From Alzheimer's to ADHD: what doctors can diagnose from ...

Titel From Alzheimer's to ADHD: what doctors can

diagnose from your voice alone PRESSESPIEGEL

Autor Arielle Duhaime-Ross Quelle The Verge Unternehmen Vox Media, Inc. Veröffentlicht 17.07.2014 Seite 1 von 7

27.1.2016 From Alzheimer's to ADHD: what doctors can diagnose from your voice alone | The Verge

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If Guillermo Cecchi wants to figure out if you've taken MDMA or meth, all he

needs is a computer and a recording of your voice. Cecchi is a computer

scientist at IBM, and part of a growing community of scientists who think our

voices can reveal far more than our sex, age, or cultural origins. He thinks it can

also unlock the mind — and the various psychological and neurological states

our brains may be experiencing at any given time.

From Alzheimer's to ADHD: what doctors

can diagnose from your voice alone

The brave new world of vocal diagnostics

By Arielle Duhaime-Ross on July 17, 2014 12:49 pm






"This is exactly what psychiatrists do every day: they talk to the patients,"

Cecchi says, "but we used machine learning and mathematics to replicate it."

In a study published earlier this year, Cecchi used recordings of short interviews

to determine which drug his test subjects had been given prior to the

experiment. His results rely largely on language and its meaning. "What we did

on the analytics side was to use machine learning techniques that can measure

things like semantic distance" — the symbolic distance between words with

related meanings. "Chair" and "table" are semantically closer than "chair" and

"flower" for instance. "We can identify individual interviews with high accuracy

with regards to the drugs they took just by computing the semantic distance to

between a handful of concepts."

PEOPLE ON ECSTASY DON’T SAY "LIKE" AND "YOU KNOW"AS OFTEN

With regards to MDMA, those concepts were friendliness, rapport, and

empathy. "There was a higher similarity to these words in the interviews with a

high dose of ecstasy," Cecchi says. He also found that people on MDMA used

fewer "catchphrases" and jargon. When contemporaries talk to each other, "the

word ‘like’ is typically 10 percent of the words." But people on ecstasy don’t use

terms such as "like" and "you know" as often. Their speech, he says, is much

more fluid.

Yet Cecchi’s drugrelated work represents only one example of the information

that our voices contain. He’s also used voice recordings to measure speech

disturbances in manic depressive patients, and people who suffer from

schizophrenia. Moreover, in recent years, scientists have begun to investigate

the voice’s potential for diagnosing Parkinson’s disease, Alzheimer’s disease,

sleepiness, depression, and even ADHD.

From hyperactive to sleepy voices






Jorg Langner is a mathematician and musicologist at a Berlinbased company

called AudioProfiling. He think ADHD isn’t just about movement or ability to

focus. That’s why his team is working on diagnosing children with ADHD using

voice recordings. "Speech rhythm of an ADHD child" is different from a child

without ADHD, he says. "The length of syllables are less equal in length." This

is but one example of the measures he makes, and he says that, so far, his

team has classified 1,000 previously diagnosed children with "above 90

percent" accuracy.

THE "SPEECH RHYTHM OF AN ADHD CHILD" IS DIFFERENT

Langner is also developing technology that will detect when someone is too

sleepy to drive. When we’re tired, he says, our "speech rhythm isn’t so precise,

it’s inexact." It’s also "not very pronounced."

Jarek Krajewski, a psychologist at the Rhenish University of Applied Sciences

Cologne, is working on a similar project — except his team wants to apply

sleepiness detection to air traffic controllers. "Sleepiness can be detected with a

classification accuracy of about 7580 percent on unseen speaker, and 8085

percent on known speaker" in a matter of seconds, he wrote in an email to The

Verge.

But detecting sleepy air traffic controllers is just the start for Krajewski. "We

have developed a depressiondetection system based on 200 subjects," he

said. "Another phonetic approach deals with measuring alcoholization, anxiety,

confidence, leadership states or personality." He also wants to build a dataset

for vocal influenza detection.

Neurological clues

Other researchers are taking a more neurological approach. "Our studies

essentially looked at speech patterns in patients with Parkinson’s disease,"






says Rahul Shrivastav, a speech scientist at Michigan State University. "People

with Parkinson’s experience changes in their voice quality, in the way they

produce their sound, so vowels and consonants aren’t clear," he says. "These

are very subtle, they aren’t not obvious just listening to it, but with a computer

you can do much more."

Shrivastav’s team is in the early stages. So far, they’ve characterized the vocal

changes that occur when the disease is more advanced, but they hope to

replicate the findings in newly diagnosed patients. This is important, he says,

because there’s "no gold standard test. There’s a whole variety of symptoms

that a neurologist will look at and a lot of time they will give the right drugs for

Parkinson’s and if the symptoms go away, then that’s what you have." That

process means that patients can go more than a decade without being

diagnosed — a reality that voice diagnosis, Shrivastav hopes, will be able to

change.

SOME PEOPLE CAN'T TRAVEL TO SEE A NEUROLOGIST. VOICERECORDINGS CAN HELP

Max Little, a research fellow at MIT and the director of the Parkinson’s Voice

Initiative, is also working on developing vocal diagnostic techniques for

Parkinson’s. His team can obtain 99 percent accuracy in labbased diagnostic

tests, but Little notes that getting that level of accuracy isn’t "nearly as easy"

with telephonequality voice recordings. The group is now working on accurate

telephonebased diagnostics. This is crucial, Little says, because many people

can’t travel to a neurologist. "For them, a piece of software running on a

smartphone would be perhaps the only lifeline they have to get useful

information about their symptoms."

Alzheimer’s disease might also hold a future with vocal diagnostics, said

Karmele Lopez de Ipiña, a computer scientist at The University of the Basque

Country in Spain, in an email to The Verge. "The deterioration of spoken






language immediately affects the patient’s ability to interact naturally with his or

her social environment," she said, "and is usually also accompanied by

alterations in emotional responses." Her team used spontaneous speech

analysis to identify features, like speech fluency, to detect Alzheimer’s disease.

Combined with an emotional response test, the technique boasts over 90

percent accuracy in discriminating Alzheimer’s patients from healthy controls.

The ultimate goal of the research, Lopez de Ipiña said, is to identify the disease

before the first clinical symptoms appear.

Supporting diagnosis

The work done by these researchers differs from Cecchi’s because it relies

more heavily on sounds — and the rhythms at which they’re emitted — than on

language. Ultimately, however, both approaches rely on computers to analyze

the connections that we make in our brains. "What our studies show is that we

can measure mental states analytically without the intervention of a psychiatrist

looking at the interview," Cecchi says.

ELIMINATING PSYCHOLOGISTS AND PHYSICIANS ISN’T THEOBJECTIVE

Of course, eliminating psychologists and physicians isn’t the objective. For

Cecchi, the goal is to "codify" medical interviews for future use, so doctors at

different hospitals in different cities, for instance, can make use of the data

when a patient moves. "Psychiatrists don’t have the time to codify or measure in

a way that can used by different psychiatrists," Cecchi says, adding that "we

aren’t talking about therapy here, but the decision that is made or the diagnosis

that’s made after an interview that happens in 30 minutes."

As for Langner and Shrivastav, both believe that their research will help

strengthen previous diagnostic procedures by supplying an additional layer of

objective testing. "The goal is to prevent misdiagnosis," Langner says. At the






moment, a kid diagnosed with ADHD will have been tested using

questionnaires and interviews with a doctor. In these instances, Langer says, a

doctor’s impressions are crucial. "In many cases, these are good impressions,"

he says, "but it still has a great subjective component to it."

Private exchanges in foreign tongues

Despite promising results, many challenges remain. One limitation is that some

speech features are very personal and specific to an individual, Cecchi says.

Another is culture. "European languages have a lot of things in common, not

just language, but also culturally," he says, adding that his group has done

voice analyses on people who speak Portuguese, English, and Spanish with

similar results. "Now, what will happen with Chinese — we don’t know."

Langner hypothesizes that results will vary widely. "More problems occur when

we go to Arabic, Farsi, and Mandarin," he says. "I think if you want to work with

these languages, major adjustments will have to be done." But Shrivastav isn’t

so sure. "There are differences across languages," he says, "but there are

some hallmarks of certain diseases that will impact all of the layers in all the

conditions, so the trick is to find those changes."

But the most worrisome aspect of this sort of research is probably the hit to

privacy. "With more and more mobile phones, so much speech is being

recorded and analyzed, it becomes such an easy signal to access," Shrivastav

says. "I think in the next several years you will see a lot more neat things — not

just for speech diagnosis." This is exactly the attitude that some critics worry

about: already, researchers are working on a phone app to help doctors predict

when someone with bipolar disorder might have a manic episode, so it’s

possible that technology will soon be used by the public, and the government.

"AN ORWELLIAN 1984 WORLD WHERE OUR SLEEPINESSSTATE IS NO LONGER PRIVATE."






"We could suffer from an Orwellian 1984 world where our sleepiness state is no

longer private," Krajewski said. He thinks health and safety concerns may one

day legitimize the use of this technology to monitor emotional and physical

states. Someone who has a cold and is waiting for a bus might not be allowed

inside the vehicle, for example. "According to a publichealth regulation you will

be not allowed to enter public transport — the bus door remains closed for you."

But the potential for that scenario remains years off. It’ll take a lot of time, and

myriad willing participants, to unlock the information that our voices carry,

Langner says. "Our brain is a giant network where everything is connected."

This means that if we have problems in one location, it will have consequences

in other regions of the brain, "especially in the parts that control speech

projection," he says. "From that we hope that we can find traces of many other

illnesses in speech sounds — but to find those solutions will be a very long

process."

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