Major advances in speech therapy for patients with Parkinson's disease (PD) have been made in the last decade. Significantly improved therapy results have been reported using the Lee Silverman Voice Treatment (LSVT) program. A core feature of LSVT is to instruct the patient to speak more loudly, thereby increasing sound pressure level (SPL). The general goal of this project is to investigate the physiologic mechanisms underlying increased SPL in patients with PD. Individuals with PD demonstrate speech movements (kinematics) which differ from normal speakers. It has been hypothesized that, in individuals with PD, increasing SPL causes a scaling-up of motor output from all three speech subsystems - respiratory, laryngeal, and articulatory - resulting in more normal speech production. The first specific aim of this project is to examine respiratory and articulatory kinematics in individuals with PD while they increase SPL. Individuals with PD may have difficulty accurately perceiving their own vocal intensity. Due to this difficulty, the mechanisms individuals with PD use to increase SPL may depend on the amount of self-monitoring of vocal intensity required by the task. Thus, the second specific aim of this project is to examine the effect of different cues to increase SPL on the kinematic mechanisms utilized by individuals with PD. Studies of motor control of the limbs have indicated that individuals with PD may have difficulty with premotor planning. If increasing SPL results in global effects to the speech system, as has been hypothesized, premotor organization may be altered. Therefore, there is one exploratory aim in the present project: to examine premotor planning of the respiratory subsystem for speech by individuals with PD. Methods employed in this project will include the collection and analysis of chest wall, lip, and jaw kinematics to examine the mechanisms for increasing SPL in individuals with PD. An understanding of the effects of increasing SPL on speech kinematics and premotor planning and of how difficulties in perception of vocal intensity affect kinematics is likely to assist with the improvement of speech therapy for individuals with PD and to further the understanding of the effects of PD on speech motor control.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Small Research Grants (R03)
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Special Emphasis Panel (ZDC1-SRB-O (30))
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Shekim, Lana O
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Purdue University
Other Health Professions
Schools of Arts and Sciences
West Lafayette
United States
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Huber, Jessica E; Darling-White, Meghan (2017) Longitudinal Changes in Speech Breathing in Older Adults with and without Parkinson's Disease. Semin Speech Lang 38:200-209
Haddad, Jeffrey M; Rietdyk, Shirley; Claxton, Laura J et al. (2013) Task-dependent postural control throughout the lifespan. Exerc Sport Sci Rev 41:123-32
Huber, Jessica E; Darling, Meghan; Francis, Elaine J et al. (2012) Impact of typical aging and Parkinson's disease on the relationship among breath pausing, syntax, and punctuation. Am J Speech Lang Pathol 21:368-79
MacPherson, Megan K; Huber, Jessica E; Snow, David P (2011) The intonation-syntax interface in the speech of individuals with Parkinson's disease. J Speech Lang Hear Res 54:19-32
Darling, Meghan; Huber, Jessica E (2011) Changes to articulatory kinematics in response to loudness cues in individuals with Parkinson's disease. J Speech Lang Hear Res 54:1247-59
Huber, Jessica E; Darling, Meghan (2011) Effect of Parkinson's disease on the production of structured and unstructured speaking tasks: respiratory physiologic and linguistic considerations. J Speech Lang Hear Res 54:33-46
Huber, Jessica E; Spruill 3rd, John (2008) Age-related changes to speech breathing with increased vocal loudness. J Speech Lang Hear Res 51:651-68
Huber, Jessica E (2008) Effects of utterance length and vocal loudness on speech breathing in older adults. Respir Physiol Neurobiol 164:323-30
Sadagopan, Neeraja; Huber, Jessica E (2007) Effects of loudness cues on respiration in individuals with Parkinson's disease. Mov Disord 22:651-9
Huber, Jessica E (2007) Effect of cues to increase sound pressure level on respiratory kinematic patterns during connected speech. J Speech Lang Hear Res 50:621-34

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