Speech volume regulation in Parkinson’s disease: effects of implicit cues and explicit instructions

Ho, Aileen K; Bradshaw, John L.; Iansek, Robert; Alfredson, R.J.

doi:10.1016/s0028-3932(99)00067-6

Cited by 136 publications

(125 citation statements)

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“…Problems with internal cueing have been well documented in PD (Jahanshahi et al., 1995; Siegert, Harper, Cameron, & Abernethy, 2002) and are thought to play a role in PD dysarthria (Sapir, 2014). Compared to habitual (internally cued) speech, measures of speech function and intelligibility improve when PD subjects are prompted (externally cued) to speak more loudly, clearly, or slowly (Dromey & Ramig, 1998; Ho, Bradshaw, Iansek, & Alfredson, 1999; Sapir, 2014; Tjaden, Sussman, & Wilding, 2014). As motor preparatory activity in PMd is biased toward the planning and execution of movements that are externally cued (Halsband, Matsuzaka, & Tanji, 1994; Halsband & Passingham, 1982; Lu, Arai, Tsai, & Ziemann, 2012; Mushiake, Inase, & Tanji, 1991), increased connectivity with GPi could reflect a mechanism for compensatory reliance on external cues during speech production in PD.…”

Section: Discussionmentioning

confidence: 99%

Altered resting‐state functional connectivity of the putamen and internal globus pallidus is related to speech impairment in Parkinson's disease

et al. 2018

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IntroductionSpeech impairment in Parkinson's disease (PD) is pervasive, with life‐impacting consequences. Yet, little is known about how functional connections between the basal ganglia and cortex relate to PD speech impairment (PDSI). Whole‐brain resting‐state connectivity analyses of basal ganglia nuclei can expand the understanding of PDSI pathophysiology.MethodsResting‐state data from 89 right‐handed subjects were downloaded from the Parkinson's Progression Markers Initiative database. Subjects included 12 older healthy controls (“OHC”), 42 PD patients without speech impairment (“PDN”), and 35 PD subjects with speech impairment (“PDSI”). Subjects were assigned to PDN and PDSI groups based on the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) Part III speech item scores (“0” vs. “1–4”). Whole‐brain functional connectivity was calculated for four basal ganglia seeds in each hemisphere: putamen, caudate, external globus pallidus (GPe), and internal globus pallidus (GPi). For each seed region, group‐averaged connectivity maps were compared among OHC, PDN, and PDSI groups using a multivariate ANCOVA controlling for the effects of age and sex. Subsequent planned pairwise t‐tests were performed to determine differences between the three groups using a voxel‐wise threshold of p < 0.001 and cluster‐extent threshold of 272 mm3 (FWE<0.05).ResultsIn comparison with OHCs, both PDN and PDSI groups demonstrated significant differences in cortical connectivity with bilateral putamen, bilateral GPe, and right caudate. Compared to the PDN group, the PDSI subjects demonstrated significant differences in cortical connectivity with left putamen and left GPi. PDSI subjects had lower connectivity between the left putamen and left superior temporal gyrus compared to PDN. In addition, PDSI subjects had greater connectivity between left GPi and three cortical regions: left dorsal premotor/laryngeal motor cortex, left angular gyrus, and right angular gyrus.ConclusionsThe present findings suggest that speech impairment in PD is associated with altered cortical connectivity with left putamen and left GPi.

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Section: Discussionmentioning

confidence: 99%

Altered resting‐state functional connectivity of the putamen and internal globus pallidus is related to speech impairment in Parkinson's disease

et al. 2018

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“…The potential effect of other concurrent motor activities, such as walking, needs to be examined. Finally, previous studies suggest that attentional demands of a speech task may influence the effect of interlocutor distance on speech intensity in PD (Ho et al, 1999a;Adams et al, 2010). Unfortunately no previous studies have attempted to systematically examine the potential interaction between changes in attention demands (i.e., concurrent task effects) and changes in interlocutor distance.…”

Section: Rationalementioning

confidence: 97%

“…Ho, Iansek, and Bradshaw (1999b) found that individuals with hypophonia had a greater reduction in intensity when the speech output was more attentionally demanding (conversation) than when reciting wellpracticed sentences. Ho, Bradshaw, Iansek, and Alfredson (1999a), Ho, Bradshaw, and Iansek (2000), and Adams et al (2010) investigated the ability of individuals with hypophonia to regulate speech intensity in background noise. These studies found that individuals with PD demonstrated relatively normal patterns of intensity regulation despite an overall reduction in intensity relative to controls.…”

Section: Speech Intensity Associated With Hypokinetic Dysarthriamentioning

confidence: 99%

“…Ho et al (1999a) examined intensity regulation in both healthy controls and participants with PD for two speech tasks, conversation and reciting sentences. Despite an overall reduction in intensity, individuals with PD demonstrated relatively normal patterns of intensity regulation in response to changes in interlocutor distance.…”

Section: Speech Intensity and Interlocutor Distancementioning

confidence: 99%

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Effect of concurrent walking and interlocutor distance on conversational speech intensity and rate in Parkinson's disease

et al. 2016

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This study examined the effects of concurrent walking tasks and interlocutor distance on conversational speech production in fifteen individuals with idiopathic Parkinson's disease (PD) and fourteen age-equivalent controls. Recent studies of speech in PD have demonstrated that changes in the behavioural conditions and the environmental context can have a powerful effect on the severity of speech symptoms in PD. This investigation focused on changes in speech intensity and speech rate in response to changes in walking speed and interlocutor distance. Results suggest that the introduction of a concurrent walking task significantly increased the conversational speech intensity of both controls and individuals with PD. When compared to sitting and talking or standing and talking, current walking and talking appeared to have an energizing effect on conversational speech intensity. In addition, walking faster was associated with a significant increase in conversational speech intensity relative to normal and slow walking speeds. These results provide important new information about the effect of concurrent walking on speech motor performance and speech symptom severity in PD. The potential energizing effect of concurrent walking conditions on conversational speech intensity may be an important consideration in the assessment and treatment of individuals with low speech intensity in PD.

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“…As an alternative to reduce the complaints of hypophonia in these patients, some authors have used auditory masking with the aim of improving voice intensity 11,12 . This method is known as the Lombard's Effect, which makes it natural for the individual to speak louder, because of noise exposure, preventing him to hear it properly, or because of hearing loss 9 .…”

Section: Introductionmentioning

confidence: 99%

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

Quedas¹,

Duprat²,

Gasparini

2007

Rev. Bras. Otorrinolaringol.

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A Doença de Parkinson afeta o sistema nervoso central resultando em alterações qualitativas da voz que pouco melhoram com o tratamento farmacológico e com a fonoterapia tradicional. Estudos mostram que o mascaramento auditivo leva ao aumento da intensidade da voz em indivíduos normais (Efeito Lombard). OBJETIVO: Avaliar implicações do efeito Lombard sobre a intensidade, freqüência fundamental e estabilidade da voz de indivíduos com doença de Parkinson (N=17). FORMA DE ESTUDO: Estudo clínico e experimental. Material e Métodos: Através de análise acústica, avaliamos as alterações de intensidade e freqüência fundamental, antes e depois da exposição a mascaramento auditivo "white noise", em 40, 70 e 90 dBNS, bem como as variações durante cada emissão e comparamos com um grupo controle (N=16). RESUTADOS: A intensidade de emissão vocal variou de acordo com a intensidade de mascaramento, tendendo a aumento não-linear, ocorrendo também nos grupos Parkinson e controle, não sendo influenciado pelo sexo. A freqüência fundamental da emissão vocal variou, tendendo a aumento não-linear, em ambos os grupos e sexos. Ocorreu melhora da estabilidade, tanto com relação à freqüência quanto à intensidade de emissão vocal. CONCLUSÃO: O Efeito Lombard elevou a intensidade e freqüência fundamental e melhorou a estabilidade da voz desses pacientes.

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Speech volume regulation in Parkinson’s disease: effects of implicit cues and explicit instructions

Cited by 136 publications

References 15 publications

Altered resting‐state functional connectivity of the putamen and internal globus pallidus is related to speech impairment in Parkinson's disease

Altered resting‐state functional connectivity of the putamen and internal globus pallidus is related to speech impairment in Parkinson's disease

Effect of concurrent walking and interlocutor distance on conversational speech intensity and rate in Parkinson's disease

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

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