Prevalence and pattern of perceived intelligibility changes in Parkinson's disease

Abstract

Background: Changes to spoken communication are inevitable in Parkinson's disease (PD). It remains unclear what consequences changes have for intelligibility of speech. Aims: To establish the prevalence of impaired speech intelligibility in people with PD and the relationship of intelligibility decline to indicators of disease progression. Methods: 125 speakers with PD and age matched unaffected controls completed a diagnostic intelligibility test and described how to carry out a common daily activity in an ''off drug'' state. Listeners unfamiliar with dysarthric speech evaluated responses. Results: 69.6% (n = 87) of people with PD fell below the control mean of unaffected speakers (n = 40), 51.2% (n = 64) by more than 21 SD below. 48% (n = 60) were perceived as worse than the lowest unaffected speaker for how disordered speech sounded. 38% (n = 47) placed speech changes among their top four concerns regarding their PD. Intelligibility level did not correlate significantly with age or disease duration and only weakly with stage and severity of PD. There were no significant differences between participants with tremor dominant versus postural instability/gait disorder motor phenotypes of PD. Conclusions: Speech intelligibility is significantly reduced in PD; it can be among the main concerns of people with PD, but it is not dependent on disease severity, duration or motor phenotype. Patients' own perceptions of the extent of change do not necessarily reflect objective measures.

Adaptação para a língua Portuguesa e aplicação de protocolo de avaliação das disartrias de origem central em pacientes com Doença de Parkinson

“…Após esta análise a pontuação obtida em cada componente foi somada, classificando a disartria em leve (1-10 pontos), moderada (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) …”

Limb use and complex ultrasonic vocalization in a rat model of Parkinson's disease: Deficit-targeted training

“…Voice and speech deficits are common complications of PD [22][23][24][25][26] and include decreased vocal loudness, decreased frequency variability (monotone), breathiness, hoarse voice quality and imprecise articulation [22,23], as well as degradation in speech intelligibility [27]. Similar to animal models of therapy, targeted exercise (speech/voice therapy) has been shown to improve specific deficits, such as communication and quality of life in patients with PD [28][29][30].…”

Speech and Communication Changes Reported by People with Parkinson’s Disease

“…In a study by Ho et al [2], 73.5% of the participants with PD had mild or more severe speech symptoms when assessed by two trained professionals. In another study, 76% of the people with PD stated that their voice was not as good as it used to be, and 56.5% reported that their speech was slurred [3]. In a Swedish survey from the 1990s, 70% of the respondents reported that they experienced speech and voice changes as a result of PD.…”

“…Twenty-nine percent of respondents perceived speaking to be their greatest current problem [4]. In a UK study, 10% of the people with PD perceived speech-voice changes as their most serious problem when asked about changes related to PD, and 38% thought speech was among their top four concerns [3]. Although it has been established that speech and voice are often affected in people with PD, there is very limited information about the experience of living with reduced speech and voice function from the perspective of the individual with PD, which is the focus of the present study.…”