scholarly journals Picture description in the assessment of connected speech intelligibility in Parkinson's disease: A pilot study

2022 ◽  
Author(s):  
Inga-Lena Johansson ◽  
Christina Samuelsson ◽  
Nicole Müller
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Oral Reading ◽  
Individual Variation ◽  
Speech Intelligibility ◽  
Group Differences ◽  
Speaker Variability ◽  
Additional Information ◽  
Picture Description ◽  
Description Task

Introduction: Assessment of intelligibility in dysarthria tends to rely on oral reading of sentences or words. However, self-generated utterances are closer to a clients’ natural speech. This study investigated how transcription of utterances elicited by picture description can be used in the assessment of intelligibility in speakers with Parkinson’s disease. Methods: Speech samples from eleven speakers with Parkinson’s disease and six neurologically healthy persons were audio-recorded. Forty-two naive listeners completed transcriptions of self-generated sentences from a picture description task and orally read sentences from the Swedish Test of Intelligibility, as well as scaled ratings of narrative speech samples. Results: Intelligibility was higher in orally read than self-generated sentences and higher for content words than for the whole sentence in self-generated sentences for most of the speakers, although these within-group differences were not statistically significant at group level. Adding contextual leads for the listeners increased intelligibility in self-generated utterances significantly, but with individual variation. Although correlations between the intelligibility measures were at least moderate or strong, there was a considerable inter- and intra-speaker variability in intelligibility scores between tasks for the speakers with Parkinson’s disease, indicating individual variation of factors that impact intelligibility. Intelligibility scores from neurologically healthy speakers were generally high across tasks with no significant differences between the conditions. Discussion/Conclusion: Within-speaker variability support literature recommendations to use multiple methods and tasks when assessing intelligibility. The inclusion of transcription of self-generated utterances elicited by picture description to the intelligibility assessment has the potential to provide additional information to assessment methods based on oral reading of pre-scripted sentences, and to inform the planning of interventions.

Constipation is Associated with Development of Cognitive Impairment in de novo Parkinson’s Disease: A Longitudinal Analysis of Two International Cohorts

2021 ◽  
pp. 1-11
Author(s):  
Valentina Leta ◽  
Daniele Urso ◽  
Lucia Batzu ◽  
Daniel Weintraub ◽  
Nataliya Titova ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
De Novo ◽  
Motor Dysfunction ◽  
Group Differences ◽  
Motor Symptoms ◽  
Kaplan Meier ◽  
Patients At Risk ◽  
Non Motor Symptoms

Background: Constipation is regarded as one of the prodromal features of Parkinson’s disease (PD) and there is emerging evidence linking gastrointestinal dysfunction and cognitive impairment (CI) in PD. Objective: We explored whether constipation is associated with development of CI in two independent cohorts of de novo PD patients (n = 196 from the Non-motor International Longitudinal Study [NILS] and n = 423 from the Parkinson’s Progression Markers Initiative [PPMI] study). Methods: Constipation was clinically defined using the Non-Motor Symptoms Scale (NMSS) item-21 [NILS] and Scales for Outcomes in PD-Autonomic (SCOPA-AUT) item-5 [PPMI]. We assessed baseline group differences (PD with or without constipation) in CI, global non-motor symptoms burden, motor dysfunction, and striatal dopaminergic denervation. Kaplan-Meier method estimated group differences in cumulative proportion of patients with incident CI over three years. In PPMI, we subsequently performed univariate and multivariate Cox survival analyses to evaluate whether constipation predicts incident mild cognitive impairment or dementia over a 6-year period, including constipation and other known predictors of CI as covariates. Results: Patients with constipation had greater motor and global non-motor burden in both cohorts at baseline (p <  0.05). Kaplan-Meier plots showed faster conversion to CI in patients with constipation in both cohorts (p <  0.05). In PPMI, 37 subjects developed dementia during a mean follow-up of 4.9 years, and constipation was an independent predictor of dementia onset (hazard ratio = 2.311; p = 0.02). Conclusion: Constipation in de novo PD patients is associated with development of cognitive decline and may serve as a clinical biomarker for identification of patients at risk for cognitive impairment.

Game-Based Augmented Visual Feedback for Enlarging Speech Movements in Parkinson's Disease

2017 ◽  
Vol 60 (6S) ◽  
pp. 1818-1825 ◽  
Author(s):  
Yana Yunusova ◽  
Elaine Kearney ◽  
Madhura Kulkarni ◽  
Brandon Haworth ◽  
Melanie Baljko ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Visual Feedback ◽  
Speech Intelligibility ◽  
Training Session ◽  
Working Space ◽  
Retention Session ◽  
Tongue Movements ◽  
Impaired Speech ◽  
And Training

Purpose The purpose of this pilot study was to demonstrate the effect of augmented visual feedback on acquisition and short-term retention of a relatively simple instruction to increase movement amplitude during speaking tasks in patients with dysarthria due to Parkinson's disease (PD). Method Nine patients diagnosed with PD, hypokinetic dysarthria, and impaired speech intelligibility participated in a training program aimed at increasing the size of their articulatory (tongue) movements during sentences. Two sessions were conducted: a baseline and training session, followed by a retention session 48 hr later. At baseline, sentences were produced at normal, loud, and clear speaking conditions. Game-based visual feedback regarding the size of the articulatory working space (AWS) was presented during training. Results Eight of nine participants benefited from training, increasing their sentence AWS to a greater degree following feedback as compared with the baseline loud and clear conditions. The majority of participants were able to demonstrate the learned skill at the retention session. Conclusions This study demonstrated the feasibility of augmented visual feedback via articulatory kinematics for training movement enlargement in patients with hypokinesia due to PD. Supplemental Materials https://doi.org/10.23641/asha.5116840

scholarly journals Listener Perception of Monopitch, Naturalness, and Intelligibility for Speakers With Parkinson's Disease

2015 ◽  
Vol 58 (4) ◽  
pp. 1134-1144 ◽  
Author(s):  
Supraja Anand ◽  
Cara E. Stepp
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Speech Intelligibility ◽  
Potential Significance ◽  
Rehabilitation Outcomes ◽  
Rate Method ◽  
Highly Correlated ◽  
Short Utterances ◽  
Speech Naturalness

PurposeGiven the potential significance of speech naturalness to functional and social rehabilitation outcomes, the objective of this study was to examine the effect of listener perceptions of monopitch on speech naturalness and intelligibility in individuals with Parkinson's disease (PD).MethodTwo short utterances were extracted from monologue samples of 16 speakers with PD and 5 age-matched adults without PD. Sixteen listeners evaluated these stimuli for monopitch, speech naturalness and intelligibility using the visual sort and rate method.ResultsNaïve listeners can reliably judge monopitch, speech naturalness, and intelligibility with minimal familiarization. While monopitch and speech intelligibility were only moderately correlated, monopitch and speech naturalness were highly correlated.ConclusionsA great deal of attention is currently being paid to improvement of vocal loudness and thus speech intelligibility in PD. Our findings suggest that prosodic characteristics such as monopitch should be explored as adjuncts to this treatment of dysarthria in PD. Development of such prosodic treatments may enhance speech naturalness and thus improve quality of life.

scholarly journals Group-based music intervention in Parkinson’s disease – findings from a mixed-methods study

2020 ◽  
Vol 34 (4) ◽  
pp. 533-544
Author(s):  
Petra Pohl ◽  
Ewa Wressle ◽  
Fredrik Lundin ◽  
Paul Enthoven ◽  
Nil Dizdar
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Intervention Group ◽  
Group Differences ◽  
Control Group ◽  
Music Intervention ◽  
Post Intervention

Objective: To evaluate a group-based music intervention in patients with Parkinson’s disease. Design: Parallel group randomized controlled trial with qualitative triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinson’s disease were randomized into intervention group ( n = 26), which received training with the music-based intervention, and control group ( n = 20) without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7’s (dual-task ability). Secondary outcomes were cognition, balance, concerns about falling, freezing of gait, and quality of life. All outcomes were evaluated at baseline, post-intervention, and three months post-intervention. Focus groups and individual interviews were conducted with the intervention group and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability. Between-group differences were observed for Falls Efficacy Scale (mean difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0, P = 0.001) and for Parkinson Disease Questionnaire-39 items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when compared to the control group post-intervention, but these were not maintained at three months post-intervention. Three themes were derived from the interviews: Expectations versus Results, Perspectives on Treatment Contents, and Key Factors for Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music intervention adds value to mood, alertness, and quality of life in patients with Parkinson’s disease. The study does not support the efficacy in producing immediate or lasting gains in dual-tasking, cognition, balance, or freezing of gait.

scholarly journals Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

2018 ◽  
Vol 120 (4) ◽  
pp. 1516-1524 ◽  
Author(s):  
Jeann L. Sabino-Carvalho ◽  
André L. Teixeira ◽  
Milena Samora ◽  
Maurício Daher ◽  
Lauro C. Vianna
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cold Pressor Test ◽  
Peripheral Resistance ◽  
Cold Pressor ◽  
Cardiovascular Responses ◽  
Group Differences ◽  
Muscle Metaboreflex ◽  
Pressor Test

Patients with Parkinson’s disease (PD) exhibit attenuated cardiovascular responses to exercise. The underlying mechanisms that are potentially contributing to these impairments are not fully understood. Therefore, we sought to test the hypothesis that patients with PD exhibit blunted cardiovascular responses to isolated muscle metaboreflex activation following exercise. For this, mean blood pressure, cardiac output, and total peripheral resistance were measured using finger photoplethysmography and the Modelflow method in 11 patients with PD [66 ± 2 yr; Hoehn and Yahr score: 2 ± 1 a.u.; time since diagnosis: 7 ± 1 yr; means ± SD) and 9 age-matched controls (66 ± 3 yr). Measurements were obtained at rest, during isometric handgrip exercise performed at 40% maximal voluntary contraction, and during postexercise ischemia. Also, a cold pressor test was assessed to confirm that blunted cardiovascular responses were specific to exercise and not representative of generalized sympathetic responsiveness. Changes in mean blood pressure were attenuated in patients with PD during handgrip (PD: ∆25 ± 2 mmHg vs. controls: ∆31 ± 3 mmHg; P < 0.05), and these group differences remained during postexercise ischemia (∆17 ± 1 mmHg vs. ∆26 ± 1 mmHg, respectively; P < 0.01). Additionally, changes in total peripheral resistance were attenuated during exercise and postexercise ischemia, indicating blunted reflex vasoconstriction in patients with PD. Responses to cold pressor test did not differ between groups, suggesting no group differences in generalized sympathetic responsiveness. Our results support the concept that attenuated cardiovascular responses to exercise observed in patients with PD are, at least in part, explained by an altered skeletal muscle metaboreflex. NEW & NOTEWORTHY Patients with Parkinson’s disease (PD) presented blunted cardiovascular responses to exercise. We showed that cardiovascular response evoked by the metabolic component of the exercise pressor reflex is blunted in patients with PD. Furthermore, patients with PD presented similar pressor response during the cold pressor test compared with age-matched controls. Altogether, our results support the hypothesis that attenuated cardiovascular responses to exercise observed in patients with PD are mediate by an altered skeletal muscle metaboreflex.

Effects of Neurosurgical Management of Parkinson's Disease on Speech Characteristics and Oromotor Function

2005 ◽  
Vol 48 (1) ◽  
pp. 5-20 ◽  
Author(s):  
Anna Farrell ◽  
Deborah Theodoros ◽  
Elizabeth Ward ◽  
Bruce Hall ◽  
Peter Silburn
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Function ◽  
Speech Intelligibility ◽  
General Motor ◽  
Neurologically Impaired ◽  
Speech Characteristics ◽  
Participant Group ◽  
Neurosurgical Intervention ◽  
Deep Brain

The present study examined the effects of neurosurgical management of Parkinson’s disease (PD), including the procedures of pallidotomy, thalamotomy, and deep-brain stimulation (DBS) on perceptual speech characteristics, speech intelligibility, and oromotor function in a group of 22 participants with PD. The surgical participant group was compared with a group of 25 non-neurologically impaired individuals matched for age and sex. In addition, the study investigated 16 participants with PD who did not undergo neurosurgical management to control for disease progression. Results revealed that neurosurgical intervention did not significantly change the surgical participants’ perceptual speech dimensions or oromotor function despite significant postoperative improvements in ratings of general motor function and disease severity. Reasons why neurosurgical intervention resulted in dissimilar outcomes with respect to participants’ perceptual speech dimensions and general motor function are proposed.

scholarly journals Olfaction in patients with Parkinson’s disease: a new threshold test analysis through turning points trajectories

2021 ◽  
Author(s):  
Maria Paola Cecchini ◽  
Elisa Mantovani ◽  
Angela Federico ◽  
Alice Zanini ◽  
Sarah Ottaviani ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Test Pattern ◽  
Turning Points ◽  
Motor Symptom ◽  
Olfactory Threshold ◽  
Test Analysis ◽  
Threshold Test ◽  
Additional Information ◽  
Olfactory Deficit

AbstractOlfactory deficit is a widely documented non-motor symptom in Parkinson’s disease (PD). Abnormal turning points trajectories through olfactory threshold testing have been recently reported in patients with olfactory dysfunction, who seem to adapt faster to olfactory stimuli, but data on PD patients are lacking. The aim of this study is to perform olfactory threshold test and explore the turning points trajectories in PD patients in comparison to normal controls. We recruited 59 PD patients without dementia, and no conditions that could influence evaluation of olfaction and cognition. Sixty healthy subjects served as controls. Patients and controls underwent a comprehensive olfactory evaluation with the Sniffin’ Sticks extended test assessing threshold, discrimination and identification and a full neuropsychological evaluation. Besides, threshold test data were analyzed examining all the turning points trajectories. PD patients showed a different olfactory threshold test pattern, i.e., faster olfactory adaptation, than controls with no effect of age. Normosmic PD patients showed different olfactory threshold test pattern, i.e., better threshold score, than normosmic controls. Visuospatial dysfunction was the only factor that significantly influenced this pattern. Olfactory threshold trajectories suggested a possible adaptation phenomenon in PD patients. Our data offered some new insights on normosmic PD patients, which appear to be a subset with a specific psychophysical profile. The analysis of the turning points trajectories, through an olfactory threshold test, could offer additional information on olfactory function in PD patients. Future larger studies should confirm these preliminary findings.

Information Content and Efficiency in the Spoken Discourse of Individuals With Parkinson's Disease

2018 ◽  
Vol 61 (9) ◽  
pp. 2259-2274 ◽  
Author(s):  
Angela Roberts ◽  
Danielle Post
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Information Content ◽  
Speech Intelligibility ◽  
Rating Scale ◽  
Control Group ◽  
Primary Analysis ◽  
Cross Sectional ◽  
Severity Scores ◽  
Global Cognition

Purpose This study compared the information content and information efficiency of spoken language in individuals with Parkinson's disease (PD) to a healthy comparator group. Method Nineteen participants with PD and 19 healthy older adults completed the prospective, cross-sectional study. In the primary analysis, 2 language samples elicited by standardized protocols were analyzed for group differences using standard discourse informativeness measures including main events (MEs; Wright, Capilouto, Wagovich, Cranfill, & Davis, 2005) analyzed as %MEs and correct information units (CIUs; Nicholas & Brookshire, 1993) analyzed as %CIUs and CIUs/min. In exploratory analyses, the following were examined: (a) associations among conceptual (%MEs) and lexical (%CIUs and CIUs/min) measures and (b) associations among informativeness measures and age, education, disease severity/duration, global cognition, speech intelligibility, and a verb confrontation naming measure. Results In the primary analysis, the PD group differed significantly from the control group on conceptual (%MEs) and lexical measures of content (%CIUs) and efficiency (CIUs/min). In exploratory analyses, for the control group %MEs were significantly correlated with CIUs/min. Significant associations among conceptual and lexical measures of informativeness were not found in the PD group. For controls, there were no significant correlations between informativeness measures and any of the demographic or speech/cognitive/language variables. In the PD group, there was a significant and positive association between CIUs/min and Dementia Rating Scale–Second Edition scores (Mattis, 2001). A significant but negative correlation was found between CIUs/min and motor severity scores. However, %MEs and verb naming were significantly and positively correlated. Conclusions Individuals with PD without dementia demonstrated reduced discourse informativeness that reflects disruptions to both conceptual and lexical discourse processes. In exploratory analyses, reduced efficiency of information content was associated with global cognition and motor severity. Clinical and research implications are discussed within a Cognitivist framework of discourse production (Sheratt, 2007).

scholarly journals Impairment in Theory of Mind in Parkinson’s Disease Is Explained by Deficits in Inhibition

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Jennifer A. Foley ◽  
Claire Lancaster ◽  
Elena Poznyak ◽  
Olga Borejko ◽  
Elaine Niven ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Theory Of Mind ◽  
Executive Functioning ◽  
Convincing Evidence ◽  
Social Reasoning ◽  
Group Differences ◽  
Healthy Controls ◽  
Significant Group

Objective. Several studies have reported that people with Parkinson’s disease (PD) perform poorly on tests of ‘Theory of Mind’ (ToM), suggesting impairment in the ability to understand and infer other people’s thoughts and feelings. However, few studies have sought to separate the processes involved in social reasoning from those involved in managing the inhibitory demands on these tests. In this study, we investigated the contribution of inhibition to ToM performance in PD. Methods. 18 PD patients and 22 age-matched healthy controls performed a ToM test that separates the ability to infer someone else’s perspective from the ability to inhibit one’s own. Participants also completed a battery of standard measures of social and executive functioning, including measures of inhibition. Results. The PD patients performed worse on the ToM test only when the inhibitory demands were high. When the level of inhibition required was reduced, there were no significant group differences. Furthermore, executive impairments in PD patients were limited to measures of inhibition, with disadvantages associated with poorer ToM performance in this group. Conclusions. This study provides convincing evidence that the apparent impairment observed on ToM tests in PD is explained by deficits in inhibition.

Feedback and Feedforward Auditory-Motor Processes for Voice and Articulation in Parkinson's Disease

2021 ◽  
pp. 1-13
Author(s):  
Defne Abur ◽  
Austeja Subaciute ◽  
Ayoub Daliri ◽  
Rosemary A. Lester-Smith ◽  
Ashling A. Lupiani ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Control ◽  
Speech Intelligibility ◽  
Adaptive Responses ◽  
Formant Frequency ◽  
Motor Processes ◽  
Medication Schedule ◽  
Articulatory Features ◽  
Auditory Acuity

Purpose Unexpected and sustained manipulations of auditory feedback during speech production result in “reflexive” and “adaptive” responses, which can shed light on feedback and feedforward auditory-motor control processes, respectively. Persons with Parkinson's disease (PwPD) have shown aberrant reflexive and adaptive responses, but responses appear to differ for control of vocal and articulatory features. However, these responses have not been examined for both voice and articulation in the same speakers and with respect to auditory acuity and functional speech outcomes (speech intelligibility and naturalness). Method Here, 28 PwPD on their typical dopaminergic medication schedule and 28 age-, sex-, and hearing-matched controls completed tasks yielding reflexive and adaptive responses as well as auditory acuity for both vocal and articulatory features. Results No group differences were found for any measures of auditory-motor control, conflicting with prior findings in PwPD while off medication. Auditory-motor measures were also compared with listener ratings of speech function: first formant frequency acuity was related to speech intelligibility, whereas adaptive responses to vocal fundamental frequency manipulations were related to speech naturalness. Conclusions These results support that auditory-motor processes for both voice and articulatory features are intact for PwPD receiving medication. This work is also the first to suggest associations between measures of auditory-motor control and speech intelligibility and naturalness.

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