Acoustically Altered Speech Perception in Frontotemporal Dementia Syndromes.

Area of Science:

• Neuroscience
• Audiology
• Neurology

Background:

• Hearing impairment is a significant clinical challenge in dementia.
• Acoustically altered speech (AAS) presents real-world listening difficulties, but its perception markers in frontotemporal dementias (FTDs) are not well-defined.

Purpose of the Study:

• To investigate if AAS perception can differentiate between FTD syndromes.
• To determine if AAS perception predicts real-world hearing symptoms in FTD patients.

Main Methods:

• A cross-sectional case-control study involving 29 FTD patients (nfvPPA, svPPA, bvFTD) and 15 controls.
• Participants underwent pure-tone audiometry (PTA) and three AAS tests: speech-in-babble (SIB), spectrally filtered speech (SFS), and time-compressed speech (TCS).
• Real-world hearing was assessed using the modified Amsterdam Inventory for Auditory Disability and Handicap (mAIAD).

Main Results:

• Patients with nonfluent/agrammatic variant primary progressive aphasia (nfvPPA) showed significantly higher PTA thresholds and worse performance on SFS and time-compressed speech (TCS) tests compared to controls and other FTD groups.
• Semantic variant primary progressive aphasia (svPPA) patients also performed worse on TCS compared to controls.
• Real-world hearing disability (mAIAD scores) correlated more strongly with AAS perception tests than with PTA thresholds.

Conclusions:

• Acoustically altered speech (AAS) perception serves as a valuable tool to stratify different frontotemporal dementia (FTD) syndromes.
• AAS perception acts as a "real-world audiogram" for assessing hearing abilities in FTD.