Nasal airflows in Parkinsonian speakers

Hoodin, Ronald B.; Gilbert, Harvey R.

doi:10.1016/0021-9924(89)90014-2

Cited by 29 publications

(16 citation statements)

References 11 publications

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“…The neural mechanisms underlying these voice and speech disorders are unclear. [26][27][28][29] Traditionally, these abnormalities have been attributed to the primary physical pathologies of IPD (rigidity, bradykinesia, hypokinesia, and tremor), yet there is little evidence in support of these etiologic factors. Alternative explanations for the speech and voice disorder have been proposed, in particular, deficits in internal cueing and sensory gating.…”

Section: Speech and Voice Characteris-tics In Parkinson's Diseasementioning

confidence: 99%

Parkinson's Disease: Speech and Voice Disorders and Their Treatment with the Lee Silverman Voice Treatment

2004

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Speech and voice disorders are very common among individuals suffering from idiopathic Parkinson's disease. In this article we review evidence for laryngeal, respiratory, articulatory, and velopharyngeal disorders in this population. We present the essential concepts and outcome data for the Lee Silverman Voice Treatment, a behavioral treatment program that has yielded significant long-term improvement in speech and voice functions in individuals with idiopathic Parkinson's disease.

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Section: Speech and Voice Characteris-tics In Parkinson's Diseasementioning

confidence: 99%

Parkinson's Disease: Speech and Voice Disorders and Their Treatment with the Lee Silverman Voice Treatment

2004

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“…Velopharyngeal function may be less commonly recognized as a problem in PD. However, several reports described significant velopharyngeal impairment in PD including decreased velopharyngeal closure and increased transnasal air flow (Darley, Aronson, & Brown, 1975; Hirose, Kiritani, Ushijima, Yoshioka, & Sawashima, 1981; Hoodin & Gilbert, 1989a, 1989b; Logemann, Fisher, Boshes, & Blonsky, 1978; Robbins, Logemann, & Kirschner, 1986). Intraoral air pressure deficits and velopharyngeal impairments in PD may contribute to reduced speech audibility, linguistic confusion, and communicative impairment.…”

Section: Introductionmentioning

confidence: 99%

Subthalamic nucleus deep brain stimulation changes velopharyngeal control in Parkinson's disease

Hammer

Barlow

Lyons

et al. 2011

Journal of Communication Disorders

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Purpose-Adequate velopharyngeal control is essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on velopharyngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of velopharyngeal control, and whether these changes were correlated with limb function and stimulation settings.Methods-Seventeen PD participants with bilateral STN DBS were tested within a morning session after a minimum of 12 h since their most recent dose of anti-PD medication. Testing occurred when STN DBS was on, and again 1 h after STN DBS was turned off, and included aerodynamic measures during syllable production, and standard neurological ratings of limb function.Results-We found that PD participants exhibited changes with STN DBS, primarily consistent with increased intraoral pressure (n = 7) and increased velopharyngeal closure (n = 5). These changes were modestly correlated with measures of limb function, and were correlated with stimulation frequency.Conclusion-Our findings suggest that STN DBS may change velopharyngeal control during syllable production in PD, with greater benefit associated with low frequency stimulation. However, DBS demonstrates a more subtle influence on speech-related velopharyngeal control than limb motor control. This distinction and its underlying mechanisms are important to consider when assessing the impact of STN DBS on PD. KeywordsAerodynamic; Air flow; Air pressure; Frequency; Speech; Velopharyngeal area © 2010 Elsevier Inc. All rights reserved. * Corresponding author at: Room K4/769 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792, USA. Tel.: +1 608 262 6018. hammer@surgery.wisc.edu (M.J. Hammer). Learning outcomes: As a result of this activity, the participant will be able to (1) describe the effects of deep brain stimulation on limb and speech function; (2) describe the effects of deep brain stimulation on velopharyngeal control; and (3) discuss the possible reasons for differences in limb outcomes compared with speech function with deep brain stimulation of the subthalamic nucleus. NIH Public Access BackgroundParkinson's disease (PD) affects more than 1 million individuals in the United States, resulting in impairment of limb motor control, including deficits in force recruitment, velocity, and acceleration of limb movements (DeLong, 1990(DeLong, , 2000Desmurget et al., 2004;Pfann, Buchman, Comella, & Corcos, 2001;Pfann et al., 2004;Robichaud, Pfann, Vaillancourt, Comella, & Corcos, 2005). Most individuals with PD will develop impairment of speech motor control, including abnormal respiratory, laryngeal, and supralaryngeal control for breathing and speech (Baker, Ramig, Luschei, & Smith, 1998;Barlow, Iacono, Paseman, Biswas, & D'Antonio, 1998;Gallena, Smith, Zeffiro, & Ludlow, 2001;Hunker, Abbs, & Barlow, 1982;Luschei, Ramig, Baker, & Smith, 1999). The Unified Parkinson's Disease Rating Scale (UPDRS, Fahn & Elton, 1987) ...

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“…Although anywhere from 10 to 40% of patients are perceived to be mildly hypernasal, hypernasality and nasal emission are not usually perceptually prominent. 5,22 Auditory-perceptual judgments continue to be the "gold standard" for guiding clinical dysarthria decisions. As discussed below, however, instrumental studies have helped to elaborate the nature of the speech mechanism impairment in PD.…”

Section: Characteristics Of Dysarthria In Parkinson's Diseasementioning

confidence: 99%

“…28,29 Movement velocities and displacements of the velum also tend to be reduced for speech, and acoustic studies suggest increased nasal airflow for speech in as many as 70% of individuals with PD. 22,30 Peak movement velocities and amplitudes of the lips and jaw also tend to be reduced during speech production for persons with PD. [31][32][33] Acoustically, reduced movement displacements and velocities of the oral articulators are evidenced by reduced vowel formant transition extents and slopes, a collapsed vowel acoustic working space, and a trend toward reduced consonant spectral distinctiveness.…”

Section: Characteristics Of Dysarthria In Parkinson's Diseasementioning

confidence: 99%

Speech and Swallowing in Parkinson's Disease

Tjaden¹

2008

Topics in Geriatric Rehabilitation

137

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Dysarthria and dysphagia occur frequently in Parkinson's disease (PD). Reduced speech intelligibility is a significant functional limitation of dysarthria, and in the case of PD is likely related articulatory and phonatory impairment. Prosodically-based treatments show the most promise for addressing these deficits as well as for maximizing speech intelligibility. Communication-oriented strategies also may help to enhance mutual understanding between a speaker and listener. Dysphagia in PD can result in serious health issues, including aspiration pneumonia, malnutrition, and dehydration. Early identification of swallowing abnormalities is critical so as to minimize the impact of dysphagia on health status and quality of life. Feeding modifications, compensatory strategies, and therapeutic swallowing techniques all have a role in the management of dysphagia in PD.

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Nasal airflows in Parkinsonian speakers

Cited by 29 publications

References 11 publications

Parkinson's Disease: Speech and Voice Disorders and Their Treatment with the Lee Silverman Voice Treatment

Parkinson's Disease: Speech and Voice Disorders and Their Treatment with the Lee Silverman Voice Treatment

Subthalamic nucleus deep brain stimulation changes velopharyngeal control in Parkinson's disease

Speech and Swallowing in Parkinson's Disease

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