37.: Lombard effect revisited: A different approach to hypophonia in Parkinson’s disease

Abstract

This study measured changes in voice quality and volume due to the Lombard effect in patients with Parkinson’s disease (PD) using voice analysis software and assessed its tolerability and impact on quality of life of PD patients and their carers. Nine patients with PD and hypophonia were provided with a portable digital music player and in-ear bud headphones pre-loaded with “loud” music from the two authors’ personal music collection. Magnitude of Lombard effect was documented by recording each patient reading a standard passage with no music then with music playing in one ear in a standard medical consulting room using a headset microphone. These patients were followed up over the phone at monthly intervals for 3 months, as well as during routine clinic appointments to see whether they continued using the headsets. Six patients demonstrated significant increase in voice volume of more than 5 dB in the office. At 1 month, five patients reported continued use with improved communication reported by patients and caregivers. Three patients were not using it frequently due to difficulty operating the music player although they experienced noticeable benefits and only one patient had found that the music did not make any difference in their communication. The study follow up is scheduled to be completed by April 2014. Lombard effect can be induced cheaply and in a tolerable manner in PD patients by using music rather than masking noise and this may improve voice and quality of life of PD patients.