Análise acústica da prosódia em mulheres com doença de Parkinson: comparação com controles normais

Abstract

RESUMO -Motivo do estudo:Alterações da voz, denominadas disartria hipocinética, têm sido bem caracterizadas em doença de Parkinson (DP), ocorrendo em 90% dos pacientes. No entanto, estudos da fala em DP, sobretudo em falantes nativos de outros idiomas que não o inglês são escassos. Nosso objetivo é comparar as características da prosódia de mulheres com DP com controles pareadas por idade, utilizando-se análise acústica. Método: Nós estudamos 8 mulheres com DP (68,4 ± 6,4 anos) e 8 mulheres controles (63,5 ± 6,8 anos). As pacientes (estágio H-Y 2, uma; estágio 2,5, quatro; estágio 3, três), embora tratadas com l-dopa, foram examinadas quando off. A frequência fundamental (Fo), intensidade e duração da fala foram analisadas com o programa , ANT menos (26 ± 12,6 Hz), NSS (4,8 ± 0,1) menor, IM mais alta (32,7 ± 5,6 dB), I max mais alta (37,1 ± 2,9 dB), I min mais alta (23,2 ± 6,1 dB) e IPNT mais alta (35,4 ± 2,9 dB). Nas controles estas variáveis tiveram os seguintes valores-248,7 ± 23,9 Hz, 216,4 ± 25,6 Hz, 197,5 ± 35,8 Hz, 0,3 ± 0,2 Hz, 22,7 ± 15,9 Hz, 36,3 ± 21,8 Hz, 5,3 ± 0,8, 30,4 ± 6,1 dB, 20,2 ± 6,6 dB, 33,1 ± 2,9 dB e 30,9 ± 4,3 dB. Conclusão: Em comparação com controles, brasileiras com DP têm uma fala caracterizada por pequena variação de Fo (o que possivelmente explica sua tessitura vocal pobre), mais lenta e de maior intensidade que controles. Este último achado é compatível com esforço para compensar pobre tessitura vocal. PALAVRAS-CHAVE: doença de Parkinson, prosódia, fonoaudiologia, voz, fala. Acoustic analysis of prosody in females with Parkinson´s disease: comparison with normal controlsABSTRACT -Background: Voice abnormalities, collectively labeled as hypokinetic dysarthria, have been well characterized and occur in 90% of Parkinson's disease (PD) patients. However, studies of speech in PD, particularly of patients whose native language is other than English, are rarely found. The aim of this study is to compare the prosodic features of the speech of female PD patients and gender-and age-matched controls using acoustic analysis. Method: We have studied 8 PD female patients (68.4 ± 6.4 years) and 8 female controls (63.5 ± 6.8 years). The PD patients (H-Y stage 2, one subject; stage 2.5, four patients; stage 3, three patients), although treated with l-dopa, were examined when off. The fundamental frequency (Fo), intensity and duration of the speech were analysed with the software WinPitch 1.8 (Philippe Martin

Prosody and levodopa in Parkinsons disease

“…These findings corroborate with other studies 10,17,22 that found lower amplitude of NT melodic variation in individuals with PD, giving speech a monotonous quality. The same stu dies show a lower rate of change of NT melodic variation in PD off compared with CG regarding the emission of short de clarative utterances.…”

“…Comparing PD off and PD on, only duration measure ments presented a statistically significant difference, show ing shorter duration in PD on, in agreement with the findings of other studies 16,17 . It is believed that this is because levodo pa therapy attenuates bradykinesia, reducing the duration of speech segments during its period of action.…”

“…It is believed that this is because levodo pa therapy attenuates bradykinesia, reducing the duration of speech segments during its period of action. However, ano ther study 17 indicated that F 0 measurements were also signifi cantly higher after levodopa administration.…”

“…Another study 15 reported the efficacy of the drug in reducing the de gree of vocal tremor in patients with IPD and the elimination of tremor in some cases. However, some studies 16,17 found a modest effect of this drug on prosodic aspects of parkinso nian speech, as only a few prosodic variables had changed after its use.…”

Persistent developmental stuttering as a cortical-subcortical dysfunction: evidence from muscle activation

“…In SD physical concomitants are common during speech due to the effort made to speak and possibly due to an associated orofacial dystonia 17,18 . In dystonias secondary to subcortical brain injuries, muscle co-contractions frequently occur, i.e.…”