Motor speech in 4RT syndromes (Cordella et al., 2022)

Purpose: The aim of this study was to use acoustic and kinematic speech measures to characterize type of motor speech impairment—apraxia of speech (AOS) versus dysarthria—in individuals with four-repeat tauopathy (4RT)–associated syndromes, including nonfluent variant primary progressive aphasia (nfvPPA), primary progressive AOS (PPAOS), corticobasal syndrome (CBS), and progressive supranuclear palsy syndrome (PSPs).

Method: Twenty patient participants were recruited and stratified into two groups: (a) a motor-speech–impaired group of individuals with nfvPPA, PPAOS, CBS, or PSPs and suspected 4RT pathology (“MSI+”) and (b) a non–motor-speech-impaired group of individuals with logopenic variant primary progressive aphasia (“MSI−”). Ten healthy, age-matched controls also participated in the study. Participants completed a battery of speech tasks, and 15 acoustic and kinematic speech measures were derived. Quantitative speech measures were grouped into feature categories (“AOS features,” “dysarthria features,” “shared features”). In addition to quantitative speech measures, two certified speech-language pathologists made independent, blinded auditory-perceptual ratings of motor speech impairment. A principal component analysis (PCA) was conducted to investigate the relative contributions of quantitative features.

Results: Quantitative speech measures were generally concordant with independent clinician ratings of motor speech impairment severity. Hypothesis-driven groupings of quantitative measures differentiated predominantly apraxic from predominantly dysarthric presentations within the MSI+ group. PCA results provided additional evidence for differential profiles of motor speech impairment in the MSI+ group; heterogeneity across individuals is explained in large part by varying levels of overall severity—captured by the shared feature variable group—and degree of apraxia severity, as measured by the AOS feature variable group.

Conclusions: Quantitative features reveal heterogeneity of MSI in the 4RT group in terms of both overall severity and subtype of MSI. Results suggest the potential for acoustic and kinematic speech assessment methods to inform characterization of motor speech impairment in 4RT-associated syndromes.

Supplemental Material S1. Interrater reliability for all acoustic and kinematic speech variables.

Supplemental Material S2. REDCap SLP rating survey of motor speech impairment.

Supplemental Material S3. Example branching logic in REDCap SLP survey.

Supplemental Material S4. Detailed summary of auditory-perceptual ratings of motor speech impairment.

Supplemental Material S5. Individual motor speech impairment profiles based on quantitative speech measures, MSI+ group.

Supplemental Material S6. Individual motor speech impairment profiles based on quantitative speech measures, MSI− group.

Cordella, C., Gutz, S. E., Eshghi, M., Stipancic, K. L., Schliep, M., Dickerson, B. C., & Green, J. R. (2022). Acoustic and kinematic assessment of motor speech impairment in patients with suspected four-repeat tauopathies. Journal of Speech, Language, and Hearing Research. Advance online publicatiom. https://doi.org/10.1044/2022_JSLHR-22-00177