Abstract
According to the U.S. National Institutes of Health, approximately 500,000 Americans have Parkinson's disease (PD), with roughly another 50,000 receiving new diagnoses each year. 70%–90% of these people also have the hypokinetic dysarthria associated with PD. Deep brain stimulation (DBS) substantially relieves motor symptoms in advanced-stage patients for whom medication produces disabling dyskinesias. This study investigated speech changes as a result of DBS settings chosen to maximize motor performance. The speech of 10 PD patients and 12 normal controls was analyzed for syllable rate and variability, syllable length patterning, vowel fraction, voice-onset time variability, and spirantization. These were normalized by the controls' standard deviation to represent distance from normal and combined into a composite measure. Results show that DBS settings relieving motor symptoms can improve speech, making it up to three standard deviations closer to normal. However, the clinically motivated settings evaluated here show greater capacity to impair, rather than improve, speech. A feedback device developed from these findings could be useful to clinicians adjusting DBS parameters, as a means for ensuring they do not unwittingly choose DBS settings which impair patients' communication.
Highlights
IntroductionParkinson’s disease (PD) is an idiopathic neurodegenerative disease caused by loss of dopamineproducing cells in the substantia nigra of the basal ganglia, affecting over one-half million people in the U.S, most over age 50
This paper reports on the results of acoustic analyses on the speech of patients with Parkinson’s disease (PD), both on and off Deep brain stimulation (DBS) stimulation
The first analysis looked for differences in mean syllable rate between treatment conditions; these results are tabulated in Table 1 for the velar alternating motion rate (AMR)
Summary
Parkinson’s disease (PD) is an idiopathic neurodegenerative disease caused by loss of dopamineproducing cells in the substantia nigra of the basal ganglia, affecting over one-half million people in the U.S, most over age 50. Its major symptoms are muscular rigidity, bradykinesia, resting tremor, and postural instability. An estimated 70%–90% of patients with PD develop speech or voice disorders [1] hypokinetic dysarthria [2, page 174]. Hypokinetic dysarthria is characterized by monopitch, monoloudness, underarticulation, and harsh and/or breathy voice. It worsens with disease severity and duration [3] so that patients who are more incapacitated and more reliant on caregivers are more difficult to understand
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