Zero-Shot Parkinson's Disease Detection from Speech: Comparing Large Audio and Language Models

Self-supervised learning (SSL) speech representations achieve strong performance for Parkinson's disease (PD) detection within individual corpora. However, it remains unclear whether these models capture disease-related characteristics or exploit dataset-specific confounds, particularly since most SSL backbones are pretrained exclusively on healthy speech. To investigate this question, we perform a layer-wise analysis of nine SSL speech backbones using a low-capacity logistic regression probe across three languages. We structure the evaluation as multiple scenarios that progressively introduce distribution shifts in participant identity, recording conditions, language, and pathology. Our results reveal two key findings. First, layer selection is highly corpus-dependent: the optimal representation layer is determined primarily by the source dataset rather than by the SSL architecture itself. Second, the transferred discriminative signal lacks pathological specificity: classifiers trained to detect PD assign similarly high probabilities to both PD and dementia speech in the target corpus. These results highlight critical limitations that must be addressed before speech-based pathology recognition models can be reliably deployed in clinical settings.

Early detection of PD remains particularly challenging in resource-constrained settings, where voice-based analysis has emerged as a promising non-invasive and cost-effective alternative. However, existing studies predominantly focus on English or other major languages; notably, no voice dataset for PD exists for Bengali -- a language spoken by over 230 million people worldwide -- posing a significant barrier to culturally inclusive and accessible healthcare solutions. We present BenSparX, the first Bengali conversational speech dataset for PD detection, along with a robust and explainable ML framework tailored for early diagnosis. The proposed framework incorporates diverse acoustic feature categories, systematic feature selection methods, and state-of-the-art ML classifiers with extensive hyperparameter optimization. Furthermore, to enhance interpretability and trust in model predictions, the framework incorporates SHAP (SHapley Additive exPlanations) analysis to quantify the contribution of individual acoustic features toward PD detection. Our framework achieves state-of-the-art performance, yielding an accuracy of 95.67%, F1 score of 95.62%, and AUC of 0.990. We further validated our approach by applying the framework to existing PD datasets in other languages, where it consistently outperforms state-of-the-art approaches. This study lays the foundation for identifying subtle yet clinically meaningful vocal biomarkers, particularly in low-resource settings such as Bengali-speaking populations, and represents a significant step toward equitable, explainable, and robust digital health diagnostics for neurodegenerative disorders. The labelled acoustic-feature dataset derived from the audio recordings in this study is available at https://github.com/riadEDU/BenSParX.

Parkinson's disease (PD) is a progressive neurodegenerative disorder that frequently causes speech impairments associated with hypokinetic dysarthria. As speech production relies on the precise coordination of complex neuromuscular mechanisms, speech analysis has emerged as a promising non-invasive and cost-effective biomarker for early PD detection. Recent deep learning approaches have shown encouraging results; however, most existing methods rely on a single speech representation, potentially overlooking complementary pathological information encoded across different feature spaces. In this work, we propose a multi-branch deep learning framework for automatic PD detection from speech. Each recording is segmented into 5-second chunks and represented using three complementary modalities: Log-Mel spectrograms, MFCCs, and HuBERT embeddings extracted from raw waveforms. The spectrograms are processed using a pre-trained ResNet-18 encoder, MFCC sequences are modeled through a BiLSTM network, and raw speech is encoded using a pre-trained HuBERT model. To effectively integrate these heterogeneous representations, we introduce a context-guided cross-modal attention mechanism that dynamically weights temporal HuBERT embeddings according to the global acoustic context derived from the spectrogram and MFCC branches. Experiments conducted on the publicly available Spanish PC-GITA corpus under strict speaker-independent 5-fold cross-validation demonstrate the effectiveness of the proposed approach. The proposed architecture achieves an accuracy of 91.51%, an F1-score of 91.24%, and an AUC of 95.97%. Furthermore, ablation studies confirm the contribution of both the proposed context-guided cross-modal attention mechanism and the integration of complementary speech representations. These findings highlight the potential of heterogeneous speech modeling for robust and clinically reliable PD detection.