Skip to main content Accessibility help

Influence of Cognitive Function on Speech and Articulation Rate in Multiple Sclerosis

  • Jonathan D. Rodgers (a1), Kris Tjaden (a2), Lynda Feenaughty (a2), Bianca Weinstock-Guttman (a1) (a3) and Ralph H. B. Benedict (a1) (a3)...


We examined cognitive predictors of speech and articulation rate in 50 individuals with multiple sclerosis (MS) and 23 healthy controls. We measured speech and articulation rate from audio-recordings of participants reading aloud and talking extemporaneously on a topic of their choice (i.e., self-generated speech). Articulation rate was calculated for each speech sample by removing lexically irrelevant vocalizations and pauses of >200 ms. Speech rate was similarly calculated including pauses. Concurrently, the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery, as well as standardized tests of sentence intelligibility and syllable repetition were administered. Analysis of variance showed that MS patients were slower on three of the four rate measures. Greater variance in rate measures was accounted for by cognitive variables for the MS group than controls. An information processing speed composite, as measured by the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT), was the strongest predictor among cognitive tests. A composite of memory tests related to self-generated speech, above and beyond information processing speed, but not to oral reading. Self-generated speech, in this study, was not found to relate more strongly to cognitive tests than simple reading. Implications for further research are discussed. (JINS, 2012, 18, 1–8)


Corresponding author

Correspondence and reprint requests to: Ralph H. B. Benedict, Neurology, D-2, Buffalo General Hospital, 100 High Street, Buffalo, New York, 14203. E-mail:


Hide All
Allard, E.R., Williams, D.F. (2008). Listeners’ perceptions of speech and language disorders. Journal of Communication Disorders, 41, 108123. doi:10.1016/j.jcomdis.2007.05.002
Arnett, P.A., Smith, M.M., Barwick, F.H., Benedict, R.H.B., Ahlstrom, B.P. (2008). Oralmotor slowing in multiple sclerosis: Relationship to neuropsychological tasks requiring an oral response. Journal of the International Neuropsychological Society, 14, 454462. doi:10.1017/s1355617708080508
Arnett, P.A., Strober, L.B. (2011). Cognitive and neurobehavioral features in multiple sclerosis. Expert Review of Neurotherapeutics, 11, 411424. doi:10.1586/ern.11.12
Bayles, K.A., Tomoeda, C.K. (1993). Arizona battery for communication disorders of dementia. Tucson, AZ: Canyonlands.
Baylor, C., Yorkston, K., Bamer, A., Britton, D., Amtmann, D. (2010). Variables associated with communicative participation in people with multiple sclerosis: A regression analysis. American Journal of Speech-Language Pathology, 19, 143153. doi:10.1044/1058-0360(2009/08-0087)
Beck, A.T., Steer, R.A., Brown, G.K. (2000). BDI-fast screen for medical patients: Manual. San Antonia, TX: Psychological Corporation
Benedict, R.H.B. (1997). Brief visuospatial memory test - revised: professional manual. Odessa, FL: Psychological Assessment Resources
Benedict, R.H.B., Bobholz, J.H. (2007). Multiple sclerosis. Seminars in Neurology, 27, 7885. doi:10.1055/s-2006-956758
Benedict, R.H.B., Cookfair, D., Gavett, R., Gunther, M., Munschauer, F., Garg, N., Weinstock-Guttman, B. (2006). Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). Journal of the International Neuropsychological Society, 12, 549558. doi:10.1017/s1355617706060723
Benedict, R.H.B., Fischer, J.S., Archibald, C.J., Arnett, P.A., Beatty, W.W., Bobholz, J., Munschauer, F. (2002). Minimal neuropsychological assessment of MS patients: A consensus approach. Clinical Neuropsychologist, 16, 381397. doi:10.1076/clin.16.3.381.13859
Benedict, R.H.B., Fishman, I., McClellan, M.M., Bakshi, R., Weinstock-Guttman, B. (2003). Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis. Multiple Sclerosis Journal, 9, 393396. doi:10.1191/1352458503ms902oa
Benedict, R.H.B., Holtzer, R., Motl, R.W., Foley, F.W., Kaur, S., Hojnacki, D., Weinstock-Guttman, B. (2011). Upper and Lower Extremity Motor Function and Cognitive Impairment in Multiple Sclerosis. Journal of the International Neuropsychological Society, 17, 643653. doi:10.1017/s1355617711000403
Benedict, R.H.B., Ramasamy, D., Munschauer, F.E., Weinstock-Guttman, B., Zivadinov, R. (2009). Memory impairment in multiple sclerosis: Correlation with deep gray matter and mesial temporal atrophy. Journal of Neurology, Neurosurgery, & Psychiatry, 80, 201206.
Benedict, R.H.B., Weinstock-Guttman, B., Fishman, I., Sharma, J., Tjoa, C.W., Bakshi, R. (2004). Prediction of neuropsychological impairment in multiple sclerosis: Comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden. Archives of Neurology, 61, 226230. doi:10.1001/archneur.61.2.226
Benton, A.L., Sivan, A.B., Hamsher, K., Varney, N.R., Spreen, O. (1994). Contributions to neuropsychological assessment: A clinical manual (2nd ed.). New York: Oxford University Press.
Clark, H.H., Fox Tree, J. (2002). Using Uh and Um in spontaneous speaking. Cognition, 84, 73111.
Compston, A., Coles, A. (2008). Multiple sclerosis. Lancet, 372, 15021517. doi:10.1016/s0140-6736(08)61620-7
Delis, D.C., Kaplan, E., Kramer, J.H. (2001). Delis-Kaplan Executive Function System. San Antonio, TX: Psychological Corporation
Delis, D.C., Kramer, J.H., Kaplan, E., Ober, B.A. (2000). California Verbal Learning Test: Adult version. San Antonio, TX: Psychological Corporation.
Drake, A.S., Weinstock-Guttman, B., Morrow, S.A., Hojnacki, D., Munschauer, F.E., Benedict, R.H.B. (2010). Psychometrics and normative data for the Multiple Sclerosis Functional Composite: Replacing the PASAT with the Symbol Digit Modalities Test. Multiple Sclerosis, 16, 228237. doi:10.1177/1352458509354552
Duffy, J.R. (2005). Motor speech disorders: Substrates, differential diagnosis, and management (2nd ed.). St. Louis: Elsevier Science.
Gadesmann, M., Miller, N. (2008). Reliability of speech diadochokinetic test measurement. International Journal of Language & Communication Disorders, 43, 4154. doi:10.1080/13682820701234444
Goldman-Eisler, F. (1968). Psycholinguistics: Experiments in spontaneous speech. New York: Academic Press.
Gronwall, D. (1977). Paced auditory serial addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367373.
Hartelius, L., Buder, E.H., Strand, E.A. (1997). Long-term phonatory instability in individuals with multiple sclerosis. Journal of Speech Language and Hearing Research, 40, 10561072.
Hartelius, L., Runmarker, B., Andersen, O. (2000). Prevalence and characteristics of dysarthria in a multiple-sclerosis incidence cohort: Relation to neurological data. Folia Phoniatrica Et Logopaedica, 52, 160177.
Huber, J.E., Darling, M. (2011). Effect of Parkinson's disease on the production of structured and unstructured speaking tasks: Respiratory physiologic and linguistic considerations. Journal of Speech Language and Hearing Research, 54, 3346. doi:10.1044/1092-4388(2010/09-0184)
Kent, R.D., Duffy, J., Kent, J.F., Vorperian, H.K., Thomas, J.E. (1999). Quantification of motor speech abilities in stroke: Time-energy analyses of syllable and word repetition. Journal of Medical Speech-Language Pathology, 7, 8390.
Kent, R.D., Kent, J.F., Rosenbek, J.C. (1987). Maximum performance tests of speech production. Journal of Speech and Hearing Disorders, 52, 367387.
Klugman, T.M., Ross, E. (2002). Perceptions of the impact of speech, language, swallowing, and hearing difficulties on quality of life of a group of South African persons with multiple sclerosis. Folia Phoniatrica Et Logopaedica, 54, 201221. doi:10.1159/000063194
Kurtzke, J.F. (1983). Rating neurologic impairment in multiple-sclerosis: An Expanded Disability Status Scale (EDSS). Neurology, 33, 14441452.
Lowit, A., Brendel, B., Dobinson, C., Howell, P. (2006). An investigation into the influences of age, pathology, and cognition on speech production. Journal of Medical Speech-Language Pathology, 14, 253262.
Mackenzie, C., Green, J. (2009). Cognitive-linguistic deficit and speech intelligibility in chronic progressive multiple sclerosis. International Journal of Language & Communication Disorders, 44, 401420. doi:10.1080/13682820802697879
Milenkovic, P. (2002). TF32: University of Wisconsin-Madison.
Parmenter, B.A., Testa, S.M., Schretlen, D.J., Weinstock-Guttman, B., Benedict, R.H.B. (2010). The utility of regression-based norms in interpreting the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). Journal of the International Neuropsychological Society, 16, 616. doi:10.1017/s1355617709990750
Polman, C.H., Reingold, S.C., Edan, G., Filippi, M., Hartung, H.P., Kappos, L., Wolinsky, J.S. (2005). Diagnostic criteria for multiple sclerosis: 2005 Revisions to the “McDonald Criteria”. Annals of Neurology, 58, 840846. doi:10.1002/ana.20703
Rosano, C., Brach, J., Studenski, S., Longstreth, W.T., Newman, A.B. (2007). Gait variability is associated with subclinical brain vascular abnormalities in high-functioning older adults. Neuroepidemiology, 29, 193200. doi:10.1159/000111582
Rosano, C., Studenski, S.A., Aizenstein, H.J., Boudreau, R.M., Longstreth, W.T., Newman, A.B. (2012). Slower gait, slower information processing and smaller prefrontal area in older adults. Age and Ageing, 41, 5864. doi:10.1093/ageing/afr113
Smith, A. (1982). Symbol digit modalities test: Manual. Los Angeles: Western Psychological Services.
Tasko, S.M., McClean, M.D. (2004). Variations in articulatory movement with changes in speech task. Journal of Speech Language and Hearing Research, 47, 85100. doi:10.1044/1092-4388(2004/008)
Tjaden, K., Watling, E. (2003). Characteristics of diadochokinesis in multiple sclerosis and Parkinson's disease. Folia Phoniatrica Et Logopaedica, 55, 241259. doi:10.1159/000072155
Tjaden, K., Wilding, G.E. (2004). Rate and loudness manipulations in dysarthria: Acoustic and perceptual findings. Journal of Speech Language and Hearing Research, 47, 766783. doi:10.1044/1092-4388(2004/058)
Tjaden, K., Wilding, G.E. (2011). Effects of speaking task on intelligibility in Parkinson's disease. Clinical Linguistics & Phonetics, 25, 155168. doi:10.3109/02699206.2010.520185
Weismer, G. (2006). Philosophy of research in motor speech disorders. Clinical Linguistics & Phonetics, 20, 315349. doi:10.1080/02699200400024806
Westbury, J., Dembowski, J.S. (1993). Articulatory kinematics of normal diadochokinetic performance. Annual Bulletin of the Research Institute of Logopedics and Phoniatrics, 27, 1336.
Yorkston, K., Beukelman, D., Tice, R. (1996). Sentence intelligibility test. Lincoln, NE: Institute for Rehabilitation Science and Engineering at Madonna Rehabilitation Hospital.
Yorkston, K.M., Beukelman, D.R. (1984). Assessment of intelligibility of dysarthric speech. Austin, TX: PRO-ED.
Yorkston, K.M., Klasner, E.R., Bowen, J., Ehde, D.M., Gibbons, L.E., Johnson, K., Kraft, G. (2003). Characteristics of multiple sclerosis as a function of the severity of speech disorders. Journal of Medical Speech-Language Pathology, 11, 7384.


Influence of Cognitive Function on Speech and Articulation Rate in Multiple Sclerosis

  • Jonathan D. Rodgers (a1), Kris Tjaden (a2), Lynda Feenaughty (a2), Bianca Weinstock-Guttman (a1) (a3) and Ralph H. B. Benedict (a1) (a3)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed