Effects of Loud and Amplified Speech on Sentence and Word Intelligibility in Parkinson Disease

Neel, Amy T.

doi:10.1044/1092-4388(2008/08-0119)

Cited by 76 publications

(89 citation statements)

References 31 publications

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“…32 There was a discrepancy between deterioration in speech intelligibility and improvement in loudness; this is contrary to other studies in PD dysarthria, where increased loudness is associated with increased speech intelligibility. 37 Our finding supports similar results from the limb motor literature on the effects of STN-DBS, which show an increase in force production but deterioration on more complex movement. 38 So far, evidence of impaired performance following STN-DBS has been limited to selected cognitive tasks and complex manual tasks.…”

Section: Factors Associated With Speech Deterioration Following 1 Yeasupporting

confidence: 82%

Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease

Tripoliti¹,

Zrinzo²,

et al. 2011

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Objective: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced Parkinson disease (PD). Following STN-DBS, speech intelligibility can deteriorate, limiting its beneficial effect. Here we prospectively examined the short-and long-term speech response to STN-DBS in a consecutive series of patients to identify clinical and surgical factors associated with speech change.Methods: Thirty-two consecutive patients were assessed before surgery, then 1 month, 6 months, and 1 year after STN-DBS in 4 conditions on-and off-medication with on-and offstimulation using established and validated speech and movement scales. Fifteen of these patients were followed up for 3 years. A control group of 12 patients with PD were followed up for 1 year. Results:Within the surgical group, speech intelligibility significantly deteriorated by an average of 14.2% Ϯ 20.15% off-medication and 16.9% Ϯ 21.8% on-medication 1 year after STN-DBS. The medical group deteriorated by 3.6% Ϯ 5.5% and 4.5% Ϯ 8.8%, respectively. Seven patients showed speech amelioration after surgery. Loudness increased significantly in all tasks with stimulation. A less severe preoperative on-medication motor score was associated with a more favorable speech response to STN-DBS after 1 year. Medially located electrodes on the left STN were associated with a significantly higher risk of speech deterioration than electrodes within the nucleus. There was a strong relationship between high voltage in the left electrode and poor speech outcome at 1 year. Conclusion:The effect of STN-DBS on speech is variable and multifactorial, with most patients exhibiting decline of speech intelligibility. Both medical and surgical issues contribute to deterioration of speech in STN-DBS patients. Classification of evidence:This study provides Class III evidence that STN-DBS for PD results in deterioration in speech intelligibility in all combinations of medication and stimulation states at 1 month, 6 months, and 1 year compared to baseline and to control subjects treated with best medical therapy. Neurology

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Section: Factors Associated With Speech Deterioration Following 1 Yeasupporting

confidence: 82%

Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease

Tripoliti¹,

Zrinzo²,

et al. 2011

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“…Following Neel (2009) and Tjaden, Sussman, and Wilding (2014), interlistener reliability was assessed using intraclass correlation coefficients (ICCs). ICCs were calculated separately for each of the 10 sentence sets because the listeners assigned to judge each of these lists heard different sentences.…”

Section: Research Question 3: Listener Reliability Comparisonmentioning

confidence: 99%

Comparison of Intelligibility Measures for Adults With Parkinson's Disease, Adults With Multiple Sclerosis, and Healthy Controls

Stipancic

Tjaden

Wilding

2016

J Speech Lang Hear Res

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Purpose This study obtained judgments of sentence intelligibility using orthographic transcription for comparison with previously reported intelligibility judgments obtained using a visual analog scale (VAS) for individuals with Parkinson's disease and multiple sclerosis and healthy controls (K. Tjaden, J. E. Sussman, & G. E. Wilding, 2014). Method Speakers read Harvard sentences in habitual, clear, loud, and slow conditions. Sentence stimuli were equated for peak intensity and mixed with multitalker babble. A total of 50 listeners orthographically transcribed sentences. Procedures were identical to those for a VAS reported in Tjaden, Sussman, and Wilding (2014). Results The percent correct scores from transcription were significantly higher in magnitude than the VAS scores. Multivariate linear modeling indicated that the pattern of findings for transcription and VAS was virtually the same with respect to differences among groups and speaking conditions. Correlation analyses further indicated a moderately strong, positive relationship between the two metrics. The majority of these correlations were significant. Last, intrajudge and interjudge listener reliability metrics for the two intelligibility tasks were comparable. Conclusion Results suggest that there may be instances when the less time-consuming VAS task may be a viable substitute for an orthographic transcription task when documenting intelligibility in mild dysarthria.

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“…Studies report strong or no links [15,25,26]. Partly this relates to artificially manipulated versus speaker-controlled manipulation.…”

Section: Discussionmentioning

confidence: 99%

“…This itself can benefit intelligibility through added suprasegmental cues to meaning [11,12]. Speaker-initiated increases in loudness/amplitude also bring changes to rate and improved articulatory precision, both of which can boost intelligibility [13,14,15]. Taking these altogether one would expect a focus on respiration and voice to be linked to improvements in intelligibility.…”

Section: Introductionmentioning

confidence: 99%

Changes in Voice Quality after Speech-Language Therapy Intervention in Older Children with Cerebral Palsy

Miller

Pennington²,

Robson³

et al. 2013

Folia Phoniatr Logop

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Objective: We examined whether perceived voice quality is altered in a group of children with cerebral palsy (CP) following an intervention focusing on respiration and phonation, and whether possible improvements might be associated with increased intelligibility levels. Methods: Sixteen individuals with CP and dysarthria (9 girls, mean age 14 years, SD = 2; 9 with spastic type CP, 2 dyskinetic, 4 mixed, 1 Worster-Drought syndrome) completed intelligibility assessments on separate days twice before intervention, at termination of treatment and at 6-week follow-up using 50 words from the Children's Speech Intelligibility Measure lists, and describing cartoon strips. Experienced speech-language pathologists rated voice quality employing GRBAS scales. Results: There was no clear evidence that change in voice quality pre-post intervention was large compared with change in the pre-intervention or post-intervention periods. Asthenia demonstrated largest improvement (effect size of 0.4). Intelligibility correlated weakly with Grade, Breathiness and Asthenia, but not with Roughness or Strain. A deterioration of 1 unit on the Grade and Asthenia scales was associated with an approximately 11% decrease in intelligibility. Conclusion: Perceived changes in voice quality were small compared to changes in intelligibility. Further investigations must examine other variables potentially associated with intelligibility gain to better understand the links between the respiratory-phonatory intervention and improved intelligibility.

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Effects of Loud and Amplified Speech on Sentence and Word Intelligibility in Parkinson Disease

Cited by 76 publications

References 31 publications

Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease

Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease

Comparison of Intelligibility Measures for Adults With Parkinson's Disease, Adults With Multiple Sclerosis, and Healthy Controls

Changes in Voice Quality after Speech-Language Therapy Intervention in Older Children with Cerebral Palsy

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