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@ARTICLE{Trger:285036,
author = {Tröger, Johannes and Rouvalis, Andreas and Dörr, Felix
and Schwed, Louisa and Linz, Nicklas and König, Alexandra
and Machts, Judith and Vielhaber, Stefan and Thies, Tabea
and Prudlo, Johannes and Hermann, Andreas and Kasper,
Elisabeth},
title = {{A}utomatically measured speech intelligibility models
bulbar-specific disease severity and progression in
{A}myotrophic {L}ateral {S}clerosis.},
journal = {Amyotrophic lateral sclerosis $\&$ frontotemporal
degeneration},
volume = {27},
number = {1-2},
issn = {2167-8421},
address = {Abingdon},
publisher = {Taylor Francis Group},
reportid = {DZNE-2026-00161},
pages = {101 - 109},
year = {2026},
abstract = {Amyotrophic lateral sclerosis (ALS) is a progressive
neurodegenerative disease that leads to widespread motor
deterioration, including significant motor speech
impairments. Speech intelligibility is a crucial component
of communication affected in ALS, requiring objective,
scalable assessment methods as an indicator of disease
progression and treatment efficacy. Objective: This study
investigates whether speech and bulbar function in ALS could
be evaluated and monitored utilizing an automated digital
measure of speech intelligibility derived from naturalistic
picture descriptions. Methods: Speech recordings from 44
patients living with ALS (plwALS) and 49 matched healthy
controls (HC) were analyzed and processed utilizing an
automated speech analysis pipeline to extract an
intelligibility score. These were part of a cross-sectional
and longitudinal study involving two assessments. Results:
The findings confirmed that speech intelligibility is
significantly reduced in plwALS compared to HC. Those with
bulbar-onset ALS have lower intelligibility than those with
spinal-onset ALS, and the intelligibility of individuals
with bulbar symptoms-regardless of the onset type-is lower
than in plwALS without bulbar symptoms. Declining
ALS-related speech scores correspond with worsening
intelligibility in longitudinal assessments. Intelligibility
correlates strongly with bulbar-specific clinical measures
but not with global scores, highlighting its role in
tracking bulbar progression. In some plwALS, we were able to
demonstrate that automated speech analyses are more
effective in detecting worsening in intelligibility earlier
than standard clinical scoring. Conclusion: Our findings
highlight that automated speech intelligibility assessments
can be a valuable marker to improve clinical monitoring and
facilitate earlier intervention in ALS as a supplement to
standard assessments.},
keywords = {Humans / Amyotrophic Lateral Sclerosis: complications /
Amyotrophic Lateral Sclerosis: physiopathology / Amyotrophic
Lateral Sclerosis: diagnosis / Male / Female / Disease
Progression / Middle Aged / Speech Intelligibility:
physiology / Aged / Cross-Sectional Studies / Longitudinal
Studies / Severity of Illness Index / Adult / Speech
Disorders: etiology / Speech Disorders: diagnosis /
Speech-based biomarkers (Other) / automated speech analysis
(Other) / disease stratification (Other) / intelligibility
(Other) / patient monitoring (Other)},
cin = {AG Teipel / AG Düzel / AG Hermann},
ddc = {610},
cid = {I:(DE-2719)1510100 / I:(DE-2719)5000006 /
I:(DE-2719)1511100},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40851280},
doi = {10.1080/21678421.2025.2549317},
url = {https://pub.dzne.de/record/285036},
}