The effects of levodopa on word intelligibility in Parkinson's disease (original) (raw)
Related papers
Effect of Speech Task on Intelligibility in Dysarthria: A Case Study of Parkinson's Disease
Brain and Language, 2002
This study assessed intelligibility in a dysarthric patient with Parkinson's disease (PD) across five speech production tasks: spontaneous speech, repetition, reading, repeated singing, and spontaneous singing, using the same phrases for all but spontaneous singing. The results show that this speaker was significantly less intelligible when speaking spontaneously than in the other tasks. Acoustic analysis suggested that relative intensity and word duration were not independently linked to intelligibility, but dysfluencies (from perceptual analysis) and articulatory/resonance patterns (from acoustic records) were related to intelligibility in predictable ways. These data indicate that speech production task may be an important variable to consider during the evaluation of dysarthria. As speech production efficiency was found to vary with task in a patient with Parkinson's disease, these results can be related to recent models of basal ganglia function in motor performance.
Clinical Linguistics & Phonetics, 2019
Intelligibility of speech is a key outcome in speech and language therapy (SLT) and research. SLT students frequently participate as raters of intelligibility but we lack information about whether they rate intelligibility in the same way as the general public. This paper aims to determine if there is a difference in the intelligibility ratings made by SLT students (trained in speech related topics) compared to individuals from the general public (untrained). The SLT students were in year 2 of a BSc programme or the first 6 months of a MSc programme. We recorded 10 speakers with Parkinson's disease (PD) related speech reading aloud the words and sentences from the Assessment of Intelligibility of Dysarthric Speech. These speech recordings were rated for intelligibility by 'trained' raters and 'untrained' raters. The effort required to understand the speech was also reported. There were no significant differences in the measures of intelligibility from the trained and untrained raters for words or sentences after adjusting for speaker by including them as a covariate in the model. There was a slight increase in effort reported by the untrained raters for the sentences. This difference in reported effort was not evident with the words. SLT students can be recruited alongside individuals from the general public as naïve raters for evaluating intelligibility in people with speech disorders.
For better or worse: The effect of levodopa on speech in Parkinson's disease
Movement Disorders, 2008
While the beneficial effect of levodopa on traditional motor control tasks have been well documented over the decades, its effect on speech motor control has rarely been objectively examined and the existing literature remains inconclusive. To examine the effect of levodopa on speech in patients with Parkinson's disease, it was hypothesized that levodopa would improve preparatory motor set related activity and alleviate hypophonia. Patients fasted and abstained from levodopa overnight. Motor examination and speech testing was performed the following day, pre-levodopa during their "off " state, then at hourly intervals postmedication to obtain the best "on " state. All speech stimuli showed a consistent tendency for increased loudness and faster rate during the "on " state, but this was accompanied by a greater extent of intensity decay. Pitch and articulation remained unchanged. Levodopa effectively upscaled the overall gain setting of vocal amplitude and tempo, similar to its well-known effect on limb movement. However, unlike limb movement, this effect on the final acoustic product of speech may or may not be advantageous, depending on the existing speech profile of individual patients.
eClinicalMedicine, 2020
Background: More than 6,000,000 individuals worldwide are diagnosed with Parkinson's disease (PD). Nearly 90% develop speech signs that may substantially impair their speech intelligibility, resulting in losses in their communication and quality of life. Benefits of intensive speech treatment have been documented for a range of speech signs. However, the critical question of whether speech is more intelligible after treatment has not been investigated in a randomised controlled trial (RCT). We hypothesised that intensive speech treatment would improve speech intelligibility in PD. Method: Sixty-four patients with hypokinetic dysarthria secondary to PD participated in this single-centre, parallel arm, statistically-powered RCT. Reporting follows CONSORT guidelines for non-pharmacological treatment. Patients were recruited from US clinics and randomised using a statistician-derived minimisation algorithm, to intensive speech treatment (16 1-hour sessions/1 month) targeting voice (voice group) or targeting articulation (articulation group) or to an untreated group (no treatment group). Speech treatments were delivered by speech clinicians who specialised in treating patients with PD. Trial design minimised bias and supported equipoise. For intelligibility assessment, blinded listeners (n = 117) orthographically transcribed 57 patients' recorded, self-generated narrative speech samples, randomly presented in multi-talker babble noise. Listeners were American-English speakers, ages 18À35 years, with normal hearing. The primary outcome was baseline (pre-treatment) to post-treatment change in transcription accuracy (TA), recognised as the most objective measure of intelligibility. TA was defined as the percentage of words transcribed correctly. Listeners, data collectors, and data managers were blinded to treatment conditions and groups. Reliability was evaluated using intraclass correlation coefficients and differences amongst groups were evaluated by mixed-effects models, in accordance with the intention-to-treat approach. This trial was registered with ClinicalTrials.gov Identifier: NCT00123084. Findings: Between June 23, 2016 and August 14, 2017, blinded listeners transcribed baseline and post-treatment speech samples for intelligibility assessment of 57 patients in the voice (n = 19), articulation (n = 19) and no treatment (n = 19) groups. Between-group differences (d) in changes from baseline to post-treatment in TA indicated significantly greater increases following treatment targeting voice than treatment targeting articulation (d = 26¢2%, 95% CI 1¢5 À 51¢0; p = 0¢04; ES=1¢0). Differences between TA changes in the treatment targeting voice and in the no treatment group were significant (d = 42¢8%, 95% CI 22¢4 À 63¢2; p = 0¢0002; ES=1¢8). Differences between TA changes in the treatment targeting articulation and in the no treatment group were not significant (d = 16¢5%, 95% CI-6¢1 À 39¢2; p = 0¢147; ES=0¢9).
2016
The motivation of this study was to examine the effects of intensive speech treatment on the conversational intelligibility of Spanish speakers with Parkinson's Disease (PD). It also aimed at investigating several acoustic variables in the speech of this population. Sixteen speakers with a medical diagnosis of PD participated in this study and their voice recordings were analyzed pre-and post-treatment. The intelligibility measures of transcription accuracy and median ease-of-understanding ratings increased significantly immediately post-treatment and gains were maintained at the one-month follow-up. The acoustic variables of vowel space and voice onset time did not change significantly pre-to-post treatment, whilst the prosodic targets of intensity and mean fundamental frequency increased significantly as a result of treatment. These findings support the implementation of intensive voice intervention to improve intelligibility in Spanish dysarthria. Clinical and theoretical considerations are discussed.
Journal of Voice, 2012
Objectives/Hypothesis. The purpose of this study was to determine whether sentence intelligibility improves in speakers with idiopathic Parkinson's disease (PD) as a result of Lee Silverman Voice Treatment (LSVT). It was hypothesized that all the speakers would improve following treatment, in association with increased vocal loudness, which was the primary target of the treatment. Study Design. Prospective study of eight Speakers with PD using a single-blinded, randomized pre-post treatment design, with multiple daily assessments before and after treatment was carried out. Resultant data were corrected for regression to the mean. Methods. Randomized digital recordings of sentences produced by speakers with idiopathic PD before and after the treatment were presented to normal-hearing listeners with equalized intensity at conversational loudness in the presence of pink noise. Percentage of words understood was calculated before and after the treatment. Changes in overall vocal intensity were also analyzed.
Brain Sciences
The majority of people with Parkinson’s disease (PD) experience both prosodic changes (reduced vocal volume, reduced pitch range) and articulatory changes (imprecise articulation) that often limit speech intelligibility and may contribute to significant declines in quality of life. We conducted a randomized control trial comparing two intensive treatments, voice (LSVT LOUD) or articulation (LSVT ARTIC) to assess single word intelligibility in the presence of background noise (babble and mall). Participants (64 PD and 20 Healthy) read words from the diagnostic rhyme test (DRT), an ANSI Standard for measuring intelligibility of speech, before and after one month (treatment or no treatment). Teams of trained listeners blindly rated the data. Speech intelligibility of words in the presence of both noise conditions improved in PD participants who had LSVT LOUD compared to the groups that had LSVT ARTIC or no treatment. Intensive speech treatment targeting prominent prosodic variables in ...
The effect of Levodopa on articulation in Parkinson’s disease: A cross-linguistic study
2018
Parkinson's disease (PD) is a neurological disorder that is characterized by a decay in global motor performance, manifest in tremor, abnormal gait, and dysarthria. PD dysarthria characteristics include monoloudness, pathological voice quality, and imprecise articulation. Standard treatment for relieving PD symptoms is the drug Levodopa, but it is currently unknown how it affects speech. We investigated the effect of Levodopa on the vowel space of 4 Dutch and 6 Slovenian PD participants. They recorded their speech on twenty occasions distributed over four days across 2-4 weeks. First and second formants of corner vowels [i-a-u] produced in isolated words were measured at acoustic midpoints of 4043 tokens. VAI [13], a metric of vowel space dispersion, was calculated for each speaker. VAI was not significantly affected by Levodopa in either language, which may indicate that the motor control underlying vowel articulation is not as sensitive to Levodopa as other motor symptoms.
Compensatory mechanisms enables intelligibility in prodromal Parkinson’s disease
BackgroundSpeech impairment is already present on the acoustic level in speakers with isolated rapid eye movement sleep behavior disorder (iRBD). The aim of this study was to determine whether speech changes are already present on the articulatory level and if how these differ from healthy control speakers and speakers with Parkinson’s disease (PD).MethodsKinematic data were collected from 68 age and sex-matched subjects: healthy control speakers (n=23), patients with iRBD (n=22), and patients with PD (n=23). All participants were recorded with electromagnetic articulography (AG 501) to capture articulatory movements of the lower lip, the tongue tip and the tongue body. Movement amplitudes, durations and average speeds were calculated per articulator. In addition, naïve listeners rated the intelligibility of the speech sampled produced by the participants.ResultsThe results of the production experiment indicate changes between the control and the iRBD group as well as between the iR...
Fluency in Parkinson?s disease: disease duration, cognitive status and age
Arquivos de Neuro-Psiquiatria, 2014
The objective of this study was to determine the frequency of occurrence and to characterize the typology of dysfluencies in individuals with Parkinson’s disease (PD), including the variables age, gender, schooling, disease duration, score on the Hoehn and Yahr scale and cognitive status (score on Mini-Mental State Examination). A cross-sectional study of a sample comprising 60 adults matched for gender, age and schooling was conducted. Group I comprised 30 adults with idiopathic PD, and Group II comprised 30 healthy adults. For assessment of fluency of speech, subjects were asked to utter a narrative based on a sequence of drawings and a transcription of 200 fluent syllables was performed to identify speech dysfluencies. PD patients exhibited a higher overall number of dysfluencies in speech with a large number of atypical dysfluencies. Additionally, results showed an influence of the variables cognitive status, disease duration and age on occurrence of dysfluencies.