{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:59:07Z","timestamp":1790780347530,"version":"4.1.0"},"reference-count":62,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Jianan Psychiatric Center and the Ministry of Health and Welfare in Taiwan","award":["2021-A02"],"award-info":[{"award-number":["2021-A02"]}],"id":[{"id":"https:\/\/ror.org\/024w0ge69","id-type":"ROR","asserted-by":"crossref"}]},{"award":["2021-A02"],"award-info":[{"award-number":["2021-A02"]}],"id":[{"id":"https:\/\/ror.org\/024w0ge69","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Department of General Psychiatry Taoyuan Psychiatric Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Drug-induced parkinsonism (DIP) is a common extrapyramidal adverse effect of dopamine-receptor blocking agents, yet interpretable biomarkers of its acoustics remain limited. This study investigated whether nonlinear dynamics could provide physiologically interpretable markers of DIP and clarify how these abnormalities vary across vowels and extrapyramidal symptoms. Methods: Sustained phonations of five vowels (\/a\/, \/i\/, \/u\/, \/e\/, \/o\/) were analyzed in 82 patients with DIP and 30 healthy controls. Hilbert\u2013Huang Transform (HHT) features were integrated along with Sample Entropy, Correlation Dimension, Largest Lyapunov Exponent, and Recurrence Quantification Analysis (RQA). Associations with Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) domains were examined. An external idiopathic Parkinson\u2019s disease (IPD) dataset and machine learning were used as secondary analyses to evaluate diagnostic utility. Results: HHT-derived features showed vowel dependence, whereas nonlinear measures revealed broader abnormalities in DIP. Sample Entropy and the Correlation Dimension were most prominently increased in rounded back vowels \/u\/ and \/o\/. RQA determinism was significantly reduced across all vowels, with recurrence rate and laminarity reduced across multiple vowels, indicating impaired recurrence of phonation. Within the DIP cohort, dyskinesia showed the strongest association with acoustic abnormalities, whereas broader motor domains, including Gait, Bradykinesia, Rigidity, Tremor, Dyskinesia, and Overall Severity, characterized patient\u2013control differences. Secondary analyses with Random Forest achieved a three-class classification of 76.0% (CI 70.3\u201381.3%). Conclusions: DIP is associated with measurable disruption of nonlinear vocal dynamics, characterized by vowel-sensitive HHT and entropy features and relatively consistent reductions in RQA determinism. These interpretable acoustic patterns may provide a non-invasive means of characterizing extrapyramidal motor dysfunction.<\/jats:p>","DOI":"10.3390\/diagnostics16193187","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:19:37Z","timestamp":1790777977000},"page":"3187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Laryngeal Stability in Drug-Induced Parkinsonism Using Hilbert\u2013Huang Transform and Chaos Dynamics: A Multi-Vowel Nonlinear Acoustic Framework for Differential Diagnosis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6262-3766","authenticated-orcid":false,"given":"Andrew An-Zhe","family":"Lee","sequence":"first","affiliation":[{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8125-4306","authenticated-orcid":false,"given":"Chun-Hung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of General Psychiatry Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan 330, Taiwan"},{"name":"Department of Education, National Taiwan Normal University, Taipei 11677, Taiwan"},{"name":"Department of Information Engineering, I-Shou University, Kaohsiung 84001, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00004850-199501005-00005","article-title":"Adverse effects of antipsychotic drugs","volume":"9","author":"Whitworth","year":"1995","journal-title":"Int. Clin. Psychopharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/JCP.0000000000001061","article-title":"Characteristics of Patients Experiencing Extrapyramidal Symptoms or Other Movement Disorders Related to Dopamine Receptor Blocking Agent Therapy","volume":"39","author":"Musco","year":"2019","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3988\/jcn.2012.8.1.15","article-title":"Drug-induced parkinsonism","volume":"8","author":"Shin","year":"2012","journal-title":"J. Clin. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.schres.2005.02.013","article-title":"Manual for the extrapyramidal symptom rating scale (ESRS)","volume":"76","author":"Chouinard","year":"2005","journal-title":"Schizophr. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8105","DOI":"10.1038\/s41598-017-08706-3","article-title":"Drug-induced Extrapyramidal Symptoms Scale (DIEPSS) Serbian Language version: Inter-rater and Test-retest Reliability","volume":"7","author":"Peljto","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1002\/mds.10255","article-title":"Metric characteristics of the drug-induced extrapyramidal symptoms scale (DIEPSS): A practical combined rating scale for drug-induced movement disorders","volume":"17","author":"Kim","year":"2002","journal-title":"Mov. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1177\/0269881120916122","article-title":"Clinical validation of the self-reported Glasgow Antipsychotic Side-effect Scale using the clinician-rated UKU side-effect scale as gold standard reference","volume":"34","author":"Bock","year":"2020","journal-title":"J. Psychopharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/JCP.0b013e3181c914b3","article-title":"Systematic evaluation of rating scales for drug-induced parkinsonism and recommendations for future research","volume":"30","author":"Knol","year":"2010","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.bandc.2004.05.002","article-title":"Variability in fundamental frequency during speech in prodromal and incipient Parkinson\u2019s disease: A longitudinal case study","volume":"56","author":"Harel","year":"2004","journal-title":"Brain Cogn."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Karimi, A., Moein, N., D\u2019Alessandro, E., Bearss, K.A., Robichaud, S., Bar, R.J., and DeSouza, J.F.X. (2025). A Pilot Study Comparing Speech Characteristics in People With Parkinson\u2019s Disease and Controls Dancing Weekly Over 5-Years. J. Voice, in press.","DOI":"10.1016\/j.jvoice.2025.05.003"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2548","DOI":"10.1044\/2024_JSLHR-23-00588","article-title":"A Systematic Review and Bayesian Meta-Analysis of Acoustic Measures of Prosody in Parkinson\u2019s Disease","volume":"67","author":"Fumel","year":"2024","journal-title":"J. Speech Lang. Hear Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/s41531-024-00817-9","article-title":"Unveiling early signs of Parkinson\u2019s disease via a longitudinal analysis of celebrity speech recordings","volume":"10","author":"Favaro","year":"2024","journal-title":"npj Park. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s00221-009-2048-2","article-title":"Laryngeal somatosensory deficits in Parkinson\u2019s disease: Implications for speech respiratory and phonatory control","volume":"201","author":"Hammer","year":"2010","journal-title":"Exp. Brain Res."},{"key":"ref_14","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_15","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1121\/1.3514381","article-title":"Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson\u2019s disease","volume":"129","author":"Rusz","year":"2011","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sedigh Malekroodi, H., Lee, B.-I., and Yi, M. (2025). Voice-Based Detection of Parkinson\u2019s Disease Using Machine and Deep Learning Approaches: A Systematic Review. Bioengineering, 12.","DOI":"10.3390\/bioengineering12111279"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.2147\/PRBM.S460283","article-title":"Exploring the Role of Machine Learning in Diagnosing and Treating Speech Disorders: A Systematic Literature Review","volume":"17","author":"Brahmi","year":"2024","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e076998","DOI":"10.1136\/bmjopen-2023-076998","article-title":"Voice disorder recognition using machine learning: A scoping review protocol","volume":"14","author":"Gupta","year":"2024","journal-title":"BMJ Open"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Paduthala, J.M., Joseph, N., Thomas, S., Varghese, N.A., and Mahesh, S. (2025, January 3\u20135). Comparative Analysis of Machine Learning Models for Speech Disorder Detection. Proceedings of the 2025 2nd International Conference on Trends in Engineering Systems and Technologies (ICTEST), Ernakulam, India.","DOI":"10.1109\/ICTEST64710.2025.11042426"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"633752","DOI":"10.3389\/fnagi.2021.633752","article-title":"Machine learning for the diagnosis of Parkinson\u2019s disease: A review of literature","volume":"13","author":"Mei","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"578369","DOI":"10.3389\/fninf.2021.578369","article-title":"X-vectors: New quantitative biomarkers for early Parkinson\u2019s disease detection from speech","volume":"15","author":"Jeancolas","year":"2021","journal-title":"Front. Neuroinform."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"107133","DOI":"10.1016\/j.cmpb.2022.107133","article-title":"Computerized analysis of speech and voice for Parkinson\u2019s disease: A systematic review","volume":"226","author":"Ngo","year":"2022","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e0303644","DOI":"10.1371\/journal.pone.0303644","article-title":"Machine learning for the detection and diagnosis of cognitive impairment in Parkinson\u2019s disease: A systematic review","volume":"19","author":"Altham","year":"2024","journal-title":"PLoS ONE"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Meral, M., Ozbilgin, F., and Durmus, F. (2025). Fine-Tuned Machine Learning Classifiers for Diagnosing Parkinson\u2019s Disease Using Vocal Characteristics: A Comparative Analysis. Diagnostics, 15.","DOI":"10.3390\/diagnostics15050645"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1475-925X-6-23","article-title":"Exploiting Nonlinear Recurrence and Fractal Scaling Properties for Voice Disorder Detection","volume":"6","author":"Roberts","year":"2007","journal-title":"Biomed. Eng. Online"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Huang, N.E. (2005). Introduction to the Hilbert\u2013Huang transform and its related mathematical problems. Hilbert-Huang Transform and Its Applications, World Scientific.","DOI":"10.1142\/5862"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2738","DOI":"10.1038\/s41598-025-32543-4","article-title":"A computer-aided diagnosis system of parkinson\u2019s disease based on hilbert spectrum features of speech","volume":"16","author":"Ma","year":"2026","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"11693","DOI":"10.1007\/s13369-024-09599-x","article-title":"Voice Pathology Detection Based on Canonical Correlation Analysis Method Using Hilbert\u2013Huang Transform and LSTM Features","volume":"50","author":"Er","year":"2025","journal-title":"Arab J. Sci. Eng."},{"key":"ref_29","unstructured":"(2026, July 20). Parkinson\u2019s Voice Dataset. Available online: https:\/\/www.kaggle.com\/datasets\/ucimachinelearning\/parkinsons-voice-dataset."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Rand, D., and Young, L.S. (1981). Detecting Strange Attractors in Turbulence. Dynamical Systems and Turbulence, Warwick 1980, Springer. Lecture Notes in Mathematics.","DOI":"10.1007\/BFb0091903"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1103\/PhysRevA.33.1134","article-title":"Independent coordinates for strange attractors from mutual information","volume":"33","author":"Fraser","year":"1986","journal-title":"Phys. Rev. A Gen. Phys."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3403","DOI":"10.1103\/PhysRevA.45.3403","article-title":"Determining embedding dimension for phase-space reconstruction using a geometrical construction","volume":"45","author":"Kennel","year":"1992","journal-title":"Phys. Rev. A"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1103\/PhysRevLett.50.346","article-title":"Characterization of Strange Attractors","volume":"50","author":"Grassberger","year":"1983","journal-title":"Phys. Rev. Lett."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/0167-2789(93)90009-P","article-title":"A practical method for calculating largest Lyapunov exponents from small data sets","volume":"65","author":"Rosenstein","year":"1993","journal-title":"Phys. D Nonlinear Phenom."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1152\/jappl.1994.76.2.965","article-title":"Dynamical assessment of physiological systems and states using recurrence plot strategies","volume":"76","author":"Webber","year":"1994","journal-title":"J. Appl. Physiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1044\/1092-4388(2006\/035)","article-title":"Voice training and therapy with a semi-occluded vocal tract: Rationale and scientific underpinnings","volume":"49","author":"Titze","year":"2006","journal-title":"J. Speech Lang. Hear Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"671.e9","DOI":"10.1016\/j.jvoice.2011.11.010","article-title":"Acoustic comparison of vowel sounds among adult females","volume":"26","author":"Franca","year":"2012","journal-title":"J. Voice"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/S0892-1997(00)80003-X","article-title":"Acoustic impedance of an artificially lengthened and constricted vocal tract","volume":"14","author":"Story","year":"2000","journal-title":"J. Voice"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jvoice.2005.08.011","article-title":"Phonatory Impairment in Parkinson\u2019s Disease: Evidence from Nonlinear Dynamic Analysis and Perturbation Analysis","volume":"21","author":"Rahn","year":"2007","journal-title":"J. Voice"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S1353-8020(97)00007-2","article-title":"Acoustic voice analysis in untreated patients with Parkinson\u2019s disease","volume":"3","author":"Gamboa","year":"1997","journal-title":"Park. Relat. Disord."},{"key":"ref_41","first-page":"235","article-title":"Effects of Parkinson\u2019s Disease on Fundamental Frequency Variability in Running Speech","volume":"21","author":"Bowen","year":"2013","journal-title":"J. Med. Speech Lang. Pathol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1044\/2022_AJSLP-22-00185","article-title":"The Effects of Speech Task on Lexical Stress in Parkinson\u2019s Disease","volume":"32","author":"Exner","year":"2023","journal-title":"Am. J. Speech-Lang. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1121\/1.4816541","article-title":"Imprecise vowel articulation as a potential early marker of Parkinson\u2019s disease: Effect of speaking task","volume":"134","author":"Rusz","year":"2013","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"085709","DOI":"10.1063\/1.5024948","article-title":"Exploiting nonlinearity of the speech production system for voice disorder assessment by recurrence quantification analysis","volume":"28","author":"Vieira","year":"2018","journal-title":"Chaos"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.jvoice.2018.09.004","article-title":"Effectiveness of Recurrence Quantification Measures in Discriminating Subjects With and Without Voice Disorders","volume":"34","author":"Lopes","year":"2020","journal-title":"J. Voice"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/08039488.2020.1777462","article-title":"Dyskinesia is most centrally situated in an estimated network of extrapyramidal syndrome in Asian patients with schizophrenia: Findings from research on Asian psychotropic prescription patterns for antipsychotics","volume":"75","author":"Park","year":"2021","journal-title":"Nord. J. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1044\/jshr.2602.297","article-title":"Formant frequency fluctuation as an index of motor steadiness in the vocal tract","volume":"26","author":"Gerratt","year":"1983","journal-title":"J. Speech Hear Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"770210","DOI":"10.3389\/fcomp.2022.770210","article-title":"Characterizing Dysarthria Diversity for Automatic Speech Recognition: A Tutorial From the Clinical Perspective","volume":"4","author":"Rowe","year":"2022","journal-title":"Front. Comput. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15761\/ABCR.1000105","article-title":"Vocal Changed in Parkinson\u2019s Disease Patients","volume":"1","author":"Yang","year":"2019","journal-title":"Arch. Biomed. Clin. Res."},{"key":"ref_50","unstructured":"Schwartz, J.S., Song, P., and Blitzer, A. (2007). Spasmodic Dysphonia, Humana Press."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1002\/mdc3.70043","article-title":"Re-Emergent Vocal Tremor in a Patient with Parkinson\u2019s Disease","volume":"12","author":"Tsuboi","year":"2025","journal-title":"Mov. Disord. Clin. Pract."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.jvoice.2017.12.010","article-title":"Voice Tremor in Parkinson\u2019s Disease: An Acoustic Study","volume":"33","author":"Miller","year":"2019","journal-title":"J. Voice"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Gianloren\u00e7o, A.C., Costa, V., Fabris-Moraes, W., Teixeira, P.E.P., Gonzalez, P., Pacheco-Barrios, K., Ramos-Estebanez, C., Di Stadio, A., El-Hagrassy, M.M., and Camsari, D.D. (2025). Associations of Voice Metrics with Postural Function in Parkinson\u2019s Disease. Life, 15.","DOI":"10.3390\/life15010027"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Cohen, H. (2003). Disorders of Speech and Language in Parkinson\u2019s Disease. Mental and Behavioral Dysfunction in Movement Disorders, Humana Press.","DOI":"10.1007\/978-1-59259-326-2_9"},{"key":"ref_55","first-page":"389195","article-title":"Progression of voice and speech impairment in the course of Parkinson\u2019s disease: A longitudinal study","volume":"2013","author":"Skodda","year":"2013","journal-title":"Park. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.jocn.2011.10.013","article-title":"A study of voice profiles and acoustic signs in patients with Parkinson\u2019s disease in North India","volume":"19","author":"Lazarus","year":"2012","journal-title":"J. Clin. Neurosci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"831428","DOI":"10.3389\/fneur.2022.831428","article-title":"Voice in Parkinson\u2019s Disease: A Machine Learning Study","volume":"13","author":"Suppa","year":"2022","journal-title":"Front. Neurol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Kwon, D.K., Kwatra, M., Wang, J., and Ko, H.S. (2022). Levodopa-Induced Dyskinesia in Parkinson\u2019s Disease: Pathogenesis and Emerging Treatment Strategies. Cells, 11.","DOI":"10.3390\/cells11233736"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1136\/pgmj.2006.054759","article-title":"Levodopa-induced dyskinesia in Parkinson\u2019s disease: Clinical features, pathogenesis, prevention and treatment","volume":"83","author":"Thanvi","year":"2007","journal-title":"Postgrad. Med. J."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"107054","DOI":"10.1016\/j.parkreldis.2024.107054","article-title":"Levodopa-induced dyskinesia in Parkinson\u2019s disease: Insights from cross-cohort prognostic analysis using machine learning","volume":"126","author":"Loo","year":"2024","journal-title":"Park. Relat. Disord."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.schres.2019.11.031","article-title":"Voice patterns in schizophrenia: A systematic review and Bayesian meta-analysis","volume":"216","author":"Parola","year":"2020","journal-title":"Schizophr. Res."},{"key":"ref_62","doi-asserted-by":"crossref","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."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/19\/3187\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:25:32Z","timestamp":1790778332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/19\/3187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":62,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["diagnostics16193187"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16193187","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]}}}