Effects of the Lee Silverman Voice Treatment (LSVT^®LOUD) on Hypomimia in Parkinson's Disease

Abstract

Given associations between facial movement and voice, the potential of the Lee Silverman Voice Treatment (LSVT) to alleviate decreased facial expressivity, termed hypomimia, in Parkinson's disease (PD) was examined. Fifty-six participants--16 PD participants who underwent LSVT, 12 PD participants who underwent articulation treatment (ARTIC), 17 untreated PD participants, and 11 controls without PD--produced monologues about happy emotional experiences at pre- and post-treatment timepoints ("T1" and "T2," respectively), 1 month apart. The groups of LSVT, ARTIC, and untreated PD participants were matched on demographic and health status variables. The frequency and variability of facial expressions (Frequency and Variability) observable on 1-min monologue videorecordings were measured using the Facial Action Coding System (FACS). At T1, the Frequency and Variability of participants with PD were significantly lower than those of controls. Frequency and Variability increases of LSVT participants from T1 to T2 were significantly greater than those of ARTIC or untreated participants. Whereas the Frequency and Variability of ARTIC participants at T2 were significantly lower than those of controls, LSVT participants did not significantly differ from controls on these variables at T2. The implications of these findings, which suggest that LSVT reduces parkinsonian hypomimia, for PD-related psychosocial problems are considered.

Speech treatment in Parkinson's disease: Randomized controlled trial (RCT)

“…Ongoing analyses of speech intelligibility, voice quality, swallowing, facial expression, and imaging (PET) in these participants will further clarify mechanisms of response to these speech treatment targets in PD.…”

Speech and Communication Changes Reported by People with Parkinson’s Disease

“…Since then, the Lee Silverman Voice Treatment (LSVT LOUD®) has been developed and launched globally. This intensive treatment program has been studied extensively, and positive outcomes have been reported regarding vocal loudness [34] and, in subsequent studies, other aspects of speech and communication, such as articulation [35] and facial expression [36]. The introduction of LSVT has certainly altered the perception that speech changes in PD are resistant to speech-language pathology intervention, and may be one factor contributing to the increase in speech-language pathology service provision.…”

The Relationship between the Experience of Hypomimia and Social Wellbeing in People with Parkinson’s Disease and their Care Partners

“…With some research showing that voice treatment may lead to short term improvement in showing expression in the face [27], future research will investigate ways to reduce hypomimia as well as the relation of reduced hypomimia to PD’s and CP’s experience of hypomimia. Future research will also aim to replicate these findings in a larger sample size and at a second time point to further investigate the link between self-reported hypomimia, depression, and social wellbeing in people with PD.…”