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El-Hagrassy, Mirret M.

https://orcid.org/0000-0002-2349-7529

Mayo Clinic

University of Massachusetts Chan Medical School

Citations 2

Exploring Bidirectional Associations Between Voice Acoustics and Objective Motor Metrics in Parkinson’s Disease
Gianlorenço, Anna Carolyna , Costa, Valton, Fabris-Moraes, Walter, Gonzalez-Mego, Paola, Ramos-Estebanez, Ciro, Stadio, Arianna Di , Camsari, Deniz Doruk, El-Hagrassy, Mirret M. , Fregni, Felipe , Wagner, Tim, Dipietro, Laura, Gianlorenço, Anna Carolyna , Costa, Valton , Ramos-Estébanez, Ciro , Costa, Valton , Ramos-Estebanez, Ciro , Di Stadio, Arianna , Fregni, Felipe , Teixeira, Paulo E. P. , Gonzalez‐Mego, Paola , Dipietro, Laura

Brain Sciences | December 31, 2025 | Volume: 16 | Issue: 1 | Pages: 48

10.3390/brainsci16010048 Get It

Background/Objectives: Speech and motor control share overlapping neural mechanisms, yet their quantitative relationships in Parkinson’s disease (PD) remain underexplored. This study investigated bidirectional associations between acoustic voice features and objective motor metrics to better understand how vocal and motor systems relate in PD. Methods: Cross-sectional baseline data from participants in a randomized neuromodulation trial were analyzed (n = 13). Motor performance was captured using an Integrated Motion Analysis Suite (IMAS), which enabled quantitative, objective characterization of motor performance during balance, gait, and upper- and lower-limb tasks. Acoustic analyses included harmonic-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPS), jitter, shimmer, median fundamental frequency (F0), F0 standard deviation (SD F0), and voice intensity. Univariate linear regressions were conducted in both directions (voice ↔ motor), as well as partial correlations controlling for PD motor symptom severity. Results: When modeling voice outcomes, faster motor performance and shorter movement durations were associated with acoustically clearer voice features (e.g., higher elbow flexion-extension peak speed with higher voice HNR, β = 8.5, R2 = 0.56, p = 0.01). Similarly, when modeling motor outcomes, clearer voice measures were linked with faster movement speed and shorter movement durations (e.g., higher voice HNR with higher peak movement speed in elbow flexion/extension, β = 0.07, R2 = 0.56, p = 0.01). Conclusions: Voice and motor measures in PD showed significant bidirectional associations, suggesting shared sensorimotor control. These exploratory findings, while limited by sample size, support the feasibility of integrated multimodal assessment for future longitudinal studies.
Associations of Voice Metrics with Postural Function in Parkinson’s Disease
Gianlorenço, Anna Carolyna , Costa, Valton , Fabris-Moraes, Walter , Gonzalez, Paola Carrillo, Pacheco-Barrios, Kevin, Ramos-Estébanez, Ciro , Stadio, Arianna Di , El-Hagrassy, Mirret M. , Camsari, Deniz Doruk, Wagner, Tim, Dipietro, Laura, Fregni, Felipe , Ramos-Estebanez, Ciro , Di Stadio, Arianna , Camsari, Deniz Durok, Fregni, Felipe , Gianlorenço, Anna Carolyna , Costa, Valton , Teixeira, Paulo E. P. , Pacheco‐Barrios, Kevin

Life | December 31, 2024 | Volume: 15 | Issue: 1 | Pages: 27

10.3390/life15010027 Get It

Background: This study aimed to explore the potential associations between voice metrics of patients with PD and their motor symptoms. Methods: Motor and vocal data including the Unified Parkinson’s Disease Rating Scale part III (UPDRS-III), Harmonic–Noise Ratio (HNR), jitter, shimmer, and smoothed cepstral peak prominence (CPPS) were analyzed through exploratory correlations followed by univariate linear regression analyses. We employed these four voice metrics as independent variables and the total and sub-scores of the UPDRS-III as dependent variables. Results: Thirteen subjects were included, 76% males and 24% females, with a mean age of 62.9 ± 10.1 years, and a median Hoehn and Yahr stage of 2.3 ± 0.7. The regression analysis showed that CPPS is associated with posture (UPDRS-III posture scores: β = −0.196; F = 10.0; p = 0.01; R2 = 0.50) and UPDRS-III postural stability scores (β = −0.130; F = 5.57; p = 0.04; R2 = 0.35). Additionally, the associations between CPPS and rapid alternating movement (β = −0.297; p = 0.07), rigidity (β= −0.36; p = 0.11), and body bradykinesia (β = −0.16; p = 0.13) showed a trend towards significance. Conclusion: These findings highlight the potential role of CPPS as a predictor of postural impairments secondary to PD, emphasizing the need for further investigation.