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Fumel J, Bahuaud D, Weed E, Fusaroli R, Basirat A. A Systematic Review and Bayesian Meta-Analysis of Acoustic Measures of Prosody in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2548-2564. [PMID: 39018262 DOI: 10.1044/2024_jslhr-23-00588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
PURPOSE Linguistic prosody is affected in Parkinson's disease (PD), which implicates the basal ganglia's role in the production of prosody. However, there is no recent systematic synthesis of the available acoustic evidence of prosodic impairment in PD. This study aimed to identify the acoustic features of linguistic prosody that are consistently affected in PD. METHOD The authors systematically reviewed articles that reported acoustic features of prosodic production in PD. Articles focused on fundamental frequency (F0) and its variability, intensity and its variability, speech and articulation rate, and pause duration and ratio. From a total of 648 records identified, 36 met criteria for inclusion and exclusion. For each acoustic measurement and task, data from people with PD (PwPD) were compared with those from controls to extract effect sizes. Pooled effect sizes were estimated using robust Bayesian hierarchical regression models. RESULTS PD was associated with decreased F0 variability and increased pause duration. There was limited evidence of reduced intensity variability and speech rate in PwPD. No evidence was found to suggest that PD affects articulation rate or pause ratio. CONCLUSIONS The primary acoustic parameters of prosody affected by PD are F0 variability and pause duration. The identification of these acoustic parameters has important clinical implications for the selection of PD management strategies. The association of F0 variability and pause duration with PD suggests that the neural circuits controlling these parameters are at least partly shared and might include the basal ganglia. While the current study focused on the phonetic realization of prosodic cues, future studies should examine whether and how PD affects prosody at higher levels of processing. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25892923.
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Affiliation(s)
- Jules Fumel
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Delphine Bahuaud
- Department of Speech and Language Therapy, Faculty of Medicine, UFR3S, Univ. Lille, F-59000 Lille, France
| | - Ethan Weed
- Department of Linguistics, Cognitive Science and Semiotics, School of Communication and Culture, Aarhus University, Denmark
- Interacting Minds Centre, School of Culture and Society, Aarhus University, Denmark
| | - Riccardo Fusaroli
- Department of Linguistics, Cognitive Science and Semiotics, School of Communication and Culture, Aarhus University, Denmark
- Interacting Minds Centre, School of Culture and Society, Aarhus University, Denmark
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia
| | - Anahita Basirat
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
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2
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Diao Y, Xie H, Wang Y, Zhao B, Yang A, Hlavnicka J, Zhang J. Acoustic assessment in mandarin-speaking Parkinson's disease patients and disease progression monitoring and brain impairment within the speech subsystem. NPJ Parkinsons Dis 2024; 10:115. [PMID: 38866758 PMCID: PMC11169641 DOI: 10.1038/s41531-024-00720-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/10/2024] [Indexed: 06/14/2024] Open
Abstract
Approximately 90% of Parkinson's patients (PD) suffer from dysarthria. However, there is currently a lack of research on acoustic measurements and speech impairment patterns among Mandarin-speaking individuals with PD. This study aims to assess the diagnosis and disease monitoring possibility in Mandarin-speaking PD patients through the recommended speech paradigm for non-tonal languages, and to explore the anatomical and functional substrates. We examined total of 160 native Mandarin-speaking Chinese participants consisting of 80 PD patients, 40 healthy controls (HC), and 40 MRI controls. We screened the optimal acoustic metric combination for PD diagnosis. Finally, we used the objective metrics to predict the patient's motor status using the Naïve Bayes model and analyzed the correlations between cortical thickness, subcortical volumes, functional connectivity, and network properties. Comprehensive acoustic screening based on prosodic, articulation, and phonation abnormalities allows differentiation between HC and PD with an area under the curve of 0.931. Patients with slowed reading exhibited atrophy of the fusiform gyrus (FDR p = 0.010, R = 0.391), reduced functional connectivity between the fusiform gyrus and motor cortex, and increased nodal local efficiency (NLE) and nodal efficiency (NE) in bilateral pallidum. Patients with prolonged pauses demonstrated atrophy in the left hippocampus, along with decreased NLE and NE. The acoustic assessment in Mandarin proves effective in diagnosis and disease monitoring for Mandarin-speaking PD patients, generalizing standardized acoustic guidelines beyond non-tonal languages. The speech impairment in Mandarin-speaking PD patients not only involves motor aspects of speech but also encompasses the cognitive processes underlying language generation.
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Affiliation(s)
- Yu Diao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hutao Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanwen Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Jan Hlavnicka
- Centre of Clinical Neuroscience, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Neurostimulation, Beijing, China.
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3
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Swinnen BEKS, Lotfalla V, Scholten MN, Prins RHN, Goes KM, de Vries S, Geytenbeek JJM, Dijk JM, Odekerken VJ, Bot M, van den Munckhof P, Schuurman PR, de Bie RMA, Beudel M. Programming Algorithm for the Management of Speech Impairment in Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease. Neuromodulation 2024; 27:528-537. [PMID: 37452799 DOI: 10.1016/j.neurom.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/19/2023] [Accepted: 05/28/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) has an ambiguous relation to speech. Speech impairment can be a stimulation-induced side effect, and parkinsonian dysarthria can improve with STN-DBS. Owing to the lack of an up-to-date and evidence-based approach, DBS reprogramming for speech impairment is largely blind and greatly relies on the physician's experience. In this study, we aimed to establish an evidence- and experience-based algorithm for managing speech impairment in patients with PD treated with STN-DBS. MATERIALS AND METHODS We performed a single-center retrospective study to identify patients with STN-DBS and speech impairment. Onset of speech impairment, lead localization, and assessment of DBS-induced nature of speech impairment were collected. When DBS settings were adjusted for improving speech, the magnitude and duration of effect were collected. We also performed a systematic literature review to identify studies describing the effects of parameter adjustments aimed at improving speech impairment in patients with PD receiving STN-DBS. RESULTS In the retrospective study, 245 of 631 patients (38.8%) with STN-DBS had significant speech impairment. The probability of sustained marked improvement upon reprogramming was generally low (27.9%). In the systematic review, 23 of 662 identified studies were included. Only two randomized controlled trials have been performed, providing evidence for interleaving-interlink stimulation only. Considerable methodologic heterogeneity precluded the conduction of a meta-analysis. CONCLUSIONS Speech impairment in STN-DBS for PD is frequent, but high-quality evidence regarding DBS parameter adjustments is scarce, and the probability of sustained improvement is low. To improve this outcome, we propose an evidence- and experience-based approach to address speech impairment in STN-DBS that can be used in clinical practice.
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Affiliation(s)
- Bart E K S Swinnen
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Veronia Lotfalla
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Marije N Scholten
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Rosanne H N Prins
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Kelly M Goes
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Stefanie de Vries
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Joke J M Geytenbeek
- Department of Rehabilitation, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Joke M Dijk
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Vincent J Odekerken
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Maarten Bot
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter R Schuurman
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Rob M A de Bie
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Martijn Beudel
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.
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Goldman JG, Volpe D, Ellis TD, Hirsch MA, Johnson J, Wood J, Aragon A, Biundo R, Di Rocco A, Kasman GS, Iansek R, Miyasaki J, McConvey VM, Munneke M, Pinto S, St. Clair KA, Toledo S, York MK, Todaro R, Yarab N, Wallock K. Delivering Multidisciplinary Rehabilitation Care in Parkinson's Disease: An International Consensus Statement. JOURNAL OF PARKINSON'S DISEASE 2024; 14:135-166. [PMID: 38277303 PMCID: PMC10836578 DOI: 10.3233/jpd-230117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD. OBJECTIVE The goal of the international Parkinson's Foundation Rehabilitation Medicine Task Force was to develop a consensus statement regarding the incorporation of rehabilitation in PD care. METHODS The Task Force, comprised of international multidisciplinary experts in PD and rehabilitation and people directly affected by PD, met virtually to discuss topics such as rehabilitative services, existing therapy guidelines and rehabilitation literature in PD, and gaps and needs. A systematic, interactive, and iterative process was used to develop consensus-based statements on core components of PD rehabilitation and discipline-specific interventions. RESULTS The expert-based consensus statement outlines key tenets of rehabilitative care including its multidisciplinary approach and discipline-specific guidance for occupational therapy, physical therapy, speech language pathology/therapy, and psychology/neuropsychology across all PD stages. CONCLUSIONS Rehabilitative interventions should be an essential component in the comprehensive treatment of PD, from diagnosis to advanced disease. Greater education and awareness of the benefits of rehabilitative services for people with PD and their care partners, and further evidence-based and scientific study are encouraged.
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Affiliation(s)
- Jennifer G. Goldman
- JPG Enterprises LLC, Medical Division, Chicago, IL, USA
- ^Shirley Ryan AbilityLab, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniele Volpe
- Fresco Parkinson Institute, Fiesole, Italy
- Fresco Parkinson Center Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
- NYU Grossman School of Medicine, New York, NY, USA
| | - Terry D. Ellis
- Boston University Sargent College of Health and Rehabilitation Sciences, Boston, MA, USA
| | - Mark A. Hirsch
- Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Charlotte, NC, USA
| | - Julia Johnson
- Kings College Hospital NHS Foundation Trust, London, UK
| | - Julia Wood
- Lewy Body Dementia Association, Lilburn, GA, USA
| | - Ana Aragon
- Independent Consultant Occupational Therapist, Bath, UK
| | | | | | | | | | | | | | - Marten Munneke
- Radboudumc Center of Expertise for Movement Disorders, Nijmegen, Netherlands
| | - Serge Pinto
- The French National Centre for Scientific Research, Aix-Marseille University, Aix-en-Provence, France
| | | | - Santiago Toledo
- ^Shirley Ryan AbilityLab, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Ronnie Todaro
- Voz Advisors, New York, NY, USA
- ^Parkinson’s Foundation, New York, NY, USA
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Skibińska J, Hosek J. Computerized analysis of hypomimia and hypokinetic dysarthria for improved diagnosis of Parkinson's disease. Heliyon 2023; 9:e21175. [PMID: 37908703 PMCID: PMC10613914 DOI: 10.1016/j.heliyon.2023.e21175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/07/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Background and Objective An aging society requires easy-to-use approaches for diagnosis and monitoring of neurodegenerative disorders, such as Parkinson's disease (PD), so that clinicians can effectively adjust a treatment policy and improve patients' quality of life. Current methods of PD diagnosis and monitoring usually require the patients to come to a hospital, where they undergo several neurological and neuropsychological examinations. These examinations are usually time-consuming, expensive, and performed just a few times per year. Hence, this study explores the possibility of fusing computerized analysis of hypomimia and hypokinetic dysarthria (two motor symptoms manifested in the majority of PD patients) with the goal of proposing a new methodology of PD diagnosis that could be easily integrated into mHealth systems. Methods We enrolled 73 PD patients and 46 age- and gender-matched healthy controls, who performed several speech/voice tasks while recorded by a microphone and a camera. Acoustic signals were parametrized in the fields of phonation, articulation and prosody. Video recordings of a face were analyzed in terms of facial landmarks movement. Both modalities were consequently modeled by the XGBoost algorithm. Results The acoustic analysis enabled diagnosis of PD with 77% balanced accuracy, while in the case of the facial analysis, we observed 81% balanced accuracy. The fusion of both modalities increased the balanced accuracy to 83% (88% sensitivity and 78% specificity). The most informative speech exercise in the multimodality system turned out to be a tongue twister. Additionally, we identified muscle movements that are characteristic of hypomimia. Conclusions The introduced methodology, which is based on the myriad of speech exercises likewise audio and video modality, allows for the detection of PD with an accuracy of up to 83%. The speech exercise - tongue twisters occurred to be the most valuable from the clinical point of view. Additionally, the clinical interpretation of the created models is illustrated. The presented computer-supported methodology could serve as an extra tool for neurologists in PD detection and the proposed potential solution of mHealth will facilitate the patient's and doctor's life.
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Affiliation(s)
- Justyna Skibińska
- Faculty of Electrical Engineering and Communication, Brno University of Technology, Technicka 12, Brno, 61600, Czechia
- Unit of Electrical Engineering, Tampere University, Kalevantie 4, Tampere, 33100, Finland
| | - Jiri Hosek
- Faculty of Electrical Engineering and Communication, Brno University of Technology, Technicka 12, Brno, 61600, Czechia
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6
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Brabenec L, Simko P, Sejnoha Minsterova A, Kostalova M, Rektorova I. Repetitive transcranial magnetic stimulation for hypokinetic dysarthria in Parkinson's disease enhances white matter integrity of the auditory-motor loop. Eur J Neurol 2023; 30:881-886. [PMID: 36529528 DOI: 10.1111/ene.15665] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE In our previous study, repeated sessions of repetitive transcranial magnetic stimulation (rTMS) over the auditory feedback area were shown to improve hypokinetic dysarthria (HD) in Parkinson's disease (PD) and led to changes in functional connectivity within the left-sided articulatory networks. We analyzed data from this previous study and assessed the effects of rTMS for HD in PD on the diffusion parameters of the left anterior arcuate fasciculus (AAF), which connects the auditory feedback area with motor regions involved in articulation. METHODS Patients were assigned to 10 sessions of real or sham 1-Hz stimulation over the right posterior superior temporal gyrus. Stimulation effects were evaluated using magnetic resonance diffusion tensor imaging and by a speech therapist using a validated tool (Phonetics score of the Dysarthric Profile) at baseline, immediately after 2 weeks of stimulation, and at follow-up visits at Weeks 6 and 10 after the baseline. RESULTS Altogether, data from 33 patients were analyzed. A linear mixed model revealed significant time-by-group interaction (p = 0.006) for the relative changes of fractional anisotropy of the AAF; the value increases were associated with the temporal evolution of the Phonetics score (R = 0.367, p = 0.028) in the real stimulation group. CONCLUSIONS Real rTMS treatment for HD in PD as compared to sham stimulation led to increases of white matter integrity of the auditory-motor loop during the 2-month follow-up period. The changes were related to motor speech improvements.
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Affiliation(s)
- Lubos Brabenec
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Patrik Simko
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Alzbeta Sejnoha Minsterova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Milena Kostalova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Neurology, University Hospital Brno, Brno, Czech Republic
| | - Irena Rektorova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- First Department of Neurology, Faculty of Medicine and St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
- International Clinical Research Center, Faculty of Medicine and St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
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7
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Svihlik J, Novotny M, Tykalova T, Polakova K, Brozova H, Kryze P, Sousa M, Krack P, Tripoliti E, Ruzicka E, Jech R, Rusz J. Long-Term Averaged Spectrum Descriptors of Dysarthria in Patients With Parkinson's Disease Treated With Subthalamic Nucleus Deep Brain Stimulation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4690-4699. [PMID: 36472939 DOI: 10.1044/2022_jslhr-22-00308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE This study aimed to evaluate whether long-term averaged spectrum (LTAS) descriptors for reading and monologue are suitable to detect worsening of dysarthria in patients with Parkinson's disease (PD) treated with subthalamic nucleus deep brain stimulation (STN-DBS) with potential effect of ON and OFF stimulation conditions and types of connected speech. METHOD Four spectral moments based on LTAS were computed for monologue and reading passage collected from 23 individuals with PD treated with bilateral STN-DBS and 23 age- and gender-matched healthy controls. Speech performance of patients with PD was compared in ON and OFF STN-DBS conditions. RESULTS All LTAS spectral moments including mean, standard deviation, skewness, and kurtosis across both monologue and reading passage were able to significantly distinguish between patients with PD in both stimulation conditions and control speakers. The spectral mean was the only LTAS measure sensitive to capture better speech performance in STN-DBS ON, as compared to the STN-DBS OFF stimulation condition (p < .05). Standardized reading passage was more sensitive compared to monologue in detecting dysarthria severity via LTAS descriptors with an area under the curve of up to 0.92 obtained between PD and control groups. CONCLUSIONS Our findings confirmed that LTAS is a suitable approach to objectively describe changes in speech impairment severity due to STN-DBS therapy in patients with PD. We envisage these results as an important step toward a continuum development of technological solutions for the automated assessment of stimulation-induced dysarthria. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21644798.
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Affiliation(s)
- Jan Svihlik
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
- Department of Computing and Control Engineering, Faculty of Chemical Engineering, University of Chemistry and Technology, Prague, Czech Republic
| | - Michal Novotny
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Tereza Tykalova
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Kamila Polakova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Hana Brozova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Petr Kryze
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Mario Sousa
- Movement Disorders Center, Department of Neurology, University Hospital of Bern, Switzerland
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital of Bern, Switzerland
| | - Elina Tripoliti
- UCL Queen Square Institute of Neurology, Department of Clinical and Movement Neurosciences, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, United Kingdom
| | - Evzen Ruzicka
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Robert Jech
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
- Movement Disorders Center, Department of Neurology, University Hospital of Bern, Switzerland
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Dai G, Wang M, Li Y, Guo Z, Jones JA, Li T, Chang Y, Wang EQ, Chen L, Liu P, Chen X, Liu H. Continuous theta burst stimulation over left supplementary motor area facilitates auditory-vocal integration in individuals with Parkinson’s disease. Front Aging Neurosci 2022; 14:948696. [PMID: 36051304 PMCID: PMC9426458 DOI: 10.3389/fnagi.2022.948696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
Accumulating evidence suggests that impairment in auditory-vocal integration characterized by abnormally enhanced vocal compensations for auditory feedback perturbations contributes to hypokinetic dysarthria in Parkinson’s disease (PD). However, treatment of this abnormality remains a challenge. The present study examined whether abnormalities in auditory-motor integration for vocal pitch regulation in PD can be modulated by neuronavigated continuous theta burst stimulation (c-TBS) over the left supplementary motor area (SMA). After receiving active or sham c-TBS over left SMA, 16 individuals with PD vocalized vowel sounds while hearing their own voice unexpectedly pitch-shifted two semitones upward or downward. A group of pairwise-matched healthy participants was recruited as controls. Their vocal responses and event-related potentials (ERPs) were measured and compared across the conditions. The results showed that applying c-TBS over left SMA led to smaller vocal responses paralleled by smaller P1 and P2 responses and larger N1 responses in individuals with PD. Major neural generators of reduced P2 responses were located in the right inferior and medial frontal gyrus, pre- and post-central gyrus, and insula. Moreover, suppressed vocal compensations were predicted by reduced P2 amplitudes and enhanced N1 amplitudes. Notably, abnormally enhanced vocal and P2 responses in individuals with PD were normalized by c-TBS over left SMA when compared to healthy controls. Our results provide the first causal evidence that abnormalities in auditory-motor control of vocal pitch production in PD can be modulated by c-TBS over left SMA, suggesting that it may be a promising non-invasive treatment for speech motor disorders in PD.
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Affiliation(s)
- Guangyan Dai
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meng Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yongxue Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhiqiang Guo
- School of Computer, Zhuhai College of Science and Technology, Zhuhai, China
| | - Jeffery A. Jones
- Psychology Department and Laurier Centre for Cognitive Neuroscience, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Tingni Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yichen Chang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Emily Q. Wang
- Department of Communication Disorders and Sciences, RUSH University Medical Center, Chicago, IL, United States
| | - Ling Chen
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peng Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Peng Liu,
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Xi Chen,
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Hanjun Liu,
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Penttilä N, Tavi L, Hyppönen M, Rontu K, Rantala L, Werner S. Prosodic features in Finnish-speaking adults with Parkinson´s disease. CLINICAL LINGUISTICS & PHONETICS 2022:1-16. [PMID: 35672929 DOI: 10.1080/02699206.2022.2081612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to assess prosodic features in Finnish speakers with (n = 16) and without (n = 20) Parkinson's disease (PD), as there are no published studies to date of prosodic features in Finnish speakers with PD. Chosen metrics were articulation rate (syllables/second), pitch (mean F0) and pitch variability (standard deviation F0), energy proportion below 1 kHz (epb1kHz), normalised pairwise variability index (nPVI), and a novel syllabic prosody index (SPI). Four statistically significant results were found: (1) energy was distributed more to lower frequencies in speakers with PD compared to control speakers, (2) male PD speakers had higher pitch and (3) higher syllabic prosody index compared to control males, and (4) female PD speakers had narrower pitch variability than controls. In this study, PD was manifested as less emphatic and breathier voice. Interestingly, male PD speakers' dysprosody was manifested as an effortful speaking style, whereas female PD speakers exhibited dysprosody with a monotonous speaking style. A novel syllable-based prosody index could be a potentially useful tool in analysing prosody in disordered speech.
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Affiliation(s)
- Nelly Penttilä
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Lauri Tavi
- National Bureau of Investigation, Finland, Finland
| | - Marianne Hyppönen
- School of Humanities, University of Eastern Finland, Joensuu, Finland
| | - Katariina Rontu
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Leena Rantala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Stefan Werner
- School of Languages and Translation Studies, University of Turku, Turku, Finland
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García AM, Arias-Vergara T, C Vasquez-Correa J, Nöth E, Schuster M, Welch AE, Bocanegra Y, Baena A, Orozco-Arroyave JR. Cognitive Determinants of Dysarthria in Parkinson's Disease: An Automated Machine Learning Approach. Mov Disord 2021; 36:2862-2873. [PMID: 34390508 DOI: 10.1002/mds.28751] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Dysarthric symptoms in Parkinson's disease (PD) vary greatly across cohorts. Abundant research suggests that such heterogeneity could reflect subject-level and task-related cognitive factors. However, the interplay of these variables during motor speech remains underexplored, let alone by administering validated materials to carefully matched samples with varying cognitive profiles and combining automated tools with machine learning methods. OBJECTIVE We aimed to identify which speech dimensions best identify patients with PD in cognitively heterogeneous, cognitively preserved, and cognitively impaired groups through tasks with low (reading) and high (retelling) processing demands. METHODS We used support vector machines to analyze prosodic, articulatory, and phonemic identifiability features. Patient groups were compared with healthy control subjects and against each other in both tasks, using each measure separately and in combination. RESULTS Relative to control subjects, patients in cognitively heterogeneous and cognitively preserved groups were best discriminated by combined dysarthric signs during reading (accuracy = 84% and 80.2%). Conversely, patients with cognitive impairment were maximally discriminated from control subjects when considering phonemic identifiability during retelling (accuracy = 86.9%). This same pattern maximally distinguished between cognitively spared and impaired patients (accuracy = 72.1%). Also, cognitive (executive) symptom severity was predicted by prosody in cognitively preserved patients and by phonemic identifiability in cognitively heterogeneous and impaired groups. No measure predicted overall motor dysfunction in any group. CONCLUSIONS Predominant dysarthric symptoms appear to be best captured through undemanding tasks in cognitively heterogeneous and preserved cohorts and through cognitively loaded tasks in patients with cognitive impairment. Further applications of this framework could enhance dysarthria assessments in PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Adolfo M García
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.,Global Brain Health Institute, University of California, San Francisco, California, USA
| | - Tomás Arias-Vergara
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University, Munich, Germany
| | - Juan C Vasquez-Correa
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany
| | - Elmar Nöth
- Friedrich-Alexander University Erlangen-Nuremberg
| | - Maria Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University, Munich, Germany
| | - Ariane E Welch
- Memory and Aging Center, University of California, San Francisco, California, USA
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan R Orozco-Arroyave
- GITA Lab, Faculty of Engineering, Universidad de Antioquia UdeA, Medellín, Colombia.,Pattern Recognition Lab, Friedrich-Alexander University, Erlangen, Nürnberg, Germany
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11
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Auffret M, Meuric V, Boyer E, Bonnaure-Mallet M, Vérin M. Oral Health Disorders in Parkinson's Disease: More than Meets the Eye. JOURNAL OF PARKINSONS DISEASE 2021; 11:1507-1535. [PMID: 34250950 PMCID: PMC8609694 DOI: 10.3233/jpd-212605] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite clinical evidence of poor oral health and hygiene in Parkinson’s disease (PD) patients, the mouth is often overlooked by both patients and the medical community, who generally focus on motor or psychiatric disorders considered more burdensome. Yet, oral health is in a two-way relationship with overall health—a weakened status triggering a decline in the quality of life. Here, we aim at giving a comprehensive overview of oral health disorders in PD, while identifying their etiologies and consequences. The physical (abnormal posture, muscle tone, tremor, and dyskinesia), behavioral (cognitive and neuropsychiatric disorders), and iatrogenic patterns associated with PD have an overall detrimental effect on patients’ oral health, putting them at risk for other disorders (infections, aspiration, pain, malnutrition), reducing their quality of life and increasing their isolation (anxiety, depression, communication issues). Interdisciplinary cooperation for prevention, management and follow-up strategies need to be implemented at an early stage to maintain and improve patients’ overall comfort and condition. Recommendations for practice, including (non-)pharmacological management strategies are discussed, with an emphasis on the neurologists’ role. Of interest, the oral cavity may become a valuable tool for diagnosis and prognosis in the near future (biomarkers). This overlooked but critical issue requires further attention and interdisciplinary research.
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Affiliation(s)
- Manon Auffret
- Behavior & Basal Ganglia Research Unit (EA 4712), University of Rennes 1, Rennes, France.,Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
| | - Vincent Meuric
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
| | - Emile Boyer
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
| | - Martine Bonnaure-Mallet
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
| | - Marc Vérin
- Behavior & Basal Ganglia Research Unit (EA 4712), University of Rennes 1, Rennes, France.,Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France.,Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, Rennes, France
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12
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Basirat A, Moreau C, Knutsen D. Parkinson's disease impacts feedback production during verbal communication. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:826-840. [PMID: 34227719 DOI: 10.1111/1460-6984.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Parkinson's disease (PD) leads to changes in verbal communications. The focus of most studies to date has been on speech impairment, which is specifically referred to as dysarthria. Although these studies are crucial to understanding the impact of PD on verbal communication, they do not focus on the features of dialogues between people with PD (PwPD) and other people in communicative contexts. AIMS To investigate whether PwPD produce less feedback than typical people during dialogue, thus potentially making it more difficult for them to reach mutual comprehension (i.e., common ground) with their conversational partner. METHODS & PROCEDURES A matching task experiment was conducted during which an experimenter described abstract pictures to a participant, who was either a PwPD or a typical participant, so that he or she could organize these pictures in a grid. The participants could produce as much feedback as they liked. OUTCOMES & RESULTS PwPD were less likely to produce feedback than typical participants. This effect was mainly driven by two specific types of feedback: acknowledgment tokens and hesitations. CONCLUSIONS & IMPLICATIONS The results suggest that PD impacts feedback production. This could decrease the communicative abilities of PwPD in interactive contexts by affecting grounding, that is, the ability to build common ground with others. This paper is one of the first to specifically document the production of feedback markers in PwPD. Future studies should examine the extent to which our results, which were obtained in a controlled dialogue task, may be generalized to daily-life conversions. From a clinical perspective, our study points to the necessity of assessing feedback production, and more generally abilities related to common ground construction and use, during PD progression. WHAT IS ALREADY KNOWN ON THE SUBJECT A few studies to date have analyzed conversational interactions between people with Parkinson's disease (PwPD) and others. The main focus is usually on potential difficulties of PwPD and their partners during the interaction and the strategies adopted to "repair" these problems. Another important feature of any interaction is the production of feedback. Feedback production plays a key role in building and using common ground to ensure mutual comprehension between interlocutors. The impact of Parkinson's disease on feedback production has received little attention in the literature to date. WHAT THIS STUDY ADDS The purpose of this study was to compare feedback production in a dialogue task (i.e., goal-oriented interaction) in PwPD versus typical controls. Our results revealed that PwPD produced less feedback for their dialogue partners than did typical participants. This effect was mainly driven by two specific types of feedback: acknowledgment tokens and hesitations. This paper is one of the firsts to specifically document the production of feedback markers in PwPD and to illustrate that PwPD and their dialogue partners may require more time and effort to establish common ground. CLINICAL IMPLICATIONS OF THIS STUDY Our findings suggest that an appropriate evaluation of feedback production by speech and language therapists, as well the management of potential deficits, would be beneficial. More broadly, we believe that the evaluation and management of PwPD should take into account the theoretical framework used in this study, in particular the role of common ground in communication.
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Affiliation(s)
- Anahita Basirat
- University of Lille, CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Lille, France
| | - Caroline Moreau
- Expert Center for Parkinson's Disease, CHU Lille, Inserm UMR 1171-2, University of Lille, Lille, France
- University of Lille, Inserm, CHU Lille, U1171-2-LilNCog-Lille Neuroscience & Cognition, Lille, France
| | - Dominique Knutsen
- University of Lille, CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Lille, France
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13
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Basirat A, Schwartz JL, Moreau C. Word segmentation based on prosody in Parkinson's Disease. CLINICAL LINGUISTICS & PHONETICS 2021; 35:534-541. [PMID: 32755289 DOI: 10.1080/02699206.2020.1797174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
While Parkinson's Disease (PD) impacts the production of prosody and may lead to dysprosody, its effect on the perception of prosody is less clear. In the current study, we investigated how people with PD (PwPD) segment continuous speech using prosodic cues. We used phonemically identical and prosodically different sequences in French. Twenty-three PwPD and 30 controls took part in the study. PwPD showed similar performance to controls (mean difference in terms of correct responses = 2%, 95% confidence interval = [-4%; 8%]). Using Bayesian statistics, our data is 3.6 times more in favour of the null model compared to the alternative model (i.e. difference between PwPD and controls). It thus seems unlikely that PD impacts the perception of prosody systematically. Furthermore, the cognitive performance of PwPD predicted their performance in our segmentation task. This suggests interesting pathways for future research on the mechanisms underlying the impact of PD on speech processing. Clinically, our findings suggest that adequate evaluation of the cognitive capacity of PwPD would help speech and language therapists in assessing speech processing skills in PwPD and in managing their speech impairments.
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Affiliation(s)
- Anahita Basirat
- University of Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Jean-Luc Schwartz
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - Caroline Moreau
- Expert Center for Parkinson's Disease, Neurological Department, CHU Lille, Inserm UMR 1171, University of Lille, Lille, France
- University of Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
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14
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Li Y, Tan M, Fan H, Wang EQ, Chen L, Li J, Chen X, Liu H. Neurobehavioral Effects of LSVT ® LOUD on Auditory-Vocal Integration in Parkinson's Disease: A Preliminary Study. Front Neurosci 2021; 15:624801. [PMID: 33716652 PMCID: PMC7952622 DOI: 10.3389/fnins.2021.624801] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Individuals with Parkinson's disease (PD) are impaired in auditory-vocal integration, characterized by abnormal compensatory responses to auditory feedback errors during self-monitoring of vocal production. The present study examined whether auditory feedback control of vocal pitch production in PD can benefit from Lee Silverman voice treatment (LSVT® LOUD), a high effort, intensive speech treatment for hypokinetic dysarthria in PD. Before and immediately after LSVT LOUD, 12 individuals with PD were instructed to produce sustained vowel sounds while hearing their voice unexpectedly pitch-shifted by -200 cents. Their vocal responses and event-related potentials (ERPs) to pitch perturbations were measured to assess the treatment outcomes. A group of 12 healthy controls were one-to-one pair matched by age, sex, and language. Individuals with PD exhibited abnormally enhanced vocal and ERP P2 responses to pitch perturbations relative to healthy controls. Successful treatment with LSVT LOUD, however, led to significantly smaller and faster vocal compensations that were accompanied by significantly larger P2 responses. Moreover, improved vocal loudness during passage reading was significantly correlated with reduced vocal compensations for pitch perturbations. These preliminary findings provide the first neurobehavioral evidence for beneficial effects of LSVT LOUD on impaired auditory-vocal integration associated with PD, which may be related to improved laryngeal motor functions and a top-down modulation of the speech motor network by LSVT LOUD.
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Affiliation(s)
- Yongxue Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingdan Tan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hao Fan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Emily Q. Wang
- Department of Communication Disorders and Sciences, RUSH University Medical Center, Chicago, IL, United States
| | - Ling Chen
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingting Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
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15
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Rusz J, Tykalova T, Ramig LO, Tripoliti E. Guidelines for Speech Recording and Acoustic Analyses in Dysarthrias of Movement Disorders. Mov Disord 2020; 36:803-814. [PMID: 33373483 DOI: 10.1002/mds.28465] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 12/13/2022] Open
Abstract
Most patients with movement disorders have speech impairments resulting from sensorimotor abnormalities that affect phonatory, articulatory, and prosodic speech subsystems. There is widespread cross-discipline use of speech recordings for diagnostic and research purposes, despite which there are no specific guidelines for a standardized method. This review aims to combine the specific clinical presentations of patients with movement disorders, existing acoustic assessment protocols, and technological advances in capturing speech to provide a basis for future research in this field and to improve the consistency of clinical assessments. We considered 3 areas: the recording environment (room, seating, background noise), the recording process (instrumentation, vocal tasks, elicitation of speech samples), and the acoustic outcome data. Four vocal tasks, namely, sustained vowel, sequential and alternating motion rates, reading passage, and monologues, are integral aspects of motor speech assessment. Fourteen acoustic vocal speech features, including their hypothesized pathomechanisms with regard to typical occurrences in hypokinetic or hyperkinetic dysarthria, are hereby recommended for quantitative exploratory analysis. Using these acoustic features and experimental speech data, we demonstrated that the hyperkinetic dysarthria group had more affected speech dimensions compared with the healthy controls than had the hypokinetic speakers. Several contrasting speech patterns between both dysarthrias were also found. This article is the first attempt to provide initial recommendations for a standardized way of recording the voice and speech of patients with hypokinetic or hyperkinetic dysarthria; thus allowing clinicians and researchers to reliably collect, acoustically analyze, and compare vocal data across different centers and patient cohorts. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.,Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tereza Tykalova
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Lorraine O Ramig
- University of Colorado Boulder, Boulder, Colorado, USA.,National Center for Voice and Speech, Denver, Colorado, USA.,Columbia University, New York, New York, USA.,LSVT Global, Inc., Tucson, Arizona, USA
| | - Elina Tripoliti
- UCL, Institute of Neurology, Department of Clinical and Movement Neurosciences, and National Hospital for Neurology and Neurosurgery, UCLH NHS Trust, London, UK
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16
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Railo H, Nokelainen N, Savolainen S, Kaasinen V. Deficits in monitoring self-produced speech in Parkinson's disease. Clin Neurophysiol 2020; 131:2140-2147. [PMID: 32682241 DOI: 10.1016/j.clinph.2020.05.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Speech deficits are common in Parkinson's disease, and behavioural findings suggest that the deficits may be due to impaired monitoring of self-produced speech. The neural mechanisms of speech deficits are not well understood. We examined a well-documented electrophysiological correlate of speech self-monitoring in patients with Parkinson's disease and control participants. METHODS We measured evoked electroencephalographic responses to self-produced and passively heard sounds (/a/ phonemes) in age-matched controls (N = 18), and Parkinson's disease patients who had minor speech impairment, but reported subjectively experiencing no speech deficits (N = 17). RESULTS During speaking, auditory evoked activity 100 ms after phonation (N1 wave) was less suppressed in Parkinson's disease than controls when compared to the activity evoked by passively heard phonemes. This difference between the groups was driven by increased amplitudes to self-produced phonemes, and reduced amplitudes passively heard phonemes in Parkinson's disease. CONCLUSIONS The finding indicates that auditory evoked activity is abnormally modulated during speech in Parkinson's patients who do not subjectively notice speech impairment. This mechanism could play a role in producing speech deficits in as the disease progresses. SIGNIFICANCE Our study is the first to show abnormal early auditory electrophysiological correlates of monitoring speech in Parkinson's disease patients.
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Affiliation(s)
- Henry Railo
- Department of Clinical Neurophysiology, University of Turku, Turku, Finland; Turku Brain and Mind Centre, University of Turku, Turku, Finland.
| | | | | | - Valtteri Kaasinen
- Turku Brain and Mind Centre, University of Turku, Turku, Finland; Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
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