{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:58:48Z","timestamp":1785405528587,"version":"3.56.0"},"posted":{"date-parts":[[2026,7,14]]},"group-title":"Neurology","reference-count":73,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"id":[{"id":"https:\/\/ror.org\/033km2469","id-type":"ROR","asserted-by":"publisher"}]},{"name":"U.S. Department of Defense","award":["HT9425-25-1-0086"],"award-info":[{"award-number":["HT9425-25-1-0086"]}]},{"name":"NIH","award":["R01 NS117826"],"award-info":[{"award-number":["R01 NS117826"]}]},{"id":[{"id":"https:\/\/ror.org\/02jqkb192","id-type":"ROR","asserted-by":"publisher"}]},{"id":[{"id":"https:\/\/ror.org\/05a0ya142","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Dake Family Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>A major obstacle for clinical trials is the lack of objective, sensitive, and reliable measures that can detect modest changes in disease progression. Here, we determine whether acoustic and linguistic digital speech measures automatically obtained during a functionally relevant passage-reading task capture multiple dimensions of disease in ataxia, including functional communication impairment, subclinical cerebellar dysfunction and disease progression.<\/jats:p>\n                <jats:p>A total of 157 individuals with ataxia and 84 controls contributed cross-sectional data, and 54 individuals with ataxia and 43 controls contributed longitudinal data within the ongoing Neurobooth natural history study. Participants completed standardized speech recordings, patient-reported outcome measures (PROMs) and neurologist-rated clinical evaluations. A novel speech processing pipeline was developed to automatically transcribe audio recordings, identify word boundaries and extract a predefined set of linguistic and within-word acoustic features.<\/jats:p>\n                <jats:p>\n                  Individuals with ataxia exhibited marked disruption of speech timing, coordination and articulatory control, including slowed speech (\n                  <jats:italic>d<\/jats:italic>\n                  =1.23), prolonged inter-word pauses (\n                  <jats:italic>d<\/jats:italic>\n                  =-0.91), higher\/more variable vocal intensity (|\n                  <jats:italic>d<\/jats:italic>\n                  |=0.43-0.51) and altered spectral content (|\n                  <jats:italic>d<\/jats:italic>\n                  |=0.43-0.79) compared to healthy controls. Linguistic features (e.g. speaking rate and within-word pause duration) showed strong associations with clinician-rated severity and PROMs (|\n                  <jats:italic>r<\/jats:italic>\n                  |=0.23-68), indicating alignment with functional communication impairment and patient-perceived disease burden. In contrast, acoustic features derived from cepstral measures captured subtle abnormalities in speech motor control, differentiating not only individuals with ataxia (\n                  <jats:italic>d<\/jats:italic>\n                  =0.65) but also pre-ataxic individuals (\n                  <jats:italic>d<\/jats:italic>\n                  =0.56), and those without clinically evident dysarthria (\n                  <jats:italic>d<\/jats:italic>\n                  =0.45), from controls. These findings indicate that acoustic features reflect subclinical cerebellar motor dysfunction involving impaired temporal coordination and vocal control before overt clinical speech impairment emerges. Longitudinally, several acoustic measures were sensitive to disease progression (\n                  <jats:italic>MSDR<\/jats:italic>\n                  =0.19-0.68), even in cases where clinical scales showed no detectable change. Speech-derived changes correlated with changes in clinical scales and PROMs. Both acoustic and linguistic features exhibited strong intra-session reliability.\n                <\/jats:p>\n                <jats:p>During passage reading, acoustic and linguistic measures provide complementary but different clinical information in ataxias. Linguistic measures primarily reflect downstream functional consequences of ataxic dysarthria, whereas acoustic measures provide sensitive indicators of subclinical cerebellar motor dysfunction and progression. These findings demonstrate that natural speech analysis can produce digital measures for detecting subclinical disease, quantifying functional impairment, monitoring progression in ataxia, with strong potential for application in clinical trials and remote monitoring.<\/jats:p>","DOI":"10.64898\/2026.07.10.26357775","type":"posted-content","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:35:14Z","timestamp":1784046914000},"source":"Crossref","is-referenced-by-count":0,"title":["Acoustic and linguistic features of reading reveal early change, progression and function in ataxias"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4624-2668","authenticated-orcid":false,"given":"Ryan Anthony J.","family":"de Belen","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"},{"name":"Ataxia Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Hoche","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"},{"name":"Ataxia Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"},{"name":"Ataxia Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Stephen","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"},{"name":"Ataxia Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy D.","family":"Schmahmann","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"},{"name":"Ataxia Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"White","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasnaa Ouadoudi","family":"Belabzioui","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Patel","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoopum S.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, United States of America, 02115"},{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"},{"name":"Ataxia Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 02114"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026071610151366000_2026.07.10.26357775v1.1","doi-asserted-by":"crossref","unstructured":"Goldman JG. Ataxia. In: Encyclopedia of Movement Disorders. Elsevier; 2010:70\u201386.","DOI":"10.1016\/B978-0-12-374105-9.00153-2"},{"key":"2026071610151366000_2026.07.10.26357775v1.2","doi-asserted-by":"publisher","DOI":"10.1080\/14734220601145459"},{"key":"2026071610151366000_2026.07.10.26357775v1.3","first-page":"302","article-title":"Ataxic dysarthria","volume":"7","year":"1970","journal-title":"International Journal of Neurology"},{"key":"2026071610151366000_2026.07.10.26357775v1.4","doi-asserted-by":"publisher","DOI":"10.1159\/000081084"},{"issue":"2","key":"2026071610151366000_2026.07.10.26357775v1.5","first-page":"63","article-title":"A speaking task analysis of the dysarthria in cerebellar disease","volume":"49","year":"1997","journal-title":"Folia Phoniatr Logop"},{"key":"2026071610151366000_2026.07.10.26357775v1.6","doi-asserted-by":"publisher","DOI":"10.1044\/jslhr.4305.1275"},{"key":"2026071610151366000_2026.07.10.26357775v1.7","doi-asserted-by":"publisher","DOI":"10.1101\/2025.07.02.25330604"},{"key":"2026071610151366000_2026.07.10.26357775v1.8","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.69.5.584"},{"key":"2026071610151366000_2026.07.10.26357775v1.9","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.110171"},{"key":"2026071610151366000_2026.07.10.26357775v1.10","doi-asserted-by":"publisher","DOI":"10.1159\/000499627"},{"key":"2026071610151366000_2026.07.10.26357775v1.11","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22681"},{"key":"2026071610151366000_2026.07.10.26357775v1.12","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000219042.60538.92"},{"key":"2026071610151366000_2026.07.10.26357775v1.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(96)00231-6"},{"issue":"7","key":"2026071610151366000_2026.07.10.26357775v1.14","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1002\/acn3.51370","article-title":"Spinocerebellar ataxia clinical trials: opportunities and challenges","volume":"8","year":"2021","journal-title":"Ann Clin Transl Neurol"},{"issue":"3","key":"2026071610151366000_2026.07.10.26357775v1.15","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1002\/ana.26712","article-title":"Responsiveness of the Scale for the assessment and Rating of ataxia and natural history in 884 recessive and early onset ataxia patients","volume":"94","year":"2023","journal-title":"Ann Neurol"},{"key":"2026071610151366000_2026.07.10.26357775v1.16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.parkreldis.2021.08.014","article-title":"Exploring the clinical meaningfulness of the Scale for the Assessment and Rating of Ataxia: A comparison of patient and physician perspectives at the item level","volume":"91","year":"2021","journal-title":"Parkinsonism Relat Disord"},{"key":"2026071610151366000_2026.07.10.26357775v1.17","doi-asserted-by":"publisher","DOI":"10.1038\/nrn.2017.92"},{"key":"2026071610151366000_2026.07.10.26357775v1.18","doi-asserted-by":"publisher","DOI":"10.1038\/nature22044"},{"key":"2026071610151366000_2026.07.10.26357775v1.19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.omtn.2021.11.015","article-title":"Allele-specific targeting of mutant ataxin-3 by antisense oligonucleotides in SCA3-iPSC-derived neurons","volume":"27","year":"2022","journal-title":"Mol Ther Nucleic Acids"},{"key":"2026071610151366000_2026.07.10.26357775v1.20","doi-asserted-by":"crossref","unstructured":"Scoles DR , Pulst SM . Oligonucleotide therapeutics in neurodegenerative diseases. RNA Biol. Published online June 2018:1\u20138.","DOI":"10.1080\/15476286.2018.1454812"},{"issue":"1","key":"2026071610151366000_2026.07.10.26357775v1.21","first-page":"1","article-title":"Oligonucleotide therapeutics for neurodegenerative diseases","volume":"4","year":"2025","journal-title":"NeuroImmune Pharm Ther"},{"issue":"3","key":"2026071610151366000_2026.07.10.26357775v1.22","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.bandl.2013.10.002","article-title":"Speech in spinocerebellar ataxia","volume":"127","year":"2013","journal-title":"Brain Lang"},{"issue":"1","key":"2026071610151366000_2026.07.10.26357775v1.23","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1055\/s-0041-1741495","article-title":"Digital phenotyping in clinical neurology","volume":"42","year":"2022","journal-title":"Semin Neurol"},{"issue":"2","key":"2026071610151366000_2026.07.10.26357775v1.24","first-page":"459","article-title":"Uncertainty of vowel predictions as a digital biomarker for ataxic dysarthria","volume":"23","year":"2024","journal-title":"Cerebellum"},{"key":"2026071610151366000_2026.07.10.26357775v1.25","doi-asserted-by":"crossref","first-page":"62328","DOI":"10.1109\/ACCESS.2024.3393243","article-title":"Sensitive quantification of cerebellar speech abnormalities using deep learning models","volume":"12","year":"2024","journal-title":"IEEE Access"},{"key":"2026071610151366000_2026.07.10.26357775v1.26","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-023-01513-9"},{"issue":"1","key":"2026071610151366000_2026.07.10.26357775v1.27","first-page":"123","article-title":"Voice alterations in patients with spinocerebellar ataxia type 7 (SCA7): Clinical-genetic correlations","volume":"31","year":"2017","journal-title":"J Voice"},{"issue":"2","key":"2026071610151366000_2026.07.10.26357775v1.28","first-page":"e194","article-title":"Features of speech and swallowing dysfunction in pre-ataxic spinocerebellar ataxia type 2","volume":"95","year":"2020","journal-title":"Neurology"},{"issue":"4","key":"2026071610151366000_2026.07.10.26357775v1.29","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1007\/s10439-020-02455-7","article-title":"Quantitative assessment of speech in Cerebellar Ataxia using magnitude and phase based cepstrum","volume":"48","year":"2020","journal-title":"Ann Biomed Eng"},{"key":"2026071610151366000_2026.07.10.26357775v1.30","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-012-0440-0"},{"issue":"2","key":"2026071610151366000_2026.07.10.26357775v1.31","first-page":"243","article-title":"Voice in friedreich ataxia","volume":"31","year":"2017","journal-title":"J Voice"},{"issue":"11","key":"2026071610151366000_2026.07.10.26357775v1.32","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1007\/s00415-012-6547-x","article-title":"Longitudinal change in dysarthria associated with Friedreich ataxia: a potential clinical endpoint","volume":"259","year":"2012","journal-title":"J Neurol"},{"issue":"9","key":"2026071610151366000_2026.07.10.26357775v1.33","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1002\/acn3.51438","article-title":"Digital endpoints for self-administered home-based functional assessment in pediatric Friedreich\u2019s ataxia","volume":"8","year":"2021","journal-title":"Ann Clin Transl Neurol"},{"issue":"4","key":"2026071610151366000_2026.07.10.26357775v1.34","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/dmcn.14811","article-title":"Dysarthria in children and adults with ataxia telangiectasia","volume":"63","year":"2021","journal-title":"Dev Med Child Neurol"},{"issue":"9","key":"2026071610151366000_2026.07.10.26357775v1.35","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1007\/s00415-018-8950-4","article-title":"Coordination and timing deficits in speech and swallowing in autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS)","volume":"265","year":"2018","journal-title":"J Neurol"},{"key":"2026071610151366000_2026.07.10.26357775v1.36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mito.2017.06.002","article-title":"Speech and swallowing abnormalities in adults with POLG associated ataxia (POLG-A)","volume":"37","year":"2017","journal-title":"Mitochondrion"},{"issue":"1","key":"2026071610151366000_2026.07.10.26357775v1.37","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1038\/s41746-023-00787-x","article-title":"SARAspeech-Feasibility of automated assessment of ataxic speech disturbance","volume":"6","year":"2023","journal-title":"NPJ Digit Med"},{"issue":"8","key":"2026071610151366000_2026.07.10.26357775v1.38","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1044\/2023_JSLHR-22-00526","article-title":"Automated vowel articulation analysis in connected speech among progressive neurological diseases, dysarthria types, and dysarthria severities","volume":"66","year":"2023","journal-title":"J Speech Lang Hear Res"},{"key":"2026071610151366000_2026.07.10.26357775v1.39","doi-asserted-by":"crossref","unstructured":"Terao Y , Tokushige SI , Inomata-Terada S , et al. How do patients with Parkinson\u2019s disease and cerebellar ataxia read aloud? -Eye-voice coordination in text reading. Front Neurosci. 2023;17:1202404.","DOI":"10.3389\/fnins.2023.1202404"},{"key":"2026071610151366000_2026.07.10.26357775v1.40","doi-asserted-by":"publisher","DOI":"10.1002\/ana.78039"},{"key":"2026071610151366000_2026.07.10.26357775v1.41","doi-asserted-by":"publisher","DOI":"10.1101\/2024.12.28.24319527"},{"key":"2026071610151366000_2026.07.10.26357775v1.42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147573"},{"issue":"4","key":"2026071610151366000_2026.07.10.26357775v1.43","first-page":"149","article-title":"Algorithmic estimation of pauses in extended speech samples of dysarthric and typical speech","volume":"12","year":"2004","journal-title":"J Med Speech Lang Pathol"},{"key":"2026071610151366000_2026.07.10.26357775v1.44","doi-asserted-by":"publisher","DOI":"10.1159\/000316976"},{"key":"2026071610151366000_2026.07.10.26357775v1.45","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28670"},{"key":"2026071610151366000_2026.07.10.26357775v1.46","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2012\/12-0140)"},{"key":"2026071610151366000_2026.07.10.26357775v1.47","unstructured":"Baevski A , Zhou H , Mohamed A , Auli M. Wav2vec 2.0: A framework for self-supervised learning of speech representations. arXiv [csCL]. Published online June 19, 2020. http:\/\/arxiv.org\/abs\/2006.11477"},{"key":"2026071610151366000_2026.07.10.26357775v1.48","doi-asserted-by":"publisher","DOI":"10.21437\/interspeech.2020-2879"},{"key":"2026071610151366000_2026.07.10.26357775v1.49","first-page":"1898","article-title":"Classification of Huntington Disease using Acoustic and Lexical Features","volume":"2018","year":"2018","journal-title":"Interspeech"},{"key":"2026071610151366000_2026.07.10.26357775v1.50","doi-asserted-by":"publisher","DOI":"10.21437\/interspeech.2016-1228"},{"key":"2026071610151366000_2026.07.10.26357775v1.51","doi-asserted-by":"crossref","unstructured":"Mengistu KT , Rudzicz F. Comparing humans and automatic speech recognition systems in recognizing dysarthric speech. In: Lecture Notes in Computer Science. Lecture notes in computer science. Springer Berlin Heidelberg; 2011:291\u2013300.","DOI":"10.1007\/978-3-642-21043-3_36"},{"key":"2026071610151366000_2026.07.10.26357775v1.52","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1996.tb02080.x"},{"key":"2026071610151366000_2026.07.10.26357775v1.53","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177730491"},{"key":"2026071610151366000_2026.07.10.26357775v1.54","doi-asserted-by":"publisher","DOI":"10.4324\/9780203771587"},{"issue":"6","key":"2026071610151366000_2026.07.10.26357775v1.55","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s12311-021-01247-6","article-title":"Decomposition of reaching movements enables detection and measurement of ataxia","volume":"20","year":"2021","journal-title":"Cerebellum"},{"key":"2026071610151366000_2026.07.10.26357775v1.56","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70104-2"},{"key":"2026071610151366000_2026.07.10.26357775v1.57","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"2026071610151366000_2026.07.10.26357775v1.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"issue":"1","key":"2026071610151366000_2026.07.10.26357775v1.59","doi-asserted-by":"crossref","first-page":"22787","DOI":"10.1038\/s41598-023-49352-2","article-title":"Towards interpretable speech biomarkers: exploring MFCCs","volume":"13","year":"2023","journal-title":"Sci Rep"},{"issue":"4","key":"2026071610151366000_2026.07.10.26357775v1.60","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3109\/17549507.2011.529940","article-title":"Spectral measures of the effects of Friedreich\u2019s ataxia on speech","volume":"13","year":"2011","journal-title":"Int J Speech Lang Pathol"},{"key":"2026071610151366000_2026.07.10.26357775v1.61","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3363-16.2017"},{"key":"2026071610151366000_2026.07.10.26357775v1.62","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24734"},{"key":"2026071610151366000_2026.07.10.26357775v1.63","doi-asserted-by":"publisher","DOI":"10.1121\/1.5100910"},{"key":"2026071610151366000_2026.07.10.26357775v1.64","doi-asserted-by":"crossref","unstructured":"Zink N , Stock AK , Vahid A , Beste C . On the neurophysiological mechanisms underlying the adaptability to varying cognitive control demands. Front Hum Neurosci. 2018;12:411.","DOI":"10.3389\/fnhum.2018.00411"},{"key":"2026071610151366000_2026.07.10.26357775v1.65","doi-asserted-by":"publisher","DOI":"10.1016\/0001-6918(77)90012-9"},{"key":"2026071610151366000_2026.07.10.26357775v1.66","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0511(99)00045-9"},{"issue":"2","key":"2026071610151366000_2026.07.10.26357775v1.67","first-page":"103","article-title":"A longitudinal study of dysarthria in spinocerebellar ataxia (SCA): aspects of articulation, prosody, and voice","volume":"16","year":"2008","journal-title":"Journal of Medical Speech-Language Pathology"},{"key":"2026071610151366000_2026.07.10.26357775v1.68","doi-asserted-by":"publisher","DOI":"10.1159\/000118510"},{"key":"2026071610151366000_2026.07.10.26357775v1.69","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27376"},{"issue":"3","key":"2026071610151366000_2026.07.10.26357775v1.70","first-page":"43","article-title":"Parkinsons disease Diagnosis using Mel frequency Cepstral Coefficients and Vector Quantization","volume":"14","year":"2011","journal-title":"Int J Comput Appl"},{"key":"2026071610151366000_2026.07.10.26357775v1.71","doi-asserted-by":"publisher","DOI":"10.21437\/slpat.2016-6"},{"key":"2026071610151366000_2026.07.10.26357775v1.72","unstructured":"Khan T. Running-speech MFCC are better markers of Parkinsonian speech deficits than vowel phonation and diadochokinetic. https:\/\/www.diva-portal.org\/smash\/get\/diva2%3A705196\/FULLTEXT01.pdf. Published online 2014."},{"issue":"1","key":"2026071610151366000_2026.07.10.26357775v1.73","doi-asserted-by":"crossref","first-page":"5080","DOI":"10.1038\/s41467-023-40917-3","article-title":"At-home wearables and machine learning sensitively capture disease progression in amyotrophic lateral sclerosis","volume":"14","year":"2023","journal-title":"Nat Commun"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.07.10.26357775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T17:15:25Z","timestamp":1784222125000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.07.10.26357775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":73,"URL":"https:\/\/doi.org\/10.64898\/2026.07.10.26357775","relation":{},"subject":[],"published":{"date-parts":[[2026,7,14]]},"subtype":"preprint"}}