Pilot Clinic Deploying Now

3 Voice Tasks.
15 Biomarkers.
Daily Clinical Intelligence.

Cognivo Bridge turns a 3-minute smartphone recording into continuous neurodegenerative disease monitoring - delivered to your nurse portal every day. No wearables. No clinic visit required.

15
Acoustic Biomarkers
9
Diseases Covered
3 min
Per Session
$102
RTM / Patient / Month
Clinical Session Report - Patient PD-0247
DDK Rate4.6 syll/secBelow Norm
Jitter1.82%Elevated
FFTR (Tremor)5.3 HzPD Range
Rate Ratio0.84Normal
AVQI3.12Monitor
Engagement87%Active
Triage Status
● YELLOW - Motor zone deviation detected. Review within 2 weeks.

From Patient's Phone to Your Nurse Portal in Seconds

The patient records at home. Our AI extracts the biomarkers. You get a clinical PDF report. It takes under 3 minutes.

1

Patient Records

3 voice tasks on their smartphone: sustained "ahhh," rapid "pa-ta-ka," and reading a short passage aloud.

2

Quality Check

The app verifies audio quality in real time (SNR > 18dB) and prompts a retry if the recording is too short or noisy.

3

AI Analysis

Our scoring engine extracts up to 15 acoustic biomarkers, classifies dysarthria subtypes, and computes zone scores within seconds.

4

Clinical Report

A 2-page PDF clinical report with biomarker trends, triage status, and clinical interpretation lands in your nurse portal.

What Each Recording Measures & Why It Matters

Each task stresses a different dimension of neuromotor speech function. Together, they give you a window into motor control, vocal fold health, and cognitive-linguistic processing.

🟢 Task 1

Sustained Vowel - "Ahhh"

The patient holds a steady "ahhh" for 8 seconds. This isolates vocal fold vibration - the gold standard task in voice laboratories worldwide. Any instability comes directly from the neuromuscular control of the larynx.

Jitter & Shimmer
Cycle-to-cycle pitch & amplitude variation
CPP (dB)
Cepstral peak prominence - early bulbar ALS marker
FFTR (Hz)
Tremor frequency: PD (4-7Hz), cerebellar (3-5Hz), ET (4-12Hz)
AVQI (0-10)
Composite voice quality index
HNR (dB)
Harmonics-to-noise ratio - voice clarity
F0 Variability
Pitch variation - monotone = PD hallmark

Why This Matters to You

FFTR frequency classifies tremor subtype without a clinic visit. CPP catches bulbar ALS onset before you can hear it. AVQI trended over weeks shows whether voice quality is stable, improving, or declining.

Which Patients Benefit Most

🧠
Parkinson's Disease
Vocal tremor at 4-7 Hz, monotone pitch (F0 CV <0.05), AVQI trending
Essential Tremor
Broader frequency band (4-12Hz) distinguishes ET from PD
🎯
ALS / Motor Neuron Disease
CPP decline - earliest measurable sign of bulbar involvement
Cerebellar Ataxia
Intention tremor at 3-5 Hz, excessive pitch variation
🔍
Multiple Sclerosis
Strained quality during relapse, voice quality fluctuation
🟣 Task 2

Rapid Syllable - "Pa-Ta-Ka"

The diadochokinetic (DDK) task: "pa" tests the lips, "ta" the tongue tip, "ka" the tongue back. Together they exercise the entire oral motor system. When corticobulbar pathways or basal ganglia timing degrade, DDK reveals it.

DDK Rate (syll/sec)
Age-adjusted: 6.5 (20-39y) to 4.2 (80+y)
DDK Regularity (CV)
Dysarthria subtype classifier: hypokinetic, ataxic, spastic, flaccid
Diurnal DDK Variance
AM vs PM comparison - medication wearing-off signal
Z1 Motor Score
Composite motor zone score (0-100)

The Medication Timing Signal

When a PD patient's DDK rate is 5.2 at 9 AM but 4.3 at 4 PM, that 17% afternoon decline quantifies levodopa wearing-off. You can adjust medication timing based on objective motor data - not subjective patient recall.

Which Patients Benefit Most

🧠
Parkinson's Disease
DDK slowing + diurnal variance catches medication wearing-off
🎯
ALS / Motor Neuron Disease
DDK rate trajectory - most sensitive longitudinal bulbar marker
Cerebellar Ataxia
Scanning rhythm, tighter ataxic threshold (CV 0.08)
🔍
Multiple Sclerosis
Spastic pattern, fatigue-related PM decline
🔥
Huntington's Disease
Hyperkinetic irregularity from choreiform movements
🟠 Task 3

Reading Passage - Connected Speech

The patient reads a standardized passage aloud. Unlike the first two tasks, reading loads the full system: respiration, phonation, articulation, and cognitive-linguistic processing simultaneously. Subtle cognitive deficits that are invisible during "ahhh" or "pa-ta-ka" become measurable here.

Speech Rate (syll/sec)
Overall connected speech speed including pauses
Rate Ratio
Speech/articulation rate - the motor-vs-cognitive discriminator
Pause Ratio
Time in silence - Alzheimer's published marker
Z3 Cognitive Score
Composite cognitive-affective zone score (0-100)

Motor vs. Cognitive - Answered Objectively

Rate ratio > 0.90 = motor-dominant slowness. Rate ratio < 0.70 = cognitive-dominant (word-finding pauses). This distinction guides whether you adjust motor medications or screen for cognitive decline. No other voice platform makes this differentiation.

Which Patients Benefit Most

🧓
Alzheimer's / Cognitive Decline
Elevated pause ratio >0.50, reduced rate ratio <0.70
🧠
Parkinson's Disease
Motor-dominant pattern: rate ratio >0.90, flat intonation
🎯
ALS / Motor Neuron Disease
Speech rate predicts when AAC may be needed
🔍
Multiple Sclerosis
Cognitive fog manifests as elevated pause ratio
⚠️
Progressive Supranuclear Palsy
Earlier and steeper decline than typical PD

9 Neurodegenerative Conditions. One Platform.

Cognivo Bridge has the broadest disease coverage of any voice biomarker platform in neurology - verified against our production scoring engine.

Tier 1 - Explicit Logic

Parkinson's Disease

Tremor classification (4-7Hz), DDK bradykinesia, medication wearing-off via diurnal variance, monotone pitch

Tier 1 - Explicit Logic

Essential Tremor

Vocal tremor at 4-12Hz, FTRI severity, frequency-based differentiation from PD

Tier 1 - Explicit Logic

Cerebellar Ataxia

Intention tremor 3-5Hz, scanning rhythm, excessive pitch variation, tighter DDK thresholds

Tier 1 - Explicit Logic

Alzheimer's Disease

Pause ratio elevation, word-finding failures, rate ratio cognitive decline, max pause duration tracking

Tier 2 - Dysarthria Subtype

ALS / Motor Neuron Disease

Flaccid dysarthria pattern, CPP trajectory for bulbar onset, DDK rate decline slope

Tier 2 - Dysarthria Subtype

Multiple Sclerosis

Spastic dysarthria pattern, relapse/remission fluctuation, fatigue-induced PM decline

Tier 2 - Dysarthria Subtype

Spasmodic Dysphonia

Voice breaks, strained quality, treatment response tracking (Botox), AVQI monitoring

Tier 3 - Monitoring Capable

Huntington's Disease

Hyperkinetic irregularity, choreiform timing disruption, variable DDK rate pattern

Tier 3 - Monitoring Capable

Progressive Supranuclear Palsy

Steeper speech decline than PD, combined motor + cognitive involvement in reading

Automated Triage - Know Who Needs Attention

Every session is automatically classified based on the patient's biomarker trajectory relative to their personal baseline.

🔵

BLUE - Baseline

Building personal baseline (first 7 sessions). No alerts - data collection phase.

🟢

GREEN - Stable

All biomarkers within personal baseline. Continue monitoring. Next scheduled visit.

🟡

YELLOW - Watch

Emerging deviation from baseline. Review PDF report. Schedule review within 2 weeks.

🔴

RED - Alert

Sustained multi-zone decline. Motor, cognitive, or global. Urgent clinical review.

RTM Billing - New Revenue for Your Practice

Every patient recording session counts as a billable RTM monitoring day. CMS pays your practice for the monitoring service. Cognivo Bridge provides the platform, the data, and the documentation.

CPT CodeDescriptionReimbursement
98975RTM initial setup & patient education (one-time)~$19
98977RTM device supply, 16+ days per 30-day period~$52/month
98980RTM treatment management, first 20 min/month~$50/month
98981Each additional 20 min review (complex patients)~$41/add'l

RTM codes (98975-98981) cover non-physiological data including voice and speech biomarkers. Distinct from RPM codes (99453-99458). Always verify current CMS rates with your billing department.

Monthly Revenue Per Patient

CPT 98977 (device supply, 16+ days)$52
CPT 98980 (clinical review, 20 min)$50
Monthly Total Per Patient$102
20 patients enrolled$2,040/mo
50 patients enrolled$5,100/mo

Nurse portal tracks billable days automatically. Compliance ring on every PDF shows proximity to 16-day threshold.

Why Cognivo Bridge Is Different

Feature
Multi-task protocol
Dysarthria subtyping
Medication wearing-off
Motor vs cognitive
Nurse portal
RTM billing built-in
Daily monitoring
Cognivo Bridge
✓ 3 tasks
✓ 4 subtypes
✓ Diurnal DDK
✓ Rate ratio
Winterlight
Aural Analytics
1 task
Sonde Health
1 task

The Opportunity

The vocal biomarkers market is $4B and growing at 18.8% CAGR. Cognivo Bridge is the only platform built for the practicing neurologist - not for pharma trials, not for enterprise wellness.

📈
$4B

Market Size

Global vocal biomarkers market (2025), growing at 18.8% CAGR to $10B+ by 2030.

🏥
18,000

US Neurologists

~6,000-8,000 neurology practices. 400 clinics at 25 patients each = 10,000 patients = $12.2M ARR.

💰
$102

Revenue Per Patient

Monthly recurring RTM revenue. Predictable, CMS-backed, scales linearly with patient enrollment.

🧬
15

Biomarkers Extracted

Most comprehensive voice biomarker panel in neurology. 3-task protocol with dysarthria subtyping and tremor classification.

🛡️
9

Diseases Covered

Broadest neurodegenerative disease coverage of any voice platform. PD, ET, Cerebellar, Alzheimer's, ALS, MS, and more.

🚀
Live

Pilot Deploying

iOS TestFlight live. Backend deployed. Nurse portal operational. Clinical validation protocol designed with ICC targets >0.75.

Start a Conversation →

The Mind Behind the Mission

VS

Venkatesh Srinivasan

Founder & Chief Vision Officer
"Our mission transcends technology. We're building bridges between human potential and artificial intelligence, creating pathways for cognitive healing that honor both the complexity of the brain and the dignity of the human spirit."

Cognivo Manora Inc. is headquartered in Fremont, California. We are building Cognivo Bridge - a voice biomarker platform purpose-built for the practicing neurologist who needs continuous, objective monitoring of their neurodegenerative disease patients between clinic visits.

See Cognivo Bridge in Action

Request a personalized demo and we'll walk you through the full platform - from patient recording to nurse portal to clinical PDF report.

  • Live walkthrough of the nurse portal and triage queue
  • Sample clinical PDF report with real biomarker data
  • RTM billing workflow and compliance tracking
  • Pilot onboarding process (typically 1 nurse training session)
  • No commitment. No charge. 30 minutes.

Request a Demo

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