Speech in ALS: Longitudinal Changes in Lips and Jaw Movements and Vowel Acoustics.

ABSTRACT

PURPOSE: The goal of this exploratory study was to investigate longitudinally the changes in facial kinematics, vowel formant frequencies, and speech intelligibility in individuals diagnosed with bulbar amyotrophic lateral sclerosis (ALS). This study was motivated by the need to understand articulatory and acoustic changes with disease progression and their subsequent effect on deterioration of speech in ALS. METHOD: Lip and jaw movements and vowel acoustics were obtained for four individuals with bulbar ALS during four consecutive recording sessions with an average interval of three months between recordings. Participants read target words embedded into sentences at a comfortable speaking rate. Maximum vertical and horizontal mouth opening and maximum jaw displacements were obtained during corner vowels. First and second formant frequencies were measured for each vowel. Speech intelligibility and speaking rate score were obtained for each session as well. RESULTS: Transient, non-vowel-specific changes in kinematics of the jaw and lips were observed. Kinematic changes often preceded changes in vowel acoustics and speech intelligibility. CONCLUSIONS: Nonlinear changes in speech kinematics should be considered in evaluation of the disease effects on jaw and lip musculature. Kinematic measures might be most suitable for early detection of changes associated with bulbar ALS.