Can Voice Parameters Provide Cutoff Values to Predict Dysphagia in Individuals with Multiple Sclerosis?

Area of Science:

• Neurology
• Speech-Language Pathology
• Biomedical Engineering

Background:

• Dysphagia is a common complication in multiple sclerosis (MS), impacting quality of life.
• Voice parameters are potential, yet under-researched, markers for dysphagia risk assessment.
• Objective voice analysis requires further validation to support clinical decision-making in MS.

Purpose of the Study:

• To identify specific voice parameters predicting dysphagia risk in individuals with MS (IwMS).
• To determine optimal cutoff values for these voice parameters in IwMS.
• To evaluate the diagnostic accuracy of voice parameters for dysphagia/penetration risk in IwMS.

Main Methods:

• Seventy-six adults (39 IwMS, 37 healthy individuals) participated.
• Standardized questionnaires (DYMUS, GUSS, VHI-10) and acoustic voice analysis (Praat) were used.
• Voice recordings were analyzed pre- and post-swallowing for fundamental frequency (F0), SD F0, jitter, shimmer (local), and HNR.
• Receiver Operating Characteristic (ROC) analysis was performed to assess diagnostic accuracy.

Main Results:

• IwMS showed significant differences in VHI-10, DYMUS, GUSS scores, jitter, shimmer (local), and HNR compared to healthy individuals pre-swallowing.
• Shimmer (local) and HNR differed significantly between pre- and post-swallowing measurements in IwMS, but not in healthy individuals.
• GUSS scores revealed significant differences in pre- and post-swallowing shimmer (local) between IwMS with and without dysphagia/penetration.
• ROC analysis indicated good diagnostic accuracy for shimmer (local) pre-swallowing (AUC 73.1%) and post-swallowing (AUC 78.6%).

Conclusions:

• Individuals with MS exhibit distinct voice parameter alterations (shimmer, HNR) associated with voice quality of life and dysphagia risk.
• Shimmer (local) pre- and post-swallowing demonstrates potential as a reliable biomarker for dysphagia risk in IwMS.
• These findings suggest that acoustic voice analysis can enhance dysphagia risk assessment in individuals with MS.