Parkinsonian Voice Acoustic Analysis in Real-Time after Stereotactic Thalamotomy

Biomarkers in Parkinson’s disease

Parkinson's disease (PD) is a common neurodegenerative disorder that is largely diagnosed and managed clinically. Biomarkers, as indicators of underlying biological processes, offer the potential to identify individuals at risk for PD, screen new therapies, assist in the diagnosis and help optimize management of PD. However, to date, biomarkers, despite their considerable promise, have had limited utility in clinical trials and practice.

Perception of Voice in the Transgender Client

Fundamental frequency (F(0)) of speech is used to measure the success of voice therapy in male-to-female transgender clients. This study evaluates the relationship between F(0) and patients' happiness with their voice. The study design used was a cross-sectional evaluation of client satisfaction questionnaires and voice recordings from transgender clients. This study was a comparative evaluation of voice recordings by voice professionals and lay observers. Twelve male-to-female transgender participants completed visual analogue scales (VASs), rating happiness with self-perceived femininity of their voice. Fifteen speech and language therapists (SLTs) and 40 naïve observers evaluated the anonymized recordings, using the same rating system. The correlation between mean F(0) and participant happiness was established. Relationships between participant happiness and rater opinions were explored. A significant relationship between F(0) and participant happiness could not be demonstrated (r=0.32, P=0.32). There was a moderately strong positive correlation between self-perception of vocal femininity and perception of femininity by SLTs and naïve observers (r=0.76 and 0.68, P=0.003 and P=0.01, respectively). This study demonstrates that happiness with voice in male-to-female transgender clients is not directly related to F(0). Clients can assess femininity of their voice in the form of perceived pitch. This may not affect happiness scores. Voice satisfaction may not correlate with perceptions of supervising voice professionals. However, professionals can reliably evaluate how the voice will be received by the lay public. Subjective measures of patient satisfaction, including VASs, are reliable and valid tools in evaluating therapeutic success.

Lombard's effect's implication in intensity, fundamental frequency and stability on the voice of individuals with Parkinson's disease

Parkinson's disease affects the central nervous system resulting in voice quality alterations. It is typically resistant to drug therapy and often persists despite extensive behavioural speech and language therapy. Previous findings show that masking noise will produce a consistent increase in voice intensity in most normal individuals (Lombard's effect).

AIM

we evaluated Lombard's effect's implication in intensity, fundamental frequency and stability on the voice of individuals with Parkinson's disease (N=17).

MATERIAL AND METHODS

through acoustic analysis, we evaluated intensity alterations and fundamental frequency, before and after white masking noise 40, 70 and 90 dBSL intensities, as well as variations during each vocalization and compared with a control group (N=16).

RESULTS

voice intensity varied according to masking intensity, tending to non-linear increases in both groups and gender. Fundamental frequency varied, tending to non-linear increase in both groups and gender. Improvement stability occurred in fundamental frequency and vocal intensity.

CONCLUSION

Lombard's effect increased intensity, fundamental frequency and improves voice stability on these patients.

STUDY

clinical and experimental.

Implicações do efeito Lombard sobre a intensidade, freqüência fundamental e estabilidade da voz de indivíduos com doença de Parkinson

A Doença de Parkinson afeta o sistema nervoso central resultando em alterações qualitativas da voz que pouco melhoram com o tratamento farmacológico e com a fonoterapia tradicional. Estudos mostram que o mascaramento auditivo leva ao aumento da intensidade da voz em indivíduos normais (Efeito Lombard). OBJETIVO: Avaliar implicações do efeito Lombard sobre a intensidade, freqüência fundamental e estabilidade da voz de indivíduos com doença de Parkinson (N=17). FORMA DE ESTUDO: Estudo clínico e experimental. Material e Métodos: Através de análise acústica, avaliamos as alterações de intensidade e freqüência fundamental, antes e depois da exposição a mascaramento auditivo "white noise", em 40, 70 e 90 dBNS, bem como as variações durante cada emissão e comparamos com um grupo controle (N=16). RESUTADOS: A intensidade de emissão vocal variou de acordo com a intensidade de mascaramento, tendendo a aumento não-linear, ocorrendo também nos grupos Parkinson e controle, não sendo influenciado pelo sexo. A freqüência fundamental da emissão vocal variou, tendendo a aumento não-linear, em ambos os grupos e sexos. Ocorreu melhora da estabilidade, tanto com relação à freqüência quanto à intensidade de emissão vocal. CONCLUSÃO: O Efeito Lombard elevou a intensidade e freqüência fundamental e melhorou a estabilidade da voz desses pacientes.