An Algorithm for the Automatic Detection of Vocal Flutter

Detecting early signs of neurodegeneration is vital for measuring the efficacy of pharmaceuticals and planning treatments for neurological diseases. This is especially true for Amyotrophic Lateral Sclerosis (ALS) where differences in symptom onset can be indicative of the prognosis. Because it can be measured noninvasively, changes in speech production have been proposed as a promising indicator of neurological decline. However, speech changes are typically measured subjectively by a clinician. These perceptual ratings can vary widely between clinicians and within the same clinician on different patient visits, making clinical ratings less sensitive to subtle early indicators. In this paper, we propose an algorithm for the objective measurement of flutter, a quasi-sinusoidal modulation of fundamental frequency that manifests in the speech of some ALS patients. The algorithm detailed in this paper employs long-term average spectral analysis on the residual F0 track of a sustained phonation to detect the presence of flutter and is robust to longitudinal drifts in F0. The algorithm is evaluated on a longitudinal speech dataset of ALS patients at varying stages in their prognosis. Benchmarking with two stages of perceptual ratings provided by an expert speech pathologist indicate that the algorithm follows perceptual ratings with moderate accuracy and can objectively detect flutter in instances where the variability of the perceptual rating causes uncertainty.