Digital voice analysis in patients with advanced Parkinson's disease undergoing deep brain stimulation therapy.

INTRODUCTION An acoustic analysis was conducted of the voice of 25 patients with Parkinson's disease (PD) subjected to deep brain stimulation (DBS) to assess the impact of therapy. MATERIALS AND METHODS We examined 25 patients with advanced PD under four different conditions: deprived of medical treatment, under medical treatment, and one week and one month after the implant of the DBS electrodes. At the four time points, the patients produced a sustained /a/ and a standard sentence in Spanish, and microphone and electroglottographic recordings were digitally analyzed using the Computerized Speech Lab program. RESULTS Waveform analysis of the sustained /a/ captured by the microphone indicated a higher fundamental frequency (F(0)) when the patients were under levodopa treatment. The frequency perturbation (jitter) decreased remarkably after the three treatments. Shimmer also fell, but differences were not significant. CONCLUSIONS Nearly all acoustic analysis parameters during phonation of a sustained /a/ improved after DBS, but the factor that was most sensitive to the impact of both surgical and medical therapy was jitter.

[1]  B. Gerratt,et al.  Glottographic Measurement of Vocal Dysfunction , 1983, The Annals of otology, rhinology, and laryngology.

[2]  A. Aronson,et al.  Motor Speech Disorders , 2014 .

[3]  P. Zwirner,et al.  Vocal tract steadiness: a measure of phonatory and upper airway motor control during phonation in dysarthria. , 1992, Journal of speech and hearing research.

[4]  C. Marsden,et al.  Recent Developments in Parkinson's Disease , 1986 .

[5]  Serge Pinto,et al.  Effect of bilateral stimulation of the subthalamic nucleus on parkinsonian dysarthria , 2003, Brain and Language.

[6]  I. Regidor,et al.  Further supporting evidence of beneficial subthalamic stimulation in Parkinson’s patients , 2002, Neurology.

[7]  Hermann Ackermann,et al.  Gender-Specific Vocal Dysfunctions in Parkinson's Disease: Electroglottographic and Acoustic Analyses , 1995, The Annals of otology, rhinology, and laryngology.

[8]  A. Aronson,et al.  Differential diagnostic patterns of dysarthria. , 1969, Journal of speech and hearing research.

[9]  J. Abbs,et al.  Vocal fold physiology : contemporary research and clinical issues , 1983 .

[10]  A. Benabid,et al.  Effect of Bilateral Stimulation of the Subthalamic Nucleus on Parkinsonian Voice , 2001, Brain and Language.

[11]  E. Lin,et al.  Glottographic Measures Before and After Levodopa Treatment in Parkinson's Disease , 1999, The Laryngoscope.

[12]  G. Mckhann,et al.  Diseases of the Nervous System: Clinical Neurobiology , 1992 .

[13]  S. Fahn Unified Parkinson's Disease Rating Scale , 1987 .

[14]  T. Pring,et al.  Speech therapy and Parkinson's disease: a review and further data. , 1990, The British journal of disorders of communication.

[15]  Jack Jiang,et al.  Clinical Evaluation of Parkinson's‐Related Dysphonia , 2006, The Laryngoscope.

[16]  Stanley Fahn,et al.  Movement disorders of the larynx , 1992 .

[17]  J A Molina,et al.  Acoustic voice analysis in untreated patients with Parkinson's disease. , 1997, Parkinsonism & related disorders.

[18]  A. Lang,et al.  An investigation of the effects of subthalamic nucleus stimulation on acoustic measures of voice , 2000, Movement disorders : official journal of the Movement Disorder Society.

[19]  G. Canter SPEECH CHARACTERISTICS OF PATIENTS WITH PARKINSON'S DISEASE. II. PHYSIOLOGICAL SUPPORT FOR SPEECH. , 1965, The Journal of speech and hearing disorders.

[20]  Gary Weismer,et al.  Acoustic Descriptions of Dysarthric Speech: Perceptual Correlates and Physiological Inferences , 1984 .

[21]  Jorge Guridi,et al.  Tratamiento quirúrgico de la enfermedad de Parkinson , 2004 .

[22]  T Murry,et al.  Phonatory function of neurologically impaired patients. , 1991, Journal of communication disorders.

[23]  A L Benabid,et al.  Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson's disease. , 1998, Brain : a journal of neurology.

[24]  I. Cobeta,et al.  Acoustic voice analysis in patients with Parkinson's disease treated with dopaminergic drugs. , 1997, Journal of voice : official journal of the Voice Foundation.

[25]  Ingo R. Titze,et al.  Acoustic Analysis of Voices of Patients with Neurologic Disease: Rationale and Preliminary Data , 1988, The Annals of otology, rhinology, and laryngology.

[26]  A. Benabid,et al.  Effect of stimulation of the subthalamic nucleus on oral control of patients with parkinsonism , 1999, Journal of neurology, neurosurgery, and psychiatry.

[27]  S. Fahn Members of the UPDRS Development Committee. Unified Parkinson's Disease Rating Scale , 1987 .