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CompletedNCT05909163Updated Jun 18, 2023

Spoken Discourse Biomarker of PD Cognitive Impairment

An observational study in Parkinson Disease, sponsored by Northwestern University. Completed at 1 site in United States. Open to participants aged 50 Years to 90 Years. Per ClinicalTrials.gov, last updated 2023-06-18.

Sponsored by Northwestern University · Observational

Study type
Observational
Model
Cohort
Time perspective
Cross-sectional
Enrollment
140
Ages
50 Years to 90 Years
Sex
All
01

Study summary

The purpose of this study is to identify unique profiles of speech and language changes that distinguish individuals with Parkinson's disease from adults without Parkinson's disease and individuals with Parkinson's disease with cognitive (e.g., memory, thinking skills) impairment from those without cognitive impairment.

Read the detailed description

Aim 1 will characterize PD-MCI (Parkinson's disease mild cognitive impairment), PDN (Parkinson's disease without cognitive impairment), and HA (healthy adult) spoken discourse, cognitive, and motor speech profiles. Phase 2 biomarker development requires robustly characterized cohorts in which to test candidate biomarkers. Using a standardized battery of cognitive, language, and motor speech tests PD participants will be assigned to PD-MCI (single/multi-domain) or PDN groups. The investigators propose collecting spoken discourse samples using standardized elicitation protocols. The same tasks will be extracted from the extant HA database. Researchers will transcribe, code, and analyze discourse samples. Group differences (including sub-analyses for single and multi-domain MCI subtypes), elicitation stimuli effects, and group x stimuli interactions will be examined using multivariate and mixed-design ANOVA procedures.

Aim 2 will develop and evaluate the classification accuracy of an optimally weighted discourse classification function for PD-MCI and PDN. The investigators propose using discriminant function analysis to identify an optimized composite variable that best predicts PD-MCI, PDN, and HA group membership. Sensitivity/specificity analyses, positive/negative predictive values, and receiver operating characteristic curves will be used to evaluate the discourse classification function properties.

The primary endpoint is an optimally weighted discourse function that can classify PD-MCI with > 80% sensitivity/specificity.

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Conditions studied

  • Parkinson Disease
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In context

Parkinson Disease

4,487 studies on the registry are indexed under Parkinson Disease; 1,082 are open to participants now.

This study's enrollment of 140 is above the median of 96 across 1,057 observational studies indexed under Parkinson Disease.

Browse Parkinson Disease studies →

Lead sponsor

Northwestern University is the lead sponsor of 1,396 studies on the registry; 199 are open to participants now.

Of its 102 completed or terminated interventional studies of FDA-regulated products, 73 (72%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
50 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Only individuals with PD will be newly recruited and enrolled as part of the study. Healthy adult data will be extracted from extant databases (publicly available) from NIH-funded studies.

Inclusion criteria

Only individuals with PD will be newly recruited and enrolled as part of the study. Healthy adult data will be extracted from extant databases (publicly available) from NIH-funded studies.

Inclusion Criteria Person with Parkinson's disease without cognitive impairment

  • Age 50-90 years
  • Diagnosis of idiopathic Parkinson's disease (UK Brain Bank criteria) made by a movement disorders specialist
  • Under the care of a movement disorders specialist for a minimum of 1-year duration
  • Native monolingual English speaker
  • Hoehn \& Yahr score between 1.5 and 4
  • Grade 10 education, or higher
  • Sufficient vision and hearing (aided or unaided) for all experiment tasks
  • Montreal Cognitive Assessment (or MoCA-converted MMSE score) greater than or equal to 25
  • No subjective complaints of cognitive difficulty or word finding issues

Inclusion Criteria Person with Parkinson's disease mild cognitive impairment

  • Age 50-90 years
  • Diagnosis of idiopathic Parkinson's disease (UK Brain Bank criteria) made by a movement disorders specialist
  • Under the care of a movement disorders specialist for a minimum of 1-year duration
  • Native monolingual English speaker
  • Hoehn \& Yahr score between 1.5 and 4
  • Grade 10 education, or higher
  • Sufficient vision and hearing (aided or unaided) for all experiment tasks
  • Montreal Cognitive Assessment (or MoCA-converted MMSE score) greater than or equal to 17
  • Subjective complaints of cognitive difficulty or word finding issues, without significant impact on activities of daily living

Inclusion Healthy Adults (from extant data base - no new recruiting)

  • Age 50-90 years
  • Montreal Cognitive Assessment (or MoCA-converted MMSE score) greater than or equal to 26
  • Native monolingual English speaker
  • Grade 10 education, or higher
  • Sufficient vision and hearing (aided or unaided) for all experiment tasks

Exclusion criteria

Exclusion Criteria:

Exclusion Criteria Neurological injury or disease (other than PD for the PD cohort)

  • History of unmanaged or untreated depression or major psychiatric illness
  • History of deep brain stimulation surgery (DBS)
  • Diagnosis of Dementia with Lewy Bodies
05

Study design

Observational model
Cohort
Time perspective
Cross-sectional
Enrollment
140 participants (actual)
Patient registry
No

Groups and cohorts

  • Pakinson's disease without cognitive impairment

    * Age 50-90 years * Diagnosis of idiopathic Parkinson's disease (UK Brain Bank criteria) made by a movement disorders specialist * Under the care of a movement disorders specialist for a minimum of 1-year duration * Native monolingual English speaker * Hoehn \& Yahr score between 1.5 and 4 * Grade 10 education, or higher * Sufficient vision and hearing (aided or unaided) for all experiment tasks * Montreal Cognitive Assessment (or MoCA-converted MMSE score) greater than or equal to 25 * No subjective complaints of cognitive difficulty or word finding issues

  • Pakinson's disease with cognitive impairment

    * Age 50-90 years * Diagnosis of idiopathic Parkinson's disease (UK Brain Bank criteria) made by a movement disorders specialist * Under the care of a movement disorders specialist for a minimum of 1-year duration * Native monolingual English speaker * Hoehn \& Yahr score between 1.5 and 4 * Grade 10 education, or higher * Sufficient vision and hearing (aided or unaided) for all experiment tasks * Montreal Cognitive Assessment (or MoCA-converted MMSE score) greater than or equal to 17 * Subjective complaints of cognitive difficulty or word finding issues, without significant impact on activities of daily living

06

What researchers measure

Primary outcomes

  1. Discourse Composite Variable

    Weighted variable comprised of discourse features extracted from spoken discourse samples across productivity, lexical retrieval, verbal fluency, syntax complexity, grammatical accuracy, narrative coherence, correct information units, and main event accuracy. Raw data from each measure are multiplied by a specified weight and summed to generate a single composite discourse score.

    Time frame: baseline

Secondary outcomes

  1. Words per minute

    Number of total words ÷ Participant speaking time in minutes

    Time frame: baseline

  2. Correct information units (CIUs)

    Number of words intelligible in context and accurate, relevant, and informative about the picture content (Brookshire \& Nicholas, 1994; Nicholas \& Brookshire, 1993)

    Time frame: baseline

  3. % CIUs

    CIUs ÷ number of words (Brookshire \& Nicholas, 1994; Nicholas \& Brookshire, 1993) × 100

    Time frame: baseline

  4. CIUs/min

    CIUs ÷ Participant speaking time in minutes (Brookshire \& Nicholas, 1994; Nicholas \& Brookshire, 1993)

    Time frame: baseline

  5. % Main Events

    Proportion of correct narrative main events (Capilouto et al., 2005)

    Time frame: baseline

  6. Moving-average type-token ratio (MATTR)

    SALT-generated moving-average ratio of different words : total words (SALT Inc., 2017"). Window size = 23 words, based on the number of words in smallest discourse sample (Roberts \& Post, 2018)

    Time frame: baseline

  7. Mean length of utterance (MLU)

    Mean length of utterance in words for intelligible, complete, verbal, task-relevant utterances (SALT Inc., 2017)

    Time frame: baseline

  8. % Grammatical

    Number of content units without lexical selection or grammar rule violations (Thompson et al., 1995, 2012) ÷ Total intelligible, complete, verbal, task-relevant utterances × 100

    Time frame: baseline

  9. Subordination index (SI)

    Subordination index composite score. The ratio of total number of subject + Predicate clauses : total number of content units (SALT Software LLC, 2018b)

    Time frame: baseline

  10. Number of clauses/content units

    Number of clauses per content units (based on the count of main verbs)

    Time frame: baseline

  11. Word-level dysfluencies/content units

    Total number of word, syllable, and sound repetitions plus the total number of initial, middle, and final sound prolongations (SALT Software LLC, 2018a) ÷ Total utterances

    Time frame: baseline

  12. Number of pauses/content units

    Number of pauses \>1.5 s ÷ Total utterances

    Time frame: baseline

  13. Percent maze words/total words

    Maze words (i.e., filled pauses, false starts, reformulations, and interjections) ÷ Maze words + non-maze words

    Time frame: baseline

Other outcomes

  1. Discourse Global Coherence

    Each utterance is rated on a scale of 1-4 judging the relation of each sentence to the overall topic. '4' reflects that the utterance is overtly related to the stimulus as defined by mention of actors, actions, and/or objects present in the stimulus, which are of significant importance to the main details of the stimulus.

    Time frame: baseline

  2. Discourse Local Coherence

    Each utterance is rated on a scale of 1-5 judging the relation of adjacent sentences to each other. '5' reflects that the utterance is in relation to continuation, elaboration, repetition, subordination or coordination of ideas from the preceding utterance.

    Time frame: baseline

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Study locations

1 site
  • Northwestern University
    Evanston, Illinois 60201, United States
08

References and documents

Publications

  • Nicholas LE, Brookshire RH. A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. J Speech Hear Res. 1993 Apr;36(2):338-50. doi: 10.1044/jshr.3602.338. PubMed 8487525 ↗
  • Brookshire RH, Nicholas LE. Speech sample size and test-retest stability of connected speech measures for adults with aphasia. J Speech Hear Res. 1994 Apr;37(2):399-407. doi: 10.1044/jshr.3702.399. PubMed 8028321 ↗
  • Capilouto G, Wright HH, Wagovich SA. CIU and main event analyses of the structured discourse of older and younger adults. J Commun Disord. 2005 Nov-Dec;38(6):431-44. doi: 10.1016/j.jcomdis.2005.03.005. Epub 2005 Apr 26. PubMed 16199238 ↗
  • Roberts A, Post D. Information Content and Efficiency in the Spoken Discourse of Individuals With Parkinson's Disease. J Speech Lang Hear Res. 2018 Sep 19;61(9):2259-2274. doi: 10.1044/2018_JSLHR-L-17-0338. PubMed 30208482 ↗
  • Thompson CK, Cho S, Hsu CJ, Wieneke C, Rademaker A, Weitner BB, Mesulam MM, Weintraub S. Dissociations Between Fluency And Agrammatism In Primary Progressive Aphasia. Aphasiology. 2012;26(1):20-43. doi: 10.1080/02687038.2011.584691. PubMed 22199417 ↗
  • Thompson, C. K., Shapiro, L. P., Li, L., & Schendel, L. (1995). Analysis of verbs and verb-argument structure: A method for quantification of aphasic language production. Clinical Aphasiology, 23, 121-140.
  • Harris Wright, H., Koutsoftas, A., Fergadiotis, G., & Capilouto, G. (2010). Coherence in Stories Told by Adults With Aphasia.
  • Wright HH, Capilouto GJ. Considering a multi-level approach to understanding maintenance of global coherence in adults with aphasia. Aphasiology. 2012 Jan 1;26(5):656-672. doi: 10.1080/02687038.2012.676855. Epub 2012 May 10. PubMed 22962509 ↗
  • Glosser G, Deser T. Patterns of discourse production among neurological patients with fluent language disorders. Brain Lang. 1991 Jan;40(1):67-88. doi: 10.1016/0093-934x(91)90117-j. PubMed 2009448 ↗
  • Van Leer E, Turkstra L. The effect of elicitation task on discourse coherence and cohesion in adolescents with brain injury. J Commun Disord. 1999 Sep-Oct;32(5):327-48; quiz 348-9. doi: 10.1016/s0021-9924(99)00008-8. PubMed 10498013 ↗

Study documents

  • Protocol and statistical analysis plan · Nov 17, 2021

Documents are hosted by the registry — open the source record to download them.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 18, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05909163
Lead sponsor
Northwestern University
Responsible party
Angela Roberts (Principal Investigator, Northwestern University) — Principal investigator
First posted
Jun 18, 2023
Start date
Mar 5, 2019
Primary completion
Feb 15, 2023
Completion
Feb 15, 2023
Last update
Jun 18, 2023

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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