This research project consists of clinical investigations of voice and speech in patients with Parkinson's disease before and after voice treatment. The long-range aims are to evaluate the efficacy of voice treatment for these patients and generate knowledge and hypotheses regarding the physiologic and neural mechanisms underlying voice and speech changes related to treatment as well as to progression of the disease.
Specific aims are to (1) evaluate the interactive roles of the respiratory and laryngeal systems in treatment-related change; (2) document co-occurring changes in articulatory and velopharyngeal function within the context of an 'increased system effort' hypothesis; (3) evaluate the relationship between treatment-related changes and speech intelligibility; (4) evaluate the role of various patient factors in treatment effectiveness: (a) the short- and long-term effects of voice treatment for patients at various stages of Parkinson's disease, (b) the preventative role of early voice treatment for recently diagnosed patients, and (c) the role of patient suitability factors such as cognitive status and depression in treatment effectiveness; (5) evaluate the role of various treatment factors in treatment effectiveness: (a) the frequency and context of delivery, and (b) the comparative effectiveness of voice treatment and neuropharmacological treatment; and (6) develop a database on the voice and speech changes accompanying progression of Parkinson's disease. The following variables will be measured before and after therapy as well as longitudinally: respiratory (rib cage and abdominal) excursions, laryngeal resistance, subglottal pressure, vocal fold adduction, intensity, phonatory stability, articulatory gestures, velopharyngeal function, speech rate, intonation, speech intelligibility, and various perceptual features of voice. These investigations which address fundamental issues in voice treatment efficacy will have implications for the assessment and establishment of treatment models for patients with Parkinson's disease as well as for other neurological disorders.
| Ramig, Lorraine; Halpern, Angela; Spielman, Jennifer et al. (2018) Speech treatment in Parkinson's disease: Randomized controlled trial (RCT). Mov Disord 33:1777-1791 |
| Mahler, Leslie A; Ramig, Lorraine O; Fox, Cynthia (2015) Evidence-based treatment of voice and speech disorders in Parkinson disease. Curr Opin Otolaryngol Head Neck Surg 23:209-15 |
| New, Anneliese B; Robin, Donald A; Parkinson, Amy L et al. (2015) The intrinsic resting state voice network in Parkinson's disease. Hum Brain Mapp 36:1951-62 |
| Dumer, Aleksey I; Oster, Harriet; McCabe, David et al. (2014) Effects of the Lee Silverman Voice Treatment (LSVT® LOUD) on hypomimia in Parkinson's disease. J Int Neuropsychol Soc 20:302-12 |
| Tsanas, Athanasios; Little, Max A; McSharry, Patrick E et al. (2012) Novel speech signal processing algorithms for high-accuracy classification of Parkinson's disease. IEEE Trans Biomed Eng 59:1264-71 |
| Sapir, Shimon; Ramig, Lorraine O; Fox, Cynthia M (2011) Intensive voice treatment in Parkinson's disease: Lee Silverman Voice Treatment. Expert Rev Neurother 11:815-30 |
| Spielman, Jennifer; Mahler, Leslie; Halpern, Angela et al. (2011) Intensive voice treatment (LSVTýýLOUD) for Parkinson's disease following deep brain stimulation of the subthalamic nucleus. J Commun Disord 44:688-700 |
| Sapir, Shimon; Ramig, Lorraine O; Spielman, Jennifer L et al. (2010) Formant centralization ratio: a proposal for a new acoustic measure of dysarthric speech. J Speech Lang Hear Res 53:114-25 |
| Narayana, Shalini; Fox, Peter T; Zhang, Wei et al. (2010) Neural correlates of efficacy of voice therapy in Parkinson's disease identified by performance-correlation analysis. Hum Brain Mapp 31:222-36 |
| Little, Max A; McSharry, Patrick E; Hunter, Eric J et al. (2009) Suitability of dysphonia measurements for telemonitoring of Parkinson's disease. IEEE Trans Biomed Eng 56:1015 |
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