{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T03:23:03Z","timestamp":1788578583394,"version":"build-2803163510"},"reference-count":109,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002366"],"award-info":[{"award-number":["UL1TR002366"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002607","name":"American Speech-Language-Hearing Foundation","doi-asserted-by":"publisher","award":["New Century Scholars Research Grant;"],"award-info":[{"award-number":["New Century Scholars Research Grant;"]}],"id":[{"id":"10.13039\/100002607","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007859","name":"University of Kansas","doi-asserted-by":"publisher","award":["Research GO Award"],"award-info":[{"award-number":["Research GO Award"]}],"id":[{"id":"10.13039\/100007859","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Communication ability\u2014a key determinant of quality of life\u2014is frequently affected and progressively declines in neurodegenerative diseases. Effective management of progressive communication disorders requires a personalized approach to deliver timely interventions tailored to the evolving profiles of communicative impairment, thereby supporting functional communication throughout the disease course. To this end, reliable tools capable of detecting and quantifying both disease-specific patterns of communicative impairment and within-disease phenotypic variability are urgently needed. This study leverages Artificial Intelligence and advanced data analytics to develop an acoustic-based framework for automated extraction of interpretable, clinically grounded speech markers to enable objective assessment and phenotyping of progressive communication disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three groups of participants, including 14 individuals with amyotrophic lateral sclerosis (ALS) and 15 individuals with Parkinson's disease (PD), alongside 10 neurologically healthy controls, performed a standardized oral passage reading task, yielding 739 speech samples. Fifty acoustic features were extracted using an automated analytic pipeline and subsequently clustered into six interpretable composite markers. The clinical utility of these markers was evaluated with the recorded speech samples by examining their (1) associations with standardized metrics of cognitive, motor speech, and overall communicative functions, (2) efficacy for detecting and differentiating disease-specific communicative impairment patterns in ALS and PD using supervised machine learning, and (3) utility for within-disease phenotyping and stratification using unsupervised clustering analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The markers effectively (1) detected subtle subclinical changes across multiple domains prior to substantial declines in functional communication outcomes; (2) differentiated disease-specific patterns of communicative impairment (multiclass area under the curve &amp;gt; 0.90); and (3) identified subgroups with distinct speech profiles within each disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The findings support the potential of the proposed framework as a clinically translatable, objective tool to facilitate early detection, differential diagnosis, and phenotyping of progressive communication disorders, ultimately advancing personalized, measurement-based care in neurodegenerative diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdgth.2026.1794169","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:09:36Z","timestamp":1777442976000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["An interpretable, clinically grounded framework for digital speech biomarker development in neurodegenerative diseases"],"prefix":"10.3389","volume":"8","author":[{"given":"Panying","family":"Rong","sequence":"first","affiliation":[{"name":"Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas","place":["Lawrence, KS, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Heidrick","sequence":"additional","affiliation":[{"name":"Department of Hearing and Speech, University of Kansas Medical Center","place":["Kansas City, KS, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1242\/dmm.030205","article-title":"Neurodegenerative disease: models, mechanisms, and a new hope","volume":"10","author":"Gitler","year":"2017","journal-title":"Dis Model Mech"},{"key":"B2","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1080\/21678421.2024.2447919","article-title":"Amyotrophic lateral sclerosis estimated prevalence cases from 2022 to 2030, data from the national ALS registry","volume":"26","author":"Mehta","year":"2025","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener"},{"key":"B3","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s00401-017-1709-7","article-title":"Interactions of pathological proteins in neurodegenerative diseases","volume":"134","author":"Spires-Jones","year":"2017","journal-title":"Acta Neuropathol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.21767\/2171-6625.100074","article-title":"Quality of life in patients with neurodegenerative diseases","volume":"7","author":"Batista","year":"2016","journal-title":"J Neurol Neurosci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1080\/146608202760839009","article-title":"Subjective experience and coping in ALS","volume":"3","author":"Hecht","year":"2002","journal-title":"Amyotroph Lateral Scler Other Motor Neuron Disord"},{"key":"B6","doi-asserted-by":"publisher","first-page":"69","DOI":"10.3233\/nre-151241","article-title":"Supporting communication for patients with neurodegenerative disease","volume":"37","author":"Fried-Oken","year":"2015","journal-title":"NeuroRehabilitation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1159\/000101769","article-title":"The degenerative dysarthrias: a window into critical clinical and research issues","volume":"59","author":"Yorkston","year":"2007","journal-title":"Folia Phoniatrica et Logopedica"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1136\/jnnp-2013-307135","article-title":"Amyotrophic lateral sclerosis: a long preclinical period?","volume":"85","author":"Eisen","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","first-page":"105922","DOI":"10.1016\/j.neubiorev.2024.105922","article-title":"From prodromal stages to clinical trials: the promise of digital speech biomarkers in Parkinson\u2019s disease","volume":"167","author":"Rusz","year":"2024","journal-title":"Neurosci Biobehav Rev"},{"key":"B10","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1136\/jnnp-2017-317245","article-title":"Human cerebral evolution and the clinical syndrome of amyotrophic lateral sclerosis","volume":"90","author":"Henderson","year":"2019","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1044\/jshr.1202.246","article-title":"Differential diagnostic patterns of dysarthria","volume":"12","author":"Darley","year":"1969","journal-title":"J Speech Hear Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1044\/jshr.1203.462","article-title":"Clusters of deviant speech dimensions in the dysarthrias","volume":"12","author":"Darley","year":"1969","journal-title":"J Speech Hear Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1038\/s41746-024-01199-1","article-title":"Responsible development of clinical speech AI: bridging the gap between clinical research and technology","volume":"7","author":"Berisha","year":"2024","journal-title":"npj Digit Med"},{"key":"B14","volume-title":"Motor Speech Disorders: Substrates, Differential Diagnosis, and Management","author":"Duffy","year":"2013"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1575753","DOI":"10.3389\/fdgth.2025.1575753","article-title":"Bridging AI innovation and healthcare: scalable clinical validation methods for voice biomarkers","volume":"7","author":"Krautz","year":"2025","journal-title":"Front Digit Health"},{"key":"B16","doi-asserted-by":"publisher","first-page":"269","DOI":"10.3389\/fpsyg.2017.00269","article-title":"Connected speech in neurodegenerative language disorders: a review","volume":"8","author":"Boschi","year":"2017","journal-title":"Front Psychol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/s1474-4422(13)70026-7","article-title":"Changes in cognition and behaviour in amyotrophic lateral sclerosis: nature of impairment and implications for assessment","volume":"12","author":"Goldstein","year":"2013","journal-title":"Lancet Neurol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1044\/2017_AJSLP-16-0087","article-title":"Speech versus speaking: the experiences of people with Parkinson\u2019s disease and implications for intervention","volume":"26","author":"Yorkston","year":"2017","journal-title":"Am J Speech Lang Pathol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"4870","DOI":"10.1093\/brain\/awad253","article-title":"Speech and language markers of neurodegeneration: a call for global equity","volume":"146","author":"Garc\u00eda","year":"2023","journal-title":"Brain"},{"key":"B20","doi-asserted-by":"publisher","first-page":"S49","DOI":"10.1016\/s1353-8020(13)70014-2","article-title":"Pathophysiology of language, speech and emotions in neurodegenerative disease","volume":"20","author":"Graff-Radford","year":"2014","journal-title":"Parkinsonism Relat Disord"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1373341","DOI":"10.3389\/fneur.2024.1373341","article-title":"Linguistic changes in neurodegenerative diseases relate to clinical symptoms","volume":"15","author":"Gumus","year":"2024","journal-title":"Front Neurol"},{"key":"B22","doi-asserted-by":"crossref","DOI":"10.1109\/SPMB55497.2022.10014965","article-title":"Cognitive and acoustic speech and language patterns occurring in different neurodegenerative disorders while performing neuropsychological tests","author":"Iglesias","year":"2022"},{"key":"B23","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.jab.2016.02.002","article-title":"Speech and language impairments in dementia","volume":"14","author":"Klimova","year":"2016","journal-title":"J Appl Biomed"},{"key":"B24","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"B25","article-title":"Speech intelligibility test for windows","author":"Yorkston","year":""},{"key":"B26","first-page":"xi","article-title":"Evidence for effectiveness of treatment of loudness, rate, or prosody in dysarthria: a systematic review","volume":"15","author":"Yorkston","year":"","journal-title":"J Med Speech Lang Pathol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1080\/17482960802654364","article-title":"Consensus criteria for the diagnosis of frontotemporal cognitive and behavioural syndromes in amyotrophic lateral sclerosis","volume":"10","author":"Strong","year":"2009","journal-title":"Amyotroph Lateral Scler"},{"key":"B28","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1044\/jshd.4603.296","article-title":"Communication efficiency of dysarthric speakers as measured by sentence intelligibility and speaking rate","volume":"46","author":"Yorkston","year":"1981","journal-title":"J Speech Hear Disord"},{"key":"B29","first-page":"149","article-title":"Algorithmic estimation of pauses in extended speech samples of dysarthric and typical speech","volume":"12","author":"Green","year":"2004","journal-title":"J Med Speech Lang Pathol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1396002","DOI":"10.3389\/fneur.2024.1396002","article-title":"A multimodal approach to automated hierarchical assessment of bulbar involvement in amyotrophic lateral sclerosis","volume":"15","author":"Rong","year":"2024","journal-title":"Front Neurol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1044\/2023_JSLHR-23-00219","article-title":"Hierarchical temporal structuring of speech: a multiscale, multimodal framework to inform the assessment and management of neuromotor speech disorder","volume":"67","author":"Rong","year":"2024","journal-title":"J Speech Lang Hear Res"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1491997","DOI":"10.3389\/fnins.2024.1491997","article-title":"A novel muscle network approach for objective assessment and profiling of bulbar involvement in ALS","volume":"18","author":"Rong","year":"2025","journal-title":"Front Neurosci"},{"key":"B33","doi-asserted-by":"publisher","first-page":"3678","DOI":"10.1044\/2025_jslhr-24-00286","article-title":"An explanatory model of speech communication centered on multiscale rhythmic modulation: implications for motor speech assessment and intervention for individuals with amyotrophic lateral sclerosis","volume":"68","author":"Rong","year":"2025","journal-title":"J Speech Lang Hear Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e0144411","DOI":"10.1371\/journal.pone.0144411","article-title":"Acoustic-Emergent phonology in the amplitude envelope of child-directed speech","volume":"10","author":"Leong","year":"2015","journal-title":"PLoS One"},{"key":"B35","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1162\/OPMI_a_00008","article-title":"The temporal modulation structure of infant-directed speech","volume":"1","author":"Leong","year":"2017","journal-title":"Open Mind"},{"key":"B36","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1121\/1.413112","article-title":"Temporal envelope and fine structure cues for speech intelligibility","volume":"97","author":"Drullman","year":"1995","journal-title":"J Acoust Soc Am"},{"key":"B37","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1038\/416087a","article-title":"Chimaeric sounds reveal dichotomies in auditory perception","volume":"416","author":"Smith","year":"2002","journal-title":"Nature"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e0240915","DOI":"10.1371\/journal.pone.0240915","article-title":"Graph-based feature extraction: a new proposal to study the classification of music signals outside the time-frequency domain","volume":"15","author":"Melo","year":"2020","journal-title":"PLoS One"},{"key":"B39","author":"Boersma","year":"2014"},{"key":"B40","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1103\/RevModPhys.50.221","article-title":"General properties of entropy","volume":"50","author":"Wehrl","year":"1978","journal-title":"Rev Mod Phys"},{"key":"B41","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.physrep.2006.11.001","article-title":"Recurrence plots for the analysis of complex systems","volume":"438","author":"Marwan","year":"2007","journal-title":"Phys Rep"},{"key":"B42","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/S0375-9601(02)01170-2","article-title":"Nonlinear analysis of bivariate data with cross recurrence plots","volume":"302","author":"Marwan","year":"2002","journal-title":"Phys Lett A"},{"key":"B43","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/S1364-6613(98)01259-5","article-title":"Complexity and coherency: integrating information in the brain","volume":"2","author":"Tononi","year":"1998","journal-title":"Trends Cogn Sci"},{"key":"B44","doi-asserted-by":"publisher","first-page":"2996","DOI":"10.1044\/2021_JSLHR-20-00743","article-title":"A novel hierarchical framework for measuring the complexity and irregularity of multimodal speech signals and its application in the assessment of speech impairment in amyotrophic lateral sclerosis","volume":"64","author":"Rong","year":"2021","journal-title":"J Speech Lang Hear Res"},{"key":"B45","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1109\/79.91217","article-title":"Wavelets and signal processing","volume":"8","author":"Rioul","year":"1991","journal-title":"IEEE Signal Process Mag"},{"key":"B46","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1044\/2018_AJSLP-17-0009","article-title":"Recommended protocols for instrumental assessment of voice: american speech-language-hearing association expert panel to develop a protocol for instrumental assessment of vocal function","volume":"27","author":"Patel","year":"2018","journal-title":"Am J Speech Lang Pathol"},{"key":"B47","author":"Revelle","year":"2020"},{"key":"B48","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/S0024-3795(97)10007-6","article-title":"Some new results on correlation-preserving factor scores prediction methods","volume":"289","author":"ten Berge","year":"1999","journal-title":"Linear Algebra Appl"},{"key":"B49","first-page":"779","article-title":"Support vector regression machines","volume":"28","author":"Drucker","year":"1997","journal-title":"Adv Neural Inform Process Syst"},{"key":"B50","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random forests","volume":"45","author":"Breiman","year":"2001","journal-title":"Mach Learn"},{"key":"B51","first-page":"405","article-title":"Clustering by means of medoids","volume-title":"Statistical Data Analysis Based on the L1 Norm and Related Methods","author":"Kaufman","year":"1987"},{"key":"B52","doi-asserted-by":"publisher","first-page":"857","DOI":"10.2307\/2528823","article-title":"A general coefficient of similarity and some of its properties","volume":"27","author":"Gower","year":"1971","journal-title":"Biometrics"},{"key":"B53","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1111\/1467-9868.00293","article-title":"Estimating the number of clusters in a data set via the gap statistic","volume":"63","author":"Tibshirani","year":"2002","journal-title":"J R Stat Soc Ser B Stat Methodol"},{"key":"B54","author":"Lenth","year":"2020"},{"key":"B55","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1007\/s00429-013-0510-1","article-title":"Action-verb processing in Parkinson\u2019s disease: new pathways for motor-language coupling","volume":"218","author":"Cardona","year":"2013","journal-title":"Brain Struct Funct"},{"key":"B56","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/bs.pbr.2022.01.017","article-title":"Speech dysfunction, cognition, and Parkinson\u2019s disease","volume":"269","author":"Rohl","year":"2022","journal-title":"Prog Brain Res"},{"key":"B57","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1136\/jnnp-2012-303526","article-title":"Is language impairment more common than executive dysfunction in amyotrophic lateral sclerosis?","volume":"84","author":"Taylor","year":"2013","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B58","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.3390\/brainsci15111131","article-title":"Pauses as a quantitative measure of linguistic planning challenges in Parkinson\u2019s disease","volume":"15","author":"D\u2019Ascanio","year":"2025","journal-title":"Brain Sci"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1910","DOI":"10.1044\/2020_ajslp-20-00003","article-title":"The impact of Parkinson\u2019s disease on breath pauses and their relationship to speech impairment: a longitudinal study","volume":"29","author":"Darling-White","year":"2020","journal-title":"Am J Speech Lang Pathol"},{"key":"B60","doi-asserted-by":"publisher","first-page":"e0147573","DOI":"10.1371\/journal.pone.0147573","article-title":"Profiling speech and pausing in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD)","volume":"11","author":"Yunusova","year":"2016","journal-title":"PLoS One"},{"key":"B61","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1136\/jnnp-2015-310734","article-title":"The cognitive profile of ALS: a systematic review and meta-analysis update","volume":"87","author":"Beeldman","year":"2016","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B62","doi-asserted-by":"publisher","first-page":"1202404","DOI":"10.3389\/fnins.2023.1202404","article-title":"How do patients with Parkinson\u2019s disease and cerebellar ataxia read aloud? -eye-voice coordination in text Reading","volume":"17","author":"Terao","year":"2023","journal-title":"Front Neurosci"},{"key":"B63","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1044\/1058-0360(2012\/11-0059)","article-title":"Impact of typical aging and Parkinson\u2019s disease on the relationship among breath pausing, syntax, and punctuation","volume":"21","author":"Huber","year":"2012","journal-title":"Am J Speech Lang Pathol"},{"key":"B64","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1080\/17482960600863951","article-title":"Respiratory systems abnormalities and clinical milestones for patients with amyotrophic lateral sclerosis with emphasis upon survival","volume":"8","author":"Vender","year":"2007","journal-title":"Amyotroph Lateral Scler"},{"key":"B65","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/S0167-6393(02)00107-3","article-title":"The analysis of speech in different temporal integration windows: cerebral lateralization as \u2018asymmetric sampling in time\u2019","volume":"41","author":"Poeppel","year":"2003","journal-title":"Speech Commun"},{"key":"B66","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1038\/s41583-020-0304-4","article-title":"Speech rhythms and their neural foundations","volume":"21","author":"Poeppel","year":"2020","journal-title":"Nat Rev Neurosci"},{"key":"B67","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1159\/000350030","article-title":"Crosslinguistic application of English-centric rhythm descriptors in motor speech disorders","volume":"65","author":"Liss","year":"2013","journal-title":"Folia Phoniatrica et Logopedica"},{"key":"B68","doi-asserted-by":"publisher","first-page":"AD3","DOI":"10.1016\/S0010-0277(00)00101-3","article-title":"Correlates of linguistic rhythm in the speech signal","volume":"75","author":"Ramus","year":"2000","journal-title":"Cognition"},{"key":"B69","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.jcomdis.2018.02.005","article-title":"Rhythmic performance in hypokinetic dysarthria: relationship between Reading, spontaneous speech and diadochokinetic tasks","volume":"72","author":"Lowit","year":"2018","journal-title":"J Commun Disord"},{"key":"B70","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1002\/mds.21996","article-title":"Speech rate and rhythm in Parkinson\u2019s disease","volume":"23","author":"Skodda","year":"2008","journal-title":"Mov Disord"},{"key":"B71","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1044\/1092-4388(2009\/08-0208)","article-title":"Quantifying speech rhythm abnormalities in the dysarthrias","volume":"52","author":"Liss","year":"2009","journal-title":"J Speech Lang Hear Res"},{"key":"B72","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1044\/jslhr.4303.683","article-title":"Segmental timing in amyotrophic lateral sclerosis","volume":"43","author":"Tjaden","year":"2000","journal-title":"J Speech Lang Hear Res"},{"key":"B73","doi-asserted-by":"publisher","first-page":"2084","DOI":"10.1044\/2020_jslhr-19-00245","article-title":"Detection of articulatory deficits in Parkinson\u2019s disease: can systematic manipulations of phonetic complexity help?","volume":"63","author":"Kuruvilla-Dugdale","year":"2020","journal-title":"J Speech Lang Hear Res"},{"key":"B74","doi-asserted-by":"publisher","first-page":"3248","DOI":"10.1044\/2019_JSLHR-S-19-0058","article-title":"The effect of tongue\u2013jaw coupling on phonetic distinctiveness of vowels in amyotrophic lateral sclerosis","volume":"62","author":"Rong","year":"2019","journal-title":"J Speech Lang Hear Res"},{"key":"B75","doi-asserted-by":"publisher","first-page":"3085","DOI":"10.1044\/2018_JSLHR-S-CSMC7-18-0116","article-title":"Predicting speech intelligibility based on spatial tongue\u2013jaw coupling in persons with amyotrophic lateral sclerosis: the impact of tongue weakness and jaw adaptation","volume":"62","author":"Rong","year":"2019","journal-title":"J Speech Lang Hear Res"},{"key":"B76","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1044\/2020_ajslp-20-00136","article-title":"Spatiotemporal control of articulation during speech and speechlike tasks in amyotrophic lateral sclerosis","volume":"30","author":"Rong","year":"2021","journal-title":"Am J Speech Lang Pathol"},{"key":"B77","doi-asserted-by":"publisher","first-page":"3697","DOI":"10.1044\/2023_jslhr-23-00129","article-title":"A vowel-centric view toward characterizing temporal organization of motor speech activities in neurologically impaired and healthy speakers","volume":"66","author":"Rong","year":"2023","journal-title":"J Speech Lang Hear Res"},{"key":"B78","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1080\/17549507.2018.1485739","article-title":"Automatic extraction of abnormal lip movement features from the alternating motion rate task in amyotrophic lateral sclerosis","volume":"20","author":"Rong","year":"2018","journal-title":"Int J Speech Lang Pathol"},{"key":"B79","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1044\/1092-4388(2008\/043)","article-title":"Articulatory movements during vowels in speakers with dysarthria and healthy controls","volume":"51","author":"Yunusova","year":"2008","journal-title":"J Speech Lang Hear Res"},{"key":"B80","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1044\/1092-4388(2013\/12-0262)","article-title":"Vowel acoustics in dysarthria: speech disorder diagnosis and classification","volume":"57","author":"Lansford","year":"2014","journal-title":"J Speech Lang Hear Res"},{"key":"B81","doi-asserted-by":"publisher","first-page":"2022","DOI":"10.1044\/2022_ajslp-22-00046","article-title":"Articulatory underpinnings of reduced acoustic-phonetic contrasts in individuals with amyotrophic lateral sclerosis","volume":"31","author":"Moore","year":"2022","journal-title":"Am J Speech Lang Pathol"},{"key":"B82","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1044\/1092-4388(2006\/031)","article-title":"Parametric quantitative acoustic analysis of conversation produced by speakers with dysarthria and healthy speakers","volume":"49","author":"Rosen","year":"2006","journal-title":"J Speech Lang Hear Res"},{"key":"B83","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1121\/1.402635","article-title":"Formant trajectory characteristics of males with amyotrophic lateral sclerosis","volume":"91","author":"Weismer","year":"1992","journal-title":"J Acoust Soc Am"},{"key":"B84","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1080\/0269920031000086248","article-title":"Toward an acoustic typology of motor speech disorders","volume":"17","author":"Kent","year":"2003","journal-title":"Clin Linguist Phon"},{"key":"B85","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1044\/jshd.5404.482","article-title":"Toward phonetic intelligibility testing in dysarthria","volume":"54","author":"Kent","year":"1989","journal-title":"J Speech Hear Disord"},{"key":"B86","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1038\/s42003-024-06444-7","article-title":"Speech prosody enhances the neural processing of syntax","volume":"7","author":"Degano","year":"2024","journal-title":"Commun Biol"},{"key":"B87","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3390\/languages8030157","article-title":"Pauses and parsing: testing the role of prosodic chunking in sentence processing","volume":"8","author":"Harrington Stack","year":"2023","journal-title":"Languages"},{"key":"B88","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1006\/jmla.1998.2620","article-title":"Prosodic facilitation and interference in the resolution of temporary syntactic closure ambiguity","volume":"40","author":"Kjelgaard","year":"1999","journal-title":"J Mem Lang"},{"key":"B89","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1080\/01690961003589492","article-title":"Experimental and theoretical advances in prosody: a review","volume":"25","author":"Wagner","year":"2010","journal-title":"Lang Cognit Process"},{"key":"B90","doi-asserted-by":"publisher","first-page":"2120","DOI":"10.1007\/s00415-018-8969-6","article-title":"The accuracy of the clinical diagnosis of Parkinson disease","volume":"265","author":"Hustad","year":"2018","journal-title":"Hunt Study J Neurol"},{"key":"B91","first-page":"S94","article-title":"Early diagnosis of Parkinson\u2019s disease: recommendations from diagnostic clinical guidelines","volume":"16","author":"Pahwa","year":"2010","journal-title":"Am J Manag Care"},{"key":"B92","doi-asserted-by":"publisher","first-page":"117054","DOI":"10.1016\/j.jns.2020.117054","article-title":"Time to diagnosis and factors affecting diagnostic delay in amyotrophic lateral sclerosis","volume":"417","author":"Richards","year":"2020","journal-title":"J Neurol Sci"},{"key":"B93","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1001\/jamaneurol.2018.4377","article-title":"Prognosis and neuropathologic correlation of clinical subtypes of Parkinson disease","volume":"76","author":"De Pablo-Fern\u00e1ndez","year":"2019","journal-title":"JAMA Neurol"},{"key":"B94","doi-asserted-by":"publisher","first-page":"647","DOI":"10.3390\/life15040647","article-title":"Pathophysiology, clinical heterogeneity, and therapeutic advances in amyotrophic lateral sclerosis: a comprehensive review of molecular mechanisms, diagnostic challenges, and multidisciplinary management strategies","volume":"15","author":"Gonz\u00e1lez-S\u00e1nchez","year":"2025","journal-title":"Life"},{"key":"B95","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1007\/s00702-023-02635-4","article-title":"The heterogeneity of Parkinson\u2019s disease","volume":"130","author":"W\u00fcllner","year":"2023","journal-title":"J Neural Transm (Vienna)"},{"key":"B96","doi-asserted-by":"publisher","first-page":"2625","DOI":"10.1044\/2020_JSLHR-19-00309","article-title":"Tongue- and jaw-specific articulatory changes and their acoustic consequences in talkers with dysarthria due to amyotrophic lateral sclerosis: effects of loud, clear, and slow speech","volume":"63","author":"Mefferd","year":"2020","journal-title":"J Speech Lang Hear Res"},{"key":"B97","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1044\/2014_jslhr-s-12-0372","article-title":"Impact of clear, loud, and slow speech on scaled intelligibility and speech severity in Parkinson\u2019s disease and multiple sclerosis","volume":"57","author":"Tjaden","year":"2014","journal-title":"J Speech Lang Hear Res"},{"key":"B98","doi-asserted-by":"publisher","first-page":"106253","DOI":"10.1016\/j.jcomdis.2022.106253","article-title":"Relationship between rate-elicited changes in muscular-kinematic control strategies and acoustic performance in individuals with ALS-A multimodal investigation","volume":"99","author":"Rong","year":"2022","journal-title":"J Commun Disord"},{"key":"B99","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1159\/000083569","article-title":"Dysarthria in traumatic brain injury: a breath group and intonational analysis","volume":"57","author":"Wang","year":"2005","journal-title":"Folia Phoniatrica et Logopedica"},{"key":"B100","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1044\/1092-4388(2005\/090)","article-title":"Breath-group intelligibility in dysarthria: characteristics and underlying correlates","volume":"48","author":"Yunusova","year":"2005","journal-title":"J Speech Lang Hear Res"},{"key":"B101","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1055\/s-2006-955118","article-title":"The science and practice of LSVT\/LOUD: neural plasticity-principled approach to treating individuals with Parkinson disease and other neurological disorders","volume":"27","author":"Fox","year":"2006","journal-title":"Semin Speech Lang"},{"key":"B102","volume-title":"The Lee Silverman Voice Treatment (LSVT\u00ae): A Practical Guide to Treating the Voice and Speech Disorders in Parkinson Disease","author":"Ramig","year":"1995"},{"key":"B103","doi-asserted-by":"publisher","first-page":"1448","DOI":"10.1044\/2020_AJSLP-19-00024","article-title":"The effect of SPEAK OUT! and the LOUD crowd on dysarthria due to Parkinson\u2019s disease","volume":"29","author":"Behrman","year":"2020","journal-title":"Am J Speech Lang Pathol"},{"key":"B104","doi-asserted-by":"publisher","first-page":"13","DOI":"10.15640\/ijhs.v3n2a3","article-title":"The effects of the \u201cSPEAK OUT! \u00ae\u201d and \u201cLOUD crowd\u00ae\u201d voice programs for Parkinson disease","volume":"3","author":"Levitt","year":"2015","journal-title":"Int J Health Sci"},{"key":"B105","year":"2022"},{"key":"B106","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1196\/annals.1284.044","article-title":"Neural basis of rhythmic timing networks in the human brain","volume":"999","author":"Thaut","year":"2003","journal-title":"Ann N Y Acad Sci"},{"key":"B107","doi-asserted-by":"publisher","first-page":"20130395","DOI":"10.1098\/rstb.2013.0395","article-title":"Timing in talking: what is it used for, and how is it controlled?","volume":"369","author":"Turk","year":"2014","journal-title":"Philos Trans R Soc, B"},{"key":"B108","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1080\/21678421.2019.1681454","article-title":"A speech measure for early stratification of fast and slow progressors of bulbar amyotrophic lateral sclerosis: lip movement jitter","volume":"21","author":"Rong","year":"2020","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener"},{"key":"B109","doi-asserted-by":"publisher","first-page":"2967","DOI":"10.21437\/Interspeech.2015-614","article-title":"Speech intelligibility decline in individuals with fast and slow rates of ALS progression","author":"Rong","year":"2015","journal-title":"Proc Interspeech"}],"container-title":["Frontiers in Digital Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2026.1794169\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:09:42Z","timestamp":1777442982000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2026.1794169\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":109,"alternative-id":["10.3389\/fdgth.2026.1794169"],"URL":"https:\/\/doi.org\/10.3389\/fdgth.2026.1794169","relation":{},"ISSN":["2673-253X"],"issn-type":[{"value":"2673-253X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]},"article-number":"1794169"}}