Does voice amplification increase intelligibility in people with Parkinson's disease?

Abstract

Background/Aims: Patients with speech intelligibility difficulties associated with a quiet voice are often prescribed a voice amplifier. This study examined whether artificial voice amplification improved intelligibility in people with Parkinson's disease and whether there was an optimum increase that brought about best improvement. Methods: Twelve people diagnosed with Parkinson's disease (mild=4, moderate intelligibility difficulties=8) and five age-matched controls read low predictability sentences in their habitual voice. Audio recordings were digitally manipulated to create samples at +2.3 dB, +5 dB and +10 dB amplification. Listeners transcribed the recorded sentences. The percentage of words correctly identified was compared across levels of amplification and groups. Results: Participants with moderate Parkinson's disease were significantly less intelligible than controls in all conditions. Moderately, but not mildly affected participants with Parkinson's disease showed higher intelligibility in the amplified conditions, though statistically significantly only at +2.3 dB. No other significant effects of intensity or interactions with groups were found. At an individual level, some participants showed clear advantages of amplification. Conclusion: Based on results from the current participants, potential benefits of amplification cannot be promised to all people with Parkinson's disease. Nevertheless, several provisos regarding methods employed suggest the question can gainfully be pursued using broader measures to assess effects of amplification with more varied groups of people with Parkinson's disease and with other aetiologies where voice production can be an issue.