Perceptual measures of speech from individuals with Parkinson's disease and multiple sclerosis: intelligibility and beyond.
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ABSTRACT:
SUBMITTER: Sussman JE
PROVIDER: S-EPMC5564315 | biostudies-other | 2012 Aug
REPOSITORIES: biostudies-other
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Project description:The perceptual consequences of rate reduction, increased vocal intensity, and clear speech were studied in speakers with multiple sclerosis (MS), Parkinson's disease (PD), and healthy controls.Seventy-eight speakers read sentences in habitual, clear, loud, and slow conditions. Sentences were equated for peak amplitude and mixed with multitalker babble for presentation to listeners. Using a computerized visual analog scale, listeners judged intelligibility or speech severity as operationally defined in Sussman and Tjaden (2012).Loud and clear but not slow conditions improved intelligibility relative to the habitual condition. With the exception of the loud condition for the PD group, speech severity did not improve above habitual and was reduced relative to habitual in some instances. Intelligibility and speech severity were strongly related, but relationships for disordered speakers were weaker in clear and slow conditions versus habitual.Both clear and loud speech show promise for improving intelligibility and maintaining or improving speech severity in multitalker babble for speakers with mild dysarthria secondary to MS or PD, at least as these perceptual constructs were defined and measured in this study. Although scaled intelligibility and speech severity overlap, the metrics further appear to have some separate value in documenting treatment-related speech changes.
| S-EPMC5564324 | biostudies-other
Project description:Sensory and motor skills can be improved with training, but learning is often restricted to practice stimuli. As an exception, training on closed-loop (CL) sensorimotor interfaces, such as action video games and musical instruments, can impart a broad spectrum of perceptual benefits. Here we ask whether computerized CL auditory training can enhance speech understanding in levels of background noise that approximate a crowded restaurant. Elderly hearing-impaired subjects trained for 8 weeks on a CL game that, like a musical instrument, challenged them to monitor subtle deviations between predicted and actual auditory feedback as they moved their fingertip through a virtual soundscape. We performed our study as a randomized, double-blind, placebo-controlled trial by training other subjects in an auditory working-memory (WM) task. Subjects in both groups improved at their respective auditory tasks and reported comparable expectations for improved speech processing, thereby controlling for placebo effects. Whereas speech intelligibility was unchanged after WM training, subjects in the CL training group could correctly identify 25% more words in spoken sentences or digit sequences presented in high levels of background noise. Numerically, CL audiomotor training provided more than three times the benefit of our subjects' hearing aids for speech processing in noisy listening conditions. Gains in speech intelligibility could be predicted from gameplay accuracy and baseline inhibitory control. However, benefits did not persist in the absence of continuing practice. These studies employ stringent clinical standards to demonstrate that perceptual learning on a computerized audio game can transfer to "real-world" communication challenges.
| S-EPMC5997394 | biostudies-literature
Project description:BackgroundMore than 6,000,000 individuals worldwide are diagnosed with Parkinson's disease (PD). Nearly 90% develop speech signs that may substantially impair their speech intelligibility, resulting in losses in their communication and quality of life. Benefits of intensive speech treatment have been documented for a range of speech signs. However, the critical question of whether speech is more intelligible after treatment has not been investigated in a randomised controlled trial (RCT). We hypothesised that intensive speech treatment would improve speech intelligibility in PD.MethodSixty-four patients with hypokinetic dysarthria secondary to PD participated in this single-centre, parallel arm, statistically-powered RCT. Reporting follows CONSORT guidelines for non-pharmacological treatment. Patients were recruited from US clinics and randomised using a statistician-derived minimisation algorithm, to intensive speech treatment (16 1-hour sessions/1 month) targeting voice (voice group) or targeting articulation (articulation group) or to an untreated group (no treatment group). Speech treatments were delivered by speech clinicians who specialised in treating patients with PD. Trial design minimised bias and supported equipoise. For intelligibility assessment, blinded listeners (n = 117) orthographically transcribed 57 patients' recorded, self-generated narrative speech samples, randomly presented in multi-talker babble noise. Listeners were American-English speakers, ages 18-35 years, with normal hearing. The primary outcome was baseline (pre-treatment) to post-treatment change in transcription accuracy (TA), recognised as the most objective measure of intelligibility. TA was defined as the percentage of words transcribed correctly. Listeners, data collectors, and data managers were blinded to treatment conditions and groups. Reliability was evaluated using intraclass correlation coefficients and differences amongst groups were evaluated by mixed-effects models, in accordance with the intention-to-treat approach.This trial was registered with ClinicalTrials.gov Identifier: NCT00123084.FindingsBetween June 23, 2016 and August 14, 2017, blinded listeners transcribed baseline and post-treatment speech samples for intelligibility assessment of 57 patients in the voice (n = 19), articulation (n = 19) and no treatment (n = 19) groups. Between-group differences (d) in changes from baseline to post-treatment in TA indicated significantly greater increases following treatment targeting voice than treatment targeting articulation (d = 26·2%, 95% CI 1·5 - 51·0; p = 0·04; ES=1·0). Differences between TA changes in the treatment targeting voice and in the no treatment group were significant (d = 42·8%, 95% CI 22·4 - 63·2; p = 0·0002; ES=1·8). Differences between TA changes in the treatment targeting articulation and in the no treatment group were not significant (d = 16·5%, 95% CI -6·1 - 39·2; p = 0·147; ES=0·9).InterpretationThese findings provide the first RCT evidence that intensive speech treatment targeting voice improves speech intelligibility in PD. Thus, this evidence-based treatment may positively impact health-related quality of life for patients with PD globally when it is included in patient management.Funding
| S-EPMC7327886 | biostudies-literature
Project description:To investigate the effects of l-dopa (Levodopa) and cZi-DBS (deep brain stimulation in caudal zona incerta) on spontaneous speech intelligibility in patients with PD (Parkinson's disease).Spontaneous utterances were extracted from anechoic recordings from 11 patients with PD preoperatively (off and on l-dopa medication) and 6 and 12 months post bilateral cZi-DBS operation (off and on stimulation, with simultaneous l-dopa medication). Background noise with an amplitude corresponding to a clinical setting was added to the recordings. Intelligibility was assessed through a transcription task performed by 41 listeners in a randomized and blinded procedure.A group-level worsening in spontaneous speech intelligibility was observed on cZi stimulation compared to off 6 months postoperatively (8 adverse, 1 positive, 2 no change). Twelve months postoperatively, adverse effects of cZi-DBS were not frequently observed (2 positive, 3 adverse, 6 no change). l-dopa administered preoperatively as part of the evaluation for DBS operation provided the overall best treatment outcome (1 adverse, 4 positive, 6 no change).cZi-DBS was shown to have smaller negative effects when evaluated from spontaneous speech compared to speech effects reported previously. The previously reported reduction in word-level intelligibility 12 months postoperatively was not transferred to spontaneous speech for most patients. Reduced intelligibility due to cZi stimulation was much more prominent 6 months postoperatively than at 12 months.
| S-EPMC4614054 | biostudies-other
Project description:Purpose Telemedicine, used to offset disparities in access to speech-language therapy, relies on technology that utilizes compression algorithms to transmit signals efficiently. These algorithms have been thoroughly evaluated on healthy speech; however, the effects of compression algorithms on the intelligibility of disordered speech have not been adequately explored. Method This case study assessed acoustic and perceptual effects of resampling and speech compression (i.e., transcoding) on the speech of 2 individuals with dysarthria. Forced-choice vowel identification and transcription tasks were utilized, completed by 20 naive undergraduate listeners. Results Results showed relative improvements and decrements in intelligibility, on various measures, based on the speakers' acoustic profiles. The transcoding of the speech compression algorithm resulted in an enlarged vowel space area and associated improvements in vowel identification for 1 speaker and a smaller vowel space area and decreased vowel identification for the other speaker. Interestingly, there was an overall decrease in intelligibility in the transcription task in this condition for both speakers. Conclusions There is a complex interplay between dysarthria and compression algorithms that warrants further exploration. The findings suggest that it is critical to be mindful of apparent changes in intelligibility secondary to compression algorithms necessary for practicing telemedicine. Supplemental Material https://doi.org/10.23641/asha.7291940.
| S-EPMC6503861 | biostudies-literature
Project description:PurposeTo determine the mechanisms of speech intelligibility impairment due to neurologic impairments, intelligibility decline was modeled as a function of co-occurring changes in the articulatory, resonatory, phonatory, and respiratory subsystems.MethodSixty-six individuals diagnosed with amyotrophic lateral sclerosis (ALS) were studied longitudinally. The disease-related changes in articulatory, resonatory, phonatory, and respiratory subsystems were quantified using multiple instrumental measures, which were subjected to a principal component analysis and mixed effects models to derive a set of speech subsystem predictors. A stepwise approach was used to select the best set of subsystem predictors to model the overall decline in intelligibility.ResultsIntelligibility was modeled as a function of five predictors that corresponded to velocities of lip and jaw movements (articulatory), number of syllable repetitions in the alternating motion rate task (articulatory), nasal airflow (resonatory), maximum fundamental frequency (phonatory), and speech pauses (respiratory). The model accounted for 95.6% of the variance in intelligibility, among which the articulatory predictors showed the most substantial independent contribution (57.7%).ConclusionArticulatory impairments characterized by reduced velocities of lip and jaw movements and resonatory impairments characterized by increased nasal airflow served as the subsystem predictors of the longitudinal decline of speech intelligibility in ALS. Declines in maximum performance tasks such as the alternating motion rate preceded declines in intelligibility, thus serving as early predictors of bulbar dysfunction. Following the rapid decline in speech intelligibility, a precipitous decline in maximum performance tasks subsequently occurred.
| S-EPMC4858181 | biostudies-literature
Project description:This study investigated the acoustic basis of within-speaker, across-utterance variation in sentence intelligibility for 12 speakers with dysarthria secondary to Parkinson's disease (PD). Acoustic measures were also obtained for 12 healthy controls for comparison to speakers with PD. Speakers read sentences using their typical speech style. Acoustic measures of speech rate, articulatory rate, fundamental frequency, sound pressure level and F2 interquartile range (F2 IQR) were obtained. A group of listeners judged sentence intelligibility using a computerized visual-analog scale. Relationships between judgments of intelligibility and acoustic measures were determined for individual speakers with PD. Relationships among acoustic measures were also quantified. Although considerable variability was noted, articulatory rate, fundamental frequency and F2 IQR were most frequently associated with within-speaker variation in sentence intelligibility. Results suggest that diversity among speakers with PD should be considered when interpreting results from group analyses.
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Project description:This study examined the effect of Parkinson's disease (PD) on the intonational marking of final and nonfinal syntactic boundaries and investigated whether the effect of PD on intonation was sex specific.Eight women and 8 men with PD and 16 age- and sex-matched control participants read a passage at comfortable pitch, rate, and loudness. Nuclear tones from final and nonfinal syntactic boundaries in clauses and lists were extracted. Measures of fundamental frequency (F0) were made on each tone contour.Individuals with PD demonstrated impaired differentiation of syntactic boundary finality/nonfinality with contour direction. They produced a lower proportion of falling contours in final boundaries and a higher proportion of falling contours in nonfinal boundaries than did control participants. Although not mediated by syntax, the effect of PD on F0 standard deviation (F0 SD) and pitch range in semitones (PRST) was sex specific. Women with PD produced greater F0 SD and PRST than did men with PD and women without PD. Men with PD produced lower PRST than did men without PD.Impaired intonational marking of syntactic boundaries likely contributes to dysprosody and reduced communicative effectiveness in PD. The effect of PD on intonation was sex specific. The results are not fully explained by PD-related motor execution impairments.
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Project description:Falls pose a serious problem in elderly and clinical populations. Most often, they lead to a loss of mobility and independence. They might also be an indirect cause of death. The aim of this study was to determine an objective predictor of the fear of falling and falls in elderly subjects (ESs) and Parkinson's disease (PD) subjects. Thirty-two ESs were examined in this study, of whom sixteen were diagnosed with PD. The testing procedures comprised force plate measurements (limit of stability test-LOS test) and clinical tests (Berg Balance Scale, Functional Reach Test, Timed Up and Go test, Tinetti test). The Falls Efficacy Scale International (FES-I) was used to evaluate the fear of falling. The range of the maximum forward lean was normalized to the length from the ankle joint to the head of the first metatarsal bone and was named the functional forward stability indicator (FFSI). The FFSI, derived from the LOS test, allowed us to demonstrate the real deficit in functional stability and individual safety margins. Moreover, the FFSI was highly correlated with the FES-I score and almost all clinical test results in elderly subjects (r>0,6; p<0.05). In PD subjects, the FFSI was poorly correlated with the fear of falling, the BBS score and the FR distance; however, a high correlation with the Tinetii test (r>0,6, p<0.05) was noted. The PD subjects presented a different balance strategy when close to their stability limits, which was also reflected in the lower values of sample entropy (t = (-2.40); p<0.05; d = 0.87). The FFSI might be a good predictor of the fear of falling in the group of elderly people. Additionally, the FFSI allows us to show real balance deficits both in PD subjects and in their healthy peers without the need for a reference group and norms. In conclusion, it is postulated that the popular clinical assessments of postural balance in PD subjects should be accompanied by reliable posturography measurements.
| S-EPMC7425912 | biostudies-literature
Project description:A speech analysis-resynthesis paradigm was used to investigate segmental and suprasegmental acoustic variables explaining intelligibility variation for 2 speakers with Parkinson's disease (PD).Sentences were read in conversational and clear styles. Acoustic characteristics from clear sentences were extracted and applied to conversational sentences, yielding 6 hybridized versions of sentences in which segment durations, short-term spectrum, energy characteristics, or fundamental frequency characteristics for clear productions were applied individually or in combination to conversational productions. Listeners (N = 20) judged intelligibility in transcription and scaling tasks.Intelligibility increases above conversation were more robust for transcription, but the pattern of intelligibility improvement was similar across tasks. For 1 speaker, hybridization involving only clear energy characteristics yielded an 8.7% improvement in transcription intelligibility above conversation. For the other speaker, hybridization involving clear spectrum yielded an 18% intelligibility improvement, whereas hybridization involving both clear spectrum and duration yielded a 13.4% improvement.Not all production changes accompanying clear speech explain its improved intelligibility. Suprasegmental adjustments contributed to intelligibility improvements when segmental adjustments, as inferred from vowel space area, were not robust. Hybridization can be used to identify acoustic variables explaining intelligibility variation in mild dysarthria secondary to PD.
| S-EPMC5564305 | biostudies-other