People with Parkinson’s produce more pauses and longer pauses (notably between sentences and in long/complex sentences); pause frequency correlates negatively with MoCA cognitive scores and pause duration correlates positively with dysarthria severity.

Provides evidence that pause metrics are a non-invasive behavioral biomarker of cognitive-linguistic and motor-speech impairment in PD useful for monitoring progression or intervention effects, but offers limited direct insight for molecular therapeutic discovery.

PURPOSE: Parkinson's disease (PD) affects forward flow of speech including fluency disruptions in 90% of individuals. One of the main parameters affecting flow and fluency of speech is pause behaviour. However, the precise language characteristics of pauses, including sentence complexity and length, and how they contribute to the fluency disruptions of PD are not fully understood. This study examined how sentence complexity and length affect pause behaviour in PD. METHOD: Seventy-one participants, comprising individuals with PD (n = 32) and neurotypical controls (n = 39), read a speech passage aloud. The number and duration of pauses, categorised by location (between, within sentences), sentence complexity (simple, complex), and sentence length (short, long) were analysed. Cognitive ability, assessed using the Montreal Cognitive Assessment (MoCA), and motor speech deficits (i.e., dysarthria) severity, assessed using a speech perceptual ranking, were evaluated and correlated with pause characteristics. RESULTS: Individuals with PD produced significantly more pauses across all categories compared to controls. However, only between-sentence and long-sentence pauses were significantly longer in duration. Pause frequency and duration in both groups were higher in more complex and longer sentences. Significant negative correlations were found between MoCA scores and number of pauses. Significant positive correlations were observed between dysarthria severity and duration of pauses. CONCLUSION: These findings suggest that increased cognitive-linguistic demands-indexed by sentence complexity and length-may underlie pausing behaviour and contribute to fluency disruptions in individuals with PD. The results extend previous research by highlighting the potential cognitive-linguistic basis of motor speech dysfunction in PD.