{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:16:10Z","timestamp":1787008570583,"version":"build-2736575974"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":162,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Peter Cohen Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative motor neuron disease that can cause progressive bulbar dysfunction and dysarthria, resulting in reduced quality of life. Quantitative motor speech analysis can identify features of dysarthria that worsen with ALS progression but are not, inherently, clinically meaningful. Listener effort (LE) is a clinician-rated feature describing how much effort the listener needs to exert to understand the dysarthric speaker. This study investigated whether LE could act as a clinically meaningful measure of ALS dysarthria that could be used as an outcome measure in clinical trials. The Everything ALS Speech Study obtained longitudinal clinical information and speech recordings from 292 participants. In a subset of 125 participants, we measured speaking rate and three speech\u2013language pathologists (SLPs) with expertise in ALS rated LE. We also built and tested a LE prediction algorithm to predict the SLPs\u2019 rating of LE. In addition, all speech recordings and associated clinical data are now being made available to ALS researchers via the Everything ALS portal. LE intra- and inter-rater reliability was very high (ICC 0.94\u20130.95). LE correlated with other measures of dysarthria at baseline and changed over time in participants with ALS (slope 0.77 pts\/month, SE = 0.15, P &amp;lt; 0.001) but not controls (slope 0.005 pts\/month, SE = 0.02, P = 0.807). The slope of LE progression was faster in people with bulbar onset than non-bulbar onset ALS (1.66 points\/month versus 0.42 pts\/month; P &amp;lt; 0.001) but was similar in all participants who had bulbar dysfunction at baseline, regardless of ALS site of onset (1.52 pts\/month for bulbar onset versus 0.98 pts\/month for non-bulbar onset with current bulbar involvement; P = 0.36). The LE prediction model predicted the true LE, with an average R2 of 0.83 \u00b1 0.07. Dysarthria is associated with decreased quality of life in people with ALS. Quantitative measures of dysarthria in ALS could be useful as ALS clinical trial outcome measures, providing insight into the progression of bulbar symptoms. Speaking rate quantifies progression but is variable across speaking stimuli, emotional states and contextual factors. LE is more inherently clinically meaningful, can be measured reliably by SLPs, changes quantitatively over time and is highly reproducible, thus may be useful as a clinical outcome assessment for ALS clinical trials. Furthermore, a LE prediction model is effective at predicting LE scores and should be validated on an external dataset.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaf232","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T07:48:40Z","timestamp":1749628120000},"source":"Crossref","is-referenced-by-count":5,"title":["Listener effort measures clinically meaningful change of dysarthria in amyotrophic lateral sclerosis"],"prefix":"10.1093","volume":"7","author":[{"given":"Indu Navar","family":"Bingham","sequence":"first","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7737-4172","authenticated-orcid":false,"given":"Raquel","family":"Norel","sequence":"additional","affiliation":[{"name":"IBM Research Center , Yorktown Heights, NY 10598 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban G","family":"Roitberg","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]},{"name":"Escuela de Ciencia y Tecnolog\u00eda, Universidad Nacional de San Mart\u00edn , Buenos Aires B1650 ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juli\u00e1n","family":"Peller","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]},{"name":"Laboratorio de Neurociencias Cognitivas Computacionales, Humai , Buenos Aires C1425 ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos A","family":"Trevisan","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de F\u00edsica\u2014CONICET\u2014Universidad de Buenos Aires, Instituto de F\u00edsica Interdisciplinaria y Aplicada (INFINA) , Buenos Aires C1428 ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Agurto","sequence":"additional","affiliation":[{"name":"IBM Research Center , Yorktown Heights, NY 10598 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4358-8671","authenticated-orcid":false,"given":"Michele","family":"Merler","sequence":"additional","affiliation":[{"name":"IBM Research Center , Yorktown Heights, NY 10598 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego E","family":"Shalom","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de F\u00edsica\u2014CONICET\u2014Universidad de Buenos Aires, Instituto de F\u00edsica Interdisciplinaria y Aplicada (INFINA) , Buenos Aires C1428 ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Aguirre","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iair","family":"Embon","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Taitz","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Harris","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]},{"name":"Department of Neurology, Lewis Katz School of Medicine at Temple University , Philadelphia, PA 19140 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Wright","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Seaver","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]},{"name":"MGH Institute of Health Professions, Charlestown Navy Yard , Boston, MA 02129 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Peter Cohen Foundation dba Everything ALS , Seattle, WA 98112 ,","place":["USA"]},{"name":"Sean M. Healey and AMG Center for ALS, Massachusetts General Hospital & Harvard Medical School , Boston, MA 02114 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan R","family":"Green","sequence":"additional","affiliation":[{"name":"MGH Institute of Health Professions, Charlestown Navy Yard , Boston, MA 02129 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyle W","family":"Ostrow","sequence":"additional","affiliation":[{"name":"Department of Neurology, Lewis Katz School of Medicine at Temple University , Philadelphia, PA 19140 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Fraenkel","sequence":"additional","affiliation":[{"name":"Department of Biological Engineering, Massachusetts Institute of Technology , Cambridge, MA 02139 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0898-6081","authenticated-orcid":false,"given":"James D","family":"Berry","sequence":"additional","affiliation":[{"name":"Sean M. 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