Browsing by Author "Ferreira, Joaquim"
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- Action verbal fluency in Parkinson’s patientsPublication . Tello Rodrigues, Inês; Ferreira, Joaquim; Coelho, Miguel; Rosa, Mário; Castro-Caldas, AlexandreWe compared the performance of 31 non-demented Parkinson´s disease (PD) patients to 61 healthy controls in an action verbal fluency task. Semantic and phonemic fluencies, cognitive impairment and behavioural dysfunction were also assessed. The mean disease duration of PD was 9.8 years (standard deviation (SD) = 6.13). There were no age (U = 899.5, p = 0.616), gender(chi-square = 0.00, p = 1.00) or literacy (U = 956, p = 0.96) differences between the two groups. A significant difference was observed between the two groups in the action verbal fluency task (U = 406.5, p < 0.01) that was not found in the other fluency tasks. The education level was the only biographical variable that influenced the action (verb) fluency outcomes, irrespective of disease duration. Our findings suggest a correlation between the disease mechanisms in PD and a specific verb deficit, support the validity of the action (verb) fluency as an executive function measure and suggest that this task provides unique information not captured with traditional executive function tasks.
- 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.
- Clinical rating scale for pantothenate kinase-associated neurodegeneration: A pilot studyPublication . Darling, Alejandra; Tello, Cristina; Martí, María Josep; Garrido, Cristina; Aguilera-Albesa, Sergio; Tomás Vila, Miguel; Gastón, Itziar; Madruga, Marcos; González Gutiérrez, Luis; Ramos Lizana, Julio; Pujol, Montserrat; Gavilán Iglesias, Tania; Tustin, Kylee; Lin, Jean Pierre; Zorzi, Giovanna; Nardocci, Nardo; Martorell, Loreto; Lorenzo Sanz, Gustavo; Gutiérrez, Fuencisla; García, Pedro J.; Vela, Lidia; Hernández Lahoz, Carlos; Ortigoza Escobar, Juan Darío; Martí Sánchez, Laura; Moreira, Fradique; Coelho, Miguel; Correia Guedes, Leonor; Castro Caldas, Ana; Ferreira, Joaquim; Pires, Paula; Costa, Cristina; Rego, Paulo; Magalhães, Marina; Stamelou, María; Cuadras Pallejà, Daniel; Rodríguez-Blazquez, Carmen; Martínez-Martín, Pablo; Lupo, Vincenzo; Stefanis, Leonidas; Pons, Roser; Espinós, Carmen; Temudo, Teresa; Pérez Dueñas, BelénPantothenate kinase-associated neurodegeneration is a progressive neurological disorder occurring in both childhood and adulthood. The objective of this study was to design and pilot-test a disease-specific clinical rating scale for the assessment of patients with pantothenate kinase-associated neurodegeneration.
- 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.
- Drooling rating scales in Parkinson’s disease: a systematic reviewPublication . Nascimento, David; Carmona, Jaqueline; Mestre, Tiago; Ferreira, Joaquim; Guimarães, IsabelBackground: Drooling is a clinically relevant non-motor symptom of people with Parkinson’s disease (PwP). Several drooling rating scales are available. Nevertheless, the compelling scientific evidence supporting their validity is limited. This study aims to evaluate clinical rating scales for drooling, assessing their characteristics, clinimetric properties, and clinical utility classification. Methods: A systematic review was undertaken. Two reviewers performed independent literature searches using the CENTRAL®, CINAHL®, Embase®, MEDLINE®, SciElo®, and SPEECH BITE® databases. We used consensusbased standards for the selection of health measurement instruments (COSMIN) and the International Parkinson’s disease and the Movement Disorders (MDS) criteria to evaluate the included rating scales. Results: The following six rating scales were identified: Drooling Impact Scale (DIS), Sialorrhea Scoring Scale (SSS), Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale (DRS), Sialorrhea Clinical Scale for Parkinson Disease (SCS-PD), and the Radboud Oral Motor inventory for Parkinson’s disease – Saliva (ROMPsaliva). The scales had heterogeneous characteristics: (i) not all were created/adapted for PwP; (ii) different dimensions associated with drooling are assessed; (iii) cross-cultural adaptations are limited to some languages. The clinimetric properties showed: (i) target population size limitations; (ii) incomplete reliability analysis; (iii) lack of robust validity; (iv) sensitivity to change not fully explored. Following the MDS criteria, only one tool was classified as “recommended”, the ROMP-saliva. Conclusions: This review provides information for an adequate selection of a drooling rating scale for clinical and/or research purposes. To date, ROMP-saliva is the only scale with substantial evidence of its clinimetric properties adequacy and data 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.
- 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.