Dataset Information

Speech and communication in Parkinson's disease: a cross-sectional exploratory study in the UK.

ABSTRACT:

Objective

To assess associations between cognitive status, intelligibility, acoustics and functional communication in PD.

Design

Cross-sectional exploratory study of functional communication, including a within-participants experimental design for listener assessment.

Setting

A major academic medical centre in the East of England, UK.

Participants

Questionnaire data were assessed for 45 people with Parkinson's disease (PD), who had self-reported speech or communication difficulties and did not have clinical dementia. Acoustic and listener analyses were conducted on read and conversational speech for 20 people with PD and 20 familiar conversation partner controls without speech, language or cognitive difficulties.

Main outcome measures

Functional communication assessed by the Communicative Participation Item Bank (CPIB) and Communicative Effectiveness Survey (CES).

Results

People with PD had lower intelligibility than controls for both the read (mean difference 13.7%, p=0.009) and conversational (mean difference 16.2%, p=0.04) sentences. Intensity and pause were statistically significant predictors of intelligibility in read sentences. Listeners were less accurate identifying the intended emotion in the speech of people with PD (14.8% point difference across conditions, p=0.02) and this was associated with worse speaker cognitive status (16.7% point difference, p=0.04). Cognitive status was a significant predictor of functional communication using CPIB (F=8.99, p=0.005, ?² = 0.15) but not CES. Intelligibility in conversation sentences was a statistically significant predictor of CPIB (F=4.96, p=0.04, ?² = 0.19) and CES (F=13.65, p=0.002, ?² = 0.43). Read sentence intelligibility was not a significant predictor of either outcome.

Conclusions

Cognitive status was an important predictor of functional communication-the role of intelligibility was modest and limited to conversational and not read speech. Our results highlight the importance of focusing on functional communication as well as physical speech impairment in speech and language therapy (SLT) for PD. Our results could inform future trials of SLT techniques for PD.

SUBMITTER: Barnish MS

PROVIDER: S-EPMC5730006 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Speech and communication in Parkinson's disease: a cross-sectional exploratory study in the UK.

Barnish Maxwell S MS Horton Simon M C SMC Butterfint Zoe R ZR Clark Allan B AB Atkinson Rachel A RA Deane Katherine H O KHO

BMJ open 20170529 5

<h4>Objective</h4>To assess associations between cognitive status, intelligibility, acoustics and functional communication in PD.<h4>Design</h4>Cross-sectional exploratory study of functional communication, including a within-participants experimental design for listener assessment.<h4>Setting</h4>A major academic medical centre in the East of England, UK.<h4>Participants</h4>Questionnaire data were assessed for 45 people with Parkinson's disease (PD), who had self-reported speech or communicati ...[more]

PMID: 28554918

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Project description:PurposeMuch of the research literature on childhood apraxia of speech (CAS) has focused on understanding, diagnosing, and treating the impairment, rather than examining its functional effect on children's daily lives. This study focuses on the Personal Factors component of the World Health Organization International Classification of Functioning, Disability and Health-Children and Youth Version Framework. Specifically, the purpose was to examine the self-reported communication attitudes of children with CAS.MethodTwo validated communication attitude questionnaires were administered to 12 children with CAS enrolled in an intensive speech-focused intervention (age range: 4-10 years old). Children's scores were compared to the questionnaires' typically developing norms. Descriptive analyses explored relationships between communication attitude and CAS severity, caregiver perceptions of communicative participation, frustration ratings during therapy, and change in communication attitude over a brief time.ResultsOlder (ages 6-10 years) but not younger (ages 4-5;11 [years;months]) children with CAS were more likely to have negative attitudes about their speech. No clear relationships were observed between communication attitudes and caregiver perceptions of communicative participation; small positive relationships were observed between communication attitude and frustration during therapy. For the younger children, there was also a relationship with CAS severity. For most children, no change in communication attitude was observed over a brief period, though one child appeared to develop more negative and one appeared to develop more positive attitudes.ConclusionsThese initial findings suggest that older children with CAS may be at greater risk for negative communication attitudes than their peers without CAS. The findings also highlight the need to include more child self-report measures in research. Further implications for CAS assessment and intervention are discussed.Supplemental materialhttps://doi.org/10.23641/asha.21834432.

Project description:ObjectivesTo determine the prevalence and clinical features associated with micrographia in Parkinson's Disease (PD).SettingThis study was conducted at a Movement Disorders clinic located in a Veteran Administration Hospital.ParticipantsPD subjects were included only if they satisfied UK Parkinson's Disease Society criteria for diagnosis. Subjects with history of severe tremors, dystonia, dyskinesia, strokes, peripheral neuropathy and dementia were excluded.DesignThis was a case-control study where PD subjects were prospectively enrolled and their demographics, Hoehn & Yahr stage, Unified Parkinson's Disease Rating Scale and Mini Mental Status examination (MMSE) scores were recorded. All subjects were specifically asked for micrographia on history and the handwritings were quantitatively documented. Bradykinesia was determined by history and quantified by a finger tap, Purdue pegboard and a timed walk test. Similarly, hypophonia was determined by history and the volume of speech quantified using a decibel meter. Controls were enrolled for validation of handwriting test scores and decibel meter recordings.Primary outcome measuresPrevalence of micrographia in the PD cohort and the clinical factors that correlate with micrographia.Results68 subjects with PD were enrolled (68 men; mean age 72.3 years). Micrographia was identified in 63.2% of the cohort on verbal history and in 50% of the cohort when the handwriting test was used for ascertainment. Micrographia ascertained on history correlated significantly with disease severity (Hoehn & Yahr stage), motor impairment (Unified Parkinson's Disease Rating Scale), cognitive impairment (MMSE) and both bradykinesia and hypophonia determined by history and quantitative testing. Micrographia on handwriting test correlated with age (p=0.02), MMSE testing (p=0.04), hypophonia by history (p=0.01) and bradykinesia by quantitative testing (p=0.04).ConclusionMicrographia was found in nearly half of the PD cohort. Disease severity and impaired cognition were important clinical correlates. Micrographia had a significant relationship with bradykinesia and hypophonia, suggesting a possible overlap in their pathophysiology.

Dataset Information

Speech and communication in Parkinson's disease: a cross-sectional exploratory study in the UK.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Speech and communication in Parkinson's disease: a cross-sectional exploratory study in the UK.

Similar Datasets

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