Percorrer por autor "Cardoso, Rita"
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- Assessment of Parkinson’s disease medication state through automatic speech analysisPublication . Pompili, Anna; Solera-Urena, Rubén; Abad, Alberto; Cardoso, Rita; Guimarães, Isabel; Fabbri, Margherita; Martins, Isabel; Ferreira, JoaquimParkinson’s disease (PD) is a progressive degenerative disorder of the central nervous system characterized by motor and nonmotor symptoms. As the disease progresses, patients alternate periods in which motor symptoms are mitigated due to medication intake (ON state) and periods with motor complications (OFF state). The time that patients spend in the OFF condition is currently the main parameter employed to assess pharmacological interventions and to evaluate the efficacy of different active principles. In this work, we present a system that combines automatic speech processing and deep learning techniques to classify the medication state of PD patients by leveraging personal speech-based bio-markers. We devise a speakerdependent approach and investigate the relevance of different acoustic-prosodic feature sets. Results show an accuracy of 90.54% in a test task with mixed speech and an accuracy of 95.27% in a semi-spontaneous speech task. Overall, the experimental assessment shows the potentials of this approach towards the development of reliable, remote daily monitoring and scheduling of medication intake of PD patients.
- Assessment of Parkinson’s disease medication state through automatic speech analysisPublication . Pompili, Anna; Solera-Urena, Rubén; Abad, Alberto; Cardoso, Rita; Guimarães, Isabel; Fabbri, Margherita; Martins, Isabel P; Ferreira, JoaquimParkinson’s disease (PD) is a progressive degenerative disorder of the central nervous system characterized by motor and nonmotor symptoms. As the disease progresses, patients alternate periods in which motor symptoms are mitigated due to medication intake (ON state) and periods with motor complications (OFF state). The time that patients spend in the OFF condition is currently the main parameter employed to assess pharmacological interventions and to evaluate the efficacy of different active principles. In this work, we present a system that combines automatic speech processing and deep learning techniques to classify the medication state of PD patients by leveraging personal speech-based bio-markers. We devise a speakerdependent approach and investigate the relevance of different acoustic-prosodic feature sets. Results show an accuracy of 90.54% in a test task with mixed speech and an accuracy of 95.27% in a semi-spontaneous speech task. Overall, the experimental assessment shows the potentials of this approach towards the development of reliable, remote daily monitoring and scheduling of medication intake of PD patients.
- Automatic detection of Parkinson’s disease: an experimental analysis of common speech production tasks used for diagnosisPublication . Pompili, Anna; Abad, Alberto; Romano, Paolo; Martins, Isabel P; Cardoso, Rita; Santos, Helena; Carvalho, Joana; Guimarães, Isabel; Ferreira, JoaquimParkinson’s disease (PD) is the second most common neurodegenerative disorder of mid-to-late life after Alzheimer’s disease. During the progression of the disease, most individuals with PD report impairments in speech due to deficits in phonation, articulation, prosody, and fluency. In the literature, several studies perform the automatic classification of speech of people with PD considering various types of acoustic information extracted from different speech tasks. Nevertheless, it is unclear which tasks are more important for an automatic classification of the disease. In this work, we compare the discriminant capabilities of eight verbal tasks designed to capture the major symptoms affecting speech. To this end, we introduce a new database of Portuguese speakers consisting of 65 healthy control and 75 PD subjects. For each task, an automatic classifier is built using feature sets and modeling approaches in compliance with the current state of the art. Experimental results permit to identify reading aloud prosodic sentences and story-telling tasks as the most useful for the automatic detection of PD.
- Cross-cultural adaptation and validation of the swallowing disturbance questionnaire and the sialorrhea clinical scale in portuguese patients with Parkinson’s diseasePublication . Cardoso, Rita; Guimarães, Isabel; Santos, Helena; Carvalho, Joana; Abreu, Daisy; Gonçalves, Nilza; Ferreira, JoaquimIntroduction: To date, no valid outcome measure has been developed in European Portuguese (EP) to evaluate the Parkinsons’ Disease (PD) patients’ (PwP) reports regarding their swallowing disturbances. Objectives: The aim of this study was to translate and cross-culturally adapt the Swallowing Disturbance Questionnaire (SDQ) and the Sialorrhea Clinical Scale for PD (SCS-PD) into EP and to determine its clinimetric properties in PwP. Materials and Methods: The original English SDQ and SCS-PD versions were cross-culturally adapted following recommendations established in international guidelines. The validation process involved 75 PwP and 65 healthy sex- and age-matched participants. Results: The EP versions of the SDQ and SCS-PD are equivalent to the original versions (content, depth, and scoring). Statistical analyses for the SDQ tool revealed good feasibility (missing data <5%), acceptability (no floor or ceiling effects), excellent internal consistency (Cronbach's = 0.95), good construct validity (78.5% revealed large to moderate loadings), moderate convergent validity (r = 0.60), good divergent validity (r = 0.40), good known-groups validity (p-value<.05) and a fair sensitivity and specificity (AUC = 0.700). Statistical analyses for the SCS-PD tool shows good feasibility, reasonable acceptability (floor effect), good internal consistency (Cronbach's a¼0.85), good construct validity (85.7% showed between large to moderate loadings), good convergent validity (r = 0.78), good divergent validity (r = 0.39), good known groups validity (p-value < .05) and a fair sensitivity and specificity (AUC = 0.704). Conclusions: The EP versions of the SDQ and SCS-PD maintained the characteristics of the original versions and therefore consistent tools to be used in PwP.
- (Dys)Prosody in Parkinson’s disease: effects of medication and disease progression on intonation and prosodic phrasingPublication . Frota, Sónia; Cruz, Marisa; Cardoso, Rita; Guimarães, Isabel; Ferreira, Joaquim; Pinto, Serge; Vigário, MarinaAbstract: The phonology of prosody has received little attention in studies of motor speech disorders. The present study investigates the phonology of intonation (nuclear contours) and speech chunking (prosodic phrasing) in Parkinson’s Disease (PD), as a function of medication intake and progression of the disease. Following methods of the prosodic and intonational phonology frameworks, we examined the ability of 30 PD patients to use intonation categories and prosodic phrasing structures in ways similar to 20 healthy controls to convey similar meanings. Speech data from PD patients were collected before and after a dopaminomimetic drug intake and were phonologically analyzed in relation to nuclear contours and intonational phrasing. Besides medication, disease duration and presence of motor fluctuations were also factors included in the analyses. PD patients showed a decreased ability to use nuclear contours and prosodic phrasing. Medication improved intonation regardless of disease progression, but did not help with dysprosodic phrasing. In turn, disease duration and motor fluctuations affected phrasing patterns, but had no impact on intonation. Our study demonstrated that the phonology of prosody is impaired in PD, and prosodic categories and structures may be differently affected, with implications for the understanding of PD neurophysiology and therapy.
- Dysarthria in individuals with Parkinson’s disease: a protocol for a binational, cross-sectional, case-controlled study in rrench and european portuguese (FraLusoPark)Publication . Pinto, Serge; Cardoso, Rita; Sadat, Jasmin; Guimarães, Isabel; Mercier, Céline; Santos, Helena; Atkinson-Clement, Cyril; Carvalho, Joana; Welby, Pauline; Oliveira, Pedro; D’Imperio, Mariapaola; Frota, Sónia; Letanneux, Alban; Vigario, Marina; Cruz, Marisa; Martins, Isabel Pavão; Viallet, François; Ferreira, JoaquimIntroduction: Individuals with Parkinson’s disease (PD) have to deal with several aspects of voice and speech decline and thus alteration of communication ability during the course of the disease. Among these communication impairments, 3 major challenges include: (1) dysarthria, consisting of orofacial motor dysfunction and dysprosody, which is linked to the neurodegenerative processes; (2) effects of the pharmacological treatment, which vary according to the disease stage; and (3) particular speech modifications that may be language-specific, that is, dependent on the language spoken by the patients. The main objective of the FraLusoPark project is to provide a thorough evaluation of changes in PD speech as a result of pharmacological treatment and disease duration in 2 different languages (French vs European Portuguese). Methods and analysis: Individuals with PD are enrolled in the study in France (N=60) and Portugal (N=60). Their global motor disability and orofacial motor functions is assessed with specific clinical rating scales, without (OFF) and with (ON) pharmacological treatment. 2 groups of 60 healthy age-matched volunteers provide the reference for between-group comparisons. Along with the clinical examinations, several speech tasks are recorded to obtain acoustic and perceptual measures. Patient-reported outcome measures are used to assess the psychosocial impact of dysarthria on quality of life. Ethics and dissemination: The study has been approved by the local responsible committees on human experimentation and is conducted in accordance with the ethical standards. A valuable largescale database of speech recordings and metadata from patients with PD in France and Portugal will be constructed. Results will be disseminated in several articles in peer-reviewed journals and in conference presentations. Recommendations on how to assess speech and voice disorders in individuals with PD to monitor the progression and management of symptoms will be provided.
- Dysphagia predicts poor outcome in late-stage Parkinson's diseasePublication . Fabbri, Margherita; Coelho, Miguel; Abreu, Daisy; Guedes, Leonor Correia; Rosa, Mario M.; Godinho, Catarina; Cardoso, Rita; Guimarães, Isabel; Antonini, Angelo; Zibetti, Maurizio; Lopiano, Leonardo; Ferreira, Joaquim J."BACKGROUND: Few data exist on the rate of clinical progression for Parkinson's disease (PD) patients who have entered a late stage of the disease. OBJECTIVE: Study the clinical progression of a late-stage PD (LSPD) population over one year follow-up. METHODS: 50 LSPD patients (Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 in MED ON) underwent an extensive clinical assessment at baseline and after one year and an acute levodopa test at baseline. RESULTS: Mean age of LSPD patients (female 46%) was 77.5 ± 5.9 years and mean disease duration was 15.5 ± 6.5 years. At baseline, 76% had levodopa-induced motor complications (MC), usually non-troublesome, 68% were demented, 54% had psychosis and 68% depression. Caregiver distress was high. l-dopa responsiveness was mild (18% ± 12 of improvement on MDS-UPDRS-III). After one-year, 20% of the patients were dead, institutionalized or HY 5. MDS-UPDRS-motor mean score worsened 7.2 ± 10.3 points although there was heterogeneity between patients, and there was a global worsening of non-motor symptoms, mostly in cognition/mood, urinary and gastrointestinal domains. Nevertheless, MC improved despite similar levodopa equivalent dose. Functional independence and quality of life worsened. Dysphagia severity at baseline predicted a poor outcome (death, institutionalization or HY 5) (Hazard ratio 2.3, 95% CI 1.12-4.4; p = 0.01), whereas magnitude of l-dopa response of LSPD patients did not. CONCLUSIONS: LSPD patients still present a significant, although heterogeneous, motor and non-motor progression over 1 year. Dysphagia severity predicts the occurrence of additional disease severity milestones and its management must be prioritized."
- Dysphagia predicts poor outcome in late-stage Parkinson's diseasePublication . Fabbri, Margherita; Coelho, Miguel; Abreu, Daisy; Guedes, Leonor Correia; Rosa, Mario M; Godinho, Catarina; Cardoso, Rita; Guimarães, Isabel; Antonini, Angelo; Zibetti, Maurizio; Lopiano, Leonardo; Ferreira, Joaquim J
- Frenchay dysarthria assessment (FDA-2) in Parkinson’s disease: cross-cultural adaptation and psychometric properties of the european portuguese versionPublication . Cardoso, Rita; Guimarães, Isabel; Santos, Helena; Loureiro, Rita; Domingos, Josefa; Abreu, Daisy; Gonçalves, Nilza; Pinto, Serge; Ferreira, JoaquimHypokinetic dysarthria is a common symptom in those with Parkinson’s disease (PD); there is currently no standardized or validated tool for assessing speech in this population. To translate into European Portuguese (EP) the FDA-2 and perform a cultural adaptation followed by an evaluation of its psychometric properties in PD in a sample of people with PD in different stages of disease progression. Translation, back-translation, experts’ analysis, pretest and final version test were performed. The EP version of the FDA-2 was administered to 80 people with PD (PwP) with dysarthria, feasibility and acceptability, reliability (internal consistency and inter-rater reliability) and validity (face and convergent) were measured. Overall, the EP-FDA-2 proved to be similar to the original demonstrating the same conceptual meanings, semantics, idiomatic and score equivalences. It has good feasibility (missing data\5 %), acceptability (ceiling and floor effects \15 %), a high reliability of the total score (0.94), an excellent inter-rater agreement for the total score (0.96) and moderate to large construct validity for 81 % of its items. It is well correlated with the gold standard for disease severity assessment in PD, the MDS-UPDRS. The EPFDA- 2 has shown the salient features of a valid tool that can be used by speech and language therapists in the assessment of dysarthria in PD in clinical practice as in the research field.
- Psychosocial impact of Parkinson’s disease-associated dysarthria: cross-cultural adaptation and validation of the Dysarthria Impact Profile into european portuguesePublication . Cardoso, Rita; Guimarães, Isabel; Santos, Helena; Loureiro, Rita; Domingos, Josefa; Abreu, Daisy; Gonçalves, Nilza; Pinto, Serge; Ferreira, JoaquimAim: The present study sought to make a cross-cultural adaptation of the Dysarthria Impact Profile (DIP) for European Portuguese (EP) and validate it for use in Parkinson’s disease (PD) patients. Methods: The cross-cultural adaptation was carried out in accordance with the guidelines. The EP version of the DIP was administered to 80 people with PD, and 30 sex- and age-matched control participants. Psychometric properties, acceptability, feasibility reliability (internal consistency and intrarater agreement) and validity (construct, convergent and known-groups validity) were assessed using other assessment tools (motor disability and impairment, and voice impact). Results: Overall, the EP-DIP final version has the same conceptual meaning, semantics, idiomatic and score equivalences as the original version. Statistical analyses showed adequate feasibility (missing data <5%), good acceptability (ceiling or floor effects <15%; high requests of assistance to complete the questionnaire), satisfactory internal consistency (Cronbach’s α = 0.9), weak-to-moderate intrarater reliability, good construct validity, strong convergent validity (with the Voice Handicap Index; Spearman’s P = −0.8) and good known-groups validity (between those with PD and control participants). Conclusions: The EP-DIP version displays the salient features of a valid patient-based assessment tool used to measure the psychosocial impact of slight-to-mild dysarthria in people with PD.