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      Call for Papers: Sex and Gender in Neurodegenerative Diseases

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      Fully Automatic Speech-Based Analysis of the Semantic Verbal Fluency Task

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          Abstract

          Background: Semantic verbal fluency (SVF) tests are routinely used in screening for mild cognitive impairment (MCI). In this task, participants name as many items as possible of a semantic category under a time constraint. Clinicians measure task performance manually by summing the number of correct words and errors. More fine-grained variables add valuable information to clinical assessment, but are time-consuming. Therefore, the aim of this study is to investigate whether automatic analysis of the SVF could provide these as accurate as manual and thus, support qualitative screening of neurocognitive impairment. Methods: SVF data were collected from 95 older people with MCI ( n = 47), Alzheimer’s or related dementias (ADRD; n = 24), and healthy controls (HC; n = 24). All data were annotated manually and automatically with clusters and switches. The obtained metrics were validated using a classifier to distinguish HC, MCI, and ADRD. Results: Automatically extracted clusters and switches were highly correlated ( r = 0.9) with manually established values, and performed as well on the classification task separating HC from persons with ADRD (area under curve [AUC] = 0.939) and MCI (AUC = 0.758). Conclusion: The results show that it is possible to automate fine-grained analyses of SVF data for the assessment of cognitive decline.

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          Most cited references31

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          Innovative diagnostic tools for early detection of Alzheimer's disease.

          Current state-of-the-art diagnostic measures of Alzheimer's disease (AD) are invasive (cerebrospinal fluid analysis), expensive (neuroimaging) and time-consuming (neuropsychological assessment) and thus have limited accessibility as frontline screening and diagnostic tools for AD. Thus, there is an increasing need for additional noninvasive and/or cost-effective tools, allowing identification of subjects in the preclinical or early clinical stages of AD who could be suitable for further cognitive evaluation and dementia diagnostics. Implementation of such tests may facilitate early and potentially more effective therapeutic and preventative strategies for AD. Before applying them in clinical practice, these tools should be examined in ongoing large clinical trials. This review will summarize and highlight the most promising screening tools including neuropsychometric, clinical, blood, and neurophysiological tests.
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            Automatic speech analysis for the assessment of patients with predementia and Alzheimer's disease

            Background To evaluate the interest of using automatic speech analyses for the assessment of mild cognitive impairment (MCI) and early-stage Alzheimer's disease (AD). Methods Healthy elderly control (HC) subjects and patients with MCI or AD were recorded while performing several short cognitive vocal tasks. The voice recordings were processed, and the first vocal markers were extracted using speech signal processing techniques. Second, the vocal markers were tested to assess their “power” to distinguish among HC, MCI, and AD. The second step included training automatic classifiers for detecting MCI and AD, using machine learning methods and testing the detection accuracy. Results The classification accuracy of automatic audio analyses were as follows: between HCs and those with MCI, 79% ± 5%; between HCs and those with AD, 87% ± 3%; and between those with MCI and those with AD, 80% ± 5%, demonstrating its assessment utility. Conclusion Automatic speech analyses could be an additional objective assessment tool for elderly with cognitive decline.
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              Spoken Language Derived Measures for Detecting Mild Cognitive Impairment.

              Spoken responses produced by subjects during neuropsychological exams can provide diagnostic markers beyond exam performance. In particular, characteristics of the spoken language itself can discriminate between subject groups. We present results on the utility of such markers in discriminating between healthy elderly subjects and subjects with mild cognitive impairment (MCI). Given the audio and transcript of a spoken narrative recall task, a range of markers are automatically derived. These markers include speech features such as pause frequency and duration, and many linguistic complexity measures. We examine measures calculated from manually annotated time alignments (of the transcript with the audio) and syntactic parse trees, as well as the same measures calculated from automatic (forced) time alignments and automatic parses. We show statistically significant differences between clinical subject groups for a number of measures. These differences are largely preserved with automation. We then present classification results, and demonstrate a statistically significant improvement in the area under the ROC curve (AUC) when using automatic spoken language derived features in addition to the neuropsychological test scores. Our results indicate that using multiple, complementary measures can aid in automatic detection of MCI.
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                Author and article information

                Journal
                DEM
                Dement Geriatr Cogn Disord
                10.1159/issn.1420-8008
                Dementia and Geriatric Cognitive Disorders
                S. Karger AG
                1420-8008
                1421-9824
                2018
                July 2018
                08 June 2018
                : 45
                : 3-4
                : 198-209
                Affiliations
                [_a] aMemory Clinic, Association IA, CoBTek Lab, CHU Université Côte d’Azur, Nice, France
                [_b] bGerman Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
                [_c] cSchool of Informatics, University of Edinburgh, Edinburgh, United Kingdom
                Author notes
                *Alexandra König, CoBTeK (Cognition Behaviour Technology) Research Lab, Université Côte d’Azur, Centre Mémoire de Ressources et de Recherche, CHU de Nice, Institut Claude Pompidou, 10 rue Molière, FR–06100 Nice (France), E-Mail alexandra.konig@inria.fr
                Article
                487852 Dement Geriatr Cogn Disord 2018;45:198–209
                10.1159/000487852
                29886493
                3d40d584-d6b3-43e5-b8c0-f51240495e44
                © 2018 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 22 December 2017
                : 20 February 2018
                Page count
                Figures: 3, Tables: 1, Pages: 12
                Categories
                Original Research Article

                Geriatric medicine,Neurology,Cardiovascular Medicine,Neurosciences,Clinical Psychology & Psychiatry,Public health
                Alzheimer’s disease,Speech recognition,Semantic verbal fluency,Dementia,Neuropsychology,Machine learning,Speech processing,Mild cognitive impairment,Assessment

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