{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:54:01Z","timestamp":1767200041567,"version":"3.48.0"},"reference-count":71,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health NINDS SBIR","award":["R43NS113737"],"award-info":[{"award-number":["R43NS113737"]}]},{"name":"National Institutes of Health NINDS SBIR","award":["R44NS080632"],"award-info":[{"award-number":["R44NS080632"]}]},{"name":"National Institutes of Health NINDS SBIR","award":["R44NS110237"],"award-info":[{"award-number":["R44NS110237"]}]},{"name":"Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES)\/Ministry of Education of Brazil"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Speech and motor control share overlapping neural mechanisms, yet their quantitative relationships in Parkinson\u2019s disease (PD) remain underexplored. This study investigated bidirectional associations between acoustic voice features and objective motor metrics to better understand how vocal and motor systems relate in PD. Methods: Cross-sectional baseline data from participants in a randomized neuromodulation trial were analyzed (n = 13). Motor performance was captured using an Integrated Motion Analysis Suite (IMAS), which enabled quantitative, objective characterization of motor performance during balance, gait, and upper- and lower-limb tasks. Acoustic analyses included harmonic-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPS), jitter, shimmer, median fundamental frequency (F0), F0 standard deviation (SD F0), and voice intensity. Univariate linear regressions were conducted in both directions (voice \u2194 motor), as well as partial correlations controlling for PD motor symptom severity. Results: When modeling voice outcomes, faster motor performance and shorter movement durations were associated with acoustically clearer voice features (e.g., higher elbow flexion-extension peak speed with higher voice HNR, \u03b2 = 8.5, R2 = 0.56, p = 0.01). Similarly, when modeling motor outcomes, clearer voice measures were linked with faster movement speed and shorter movement durations (e.g., higher voice HNR with higher peak movement speed in elbow flexion\/extension, \u03b2 = 0.07, R2 = 0.56, p = 0.01). Conclusions: Voice and motor measures in PD showed significant bidirectional associations, suggesting shared sensorimotor control. These exploratory findings, while limited by sample size, support the feasibility of integrated multimodal assessment for future longitudinal studies.<\/jats:p>","DOI":"10.3390\/brainsci16010048","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:08:00Z","timestamp":1767197280000},"page":"48","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Bidirectional Associations Between Voice Acoustics and Objective Motor Metrics in Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7334-3835","authenticated-orcid":false,"given":"Anna Carolyna","family":"Gianloren\u00e7o","sequence":"first","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Mass General Brigham, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA 02138, USA"},{"name":"Laboratory of Neuroscience and Neurological Rehabilitation, Physical Therapy Department, Federal University of Sao Carlos, Rodovia Washington Luis, km 235, S\u00e3o Carlos 13506-900, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Eduardo Portes","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Highland Instruments, Inc., Cambridge, MA 02238, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2356-7523","authenticated-orcid":false,"given":"Valton","family":"Costa","sequence":"additional","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Mass General Brigham, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA 02138, USA"},{"name":"Laboratory of Neuroscience and Neurological Rehabilitation, Physical Therapy Department, Federal University of Sao Carlos, Rodovia Washington Luis, km 235, S\u00e3o Carlos 13506-900, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Fabris-Moraes","sequence":"additional","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Mass General Brigham, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA 02138, USA"},{"name":"Faculty of Medicine, University of Sao Paulo, Avenida Doutor Arnaldo, 455, Sao Paulo 05508-090, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Gonzalez-Mego","sequence":"additional","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Mass General Brigham, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA 02138, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6737-5374","authenticated-orcid":false,"given":"Ciro","family":"Ramos-Estebanez","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation, 912 S Wood St., Room 174N, MC 796, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5510-3814","authenticated-orcid":false,"given":"Arianna","family":"Di Stadio","sequence":"additional","affiliation":[{"name":"Department of Life and Health Science, Link University, 00100 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz Doruk","family":"Camsari","sequence":"additional","affiliation":[{"name":"Mayo Clinic, 200 1st St. SW, Rochester, MN 55901, USA"},{"name":"Mindpath College Health, 948 Embarcadero del Norte #102, Isla Vista, CA 93117, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirret M.","family":"El-Hagrassy","sequence":"additional","affiliation":[{"name":"Neurology Department, UMass Memorial, UMass Chan Medical School, 67 Belmont St., Worcester, MA 01605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1703-7526","authenticated-orcid":false,"given":"Felipe","family":"Fregni","sequence":"additional","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Mass General Brigham, Harvard Medical School, 1575 Cambridge Street, Cambridge, MA 02138, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Wagner","sequence":"additional","affiliation":[{"name":"Highland Instruments, Inc., Cambridge, MA 02238, USA"},{"name":"Harvard\/MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Dipietro","sequence":"additional","affiliation":[{"name":"Highland Instruments, Inc., Cambridge, MA 02238, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1136\/jnnp-2019-322338","article-title":"Parkinson\u2019s disease: Etiopathogenesis and treatment","volume":"91","author":"Jankovic","year":"2020","journal-title":"J. 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