{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:29:09Z","timestamp":1770834549820,"version":"3.50.1"},"reference-count":64,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Rapid Eye Movement (REM) sleep behavior disorder (RBD) is a parasomnia resulting from degeneration of pontine and medullary circuits responsible for muscle atonia during REM sleep, leading to dream-enactment behaviors and vocalizations. It is strongly linked to \u03b1-synucleinopathies, particularly Parkinson\u2019s disease. Current biomarkers such as neurophysiological measures and imaging support diagnosis and monitoring, but remain invasive or costly. Aim: This study aims to evaluate vocal and speech alterations as exploratory, non-validated candidate biomarkers of REM sleep behavior disorder. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed, IEEE Digital Library Web of Science, Embase and the Cochrane Library were systematically searched for studies published from database inception to November 2025, as preregistered on the Open Science Framework. Studies were selected through a multi-step screening process and underwent qualitative quality assessment. Results: Twelve studies met inclusion criteria. Individuals with RBD exhibited abnormal nocturnal vocalizations and early lexical, syntactic, and narrative disruptions despite preserved perceptual speech. Quantitative analyses identified consistent deficits in prosody, phonation stability, timing, and articulation, with significant group differences and diagnostic accuracy up to 96% sensitivity. Multilingual cohorts demonstrated progression over time, while digital phenotyping detected emerging Parkinsonian signs with AUC &gt; 0.70. Conclusions: Speech and vocal abnormalities in iRBD reflect early neurodegenerative changes and show promising but still exploratory diagnostic and prognostic potential. Integrating vocal markers with established biomarkers may enhance early detection; however, further research is required to validate a reliable and reproducible vocal signature of prodromal synucleinopathies.<\/jats:p>","DOI":"10.3390\/brainsci16020216","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T17:45:36Z","timestamp":1770831936000},"page":"216","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Speech and Language Changes During Rapid Eye Movement (REM) Sleep with Potential Diagnostic Markers: A Systematic Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0978-605X","authenticated-orcid":false,"given":"Maria","family":"Pagano","sequence":"first","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4862-3832","authenticated-orcid":false,"given":"Francesco","family":"Corallo","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Anselmo","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2052-0970","authenticated-orcid":false,"given":"Davide","family":"Cardile","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-4366","authenticated-orcid":false,"given":"Rosaria","family":"De Luca","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Quartarone","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-3166","authenticated-orcid":false,"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-2331","authenticated-orcid":false,"given":"Irene","family":"Cappadona","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, S.S. 113, C.da Casazza, 98124 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"ref_1","first-page":"e84232","article-title":"The role of sleep and the effects of sleep loss on cognitive, affective, and behavioral processes","volume":"17","author":"Hyndych","year":"2025","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.sleep.2023.07.001","article-title":"World Sleep Society international sleep medicine guidelines position statement endorsement of behavioral and psychological treatments for chronic insomnia disorder in adults","volume":"109","author":"Morin","year":"2023","journal-title":"Sleep Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E53","DOI":"10.5888\/pcd20.220400","article-title":"Prevalence and geographic patterns of self-reported short sleep duration among U.S. adults, 2020","volume":"20","author":"Pankowska","year":"2023","journal-title":"Prev. Chronic Dis."},{"key":"ref_4","first-page":"e77397","article-title":"The impact of poor sleep quality on cardiovascular risk factors and quality of life","volume":"17","author":"Onyegbule","year":"2025","journal-title":"Cureus"},{"key":"ref_5","first-page":"771","article-title":"Sleep, sex and psychosocial health: Expanding the horizons of behavioral sleep medicine","volume":"62","author":"Andersen","year":"2025","journal-title":"Dent. Med. Probl."},{"key":"ref_6","first-page":"5","article-title":"Lifestyle, daily habits, sleep hygiene, and diet: Proposal of a new approach for sleep bruxism management","volume":"62","author":"Smardz","year":"2025","journal-title":"Dent. Med. Probl."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pfeiffer, A.M., Triplett, C., and Schaefers, O. (2026). Improving sleep health through sleep hygiene education in adults aged 50\u201380 years. Front. Sleep, 4.","DOI":"10.3389\/frsle.2025.1722557"},{"key":"ref_8","first-page":"50","article-title":"Sleep apnea and orofacial pain: An integrative clinical perspective","volume":"39","author":"Patil","year":"2025","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S3346","DOI":"10.4103\/jpbs.jpbs_1401_25","article-title":"Prevalence of temporomandibular disorders in obstructive sleep apnea patients and relationship between temporomandibular disorder phenotypes and severity of sleep apnea: An observational study","volume":"17","author":"Chakraborty","year":"2025","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1523\/JNEUROSCI.1020-22.2022","article-title":"Emotional memory processing during REM sleep with implications for post-traumatic stress disorder","volume":"43","author":"Rho","year":"2023","journal-title":"J. Neurosci."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Alsaeed, S., Huynh, N., Wensley, D., Lee, K., Hamoda, M.M., Ayers, E., Sutherland, K., and Almeida, F.R. (2023). Orthodontic and facial characteristics of craniofacial syndromic children with obstructive sleep apnea. Diagnostics, 13.","DOI":"10.3390\/diagnostics13132213"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Paradowska-Stolarz, A., \u015aluzalec-Wi\u0119ckiewicz, K., Mikulewicz, M., Mas\u0142owiec, C., Kokot, K., Miralles-Jord\u00e0, L., Soba\u0144ska, M., and Laskowska, J. (2025). Obstructive sleep apnoea in patients with Treacher Collins syndrome: A narrative review. J. Clin. Med., 14.","DOI":"10.3390\/jcm14134741"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1097\/SCS.0000000000006306","article-title":"Cleidocranial dysplasia: Management of the multiple craniofacial and skeletal anomalies","volume":"31","author":"Jirapinyo","year":"2020","journal-title":"J. Craniofacial Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.cger.2021.04.008","article-title":"Rapid eye movement behavior disorder and other parasomnias","volume":"37","author":"Korotun","year":"2021","journal-title":"Clin. Geriatr. Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Roguski, A., Rayment, D., Whone, A.L., Jones, M.W., and Rolinski, M. (2020). A neurologist\u2019s guide to REM sleep behavior disorder. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.00610"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1378\/chest.14-0970","article-title":"International classification of sleep disorders\u2014Third edition: Highlights and modifications","volume":"146","author":"Sateia","year":"2014","journal-title":"Chest"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jsmc.2022.02.005","article-title":"Parasomnias and sleep-related movement disorders in older adults","volume":"17","author":"Iranzo","year":"2022","journal-title":"Sleep Med. Clin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1007\/s13311-021-01011-y","article-title":"Non-REM disorders of arousal and related parasomnias: An updated review","volume":"18","author":"Irfan","year":"2021","journal-title":"Neurotherapeutics"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Figorilli, M., Lanza, G., Congiu, P., Lecca, R., Casaglia, E., Mogavero, M.P., Puligheddu, M., and Ferri, R. (2021). Neurophysiological aspects of REM sleep behavior disorder (RBD): A narrative review. Brain Sci., 11.","DOI":"10.3390\/brainsci11121588"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s11910-023-01322-x","article-title":"Neural control of REM sleep and motor atonia: Current perspectives","volume":"23","author":"Vetrivelan","year":"2023","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/j.neuron.2024.01.027","article-title":"Multimodal sensory control of motor performance by glycinergic interneurons of the mouse spinal cord deep dorsal horn","volume":"112","author":"Gradwell","year":"2024","journal-title":"Neuron"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"zsae178","DOI":"10.1093\/sleep\/zsae178","article-title":"Major alteration of motor control during rapid eye movement sleep in mouse models of sleep disorders","volume":"47","author":"Grenot","year":"2024","journal-title":"Sleep"},{"key":"ref_23","first-page":"1501","article-title":"Whole-brain mapping of monosynaptic afferents to GABAergic neurons in the sublaterodorsal tegmental nucleus of mice","volume":"46","author":"Zhong","year":"2025","journal-title":"Zool. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1523\/JNEUROSCI.0688-20.2020","article-title":"A discrete glycinergic neuronal population in the ventromedial medulla that induces muscle atonia during REM sleep and cataplexy in mice","volume":"41","author":"Uchida","year":"2021","journal-title":"J. Neurosci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"315","DOI":"10.14336\/AD.2019.0324","article-title":"Rapid eye movement sleep behavior disorder and neurodegenerative diseases: An update","volume":"11","author":"Zhang","year":"2020","journal-title":"Aging Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1093\/brain\/awz030","article-title":"Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: A multicentre study","volume":"142","author":"Postuma","year":"2019","journal-title":"Brain"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1093\/brain\/awz014","article-title":"REM sleep behaviour disorder: An early window for prevention in neurodegeneration?","volume":"142","author":"Weil","year":"2019","journal-title":"Brain"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"149576","DOI":"10.1016\/j.brainres.2025.149576","article-title":"Basal ganglia connectivity and network asymmetry in Parkinson\u2019s disease: A resting-state fMRI study","volume":"1856","author":"Liu","year":"2025","journal-title":"Brain Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"112762","DOI":"10.1016\/j.exger.2025.112762","article-title":"Investigating the relationship between sleep disturbances and cortical thickness, brainstem volume, amyloid accumulation, and inflammatory markers in Parkinson\u2019s disease patients","volume":"205","author":"Chen","year":"2025","journal-title":"Exp. Gerontol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1055\/s-0043-1777111","article-title":"REM sleep behavior disorder: Update on diagnosis and management","volume":"81","author":"Stelzer","year":"2023","journal-title":"Arq. De Neuro-Psiquiatr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1097\/WCO.0000000000001084","article-title":"Imaging of sleep disorders in pre-Parkinsonian syndromes","volume":"35","author":"Ota","year":"2022","journal-title":"Curr. Opin. Neurol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Jo, H., Kim, D., Song, J., Choi, S., and Joo, E. (2021). Sleep disturbances and phenoconversion in patients with REM sleep behavior disorder. J. Clin. Med., 10.","DOI":"10.3390\/jcm10204709"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"769","DOI":"10.5664\/jcsm.10426","article-title":"Management of REM sleep behavior disorder: An American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment","volume":"19","author":"Howell","year":"2023","journal-title":"J. Clin. Sleep Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/mds.24957","article-title":"REM sleep behavior disorder: Motor manifestations and pathophysiology","volume":"27","author":"Arnulf","year":"2012","journal-title":"Mov. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"sfae130","DOI":"10.1093\/ckj\/sfae130","article-title":"Biomarkers in clinical epidemiology studies","volume":"17","author":"Zoccali","year":"2024","journal-title":"Clin. Kidney J."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Wayland, R., Meyer, R., and Tang, K. (2025). Speech markers of Parkinson\u2019s disease: Phonological features and acoustic measures. Brain Sci., 15.","DOI":"10.3390\/brainsci15111162"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jocn.2019.12.029","article-title":"Voice changes in Parkinson\u2019s disease: What are they telling us?","volume":"72","author":"Ma","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Xu, H., Xie, W., Pang, M., Li, Y., Jin, L., Huang, F., and Shao, X. (2025). Non-invasive detection of Parkinson\u2019s disease based on speech analysis and interpretable machine learning. Front. Aging Neurosci., 17.","DOI":"10.3389\/fnagi.2025.1586273"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Vitazkova, D., Kosnacova, H., Turonova, D., Foltan, E., Jagelka, M., Berki, M., Micjan, M., Kokavec, O., Gerhat, F., and Vavrinsky, E. (2025). Transforming sleep monitoring: Review of wearable and remote devices advancing home polysomnography and their role in predicting neurological disorders. Biosensors, 15.","DOI":"10.3390\/bios15020117"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/XEB.0000000000000055","article-title":"Summarizing systematic reviews: Methodological development, conduct and reporting of an umbrella review approach","volume":"13","author":"Aromataris","year":"2015","journal-title":"Int. J. Evid. Based Healthc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"431","DOI":"10.5665\/sleep.3468","article-title":"Rapid eye movement sleep behavioral events: A new marker for neurodegeneration in early Parkinson disease?","volume":"37","author":"Trautmann","year":"2014","journal-title":"Sleep"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.sleep.2015.07.030","article-title":"Quantitative assessment of motor speech abnormalities in idiopathic rapid eye movement sleep behaviour disorder","volume":"19","author":"Rusz","year":"2016","journal-title":"Sleep Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1038\/s41598-017-00047-5","article-title":"Automated analysis of connected speech reveals early biomarkers of Parkinson\u2019s disease in patients with rapid eye movement sleep behaviour disorder","volume":"7","author":"Rusz","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Skorvanek, M., Feketeova, E., Kurtis, M.M., Rusz, J., and Sonka, K. (2018). Accuracy of rating scales and clinical measures for screening of rapid eye movement sleep behavior disorder and for predicting conversion to Parkinson\u2019s disease and other synucleinopathies. Front. Neurol., 9.","DOI":"10.3389\/fneur.2018.00376"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.parkreldis.2019.04.026","article-title":"Speech difficulties in early de novo patients with Parkinson\u2019s disease","volume":"64","author":"Polychronis","year":"2019","journal-title":"Park. Relat. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.sleep.2019.11.1261","article-title":"Gender differences in clinical findings and \u03b1-synucleinopathy-related markers in patients with idiopathic REM sleep behavior disorder","volume":"66","author":"Takeuchi","year":"2020","journal-title":"Sleep Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1002\/ana.26085","article-title":"Speech biomarkers in rapid eye movement sleep behavior disorder and Parkinson disease","volume":"90","author":"Rusz","year":"2021","journal-title":"Ann. Neurol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1002\/mds.29140","article-title":"Linguistic abnormalities in isolated rapid eye movement sleep behavior disorder","volume":"37","author":"Rusz","year":"2022","journal-title":"Mov. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.parkreldis.2022.01.003","article-title":"Voice characteristics from isolated rapid eye movement sleep behavior disorder to early Parkinson\u2019s disease","volume":"95","author":"Jeancolas","year":"2022","journal-title":"Park. Relat. Disord."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1002\/mds.29921","article-title":"Smartphone voice calls provide early biomarkers of parkinsonism in rapid eye movement sleep behavior disorder","volume":"39","author":"Illner","year":"2024","journal-title":"Mov. Disord."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1002\/ana.26835","article-title":"Spoken language alterations can predict phenoconversion in isolated rapid eye movement sleep behavior disorder: A multicenter study","volume":"95","author":"Pelletier","year":"2024","journal-title":"Ann. Neurol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"263","DOI":"10.2147\/NSS.S435201","article-title":"Dreaming characteristics in non-rapid eye movement parasomnia and idiopathic rapid eye movement sleep behaviour disorder: Similarities and differences","volume":"16","author":"See","year":"2024","journal-title":"Nat. Sci. Sleep"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.cobeha.2019.12.007","article-title":"Physiological changes in sleep that affect fMRI inference","volume":"33","author":"Duyn","year":"2020","journal-title":"Curr. Opin. Behav. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1038\/s41598-025-30251-7","article-title":"ParkMAE: A cross-linguistic masked autoencoder framework for robust Parkinson\u2019s disease detection from speech","volume":"16","author":"Ando","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Roland, V., Huet, K., Harmegnies, B., Piccaluga, M., Verhaegen, C., and Delvaux, V. (2023). Vowel production: A potential speech biomarker for early detection of dysarthria in Parkinson\u2019s disease. Front. Psychol., 14.","DOI":"10.3389\/fpsyg.2023.1129830"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Angelopoulou, G., Kasselimis, D., Goutsos, D., and Potagas, C. (2024). A methodological approach to quantifying silent pauses, speech rate, and articulation rate across distinct narrative tasks: Introducing the Connected Speech Analysis Protocol (CSAP). Brain Sci., 14.","DOI":"10.3390\/brainsci14050466"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2871","DOI":"10.1121\/1.5100272","article-title":"Developing a large scale population screening tool for the assessment of Parkinson\u2019s disease using telephone-quality voice","volume":"145","author":"Arora","year":"2019","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_59","doi-asserted-by":"crossref","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":"ref_60","doi-asserted-by":"crossref","unstructured":"Pizzimenti, M., Kalia, A., Toghranegar, J.A., Ebraheem, M., Cummins, N., Ghosh, S.S., Anibal, J.T., Au, R., Azarang, A., and Bahr, R.H. (2025). Consensus-based definitions for vocal biomarkers: The International VOCAL Initiative. medRxiv.","DOI":"10.1101\/2025.10.23.25338518"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Johnson, S., Kantartjis, M., Severson, J., Dorsey, R., Adams, J.L., Kangarloo, T., Kostrzebski, M.A., Best, A., Merickel, M., and Amato, D. (2024). Wearable sensor-based assessments for remotely screening early-stage Parkinson\u2019s disease. Sensors, 24.","DOI":"10.20944\/preprints202408.1197.v1"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S1474-4422(24)00170-4","article-title":"Sleep and sleep disorders in people with Parkinson\u2019s disease","volume":"23","author":"Iranzo","year":"2024","journal-title":"Lancet Neurol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e766","DOI":"10.1212\/WNL.0000000000007968","article-title":"Mild behavioral impairment is linked to worse cognition and brain atrophy in Parkinson disease","volume":"93","author":"Yoon","year":"2019","journal-title":"Neurology"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.parkreldis.2020.05.017","article-title":"Pareidolias and cognition in isolated REM sleep behavior disorder","volume":"75","author":"Honeycutt","year":"2020","journal-title":"Park. Relat. Disord."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/2\/216\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:01:29Z","timestamp":1770832889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/2\/216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":64,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["brainsci16020216"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16020216","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]}}}