Speech Test Research Articles

Audiometric Outcomes of Auditory Brainstem Implantation during Vestibular Schwannoma Resection in NF2 Patients

Abstract Background Many patients with neurofibromatosis type 2 (NF2) suffer from sensorineural hearing loss, and associated cochlear nerve compromise in NF2 patients makes auditory brainstem implant (ABI) an attractive treatment option. The long-term outcomes and benefits of the device are still being explored. Methods A retrospective review was conducted for 11 ABI recipients at a single-institution tertiary center between November 2017 and August 2022. Patients diagnosed with NF2 undergoing resection for concurrent vestibular schwannoma (VS) were included. Pre- and postaudiometric assessments were reviewed. Evaluation included pure-tone audiometry and speech testing. Results Our cohort included 11 patients with a median age of 34 years. All patients underwent a translabyrinthine approach for implant placement with concurrent VS resection. Average tumor size of VS was 2.87 cm. Preoperatively, 8 patients had pure-tone averages with no response at 110 dB, 2 were within mild–moderate hearing loss (25–45 dB), and one patient had a PTA of profound loss (92 dB). Postoperatively, 9 (81%) patients had improvement in PTA. In total, seven patients reported mild side effects upon ABI activation which included dizziness (n = 2), tinnitus (n = 1), and abdominal and lower extremity tingling sensation (n = 3). Of the seven patients with early speech perception (ESP) scores, five had a score >75%, indicating the auditory ability to detect pattern perception upon auditory stimulation through the ABI alone. Conclusion Nine of 11 patients derived benefits from ABI placement. These findings demonstrate that ABI placement during concurrent VS resection can provide a significant hearing benefit for NF2 patients.

Investigating the Effects of Face Mask on Word Recognition Score Test During the COVID-19 Outbreak: Considerations and Limitations

Introduction: Using personal protective equipment, especially face masks, in the COVID-19 pandemic era may make verbal communication difficult. Furthermore, acoustic changes in mask-wearing conditions may affect speech audiometry results. This study investigates the effect of wearing a face mask on the word recognition score and the role of speech frequency content in this effect.
 Materials and Methods: This study was planned and conducted in two phases. In the first phase, the validity and reliability of two speech material lists, high-pitch and low-pitch, were determined. In the second phase, the word recognition score was measured for “mask-wearing” and “covering mouth without a mask.”
 Results: The statistical analysis showed that the content validity ratio was 0.92, and the content validity index was 0.8. Therefore, both speech lists were valid. For these lists, the mixed analysis of variance analysis showed that the scores for “mask-wearing” were significantly lower than “covering mouth without a mask,” and there was more reduction in scores for the high-pitched list (F=8.7, df=1, P<0.005).
 Conclusion: In terms of the impact of a face mask on speech, explaining how speech audiometry is performed, especially in monitoring treatments, may help limit the probability of misinterpretation of speech test findings. Furthermore, understanding the impact of face masks on word recognition scores in adopting sufficient auditory rehabilitation procedures is necessary.

ART and AutoART ECAP measurements and cochlear nerve anatomy as predictors in adult cochlear implant recipients

PurposeThe purpose of this retrospective study is to compare the results of electrically evoked compound action potential (ECAP) measurements using automatic auditory response telemetry (AutoART) with those obtained by ART in adults. The study also aimed to evaluate the predictive value of intraoperative ART and AutoART ECAPs for speech intelligibility (SI) and hearing success (HS), and to determine if cochlear nerve (CN) cross-sectional area (CSA) obtained preoperatively by magnetic resonance imaging (MRI) scans could predict ART and AutoART ECAPs and SI and HS outcome.MethodsThe study analyzed and correlated ART and AutoART ECAP thresholds at electrodes E2, E6, and E10, as well as averaged ECAP thresholds over electrodes E1–E12, using data from 32 implants. Correlations were also examined for ART and AutoART ECAP slopes. In addition, averaged ART and AutoART ECAP thresholds and slopes over all 12 electrodes for each participant were correlated with CN CSA measured from MRI sequences. SI of the monosyllabic Freiburg Speech Test at 65 dB sound pressure level was examined along with averaged ART and AutoART thresholds and slopes over all 12 electrodes. A parallel analysis was performed for HS, derived from the difference between baseline and 6-month SI. Finally, correlations between CN CSA and SI, as well as CN CSA and HS were examined.ResultsThe results of the study showed a significant positive correlation between ART and AutoART ECAP thresholds and as well as slopes for E2, E6, E10 and averaged thresholds and slopes of E1–E12. However, no significant correlation was observed between ART and AutoART averaged ECAP thresholds and slopes and either SI and HS or CN CSA. Furthermore, no significant correlation was found between CN CSA and SI and HS.ConclusionWhile AutoART is a reliable and safe program for measuring ECAPs in adults, the study found no preoperative prognostic information on intraoperative ECAP results using parameters extracted from current MRI sequences or pre-/intraoperative information on subsequent hearing outcome using ECAP and CN CSA.

Early identification of stroke through deep learning with multi-modal human speech and movement data.

JOURNAL/nrgr/04.03/01300535-202501000-00031/figure1/v/2024-05-14T021156Z/r/image-tiff Early identification and treatment of stroke can greatly improve patient outcomes and quality of life. Although clinical tests such as the Cincinnati Pre-hospital Stroke Scale (CPSS) and the Face Arm Speech Test (FAST) are commonly used for stroke screening, accurate administration is dependent on specialized training. In this study, we proposed a novel multimodal deep learning approach, based on the FAST, for assessing suspected stroke patients exhibiting symptoms such as limb weakness, facial paresis, and speech disorders in acute settings. We collected a dataset comprising videos and audio recordings of emergency room patients performing designated limb movements, facial expressions, and speech tests based on the FAST. We compared the constructed deep learning model, which was designed to process multi-modal datasets, with six prior models that achieved good action classification performance, including the I3D, SlowFast, X3D, TPN, TimeSformer, and MViT. We found that the findings of our deep learning model had a higher clinical value compared with the other approaches. Moreover, the multi-modal model outperformed its single-module variants, highlighting the benefit of utilizing multiple types of patient data, such as action videos and speech audio. These results indicate that a multi-modal deep learning model combined with the FAST could greatly improve the accuracy and sensitivity of early stroke identification of stroke, thus providing a practical and powerful tool for assessing stroke patients in an emergency clinical setting.

Speech intelligibility and its relation to auditory temporal processing in Czech and Swiss German subjects with and without tinnitus.

Previous studies have shown that levels for 50% speech intelligibility in quiet and in noise differ for different languages. Here, we aimed to find out whether these differences may relate to different auditory processing of temporal sound features in different languages, and to determine the influence of tinnitus on speech comprehension in different languages. We measured speech intelligibility under various conditions (words in quiet, sentences in babble noise, interrupted sentences) along with tone detection thresholds in quiet [PTA] and in noise [PTAnoise], gap detection thresholds [GDT], and detection thresholds for frequency modulation [FMT], and compared them between Czech and Swiss subjects matched in mean age and PTA. The Swiss subjects exhibited higher speech reception thresholds in quiet, higher threshold speech-to-noise ratio, and shallower slope of performance-intensity function for the words in quiet. Importantly, the intelligibility of temporally gated speech was similar in the Czech and Swiss subjects. The PTAnoise, GDT, and FMT were similar in the two groups. The Czech subjects exhibited correlations of the speech tests with GDT and FMT, which was not the case in the Swiss group. Qualitatively, the results of comparisons between the Swiss and Czech populations were not influenced by presence of subjective tinnitus. The results support the notion of language-specific differences in speech comprehension which persists also in tinnitus subjects, and indicates different associations with the elementary measures of auditory temporal processing.

Determining cochlear implant candidacy in children with residual hearing: A scoping review

ObjectivesThe purpose of this review was to summarize what is known about criteria, assessments, and recommendations for evaluating cochlear implant (CI) candidacy in children with residual hearing. MethodsPeer-reviewed studies were identified through a systematic search in five electronic databases. Articles were screened and assessed for eligibility. From the eligible studies, data were extracted to summarize and present a narrative synthesis of the findings. ResultsA total of seven articles (two reviews and five primary studies) were included in the final analysis. Hearing levels better than the moderately severe to severe range (65–90 dB HL) tend to be supported as audiological candidacy criteria for pediatric CI. Recommendations for candidacy consideration based on audiologic thresholds range from 65 to 80 dB Hl pure-tone average as the lower boundary. Our review did not identify any specific assessment protocols. However, additional decision-making considerations related to borderline hearing loss configurations and assessment tools (the Speech Intelligibility Index and the Pediatric Minimum Speech Test Battery) were identified. Supplementary assessment considerations were also reported. ConclusionThere is limited information regarding specific assessment protocols for children with residual hearing. The literature is primarily focused on guidelines related to audiologic criteria, although it is widely recommended that other areas of functioning should also be considered. Most recommendations appear to be based on expert opinion, clinical expertise, and evidence from overall pediatric CI outcomes rather than empirical evidence targeting children with residual hearing. There is an ongoing need for research to further develop protocols and tools that can assist clinicians and families in making cochlear implantation decisions for children with residual hearing.

A Step Toward Precision Audiology: Individual Differences and Characteristic Profiles From Auditory Perceptual and Cognitive Abilities.

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals' auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH (n = 20) and OHL (n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing.

Impacto do uso da verificação eletroacústica dos aparelhos de amplificação sonora individual na percepção de fala e desempenho do usuário nas atividades diárias

ABSTRACT Purpose: to assess the impact of electroacoustic verification on the satisfaction level and speech recognition in quiet and noise of hearing aid users. Methods: 24 individuals who had been using the device for at least 1 year and had not previously performed electroacoustic verification were assessed. In the first session, participants responded to the International Outcome Inventory for Hearing Aids validation questionnaire and indicated their satisfaction level on a visual analog scale. They were, then, subjected to speech perception tests in quiet and noise and electroacoustic verification, returning after 3 months and repeating the first stage assessments. The Wilcoxon test and paired t-test were used for data analysis, with significance set at p-value ≤ 0.05. Results: the visual analog scale assessment, the International Outcome Inventory for Hearing Aids score, the speech perception threshold in quiet and noise, and the signal/noise ratio improved after 3 months. Conclusion: individuals who had been using the device for at least 1 year had a substantial improvement in their satisfaction level and speech perception in quiet and noise after the electroacoustic verification.

Evidências de validade e fidedignidade do Teste de Fala Comprimida com Figuras

ABSTRACT Purpose To seek evidence of validity and reliability for the Compressed Speech Test with Figures. Methods The study was subdivided into three stages: construct validation, criteria and reliability. All participants were aged between 6:00 and 8:11. For the construct, Compressed Speech with Figures and the gold standard Adapted Compressed Speech test were applied to children with typical phonological development. For criterion analysis, Compressed Speech with Figures was applied in two groups, with typical (G1) and atypical (G2) phonological development. Finally, the application protocols underwent analysis by two Speech Therapists, with experience in the area of Central Auditory Processing, seeking to obtain an inter-evaluator reliability analysis. Results The correlation test indicated an almost perfect construct (correlation 0.843 for the right ear and 0.823 for the left ear). In the criterion analysis, it was noticed that both groups presented satisfactory results (G1 = 99.6 to 100%; G2 = 96 to 96.5%). The reliability analysis demonstrated that the protocol is easy to analyze, as both professionals presented unanimous responses. Conclusion It was possible to obtain evidence of validity and reliability for the Compressed Speech with Figures instrument. The construct analysis showed that the instrument measures the same variable as the gold standard test, with an almost perfect correlation. In the criterion analysis, both groups presented similar performance, demonstrating that the instrument does not seem to differentiate populations with and without mild phonological disorder. The inter-evaluator reliability analysis demonstrated that the protocol is easy to analyze and score.

Evidence of validity and reliability of the Compressed Speech Test with Figures.

To seek evidence of validity and reliability for the Compressed Speech Test with Figures. The study was subdivided into three stages: construct validation, criteria and reliability. All participants were aged between 6:00 and 8:11. For the construct, Compressed Speech with Figures and the gold standard Adapted Compressed Speech test were applied to children with typical phonological development. For criterion analysis, Compressed Speech with Figures was applied in two groups, with typical (G1) and atypical (G2) phonological development. Finally, the application protocols underwent analysis by two Speech Therapists, with experience in the area of Central Auditory Processing, seeking to obtain an inter-evaluator reliability analysis. The correlation test indicated an almost perfect construct (correlation 0.843 for the right ear and 0.823 for the left ear). In the criterion analysis, it was noticed that both groups presented satisfactory results (G1 = 99.6 to 100%; G2 = 96 to 96.5%). The reliability analysis demonstrated that the protocol is easy to analyze, as both professionals presented unanimous responses. It was possible to obtain evidence of validity and reliability for the Compressed Speech with Figures instrument. The construct analysis showed that the instrument measures the same variable as the gold standard test, with an almost perfect correlation. In the criterion analysis, both groups presented similar performance, demonstrating that the instrument does not seem to differentiate populations with and without mild phonological disorder. The inter-evaluator reliability analysis demonstrated that the protocol is easy to analyze and score.

Classification of dementia from spoken speech using feature selection and the bag of acoustic words model

<p>Memory disorders and dementia are a central factor in the decline of functioning and daily activities in older individuals. The workload related to standardized speech tests in clinical settings has led to a growing emphasis on developing automatic machine learning techniques for analyzing naturally spoken speech. This study presented a bag of acoustic words approach for distinguishing dementia patients from control individuals based on audio speech recordings. In this approach, each individual's speech was segmented into voiced periods, and these segments were characterized by acoustic features using the open-source openSMILE library. Word histogram representations were formed from the characterized speech segments of each speaker, which were used for classifying subjects. The formation of word histograms involved a clustering phase where feature vectors were quantized. It is well-known that partitional clustering involves instability in clustering results due to the selection of starting points, which can cause variability in classification outcomes. This study aimed to address instability by utilizing robust K-spatial-medians clustering, efficient K-means$ ++ $ clustering initialization, and selecting the smallest clustering error from repeated clusterings. Additionally, the study employed feature selection based on the Wilcoxon signed-rank test to achieve computational efficiency in the methods. The results showed that it is possible to achieve a consistent 75% classification accuracy using only twenty-five features, both with the external ADReSS 2020 test data and through leave-one-subject-out cross-validation of the entire dataset. The results rank at the top compared to international research, where the same dataset and only acoustic features have been used to diagnose patients.</p>

Complaint Speech Acts Used by Learners of Turkish as a Foreign Language

The aim of this study is to identify the uses of the complaint speech act by learners of Turkish as a foreign language in different situations and locations, utilizing the speech act theory developed by Austin and Searle. The research, designed according to the case study pattern with a qualitative research approach, collected data from 87 participants using a single pattern sample. The responses given by the participants to the complaint speech act with the Speech Completion Test (SCT), consisting of seven different situations, have been classified according to strategies. In the classification, the strategies created by Trosborg in the Speech Completion Test for the complaint speech act; later additions made by Bikmen - Martı, and strategies obtained in the study of Murphy and Neu were used. The classified results were subjected to descriptive analysis. As a result of the evaluation of the obtained results, it is seen that the request strategy for compensation is most commonly used in complaint speech act situations. Participants used the direct behavior dimension 279 times for the complaint speech act. This result constitutes 50% of all responses. Participants have turned to direct actions to take action against situations. It has been determined that the mother tongues and foreign languages known by the participants, gender variables did not create a difference in the use of speech acts, but the change in the age factor caused various differences. This difference can be more clearly seen in terms of address and formality. It has been determined that the participants did not have difficulty in understanding the message to be given in the complaint speech act, and they were also successful in choosing appropriate forms of address and greetings according to the context.

Особенности фонематического восприятия речи у обучающихся с билингвизмом

<p>According to various sources, from 277 to 295 different languages are used in the Russian Federation, which makes it very important to assess the impact of bilingualism on speech perception, for example, in the context of school education. There is conflicting evidence about how bilingual children recognize individual phonemes. We compared the perception of phonemes of the Russian language by ear in children of early school age from a monolingual (Russian-speaking) and bilingual (Russian-speaking and Ossetian-speaking) environment using the speech test "Clinical assessment of the development of basic linguistic competencies" and psychophysical tasks for distinguishing words in noise. Bilingual children were found to be worse at repeating pseudowords and recognizing phonemes in stationary noise. The reasons for the difficulties may be related to the fact that children growing up in a bilingual environment have a much wider list of phonemes that need to be recognized than children growing up in a monolingual environment. This can lead to reduced speech recognition in the language of instruction and, consequently, a possible decrease in the quality of education.</p>

Does it make any sense to fit cochlear implants according to the anatomy-based fitting? Our experience with the first series of patients

IntroductionPersonalization of treatment is a growing trend in various fields of medicine, and this includes cochlear implantation. Both the precise choice of the length and shape of the electrode array to fit a particular cochlear anatomy, as well as an individualized fitting setting have been suggested to improve hearing outcomes with a cochlear implant (CI). The aim of this study was to compare anatomy-based fitting (ABF) vs. default fitting in terms of frequency-to-place mismatch, speech discrimination, and subjective outcomes in MED-EL CI users.MethodsEight adult CI users implanted with a Synchrony ST Flex28 were enrolled prospectively. Insertion depth and tonotopic distribution of each electrode was calculated using the Otoplan software. The mismatch was calculated for each fitting strategy relative to the electrodes' tonotopic place-frequency. Speech tests and patient preference was evaluated after 9 months with ABF and 1 month after default fitting.ResultsMedian angular insertion of the most apical active electrode was 594° (interquartile range 143°). ABF showed lower mismatches than default fitting in all patients (p ≤ 0.01). Mean speech discrimination score with ABF and default fitting was 73 ± 11% and 72 ± 16%, respectively (p = 0.672). Mean speech reception threshold with ABF and default fitting was 3.6 ± 3.4 dB and 4.2 ± 5.0 dB, respectively (p = 0.401). All patients except one preferred ABF when they were asked about their preference.ConclusionABF maps have a lower frequency-to-place mismatch than default fitting maps. In spite of similar hearing outcomes most patients prefer ABF. More data are necessary to corroborate the benefit of the ABF over default fitting in speech and subjective tests.

Estimating the United States Patient Population Size Meeting Audiologic Candidacy for Cochlear Implantation.

This study aimed to estimate the size of the United States candidacy pool meeting expanded Center for Medicare Services criteria for cochlear implantation. Retrospective cross-sectional. Tertiary care center. Preimplantation audiometric data from 486 patients seen at a single academic medical center were collected retrospectively and used to generate a predictive model of AzBio score based on audiometric pure tone thresholds. This model was then used to estimate nationally representative cochlear implantation (CI)-candidacy using pure tone averages included in the National Health and Nutrition Examination Survey. Qualitative and quantitative analyses were performed. We find that the estimated prevalence of CI candidacy in individuals 65 years of age or older is expected to more than double with a change in the CI candidacy criteria from ≤40% to ≤60% (from 1.42%, 95% confidence interval [1.33, 1.63] to 3.73% [2.71, 6.56]) on speech testing. We also found the greatest absolute increase in candidacy in the 80+ age group, increasing from 4.14% [3.72, 5.1] of the population meeting the ≤40% criteria to 12.12% [9.19, 18.35] meeting the ≤60% criteria. The United States population size meeting expanded CMS audiologic criteria for cochlear implantation is estimated to be 2.5 million adults and 2.1 million age 65 or older. Changing the CI candidacy criteria from ≤40% to ≤60% on CI testing has the greatest effect on the eligible patient population in the >65-year-old age group. The determination of utilization rates in newly eligible patients will require further study.

Music Therapy Enhances Episodic Memory in Alzheimer's and Mixed Dementia: A Double-Blind Randomized Controlled Trial.

Objective: This study aimed to assess whether a music therapy (MT) intervention could improve memory decline in older adults with and without cognitive impairment. A dual-retrieval model of episodic memory was employed to estimate memory processes. Methods: Forty-three older adults with a mean age of 76.49 years (n = 25 with Alzheimer's disease (AD) and mixed dementia, and n = 18 healthy older adults) were randomly selected for the experimental and control groups. The study design was a double-blind randomized controlled clinical trial and a certified music therapist delivered the MT. The primary outcomes were measures of working memory, episodic memory, and autobiographical memory. Results: In the primary outcome measures, MT effects were restricted to episodic memory measures like the Figure Memory Test of the BCSB and the Speech and Sing Memory Test. In both tests, the experimental group improved from pre-test to post-test in delayed recall, but in the Speech and Sing Memory Test, the improvement was restricted to the AD and mixed dementia group. MT had no effects on the secondary outcome measures. Conclusions: These findings suggest that a structured MT intervention can be promising for rehabilitating episodic memory in older adults with dementia.

Analysis of clinical audiological characteristics of noise-induced silent hearing loss

Objective: To explore the characteristics of audiology examination of Noise-Induced Hidden Hearing Loss (NIHHL), and then explore its valuable diagnostic methods.Methods: A total of 80 young men aged between 19 and 35 were selected. They were classified into the experimental group with noise exposure history and the control group without noise exposure history, with 40 men in each group. We carried out extended high-frequency audiometry test for good ears; conducted speech in noise measurement and distortion product emission for good ears; DPOAE test, compare and analyze the results of each test.Results: The extended high frequency hearing threshold test results showed that the hearing threshold of the experimental group was larger than that of the control group at the frequency above 8kHz, with significant statistical difference (p < .01). The results of speech audiometry under noise showed that the signal-to-noise ratio loss in the experimental group was greater than that in the control group, with a significant statistical difference (p < .01). The results of otoacoustic emission showed that the signal-to-noise ratio of the experimental group was lower than that of the control group at the frequency of 6 kHz and above, with a statistically significant difference (p < .01). There is a correlation between pure tone audiometry and DPOAE test results at high frequencies (6 kHz: p <. 0001, r = -.478; 8 kHz: p < .0001, r = -.491;) ; There was a correlation between speech audiometry and DPOAE test results under noise (p = .031, r = -.299).Conclusion: Compared with the control group, the extended high frequency pure tone hearing threshold increased or could not be elicited in the experimental group, speech recognition ability decreased significantly under noise, DPOAE was normally elicited but signal-to-noise ratio decreased, and there was a certain correlation between them. The above three audiological examination methods have a certain reference value for early recognition of hidden hearing loss.

Effectiveness of Television Streaming on Hearing Aid User Performance and Satisfaction in Quiet and in Noise.

The purpose of this study was to determine the effectiveness of television (TV) streaming on hearing aid user performance and satisfaction in quiet and in noise. Twenty experienced hearing aid users were evaluated in quiet and in noise (5 dB SNR) under three hearing aid conditions: hearing aids, streaming with hearing aid microphones attenuated by 6 dB, and streaming with hearing aid microphones muted. The audiovisual Connected Speech Test served as the signal, and the ipsilateral competing message from the Synthetic Sentence Identification-Ipsilateral Competing Message (SSI-ICM) served as the noise. Measures of speech understanding, satisfaction with sound quality and clarity, and preference were obtained. Speech understanding was significantly better in quiet than in noise, and streaming improved performance in noise when the hearing aid microphones were muted. Sound quality satisfaction was significantly better in quiet than in noise but was not impacted significantly by the hearing aid settings. Speech clarity satisfaction was significantly better in quiet than in noise, and streaming improved satisfaction in noise when the hearing aid microphones were muted. More participants preferred streaming with the microphones muted in quiet, in noise, and overall; however, results did not reach statistical significance. Hearing aid users did not benefit from TV streaming with the microphones attenuated or muted when listening in quiet. TV streaming was more beneficial to hearing aid users when listening in noise with the microphones muted. Hearing aid users should be counseled on the impact of the hearing aid microphone settings when using a TV streamer, particularly in noise.

Quantitative Speech Assessment in Ataxia—Consensus Recommendations by the Ataxia Global Initiative Working Group on Digital-Motor Markers

Dysarthria is a common and debilitating symptom of many neurodegenerative diseases, including those resulting in ataxia. Changes to speech lead to significant reductions in quality of life, impacting the speaker in most daily activities. Recognition of its importance as an objective outcome measure in clinical trials for ataxia is growing. Its viability as an endpoint across the disease spectrum (i.e. pre-symptomatic onwards) means that trials can recruit ambulant individuals and later-stage individuals who are often excluded because of difficulty completing lower limb tasks. Here we discuss the key considerations for speech testing in clinical trials including hardware selection, suitability of tasks and their role in protocols for trials and propose a core set of tasks for speech testing in clinical trials. Test batteries could include forms suitable for remote short, sensitive and easy to use, with norms available in several languages. The use of artificial intelligence also could improve accuracy and automaticity of analytical pipelines in clinic and trials.

The association between maternal prenatal vitamin B12 intake and child cognitive development

Abstract Background Nutrient deficiencies in diet during pregnancy may have an adverse effect on the development of offspring. The association between prenatal vitamin B12 intake and cognitive functioning in children is unclear. Therefore, we examined such association in Czech children. Methods Czech part of European Longitudinal Study of Pregnancy and Childhood is a population-based prospective longitudinal birth cohort study of pregnant women and their children enrolled in 1991-1992. Dietary data was measured at 32 weeks of gestation using 145 items self-reported food frequency questionnaire. Parents reported on their child's speech and language development at 18 months, 3, 5, and 7 years of age (outcomes ranging from n = 1891 to n = 2362), from which single scores for vocabulary, language, early communication, understanding, and intelligibility were calculated. Higher scores indicate better speech and language development. Data were analysed using multiple ordinal and logistic regression models. Results Higher prenatal vitamin B12 intake was associated with higher speech and language test scores in fully adjusted models. Children of mothers with higher B12 intake had increased likelihood of higher scores in vocabulary (OR = 1.06, 95% CI: 1.01; 1.11), language (OR = 1.05, 95% CI: 1.01; 1.10), early communication (OR = 1.06, 95% CI: 1.01; 1.11) and understanding (OR = 1.09, 95% CI: 1.04; 1.14) at 18 months of age. Furthermore, they were more likely to get maximum points in the intelligibility test at age 3 (OR = 1.08, 95% CI: 1.02; 1.14) opposed to children of mothers with lower B12 intake. There were no associations at 5 and 7 years. Conclusions We found consistent and significant associations between prenatal vitamin B12 intake and early speech and language development. The results suggest that a diet during pregnancy low in vitamin B12 may negatively affect children's cognitive development. Thus, a healthy pregnancy diet with sufficient vitamin B12 should be promoted. Key messages • A diet low in vitamin B12 during pregnancy may have negative effects on the cognitive development of offspring, according to a longitudinal birth cohort study. • Adequate prenatal vitamin B12 intake is important for cognitive development, particularly speech and language development.