The long-term objectives of this research are to evaluate the role of phonation in enhancing oral communication in patients with motor speech disorders and to document fundamental mechanisms associated with treatment- related change. The following specific aims are to be accomplished in a five year period: 1) define the mechanism of glottal incompetence in patients with idiopathic Parkinson's disease and determine the relationship between patterns of laryngeal electromyographic (cricothyroid (CT), thyroarytenoid (TA) & lateral cricoarytenoid (LCA)) activity, subglottal air pressure and sound pressure level in these patients; 2) evaluate the changes in patterns of laryngeal EMG (CT, TA & LCA) activity, glottal competence, subglottal air pressure and sound pressure level after intensive voice treatment; 3) evaluate the impact of intensive voice treatment on mandibular (medial pterygoid (MP) & anterior belly of digastric (ABD)) and labial (orbicularis oris superior & inferior (OOS & OO1)) muscle activity, labial kinematics and articulatory acoustics; 4) establish the interactive roles of phonatory and articulatory enhancement on phonetic accuracy and speech intelligibility; 5) evaluate the impact of intensive voice treatment on other motor speech disorders characterized by glottal incompetence. The following variables will be measured: sound pressure level, subglottal air pressure, electromyographic activity from laryngeal (CT, TA & LCA), labial (001 & ))S) and mandibular (MP & ABD) muscles, labial kinematics, vocal fold adduction, phonetic accuracy, acoustic characteristics of speech and speech intelligibility. Data will be collected from patients with glottal incompetence (hypophonia) accompanying idiopathic Parkinson's disease, multiple sclerosis, closed head injury and cerebral vascular accidents. This programmatic research will address these aims through documentation of system-wide effects of phonatory effort treatment. This multi-level assessment of enhanced oral communication will generate data of relevance to models of treatment efficacy and theories of motor speech production.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-HAR (01))
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Colorado at Boulder
Schools of Arts and Sciences
United States
Zip Code
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

Showing the most recent 10 out of 45 publications