Speech dysfunction in early Parkinson's disease

Abstract

The purpose of this study is to determine if subjects in the early stages of untreated Parkinson's disease (PD) or PD treated with deprenyl alone suffer from motor speech abnormalities. Speech defects are common in advanced PD, including disturbances of respiration, phonation, and articulation. We studied 12 subjects with early PD (Hoehn and Yahr stage < or = 2, mean duration disease 3.2 years) who were not taking symptomatic therapy and tested them under two conditions: on and off deprenyl. None of the subjects was depressed or demented (Mini Mental Status mean 29.9/30; Hamilton Depression Rating mean 2.7/52). All functioned independently (Schwab and England Activities of Daily Living mean 93.1/100). Acoustic and speech productions were assessed using the DSP Sona-Graph 5500 and an evaluation of dysarthria. All 12 had at least two characteristics of dysarthria on examination, although 8 were not aware of it. Vocal tremor was identified on narrow band spectrogram for four subjects. Deprenyl did not have a consistent effect on speech. Ten subjects had no detectable change in speech on deprenyl, one was worse, and one was improved.

Vocal Acoustic Characteristics of Patients with Parkinson’s Disease

“…Although previous studies involving tremor analyses in male PD patients have not reached a unified conclusion, the present results support those studies, demonstrating an increase in both amplitude and frequency measurements [10] . Many studies have documented tremors in the larynx of PD patients [28,29] , suggesting that vocal tremors related to frequency, as confirmed in the present study, are related to physiological findings in the larynx.…”

“…While these measurements have shown that tremor increases in men and women are reflected in frequency more than amplitude [10] , a report has documented a reverse relationship in women [9] .…”

Pitch Variability in Patients With Parkinson’s Disease: Effects of Deep Brain Stimulation of Caudal Zona Incerta and Subthalamic Nucleus

“…Darley, Aronson, & Brown, 1969;R. D. Kent & Kim, 2003;Pinto et al, 2004;Skodda, Grönheit, & Schlegel, 2011;Stewart et al, 1995). Pitch level, variability and range provide the frame within which tonal components of prosodic contrasts may function, and reduced ability in voluntary manipulation of pitch therefore constitutes a key component in dysprosody (MacPherson, Huber, & Snow, 2011).…”

Residual signal auto-correlation to evaluate speech in Parkinson’s disease patients

“…Even having consensus that some voice parameters (breathiness, mono-pitch, mono-loudness, low loudness, and reduced maximum phonation frequency range) are poor, depending of volume and intensity of expelled air, with age and seriousness of diseases symptoms 5 , also there are discre pancies in the sensitivity levels of diff e rent functional grading scales for re c o rding hypo-phonetic dysarthia in PD 12 . Common instrumentation methods are sensitive, but have low specificity in evaluating speech impediments in PD; this is demonstrated by the lack of diff e rentiation between PD patients and contro l s for fundamental frequency (Fo), duty cycle DC, and closing time (CT) 4 , and also between before and after s u rg e ry for Fo, jitter and PPQ, shimmer and APQ, and the harmonic to noise ratio (HNR), all obtained by sustained vocal emission, as in our study 1 3 .…”