Supraglottal Hyperadduction in an Individual With Parkinson Disease

Abstract

Recent treatment for voice problems associated with idiopathic Parkinson disease has primarily focused on increasing reduced vocal loudness and improving true vocal fold hypoadduction, common voice deficits observed in these individuals. This study presents an individual with reduced vocal loudness and supraglottic hyperadduction accompanying Parkinson disease and the outcome following a course of the Lee Silverman Voice Treatment (LSVT). Posttreatment observations included increased vocal loudness, decreased supraglottic hyperadduction, and improved intonation and overall voice quality when compared with pretreatment observations. These results suggest that in this individual, supraglottic hyperadduction was due to a secondary compensatory behavior resulting from mild true vocal fold hypoadduction that responded positively to adduction therapy (LSVT). This study also demonstrates the use of a continuum of observations ranging from functional ratings to physiological measures to evaluate the impact of intensive voice treatment and identify mechanisms underlying treatment-related change in an individual with Parkinson disease.