Voice and Speech Characteristics of Persons With Parkinson’s Disease Pre- and Post-Pallidotomy Surgery

Abstract

Pallidotomy surgery, lesioning the globus pallidus internal, has been performed to alleviate Parkinsonian symptoms and drug-induced dyskinesias. Improvements in limb motor function have been reported in recent years following pallidotomy surgery. The purpose of this preliminary study was to determine the effect of pallidotomy surgery on select voice and speech characteristics of 6 patients with Parkinson's disease. Acoustic measures were analyzed pre-pallidotomy surgery and again at 3 months following surgery. Preliminary findings indicated that all participants demonstrated positive changes in at least one acoustic measure; 2 of the participants consistently demonstrated positive changes in phonatory and articulatory measures, whereas 3 participants did not consistently demonstrate positive changes postsurgery. The results are discussed relative to the differential effects observed across participants.

Acoustic voice assessment in Parkinson's disease patients submitted to posteroventral pallidotomy

“…However, this study did not show evidence of changes in the usual frequency range, which is similar to the study of Ramig et al 19 . In the studied periods, it was observed an increase in F0 as Schulz et al 8 that observed an increase in the fundamental frequency in three out of six cases evaluated.…”

“…There is an intimate relationship between F0 and vocal intensity; although increases in intensity are measured by greater glottal coaptation and activity of the respiratory mechanism, variations in intensity are dependent on the frequency and vice-versa. Regarding the evaluation of vocal intensity, some studies described a reduction in loudness after PVP 5,8,15, while Laitinen et al 6 observed an increase. Schulz et al 8 did not observe a correlation between the increase of F0 and the increase in vocal intensity.…”

“…Regarding the evaluation of vocal intensity, some studies described a reduction in loudness after PVP 5,8,15, while Laitinen et al 6 observed an increase. Schulz et al 8 did not observe a correlation between the increase of F0 and the increase in vocal intensity. They only perceived that vocal intensity was greater after PVP in patients that showed mild dysarthrophonia 9 .…”

“…Buck and Cooper 7 studied the speech after chemopallidectomy or occlusion of the anterior coroid artery, and observed a reduction of the diadochokinetic rate of the vocal folds. Schulz et al 8 studied the effect of pallidotomy on selected voice and speech characteristics of 6 PD patients. Acoustic measurements were analyzed pre-pallidotomy and again at 3 months following surgery.…”

Implicações do efeito Lombard sobre a intensidade, freqüência fundamental e estabilidade da voz de indivíduos com doença de Parkinson

“…The "Deep Brain Stimulation", whose goal is to reduce the activities of the globus pallidus, subthalamic nucleus and thalamus, is a great promise for these patients 38 . Postoperative results have been very promising with important voice improvements, showing the way to a new therapeutic horizon [39][40][41][42] . However, we have to take into account that this technology is not available to most of these patients, especially in a developing country like Brazil, thus the importance of developing innovative and accessible approaches that help in assessing and treating vocal symptoms in this group.…”