背景:数字语音评估最早具有潜在的相关性,阿尔茨海默病(AD)的临床前阶段。我们评估了可行性,测试-重测可靠性,以及与AD相关的β淀粉样蛋白(Aβ)病理学相关的语音声学在远程环境中进行多次评估。
方法:50名认知未受损的成年人(年龄68±6.2岁,58%女性,46%Aβ阳性)完成远程,基于平板电脑的语音评估(即,图片描述,日记提示讲故事,口头流利的任务)五天。在2-3周后重复测试范例。从录音中自动提取声学语音特征,并计算5天期间的平均得分.我们通过系统可用性量表(SUS)问卷的依从率和可用性评级来评估可行性。采用组内相关系数(ICC)检查重测信度。我们调查了声学特征与Aβ病理学之间的关联,使用线性回归模型,根据年龄调整,性和教育。
结果:语音评估是可行的,91.6%的依从性和可用性评分为86.0±9.9。在平均语音样本中发现高可靠性(ICC≥0.75)。Aβ阳性个体在图片描述(B=-0.05,p=0.040)和日记提示讲故事(B=-0.07,p=0.032)中显示出比Aβ阴性个体更高的停顿与单词比率,尽管这种影响在多次测试校正后失去了意义。
结论:我们的研究结果支持对有和没有Aβ病理学的认知未受损个体进行语音声学的多日远程评估的可行性和可靠性,这为在早期AD中使用语音生物标志物奠定了基础。
BACKGROUND: Digital speech assessment has potential relevance in the earliest, preclinical stages of Alzheimer\'s disease (AD). We evaluated the feasibility, test-retest reliability, and association with AD-related amyloid-beta (Aβ) pathology of speech acoustics measured over multiple assessments in a remote setting.
METHODS: Fifty cognitively unimpaired adults (Age 68 ± 6.2 years, 58% female, 46% Aβ-positive) completed remote, tablet-based speech assessments (i.e., picture description, journal-prompt storytelling, verbal fluency tasks) for five days. The testing paradigm was repeated after 2-3 weeks. Acoustic speech features were automatically extracted from the voice recordings, and mean scores were calculated over the 5-day period. We assessed feasibility by adherence rates and usability ratings on the System Usability Scale (SUS) questionnaire. Test-retest reliability was examined with intraclass correlation coefficients (ICCs). We investigated the associations between acoustic features and Aβ-pathology, using linear regression models, adjusted for age, sex and education.
RESULTS: The speech assessment was feasible, indicated by 91.6% adherence and usability scores of 86.0 ± 9.9. High reliability (ICC ≥ 0.75) was found across averaged speech samples. Aβ-positive individuals displayed a higher pause-to-word ratio in picture description (B = -0.05, p = 0.040) and journal-prompt storytelling (B = -0.07, p = 0.032) than Aβ-negative individuals, although this effect lost significance after correction for multiple testing.
CONCLUSIONS: Our findings support the feasibility and reliability of multi-day remote assessment of speech acoustics in cognitively unimpaired individuals with and without Aβ-pathology, which lays the foundation for the use of speech biomarkers in the context of early AD.