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Thies T, Barbe MT, Mücke D. Prosody matters: Preserved prominence marking strategies in people with Parkinson's disease independent of motor status. PLoS One 2024; 19:e0308655. [PMID: 39163326 PMCID: PMC11335121 DOI: 10.1371/journal.pone.0308655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 07/27/2024] [Indexed: 08/22/2024] Open
Abstract
While many studies focus on segmental variation in Parkinsonian speech, little is known about prosodic modulations reflecting the ability to adapt to communicative demands in people with Parkinson's disease (PwPD). This type of prosodic modulation is important for social interaction, and it involves modifications in speech melody (intonational level) and articulation of consonants and vowels (segmental level). The present study investigates phonetic cues of prosodic modulations with respect to different focus structures in mild dysarthric PwPD as a function of levodopa. Acoustic and kinematic speech parameters of 25 PwPD were assessed in two motor conditions. Speech production data from PwPD were collected before (medication-OFF) and after levodopa intake (medication-ON) by means of 3-D electromagnetic articulography. On the acoustic level, intensity, pitch, and syllable durations were analyzed. On the kinematic level, movement duration and amplitude were investigated. Spatio-temporal modulations of speech parameters were examined and compared across three different prosodic focus structures (out-of-focus, broad focus, contrastive focus) to display varying speech demands. Overall, levodopa had beneficial effects on motor performance, speech loudness, and pitch modulation. Acoustic syllable durations and kinematic movement durations did not change, revealing no systematic effects of motor status on the temporal domain. In contrast, there were spatial modulations of the oral articulators: tongue tip movements were smaller and lower lip movements were larger in amplitude under levodopa, reflecting a more agile and efficient articulatory movement under levodopa. Thus, respiratory-phonatory functions and consonant production improved, while syllable duration and tongue body kinematics did not change. Interestingly, prominence marking strategies were comparable between the medication conditions under investigation, and in fact, appear to be preserved in mild dysarthric PwPD.
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Affiliation(s)
- Tabea Thies
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- IfL Phonetics, Faculty of Arts and Humanities, University of Cologne, Cologne, Germany
| | - Michael T. Barbe
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Doris Mücke
- IfL Phonetics, Faculty of Arts and Humanities, University of Cologne, Cologne, Germany
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Bianchini E, Rinaldi D, Alborghetti M, Simonelli M, D’Audino F, Onelli C, Pegolo E, Pontieri FE. The Story behind the Mask: A Narrative Review on Hypomimia in Parkinson's Disease. Brain Sci 2024; 14:109. [PMID: 38275529 PMCID: PMC10814039 DOI: 10.3390/brainsci14010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Facial movements are crucial for social and emotional interaction and well-being. Reduced facial expressions (i.e., hypomimia) is a common feature in patients with Parkinson's disease (PD) and previous studies linked this manifestation to both motor symptoms of the disease and altered emotion recognition and processing. Nevertheless, research on facial motor impairment in PD has been rather scarce and only a limited number of clinical evaluation tools are available, often suffering from poor validation processes and high inter- and intra-rater variability. In recent years, the availability of technology-enhanced quantification methods of facial movements, such as automated video analysis and machine learning application, led to increasing interest in studying hypomimia in PD. In this narrative review, we summarize the current knowledge on pathophysiological hypotheses at the basis of hypomimia in PD, with particular focus on the association between reduced facial expressions and emotional processing and analyze the current evaluation tools and management strategies for this symptom, as well as future research perspectives.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Domiziana Rinaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marika Alborghetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Marta Simonelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Ospedale dei Castelli, ASL Rome 6, 00040 Ariccia, Italy
| | | | - Camilla Onelli
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy;
| | - Elena Pegolo
- Department of Information Engineering, University of Padova, 35131 Padova, Italy;
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy; (E.B.); (D.R.); (M.A.); (M.S.)
- Sant’Andrea University Hospital, 00189 Rome, Italy;
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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Weismer G. Oromotor Nonverbal Performance and Speech Motor Control: Theory and Review of Empirical Evidence. Brain Sci 2023; 13:brainsci13050768. [PMID: 37239240 DOI: 10.3390/brainsci13050768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
This position paper offers a perspective on the long-standing debate concerning the role of oromotor, nonverbal gestures in understanding typical and disordered speech motor control secondary to neurological disease. Oromotor nonverbal tasks are employed routinely in clinical and research settings, but a coherent rationale for their use is needed. The use of oromotor nonverbal performance to diagnose disease or dysarthria type, versus specific aspects of speech production deficits that contribute to loss of speech intelligibility, is argued to be an important part of the debate. Framing these issues are two models of speech motor control, the Integrative Model (IM) and Task-Dependent Model (TDM), which yield contrasting predictions of the relationship between oromotor nonverbal performance and speech motor control. Theoretical and empirical literature on task specificity in limb, hand, and eye motor control is reviewed to demonstrate its relevance to speech motor control. The IM rejects task specificity in speech motor control, whereas the TDM is defined by it. The theoretical claim of the IM proponents that the TDM requires a special, dedicated neural mechanism for speech production is rejected. Based on theoretical and empirical information, the utility of oromotor nonverbal tasks as a window into speech motor control is questionable.
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Affiliation(s)
- Gary Weismer
- Department of Communication Sciences & Disorders, University of Wisconsin-Madison, Madison, WI 53706, USA
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Clark HM, Duffy JR, Strand EA, Hanley H, Solomon NP. Orofacial Muscle Strength across the Dysarthrias. Brain Sci 2022; 12:brainsci12030365. [PMID: 35326321 PMCID: PMC8946724 DOI: 10.3390/brainsci12030365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
This study compared orofacial muscle strength between normal and dysarthric speakers and across types of dysarthria, and examined correlations between strength and dysarthria severity. Participants included 79 speakers with flaccid, spastic, mixed spastic–flaccid, ataxic, or hypokinetic dysarthria and 33 healthy controls. Maximum pressure generation (Pmax) by the tongue, lips, and cheeks represented strength. Pmax was lower for speakers with mixed spastic–flaccid dysarthria for all tongue and lip measures, as well as for speakers with flaccid or spastic dysarthria for anterior tongue elevation and lip compression. Anterior tongue elevation and cheek compression tended to be lower than normal for the hypokinetic group. Pmax did not differ significantly between controls and speakers with ataxic dysarthria on any measure. Correlations were generally weak between dysarthria severity and orofacial weakness but were stronger in the dysarthria groups with more prominent orofacial weakness. The results generally support predictions that orofacial weakness accompanies flaccid and/or spastic dysarthria but not ataxic dysarthria. The findings support including type of dysarthria as a variable of interest when examining orofacial weakness in motor speech disorders.
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Affiliation(s)
- Heather M. Clark
- Mayo Clinic, Rochester, MN 55905, USA; (J.R.D.); (E.A.S.)
- Correspondence: ; Tel.: +1-507-2983-1283
| | | | | | - Holly Hanley
- Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC 28608, USA;
| | - Nancy Pearl Solomon
- National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA;
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Levodopa-Based Changes on Vocalic Speech Movements during Prosodic Prominence Marking. Brain Sci 2021; 11:brainsci11050594. [PMID: 34064356 PMCID: PMC8147761 DOI: 10.3390/brainsci11050594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022] Open
Abstract
The present study investigates speech changes in Parkinson’s disease on the acoustic and articulatory level with respect to prosodic prominence marking. To display movements of the underlying articulators, speech data from 16 patients with Parkinson’s disease were recorded using electromagnetic articulography. Speech tasks focused on strategies of prominence marking. Patients’ ability to encode prominence in the laryngeal and supra-laryngeal domain is tested in two conditions to examine the influence of motor performance on speech production further: without dopaminergic medication and with dopaminergic medication. The data reveal that patients with Parkinson’s disease are able to highlight important information in both conditions. They maintain prominence relations across- and within-accentuation by adjusting prosodic markers, such as vowel duration and pitch modulation, while the acoustic vowel space remains the same. For differentiating across-accentuation, not only intensity but also all temporal and spatial parameters related to the articulatory tongue body movements during the production of vowels are modulated to signal prominence. In response to the levodopa intake, gross motor performance improved significantly by 42%. The improvement in gross motor performance was accompanied by an improvement in speech motor performance in terms of louder speech and shorter, larger and faster tongue body movements. The tongue body is more agile under levodopa increase, a fact that is not necessarily detectable on the acoustic level but important for speech therapy.
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Slis A, Lévêque N, Fougeron C, Pernon M, Assal F, Lancia L. Analysing spectral changes over time to identify articulatory impairments in dysarthria. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:758. [PMID: 33639779 DOI: 10.1121/10.0003332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Identifying characteristics of articulatory impairment in speech motor disorders is complicated due to the time-consuming nature of kinematic measures. The goal is to explore whether analysing the acoustic signal in terms of total squared changes of Mel-Frequency Cepstral Coefficients (TSC_MFCC) and its pattern over time provides sufficient spectral information to distinguish mild and moderate dysarthric French speakers with Amyotrophic Lateral Sclerosis (ALS) and Parkinson's Disease (PD) from each other and from healthy speakers. Participants produced the vowel-glide sequences /ajajaj/, /ujujuj/, and /wiwiwi/. From the time course of TSC_MFCCs, event-related and global measures were extracted to capture the degree of acoustic change and its variability. In addition, durational measures were obtained. For both mild and moderately impaired PD and ALS speakers, the degree of acoustic change and its variability, averaged over the complete contour, separated PD and ALS speakers from each other and from healthy speakers, especially when producing the sequences /ujujuj/ and /wiwiwi/. Durational measures separated the moderate ALS from healthy and moderate PD speakers. Using the approach on repetitive sequences targeting the lingual and labial articulators to characterize articulatory impairment in speech motor disorders is promising. Findings are discussed against prior findings of articulatory impairment in the populations studied.
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Affiliation(s)
- A Slis
- LPP, UMR 7018, CNRS/University Sorbonne-Nouvelle, Paris, France
| | - N Lévêque
- APHP, Department of Neurology, Pitié-Salpêtrière Hospital, ALS Reference Center, France
| | - C Fougeron
- LPP, UMR 7018, CNRS/University Sorbonne-Nouvelle, Paris, France
| | - M Pernon
- Department of Clinical Neurosciences, Geneva University Hospital, Switzerland
| | - F Assal
- Department of Clinical Neurosciences, Geneva University Hospital, Switzerland
| | - L Lancia
- LPP, UMR 7018, CNRS/University Sorbonne-Nouvelle, Paris, France
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Chu SY, Barlow SM, Lee J, Wang J. Effects of utterance rate and length on the spatiotemporal index in Parkinson's disease. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:141-151. [PMID: 31213093 DOI: 10.1080/17549507.2019.1622781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 02/26/2019] [Accepted: 05/16/2019] [Indexed: 06/09/2023]
Abstract
Purpose: To characterise labial articulatory pattern variability using the spatiotemporal index (STI) in speakers with idiopathic Parkinson's disease (PD) across different speaking rates and syllable-sentence conditions compared to age- and sex-matched healthy controls.Method: Ten speakers with mild-severe idiopathic PD and 10 controls produced "pa" and the Rainbow Passage at slow, typical and fast speech rates. Upper lip and lower lip kinematics were digitised during a motion capture system. Data were analysed using linear mixed modelling.Result: Regardless of the participant group, a high STI value was observed in the fast speech rate for the "pa" syllable condition, particularly for movements of the lower lip. As utterance rate increased, the control group showed the highest variability, followed by PD OFF and PD ON conditions. Syllable "pa" showed a greater STI value compared to both the first and second utterance of Rainbow Passage.Conclusion: PD manifests sufficient residual capacity to achieve near-normal motor compensation to preserve the consistency of lower lip movements during speech production. The lack of a significant difference in lip STI values between ON-OFF medication states suggests that dopaminergic treatment does not influence stability of speech for individuals with mild-moderate stage PD.
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Affiliation(s)
- Shin Ying Chu
- Faculty of Health Sciences, Centre for Rehabilitation & Special Needs, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Steven M Barlow
- Department of Special Education and Communication Disorders and Department of Biological Systems Engineering, Center for Brain, Biology and Behavior, University of Nebraska, Lincoln, NE, USA
- Communication Neuroscience Laboratories, University of Nebraska, Lincoln, NE, USA, and
| | - Jaehoon Lee
- Department of Educational Psychology and Leadership, Institute for Measurement, Methodology, Analysis and Policy (IMMAP), Texas Tech University, Lubbock, TX, USA
| | - Jingyan Wang
- Communication Neuroscience Laboratories, University of Nebraska, Lincoln, NE, USA, and
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Baskwill AJ, Belli P, Kelleher L. Evaluation of a Gait Assessment Module Using 3D Motion Capture Technology. Int J Ther Massage Bodywork 2017; 10:3-9. [PMID: 28293329 PMCID: PMC5340468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Gait analysis is the study of human locomotion. In massage therapy, this observation is part of an assessment process that informs treatment planning. Massage therapy students must apply the theory of gait assessment to simulated patients. At Humber College, the gait assessment module traditionally consists of a textbook reading and a three-hour, in-class session in which students perform gait assessment on each other. In 2015, Humber College acquired a three-dimensional motion capture system. PURPOSE The purpose was to evaluate the use of 3D motion capture in a gait assessment module compared to the traditional gait assessment module. PARTICIPANTS Semester 2 massage therapy students who were enrolled in Massage Theory 2 (n = 38). RESEARCH DESIGN Quasi-experimental, wait-list comparison study. INTERVENTION The intervention group participated in an in-class session with a Qualisys motion capture system. MAIN OUTCOME MEASURES The outcomes included knowledge and application of gait assessment theory as measured by quizzes, and students' satisfaction as measured through a questionnaire. RESULTS There were no statistically significant differences in baseline and post-module knowledge between both groups (pre-module: p = .46; post-module: p = .63). There was also no difference between groups on the final application question (p = .13). The intervention group enjoyed the in-class session because they could visualize the content, whereas the comparison group enjoyed the interactivity of the session. The intervention group recommended adding the assessment of gait on their classmates to their experience. Both groups noted more time was needed for the gait assessment module. CONCLUSIONS Based on the results of this study, it is recommended that the gait assessment module combine both the traditional in-class session and the 3D motion capture system.
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Affiliation(s)
- Amanda J. Baskwill
- Corresponding author: Amanda Baskwill, MSc, BEd, RMT, Massage Therapy Program, Humber Institute of Technology and Advanced Learning, 205 Humber College Blvd, Toronto, ON, M9W 5L7, Canada,
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