Neurobehavioral Effects of LSVT® LOUD on Auditory-Vocal Integration in Parkinson’s Disease: A Preliminary Study

Li, Yongxue; Tan, Mingdan; Fan, Hao; Wang, Emily Q; Chen, Ling; Li, Jingting; Chen, Xi; Liu, Hanjun

doi:10.3389/fnins.2021.624801

Cited by 13 publications

(20 citation statements)

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“…The approach generates greater somatosensory feedback from the articulatory and laryngeal systems compared to normal speech. One of the effects of the LSVT is smaller vocal pitch compensations following treatment suggesting a down regulation of the enhanced auditory response 44 . Hence, it is reasonable to suggest that by increasing loudness, the LSVT treatment may act to reset the balance between the feedback systems providing the conditions for more normal speech production and perception.…”

Section: Discussionmentioning

confidence: 99%

Early auditory responses to speech sounds in Parkinson’s disease: preliminary data

Mollaei

Shiller

Baum

et al. 2022

Sci Rep

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Parkinson’s disease (PD), as a manifestation of basal ganglia dysfunction, is associated with a number of speech deficits, including reduced voice modulation and vocal output. Interestingly, previous work has shown that participants with PD show an increased feedback-driven motor response to unexpected fundamental frequency perturbations during speech production, and a heightened ability to detect differences in vocal pitch relative to control participants. Here, we explored one possible contributor to these enhanced responses. We recorded the frequency-following auditory brainstem response (FFR) to repetitions of the speech syllable [da] in PD and control participants. Participants with PD displayed a larger amplitude FFR related to the fundamental frequency of speech stimuli relative to the control group. The current preliminary results suggest the dysfunction of the basal ganglia in PD contributes to the early stage of auditory processing and may reflect one component of a broader sensorimotor processing impairment associated with the disease.

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Section: Discussionmentioning

confidence: 99%

Early auditory responses to speech sounds in Parkinson’s disease: preliminary data

Mollaei

Shiller

Baum

et al. 2022

Sci Rep

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“…After LSVT LOUD, subjects showed compensatory responses to auditory feedback similar to the performance of healthy subjects. Additionally, significantly greater EEG cortical responses (P2) were observed in response to pitch perturbations after LSVT LOUD, reflecting the intervention's possible top-down modulatory effect on auditory-motor integration for voice regulation in the PD subjects [42].…”

Section: Evidence Of Auditory-vocal Impairment and Behavioral Voice Disordersmentioning

confidence: 95%

“…Some authors have already started exploring the impact of devices and other interventions to alter or improve auditory feedback on the voice. A recently published study addressed whether auditory feedback control of vocal pitch production in subjects with PD could benefit from Lee Silverman voice treatment (LSVT® LOUD) [42]. LSVT LOUD is an intensive voice treatment program that aims to increase voice intensity in people with hypokinetic dysarthria through a sensorimotor recalibration of increased vocal loudness [43,44].…”

Section: Evidence Of Auditory-vocal Impairment and Behavioral Voice Disordersmentioning

confidence: 99%

“…LSVT LOUD is an intensive voice treatment program that aims to increase voice intensity in people with hypokinetic dysarthria through a sensorimotor recalibration of increased vocal loudness [43,44]. Li's study demonstrated the positive effects of LSVT LOUD on auditory-vocal integration in people with PD [42]. After LSVT LOUD, subjects showed compensatory responses to auditory feedback similar to the performance of healthy subjects.…”

Section: Evidence Of Auditory-vocal Impairment and Behavioral Voice Disordersmentioning

confidence: 99%

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Auditory-vocal integration impairment: New challenges and opportunities for voice assessment and therapy

Castillo‐Allendes¹,

Contreras-Ruston²,

Searl³

2021

Rev. Investig. Innov. Cienc. Salud

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This reflection paper addresses the importance of the interaction between voice perception and voice production, emphasizing the processes of auditory-vocal integration that are not yet widely reported in the context of voice clinicians. Given the above, this article seeks to 1) highlight the important link between voice production and voice perception and 2) consider whether this relationship might be exploited clinically for diagnostic purposes and therapeutic benefit. Existing theories on speech production and its interaction with auditory perception provide context for discussing why the evaluation of auditory-vocal processes could help identify associated origins of dysphonia and inform the clinician around appropriate management strategies. Incorporating auditory-vocal integration assessment through sensorimotor adaptation paradigm testing could prove to be an important addition to voice assessment protocols at the clinical level. Further, if future studies can specify the means to manipulate and enhance a person’s auditory-vocal integration, the efficiency of voice therapy could be increased, leading to improved quality of life for people with voice disorders.

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“…Among basal ganglia-based disorders, vocal motor deficits can be less responsive to pharmacologic treatment and deep brain stimulation therapies than are limb-motor functions. While progress has been made with certain types of speech therapy [20], these iterative and time-intensive treatments -which also harness the brain's own activity patterns-could be augmented by a better understanding of the neural mechanisms for speech. Notwithstanding the lack of a common ancestor with the capacity for vocal learning, neural circuitbreaking work in songbirds, like that of Moorman et al [5], may 'burst' open the door to overcoming human speech disorders.…”

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confidence: 99%

Basal ganglia: Bursting with song

Coleman

White

2021

Current Biology

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The songs of mature zebra finches are notoriously repetitious, or 'crystallized'. Despite this stability, new work reveals that chronic pharmacologically-driven bursting of cortical inputs to the basal ganglia can drive cumulative and lasting changes to multiple vocal features, including phenomena reminiscent of human stuttering."I never had professional therapy, but a couple of nuns taught me to put a cadence to my speaking, and that's why I spent so much time reading poetry -Emerson and Yeats," In this quote from US Joe President Biden, he shares advice on how iterative behavioral practice can largely overcome certain motor disabilities, in his case, childhood stuttering.The basal ganglia are key brain structures for learning complex behaviors including speech; when these circuits malfunction, speech can go awry [1]. Songbirds are useful model organisms to understand brain mechanisms for speech due to significant parallels in how songs and speech are developmentally acquired and actively maintained in maturity [2]. This evolutionary convergence acts at multiple levels, all the way from transcriptional expression profiles in vocal control regions [3] to the functional effects of cooling brain tissue on vocal output [4]. A recent paper by Moorman et al. [5] makes expert use of the zebra finch songbird model to show that the crystallized songs of adult birds can be induced to change and that these changes can persist, likely via transfer to vocal command pathways in the brain. Fortuitously, the brains of zebra finches and related songbirds possess well-defined vocal control circuitry dedicated to learned song. These anatomically tractable regions include a posterior vocal motor control pathway, essential for song production, and an intersecting cortico-basal ganglia loop called the anterior forebrain pathway (AFP), required for vocal plasticity during critical period learning (Figure 1A). The AFP is also crucial for active song maintenance in adulthood. Moreover, the crystallized song of male finches provides a readily quantifiable behavior.Despite the repetitious stability of zebra finch song, work from multiple groups (reviewed by Woolley and Kao [6]) demonstrates that adult finches can acutely adjust their songs when they are experimentally subjected to perturbed auditory feedback. In many experiments, perturbation is made feasible by the fact that there is a slight rendition-to-rendition variation in the fundamental frequency of certain syllables that is actively generated by the premotor cortical AFP region known as the lateral nucleus of the anterior neopallium (LMAN). Reinforcement paradigms can thereby 'punish' birds when the fundamental frequency is outside an experimentally determined value by delivering a blast of white noise. Birds respond by shifting their fundamental frequencies away from this target range, thereby avoiding the aversive stimulus. Perturbed auditory feedback also acutely alters human speech, notably by inducing stuttering (reviewed in Cynx & Von Rad[7]). In both cases, these immediat...

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Neurobehavioral Effects of LSVT® LOUD on Auditory-Vocal Integration in Parkinson’s Disease: A Preliminary Study

Cited by 13 publications

References 74 publications

Early auditory responses to speech sounds in Parkinson’s disease: preliminary data

Early auditory responses to speech sounds in Parkinson’s disease: preliminary data

Auditory-vocal integration impairment: New challenges and opportunities for voice assessment and therapy

Basal ganglia: Bursting with song

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