Charalambos Themistocleous

Dr. Charalambos Themistocleous

Department of Special Needs Education, University of Oslo, Oslo, Norway
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Research Focus & Metrics

Academic Career Length

13Years (2014-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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13 July 2020 in PLOS ONE
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CTCharalambos Themistocleous
Charalambos Themistocleous
MEMarie Eckerström
Marie Eckerström
DKDimitrios Kokkinakis
Dimitrios Kokkinakis
Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level. This study aims to determine whether voice quality and speech fluency distinguish patients with MCI from healthy individuals to improve diagnosis of patients with MCI. We analyzed recordings of the Cookie Theft picture description task produced by 26 patients with MCI and 29 healthy controls from Sweden and calculated measures of voice quality and speech fluency. The results show that patients with MCI differ significantly from HC with respect to acoustic aspects of voice quality, namely H1-A3, cepstral peak prominence, center of gravity, and shimmer; and speech fluency, namely articulation rate and averaged speaking time. The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.

15 November 2018 in Frontiers in Neurology
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CTCharalambos Themistocleous
Charalambos Themistocleous
MEMarie Eckerström
Marie Eckerström
DKDimitrios Kokkinakis
Dimitrios Kokkinakis
While people with mild cognitive impairment (MCI) portray noticeably incipient memory difficulty in remembering events and situations along with problems in decision making, planning, and finding their way in familiar environments, detailed neuropsychological assessments also indicate deficits in language performance. To this day, there is no cure for dementia but early-stage treatment can delay the progression of MCI; thus, the development of valid tools for identifying early cognitive changes is of great importance. In this study, we provide an automated machine learning method, using Deep Neural Network Architectures, that aims to identify MCI. Speech materials were obtained using a reading task during evaluation sessions, as part of the Gothenburg MCI research study. Measures of vowel duration, vowel formants (F1 to F5), and fundamental frequency were calculated from speech signals. To learn the acoustic characteristics associated with MCI vs. healthy controls, we have trained and evaluated ten Deep Neural Network Architectures and measured how accurately they can diagnose participants that are unknown to the model. We evaluated the models using two evaluation tasks: a 5-fold crossvalidation and by splitting the data into 90% training and 10% evaluation set. The findings suggest first, that the acoustic features provide significant information for the identification of MCI; second, the best Deep Neural Network Architectures can classify MCI and healthy controls with high classification accuracy (M = 83%); and third, the model has the potential to offer higher accuracy than 84% if trained with more data (cf., SD≈15%). The Deep Neural Network Architecture proposed here constitutes a method that contributes to the early diagnosis of cognitive decline, quantify the progression of the condition, and enable suitable therapeutics.

2 February 2021 in Journal of Alzheimer’s Disease
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CTCharalambos Themistocleous
Charalambos Themistocleous
BFBronte Ficek
Bronte Ficek
KWKimberly Webster
Kimberly Webster
DODirk-Bart Den Ouden
Dirk-Bart Den Ouden
AHArgye E. Hillis
Argye E. Hillis
KTKyrana Tsapkini
Kyrana Tsapkini
Background: The classification of patients with primary progressive aphasia (PPA) into variants is time-consuming, costly, and requires combined expertise by clinical neurologists, neuropsychologists, speech pathologists, and radiologists. Objective: The aim of the present study is to determine whether acoustic and linguistic variables provide accurate classification of PPA patients into one of three variants: nonfluent PPA, semantic PPA, and logopenic PPA. Methods: In this paper, we present a machine learning model based on deep neural networks (DNN) for the subtyping of patients with PPA into three main variants, using combined acoustic and linguistic information elicited automatically via acoustic and linguistic analysis. The performance of the DNN was compared to the classification accuracy of Random Forests, Support Vector Machines, and Decision Trees, as well as to expert clinicians’ classifications. Results: The DNN model outperformed the other machine learning models as well as expert clinicians’ classifications with 80% classification accuracy. Importantly, 90% of patients with nfvPPA and 95% of patients with lvPPA was identified correctly, providing reliable subtyping of these patients into their corresponding PPA variants. Conclusion: We show that the combined speech and language markers from connected speech productions can inform variant subtyping in patients with PPA. The end-to-end automated machine learning approach we present can enable clinicians and researchers to provide an easy, quick, and inexpensive classification of patients with PPA.

25 June 2020 in American Journal of Speech-Language Pathology
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Journal Article
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BSBrielle C. Stark
Brielle C. Stark
MDManaswita Dutta
Manaswita Dutta
LMLaura L. Murray
Laura L. Murray
LBLucy Bryant
Lucy Bryant
DFDavida Fromm
Davida Fromm
SSSaryu Sharma
Saryu Sharma
Purpose: The heterogeneous nature of measures, methods, and analyses reported in the aphasia spoken discourse literature precludes comparison of outcomes across studies (e.g., meta-analyses) and inhibits replication. Furthermore, funding and time constraints significantly hinder collecting test–retest data on spoken discourse outcomes. This research note describes the development and structure of a working group, designed to address major gaps in the spoken discourse aphasia literature, including a lack of standardization in methodology, analysis, and reporting, as well as nominal data regarding the psychometric properties of spoken discourse outcomes. Method: The initial initiatives for this working group are to (a) propose recommendations regarding standardization of spoken discourse collection, analysis, and reporting in aphasia, based on the results of an international survey and a systematic literature review and (b) create a database of test–retest spoken discourse data from individuals with and without aphasia. The survey of spoken discourse collection, analysis, and interpretation procedures was distributed to clinicians and researchers involved in aphasia assessment and rehabilitation from September to November 2019. We will publish survey results and recommend standards for collecting, analyzing, and reporting spoken discourse in aphasia. A multisite endeavor to collect test–retest spoken discourse data from individuals with and without aphasia will be initiated. This test–retest information will be contributed to a central site for transcription and analysis, and data will be subsequently openly curated. Conclusion: The goal of the working group is to create recommendations for field-wide standards in methods, analysis, and reporting of spoken discourse outcomes, as has been done across other related disciplines (e.g., Consolidated Standards of Reporting Trials, Enhancing the Quality and Transparency of Health Research, Committee on Best Practice in Data Analysis and Sharing). Additionally, the creation of a database through our multisite collaboration will allow the identification of psychometrically sound outcome measures and norms that can be used by clinicians and researchers to assess spoken discourse abilities in aphasia.

22 July 2020 in American Journal of Speech-Language Pathology
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CTCharalambos Themistocleous
Charalambos Themistocleous
KWKimberly Webster
Kimberly Webster
AAAlexandros Afthinos
Alexandros Afthinos
KTKyrana Tsapkini
Kyrana Tsapkini
Background: Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a progressive decline of language functions. Its symptoms are grouped into three PPA variants: nonfluent PPA, logopenic PPA, and semantic PPA. Grammatical deficiencies differ depending on the PPA variant. Aims: This study aims to determine the differences between PPA variants with respect to part of speech (POS) production and to identify morphological markers that classify PPA variants using machine learning. By fulfilling these aims, the overarching goal is to provide objective measures that can facilitate clinical diagnosis, evaluation, and prognosis. Method and Procedure: Connected speech productions from PPA patients produced in a picture description task were transcribed, and the POS class of each word was estimated using natural language processing, namely, POS tagging. We then implemented a twofold analysis: (a) linear regression to determine how patients with nonfluent PPA, semantic PPA, and logopenic PPA variants differ in their POS productions and (b) a supervised classification analysis based on POS using machine learning models (i.e., random forests, decision trees, and support vector machines) to subtype PPA variants and generate feature importance (FI). Outcome and Results: Using an automated analysis of a short picture description task, this study showed that content versus function words can distinguish patients with nonfluent PPA, semantic PPA, and logopenic PPA variants. Verbs were less important as distinguishing features of patients with different PPA variants than earlier thought. Finally, the study showed that among the most important distinguishing features of PPA variants were elaborative speech elements, such as adjectives and adverbs.

20 February 2022 in Aphasiology
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Journal Article
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BSBrielle C. Stark
Brielle C. Stark
LBLucy Bryant
Lucy Bryant
CTCharalambos Themistocleous
Charalambos Themistocleous
DODirk B. Den Ouden
Dirk B. Den Ouden
ARAngela C Roberts
Angela C Roberts
Spoken discourse is a fundamental form of communication, yet often disrupted in persons with aphasia and other neurogenic communication disorders. It follows that discourse analysis is important fo...