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Abstract Details

Multimodal Biomarkers of Prodromal Neurodegeneration: Integrating Speech, Alpha-synuclein, and Smell in RBD
Aging, Dementia, and Behavioral Neurology
P11 - Poster Session 11 (11:45 AM-12:45 PM)
13-013

Relationships between speech, alpha-synuclein, and smell were examined in patients with SSRI-induced REM sleep behavior disorder (5-HT RBD).

It is uncertain if 5-HT RBD is, like idiopathic RBD, a syndrome synucleinopathy and a prodrome of Parkinson’s disease (PD) and Dementia with Lewy Bodies (DLB). Because speech and smell changes associated with synucleinopathy may be early PD indicators in this population.

28 patients with 5-HT RBD and 19 controls completed speech tasks, skin biopsy for alpha-synuclein, and smell testing. Speech acoustics were analyzed with the Acoustic Voice Quality Index (AVQI), smoothed cepstral peak prominence (CPP), Harmonics-to-Noise ratio (HNR), and percent creak. Relationships among speech acoustics, smell testing, and synucleinopathy were assessed with multimodal analysis, controlling for sex and age.

5-HT RBD cases demonstrated significant differences in several speech tasks compared to controls. In particular CPPs (p=0.020) was lower in glottal stop sentences, and percent creak was higher in spontaneous speech (p=0.034). Total Voiced Time was higher in easy onset (p=0.005), all voiced (p=0.033), and glottal stop (p=0.008) sentences. HNR was significantly lower in all voiced sentences (p=0.03) and in spontaneous speech (p=0.003). Controlling for group, patients with synucleinopathy had higher total voiced time (p=0.016) in easy onset sentences, lower AVQI (p=0.042) in all voiced sentences, and higher HNR in the rainbow passage (p=0.004). Total voiced time was higher in glottal stop sentences in patients with normal smell function (p=0.007).

Patients with 5-HT RBD demonstrated evidence of prodromal speech differences consistent with early parkinsonism. These findings suggest that speech changes represent a signal that may precede cutaneous synuclein pathology, representing a unique early biomarker of disease progression. These findings suggest speech acoustics could be used as outcome measures in the development of disease-modifying neuroprotective therapies to prevent PD and DLB.
Authors/Disclosures
Saeid Sadeghian, MD
PRESENTER 		Dr. Sadeghian has nothing to disclose.
Michael J. Howell, MD, FAAN The institution of Dr. Howell has received research support from National Institutes of Health. Dr. Howell has received publishing royalties from a publication relating to health care.
Joy Schmidt Mrs. Schmidt has nothing to disclose.
Erjia Cui Dr. Cui has nothing to disclose.
Jesse D. Hoffmeister, PhD The institution of Dr. Hoffmeister has received research support from NIH. The institution of Dr. Hoffmeister has received research support from Uniformed Services University. The institution of Dr. Hoffmeister has received research support from Dr. Ralph and Mariak Falk Medical Trust.