Intensity Resolution in Individuals With Parkinson's Disease: Sensory and Auditory Memory Limitations

Sensory-Behavioral Deficits in Parkinson's Disease: Insights from a 6-OHDA Mouse Model

Parkinson's disease (PD) is characterized by the degeneration of dopaminergic neurons in the striatum, predominantly associated with motor symptoms. However, non-motor deficits, particularly sensory symptoms, often precede motor manifestations, offering a potential early diagnostic window. The impact of non-motor deficits on sensation behavior and the underlying mechanisms remains poorly understood. In this study, we examined changes in tactile sensation within a Parkinsonian state by employing a mouse model of PD induced by 6-hydroxydopamine (6-OHDA) to deplete striatal dopamine (DA). Leveraging the conserved mouse whisker system as a model for tactile-sensory stimulation, we conducted psychophysical experiments to assess sensory-driven behavioral performance during a tactile detection task in both the healthy and Parkinson-like states. Our findings reveal that DA depletion induces pronounced alterations in tactile sensation behavior, extending beyond expected motor impairments. We observed diverse behavioral deficits, spanning detection performance, task engagement, and reward accumulation, among lesioned individuals. While subjects with extreme DA depletion consistently showed severe sensory behavioral deficits, others with substantial DA depletion displayed minimal changes in sensory behavior performance. Moreover, some exhibited moderate degradation of behavioral performance, likely stemming from sensory signaling loss rather than motor impairment. The implementation of a sensory detection task is a promising approach to quantify the extent of impairments associated with DA depletion in the animal model. This facilitates the exploration of early non-motor deficits in PD, emphasizing the importance of incorporating sensory assessments in understanding the diverse spectrum of PD symptoms.

Respiratory Responses to Two Voice Interventions for Parkinson's Disease

PURPOSE

The purpose of this study was to examine the respiratory strategies used by persons with Parkinson's disease (PD) to support louder speech in response to two voice interventions. Contrasting interventions were selected to investigate the role of internal and external cue strategies on treatment outcomes. LSVT LOUD, which uses an internal cueing framework, and the SpeechVive prosthesis, which employs an external noise cue to elicit louder speech, were studied.

METHOD

Thirty-four persons with hypophonia secondary to idiopathic PD were assigned to one of three groups: LSVT LOUD (n = 12), SpeechVive (n = 12), or a nontreatment clinical control (n = 10). The LSVT LOUD and SpeechVive participants received 8 weeks of voice intervention. Acoustic and respiratory kinematic data were simultaneously collected at pre-, mid- and posttreatment during a monologue speech sample. Intervention outcomes included sound pressure level (SPL), utterance length, lung volume initiation, lung volume termination, and lung volume excursion.

RESULTS

As compared to controls, the LSVT LOUD and SpeechVive participants significantly increased SPL at mid- and posttreatment, thus confirming a positive intervention effect. Treatment-related changes in speech breathing were further identified, including significantly longer utterance lengths (syllables per breath group) at mid- and posttreatment, as compared to pretreatment. The respiratory strategies used to support louder speech varied by group. The LSVT LOUD participants terminated lung volume at significantly lower levels at mid- and posttreatment, as compared to pretreatment. This finding suggests the use of greater expiratory muscle effort by the LSVT LOUD participants to support louder speech. Participants in the SpeechVive group did not significantly alter their respiratory strategies across the intervention period. Single-subject effect sizes highlight the variability in respiratory strategies used across speakers to support louder speech.

CONCLUSIONS

This study provides emerging evidence to suggest that the LSVT LOUD and SpeechVive therapies elicit different respiratory adjustments in persons with PD. The study highlights the need to consider respiratory function when addressing voice targets in persons with PD.

Impaired perceptual phonetic plasticity in Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative condition primarily associated with its motor consequences. Although much of the focus within the speech domain has focused on PD's consequences for production, people with PD have been shown to differ in the perception of emotional prosody, loudness, and speech rate from age-matched controls. The current study targeted the effect of PD on perceptual phonetic plasticity, defined as the ability to learn and adjust to novel phonetic input, both in second language and native language contexts. People with PD were compared to age-matched controls (and, for three of the studies, a younger control population) in tasks of explicit non-native speech learning and adaptation to variation in native speech (compressed rate, accent, and the use of timing information within a sentence to parse ambiguities). The participants with PD showed significantly worse performance on the task of compressed rate and used the duration of an ambiguous fricative to segment speech to a lesser degree than age-matched controls, indicating impaired speech perceptual abilities. Exploratory comparisons also showed people with PD who were on medication performed significantly worse than their peers off medication on those two tasks and the task of explicit non-native learning.

Evaluation of multi-feature auditory deviance detection in Parkinson's disease: a mismatch negativity study

Behavioral studies on auditory deviance detection in patients with Parkinson's disease (PD) have reported contradictory results. The primary aim of this study was to investigate auditory deviance detection of multiple auditory features in patients with PD by means of objective and reliable electroencephalographic (EEG) measurements. Twelve patients with early-stage PD and twelve age- and gender-matched healthy controls (HCs) were included in this study. Patients with PD participated without their regular dopaminergic medication. All subjects underwent an audiometric screening and performed a passive multi-feature mismatch negativity (MMN) paradigm. Repeated-measures analysis of variance (ANOVA) demonstrated no significant differences between patients with PD and HCs regarding MMN mean amplitude and latency for frequency, duration and gap deviants. Nevertheless, a trend towards increased MMN mean amplitude and latency was found in response to intensity deviants in patients with PD compared to HCs. Increased intensity MMN amplitude may indicate that more neural resources are allocated to the processing of intensity deviances in patients with PD compared to HCs. The interpretation of this intensity-specific MMN alteration is further discussed in the context of a compensatory mechanism for auditory intensity processing and involuntary attention switching in PD.

The Effect of Parkinson's Disease on Otoacoustic Emissions and Efferent Suppression of Transient Evoked Otoacoustic Emissions

Purpose Several studies have demonstrated increased auditory thresholds in patients with Parkinson's disease (PD) based on subjective tonal audiometry. However, the pathophysiological mechanisms underlying auditory dysfunction in PD remain elusive. The primary aim of this study was to investigate cochlear and olivocochlear function in PD using objective measurements and to assess the effect of dopaminergic medication on auditory function. Method Eighteen patients with PD and 18 gender- and age-matched healthy controls (HCs) were included. Patients with PD participated in medication on and off conditions. Linear mixed models were used to determine the effect of PD on tonal audiometry, transient evoked and distortion product otoacoustic emissions (OAEs), and efferent suppression (ES). Results Tonal audiometry revealed normal auditory thresholds in patients with PD for their age across all frequencies. OAE signal amplitudes demonstrated a significant interaction effect between group (PD vs. HC) and frequency, indicating decreased OAEs at low frequencies and increased OAEs at high frequencies in patients with PD. No significant differences were found between patients with PD and HCs regarding ES. In addition, no significant effect of medication status was found on auditory measurements in patients with PD. Conclusions Altered OAEs support the hypothesis of cochlear alterations in PD. No evidence was found for the involvement of the medial olivocochlear system. Altogether, OAEs may provide an objective early indicator of auditory alterations in PD and should complement subjective tonal audiometry when assessing and monitoring auditory function in PD.

Acuity to Changes in Self-Generated Vocal Pitch in Parkinson's Disease

Purpose Given the role of auditory perception in voice production, studies have investigated whether impairments in auditory perception may underlie the noted disruptions in speech in Parkinson's disease (PD). Studies of loudness perception in PD show impairments in the perception of self-generated speech, but not external tones. Studies of pitch perception in PD have only examined external tones, but these studies differed in terms of the interstimulus intervals (ISIs) that were used, did not examine the impact of cognition, and report conflicting results. To clarify pitch perception in PD, this work investigated perception of self-generated vocal pitch, controlling for cognition and ISI. Method A total of 30 individuals with and without PD completed (a) hearing threshold testing, (b) the Montreal Cognitive Assessment, and (c) an adaptive just-noticeable-difference paradigm under two separate ISIs (100 ms and 1,000 ms) to assess acuity to self-generated vocal pitch. Results There was no significant difference in acuity between individuals with and without PD. Both groups demonstrated significantly worse acuity for longer compared to shorter ISIs. Montreal Cognitive Assessment scores were not a significant predictor of acuity. Conclusions The results suggest that acuity to self-generated vocal pitch does not differ between individuals with and without PD.