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Steurer H, Körner Gustafsson J, Franzén E, Schalling E. Using Portable Voice Accumulators to Study Transfer of Speech Outcomes Following Intervention - A Feasibility Study. J Voice 2024; 38:965.e1-965.e13. [PMID: 34852954 DOI: 10.1016/j.jvoice.2021.10.016] [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: 07/02/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the process and scientific feasibility of using a portable voice accumulator (PVA) to study carry-over of treatment effects on speech and voice in people with mild-moderate Parkinson's disease. METHODS The study was guided by the checklist in Consolidated Standards of Reporting Trials (CONSORT) 2010 statement: extension to randomized pilot and feasibility trials. Participants with Parkinson's disease were recruited within the context of a randomized controlled trial with random allocation to intervention with either HiCommunication, a program targeting speech and communication, or HiBalance, a program targeting balance and strength. Before and after intervention data was collected from standardized studio recordings of speech and registrations of voice use in daily life with the PVA VoxLog. RESULTS Fifteen participants were included in the study and sufficient data was yielded from six of them. Reasons for insufficient data included technical issues and difficulties handling the PVA. Changes in voice sound level from pre to post intervention differed at an individual level when assessed in daily life compared to studio recordings. Registrations in daily life provided information on phonation ratio and ability to adapt voice sound level to environmental noise. CONCLUSION This study highlights the challenges of studying intervention effects on voice use in daily life using a PVA. Improvements of test protocols in future studies are suggested. We exemplify how PVA data may generate a more detailed and ecologically valid picture of voice use complementing studio recordings of speech. Finally, we encourage technical development of more user-friendly PVAs.
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Affiliation(s)
- Hanna Steurer
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Stockholm, Sweden; Stockholms Sjukhem, R&D unit, Stockholm, Sweden.
| | - Joakim Körner Gustafsson
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Stockholm, Sweden; Karolinska University Hospital, Theme Women's Health and Allied Health Professionals, Medical unit Speech & Language Pathology, Stockholm, Sweden
| | - Erika Franzén
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physical Therapy, Stockholm, Sweden; Karolinska University Hospital, Women's Health and Allied Health Professionals Theme, Medical unit Occupational Therapy & Physiotherapy, Stockholm, Sweden; Stockholms Sjukhem, R&D unit, Stockholm, Sweden
| | - Ellika Schalling
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Stockholm, Sweden; Karolinska University Hospital, Theme Women's Health and Allied Health Professionals, Medical unit Speech & Language Pathology, Stockholm, Sweden; Uppsala University, Department of Neuroscience, Speech-Language Pathology, Uppsala, Sweden
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Hyperacusis: Loudness Intolerance, Fear, Annoyance and Pain. Hear Res 2022; 426:108648. [DOI: 10.1016/j.heares.2022.108648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
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Automatic Parkinson’s disease detection based on the combination of long-term acoustic features and Mel frequency cepstral coefficients (MFCC). Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.104013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Weerathunge HR, Tomassi NE, Stepp CE. What Can Altered Auditory Feedback Paradigms Tell Us About Vocal Motor Control in Individuals With Voice Disorders? PERSPECTIVES OF THE ASHA SPECIAL INTEREST GROUPS 2022; 7:959-976. [PMID: 37397620 PMCID: PMC10312128 DOI: 10.1044/2022_persp-21-00195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Purpose The goal of this review article is to provide a summary of the progression of altered auditory feedback (AAF) as a method to understand the pathophysiology of voice disorders. This review article focuses on populations with voice disorders that have thus far been studied using AAF, including individuals with Parkinson's disease, cerebellar degeneration, hyperfunctional voice disorders, vocal fold paralysis, and laryngeal dystonia. Studies using AAF have found that individuals with Parkinson's disease, cerebellar degeneration, and laryngeal dystonia have hyperactive auditory feedback responses due to differing underlying causes. In persons with PD, the hyperactivity may be a compensatory mechanism for atypically weak feedforward motor control. In individuals with cerebellar degeneration and laryngeal dystonia, the reasons for hyperactivity remain unknown. Individuals with hyperfunctional voice disorders may have auditory-motor integration deficits, suggesting atypical updating of feedforward motor control. Conclusions These findings have the potential to provide critical insights to clinicians in selecting the most effective therapy techniques for individuals with voice disorders. Future collaboration between clinicians and researchers with the shared objective of improving AAF as an ecologically feasible and valid tool for clinical assessment may provide more personalized therapy targets for individuals with voice disorders.
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Affiliation(s)
- Hasini R. Weerathunge
- Department of Biomedical Engineering, Boston University, MA
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Nicole E. Tomassi
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- Graduate Program for Neuroscience, Boston University, MA
| | - Cara E. Stepp
- Department of Biomedical Engineering, Boston University, MA
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- Department of Otolaryngology—Head and Neck Surgery, Boston University School of Medicine, MA
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De Groote E, De Keyser K, Santens P, Talsma D, Bockstael A, Botteldooren D, De Letter M. Future Perspectives on the Relevance of Auditory Markers in Prodromal Parkinson's Disease. Front Neurol 2020; 11:689. [PMID: 32765404 PMCID: PMC7378374 DOI: 10.3389/fneur.2020.00689] [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: 12/14/2019] [Accepted: 06/09/2020] [Indexed: 11/13/2022] Open
Abstract
Research on auditory processing in Parkinson's disease (PD) has recently made substantial progress. At present, evidence has been found for altered auditory processing in the clinical stage of PD. The auditory alterations in PD have been demonstrated with low-cost and non-invasive assessments that are already used in routine clinical practice. Since auditory alterations have been reported early in disease progression, it would be highly relevant to investigate whether auditory markers could be provided in the prodromal stage of PD. In addition, auditory alterations in early stage PD might be modulated by dopaminergic medication. Therefore, the aim of this review is (1) to summarize the literature on auditory processing in PD with a specific focus on the early disease stages, (2) to give future perspectives on which audiological and electrophysiological measurements could be useful in the prodromal stage of PD and (3) to assess the effect of dopaminergic medication on potential auditory markers in the prodromal stage of PD.
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Affiliation(s)
- Evelien De Groote
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Kim De Keyser
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Durk Talsma
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Annelies Bockstael
- Department of Information Technology, INTEC, Acoustics Research Group, Ghent University, Ghent, Belgium
| | - Dick Botteldooren
- Department of Information Technology, INTEC, Acoustics Research Group, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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6
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Yang S, Wang F, Yang L, Xu F, Luo M, Chen X, Feng X, Zou X. The physical significance of acoustic parameters and its clinical significance of dysarthria in Parkinson's disease. Sci Rep 2020; 10:11776. [PMID: 32678256 PMCID: PMC7366911 DOI: 10.1038/s41598-020-68754-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/23/2020] [Indexed: 11/09/2022] Open
Abstract
Dysarthria is universal in Parkinson’s disease (PD) during disease progression; however, the quality of vocalization changes is often ignored. Furthermore, the role of changes in the acoustic parameters of phonation in PD patients remains unclear. We recruited 35 PD patients and 26 healthy controls to perform single, double, and multiple syllable tests. A logistic regression was performed to differentiate between protective and risk factors among the acoustic parameters. The results indicated that the mean f0, max f0, min f0, jitter, duration of speech and median intensity of speaking for the PD patients were significantly different from those of the healthy controls. These results reveal some promising indicators of dysarthric symptoms consisting of acoustic parameters, and they strengthen our understanding about the significance of changes in phonation by PD patients, which may accelerate the discovery of novel PD biomarkers.
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Affiliation(s)
- Shu Yang
- College of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.,Department of Public Health, Chengdu Medical College, Chengdu, 610500, Sichuan, China
| | - Fengbo Wang
- Department of Rehabilitation, First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, Sichuan, China
| | - Liqiong Yang
- Department of Pharmacy, Chengdu Medical College, Chengdu, 610500, Sichuan, China
| | - Fan Xu
- Department of Public Health, Chengdu Medical College, Chengdu, 610500, Sichuan, China
| | - Man Luo
- Department of Neurology, First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, Sichuan, China
| | - Xiaqing Chen
- Department of Neurology, First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, Sichuan, China
| | - Xixi Feng
- Department of Public Health, Chengdu Medical College, Chengdu, 610500, Sichuan, China.
| | - Xianwei Zou
- Department of Neurology, First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, Sichuan, China.
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Jafari Z, Kolb BE, Mohajerani MH. Auditory Dysfunction in Parkinson's Disease. Mov Disord 2020; 35:537-550. [PMID: 32052894 DOI: 10.1002/mds.28000] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 12/11/2022] Open
Abstract
PD is a progressive and complex neurological disorder with heterogeneous symptomatology. PD is characterized by classical motor features of parkinsonism and nonmotor symptoms and involves extensive regions of the nervous system, various neurotransmitters, and protein aggregates. Extensive evidence supports auditory dysfunction as an additional nonmotor feature of PD. Studies indicate a broad range of auditory impairments in PD, from the peripheral hearing system to the auditory brainstem and cortical areas. For instance, research demonstrates a higher occurrence of hearing loss in early-onset PD and evidence of abnormal auditory evoked potentials, event-related potentials, and habituation to novel stimuli. Electrophysiological data, such as auditory P3a, also is suggested as a sensitive measure of illness duration and severity. Improvement in auditory responses following dopaminergic therapies also indicates the presence of similar neurotransmitters (i.e., glutamate and dopamine) in the auditory system and basal ganglia. Nonetheless, hearing impairments in PD have received little attention in clinical practice so far. This review summarizes evidence of peripheral and central auditory impairments in PD and provides conclusions and directions for future empirical and clinical research. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Zahra Jafari
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada.,Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Science (IUMS), Tehran, Iran
| | - Bryan E Kolb
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| | - Majid H Mohajerani
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
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Mollaei F, Shiller DM, Baum SR, Gracco VL. The Relationship Between Speech Perceptual Discrimination and Speech Production in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4256-4268. [PMID: 31738857 DOI: 10.1044/2019_jslhr-s-18-0425] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Purpose We recently demonstrated that individuals with Parkinson's disease (PD) respond differentially to specific altered auditory feedback parameters during speech production. Participants with PD respond more robustly to pitch and less robustly to formant manipulations compared to control participants. In this study, we investigated whether differences in perceptual processing may in part underlie these compensatory differences in speech production. Methods Pitch and formant feedback manipulations were presented under 2 conditions: production and listening. In the production condition, 15 participants with PD and 15 age- and gender-matched healthy control participants judged whether their own speech output was manipulated in real time. During the listening task, participants judged whether paired tokens of their previously recorded speech samples were the same or different. Results Under listening, 1st formant manipulation discrimination was significantly reduced for the PD group compared to the control group. There was a trend toward better discrimination of pitch in the PD group, but the group difference was not significant. Under the production condition, the ability of participants with PD to identify pitch manipulations was greater than that of the controls. Conclusion The findings suggest perceptual processing differences associated with acoustic parameters of fundamental frequency and 1st formant perturbations in PD. These findings extend our previous results, indicating that different patterns of compensation to pitch and 1st formant shifts may reflect a combination of sensory and motor mechanisms that are differentially influenced by basal ganglia dysfunction.
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Affiliation(s)
- Fatemeh Mollaei
- Centre for Research on Brain, Language and Music, Montréal, Quebec, Canada
- School of Communication Sciences and Disorders, McGill University, Montréal, Quebec, Canada
| | - Douglas M Shiller
- Centre for Research on Brain, Language and Music, Montréal, Quebec, Canada
- École d'orthophonie et d'audiologie, Université de Montréal, Quebec, Canada
| | - Shari R Baum
- Centre for Research on Brain, Language and Music, Montréal, Quebec, Canada
- School of Communication Sciences and Disorders, McGill University, Montréal, Quebec, Canada
| | - Vincent L Gracco
- Centre for Research on Brain, Language and Music, Montréal, Quebec, Canada
- School of Communication Sciences and Disorders, McGill University, Montréal, Quebec, Canada
- Haskins Laboratories, New Haven, CT
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De Keyser K, De Letter M, De Groote E, Santens P, Talsma D, Botteldooren D, Bockstael A. Systematic Audiological Assessment of Auditory Functioning in Patients With Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4564-4577. [PMID: 31770043 DOI: 10.1044/2019_jslhr-h-19-0097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Alterations in primary auditory functioning have been reported in patients with Parkinson's disease (PD). Despite the current findings, the pathophysiological mechanisms underlying these alterations remain unclear, and the effect of dopaminergic medication on auditory functioning in PD has been explored insufficiently. Therefore, this study aimed to systematically investigate primary auditory functioning in patients with PD by using both subjective and objective audiological measurements. Method In this case-control study, 25 patients with PD and 25 age-, gender-, and education-matched healthy controls underwent an audiological test battery consisting of tonal audiometry, short increment sensitivity index, otoacoustic emissions (OAEs), and speech audiometry. Patients with PD were tested in the on- and off-medication states. Results Increased OAE amplitudes were found when patients with PD were tested without dopaminergic medication. In addition, speech audiometry in silence and multitalker babble noise demonstrated higher phoneme scores for patients with PD in the off-medication condition. The results showed no differences in auditory functioning between patients with PD in the on-medication condition and healthy controls. No effect of disease stage or motor score was evident. Conclusions This study provides evidence for a top-down involvement in auditory processing in PD at both central and peripheral levels. Most important, the increase in OAE amplitude in the off-medication condition in PD is hypothesized to be linked to a dysfunction of the olivocochlear efferent system, which is known to have an inhibitory effect on outer hair cell functioning. Future studies may clarify whether OAEs may facilitate an early diagnosis of PD.
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Affiliation(s)
- Kim De Keyser
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | | | - Durk Talsma
- Department of Experimental Psychology, Ghent University, Belgium
| | - Dick Botteldooren
- Department of Information Technology (INTEC)-Acoustics Research Group, Ghent University, Belgium
| | - Annelies Bockstael
- Ecole d'Orthophonie et d'Audiologie, Université de Montréal, Quebec, Canada
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Richardson KC, Sussman JE. Intensity Resolution in Individuals With Parkinson's Disease: Sensory and Auditory Memory Limitations. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3564-3581. [PMID: 31513750 DOI: 10.1044/2019_jslhr-h-18-0424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The purpose of the current study was to examine sensory and auditory memory limitations on intensity resolution in individuals with Parkinson's disease as compared to healthy older and younger adults. Method Nineteen individuals with Parkinson's disease, 10 healthy age- and hearing-matched adults, and 10 healthy young adults were studied. The listeners participated in 2 intensity discrimination tasks: a lower memory load 4IAX task (sensory limitations) and a higher memory load ABX task (auditory memory limitations). Intensity resolution was examined across groups and tasks using a bias-free measurement of signal detectability known as d' (d-prime). Listeners also participated in a loudness scaling task where they were instructed to rate the loudness level of each signal intensity along the experimental continuum using a computerized 150-mm visual analog scale. Results Intensity discrimination sensitivity (d') was significantly poorer in the 4IAX and ABX conditions for the individuals with Parkinson's disease, as compared to the older and younger controls. Furthermore, a significant age-related difference was identified for the loudness scaling condition. The younger controls rated most stimuli along the experimental continuum significantly louder as compared to the older controls and the individuals with Parkinson's disease. Conclusions The present discrimination data suggest sensory and auditory memory limitations may contribute to the intensity resolution issues associated with Parkinson's disease. Age-related differences in loudness scaling will be reviewed.
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Affiliation(s)
- Kelly C Richardson
- Department of Communication Disorders, University of Massachusetts Amherst
| | - Joan E Sussman
- Department of Communicative Disorders & Sciences, University at Buffalo, NY
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