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Objective acoustic analysis of speech can quantify speech alterations. It is currently unknown, however, at what stage of HD speech alterations can be reliably detected. We aimed to explore the patterns and extent of speech alterations using objective acoustic analysis in HD and to assess correlations with both rater\u2010assessed phenotypical features and biological determinants of HD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Speech samples were acquired from 44 premanifest (29 pre\u2010symptomatic and 15 prodromal) and 25 manifest HD gene expansion carriers, and 25 matched healthy controls. A quantitative automated acoustic analysis of 10 speech dimensions was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Automated speech analysis allowed us to differentiate between participants with HD and controls, with areas under the curve of 0.74 for pre\u2010symptomatic, 0.92 for prodromal, and 0.97 for manifest stages. In addition to irregular alternating motion rates and prolonged pauses seen only in manifest HD, both prodromal and manifest HD displayed slowed articulation rate, slowed alternating motion rates, increased loudness variability, and unstable steady\u2010state position of articulators. In participants with premanifest HD, speech alteration severity was associated with cognitive slowing (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.52, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and the extent of bradykinesia (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.43, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004). Speech alterations correlated with a measure of exposure to mutant gene products (CAG\u2010age\u2010product score; <jats:italic>r<\/jats:italic>\u00a0=\u00a00.60, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Speech abnormalities in HD are associated with other motor and cognitive deficits and are measurable already in premanifest stages of HD. Therefore, automated speech analysis might represent a quantitative HD biomarker with potential for assessing disease progression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15726","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T04:54:01Z","timestamp":1675400041000},"page":"1262-1271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Speech biomarkers in Huntington's disease: A cross\u2010sectional study in pre\u2010symptomatic, prodromal and early manifest stages"],"prefix":"10.1111","volume":"30","author":[{"given":"Tomas","family":"Kouba","sequence":"first","affiliation":[{"name":"Department of Circuit Theory, Faculty of Electrical Engineering Czech Technical University in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Neurology University Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza","family":"Tykalova","sequence":"additional","affiliation":[{"name":"Department of Circuit Theory, Faculty of Electrical Engineering Czech Technical University in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alzbeta","family":"M\u00fchlb\u00e4ck","sequence":"additional","affiliation":[{"name":"Department of Neurology University Ulm  Ulm Germany"},{"name":"Department of Neuropsychiatry, Huntington Center South kbo\u2010Isar\u2010Amper\u2010Klinikum Taufkirchen (Vils)  Taufkirchen Germany"},{"name":"Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine Charles University and General University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u0159\u00ed","family":"Klemp\u00ed\u0159","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine Charles University and General University Hospital  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin S.","family":"Lindenberg","sequence":"additional","affiliation":[{"name":"Department of Neurology University Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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