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Lechien JR, Gorton A, Robertson J, Vaira LA. Is ChatGPT-4 Accurate in Proofread a Manuscript in Otolaryngology-Head and Neck Surgery? Otolaryngol Head Neck Surg 2024; 170:1527-1530. [PMID: 37717252 DOI: 10.1002/ohn.526] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/01/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023]
Abstract
ChatGPT is a new artificial intelligence-powered language model of chatbot able to help otolaryngologists in clinical practice and research. We investigated the ability of ChatGPT-4 in the editing of a manuscript in otolaryngology. Four papers were written by a nonnative English otolaryngologist and edited by a professional editing service. ChatGPT-4 was used to detect and correct errors in manuscripts. From the 171 errors in the manuscripts, ChatGPT-4 detected 86 errors (50.3%) including vocabulary (N = 36), determiner (N = 27), preposition (N = 24), capitalization (N = 20), and number (N = 11). ChatGPT-4 proposed appropriate corrections for 72 (83.7%) errors, while some errors were poorly detected (eg, capitalization [5%] and vocabulary [44.4%] errors. ChatGPT-4 claimed to change something that was already there in 82 cases. ChatGPT demonstrated usefulness in identifying some types of errors but not all. Nonnative English researchers should be aware of the current limits of ChatGPT-4 in the proofreading of manuscripts.
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology-Head Neck Surgery, Division of Laryngology and Broncho-esophagology, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
- Polyclinique Elsan de Poitiers, Poitiers, France
| | - Amy Gorton
- Faculty of Translation and Interpretation (FTI-EII), University of Mons, Mons, Belgium
| | - Jean Robertson
- Faculty of Translation and Interpretation (FTI-EII), University of Mons, Mons, Belgium
| | - Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- PhD School of Biomedical Sciences, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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Lechien JR, Geneid A, Bohlender JE, Cantarella G, Avellaneda JC, Desuter G, Sjogren EV, Finck C, Hans S, Hess M, Oguz H, Remacle MJ, Schneider-Stickler B, Tedla M, Schindler A, Vilaseca I, Zabrodsky M, Dikkers FG, Crevier-Buchman L. Consensus for voice quality assessment in clinical practice: guidelines of the European Laryngological Society and Union of the European Phoniatricians. Eur Arch Otorhinolaryngol 2023; 280:5459-5473. [PMID: 37707614 DOI: 10.1007/s00405-023-08211-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION To update the European guidelines for the assessment of voice quality (VQ) in clinical practice. METHODS Nineteen laryngologists-phoniatricians of the European Laryngological Society (ELS) and the Union of the European Phoniatricians (UEP) participated to a modified Delphi process to propose statements about subjective and objective VQ assessments. Two anonymized voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 3/4. The statements with ≥ 3/4 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected. RESULTS Of the 90 initial statements, 51 were validated after two voting rounds. A multidimensional set of minimal VQ evaluations was proposed and included: baseline VQ anamnesis (e.g., allergy, medical and surgical history, medication, addiction, singing practice, job, and posture), videolaryngostroboscopy (mucosal wave symmetry, amplitude, morphology, and movements), patient-reported VQ assessment (30- or 10-voice handicap index), perception (Grade, Roughness, Breathiness, Asthenia, and Strain), aerodynamics (maximum phonation time), acoustics (Mean F0, Jitter, Shimmer, and noise-to-harmonic ratio), and clinical instruments associated with voice comorbidities (reflux symptom score, reflux sign assessment, eating-assessment tool-10, and dysphagia handicap index). For perception, aerodynamics and acoustics, experts provided guidelines for the methods of measurement. Some additional VQ evaluations are proposed for voice professionals or patients with some laryngeal diseases. CONCLUSION The ELS-UEP consensus for VQ assessment provides clinical statements for the baseline and pre- to post-treatment evaluations of VQ and to improve collaborative research by adopting common and validated VQ evaluation approach.
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France.
- Department of Otolaryngology-Head Neck Surgery, CHU Saint-Pierre, Brussels, Belgium.
- Department of Laryngology and Broncho-Esophagology, EpiCURA Hospital, Anatomy Department of University of Mons, Mons, Belgium.
- Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France.
| | - Ahmed Geneid
- Department of Otolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jörg E Bohlender
- Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Giovanna Cantarella
- Department of Otolaryngology and Head and Neck Surgery Fondazione, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health Università degli Studi di Milano, Milan, Italy
| | - Juan C Avellaneda
- Department of Surgery, Otolaryngology Service. Hospital Universitario Mayor Mederi, Universidad del Rosario, Bogotá, Colombia
| | - Gauthier Desuter
- ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Elisabeth V Sjogren
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Camille Finck
- Department of Otorhinolaryngology-Head and Neck Surgery, CHU de Liege, Université de Liège, Liège, Belgium
| | - Stephane Hans
- Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France
- Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France
| | - Markus Hess
- Medical Voice Center (MEVOC), Hamburg, Germany
| | - Haldun Oguz
- Department of Otolaryngology, Fonomer, Ankara, Turkey
| | - Marc J Remacle
- Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France
- Department of Otorhinolaryngology-Head and Neck Surgery, Center Hospitalier de Luxembourg, Eich, Luxembourg
| | | | - Miroslav Tedla
- Department of Otolaryngology, Head and Neck Surgery, Comenius University, University Hospital, Bratislava, Slovakia
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Isabel Vilaseca
- Department of Otorhinolaryngology, Hospital Clínic, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Michal Zabrodsky
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Frederik G Dikkers
- Department of Otorhinolaryngology-Head and Neck Surgery, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lise Crevier-Buchman
- Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France
- Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France
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Cavallieri F, Di Rauso G, Gessani A, Budriesi C, Fioravanti V, Contardi S, Menozzi E, Pinto S, Moro E, Antonelli F, Valzania F. A study on the correlations between acoustic speech variables and bradykinesia in advanced Parkinson's disease. Front Neurol 2023; 14:1213772. [PMID: 37533469 PMCID: PMC10393249 DOI: 10.3389/fneur.2023.1213772] [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: 04/28/2023] [Accepted: 06/15/2023] [Indexed: 08/04/2023] Open
Abstract
Background Very few studies have assessed the presence of a possible correlation between speech variables and limb bradykinesia in patients with Parkinson's disease (PD). The objective of this study was to find correlations between different speech variables and upper extremity bradykinesia under different medication conditions in advanced PD patients. Methods Retrospective data were collected from a cohort of advanced PD patients before and after an acute levodopa challenge. Each patient was assessed with a perceptual-acoustic analysis of speech, which included several quantitative parameters [i.e., maximum phonation time (MPT) and intensity (dB)]; the Unified Parkinson's Disease Rating Scale (UPDRS) (total scores, subscores, and items); and a timed test (a tapping test for 20 s) to quantify upper extremity bradykinesia. Pearson's correlation coefficient was applied to find correlations between the different speech variables and the tapping rate. Results A total of 53 PD patients [men: 34; disease duration: 10.66 (SD 4.37) years; age at PD onset: 49.81 years (SD 6.12)] were included. Levodopa intake increased the MPT of sustained phonation (p < 0.01), but it reduced the speech rate (p = 0.05). In the defined-OFF condition, MPT of sustained phonation positively correlated with both bilateral mean (p = 0.044, r-value:0.299) and left (p = 0.033, r-value:0.314) tapping. In the defined-ON condition, the MPT correlated positively with bilateral mean tapping (p = 0.003), left tapping (p = 0.003), and right tapping (p = 0.008). Conclusion This study confirms the presence of correlations between speech acoustic variables and upper extremity bradykinesia in advanced PD patients. These findings suggest common pathophysiological mechanisms.
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Affiliation(s)
- Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giulia Di Rauso
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Neurology, Neuroscience Head Neck Department, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Annalisa Gessani
- Neurology, Neuroscience Head Neck Department, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Carla Budriesi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Neurology, Neuroscience Head Neck Department, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Valentina Fioravanti
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sara Contardi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Bologna, Italy
| | - Elisa Menozzi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Serge Pinto
- Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France
| | - Elena Moro
- Grenoble Alpes University, Division of Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble Institute of Neuroscience, Grenoble, France
| | - Francesca Antonelli
- Neurology, Neuroscience Head Neck Department, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Franco Valzania
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Baudouin R, Lechien JR, Carpentier L, Gurruchaga JM, Lisan Q, Hans S. Deep Brain Stimulation Impact on Voice and Speech Quality in Parkinson's Disease: A Systematic Review. Otolaryngol Head Neck Surg 2023; 168:307-318. [PMID: 36040825 DOI: 10.1177/01945998221120189] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Deep brain stimulation (DBS) has considerable efficacy for the motor dysfunction of idiopathic Parkinson's disease (PD) on patient quality of life. However, the benefit of DBS on voice and speech quality remains controversial. We carried out a systematic review to understand the influence of DBS on parkinsonian dysphonia and dysarthria. DATA SOURCES A PubMed/MEDLINE and Cochrane systematic review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Population, Intervention, Comparison, Outcome, Timing, and Setting (PICOTS) statements. REVIEW METHODS Three investigators screened studies published in the literature from inception to May 2022. The following data were retrieved: age, demographic, sex, disease duration, DBS duration, DBS location, speech, and voice quality measurements. RESULTS From the 180 studies identified, 44 publications met the inclusion criteria, accounting for 866 patients. Twenty-nine studies focused on voice/speech quality in subthalamic DBS patients, and 6 included patients with stimulation of pallidal, thalamic, and zona incerta regions. Most studies (4/6) reported a deterioration of the vocal parameters on subjective voice quality evaluation. For speech, the findings were more contrasted. There was an important heterogeneity between studies regarding the voice and speech quality outcomes used to evaluate the impact of DBS on voice/speech quality. CONCLUSION The impact of DBS on voice and speech quality significantly varies between studies. The stimulated anatomical region may have a significant role since the stimulation of the pallidal area was mainly associated with voice quality improvement, in contrast with other regions. Future controlled studies comparing all region stimulation are needed to get reliable findings. LEVEL OF EVIDENCE Level III: evidence from evidence summaries developed from systematic reviews.
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Affiliation(s)
- Robin Baudouin
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
| | - Jérôme R Lechien
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
- Department of Otolaryngology, Elsan Hospital, Paris, France
- Department of Otolaryngology-Head Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Brussels, Belgium
| | | | - Jean-Marc Gurruchaga
- Department of Neurosurgery, Henri Mondor Hospital, Université Paris-Est Créteil, Créteil, France
| | - Quentin Lisan
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
| | - Stéphane Hans
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
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Šimek M, Rusz J. Validation of cepstral peak prominence in assessing early voice changes of Parkinson's disease: Effect of speaking task and ambient noise. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:4522. [PMID: 34972306 DOI: 10.1121/10.0009063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
Although the cepstral peak prominence (CPP) and its variant, the cepstral peak prominence smooth (CPPS), are considered to be robust acoustic measures for the evaluation of dysphonia, whether they are sensitive to capture early voice changes in Parkinson's disease (PD) has not yet been explored. This study aimed to investigate the voice changes via the CPP measures in the idiopathic rapid eye movement sleep behavior disorder (iRBD), a special case of prodromal neurodegeneration, and recently diagnosed and advanced-stage Parkinson's disease (AS-PD) patients using different speaking tasks across noise-free and noisy environments. The sustained vowel phonation, reading of passages, and monologues of 60 early stage untreated PD, 30 advanced-stage Parkinson's disease, 60 iRBD, and 60 healthy control (HC) participants were evaluated. Significant differences were found between the PD groups and controls in sustained phonation via the CPP (p < 0.05) and CPPS (p < 0.01) and the monologue via the CPP (p < 0.01), although neither the CPP nor CPPS measures were sufficiently sensitive to capture the possible prodromal dysphonia in the iRBD. The quality of the CPP and CPPS measures was influenced substantially by the addition of ambient noise. It was anticipated that the CPP measures might serve as a promising digital biomarker in assessing the dysphonia from the early stages of PD.
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Affiliation(s)
- Michal Šimek
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
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Rusz J, Tykalova T, Novotny M, Zogala D, Sonka K, Ruzicka E, Dusek P. Defining Speech Subtypes in De Novo Parkinson Disease: Response to Long-term Levodopa Therapy. Neurology 2021; 97:e2124-e2135. [PMID: 34607922 DOI: 10.1212/wnl.0000000000012878] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/20/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Patterns of speech disorder in Parkinson disease (PD), which are highly variable across individual patients, have not been systematically studied. Our aim was to identify speech subtypes in treatment-naive patients with PD and to examine their response to long-term dopaminergic therapy. METHODS We recorded speech data from a total of 111 participants with de novo PD; 83 of the participants completed the 12-month follow-up (69 patients with PD on stable dopaminergic medication and 14 untreated controls with PD). Unsupervised k-means cluster analysis was performed on 8 distinctive parameters of hypokinetic dysarthria examined with quantitative acoustic analysis. RESULTS Three distinct speech subtypes with similar prevalence, symptom duration, and motor severity were detected: prosodic, phonatory-prosodic, and articulatory-prosodic. Besides monopitch and monoloudness, which were common in each subtype, speech impairment was more severe in the phonatory-prosodic subtype with predominant dysphonia and the articulatory-prosodic subtype with predominant imprecise consonant articulation than in the prosodic subtype. Clinically, the prosodic subtype was characterized by a prevalence of women and younger age, while articulatory-prosodic subtype was characterized by the prevalence of men, older age, greater severity of axial gait symptoms, and poorer cognitive performance. The phonatory-prosodic subtype clinically represented intermediate status in age with mostly men and preserved cognitive performance. While speech of untreated controls with PD deteriorated over 1 year (p = 0.02), long-term dopaminergic medication maintained stable speech impairment severity in the prosodic and articulatory-prosodic subtypes and improved speech performance in patients with the phonatory-prosodic subtype (p = 0.002). DISCUSSION Distinct speech phenotypes in de novo PD reflect divergent underlying mechanisms and allow prediction of response of speech impairment to levodopa therapy. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that, in patients with newly diagnosed PD with speech impairment, speech phenotype is associated with levodopa responsiveness.
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Affiliation(s)
- Jan Rusz
- From the Department of Circuit Theory (J.R., T.T., M.N.), Faculty of Electrical Engineering, Czech Technical University in Prague; Department of Neurology and Centre of Clinical Neuroscience (J.R., K.S., E.R., P.D.), First Faculty of Medicine, Charles University; and Institute of Nuclear Medicine (D.Z.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
| | - Tereza Tykalova
- From the Department of Circuit Theory (J.R., T.T., M.N.), Faculty of Electrical Engineering, Czech Technical University in Prague; Department of Neurology and Centre of Clinical Neuroscience (J.R., K.S., E.R., P.D.), First Faculty of Medicine, Charles University; and Institute of Nuclear Medicine (D.Z.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Michal Novotny
- From the Department of Circuit Theory (J.R., T.T., M.N.), Faculty of Electrical Engineering, Czech Technical University in Prague; Department of Neurology and Centre of Clinical Neuroscience (J.R., K.S., E.R., P.D.), First Faculty of Medicine, Charles University; and Institute of Nuclear Medicine (D.Z.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - David Zogala
- From the Department of Circuit Theory (J.R., T.T., M.N.), Faculty of Electrical Engineering, Czech Technical University in Prague; Department of Neurology and Centre of Clinical Neuroscience (J.R., K.S., E.R., P.D.), First Faculty of Medicine, Charles University; and Institute of Nuclear Medicine (D.Z.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Karel Sonka
- From the Department of Circuit Theory (J.R., T.T., M.N.), Faculty of Electrical Engineering, Czech Technical University in Prague; Department of Neurology and Centre of Clinical Neuroscience (J.R., K.S., E.R., P.D.), First Faculty of Medicine, Charles University; and Institute of Nuclear Medicine (D.Z.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Evzen Ruzicka
- From the Department of Circuit Theory (J.R., T.T., M.N.), Faculty of Electrical Engineering, Czech Technical University in Prague; Department of Neurology and Centre of Clinical Neuroscience (J.R., K.S., E.R., P.D.), First Faculty of Medicine, Charles University; and Institute of Nuclear Medicine (D.Z.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Petr Dusek
- From the Department of Circuit Theory (J.R., T.T., M.N.), Faculty of Electrical Engineering, Czech Technical University in Prague; Department of Neurology and Centre of Clinical Neuroscience (J.R., K.S., E.R., P.D.), First Faculty of Medicine, Charles University; and Institute of Nuclear Medicine (D.Z.), First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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Objective vowel sound characteristics and their relationship with motor dysfunction in Asian Parkinson's disease patients. J Neurol Sci 2021; 426:117487. [PMID: 34004464 DOI: 10.1016/j.jns.2021.117487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Speech impairments are very common in patients with Parkinson's disease (PD). However, knowledge of their objective characteristics and relationship to other motor symptoms amongst Asian PD patients is limited. OBJECTIVES To identify objective vowel sound characteristics in Thai PD patients and correlate with disease severity, as determined by UPDRS and various sub-scores. METHOD We evaluated 100 Thai PD patients, with a mean age of 66.56 years (±7.52) and HY of 2.7 (±1.08), and 101 age-matched controls. Phonatory evaluation, comprising of 15 objective parameters, was conducted using the Multi-Dimensional Voice Programme with a sustained /a/ phonation. RESULTS PD patients exhibited significantly higher values of all dimensions of the phonatory parameters evaluated compared to controls (All, p < 0.001) except for duration of sustained phonation, which was significantly shorter in PD patients. When early- and advanced-stage patients were compared, significantly different parameters were limited to frequency perturbation parameters (Jitt, p = 0.01; RAP, p = 0.013; PPQ, p = 0.01; sPPQ, p = 0.001; vF0, p = 0.011), and NHR (p = 0.028). Several significant and moderate correlations were observed between both STD and frequency perturbation parameters and UPDRS-III, bradykinesia sub-score, and gait and postural instability sub-score. Both vF0, and STD significantly correlated with UPDRS-III and sub-scores in advanced stage patients. CONCLUSION Our study provides objective evidence of phonatory dysfunction in Asian PD patients with certain characteristics correlated with advanced stage or different motor dysfunction. Sustained vowel phonation is a promising digital outcome for global phenotyping a large number of PD patients.
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Are the Acoustic Measurements Reliable in the Assessment of Voice Quality? A Methodological Prospective Study. J Voice 2021; 35:203-215. [DOI: 10.1016/j.jvoice.2019.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 11/22/2022]
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Cavallieri F, Budriesi C, Gessani A, Contardi S, Fioravanti V, Menozzi E, Pinto S, Moro E, Valzania F, Antonelli F. Dopaminergic Treatment Effects on Dysarthric Speech: Acoustic Analysis in a Cohort of Patients With Advanced Parkinson's Disease. Front Neurol 2021; 11:616062. [PMID: 33613419 PMCID: PMC7892955 DOI: 10.3389/fneur.2020.616062] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/29/2020] [Indexed: 01/10/2023] Open
Abstract
Importance: The effects of dopaminergic treatment on speech in patients with Parkinson's disease (PD) are often mixed and unclear. The aim of this study was to better elucidate those discrepancies. Methods: Full retrospective data from advanced PD patients before and after an acute levodopa challenge were collected. Acoustic analysis of spontaneous monologue and sustained phonation including several quantitative parameters [i.e., maximum phonation time (MPT); shimmer local dB] as well as the Unified Parkinson's Disease Rating Scale (UPDRS) (total scores, subscores, and items) and the Clinical Dyskinesia Rating Scale (CDRS) were performed in both the defined-OFF and -ON conditions. The primary outcome was the changes of speech parameters after levodopa intake. Secondary outcomes included the analysis of possible correlations of motor features and levodopa-induced dyskinesia (LID) with acoustic speech parameters. Statistical analysis included paired t-test between the ON and OFF data (calculated separately for male and female subgroups) and Pearson correlation between speech and motor data. Results: In 50 PD patients (male: 32; female: 18), levodopa significantly increased the MPT of sustained phonation in female patients (p < 0.01). In the OFF-state, the UPDRS part-III speech item negatively correlated with MPT (p = 0.02), whereas in the ON-state, it correlated positively with the shimmer local dB (p = 0.01), an expression of poorer voice quality. The total CDRS score and axial subscores strongly correlated with the ON-state shimmer local dB (p = 0.01 and p < 0.01, respectively). Conclusions: Our findings emphasize that levodopa has a poor effect on speech acoustic parameters. The intensity and location of LID negatively influenced speech quality.
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Affiliation(s)
- Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Carla Budriesi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Annalisa Gessani
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Sara Contardi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Valentina Fioravanti
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Menozzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Ospedaliero Universitaria di Modena, Modena, Italy
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Serge Pinto
- Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, Grenoble Institute of Neurosciences, Grenoble, France
| | - Franco Valzania
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Antonelli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Ospedaliero Universitaria di Modena, Modena, Italy
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10
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Bryans LA, Palmer AD, Anderson S, Schindler J, Graville DJ. The impact of Lee Silverman Voice Treatment (LSVT LOUD®) on voice, communication, and participation: Findings from a prospective, longitudinal study. JOURNAL OF COMMUNICATION DISORDERS 2021; 89:106031. [PMID: 33259945 DOI: 10.1016/j.jcomdis.2020.106031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Lee Silverman Voice Treatment (LSVT LOUD®), an intensive 4-week program of voice therapy, is regarded as the most well-researched, efficacious treatment for hypokinetic dysarthria in individuals with Parkinson's disease (PD). Although numerous studies have published acoustic and perceptual findings, there is comparatively little information about the impact of LSVT LOUD® on functional communication outcomes. METHODS This prospective, longitudinal study investigated the impact of treatment on daily communication in 25 individuals with PD. Three validated communication measures (the Voice Handicap Index, the Communicative Effectiveness Scale, and the Communicative Participation Item Bank) were given before and after treatment and again 4-8 weeks and 3-6 months following treatment. Communication partners were also asked to rate communication effectiveness at all four timepoints. RESULTS Significant improvements were found for all three self-reported scales which remained above baseline across all post-treatment timepoints. In addition, self-reported communicative effectiveness was significantly correlated with the assessments of communication partners. Particular benefits were reported for more complex communicative activities such as asking questions, giving detailed information, communicating in noisy situations, and speaking in groups. CONCLUSIONS Overall, the findings suggested that LSVT LOUD® promotes an increased sense of personal control over the communication difficulties resulting from PD by decreasing voice handicap and improving communication effectiveness and communicative participation. For individuals with PD, LSVT LOUD® may reduce the risk of social isolation by improving communication and facilitating social participation. LEARNING OUTCOMES As a result of this activity, the participant will be able to (1) describe the impact of PD on voice and communication, (2) discuss how these characteristics may be associated with more global measures of functional communication and particularly communicative participation, (3) explain which aspects of functional communication were affected by LSVT LOUD® as assessed by study participants and their communication partners.
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Affiliation(s)
- Linda A Bryans
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
| | - Andrew D Palmer
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
| | - Shannon Anderson
- Dept. of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA.
| | - Joshua Schindler
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
| | - Donna J Graville
- NW Center for Voice & Swallowing, Dept. of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Rd., Portland, OR, 97239, USA.
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11
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Saggio G, Costantini G. Worldwide Healthy Adult Voice Baseline Parameters: A Comprehensive Review. J Voice 2020; 36:637-649. [PMID: 33039203 DOI: 10.1016/j.jvoice.2020.08.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022]
Abstract
The voice results in acoustic signals analyzed and synthetized at first for telecommunication matters, and more recently investigated for medical purposes. In particular, voice signal characteristics can evidence individual health conditions useful for screening, diagnostic and remote monitoring aims. Within this frame, the knowledge of baseline features of healthy voice is mandatory, in order to balance a comparison with their unhealthy counterpart. However, the baseline features of the human voice depend on gender, age-range and ethnicity and, as far as we know, no work reports as those features spread worldwide. This paper intends to cover this lack. Our database research yielded 179 relevant published studies, retrieved using digital libraries of IEEE Xplore, Scopus, Web of Science, Iop Science, Taylor and Francis Online, and Scitepress. These relevant studies report different features, among which here we consider the most investigated ones, within the most investigated age-range. In particular, the features are the fundamental frequency, the jitter, the shimmer, the harmonic-to-noise ratio, and the cepstral peak prominence, the most investigated age-range is within 20-40 years and, related to the ethnicity, 20 countries are considered.
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Affiliation(s)
- Giovanni Saggio
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy.
| | - Giovanni Costantini
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy
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12
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Lechien JR, Delsaut B, Abderrakib A, Huet K, Delvaux V, Piccaluga M, Khalife M, Harmegnies B, Saussez S, Blecic S. Orofacial Strength and Voice Quality as Outcome of Levodopa Challenge Test in Parkinson Disease. Laryngoscope 2020; 130:E896-E903. [PMID: 32239775 DOI: 10.1002/lary.28645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/22/2020] [Accepted: 03/03/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the usefulness of orofacial strength and voice quality as assessment of response to levodopa challenge test (LCT) used in the diagnosis of early idiopathic Parkinson disease (IPD). STUDY DESIGN Controlled Prospective Study. METHODS From January 2014 to April 2019, patients with early IPD and healthy individuals were recruited and evaluated for clinical findings (Hoehn and Yahr scale; Unified Parkinson's Disease Rating Scale); Voice Handicap Index (VHI); grade of dysphonia, roughness, breathiness, asthenia, and strain and instability (GRBASI); maximal phonation time; phonation quotient; acoustic parameters; and orofacial muscle strength Oral Performance Instrument (IOPI; IOPI Medical, Woodinville, WA, USA) t) at baseline and 45 minutes after the levodopa intake (LCT). RESULTS A total of 32 IPD patients and 20 healthy individuals completed the study. Healthy individuals exhibited better VHI, grade of dysphonia, breathiness, asthenia, strain, instability, and acoustic measurements (noise-related, tremor, F0 short- and mid-term and intensity short-term parameters) than healthy subjects. The mean values of muscle strength of lips, cheeks, fundamental frequency (F0), highest F0, and shimmer significantly improved from pre- to post-LCT in IPD patients. Healthy individuals did not exhibit significant changes of orofacial strength and voice quality assessment from pre- to post-LCT. Significant associations were found between clinical, orofacial strength, and some aerodynamic and acoustic measurements. CONCLUSION Orofacial strength and acoustic voice quality measurements may be used as objective outcomes of the LCT responsiveness in patients with early IPD. LEVEL OF EVIDENCE 3A. Laryngoscope, 2020.
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Affiliation(s)
- Jérôme R Lechien
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
| | - Bertil Delsaut
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Neurology, EpiCURA Hospital, Baudour, Belgium
| | - Anissa Abderrakib
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Neurology, EpiCURA Hospital, Baudour, Belgium
| | - Kathy Huet
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Veronique Delvaux
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Myriam Piccaluga
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Mohamad Khalife
- Department of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
| | - Bernard Harmegnies
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Sven Saussez
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
| | - Serge Blecic
- Department of Neurology, EpiCURA Hospital, Baudour, Belgium
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13
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Abstract
The primary movement disorders affecting the voice are laryngeal dystonia (including spasmodic dysphonia), essential voice tremor, and Parkinson disease. Diagnosis of these conditions is clinical and based on a detailed history, voice evaluation, and physical and laryngoscopic examination. Laryngeal dystonia and essential voice tremor are hyperfunctional disorders and are treated most commonly with botulinum toxin injections. Parkinson disease is a hypofunctional disorder that may affect the voice and most commonly is treated with Lee Silverman Voice Treatment.
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14
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Lechien JR, Blecic S, Ghosez Y, Huet K, Harmegnies B, Saussez S. Voice Quality and Orofacial Strength as Outcome of Levodopa Effectiveness in Patients with Early Idiopathic Parkinson Disease: A Preliminary Report. J Voice 2018; 33:716-720. [PMID: 29724466 DOI: 10.1016/j.jvoice.2018.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Sixty to 90% of patients with idiopathic Parkinson disease (IPD) developed early dysphonia and subtle speech impairment, which is usually related to orofacial muscular dysfunctions. The aim of this preliminary study is to assess the usefulness of voice quality and orofacial strength (involved in speech) as outcome of levodopa challenge test used for the IPD diagnosis. MATERIAL AND METHODS A total of 20 patients with early IPD were recruited and evaluated for clinical findings (Hoehn and Yahr scale), voice handicap index, maximal phonation time, phonation quotient, percent jitter, percent shimmer, noise-to-harmonic ratio, and orofacial muscular strength (Iowa Oral Performance Instrument) at baseline, throughout the levodopa challenge test and after therapeutic stabilization. RESULTS The intake of a standardized dose of levodopa (levodopa challenge test) significantly improved phonation quotient and percent shimmer. We did not find similar improvement after medical stabilization of patients (based on levodopa medication) despite an improvement of Hoehn and Yahr mean score. The intake of levodopa significantly improved cheeks and lips strength involved in speech quality both along the challenge test and after the therapeutic stabilization. CONCLUSIONS These preliminary findings support a differential impact of levodopa on voice and speech functions in early diagnosed IPD and a mismatch between the clinical examination, orofacial strength, and voice quality improvements once the patient is medically stabilized.
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Affiliation(s)
- Jérôme R Lechien
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, RHMS Baudour, EpiCURA Hospital, Baudour, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium.
| | - Serge Blecic
- Department of Neurology, EpiCURA Hospital, Baudour, Belgium
| | - Yves Ghosez
- Department of Anesthesiology, EpiCURA Hospital, Baudour, Belgium
| | - Kathy Huet
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Bernard Harmegnies
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Sven Saussez
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, RHMS Baudour, EpiCURA Hospital, Baudour, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
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