Additional evidence for a therapeutic effect of dextromethorphan/quinidine on bulbar motor function in patients with amyotrophic lateral sclerosis: A quantitative speech analysis

British Journal of Clinical Pharmacology
Jordan R GreenRichard A Smith

Abstract

A recent double-blind placebo-controlled crossover 70-day trial demonstrated that a fixed combination of dextromethorphan and quinidine (DM/Q) improves speech and swallowing function in most patients with amyotrophic lateral sclerosis. In this study, a subset of participants, many of whom did not substantially improve while on DM/Q, were re-evaluated using computer-based speech analyses and expert clinician ratings of the overall severity of speech impairment. Speech samples were recorded from the subset of 10 patients at four visits made at approximately 30-day intervals. The recordings were analysed by automated computer-based analysis of speech pausing patterns. Severity of speech impairment was rated by three experienced speech-language pathologists using direct magnitude estimation. Scores on patient-reported and clinician-administered scales of bulbar motor involvement were obtained at each visit. The effects of DM/Q were detected on several of the objective speech measures, including total pause duration (s) (Cohen's d = 0.73, 95% confidence interval (CI) -1.70, 0.24), pause time (%) (d = 0.77, 95% CI -1.75, 0.21), and mean speech event duration (s) (d = 0.52, 95% CI -0.44, 1.47), but not on clinician ratings of speech o...Continue Reading

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Citations

Mar 7, 2020·Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration·Carolina BarnettYana Yunusova
Sep 27, 2018·International Journal of Speech-language Pathology·Panying RongJordan R Green
May 30, 2019·Annals of Clinical and Translational Neurology·James D BerryJukka Pekka Onnela
Mar 7, 2019·Frontiers in Neurology·Yana YunusovaPeter Bede
Nov 6, 2020·British Journal of Clinical Pharmacology·Igor RadanovicGeert Jan Groeneveld
Feb 20, 2021·Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration·Mary Kay FloeterHiroshi Mitsumoto
Feb 26, 2021·American Journal of Speech-language Pathology·Panying Rong, Lindsey Heidrick
Jul 2, 2019··Jackson LiscombeMike Merrill

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Clinical Trials Mentioned

NCT01492686
NCT01806857

Software Mentioned

Speech Pause Analysis
SPA
Speech Pause Analysis ( SPA )

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