scholarly journals Consonant Acoustics in Parkinson's Disease and Multiple Sclerosis: Comparison of Clear and Loud Speaking Conditions

2017 ◽  
Vol 26 (2S) ◽  
pp. 569-582 ◽  
Author(s):  
Kris Tjaden ◽  
Vincent Martel-Sauvageau
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Future Research ◽  
Clear Speech ◽  
Spectral Contrast ◽  
Treatment Techniques ◽  
Time Histories ◽  
Vocal Intensity ◽  
The Impact

Purpose The impact of clear speech or an increased vocal intensity on consonant spectra was investigated for speakers with mild dysarthria secondary to multiple sclerosis or Parkinson's disease and healthy controls. Method Sentences were read in habitual, clear, and loud conditions. Spectral moment coefficients were obtained for word-initial and word-medial /s/, /ʃ/, /t/, and /k/. Global production differences among conditions were confirmed with measures of vocal intensity and articulation rate. Results Static or slice-in-time first moments (M1) for loud differed most frequently from habitual, but neither loud nor clear enhanced M1 contrast for consonant pairs. In several instances, the clear and loud conditions yielded stable or nonvarying fricative M1 time histories. Spectral contrast was reduced for word-medial versus word-initial consonant pairs. Conclusion The finding that the loud and especially clear condition yielded fairly subtle changes in consonant spectra suggests these global techniques may minimally enhance consonant segmental production or contrast in mild dysarthria. The robust effect of word position on consonant spectra indicates that this variable deserves consideration in future studies. Future research also is needed to investigate how or whether consonant production bears on the improved intelligibility previously reported for these global dysarthria treatment techniques.

scholarly journals Vowel Acoustics in Parkinson's Disease and Multiple Sclerosis: Comparison of Clear, Loud, and Slow Speaking Conditions

2013 ◽  
Vol 56 (5) ◽  
pp. 1485-1502 ◽  
Author(s):  
Kris Tjaden ◽  
Jennifer Lam ◽  
Greg Wilding
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Spectral Characteristics ◽  
Vowel Duration ◽  
Clear Speech ◽  
Formant Frequency ◽  
Vocal Intensity ◽  
The Impact ◽  
Clear Condition

Purpose The impact of clear speech, increased vocal intensity, and rate reduction on acoustic characteristics of vowels was compared in speakers with Parkinson's disease (PD), speakers with multiple sclerosis (MS), and healthy controls. Method Speakers read sentences in habitual, clear, loud, and slow conditions. Variations in clarity, intensity, and rate were stimulated using magnitude production. Formant frequency values for peripheral and nonperipheral vowels were obtained at 20%, 50%, and 80% of vowel duration to derive static and dynamic acoustic measures. Intensity and duration measures were obtained. Results Rate was maximally reduced in the slow condition, and vocal intensity was maximized in the loud condition. The clear condition also yielded a reduced articulatory rate and increased intensity, although less than for the slow or loud conditions. Overall, the clear condition had the most consistent impact on vowel spectral characteristics. Spectral and temporal distinctiveness for peripheral–nonperipheral vowel pairs was largely similar across conditions. Conclusions Clear speech maximized peripheral and nonperipheral vowel space areas for speakers with PD and MS while also reducing rate and increasing vocal intensity. These results suggest that a speech style focused on increasing articulatory amplitude yields the most robust changes in vowel segmental articulation.

scholarly journals Impact of Clear, Loud, and Slow Speech on Scaled Intelligibility and Speech Severity in Parkinson's Disease and Multiple Sclerosis

2014 ◽  
Vol 57 (3) ◽  
pp. 779-792 ◽  
Author(s):  
Kris Tjaden ◽  
Joan E. Sussman ◽  
Gregory E. Wilding
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Visual Analog Scale ◽  
Healthy Controls ◽  
Clear Speech ◽  
Rate Reduction ◽  
Analog Scale ◽  
Vocal Intensity ◽  
Slow Speech

Purpose 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. Method 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). Results 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. Conclusions 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.

scholarly journals Frequency of and risk factors for potentially inappropriate medication use in Parkinson’s disease

2020 ◽  
Vol 49 (5) ◽  
pp. 786-792
Author(s):  
Danielle S Abraham ◽  
Thanh Phuong Pham Nguyen ◽  
Sean Hennessy ◽  
Daniel Weintraub ◽  
Shelly L Gray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Inappropriate Medication ◽  
Potentially Inappropriate Medication ◽  
Future Research ◽  
Motor Symptoms ◽  
The Impact

Abstract Background impairments in neurotransmitter pathways put Parkinson’s disease (PD) patients at risk for drug–disease interactions and adverse medication events. Objective to determine the prevalence and risk factors for potentially inappropriate medication (PIM) prescriptions, as defined by the 2015 Beers List, in PD. Methods cross-sectional analysis was conducted on 2014 Medicare beneficiaries with PD who had parts A, B and D coverage. The prevalence of PIM prescriptions for older adults was determined overall, and specifically for medications that can exacerbate motor symptoms or cognitive impairment in PD. Logistic regression models were constructed to determine the association between age, sex, race, geography and poverty with PIM prescriptions. Results the final sample included 458,086 beneficiaries. In 2014, 35.8% of beneficiaries with PD filled a prescription for at least one PIM for older adults. In total, 8.7% of beneficiaries received a PIM that could exacerbate motor symptoms and 29.0% received a PIM that could worsen cognitive impairment. After adjustment, in all models, beneficiaries who were younger, female, white, urban-dwelling and eligible for Medicaid benefits were more likely to receive a PIM. Conclusion PIM prescriptions are not uncommon in PD, particularly for medications that can exacerbate cognitive impairment. Future research will examine underlying drivers of sex and other disparities in PIM prescribing. Additional studies are needed to understand the impact of PIMs on disease symptoms, healthcare utilisation and patient outcomes.

Health behaviors a year after an early intervention exercise and education program for people with Parkinson's disease

2021 ◽  
Vol 11 (1) ◽  
pp. 65-75
Author(s):  
Gillian Li ◽  
Jeremey Horne ◽  
Serene S Paul
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Intervention ◽  
Behavior Change ◽  
Intervention Program ◽  
Exercise Program ◽  
Exercise Behavior ◽  
Future Research ◽  
The Impact

Aim: To evaluate the impact of an early intervention program on exercise behavior and mood in people with Parkinson's disease (PD) 1 year following participation. Patients & methods: Education and exercise program participants (n = 152) were followed up for 1 year. Changes in exercise behavior and mood and factors associated with these changes were examined. Results: At follow-up, 28% more participants exercised (p < 0.001). Changes in the proportion reporting depression (12% reduction; p = 0.10) or anxiety (4% increase, p = 0.09) were not statistically significant. Conclusion: An education and exercise program promoted positive exercise behavior change sustained for a year, supporting the importance of early intervention for people with PD. Future research should explore sustainable ways to encourage prolonged behavior change, including regular follow-up.

scholarly journals The Contribution of Small Vessel Disease to Neurodegeneration: Focus on Alzheimer’s Disease, Parkinson’s Disease and Multiple Sclerosis

2021 ◽  
Vol 22 (9) ◽  
pp. 4958
Author(s):  
Federico Paolini Paoletti ◽  
Simone Simoni ◽  
Lucilla Parnetti ◽  
Lorenzo Gaetani
Keyword(s):  
Multiple Sclerosis ◽  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Immune System Activation ◽  
The Impact

Brain small vessel disease (SVD) refers to a variety of structural and functional changes affecting small arteries and micro vessels, and manifesting as white matter changes, microbleeds and lacunar infarcts. Growing evidence indicates that SVD might play a significant role in the neurobiology of central nervous system (CNS) neurodegenerative disorders, namely Alzheimer’s disease (AD) and Parkinson’s disease (PD), and neuroinflammatory diseases, such as multiple sclerosis (MS). These disorders share different pathophysiological pathways and molecular mechanisms (i.e., protein misfolding, derangement of cellular clearance systems, mitochondrial impairment and immune system activation) having neurodegeneration as biological outcome. In these diseases, the actual contribution of SVD to the clinical picture, and its impact on response to pharmacological treatments, is not known yet. Due to the high frequency of SVD in adult-aged patients, it is important to address this issue. In this review, we report preclinical and clinical data on the impact of SVD in AD, PD and MS, with the main aim of clarifying the predictability of SVD on clinical manifestations and treatment response.

Parkinson's disease Simulating complexity via improving the identification of significant genetic alterations and environmental contaminants should be a priority

2021 ◽  
Author(s):  
Moataz Dowaidar
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Modeling ◽  
Environmental Contaminants ◽  
Genetic Alterations ◽  
Future Research ◽  
Toxic Exposure ◽  
A Priority ◽  
The Impact ◽  
Time Future

Despite great improvements, more research is required to model Parkinson's complex neurodegenerative disease. Simulating the disease's complexity via improving the identification of significant genetic alterations and environmental contaminants should be a priority. Furthermore, because environmental toxins are typically exposed in a variety of combinations and over long periods of time, future research on Parkinson's disease modeling should take into account the diversity of hazardous exposures. To successfully mimic the impact of environmental contaminants on Parkinson's disease development, toxic exposure should be done through physiological channels as well, with chronic exposure regimens preferred over acute exposure regimens.

scholarly journals Assessment of Prosodic Communicative Efficiency in Parkinson's Disease As Judged by Professional Listeners

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Heidi Martens ◽  
Gwen Van Nuffelen ◽  
Patrick Cras ◽  
Barbara Pickut ◽  
Miet De Letter ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Assessment Method ◽  
Interrater Agreement ◽  
Future Research ◽  
Emotional Prosody ◽  
Communicative Functions ◽  
Communicative Efficiency ◽  
The Impact ◽  
Therapy Programme

This study examines the impact of Parkinson's disease (PD) on communicative efficiency conveyed through prosody. A new assessment method for evaluating productive prosodic skills in Dutch speaking dysarthric patients was devised and tested on 36 individuals (18 controls, 18 PD patients). Three professional listeners judged the intended meanings in four communicative functions of Dutch prosody: Boundary Marking, Focus, Sentence Typing, and Emotional Prosody. Each function was tested through reading and imitation. Interrater agreement was calculated. Results indicated that healthy speakers, compared to PD patients, performed significantly better on imitation of Boundary Marking, Focus, and Sentence Typing. PD patients with a moderate or severe dysarthria performed significantly worse on imitation of Focus than on reading of Focus. No significant differences were found for Emotional Prosody. Judges agreed well on all tasks except Emotional Prosody. Future research will focus on elaborating the assessment and on developing a therapy programme paralleling the assessment.

The Impact of Clear Speech on the Perceptual and Acoustic Properties of Fricative–Vowel Sequences in Speakers With Dysarthria

2021 ◽  
pp. 1-19
Author(s):  
Vincent Martel-Sauvageau ◽  
Myriam Breton ◽  
Alexandra Chabot ◽  
Mélanie Langlois
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Acoustic Properties ◽  
Clear Speech ◽  
Acoustic Characteristics ◽  
Acoustic Measures ◽  
Sentence Reading ◽  
Dysarthric Speech ◽  
Acoustic Analyses ◽  
The Impact

Purpose Studies have reported that clear speech has the potential to influence suprasegmental and segmental aspects of speech, in both healthy and dysarthric speakers. While the impact of clear speech has been studied on the articulation of individual segments, few studies have investigated its effects on coarticulation with multisegment sequences such as fricative–vowel. Objectives The goals of this study are to investigate, in healthy and dysarthric speech, the impact of clear speech on (a) the perception of anticipatory vowel coarticulation in fricatives and (b) the acoustic characteristics of this effect. Method Ten speakers with dysarthria secondary to idiopathic Parkinson's disease were recruited as well as 10 age- and sex-matched healthy speakers. A sentence reading task was performed in natural and clear speaking conditions. The sentences contained words with the initial fricatives /s/ and /ʃ/ preceded by /ə/ and followed by the vowels /i/, /y/, /u/, or /a/. For the perceptual measurements, five listeners were recruited and were asked to predict the upcoming word by listening only to the isolated fricative. Acoustic analyses consisted of spectral moment analysis (M1–M4) on averaged time series. Results Perceptual findings report that identification rates were improved with clear speech for the speakers with dysarthria, but only for the fricative–/i/ sequences. Error pattern analysis indicates that this improvement is associated with an increase in the roundness parameter (lip spreading) identification. Acoustic results are unclear for M1 and M3 but suggest that M2 and M4 differentiation between the rounded versus unrounded vowel contexts is increased with clear speech for the speakers with dysarthria. Discussion Taken together, these findings suggest that clear speech may improve lip coordination in dysarthric speakers with Parkinson's disease. However, the impact of clear speech on the acoustic measures of fricative spectral moments is somewhat limited. This suggests that these metrics, when taken individually, do not capture the entire complexity of fricative–vowel coarticulation.

39 The Experiences of Treatment Burden Among People with Parkinson’s Disease and Their Caregivers: A Systematic Review

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i7-i11
Author(s):  
Q Y Tan ◽  
K Ibrahim ◽  
N J Cox ◽  
S E Lim ◽  
L Coutts ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Care Home ◽  
Grey Literature ◽  
Well Being ◽  
Future Research ◽  
Treatment Burden ◽  
Healthcare Provision ◽  
The Impact

Abstract Introduction Treatment burden is the “workload of healthcare and its impact on patient functioning and well-being”. High treatment burden may lead to non-adherence to treatment regimens, poor health outcomes, poor quality of life and wasted healthcare resources. Treatment burden among people with Parkinson’s (PwP) and their caregivers has not been previously explored. Methods Using five electronic databases (MEDLINE, Embase, CINAHL, Scopus and PsychInfo), we conducted a systematic review of studies published since 2006 when the first National Institute for Clinical Excellence (NICE) Clinical Guideline for Parkinson’s Disease was published. This allows an understanding of the impact of current healthcare systems on treatment burden. We included qualitative and mixed-method studies with a qualitative component that reported data from PwP and/or caregivers. Quantitative studies, qualitative data from clinical trials not related to usual care and grey literature were excluded. Two reviewers independently screened articles and extracted data. Data analysis was conducted using framework analysis. Results 1757 articles were screened, and 39 included in this review. Understanding treatment burden among PwP and their caregivers was not the primary aim in any of the included studies. They described the experiences of those living at home and during hospital or care home admissions. Issues with medications (adherence to advice, effectiveness, side-effects and timing), obtaining appropriate levels of information and healthcare provision (lack of integrated care, care coordination and person-centred approach) were among factors that exacerbate treatment burden experienced by PwP and caregivers. Both reported the impact of Parkinson’s on their daily lives, physical and mental exhaustion of self-care and limitations on their role and social activities. Conclusion This review describes considerable treatment burden experienced by PwP and their caregivers and its major influences including aspects of current healthcare provision. Future research should focus on patient-centred care with service redesign to improve this treatment burden.

Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Study Data ◽  
Functional Mobility ◽  
Quality Improvement Initiative ◽  
Timed Up And Go ◽  
Mobility Performance ◽  
Risk Of Mortality ◽  
The Impact

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

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