Journal of voice : official journal of the Voice Foundation · 2026
Association Between Acoustic Speech Measures and Disability in Multiple Sclerosis: A Systematic Review and Meta-analysis.
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Hernández Jonathan Delgado, Montesinos Moisés Betancort, Arias Tatiana Romero, Pérez Miguel Ángel Hernández
Аннотация
OBJECTIVES: To investigate the relationship between disability status (expanded disability status scale [EDSS]) and acoustic speech measures in multiple sclerosis (MS) through a systematic review and meta-analysis.
METHODS: A systematic search was conducted (PubMed, Scopus, and Web of Science) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Studies correlating objective acoustic measures with EDSS scores were included. Random-effects meta-analyses were performed for outcomes reported in ≥3 independent studies; others were synthesized narratively.
RESULTS: Twelve studies (N = 900) were included. A hierarchical pattern emerged where motor-demanding tasks yielded the strongest associations. Reading-based measures, specifically Articulation Rate (r up to -0.50) and Formant Centralization Ratio (r = 0.48), proved most sensitive to disability. Jitter showed a consistent positive correlation (r = 0.28, P < 0.0001). Conversely, maximum phonation time (MPT) (P = 0.35) and general voice quality measures showed no significant relationship with disease progression.
CONCLUSIONS: Acoustic markers of speech timing and articulatory precision correlate moderately with physical disability, whereas aerodynamic capacity and voice quality appear relatively preserved. Consequently, clinical protocols for MS should prioritize a multimodal approach combining reading tasks (to capture prosodic and articulatory deficits) and sustained vowels (to monitor phonatory instability), while aerodynamic measures such as MPT appear to have limited utility for tracking disease progression.
METHODS: A systematic search was conducted (PubMed, Scopus, and Web of Science) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Studies correlating objective acoustic measures with EDSS scores were included. Random-effects meta-analyses were performed for outcomes reported in ≥3 independent studies; others were synthesized narratively.
RESULTS: Twelve studies (N = 900) were included. A hierarchical pattern emerged where motor-demanding tasks yielded the strongest associations. Reading-based measures, specifically Articulation Rate (r up to -0.50) and Formant Centralization Ratio (r = 0.48), proved most sensitive to disability. Jitter showed a consistent positive correlation (r = 0.28, P < 0.0001). Conversely, maximum phonation time (MPT) (P = 0.35) and general voice quality measures showed no significant relationship with disease progression.
CONCLUSIONS: Acoustic markers of speech timing and articulatory precision correlate moderately with physical disability, whereas aerodynamic capacity and voice quality appear relatively preserved. Consequently, clinical protocols for MS should prioritize a multimodal approach combining reading tasks (to capture prosodic and articulatory deficits) and sustained vowels (to monitor phonatory instability), while aerodynamic measures such as MPT appear to have limited utility for tracking disease progression.