Self-Supervised Speech Representations for Cross-Speaker Dysarthria Detection During Awake Craniotomy

Abstract

Detecting intra-operative speech impairment during awake craniotomy is essential for preserving language function. However, automated detection remains challenging because operating-room recordings contain substantial acoustic interference, clinically relevant speech events are rare, and available cohorts are small and heterogeneous across speakers. This study presents a systematic component-wise evaluation of a pipeline for distinguishing dysarthric from no-trouble speech in the DATABRASE corpus of awake-craniotomy recordings. The pipeline incorporates speaker diarization to isolate patient speech, a multi-view representation combining handcrafted acoustic descriptors with multilayer wav2vec 2.0 embeddings, speaker-conditional normalization and transferability-based feature selection to improve cross-speaker robustness, and a cascaded classifier comprising a gradient-boosted first stage and a neural second stage. Evaluation was conducted under strict speaker-independent conditions using leave-one-speaker-out cross-validation. The results show that cross-speaker performance is influenced more strongly by the speech representation than by classifier choice. The AUCs of three classifiers differed by no more than 4.7%, whereas replacing conventional acoustic descriptors with the multilayer self-supervised representation produced AUC improvements of 18.2%-26.1%. Diarization-conditioned feature extraction and the proposed classifier cascade provided additional consistent gains. These findings indicate that reliable patient-specific speech isolation and strong pretrained representations are more important than increased classifier complexity in low-resource intra-operative settings. They also quantify the potential performance gains that may be achieved through patient-specific preoperative calibration.