Purpose: Motor speech abnormalities are highly common and debilitating in individuals with idiopathic Parkinson's disease (IPD). These abnormalities, collectively termed hypokinetic dysarthria (HKD), ...have been traditionally attributed to hypokinesia and bradykinesia secondary to muscle rigidity and dopamine deficits. However, the role of rigidity and dopamine in the development of HKD is far from clear. The purpose of the present study was to offer an alternative view of the factors underlying HKD. Method: The authors conducted an extensive, but not exhaustive, review of the literature to examine the evidence for the traditional view versus the alternative view. Results: The review suggests that HKD is a highly complex and variable phenomenon including multiple factors, such as scaling and maintaining movement amplitude and effort; preplanning and initiation of movements; internal cueing; sensory and temporal processing; automaticity; emotive vocalization; and attention to action (vocal vigilance). Although not part of the dysarthria, nonmotor factors, such as depression, aging, and cognitive-linguistic abnormalities, are likely to contribute to the overall speech symptomatology associated with IPD. Conclusion: These findings have important implications for clinical practice and research.
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Recent advances in neuroscience have suggested that exercise-based behavioral treatments may improve function and possibly slow progression of motor symptoms in individuals with Parkinson disease ...(PD). The LSVT (Lee Silverman Voice Treatment) Programs for individuals with PD have been developed and researched over the past 20 years beginning with a focus on the speech motor system (LSVT LOUD) and more recently have been extended to address limb motor systems (LSVT BIG). The unique aspects of the LSVT Programs include the combination of (a) an exclusive target on increasing amplitude (loudness in the speech motor system; bigger movements in the limb motor system), (b) a focus on sensory recalibration to help patients recognize that movements with increased amplitude are within normal limits, even if they feel “too loud” or “too big,” and (c) training self-cueing and attention to action to facilitate long-term maintenance of treatment outcomes. In addition, the intensive mode of delivery is consistent with principles that drive activity-dependent neuroplasticity and motor learning. The purpose of this paper is to provide an integrative discussion of the LSVT Programs including the rationale for their fundamentals, a summary of efficacy data, and a discussion of limitations and future directions for research.
To review recent research and clinical studies pertaining to the nature, diagnosis, and treatment of speech and swallowing disorders in Parkinson disease.
Although some studies indicate improvement ...in voice and speech with dopamine therapy and deep brain stimulation of the subthalamic nucleus, others show minimal or adverse effects. Repetitive transcranial magnetic stimulation of the mouth motor cortex and injection of collagen in the vocal folds have preliminary data supporting improvement in phonation in people with Parkinson disease. Treatments focusing on vocal loudness, specifically LSVT LOUD (Lee Silverman Voice Treatment), have been effective for the treatment of speech disorders in Parkinson disease. Changes in brain activity due to LSVT LOUD provide preliminary evidence for neural plasticity. Computer-based technology makes the Lee Silverman Voice Treatment available to a large number of users. A rat model for studying neuropharmacologic effects on vocalization in Parkinson disease has been developed. New diagnostic methods of speech and swallowing are also available as the result of recent studies.
Speech rehabilitation with the LSVT LOUD is highly efficacious and scientifically tested. There is a need for more studies to improve understanding, diagnosis, prevention, and treatment of speech and swallowing disorders in Parkinson disease.
Expression and perception of emotions by voice are fundamental for basic mental health stability. Since different languages interpret results differently, studies should be guided by the relationship ...between speech complexity and the emotional perception. The aim of our study was therefore to analyze the efficiency of speech stimuli,
vs.
, as it relates to the accuracy of four different categories of emotions:
,
,
, and
. To this end, a total of 2,235 audio clips were presented to 49 females, native Hebrew speakers, aged 20-30 years (M = 23.7; SD = 2.13). Participants were asked to judge audio utterances according to one of four emotional categories: anger, sadness, happiness, and neutrality. Simulated voice samples were consisting of words and meaningful sentences, provided by 15 healthy young females Hebrew native speakers. Generally,
vs.
was not originally accepted as a means of emotional recognition of voice; However, introducing a variety of speech utterances revealed a different perception. Thus, the emotional conveyance provided new, even higher precision to our findings:
emotions produced a higher impact to the single
(χ
= 10.21,
< 0.01) as opposed to the
, while
was identified more accurately with a sentence (χ
= 3.83,
= 0.05). Our findings resulted in a better understanding of how speech types can interpret perception, as a part of mental health.
Abstract In a preliminary study, we documented significant changes in formant transitions associated with successful manual circumlaryngeal treatment (MCT) of muscle tension dysphonia (MTD), ...suggesting improvement in speech articulation. The present study explores further the effects of MTD on vowel articulation by means of additional vowel acoustic measures. Pre- and post-treatment audio recordings of 111 women with MTD were analyzed acoustically using two measures: vowel space area (VSA) and vowel articulation index (VAI), constructed using the first (F1) and second (F2) formants of 4 point vowels/ ɑ, i, æ, u/, extracted from eight words within a standard reading passage. Pairwise t -tests revealed significant increases in both VSA and VAI, confirming that successful treatment of MTD is associated with vowel space expansion. Although MTD is considered a voice disorder, its treatment with MCT appears to positively affect vocal tract dynamics. While the precise mechanism underlying vowel space expansion remains unknown, improvements may be related to lowering of the larynx, expanding oropharyngeal space, and improving articulatory movements. Learning outcomes: The reader will be able to: (1) describe possible articulatory changes associated with successful treatment of muscle tension dysphonia; (2) describe two acoustic methods to assess vowel centralization and decentralization, and; (3) understand the basis for viewing muscle tension dysphonia as a disorder not solely confined to the larynx.
We studied the role of gender in metacognition of voice emotion recognition ability (ERA), reflected by self-rated confidence (SRC). To this end, we guided our study in two approaches: first, by ...examining the role of gender in voice ERA and SRC independently and second, by looking for gender effects on the ERA association with SRC.
We asked 100 participants (50 men, 50 women) to interpret a set of vocal expressions portrayed by 30 actors (16 men, 14 women) as defined by their emotional meaning. Targets were 180 repetitive lexical sentences articulated in congruent emotional voices (anger, sadness, surprise, happiness, fear) and neutral expressions. Trial by trial, the participants were assigned retrospective SRC based on their emotional recognition performance.
A binomial generalized linear mixed model (GLMM) estimating ERA accuracy revealed a significant gender effect, with women encoders (speakers) yielding higher accuracy levels than men. There was no significant effect of the decoder's (listener's) gender. A second GLMM estimating SRC found a significant effect of encoder and decoder genders, with women outperforming men. Gamma correlations were significantly greater than zero for women and men decoders.
In spite of varying interpretations of gender in each independent rating (ERA and SRC), our results suggest that both men and women decoders were accurate in their metacognition regarding voice emotion recognition. Further research is needed to study how individuals of both genders use metacognitive knowledge in their emotional recognition and whether and how such knowledge contributes to effective social communication.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
...preliminary data from laryngeal EMG in two individuals with IPD have documented positive increases in thyroarytenoid (TA) muscle activity post-- LSVT from a pretreatment reduction in TA ...activity-as compared to healthy aging individuals (Ramig, Sapir, et al., 2000). ...increasing loudness does not involve deautomatization of speech production by requiring individuals to focus on specific speech parameters such as rate, pauses, or articulatory precision; rather the speaker simply speaks louder (Dromey, 2000; Klienow et al., 2001; Ramig, Pawlas, et al., 1995). ...studies examining modifications of LSVT at different levels of intensity, with variable versus blocked practice of treatment tasks, treatment in groups, and shorter or longer periods of treatment, will help to elucidate the best mode of administration for optimal treatment results. ...reduced working memory capacity, also described as short-term memory (Baddeley, 1995), has often been found in individuals with IPD (Dalrymple, Kalders, Jones, & Watson, 1994; Gabrieli, Singh, Stebbins, & Goetz, 1996; Owen, Iddon, Hodges, Summers, & Robbins, 1997).
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Purpose: The vowel space area (VSA) has been used as an acoustic metric of dysarthric speech, but with varying degrees of success. In this study, the authors aimed to test an alternative metric to ...the VSA--the "formant centralization ratio" (FCR), which is hypothesized to more effectively differentiate dysarthric from healthy speech and register treatment effects. Method: Speech recordings of 38 individuals with idiopathic Parkinson's disease and dysarthria (19 of whom received 1 month of intensive speech therapy Lee Silverman Voice Treatment; LSVT LOUD) and 14 healthy control participants were acoustically analyzed. Vowels were extracted from short phrases. The same vowel-formant elements were used to construct the FCR, expressed as (F2u + F2a + F1i + F1u ) / (F2i + F1a ), the VSA, expressed as ABS(F1i x (F2a - F2u ) + F1a x (F2u - F2i ) + F1u x (F2i - F2a ) / 2), a logarithmically scaled version of the VSA (LnVSA), and the F2i /F2u ratio. Results: Unlike the VSA and the LnVSA, the FCR and F2i /F2u ratio robustly differentiated dysarthric from healthy speech and were not gender sensitive. All metrics effectively registered treatment effects and were strongly correlated with each other. Conclusion: Albeit preliminary, the present findings indicate that the FCR is a sensitive, valid, and reliable acoustic metric for distinguishing dysarthric from unimpaired speech and for monitoring treatment effects, probably because of reduced sensitivity to interspeaker variability and enhanced sensitivity to vowel centralization.
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Control of Vocal Loudness in Young and Old Adults Baker, Kristin K; Ramig, Lorraine Olson; Sapir, Shimon ...
Journal of speech, language, and hearing research,
04/2001, Letnik:
44, Številka:
2
Journal Article
Recenzirano
This study examined the effect of aging on respiratory and laryngeal mechanisms involved in vocal loudness control. Simultaneous measures of subglottal pressure and electromyographic (EMG) activity ...from the thyroarytenoid (TA), lateral cricoarytenoid (LCA), and cricothyroid (CT) muscles were investigated in young and old individuals while they attempted to phonate at three loudness levels, "soft," "comfortable," and "loud." Voice sound pressure level (SPL) and fundamental frequency (F ) measures were also obtained. Across loudness conditions, subglottal pressure levels were similar for both age groups. Laryngeal EMG measures tended to be lower and more variable for old compared with young individuals. These differences were most apparent for the TA muscle. Finally, across the three loudness conditions, the old individuals generated SPLs that were lower overall than those produced by the young individuals but modulated loudness levels in a manner similar to that of the young subjects. These findings suggest that the laryngeal mechanism may be more affected than the respiratory system in these old individuals and that these changes may affect vocal loudness levels.
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