Speech and communication in Parkinson’s disease: a cross-sectional exploratory study in the UK

Abstract

ObjectiveTo assess associations between cognitive status, intelligibility, acoustics and functional communication in PD.DesignCross-sectional exploratory study of functional communication, including a within-participants experimental design for listener assessment.SettingA major academic medical centre in the East of England, UK.ParticipantsQuestionnaire data were assessed for 45 people with Parkinson’s disease (PD), who had self-reported speech or communication difficulties and did not have clinical dementia. Acoustic and listener analyses were conducted on read and conversational speech for 20 people with PD and 20 familiar conversation partner controls without speech, language or cognitive difficulties.Main outcome measuresFunctional communication assessed by the Communicative Participation Item Bank (CPIB) and Communicative Effectiveness Survey (CES).ResultsPeople with PD had lower intelligibility than controls for both the read (mean difference 13.7%, p=0.009) and conversational (mean difference 16.2%, p=0.04) sentences. Intensity and pause were statistically significant predictors of intelligibility in read sentences. Listeners were less accurate identifying the intended emotion in the speech of people with PD (14.8% point difference across conditions, p=0.02) and this was associated with worse speaker cognitive status (16.7% point difference, p=0.04). Cognitive status was a significant predictor of functional communication using CPIB (F=8.99, p=0.005, η2 = 0.15) but not CES. Intelligibility in conversation sentences was a statistically significant predictor of CPIB (F=4.96, p=0.04, η2 = 0.19) and CES (F=13.65, p=0.002, η2 = 0.43). Read sentence intelligibility was not a significant predictor of either outcome.ConclusionsCognitive status was an important predictor of functional communication—the role of intelligibility was modest and limited to conversational and not read speech. Our results highlight the importance of focusing on functional communication as well as physical speech impairment in speech and language therapy (SLT) for PD. Our results could inform future trials of SLT techniques for PD.

The Communicative Participation Item Bank: Evaluating, and Reevaluating, Its Use across Communication Disorders in Adults

“…Intelligibility measures based on isolated read sentence production did not significantly predict CPIB scores, whereas intelligibility measures based on more naturalistic, contextually produced sentences or monologue samples did. 47,48 These findings suggest that communication proficiency measures that replicate naturalistic communication may be stronger predictors of communicative participation.…”

“…46 Relationships between CPIB scores and clinician-administered measures of PD severity may be more nuanced. For example, Spencer et al 47 found that clinicianadministered measures of motor severity and a cognitive screening did not significantly predict CPIB scores, 47 while Barnish et al 48 did find that scores on a cognitive screening did predict CPIB scores. 48 Both of these studies demonstrated that the ability of speech intelligibility measures to predict CPIB scores depended on the task.…”

“…For example, Spencer et al 47 found that clinicianadministered measures of motor severity and a cognitive screening did not significantly predict CPIB scores, 47 while Barnish et al 48 did find that scores on a cognitive screening did predict CPIB scores. 48 Both of these studies demonstrated that the ability of speech intelligibility measures to predict CPIB scores depended on the task. Intelligibility measures based on isolated read sentence production did not significantly predict CPIB scores, whereas intelligibility measures based on more naturalistic, contextually produced sentences or monologue samples did.…”

A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson’s disease

“…Future studies could use more modern outcome measures that are more focused on communicative participation such as the Communicative Participation Item Bank [121,122] or the Communicative Effectiveness Survey [123,124]. Indeed, communicative participation itself is a complex concept that is believed to be influenced by a range of PD-related factors including level of cognitive impairment, [125,126] so would benefit from further study from a range of perspectives including in the context of performing arts interventions.…”

A Systematic Review of Active Group-Based Dance, Singing, Music Therapy and Theatrical Interventions for Quality of Life, Functional Communication, Speech, Motor Function and Cognitive Status in People with Parkinson’s Disease

“…Future studies could use more modern outcome measures that are more focused on communicative participation such as the Communicative Participation Item Bank [122][123] or the Communicative Effectiveness Survey. [124][125] Indeed, communicative participation itself is a complex concept that is believed to be in uenced by a range of PD-related factors including level of cognitive impairment, [126][127] so would bene t from further study from a range of perspectives including in the context of performing arts interventions.…”