Méthode d’analyse des pauses pour l’évaluation de troubles cognitifs subtils appliquée au Cancer-Related Cognitive Impairment.

Background. Speech analysis can detect subtle cognitive impairment, particularly because prosody contains fine elements, such as pauses, which might be behavioral markers of NeuroCognitive Disorders. However, the absence of simple, detailed methods compromises the feasibility of such an analysis in clinics. Mild Neurocognitive Disorders (mNCD) refer to a cognitive change reported by an individual whose autonomy is preserved. This terminology covers many underlying pathophysiologies, such as Cancer-Related Cognitive Impairment (CRCI). CRCI is an mNCD characterized by a memory complaint (e.g., "I forget what I’m told") and a language complaint (e.g., "I search for my words") for which the frequency and intensity exceed the scores of speech-language tests or neuropsychological tests. The lack of sensitive tools to detect this subtle impairment often leads to its underdiagnosis. New methods such as speech analysis are needed to assess CRCI. Objectives. The study aims are (i) to propose a method for analyzing pauses which is practical in clinical context, (ii) to identify participants with CRCI using this method. Methods. Thirteen participants post breast cancer and thirteen healthy controls were included in the study. The participants were instructed to tell a picture-based story. Their narratives were recorded, then automatically transcribed with Whisper and analyzed using SPPAS and Praat software. Silent pauses, filled pauses (e.g., "uh"), and sustained vowels (e.g., "a smaall boy") were annotated, then examined on JASP for a statistical analysis. Results. The duration of silent pauses in post-cancer participants was significantly longer than that of the controls. However, the duration of filled pauses and sustained vowels did not show a significant difference between the two groups. Similarly, the rate of pauses (i.e., number of occurrences/total speech duration) did not show a significant difference between the two groups. Conclusions. This study provides a well-described method for pause analysis designed for the purpose of clinical context. The results suggest that the duration of silent pauses is a good marker for differentiating post-cancer participants from controls.