1
|
Frankford SA, Estrada A, Stepp CE. Contributions of Speech Timing and Articulatory Precision to Listener Perceptions of Intelligibility and Naturalness in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-13. [PMID: 39116309 DOI: 10.1044/2024_jslhr-23-00802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
PURPOSE Parkinson's disease (PD) results in hypokinetic dysarthria in as many as 90% of cases. Among the most distinctive features of hypokinetic dysarthria are atypical timing and articulatory imprecision in speech production. Here, we examined the contributions of perceived speech timing typicality and articulatory precision, both on their own and while controlling for the other, on intelligibility and naturalness in speakers with PD. METHOD Twenty speakers with PD and four healthy older adults read aloud the first paragraph of the Rainbow Passage. Twenty inexperienced listeners with typical hearing listened to these recordings and rated intelligibility, naturalness, timing typicality, and articulatory precision using separate visual analog scales. Ratings were averaged across listeners and entered into linear regression models with intelligibility and naturalness as dependent variables and timing typicality and articulatory precision as independent variables in each. RESULTS Articulatory precision, but not timing typicality, was positively correlated with intelligibility on its own, but neither was associated with intelligibility after accounting for the other. Both timing typicality and articulatory precision were positively correlated with naturalness on their own as well as after controlling for the other variable. CONCLUSION These results contribute to the overall understanding of speech factors associated with intelligibility and naturalness in speakers with PD and indicate that considering the unique contributions of related perceptual constructs may provide more information than bivariate relationships alone.
Collapse
|
2
|
Mustile M, Kourtis D, Ladouce S, Edwards MG, Volpe D, Pilleri M, Pelosin E, Donaldson DI, Ietswaart M. Investigating the Brain Mechanisms of Externally Cued Sit-to-Stand Movement in Parkinson's Disease. Mov Disord 2024. [PMID: 38984716 DOI: 10.1002/mds.29889] [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: 02/09/2024] [Revised: 05/01/2024] [Accepted: 05/28/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND One of the more challenging daily-life actions for Parkinson's disease patients is starting to stand from a sitting position. Parkinson's disease patients are known to have difficulty with self-initiated movements and benefit from external cues. However, the brain processes underlying external cueing as an aid remain unknown. The advent of mobile electroencephalography (EEG) now enables the investigation of these processes in dynamic sit-to-stand movements. OBJECTIVE To identify cortical correlates of the mechanisms underlying auditory cued sit-to-stand movement in Parkinson's disease. METHODS Twenty-two Parkinson's disease patients and 24 healthy age-matched participants performed self-initiated and externally cued sit-to-stand movements while cortical activity was recorded through 32-channel mobile EEG. RESULTS Overall impaired integration of sensory and motor information can be seen in the Parkinson's disease patients exhibiting less modulation in the θ band during movement compared to healthy age-matched controls. How Parkinson's disease patients use external cueing of sit-to-stand movements can be seen in larger high β power over sensorimotor brain areas compared to healthy controls, signaling sensory integration supporting the maintenance of motor output. This appears to require changes in cognitive processing to update the motor plan, reflected in frontal θ power increases in Parkinson's disease patients when cued. CONCLUSION These findings provide the first neural evidence for why and how cueing improves motor function in sit-to-stand movement in Parkinson's disease. The Parkinson's disease patients' neural correlates indicate that cueing induces greater activation of motor cortical areas supporting the maintenance of a more stable motor output, but involves the use of cognitive resources to update the motor plan. © 2024 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Magda Mustile
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
- The Psychological Sciences Research Institute, University of Louvain, Louvain-la-Neuve, Belgium
| | - Dimitrios Kourtis
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Simon Ladouce
- Brain and Cognition, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Martin G Edwards
- The Psychological Sciences Research Institute, University of Louvain, Louvain-la-Neuve, Belgium
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
| | - Manuela Pilleri
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Genoa, Italy
- IRCCS, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - David I Donaldson
- School of Psychology and Neuroscience, University of St Andrews, St. Andrews, United Kingdom
| | - Magdalena Ietswaart
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| |
Collapse
|
3
|
Kim Y, Thompson A, Nip ISB. Effects of Deep-Brain Stimulation on Speech: Perceptual and Acoustic Data. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1090-1106. [PMID: 38498664 PMCID: PMC11005955 DOI: 10.1044/2024_jslhr-23-00511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/15/2023] [Accepted: 01/16/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE This study examined speech changes induced by deep-brain stimulation (DBS) in speakers with Parkinson's disease (PD) using a set of auditory-perceptual and acoustic measures. METHOD Speech recordings from nine speakers with PD and DBS were compared between DBS-On and DBS-Off conditions using auditory-perceptual and acoustic analyses. Auditory-perceptual ratings included voice quality, articulation precision, prosody, speech intelligibility, and listening effort obtained from 44 listeners. Acoustic measures were made for voicing proportion, second formant frequency slope, vowel dispersion, articulation rate, and range of fundamental frequency and intensity. RESULTS No significant changes were found between DBS-On and DBS-Off for the five perceptual ratings. Four of six acoustic measures revealed significant differences between the two conditions. While articulation rate and acoustic vowel dispersion increased, voicing proportion and intensity range decreased from the DBS-Off to DBS-On condition. However, a visual examination of the data indicated that the statistical significance was mostly driven by a small number of participants, while the majority did not show a consistent pattern of such changes. CONCLUSIONS Our data, in general, indicate no-to-minimal changes in speech production ensued from DBS stimulation. The findings are discussed with a focus on large interspeaker variability in PD in terms of their speech characteristics and the potential effects of DBS on speech.
Collapse
Affiliation(s)
- Yunjung Kim
- School of Communication Science and Disorders, Florida State University, Tallahassee
| | - Austin Thompson
- Department of Communication Sciences and Disorders, University of Houston, TX
| | - Ignatius S. B. Nip
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| |
Collapse
|
4
|
Pérez-Sánchez MDC, González-Nosti M, Cuetos F, Álvarez-Cañizo M. Reading fluency in Spanish patients with Parkinson's disease: A reading prosody examination. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:357-375. [PMID: 36269041 DOI: 10.1111/1460-6984.12793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The expressiveness during reading is essential for a fluent reading. Reading prosody has been scarcely studied in an experimental manner, owing to the difficulties in taking objective and direct measures of this reading skill. However, new technologies development has made it possible to analyse reading prosody in an experimental way. Prosodic patterns may vary, not being the same at the beginning of the reading learning process as in adulthood. They may also be altered in disorders such as dyslexia, but little is known about the prosodic characteristics and reading fluency of people with neurodegenerative diseases that cause language impairment, such as Parkinson's disease (PD). AIMS The aim of this work was to study reading fluency in PD considering the prosodic characteristics of its reading. METHODS & PROCEDURES The participants were 31 Spanish adults with PD and 31 healthy controls, aged 59-88 years. Two experimental texts were designed that included declarative, interrogative, and exclamatory sentences and experimental verbs and nouns. The manipulability level of the nouns and the motor content of the verbs were considered. The reading of the participants was recorded and analysed with Praat software. OUTCOMES & RESULTS A longer reading duration and a greater number of pauses, especially in verbs, were found in the PD group, which also showed less pitch variation than the control group in the experimental sentences. The control group showed a big initial rise in declarative and interrogative sentences, as well as a stronger final declination in declarative and exclamatory ones, when compared to the PD group. CONCLUSIONS & IMPLICATIONS The use of experimental methodologies for the analysis of reading fluency allows learning more about the prosodic characteristics of people with different pathologies, such as PD. Scarce pitch variability found in the analysis, together with the great number of pauses and the longer reading duration, leads to poorly expressive reading, which compromises fluency in PD. The exhaustive evaluation of the reading fluency of PD patients will make it possible to design more complete assessment methods that will favour the diagnosis and early detection of this pathology. WHAT THIS STUDY ADDS What is already known on this subject • The speech of people with Parkinson's disease (PD) is often impaired by the appearance of hypokinetic dysarthria. The language of people with PD is usually affected with the progression of the disease, with lexico-semantic impairment which mainly affects verbs. Previous literature on reading fluency in PD usually considers reading speed and accuracy, neglecting prosody. Other neurodegenerative diseases with language impairment, such as Alzheimer's disease, commonly cause reading fluency problems. What this paper adds to existing knowledge • This study provides direct and objective measures of the reading fluency (speed, accuracy and prosody) in patients with PD, by the design of experimental texts. Reading fluency characteristics were found to be altered in these patients, especially in pitch variations and reading duration. The reading of Parkinson's patients showed a more flattened pitch. In addition, a greater number of pauses and longer reading durations were also found in the reading of verbs compared to the control group. What are the potential or actual clinical implications of this work? • The use of experimentally created texts makes it possible to analyse the influence of different psycholinguistic variables (frequency, length, motor content, manipulability) on reading fluency, and how the processing of these stimuli could be affected in PD. The objective analysis of the reading fluency characteristics in PD allows the design of more specific evaluation and diagnostic tasks. More complete assessment methods may allow the early detection of the disease. In the same way, it may favour a differential diagnosis with other neurodegenerative diseases.
Collapse
|
5
|
Kim Y, Sidtis D, Sidtis JJ. Singing and Speaking Ability in Parkinson's Disease and Spinocerebellar Ataxia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:126-153. [PMID: 36608288 PMCID: PMC10023174 DOI: 10.1044/2022_jslhr-22-00274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/27/2022] [Accepted: 09/30/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This study examined spontaneous, spoken-to-a-model, and two sung modes in speakers with Parkinson's disease (PD), speakers with cerebellar disease (CD), and healthy controls. Vocal performance was measured by intelligibility scores and listeners' perceptual ratings. METHOD Participants included speakers with hypokinetic dysarthria secondary to PD, those with ataxic dysarthria secondary to CD, and healthy speakers. Participants produced utterances in four vocal modes: spontaneous speech, spoken-to-a-model, sung-to-a-model, and spontaneous singing. For spoken-to-a-model and sung-to-a-model modes, written material was provided the model. For spontaneous singing, participants sang songs that they endorsed as familiar. DEPENDENT VARIABLES In Experiment I, listeners orthographically transcribed the audio samples of the first three vocal modes. In Experiment IIa, raters evaluated the accuracy of the pitch and rhythm of the spontaneous singing of familiar songs. Finally, familiar songs and sung-to-a-model utterances were rated on a competency scale by a second group of raters (Experiment IIb). RESULTS Results showed increases in intelligibility during the spoken-to-a-model mode compared with the spontaneous mode in both PD and CD groups. Singing enhanced the vocal output of speakers with PD more than in speakers with CD, as measured by percent intelligibility. PD participants' pitch and rhythm accuracy and competency in singing familiar songs was rated more favorably than those produced by CD participants. CONCLUSIONS The findings reveal a vocal task effect for spoken utterances in both groups. Sung exemplars, more impaired in CD, suggest a significant involvement of the cerebellum in singing. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21809544.
Collapse
Affiliation(s)
- Yoonji Kim
- Department of Speech, Language and Hearing Science, Temple University, Philadelphia, PA
- Geriatrics Division, The Nathan Kline Institute for Psychiatric Research at Rockland Psychiatric Center, Orangeburg, NY
| | - Diana Sidtis
- Geriatrics Division, The Nathan Kline Institute for Psychiatric Research at Rockland Psychiatric Center, Orangeburg, NY
- Department of Communicative Sciences and Disorders, New York University, NY
| | - John J. Sidtis
- Geriatrics Division, The Nathan Kline Institute for Psychiatric Research at Rockland Psychiatric Center, Orangeburg, NY
- Department of Psychiatry, New York University Langone School of Medicine, NY
| |
Collapse
|
6
|
Sidtis JJ, Sidtis DVL, Dhawan V, Tagliati M, Eidelberg D. Stimulation of the Subthalamic Nucleus Changes Cortical-Subcortical Blood Flow Patterns During Speech: A Positron Emission Tomography Study. Front Neurol 2021; 12:684596. [PMID: 34122323 PMCID: PMC8187801 DOI: 10.3389/fneur.2021.684596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/05/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for Parkinson's disease (PD) but can have an adverse effect on speech. In normal speakers and in those with spinocerebellar ataxia, an inverse relationship between regional cerebral blood flow (rCBF) in the left inferior frontal (IFG) region and the right caudate (CAU) is associated with speech rate. This pattern was examined to determine if it was present in PD, and if so, whether it was altered by STN-DBS. Methods: Positron Emission Tomography (PET) measured rCBF during speech in individuals with PD not treated with STN-DBS (n = 7), and those treated with bilateral STN-DBS (n = 7). Previously reported results from non-PD control subjects (n = 16) were reported for comparison. The possible relationships between speech rate during scanning and data from the left and right IFG and CAU head regions were investigated using a step-wise multiple linear regression to identify brain regions that interacted to predict speech rate. Results: The multiple linear regression analysis replicated previously reported predictive coefficients for speech rate involving the left IFG and right CAU regions. However, the relationships between these predictive coefficients and speech rates were abnormal in both PD groups. In PD who had not received STN-DBS, the right CAU coefficient decreased normally with increasing speech rate but the left IFG coefficient abnormally decreased. With STN-DBS, this pattern was partially normalized with the addition of a left IFG coefficient that increased with speech rate, as in normal controls, but the abnormal left IFG decreasing coefficient observed in PD remained. The magnitudes of both cortical predictive coefficients but not the CAU coefficient were exaggerated with STN-DBS. Conclusions: STN-DBS partially corrects the abnormal relationships between rCBF and speech rate found in PD by introducing a left IFG subregion that increases with speech rate, but the conflicting left IFG subregion response remained. Conflicting IFG responses may account for some of the speech problems observed after STN-DBS. Cortical and subcortical regions may be differentially affected by STN-DBS.
Collapse
Affiliation(s)
- John J Sidtis
- Brain and Behavior Laboratory, Geriatrics Department, Nathan Kline Institute, Orangeburg, NY, United States.,Department of Psychiatry, School of Medicine, New York University Langone, New York, NY, United States
| | - Diana Van Lancker Sidtis
- Brain and Behavior Laboratory, Geriatrics Department, Nathan Kline Institute, Orangeburg, NY, United States.,Department of Communicative Disorders and Sciences, New York University Steinhardt School, New York, NY, United States
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| | - Michele Tagliati
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| |
Collapse
|
7
|
Brown KA, Spencer KA. The Relationship Between Speech Characteristics and Motor Subtypes of Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2145-2154. [PMID: 32997516 DOI: 10.1044/2020_ajslp-20-00058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The aim of this study was to examine whether acoustic dysarthria characteristics align with overall motor profile in individuals with Parkinson's disease (PD). Potential speech differences between tremor-dominant and non-tremor-dominant subtypes are theoretically motivated but empirically inconclusive. Method Twenty-seven individuals with dysarthria from PD provided a contextual speech sample. Participants were grouped into non-tremor-dominant (n = 12) and tremor-dominant (n = 15) motor subtypes according to the Unified Parkinson Disease Rating Scale. Dependent speech variables included fundamental frequency range, average pause duration, cepstral peak prominence, stuttering dysfluencies, and maze dysfluencies. Results There were no significant differences between the speech of the tremor-dominant and non-tremor-dominant groups. High within-group variability existed across parameters and motor subtypes. Conclusion Speech characteristics across the areas of phonation, prosody, and fluency did not differ appreciably between PD motor subtypes.
Collapse
Affiliation(s)
- Katherine A Brown
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kristie A Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| |
Collapse
|
8
|
Speech Intelligibility During Clinical and Low Frequency. Brain Sci 2020; 10:brainsci10010026. [PMID: 31906549 PMCID: PMC7016584 DOI: 10.3390/brainsci10010026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/23/2019] [Accepted: 12/30/2019] [Indexed: 11/16/2022] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become an effective and widely used tool in the treatment of Parkinson’s disease (PD). STN-DBS has varied effects on speech. Clinical speech ratings suggest worsening following STN-DBS, but quantitative intelligibility, perceptual, and acoustic studies have produced mixed and inconsistent results. Improvements in phonation and declines in articulation have frequently been reported during different speech tasks under different stimulation conditions. Questions remain about preferred STN-DBS stimulation settings. Seven right-handed, native speakers of English with PD treated with bilateral STN-DBS were studied off medication at three stimulation conditions: stimulators off, 60 Hz (low frequency stimulation—LFS), and the typical clinical setting of 185 Hz (High frequency—HFS). Spontaneous speech was recorded in each condition and excerpts were prepared for transcription (intelligibility) and difficulty judgements. Separate excerpts were prepared for listeners to rate abnormalities in voice, articulation, fluency, and rate. Intelligibility for spontaneous speech was reduced at both HFS and LFS when compared to STN-DBS off. On the average, speech produced at HFS was more intelligible than that produced at LFS, but HFS made the intelligibility task (transcription) subjectively more difficult. Both voice quality and articulation were judged to be more abnormal with DBS on. STN-DBS reduced the intelligibility of spontaneous speech at both LFS and HFS but lowering the frequency did not improve intelligibility. Voice quality ratings with STN-DBS were correlated with the ratings made without stimulation. This was not true for articulation ratings. STN-DBS exacerbated existing voice problems and may have introduced new articulatory abnormalities. The results from individual DBS subjects showed both improved and reduced intelligibility varied as a function of DBS, with perceived changes in voice appearing to be more reflective of intelligibility than perceived changes in articulation.
Collapse
|
9
|
Huang X, Fan H, Li J, Jones JA, Wang EQ, Chen L, Chen X, Liu H. External cueing facilitates auditory-motor integration for speech control in individuals with Parkinson's disease. Neurobiol Aging 2019; 76:96-105. [DOI: 10.1016/j.neurobiolaging.2018.12.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/28/2018] [Accepted: 12/31/2018] [Indexed: 01/13/2023]
|