Alzheimer's, Parkinson's & Mental Health
Faster Method to Detect Parkinson’s
May Lead to Better Control of Symptoms
This disorder of the nervous system
affects movement and usually strikes seniors over 60; see video
MSU’s Rahul Shrivastav chats with
Parkinson’s patient Peter Hasbrook.
June 13, 2013 - Parkinson’s disease
is a neurological disorder that affects a half million people in the
United States, with about 50,000 newly diagnosed cases each year. And,
it normally strikes older people as the pass age 60. There is no cure
and, until now, no reliable method for detecting the disease.
research team from
Michigan State has developed an innovative detection
method they say is a major breakthrough in diagnosing Parkinson’s in
early stages - the point at which treatment to control symptoms is most
Parkinson's, a disorder of the
nervous system that affects movement, occurs when nerve cells in the
brain stop producing the chemical dopamine, which helps control muscle
movement. Without dopamine, nerve cells can’t properly send messages,
causing the loss of muscle function. (See more in box below from
The method of detection, developed
in part by Rahul Shrivastav, professor and chair of MSU’s Department of
Communicative Sciences and Disorders, involves monitoring a patient’s
speech patterns, specifically movement patterns of the tongue and jaw.
Shrivastav says Parkinson’s affects all patients’ speech and changes in
speech patterns are detectable before other movement and muscles are
affected by the disease.
The new early detection method has
proved to be more than 90 percent effective and is noninvasive and
inexpensive. Requiring as little as two seconds of speech, monitoring
can be done remotely and in telemedicine applications. In addition, the
new method has the potential to track the progression of Parkinson’s and
measure the effectiveness of treatment.
Researcher profile: Rahul
Shaky hands, tremors, rigid
muscles, slower movements—these are all recognizable symptoms of
Parkinson’s disease, a neurological disorder affecting a half million
people in the United States.
Parkinson's Disease - usually begins around age 60
Also called: Paralysis agitans, Shaking palsy
Parkinson's disease (PD) is a type of
movement disorder. It happens when nerve cells in the brain
don't produce enough of a brain chemical called dopamine.
Sometimes it is genetic, but most cases do not seem to run in
families. Exposure to chemicals in the environment might play a
begin gradually, often on one side of the body. Later they
affect both sides. They include
Trembling of hands, arms, legs, jaw and face
Stiffness of the arms, legs and trunk
Slowness of movement
balance and coordination
symptoms get worse, people with the disease may have trouble
walking, talking, or doing simple tasks. They may also have
problems such as depression, sleep problems, or trouble chewing,
swallowing, or speaking.
no lab test for PD, so it can be difficult to diagnose. Doctors
use a medical history and a neurological examination to diagnose
begins around age 60, but it can start earlier. It is more
common in men than in women. There is no cure for PD.
of medicines sometimes help symptoms dramatically. Surgery and
deep brain stimulation (DBS) can help severe cases. With DBS,
electrodes are surgically implanted in the brain. They send
electrical pulses to stimulate the parts of the brain that
National Institute of Neurological Disorders and Stroke
Rahul Shrivastav, professor and
chair of MSU’s Department of Communicative Sciences and Disorders, is
working on a way to detect the disease earlier in patients by measuring
a lesser known symptom: a change in speech.
“I was looking at speech changes
and Parkinson’s disease about five years ago as part of another team,”
says Shrivastav. “That sort of evolved into this new project where my
team and I said, ‘If we can measure small changes in speech, what could
we use that measurement for?’ One of the things that came out was we
could use it to detect the onset of the disease.”
There is no cure for Parkinson’s
disease, so early detection is particularly important since the
treatments currently available for controlling symptoms are most
effective at that stage.
“It’s a pretty aggressive disease,”
says Shrivastav. “It starts off gradually but has a very big impact on
people’s lives eventually. There’s no formal diagnostic method. It’s
mostly subjective. Speech is one of the things we know very well
changes. In fact, there is enough data out there to know it’s one of the
first things to change in a lot of people.”
Shrivastav hopes that by designing
tools to capture those changes, which are very small, inaudible changes,
neurologists and other health care providers will have a way to make a
diagnostic decision that isn’t possible otherwise.
Those same tools might have
applications in diagnosing and treating other diseases as well.
“Our goal is to be able to come up
with ways to essentially find a fingerprint in the speech sample for a
variety of different diseases,” says Shrivastav. “Parkinson’s is just
the one that we are probably farthest along with. We’ve started looking
at other conditions as well. They’re all things that affect part of the
brain that impact speech.”
None of Shrivastav’s work is
possible without collaboration between experts in different areas.
“Mark Skowronski is working with
us. He’s an engineer,” Shrivastav says. “He does a lot of the signal
processing side for us. We have people who are really engaged in the
speech and speech disorders side. We have the neurologists who know the
disease and the treatment and how it impacts patients. It’s all
teamwork. It’s impossible for any one person to do this. It’s so
enmeshed, it’s impossible to say that this came out of any one academic
Shrivastav, who has been at MSU for
a year, is hopeful that the work the team is doing will lead to
invaluable tools that will change the diagnosis and treatment of this
“With the aging population, the
statistic is about 50,000 new diagnoses every year,” Shrivastav says.
“We hope that we can really come up with a low-cost, highly sensitive
method that could be used by as many people as possible to improve
health care and the quality of life.”
Field note: An ear for
diagnosing Parkinson’s disease
Mark Skowronski is an assistant
professor in the Department of Communicative Sciences and Disorders,
College of Communication Arts and Sciences at MSU
Sitting with Jay Rosenbek, a
clinical expert in neurological abnormalities of speech and language
from the University of Florida, and listening to recordings of
disordered speech, I wondered what would come of our efforts to detect
signs of Parkinson’s disease (PD) in speech.
While characteristics of
Parkinson’s speech have been known since the 1960s, few studies have
tried to differentiate it from normal speech experimentally, and none
have used anything but sustained vowels—the ubiquitous “ahhhhh” that
doctors prefer—for speech material.
We were listening to sentences and
longer passages being read, and Jay, drawing from more than 40 years of
experience in the field, was dissecting the material like a surgeon. For
my part of our collaboration, as an electrical engineer with expertise
in signal processing, I was weighing all of Jay’s observations against
my own thoughts on how exactly we were going to implement any of his
ideas in a robust and automated algorithm.
Previously, I had collaborated with
a range of non-engineer experts, from OB-GYN doctors to bat biologists
to audiologists and speech pathologists, and those experiences shaped
the philosophy that it is wise to let the experts in the field establish
the foundation for signal processing development. After several
back-and-forth sessions and a few mini experiments, a strategy emerged.
Parkinson’s disease affects speech
by disturbing muscle planning and control, interfering with the delicate
coordination of the diaphragm, the larynx, and movements of the
articulators: the tongue, jaw, lips, and velum. While other studies
focused on the “ahhhhh” from the larynx, we focused on the articulators,
partly because their imprecise movements were readily audible, according
to Jay, and partly because of our experience capturing articulation for
the purpose of automatic speech recognition.
Our articulation features, called
the cepstrum—a play on the word “spectrum”—were borne from a
mathematician’s desire to convert more complicated mathematical
operations into addition and subtraction and have stood the test of time
as automatic speech recognition features for more than 30 years. The
cepstrum elegantly separates the contributions of the larynx and the
articulators to speech, providing a quantified snapshot of articulator
position and movement during any moment of speech production.
Finally, we converted the cepstrum
snapshots into measures of variance of articulator position and movement
over time (so-called range and rate measures). In a cross-validation
experiment, our range and rate measures distinguished between PD and
normal talkers with an accuracy of 93 percent.
The results are exciting, in part
because they validate our expert-driven design philosophy and also
because they demonstrate that the effects of neurological disorders may
be quantified noninvasively using robust speech measures. One day, we
may be using a telephone application to monitor our long-term health
through our speech, providing early detection of health changes and
leading to early treatment.
More at MSU Today
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