Kinematic Features of Jaw and Lips Distinguish Symptomatic From Presymptomatic Stages of Bulbar Decline in Amyotrophic Lateral Sclerosis Purpose The goals of this study were to (a) classify speech movements of patients with amyotrophic lateral sclerosis (ALS) in presymptomatic and symptomatic phases of bulbar function decline relying solely on kinematic features of lips and jaw and (b) identify the most important measures that detect the transition between early ... Research Article
Research Article  |   May 17, 2018
Kinematic Features of Jaw and Lips Distinguish Symptomatic From Presymptomatic Stages of Bulbar Decline in Amyotrophic Lateral Sclerosis
 
Author Affiliations & Notes
  • Andrea Bandini
    University Health Network, Toronto Rehabilitation Institute, Ontario, Canada
  • Jordan R. Green
    Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
  • Jun Wang
    Department of Bioengineering, The University of Texas at Dallas, Richardson
    Callier Center for Communication Disorders, The University of Texas at Dallas
  • Thomas F. Campbell
    Callier Center for Communication Disorders, The University of Texas at Dallas
  • Lorne Zinman
    Neurology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
    Brain Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
  • Yana Yunusova
    University Health Network, Toronto Rehabilitation Institute, Ontario, Canada
    Brain Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
    Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Andrea Bandini: andrea.bandini@uhn.ca
  • Editor-in-Chief: Julie Liss
    Editor-in-Chief: Julie Liss×
  • Editor: Megan McAuliffe
    Editor: Megan McAuliffe×
Article Information
Speech, Voice & Prosodic Disorders / Special Populations / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   May 17, 2018
Kinematic Features of Jaw and Lips Distinguish Symptomatic From Presymptomatic Stages of Bulbar Decline in Amyotrophic Lateral Sclerosis
Journal of Speech, Language, and Hearing Research, May 2018, Vol. 61, 1118-1129. doi:10.1044/2018_JSLHR-S-17-0262
History: Received July 11, 2017 , Revised November 27, 2017 , Accepted January 25, 2018
 
Journal of Speech, Language, and Hearing Research, May 2018, Vol. 61, 1118-1129. doi:10.1044/2018_JSLHR-S-17-0262
History: Received July 11, 2017; Revised November 27, 2017; Accepted January 25, 2018

Purpose The goals of this study were to (a) classify speech movements of patients with amyotrophic lateral sclerosis (ALS) in presymptomatic and symptomatic phases of bulbar function decline relying solely on kinematic features of lips and jaw and (b) identify the most important measures that detect the transition between early and late bulbar changes.

Method One hundred ninety-two recordings obtained from 64 patients with ALS were considered for the analysis. Feature selection and classification algorithms were used to analyze lip and jaw movements recorded with Optotrak Certus (Northern Digital Inc.) during a sentence task. A feature set, which included 35 measures of movement range, velocity, acceleration, jerk, and area measures of lips and jaw, was used to classify sessions according to the speaking rate into presymptomatic (> 160 words per minute) and symptomatic (< 160 words per minute) groups.

Results Presymptomatic and symptomatic phases of bulbar decline were distinguished with high accuracy (87%), relying only on lip and jaw movements. The best features that allowed detecting the differences between early and later bulbar stages included cumulative path of lower lip and jaw, peak values of velocity, acceleration, and jerk of lower lip and jaw.

Conclusion The results established a relationship between facial kinematics and bulbar function decline in ALS. Considering that facial movements can be recorded by means of novel inexpensive and easy-to-use, video-based methods, this work supports the development of an automatic system for facial movement analysis to help clinicians in tracking the disease progression in ALS.

Acknowledgments
The authors would like to acknowledge the funding support from National Institutes of Health Grants R01DC013547 (awarded to J. R. Green, Y. Yunusova, T. F. Campbell, J. Wang, and L. Zinman) and K24DC016312 (awarded to J. R. Green), as well as from AGE-WELL Graduate Student and Postdoctoral Award in Technology and Aging AW-HQP2017-017 (awarded to A. Bandini and Y. Yunusova). The authors are thankful to the participants and their families for taking part in this project. The authors also thank Madhura Kulkarni for her assistance with this project.
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