Cinegraphic observations of laryngeal function in parkinson's disease

Hanson, David G.; Gerratt, Bruce R.; Ward, Paul H.

doi:10.1288/00005537-198403000-00011

Cited by 152 publications

(93 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The main symptoms of PD are tremor, rigidity and other general movement disorders. Of particular importance to this study, vocal impairment is also common [10,11], with studies reporting 70-90% prevalence after the onset of the disease [11][12][13]. In addition, it may be one of the earliest indicators of the disease [14,15], and 29% of patients consider it one of their greatest hindrances [13].…”

Section: Introductionmentioning

confidence: 99%

Accurate Telemonitoring of Parkinson's Disease Progression by Noninvasive Speech Tests

Tsanas

Little

McSharry

et al. 2010

IEEE Trans. Biomed. Eng.

512

271

View full text Add to dashboard Cite

Abstract-Tracking Parkinson's disease (PD) symptom progression often uses the Unified Parkinson's DiseaseRating Scale (UPDRS), which requires the patient's presence in clinic, and time-consuming physical examinations by trained medical staff. Thus, symptom monitoring is costly and logistically inconvenient for patient and clinical staff alike, also hindering recruitment for future large-scale clinical trials. Here, for the first time, we demonstrate rapid, remote replication of UPDRS assessment with clinically useful accuracy (about 7.5 UPDRS points difference from the clinicians' estimates), using only simple, self-administered, and non-invasive speech tests. We characterize speech with signal processing algorithms, extracting clinically useful features of average PD progression. Subsequently, we select the most parsimonious model with a robust feature selection algorithm, and statistically map the selected subset of features to UPDRS using linear and nonlinear regression techniques, which include classical least squares and nonparametric classification and regression trees (CART). We verify our findings on the largest database of PD speech in existence (~6,000 recordings from 42 PD patients, recruited to a six-month, multi-centre trial). These findings support the feasibility of frequent, remote and accurate UPDRS tracking. This technology could play a key part in telemonitoring frameworks that enable large-scale clinical trials into novel PD treatments.

show abstract

Section: Introductionmentioning

confidence: 99%

Accurate Telemonitoring of Parkinson's Disease Progression by Noninvasive Speech Tests

Tsanas

Little

McSharry

et al. 2010

IEEE Trans. Biomed. Eng.

512

271

View full text Add to dashboard Cite

show abstract

“…Behrman, Abramson, and Myssiorek (2001) found that 60% of individuals with a diagnosis of presbylarnygeal dysphonia (voice problems due to an aged larynx) presented with glottal gaps. Second, individuals with PD often present with increased glottal gap (Blumin, Pcolinsky, & Atkins, 2004; D. G. Hanson, , & Ward, 1984;Midi et al, 2008). The present findings show individuals with PD utilize glottal approximation at maximal closure to the same degree as their healthy peers when increasing intensity, but that the mechanisms for changing MinFlow with increasing SPL may differ in people with PD as compared to HOA.…”

Section: Discussionmentioning

confidence: 62%

Laryngeal Aerodynamics in Healthy Older Adults and Adults With Parkinson's Disease

Matheron

Stathopoulos

Huber

et al. 2017

J Speech Lang Hear Res

View full text Add to dashboard Cite

Purpose: The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity. Method: Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and individuals with PD who had a diagnosis of hypophonia. Increased vocal intensity was elicited via monaurally presented multitalker background noise. Results: At a comfortable speaking intensity, HOAs and individuals with PD produced comparable vocal intensity, rates of vocal fold closure, and minimum flow. HOAs used smaller OQs, higher subglottal pressure, and lower peak-topeak flow than individuals with PD. Both groups increased speaking intensity when speaking in noise to the same degree. However, HOAs produced increased intensity with greater driving pressure, faster vocal fold closure rates, and smaller OQs than individuals with PD. Conclusions: Monaural background noise elicited equivalent vocal intensity increases in HOAs and individuals with PD. Although both groups used laryngeal mechanisms as expected to increase sound pressure level, they used these mechanisms to different degrees. The HOAs appeared to have better control of the laryngeal mechanism to make changes to their vocal intensity. It is projected that more than 610,000 individuals will be affected by PD by 2030(Dorsey et al., 2007. Aging of the general population and increased prevalence of PD motivate the need to understand how age, disease state, and disease progression affect underlying speech subsystems. With the aging of the general population, and with an increased prevalence of individuals with PD, the first purpose of the current study was to investigate whether healthy older adults (HOAs) and individuals with PD perform similarly with respect to laryngeal function during speech. Further, as hypophonia (perceptually quiet voice) is a concern in individuals with PD, the second purpose of the current study was to assess whether HOAs and adults with PD and hypophonia were able to utilize the same laryngeal adjustments when increasing sound pressure level (SPL).Typically aging adults may experience qualitative voice changes as they age. One investigation of younger and older women reported that older women were no breathier than their younger peers (Gorham-Rowan & Laures-Gore, 2006). However, other studies described the voices of typically aging adults as having a breathy quality

show abstract

“…In producing breathy phonation, these speakers usually demonstrated a gap through the cartilaginous glottis, which may extend continuously through some or all of the membranous glottis (Holmberg et al, 1988;S€ odersten and Lindestad, 1990). However, speakers with voice disorders may have a gap that appears only in the membranous glottis, as occurs in presbylaryngis (the aged larynx) or in some patients with Parkinson disease who have breathy voices (Hanson et al, 1984). Because this glottal configuration was not included in our study, it is possible that AC/OQ may not measure these voices adequately.…”

Section: Discussionmentioning

confidence: 99%

Development of a glottal area index that integrates glottal gap size and open quotient

Chen

Kreiman

Gerratt

et al. 2013

The Journal of the Acoustical Society of America

Self Cite

View full text Add to dashboard Cite

Because voice signals result from vocal fold vibration, perceptually meaningful vibratory measures should quantify those aspects of vibration that correspond to differences in voice quality. In this study, glottal area waveforms were extracted from high-speed videoendoscopy of the vocal folds. Principal component analysis was applied to these waveforms to investigate the factors that vary with voice quality. Results showed that the first principal component derived from tokens without glottal gaps was significantly (p < 0.01) associated with the open quotient (OQ). The alternating-current (AC) measure had a significant effect (p < 0.01) on the first principal component among tokens exhibiting glottal gaps. A measure AC/OQ, defined as the ratio of AC to OQ, was proposed to combine both amplitude and temporal characteristics of the glottal area waveform for both complete and incomplete glottal closures. Analyses of "glide" phonations in which quality varied continuously from breathy to pressed showed that the AC/OQ measure was able to characterize the corresponding continuum of glottal area waveform variation, regardless of the presence or absence of glottal gaps.

show abstract

Cinegraphic observations of laryngeal function in parkinson's disease

Cited by 152 publications

References 5 publications

Accurate Telemonitoring of Parkinson's Disease Progression by Noninvasive Speech Tests

Accurate Telemonitoring of Parkinson's Disease Progression by Noninvasive Speech Tests

Laryngeal Aerodynamics in Healthy Older Adults and Adults With Parkinson's Disease

Development of a glottal area index that integrates glottal gap size and open quotient

Contact Info

Product

Resources

About