Neurobehavioral Effects of LSVT® LOUD on Auditory-Vocal Integration in Parkinson's Disease: A Preliminary Study.

Yongxue Li,Mingdan Tan,Emily Q Wang,Ling Chen,Hao Fan,Xi Chen,Hanjun Liu,Jingting Li

doi:10.3389/fnins.2021.624801

Abstract

Individuals with Parkinson’s disease (PD) are impaired in auditory-vocal integration, characterized by abnormal compensatory responses to auditory feedback errors during self-monitoring of vocal production. The present study examined whether auditory feedback control of vocal pitch production in PD can benefit from Lee Silverman voice treatment (LSVT® LOUD), a high effort, intensive speech treatment for hypokinetic dysarthria in PD. Before and immediately after LSVT LOUD, 12 individuals with PD were instructed to produce sustained vowel sounds while hearing their voice unexpectedly pitch-shifted by −200 cents. Their vocal responses and event-related potentials (ERPs) to pitch perturbations were measured to assess the treatment outcomes. A group of 12 healthy controls were one-to-one pair matched by age, sex, and language. Individuals with PD exhibited abnormally enhanced vocal and ERP P2 responses to pitch perturbations relative to healthy controls. Successful treatment with LSVT LOUD, however, led to significantly smaller and faster vocal compensations that were accompanied by significantly larger P2 responses. Moreover, improved vocal loudness during passage reading was significantly correlated with reduced vocal compensations for pitch perturbations. These preliminary findings provide the first neurobehavioral evidence for beneficial effects of LSVT LOUD on impaired auditory-vocal integration associated with PD, which may be related to improved laryngeal motor functions and a top-down modulation of the speech motor network by LSVT LOUD.

Highlights

Idiopathic Parkinson’s disease (PD) is a neurodegenerative disorder, affecting 1.0–1.5% of individuals aged 60 years and older (Marsden, 1994) and younger individuals aged 20– 40 years (Kostic, 2009)
This discrepancy may be related to the distinct mechanisms underlying the control of fo and F1 during speech production (Bouchard et al, 2013). These abnormalities in feedback control process associated with PD affect sensorimotor learning during speech production, as reflected by reduced adaptive responses to persistent perturbations in voice fo and speech F1 (Mollaei et al, 2013; Abur et al, 2018). These findings demonstrate that individuals with PD are impaired in auditory-vocal integration, leading to their deficits in the online detection and correction of auditory feedback errors during self-produced speech
The present study investigated whether impaired auditorymotor control of vocal pitch production in PD can benefit from intensive voice treatment with LSVT LOUD

Summary

Introduction

Idiopathic Parkinson’s disease (PD) is a neurodegenerative disorder, affecting 1.0–1.5% of individuals aged 60 years and older (Marsden, 1994) and younger individuals aged 20– 40 years (Kostic, 2009). This discrepancy may be related to the distinct mechanisms underlying the control of fo and F1 during speech production (Bouchard et al, 2013) These abnormalities in feedback control process associated with PD affect sensorimotor learning during speech production, as reflected by reduced adaptive responses to persistent perturbations in voice fo and speech F1 (Mollaei et al, 2013; Abur et al, 2018). Together, these findings demonstrate that individuals with PD are impaired in auditory-vocal integration, leading to their deficits in the online detection and correction of auditory feedback errors during self-produced speech

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