Voice and Fluency Changes as a Function of Speech Task and Deep Brain Stimulation Complimentary Author Pdf: Not for Broad Dissemination Complimentary Author Pdf: Not for Broad Dissemination

PURPOSE Speaking, which naturally occurs in different modes or "tasks" such as conversation and repetition, relies on intact basal ganglia nuclei. Recent studies suggest that voice and fluency parameters are differentially affected by speech task. In this study, the authors examine the effects of subcortical functionality on voice and fluency, comparing measures obtained from spontaneous and matched repeated speech samples. METHOD Subjects with Parkinson's disease who were being treated with bilateral deep brain stimulation (DBS) of the subthalamic nuclei were tested with stimulators ON and OFF. RESULTS The study found that a voice measure, harmonic to noise ratio, is improved in repetition and in the DBS-ON condition and that dysfluencies are more plentiful in conversation with little or variable influence of DBS condition. CONCLUSIONS These findings suggest that voice and fluency are differentially affected by DBS treatment and that task conditions, interacting with subcortical functionality, influence motor speech performance.

[1]  G. Schulz,et al.  A preliminary study of the effects of sub thalamic nucleus (STN) deep brain stimulation (DBS) on voice and speech characteristics in Parkinson's Disease (PD) , 2001, Clinical linguistics & phonetics.

[2]  G. Weismer,et al.  Kinematic, acoustic, and perceptual analyses of connected speech produced by parkinsonian and normal geriatric adults. , 1989, The Journal of the Acoustical Society of America.

[3]  Daniel Kempler,et al.  Effect of Speech Task on Intelligibility in Dysarthria: A Case Study of Parkinson's Disease , 2002, Brain and Language.

[4]  P. Burgess,et al.  Executive function , 2008, Current Biology.

[5]  G Curio,et al.  Effects of subthalamic deep brain stimulation on dysarthrophonia in Parkinson’s disease , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[6]  R. Hassler.  Striatal control of locomotion, intentional actions and of integrating and perceptive activity , 1978, Journal of the Neurological Sciences.

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

[8]  P. Boon,et al.  Levodopa‐induced modifications of prosody and comprehensibility in advanced Parkinson's disease as perceived by professional listeners , 2007, Clinical linguistics & phonetics.

[9]  P. Alm.  Stuttering and the basal ganglia circuits: a critical review of possible relations. , 2004, Journal of communication disorders.

[10]  Alain Ghio,et al.  L-dopa and STN stimulation effects on pneumophonic coordination in Parkinsonian dysarthria: intra-oral pressure measurements , 2009 .

[11]  Seung-Hun Oh,et al.  Effects of Subthalamic Nucleus Deep Brain Stimulation on the Phonation and Articulation of the Patients with Parkinson's Disease , 2004 .

[12]  Hermann Ackermann,et al.  The contribution of the insula to motor aspects of speech production: A review and a hypothesis , 2004, Brain and Language.

[13]  T. Schenk,et al.  Effects of deep brain stimulation on prehensile movements in PD patients are less pronounced when external timing cues are provided , 2003, Neuropsychologia.

[14]  C. Ludlow.  Central nervous system control of the laryngeal muscles in humans , 2005, Respiratory Physiology & Neurobiology.

[15]  M. Hoehn,et al.  Parkinsonism , 1967, Neurology.

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

[17]  S Fahn,et al.  Committee. Unified Parkinson’s Disease Rating Scale. , 2001 .

[18]  K. V. Baev,et al.  Disturbances of learning processes in the basal ganglia in the pathogenesis of Parkinson's disease: a novel theory. , 1995, Neurological research.

[19]  Torrey M. J. Loucks,et al.  Human brain activation during phonation and exhalation: Common volitional control for two upper airway functions , 2007, NeuroImage.

[20]  P. Boon,et al.  The effect of levodopa on respiration and word intelligibility in people with advanced Parkinson's disease , 2007, Clinical Neurology and Neurosurgery.

[21]  G. Canter.  SPEECH CHARACTERISTICS OF PATIENTS WITH PARKINSON'S DISEASE. 3. ARTICULATION, DIADOCHOKINESIS, AND OVER-ALL SPEECH ADEQUACY. , 1965, The Journal of speech and hearing disorders.

[22]  D R Beukelman,et al.  Communication efficiency of dysarthric speakers as measured by sentence intelligibility and speaking rate. , 1981, The Journal of speech and hearing disorders.

[23]  J. Jackson.  On the nature of the duality of the brain. , 1874 .

[24]  C. Coelho,et al.  Acoustic analysis of parkinsonian speech I: speech characteristics and L-Dopa therapy. , 2002, NeuroRehabilitation.

[25]  Paul Boersma,et al.  Praat, a system for doing phonetics by computer , 2002 .

[26]  David R. Beukelman,et al.  Clinical Management of Dysarthric Speakers , 1987 .

[27]  R. Mailman,et al.  Task specific influences of Parkinson’s disease on the striato-thalamo-cortical and cerebello-thalamo-cortical motor circuitries , 2007, Neuroscience.

[28]  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.

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

[30]  J. Yelnik.  Functional anatomy of the basal ganglia , 2002, Movement disorders : official journal of the Movement Disorder Society.

[31]  R. Barker,et al.  Movement Disorders , 1994, Stereotactic and Functional Neurosurgery.

[32]  Raymond D. Kent,et al.  Task-Based Profiles of the Dysarthrias , 1999, Folia Phoniatrica et Logopaedica.

[33]  A Yamadori,et al.  Preservation of singing in Broca's aphasia. , 1977, Journal of neurology, neurosurgery, and psychiatry.

[34]  A. Benabid,et al.  Effect of Bilateral Subthalamic Nucleus Stimulation and Dopatherapy on Oral Control in Parkinson’s Disease , 1999, European Neurology.

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

[36]  R Iansek,et al.  Motor functions of the basal ganglia , 1993, Psychological research.

[37]  J. Mattingley,et al.  An evaluation of the role of internal cues in the pathogenesis of parkinsonian hypokinesia. , 1993, Brain : a journal of neurology.

[38]  D. Brooks.  Basal ganglia function during normal and parkinsonian movement. PET activation studies. , 1996, Advances in neurology.

[39]  K. J. Cole,et al.  Parkinsonian deficits in serial multiarticulate movements for speech. , 1989, Brain : a journal of neurology.

[40]  C. Marsden,et al.  Disturbance of sequential movements in patients with Parkinson's disease. , 1987, Brain : a journal of neurology.

[41]  Peter Redgrave,et al.  A computational model of action selection in the basal ganglia. I. A new functional anatomy , 2001, Biological Cybernetics.

[42]  C. Marsden.  The mysterious motor function of the basal ganglia , 1982, Neurology.

[43]  Raymond D. Kent,et al.  A speaking task analysis of the dysarthria in cerebellar disease. , 1997, Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics.

[44]  Michael Blomgren,et al.  Parkinsonian speech disfluencies: effects of L-dopa-related fluctuations. , 2003, Journal of fluency disorders.

[45]  G. Andrews,et al.  Stuttering: speech pattern characteristics under fluency-inducing conditions. , 1982, Journal of speech and hearing research.

[46]  M. Ghilardi,et al.  Effects of levodopa infusion on motor activation responses in Parkinson’s disease , 2002, Neurology.

[47]  T. J. Grabowski.  Re-examining the Brain Regions Crucial for Orchestrating Speech Articulation , 2006 .

[48]  Apostolos P. Georgopoulos,et al.  Cortico-basal ganglia relations and coding of motor performance , 1983 .

[49]  Serge Blond,et al.  Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility , 2004, Journal of Neurology.

[50]  Patrick Santens,et al.  The effects of levodopa on word intelligibility in Parkinson's disease. , 2005, Journal of communication disorders.

[51]  K. Simonyan,et al.  Efferent subcortical projections of the laryngeal motorcortex in the rhesus monkey , 2003, Brain Research.

[52]  E. Montgomery,et al.  The relationship of neuronal activity within the sensori-motor region of the subthalamic nucleus to speech , 2006, Brain and Language.

[53]  Paul Boersma,et al.  Praat: doing phonetics by computer , 2003 .

[54]  A. Graybiel.  The Basal Ganglia and Chunking of Action Repertoires , 1998, Neurobiology of Learning and Memory.

[55]  Stephen C. Strother,et al.  Mapping cerebral blood flow during speech production in hereditary ataxia , 2006, NeuroImage.

[56]  Richard S. J. Frackowiak,et al.  The syndrome of gait ignition failure: A report of six cases , 1993, Movement disorders : official journal of the Movement Disorder Society.

[57]  A. Goberman,et al.  Correlation between acoustic speech characteristics and non-speech motor performance in Parkinson Disease. , 2005, Medical science monitor : international medical journal of experimental and clinical research.

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

[59]  V. Wolfe,et al.  Speech changes in Parkinson's disease during treatment with L-dopa. , 1975, Journal of communication disorders.

[60]  Bruce E. Murdoch,et al.  Subcortical Brain Mechanisms in Speech and Language , 2001, Folia Phoniatrica et Logopaedica.

[61]  Stanley T. Rolfe,et al.  A Comparison of the J -lntegral and CTOD Parameters for Short Crack Specimen Testing , 1991 .

[62]  M. Gentil,et al.  The Effect of Levodopa on Vocal Function in Parkinson's Disease , 2001, Clinical neuropharmacology.

[63]  Beth Frearson.  A Comparison of the Aids Sentence List and Spontaneous Speech Intelligibility Scores for Dysarthric Speech , 1985 .

[64]  I. Peretz,et al.  Revisiting the dissociation between singing and speaking in expressive aphasia. , 2003, Brain : a journal of neurology.

[65]  Peter Redgrave,et al.  A computational model of action selection in the basal ganglia. II. Analysis and simulation of behaviour , 2001, Biological Cybernetics.

[66]  Noma B. Anderson,et al.  Human Communication Disorders: An Introduction , 1986 .

[67]  John W. Scott,et al.  Selected Writings of John Hughlings Jackson , 1959 .

[68]  M. A. Basso,et al.  The basal ganglia: An overview of circuits and function , 2008, Neuroscience & Biobehavioral Reviews.

[69]  John L Bradshaw,et al.  For better or worse: The effect of levodopa on speech in Parkinson's disease , 2008, Movement disorders : official journal of the Movement Disorder Society.

[70]  A. Bentivoglio,et al.  Effects of bilateral subthalamic nucleus stimulation and medication on parkinsonian speech impairment. , 2008, Journal of voice : official journal of the Voice Foundation.

[71]  C. Ludlow,et al.  Stuttering: a dynamic motor control disorder. , 2003, Journal of fluency disorders.

[72]  G. Canter.  SPEECH CHARACTERISTICS OF PATIENTS WITH PARKINSON'S DISEASE: I. INTENSITY, PITCH, AND DURATION. , 1963, The Journal of speech and hearing disorders.

[73]  Emily Q. Wang,et al.  The effect of unilateral electrostimulation of the subthalamic nucleus on respiratory/phonatory subsystems of speech production in Parkinson's disease—a preliminary report , 2003, Clinical linguistics & phonetics.

[74]  A. Parent,et al.  Functional anatomy of the basal ganglia. II. The place of subthalamic nucleus and external pallidium in basal ganglia circuitry , 1995, Brain Research Reviews.

[75]  Stephen C Strother,et al.  Predicting performance from functional imaging data: methods matter , 2003, NeuroImage.

[76]  J. Cummings.  Frontal-subcortical circuits and human behavior. , 1998, Archives of neurology.

[77]  J. C. Snidecor,et al.  A comparative study of the pitch and duration characteristics of impromptu speaking and oral reading , 1943 .

[78]  W. Friedman,et al.  The Effects of Pallidotomy Surgery on Sentence Measures across Three Tasks in Parkinson Patients , 2004 .

[79]  Elina Tripoliti,et al.  Effects of contact location and voltage amplitude on speech and movement in bilateral subthalamic nucleus deep brain stimulation , 2008, Movement disorders : official journal of the Movement Disorder Society.

[80]  Shannon C. Mauszycki,et al.  Task Specificity in Adductor Spasmodic Dysphonia Versus Muscle Tension Dysphonia , 2005, The Laryngoscope.

[81]  D. V. van Lancker,et al.  Disturbances of the temporal organization of speech following bilateral thalamic surgery in a patient with Parkinson's disease. , 1985, Journal of communication disorders.

[82]  F. Horak,et al.  Step initiation in Parkinson's disease: Influence of levodopa and external sensory triggers , 1997, Movement disorders : official journal of the Movement Disorder Society.

[83]  A. Parent,et al.  Functional anatomy of the basal ganglia. I. The cortico-basal ganglia-thalamo-cortical loop , 1995, Brain Research Reviews.

[84]  H. Braak,et al.  Stanley Fahn Lecture 2005: The staging procedure for the inclusion body pathology associated with sporadic Parkinson's disease reconsidered , 2006, Movement disorders : official journal of the Movement Disorder Society.

[85]  David Eidelberg,et al.  The assessment of neurological systems with functional imaging , 2007, Brain and Language.

[86]  A. Benabid,et al.  Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease. , 2003, The New England journal of medicine.

[87]  G. Docherty,et al.  Phonetic variation in dysarthric speech as a function of sampling task. , 1995, European journal of disorders of communication : the journal of the College of Speech and Language Therapists, London.

[88]  Patrick Santens,et al.  Levodopa-induced alterations in speech rate in advanced Parkinson's disease. , 2006, Acta neurologica Belgica.