AphaVoice: Text-to-Speech Model for Aphasia Patient Simulation

Building a diagnosis model for primary progressive aphasia (PPA) has been challenging due to the data scarcity. Collecting clinical data at scale is limited by the high vulnerability of clinical population and the high cost of expert labeling. To circumvent this, previous studies simulate dysfluent speech to generate training data. However, those approaches are not comprehensive enough to simulate PPA as holistic, multi-level phenotypes, instead relying on isolated dysfluencies. To address this, we propose a novel, clinically grounded simulation framework, Hierarchical Aphasic Speech Simulation (HASS). HASS aims to simulate behaviors of logopenic variant of PPA (lvPPA) with varying degrees of severity. To this end, semantic, phonological, and temporal deficits of lvPPA are systematically identified by clinical experts, and simulated. We demonstrate that our framework enables more accurate and generalizable detection models.

Conventional automatic word-naming recognition systems struggle to recognize words from post-stroke patients with aphasia because of disfluencies and mispronunciations, limiting reliable automated assessment in this population. In this paper, we propose a Contrastive Language-Audio Pretraining (CLAP) based approach for automatic word-naming recognition to address this challenge by leveraging text-audio alignment. Our approach treats word-naming recognition as an audio-text matching problem, projecting speech signals and textual prompts into a shared embedding space to identify intended words even in challenging recordings. Evaluated on two speech datasets of French post-stroke patients with aphasia, our approach achieves up to 90% accuracy, outperforming existing classification-based and automatic speech recognition-based baselines.

Aphasia following stroke commonly produces systematic naming errors with characteristic profiles, but whether general-purpose language models not designed for clinical simulation can reproduce these patterns remains untested. We investigated (1) whether lesions or controlled perturbations to a multimodal language model can reproduce different types of errors in picture naming, and (2) whether the framework can reproduce the complete error profile of individual persons with aphasia (PWAs). Using LLaVA 1.6, we evaluated perturbation configurations that varied the layer, proportion, and amount of noise applied to model units. We examined 278 PWAs on the Philadelphia Naming Test, classifying responses into seven categories using a validated neural classifier. Six of seven response categories (correct, semantic, mixed, unrelated, neologism, no response errors) emerged at clinically-comparable proportions across distinct parameter space regions, with formal paraphasia being the exception. Searching the perturbation space revealed configurations that reproduced the individual error profile in at least six of seven categories for 97.8% of PWAs and in all seven categories for 79.5% of PWAs. Monte Carlo baselines confirmed that this matching reflects joint inter-category structure rather than marginal overlap. These results establish a quantitative framework for reproducing individual aphasic error patterns in picture naming. They suggest the potential for language models to serve as digital twins of individuals with post-stroke aphasia.