Monitoring L-Dopa induced dyskinesias (LID) using speech acoustic measures in patients with Parkinson's disease

Abstract

More than 90% of patients with Parkinson's disease (PD) treated with levodopa for over 5 years will develop motor fluctuations and involuntary movements known as levodopa-induced dyskinesias (LID). Since LID commonly manifested in the head-neck and trunk areas speech is inevitably affected. In this study, eight acoustic speech measures derived from three speech tasks were selected to examine changes in speech acoustics associated with LID. Twenty subjects with PD, ten during the medication-off state without dyskinesia, and ten during the medication-on state with dyskinesia completed the speech tasks. Results revealed that three speech acoustic measures demonstrated sensitivity to changes associated with LID. In order to capture the changes associated with LID throughout medication cycles, ten PD subjects were provided an Android phone with HopkinsPD, an Android phone application, installed. One-minute speech and video samples were simultaneously collected at three time points over a medication cycle (before, peak, and end dose), twice a day (first morning dose and first afternoon dose) and repeated over three days (every other day) at a patient’s home. The results were discussed in light of the long-term goal to develop a reliable at home LID Smart-phone monitoring system that uses speech acoustic measures to monitor LID real-time remotely.