Speech pauses in multiple sclerosis may indicate cognitive impairment

Key takeaways:

• The researchers sought to evaluate how speech biomarkers may detect MS.
• Patients with MS performed poorer in overall cognition and executive function compared with healthy controls.

WEST PALM BEACH, Fla. — Variability and length of pauses in speech may indicate cognitive impairment for German-speaking individuals with multiple sclerosis, according to a poster from ACTRIMS 2024.

“We are looking for an unobtrusive and etiologically valid method — meaning in a normal environment — to measure certain symptoms in multiple sclerosis,” Nicklas Linz, PhD, co-founder and CEO of ki:elements, a speech biomarker company based in Germany, told Healio. “These include cognitive impairment and we tried to do this through the automatic analysis of speech.”

Since cognitive impairment is a conspicuous symptom of MS, Linz and colleagues aimed to evaluate how speech biomarkers may detect the condition, particularly in highly prevalent domains such as processing speed and executive function, in a cohort of German-speaking individuals.

Their study included 169 participants (those with MS, n = 76; healthy controls, n = 93) who submitted to a cognitive test battery involving speech tasks as well as evaluation on the Symbol Digit Modalities Test (SDMT). From three free speech tasks (telling a negative and positive story, picture description), researchers extracted both temporal and acoustic aspects of speech such as duration of pauses, pause rate, pitch and jitter, correlating them with SDMT performance.

Additionally, the researchers applied the novel ki:elements speech biomarker for cognition (ki:e SB-C), a composite score derived from a 15-minute long speech assessment, for comparison between the MS population and healthy controls.

For the MS group, results showed pause rate correlated significantly with the SDMT (r = -.2, P = .05, d = 0.41 and r = -.291, P = .05, d = 0.61) with respect to the picture description and negative storytelling tasks.

Data further showed, in both tasks, standard deviation of pause length correlated significantly with the SDMT, while acoustic features such as deviations in jitter and formants correlated with the SDMT in all three tasks.

The researchers also found those with MS recorded significantly lower scores than healthy counterparts in the ki:e SB-C composite score for overall cognition (H = 5.04, P = .01, d = 0.24) and for the sub-score of executive functioning (H = 6.86, P = .01, d = 0.29).

“We found that pausing behavior — how many pauses they make, how long these pauses are — negatively correlated with their processing speed ability,” Linz told Healio. “If you make more pauses, the slower your information processing.”