Using Automatic Acoustic Speech Analysis and REM Sleep Behavior Disorder to Detect Individuals at High Risk of Parkinson's Disease and Other Alpha-synucleinopathies

Study Rationale:
Speech is an important indicator of motor function and movement coordination and can be extremely sensitive to the progression of neurologic diseases. The aim of this project is to use simple speech recording and high-end pattern analysis to detect pre-clinical stages of disabling central nervous system disorders including Parkinson's disease (PD) and other alpha-synucleinopathies in high-risk individuals with REM sleep behavior disorder. We hope to provide an essential tool for trials and studies on REM sleep behavior disorder with preventive therapy.

Hypothesis:
We hypothesize that motor speech disorder is a sensitive prodromal marker of PD and related neurodegenerative disorders, and that automated acoustic speech analysis will allow for objective capture of prodromal speech impairment in REM sleep behavior disorder across different languages.

Study Design:
Seven centers of excellence in sleep research will investigate speech and other clinical symptoms in more than 100 participants with REM sleep behavior disorder. Analyses of several unique speech dimensions based upon three fundamental categories of simple speaking tasks will be used to search for specific prodromal alterations in speech patterns in REM sleep behavior disorder by comparing age- and gender-matched PD and healthy participants. Robust algorithms for automated speech analysis will be developed and optimized in English, German, French, Czech and Italian languages.

Impact on Diagnosis/Treatment of Parkinson's Disease:
Early motor dysfunction strongly predicts PD and other alpha-synucleinopathies. In this regard, vocal assessment has potential advances, as it is non-invasive, inexpensive, simple to administer and scalable to large population with the possibility to perform recordings remotely, even by telephone from participants' homes.

Next Steps for Development:
Speech analysis may serve as a simple tool to screen large populations at risk of developing PD. If speech impairment appears to be a strong biomarker of early motor dysfunction, speech screening may improve stratification for future neuroprotective therapies for PD and other synucleinopathies.