A REVIEW OF VOCAL BIOMARKERS FOR HEALTH ASSESSMENT AND PATIENT MONITORING

A Review of Vocal Biomarkers for Health Assessment and Patient Monitoring

A Review of Vocal Biomarkers for Health Assessment and Patient Monitoring

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Voice as a Biomarker

Our voice contains a wealth of information about our physical and mental state. Even subtle changes in the voice can provide clues about a person's health. Many diseases and conditions manifest themselves through alterations to various acoustic properties of speech, such as frequency, pitch, loudness, and resonance. By analyzing these vocal biomarkers, researchers have been able to detect and monitor various medical conditions from a distance just by listening to a person speak or sing.

Detecting Neurological Disorders

Several neurological disorders have distinct Vocal Biomarkers profiles that can help with early detection. For example, people in the early stages of Parkinson's disease often exhibit hypophonia, a reduction in voice volume. Their speech may also show increased pitch instability and microstructural abnormalities. Similarly, individuals with Alzheimer's disease tend to have slower speech rate and increased pause time between words as the disease progresses. Vocal biomarkers have shown potential for aiding in the diagnosis of these conditions, sometimes even before physical symptoms appear.

Monitoring Lung and respiratory Function

The lungs and respiratory tract greatly influence speech production. Consequently, respiratory illnesses tend to impact the voice in detectable ways. Changes in parameters like phonation time, pitch, and harmonics-to-noise ratio have been correlated with the severity of asthma, chronic obstructive pulmonary disease (COPD), and Covid-19 infections. By periodically analyzing a patient's voice, doctors may be able to track the progression of lung dysfunction and responsiveness to treatment over time in a non-invasive manner. This can help guide clinical decisions and reduce reliance on periodic medical examinations involving invasive tests.

Revealing Signs of Depression and Mental Health Issues

Our mental state unconsciously colors various speech characteristics. Several studies found that individuals experiencing depression often speak with reduced loudness, increased pause frequency and duration, and decreased pitch variability. Meanwhile, bipolar disorder and symptoms of mania have been linked to faster speech rate, higher pitch, and increased vocal intensity. Vocal biomarkers could serve as digital biomarkers to remotely monitor at-risk individuals and flag changes indicative of worsening mental health requiring medical intervention. With advances in technology, voice analysis may emerge as a widely usable, passive screening and monitoring tool.

Detecting Stress, Fatigue and Overtraining

Persistent stress takes a bodily toll betrayed through subtle vocal changes. High stress has been associated with increased jitter (rapid variations in fundamental frequency), shimmer (rapid variations in amplitude), and harmonics-to-noise ratio in the voice. These biomarkers potentially allow detection of excessive strain and overtraining before physical signs emerge. Similarly, fluctuations in parameters like pitch, loudness, and pause frequency have revealed signs of fatigue accumulation over prolonged exercise or work. Applying voice analysis in fitness tracking or occupational health monitoring could help optimize work-life balance and prevent burnout.

Illuminating Internal Physiological Changes

Our voice resonates with ongoing changes within the body. Certain diseases manifest initially through their impacts on vocal production rather than outward symptoms. For example, biomarkers like increased pitch, decreased harmonics, and abrupt frequency changes have suggested the presence of thyroid issues even before clinical abnormalities appear on standard lab tests. Voice analysis also shows promise for early tracking of disease progression in conditions like diabetes, based on correlations between vocal profiles and glycated hemoglobin (HbA1c) levels over time. Such non-invasive physiological surveillance through digital biomarkers holds exciting potential.

Enabling Remote Patient Monitoring and Telehealth

The development of reliable vocal biomarkers has positioned voice analysis for playing an expanded role in telemedicine and remote healthcare. Checking voice parameters through smartphone apps can help doctors and care teams monitor patients recovering from illnesses or injuries at home instead of frequent follow-up appointments. Vocal cues may also assist the triaging of cases and identification of high-risk individuals needing emergent attention. Over time, aggregated voice data could help create personalized digital profiles outlining an individual's typical vocal state and deviations indicating developments requiring clinical evaluation. When coupled with other digital biomarkers, passive continuous voice monitoring shows promise for improving outcomes through more proactive, coordinated care.


Our voice contains a wealth of physiological and psychological information expressed through measurable acoustic features. By leveraging evolving techniques in vocal analytics and machine learning, researchers continue discovering informative biomarkers spanning neurological, respiratory, psychological, and internal medical conditions. Such digital vocal signatures now allow non-invasive passive longitudinal tracking with potential uses in screening, diagnosis, treatment monitoring, telehealth and occupational/fitness monitoring. Though challenges remain around multiple acoustic confounders and standardization, vocal biomarkers represent an exciting frontier for advancing personalized digital healthcare through enhanced remote surveillance capabilities. Integrating this novel data stream along with other digital biomarkers could help transform models of care delivery in the years ahead.



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