Given that cognitive impairments and central auditory processing deficits are reported in early and mildly impaired MS ( Migliore et al., 2017), we hypothesized that pwMS would exhibit deficits in the dynamic auditory and cognitive processes underlying SiN discrimination, and that these deficits would predate overt physical disability. While the EDSS provides a sound measure of motor dysfunction, particularly later in the disease when symptoms are more pronounced, it has been less reliable at detecting early symptomology (EDSS scores of 10 years after onset, EDSS < 3) were also evaluated as physical and cognitive deficits may develop separately over the course of MS ( Rahn et al., 2012). Currently, the gold standard clinical measure of MS disability is the Expanded Disability Status Scale (EDSS) ( Kurtzke, 1983). People with MS (pwMS) display a range of motor, sensory and cognitive symptoms that can sometimes cause serious disability, although occasionally can be mild ( Huang et al., 2017 Fielding and Clough, 2019). Multiple sclerosis (MS), a debilitating disease of the central nervous system (CNS), is the most common cause of neurological disability in young adults ( Wallin et al., 2019). Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of −1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble – but not speech-weighted noise. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. All speech and noise were presented via headphones to controls ( n = 38), early MS ( n = 23), and late MS ( n = 12) who were required to verbally repeat the target speech. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (10 years) stages of MS subjects with mild severity. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. 2Department of Neuroscience, Central Clinical School, Monash University, Alfred Centre, Melbourne, VIC, Australia.1Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia.Pippa Iva 1*, Joanne Fielding 2, Meaghan Clough 2, Owen White 2, Branislava Godic 1, Russell Martin 1 and Ramesh Rajan 1
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