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Perceptual and Acoustical Features of Dysarthria in Essential Tremor: An Observational Study that Expands the Cerebellar Features of Essential Tremor Cover

Perceptual and Acoustical Features of Dysarthria in Essential Tremor: An Observational Study that Expands the Cerebellar Features of Essential Tremor

Open Access
|May 2026

Figures & Tables

Table 1

Perceptual Features Rated for Different Speaking Tasks in Each Perceptual Domain.

PERCEPTUAL DOMAINSPEAKING TASKPERCEPTUAL FEATURES RATED
Speech timingSentences, spontaneous speechSlow rate, fast rate, variable rate, short phrases, prolonged interword intervals, atypical pauses/silences, prolonged phonemes
FluencySentences, spontaneous speechAbnormal noises that interrupt speech or occur when patient is not speaking, stutter-like disfluencies, distorted substitutions or articulatory additions, syllable segregation
ProsodySentences, spontaneous speechReduced use of stress, prosodic excess or scanning, errors marking stress, monopitch, monoloudness
ArticulationSentences, spontaneous speechImprecise consonants, distorted vowels, irregular articulatory breakdown, articulatory groping, telescoping, deterioration of speech during continuous speaking
ResonanceSustained vowels, sentences, spontaneous speechAudible nasal emission or nasal snorting, hyponasality, hypernasality
Voice QualitySustained vowels, sentences, spontaneous speechBreathiness, aphonia, hoarseness, strained/strangled, diplophonia, harshness, voice stoppage, vocal tremor, rapid vocal flutter
LoudnessSustained vowels, sentences, spontaneous speechReduced loudness, explosive loudness bursts, loudness decay, excess loudness variation
Table 2

Acoustical Analyses of Speech and Voice Features.

PERCEPTUAL DOMAINPERCEPTUAL FEATUREACOUSTICAL CORRELATESPEAKING TASKANALYSIS TOOLANALYSIS DESCRIPTION
Speech timingSlow rate of speechSpeech rateSpontaneous speechPublicly-available Praat script (Praat Vocal Toolkit) [54]Number of syllables divided by the entire utterance duration (including silent and filled pauses and other dysfluencies like syllable repetitions) [34]
Articulation rateSpontaneous speechPublicly-available Praat script (Praat Vocal Toolkit) [54]The number of syllables divided by the phonation duration, which excluded silent pauses [34, 54]
Prolonged inter-word intervalsSilent pause durationSpontaneous speechPublicly-available Praat script (Praat Vocal Toolkit) [54]Duration of silences at least 0.3 s long
Filled pause durationSpontaneous speechCustom-written Python scriptNumber and duration of filled pauses (“uh”, “uhm”, etc.) obtained from transcribed .txt files and corresponding TextGrids generated using Montreal Forced Aligner
Prolonged phonemesSyllable durationSpontaneous speechPublicly-available Praat script (Praat Vocal Toolkit) [54]Mean duration of syllables
Variable rate of speech, imprecise consonants and other articulatory inaccuraciesVariability of syllable durationSpontaneous speechCustom-written Praat scriptSD of syllable duration obtained from a TextGrid generated using Corretge (2021–2024).
ProsodyProsodic excessVariability of foSpontaneous speechCustom-written Praat script.1SD of fo computed using autocorrelation
Voice QualityVocal tremorfo modulation rate and extent, intensity modulation rate and extentSustained vowelsCustom-written Praat scripts [55]Number of cycles of fo modulation per second and magnitude of fo modulation for the middle 1 s segment of each sustained /ɑ/ and /i/2
Harshness, Breathiness, HoarsenessSmoothed cepstral peak prominence (CPPS)Sustained vowelsPublicly-available Praat script (Praat Vocal Toolkit)A measure of periodic energy in the voice signal from the middle 1 s segment of the second sustained /ɑ/ produced by each participant [56]

[i] 1 A template of this Praat script was generated using OpenAI (2025) using the prompt “generate a Praat script to calculate SD of fundamental frequency” and then modified by the first author.

2 Semi-automated analyses of vocal tremor were completed for participants who exhibited rhythmic modulation of fo or intensity based on visual inspection of the contours in Praat.

Figure 1

Perceptual Features of Dysarthria Across Speaking Tasks.

Figure 2

Speech Timing Measures in Spontaneous Speech Samples from Participants With ET.

A. Speech rate (syllables/s).

B. Articulation rate (syllables/s).

C. Silent pause duration (s).

D. Filled pause duration (s).

The solid blue box represents the interquartile range of the speech timing measure, with the black dots representing individual participants and the black horizontal lines representing the group mean. The dashed orange line marks the normative mean, and the shaded orange region indicates the normative range (±1 SD from the mean). Square brackets on the y-axis indicate patterns associated with ataxic or hyperkinetic dysarthria.

Figure 3

Syllable Duration Measures in Spontaneous Speech Samples from Participants with ET.

A. Mean syllable duration

B. SD of syllable duration

The solid blue boxes represent the interquartile range, with the black dots representing individual participants and the black horizontal lines representing the group mean. The dashed orange line in A. marks the normative mean, and the shaded orange region indicates the normative range (±1 SD from the mean). Because the mean SD of syllable duration was not reported in previous studies, the shaded orange region indicates the normative range only in B. Square brackets on the y-axis indicate patterns associated with ataxic or hyperkinetic dysarthria.

Figure 4

The fo Variability in Spontaneous Speech Samples of Female and Male Participants with ET.

The solid blue boxes represent the interquartile ranges, with the black dots representing individual participants and the black horizontal lines representing the group mean. The dashed orange line marks the normative mean, and the shaded orange region indicates the normative range (±1 SD from the mean). Square brackets on the y-axis indicate ranges associated with ataxic or hyperkinetic dysarthria.

Figure 5

CPPS for Female and Male Participants from Sustained Vowels.

The solid orange boxes represent the interquartile range, with the black dots representing individual participants and the black horizontal lines representing the group mean. The dashed blue line marks the normative mean, and the shaded blue region indicates the normative range (±2 SD from the mean).

Table 3

Participant-level means of the acoustical features illustrated in Figures 2, 3, 4, 5. Dysarthria feature classifications are indicated in parentheses: (H) hyperkinetic, (A) ataxic, and (B) both hyperkinetic and ataxic.

PARTICIPANTSEXAGE (years)SPEECH RATE (syllables/s)ARTICULATION RATE (syllables/s)AVG SILENT PAUSE DURATION (s)AVG FILLED PAUSE DURATION (s)AVG SYLLABLE DURATION (s)SD OF SYLLABLE DURATIONSD OF foCPPS (dB)
P1F683.03.4 (B)0.40.20.3 (A)0.1 (A)35.810.9
P2M624.94.90.00.40.20.1 (A)79.9 (A)12.8
P3M653.94.50.50.40.2 (A)0.1 (A)18.29.6 (H)
P4F774.04.70.60.40.20.1 (A)26.211.6
P5M803.33.3 (B)0.00.50.3 (A)0.3 (A)44.19.3 (H)
P6M694.14.1 (B)0.00.60.2 (A)0.1 (A)22.910.2 (H)
P7M822.8 (B)4.60.9 (H)0.00.20.1 (A)52.3 (A)9.8 (H)
P8F823.34.2 (B)0.70.70.2 (A)0.1 (A)48.7 (A)7.2 (H)
P9F763.03.0 (B)0.00.40.3 (A)0.2 (A)40.83.7 (H)
P10F834.14.80.70.00.20.1 (A)60.0 (A)9.1 (H)
P11F811.9 (B)3.3 (B)1.2 (H)0.40.3 (A)0.2 (A)30.211.9
P12F832.9 (B)4.2 (B)0.50.00.2 (A)0.1 (A)41.55.7 (H)
P13F884.64.70.00.40.20.1 (A)99.9 (A)8.2 (H)
P14M673.44.50.30.40.2 (A)0.1 (A)23.26.5 (H)
P15M753.34.1 (B)0.20.40.2 (A)0.1 (A)33.6 (A)6.9 (H)
DOI: https://doi.org/10.5334/tohm.1180 | Journal eISSN: 2160-8288
Language: English
Page range: 30 - 30
Submitted on: Feb 4, 2026
Accepted on: Apr 14, 2026
Published on: May 6, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2026 Nayanika Ghosh, Nora Hernandez, Ethan Wainman, Isabella Forestieri, Elan D. Louis, Rosemary A. Lester-Smith, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.