognitive status during a two-year period.
authors.affiliation: First Department of Neurology, School of Medicine, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic. Electronic address: irena.rektorova@fnusa.cz.
authors.forename: Irena
authors.initials: I
authors.lastname: Rektorova
authors.affiliation: Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Mekyska
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 126/3, 62500 Brno, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Janousova
authors.affiliation: Department of Neurology, Faculty Hospital and Masaryk University, Jihlavska 20, 63900 Brno, Czech Republic.
authors.forename: Milena
authors.initials: M
authors.lastname: Kostalova
authors.affiliation: First Department of Neurology, School of Medicine, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic.
authors.forename: Ilona
authors.initials: I
authors.lastname: Eliasova
authors.affiliation: First Department of Neurology, School of Medicine, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic.
authors.forename: Martina
authors.initials: M
authors.lastname: Mrackova
authors.affiliation: Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic; Department of Neurology, University Hospital in Ostrava, 708 52 Ostrava, Czech Republic.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Berankova
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 126/3, 62500 Brno, Czech Republic.
authors.forename: Tereza
authors.initials: T
authors.lastname: Necasova
authors.affiliation: Department of Telecommunications, Brno University of Technology, Technicka 10, 61600 Brno, Czech Republic.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Smekal
authors.affiliation: First Department of Neurology, School of Medicine, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic; Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Komenskeho nam. 2, 60200 Brno, Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Marecek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications*; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000209:etiology*; D013223:Statistics as Topic; D018709:Statistics, Nonparametric
keywords: Acoustic analysis; Cognitive; Dementia; Parkinson’s disease; Speech prosody