Self-perception of speech impairment in MS: Associations with dysarthria severity and speech measures

To investigate the relationship between patient-reported speech difficulties, clinician-rated dysarthria severity, and acoustic speech measures in persons with multiple sclerosis (MS).

This cross-sectional study included individuals with a diagnosis of MS, excluding those who had a relapse within the last three months. The sociodemographic variables (age, sex, and education level) and clinical variables (disease duration, age at symptom onset, and Expanded Disability Status Scale score) were collected. Participants completed a self-perception questionnaire. Speech assessment consisted of auditory-perceptual evaluation and acoustic speech analysis, based on recordings of the following speech tasks: sustained vowel /a/; sentences with different intonation patterns; diadochokinesis; spontaneous speech; and repeated production of the diphthong /iu/.

Forty-seven participants were included, 34 (72.3%) were female, with a mean age of 47.7 (±11.83) years, a mean education level of 10.7 (±2.92) years, and a mean disease duration of 13.66 (±6.49) years. Self-perceived speech impairment (LwD total score) was significantly associated with dysarthria severity (p = 0.0277) and with articulator acoustic measures, including phonation time, number of syllables, and phonation rate. The regression model indicated that phonation time was a significant predictor of self-perceived speech difficulty (p = 0.016), explaining 20.6% of the variance.

Speech self-perception in individuals with MS was associated with both auditory-perceptual and objective acoustic parameters. Phonation time emerged as a sensitive acoustic marker, associated with perceived speech impairment, supporting the inclusion of brief articulatory tasks in screening protocols and reinforcing the clinical relevance of patient-reported speech outcomes within an integrative assessment framework.