Ellika Schalling

Perceptual and acoustic analysis of speech in individuals with spinocerebellar ataxia (SCA)

With current progress in genetic research, autosomal, dominant, hereditary, neurodegenerative diseases, affecting the cerebellum and cerebellar connections, are increasingly diagnosed as spinocerebellar ataxias (SCA). In the present study speech samples from 21 subjects with spinocerebellar ataxia (SCA), and 21 matched control subjects were analyzed using perceptual and acoustic methodology. Dysarthria assessment showed that subjects had mild or mild-moderate dysarthria. Perceptual analysis indicated that equalized stress, imprecise consonants, vocal instability, monotony and reduced speech rate were the speech parameters that yielded the highest mean perceptual ratings. A factor analysis of perceptual speech parameters revealed two main factors: Factor 1 was associated with articulatory timing and Factor 2 with vocal quality. Acoustic analysis revealed significantly reduced speech rate during text reading, reduced alternating and sequential motion rates (AMR/SMR), significantly longer and more variable syllable and pause durations, and significantly higher vocal instability for subjects with SCA compared to control subjects.

Effects of Tactile Biofeedback by a Portable Voice Accumulator on Voice Sound Level in Speakers with Parkinson's Disease

OBJECTIVES To study the effects of biofeedback on voice sound level (SL) in subjects with reduced voice SL, secondary to Parkinson disease (PD), using a portable voice accumulator. STUDY DESIGN Prospective intervention study. METHODS Voice SL, phonation time, and level of background noise were registered with a portable voice accumulator during three consecutive registration periods. Six subjects with reduced voice SL secondary to PD participated. Biofeedback, in the form of a vibration signal when voice SL went below an individually set threshold level, was administered during the second registration period only. Mean voice SL was calculated for registration periods with and without feedback. Data on phonation time and level of background noise was also collected. Field registrations with the portable voice accumulator were also compared with registrations made in a recording studio. In addition, subjects were asked about subjective experiences of using the portable voice accumulator for up to 15 days. RESULTS There was a statistically significant increase in voice SL during the period when biofeedback of voice SL was administered. Subjects reported that using the portable voice accumulator was a positive experience. Several participants wished to continue using the device. In general, subjects handled the device independently with no major problems and did not report any negative experiences. CONCLUSIONS Although this study was a first trial including six subjects with reduced voice SL secondary to PD, the findings indicate that biofeedback of voice SL administered via a portable voice accumulator may be a useful treatment tool for this group of patients and that further studies are needed.

Acoustic Analysis of Speech Tasks Performed by Three Individuals with Spinocerebellar Ataxia

A number of speech tasks produced by three female subjects with different types of genetically diagnosed spinocerebellar ataxia and with mild dysarthria were investigated using acoustic instrumentation. All subjects showed a number of signs of decreased speech rate, increased pause duration, increased and more variable durations of alternating motion rate, sequential motion rate syllables and inter-stress intervals in addition to vocal instability. These signs were consistent with the perceptual judgment of ataxic dysarthria. Furthermore, the severity of impairment found using these speech analysis methods seemed to correspond to the general severity of the disease and the duration of the illness in these few subjects. The tasks studied appeared to be relevant and suitable for acoustic analyses as they did reveal deviations in the speech of the subjects compared with controls.

Speech in spinocerebellar ataxia.

Spinocerebellar ataxias (SCAs) are a heterogeneous group of autosomal dominant cerebellar ataxias clinically characterized by progressive ataxia, dysarthria and a range of other concomitant neurological symptoms. Only a few studies include detailed characterization of speech symptoms in SCA. Speech symptoms in SCA resemble ataxic dysarthria but symptoms related to phonation may be more prominent. One study to date has shown an association between differences in speech and voice symptoms related to genotype. More studies of speech and voice phenotypes are motivated, to possibly aid in clinical diagnosis. In addition, instrumental speech analysis has been demonstrated to be a reliable measure that may be used to monitor disease progression or therapy outcomes in possible future pharmacological treatments. Intervention by speech and language pathologists should go beyond assessment. Clinical guidelines for management of speech, communication and swallowing need to be developed for individuals with progressive cerebellar ataxia.

Speech and Communication Changes Reported by People with Parkinson’s Disease

Background: Changes in communicative functions are common in Parkinson’s disease (PD), but there are only limited data provided by individuals with PD on how these changes are perceived, what their consequences are, and what type of intervention is provided. Aim: To present self-reported information about speech and communication, the impact on communicative participation, and the amount and type of speech-language pathology services received by people with PD. Methods: Respondents with PD recruited via the Swedish Parkinson’s Disease Society filled out a questionnaire accessed via a Web link or provided in a paper version. Results: Of 188 respondents, 92.5% reported at least one symptom related to communication; the most common symptoms were weak voice, word-finding difficulties, imprecise articulation, and getting off topic in conversation. The speech and communication problems resulted in restricted communicative participation for between a quarter and a third of the respondents, and their speech caused embarrassment sometimes or more often to more than half. Forty-five percent of the respondents had received speech-language pathology services. Conclusions: Most respondents reported both speech and language symptoms, and many experienced restricted communicative participation. Access to speech-language pathology services is still inadequate. Services should also address cognitive/linguistic aspects to meet the needs of people with PD.

Perceptual assessment of dysarthria: Comparison of a general and a detailed assessment protocol

Objective. The present, preliminary study was designed to investigate whether the results of the use of a detailed assessment protocol ad modum the Mayo Clinic rating of dysarthria and that of a more general assessment protocol, corresponding to ratings of deviances of the different speech production processes, differed primarily in terms of reliability. Patients and methods. Recordings of text readings of 20 patients with various degrees and types of dysarthria were assessed using both protocols by five clinicians with extensive experience in assessment of neurogenic communication disorders, and results from both assessments were compared. Results. The general assessment protocol was carried out with higher intra- and inter-rater reliability compared with the detailed assessment protocol. Perceptual deviations were identified in the same domains using both protocols, although only the more detailed protocol could be used to specify particular audible symptoms. Monotony, imprecise consonants, and harsh voice were the most prominent deviations identified with the detailed protocol. Conclusion. It is concluded that a general assessment protocol is sufficient to identify problem areas reliably and indicate severity of dysarthria but needs to be complemented with a short description of the most prominent audible symptoms and an assessment of intelligibility.

Effects of glossopharyngeal breathing on speech and respiration in multiple sclerosis: a case report

This case report describes the effects of glossopharyngeal breathing on respiration and speech in a patient with tetraplegia due to multiple sclerosis. Glossopharyngeal breathing is a technique where air is insufflated with the glossopharyngeal muscles, to increase vital capacity. Results from follow-up assessments up to 20 months after intervention showed that (1) the patient’s speech and respiratory function with glossopharyngeal breathing improved over time, (2) the patient’s respiratory function without glossopharyngeal breathing deteriorated over time (possibly because of a severe cold), and (3) at each assessment, the patient’s speech and respiratory function was better with glossopharyngeal breathing than without it.

Treatment for dysphagia (swallowing difficulties) in hereditary ataxia syndromes

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the efficacy of interventions for swallowing impairment (dysphagia) in people with hereditary ataxia syndromes.

Stimulation of zona incerta in Parkinson’s disease : a first look at speech outcomes

This paper discusses Initiation and inhibition of wrist movements in parkinson patients and healthy controls. It was presented at the Fourteenth International Congress of Parkinsons Disease and Movement Disorders.

Long-term effects of Lee Silverman Voice Treatment on daily voice use in Parkinson’s disease as measured with a portable voice accumulator

Abstract This study examines the effects of an intensive voice treatment focusing on increasing voice intensity, LSVT LOUD® Lee Silverman Voice Treatment, on voice use in daily life in a participant with Parkinson’s disease, using a portable voice accumulator, the VoxLog. A secondary aim was to compare voice use between the participant and a matched healthy control. Participants were an individual with Parkinson’s disease and his healthy monozygotic twin. Voice use was registered with the VoxLog during 9 weeks for the individual with Parkinson’s disease and 2 weeks for the control. This included baseline registrations for both participants, 4 weeks during LSVT LOUD for the individual with Parkinson’s disease and 1 week after treatment for both participants. For the participant with Parkinson’s disease, follow-up registrations at 3, 6, and 12 months post-treatment were made. The individual with Parkinson’s disease increased voice intensity during registrations in daily life with 4.1 dB post-treatment and 1.4 dB at 1-year follow-up compared to before treatment. When monitored during laboratory recordings an increase of 5.6 dB was seen post-treatment and 3.8 dB at 1-year follow-up. Changes in voice intensity were interpreted as a treatment effect as no significant correlations between changes in voice intensity and background noise were found for the individual with Parkinson’s disease. The increase in voice intensity in a laboratory setting was comparable to findings previously reported following LSVT LOUD. The increase registered using ambulatory monitoring in daily life was lower but still reflecting a clinically relevant change.