Articulatory Consequences of Parkinson's Disease: Perspectives from Two Modalities

doi:10.1006/brcg.1998.1086

Brain and Cognition

Volume 40, Issue 2, July 1999, Pages 355-386

https://doi.org/10.1006/brcg.1998.1086 Get rights and content

Abstract

Language production involves complex yet productively varying motor behavior. Rule-governed combinations yield a finite set of formational units combined in an infinite number of ways. The creativity of language ensures that no particular articulation will be highly automatized. Linguistic articulation is highly complex and varied. As such, it differs from the other more automatized motor behaviors typically studied such as learned movements in apraxia studies or repetitive behavior as occurs in walking or other everyday activities. Language also strives to maintain a balance between ease of articulation and ease of perception, while maintaining linguistically relevant distinctions. We report here a number of studies on the articulatory consequences of Parkinson's disease (PD) in the spoken and signed modalities. Our goal is to highlight the commonalities and distinctions between the two modalities of speech and sign that will allow us to better understand the impingements of PD on language production in general.

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Cited by (41)

Advances in Parkinson's Disease detection and assessment using voice and speech: A review of the articulatory and phonatory aspects
2021, Biomedical Signal Processing and Control
Citation Excerpt :
Several studies previous to 1970 described the speech of people with PD [4,5], although it is not until 1969 [6,7] that a group of researchers analyzed more thoroughly the problems of phonation, prosody, and articulation of PD patients. Since then, a plethora of studies have presented evidence that the neurodegenerative processes associated with PD cause dysphonia and dysarthria, particularly hypokinetic dysarthria [6,8–10] in different stages of the disease [11]. Dysphonia can be defined as the speaker's incapacity to produce a normal phonation due to the phonatory system's impaired functioning, while dysarthria is more related to problems with articulation when pronouncing words.
Parkinson's Disease (PD) affects speech in the form of dysphonia and hypokinetic dysarthria. Multiple studies have evaluated PD's influence on different aspects of speech, showing differences between speakers with and without PD. Most recent studies are focused on the proposal of new automatic and objective tools to help in the diagnosis and severity assessment. This comprehensive review identifies the most common features and machine learning techniques employed in automatically detecting and assessing the severity of PD using phonatory and articulatory aspects of speech and voice. We discuss their discriminant properties and literature findings as well as identify common methodological issues that can potentially bias results. The objective is to provide a broad overview of these methods, their advantages and disadvantages, and to identify the most promising methodologies to be explored in future works. We conclude that there is clear evidence that the articulatory and phonatory aspects of speech and voice are relevant for the automatic detection and severity assessment of PD. However, there is no standard methodology sufficiently validated in a clinical trial, and further research is required, especially to develop larger corpora and identify new objective biomarkers.
A forced gaussians based methodology for the differential evaluation of Parkinson's Disease by means of speech processing
2019, Biomedical Signal Processing and Control
Citation Excerpt :
The neurodegenerative processes associated to Parkinson's Disease (PD) cause multidimensional voice and speech impairments called dysphonia [1], dysprosody [2,3] and dysarthria in patients, in particular hypokinetic dysarthria [4–7].
Literature evidences the existence of hypokinetic dysarthria in parkinsonian patients and, consequently, the objective characterization of the dysarthric signs associated to the articulatory aspect of speech can be used to detect Parkinson's Disease (PD) providing clinicians with new tools to support the clinical diagnosis.
However, no work has analyzed in detail the importance of the different phonemes in the automatic detection of PD from the speech.
This work proposes new approaches for this detection by using new classification schemes that allow to compare independently the different phonetic units of patients and controls employed during several speech tasks. Three different parkinsonian corpora were used allowing cross-validation and cross-corpora trials.
The results of cross-validation trials (k-folds) provided accuracies between 81% and 94%, with AUC between 0.87 and 0.97 depending on the corpus, while cross-corpora trials yielded accuracies between 66% and 76% with AUC between 0.76 and 0.87.
These results suggest that PD affects to the articulatory sequence as a whole, influencing more clearly phonetic units requiring a higher narrowing of the vocal tract. Additionally, text-dependent utterances are considered as the recommended speech task for the detection of PD in this type of schemes as these allow to compare more precisely the phonetic units of patients and controls. Lastly, this work discusses the existence of a glass ceiling in the accuracy of the systems for the automatic detection of PD using speech, concluding that this is below 95% for most of the cases.
Analysis of speaker recognition methodologies and the influence of kinetic changes to automatically detect Parkinson's Disease
2018, Applied Soft Computing Journal
Citation Excerpt :
Speech production, an ability that is almost universal, might be affected by PD since it involves complex and very precise movements, but on spite of being good candidate for PD detection and evaluation, its capabilities have not been deeply exploited yet. It is well known that the neurodegenerative processes associated to the disorder cause hypokinetic dysarthria, thus producing a reduction of loudness and articulation amplitude, slowing down the speech sometimes and principally reducing intelligibility [5–9]. Literature evidences the influence of PD on speech from early to advanced stages although it is mainly perceived in mild to advanced phases [10–12].
The diagnosis of Parkinson's Disease is a challenging task which might be supported by new tools to objectively evaluate the presence of deviations in patient's motor capabilities.
To this respect, the dysarthric nature of patient's speech has been exploited in several works to detect the presence of this disease, but none of them has deeply studied the use of state-of-the-art speaker recognition techniques for this task.
In this paper, two classification schemes (GMM-UBM and i-Vectors-GPLDA) are employed separately with several parameterization techniques, namely PLP, MFCC and LPC. Additionally, the influence of the kinetic changes, described by their derivatives, is analysed.
With the proposed methodology, an accuracy of 87% with an AUC of 0.93 is obtained in the optimal configuration. These results are comparable to those obtained in other works employing speech for Parkinson's Disease detection and confirm that the selected speaker recognition techniques are a solid baseline to compare with future works. Results suggest that Rasta-PLP is the most reliable parameterization for the proposed task among all the tested features while the two employed classification schemes perform similarly. Additionally, results confirm that kinetic changes provide a substantial performance improvement in Parkinson's Disease automatic detection systems and should be considered in the future.
Speech rate in Parkinson's disease: A controlled study
2016, Neurologia
Las alteraciones en el habla aparecen en la mayoría de los pacientes con la enfermedad de Parkinson (EP) en el curso del trastorno. Su origen y gravedad son de interés clínico y diagnóstico.
Evaluar los patrones de deterioro en el habla en pacientes con la EP, e identificar diferencias en la velocidad de elocución y articulación en comparación con sujetos de control, empleando un método de análisis automático en una tarea de lectura.
Participaron 39 pacientes con la EP y 45 controles asintomáticos igualados en sexo y edad. Los pacientes con la EP, en estado on, no presentaban fluctuaciones motoras ni discinesias durante la evaluación del habla.
El grupo de pacientes con la EP muestran una significativa reducción de la velocidad de elocución y articulación. No se encontraron correlaciones significativas entre los parámetros del habla estudiados y las características de los pacientes, tales como la dosis de L-dopa, duración del trastorno, edad, ni en las puntuaciones en las escalas UPDRS III o Hoehn y Yahr.
Los pacientes con la EP muestran un patrón característico de deterioro del ritmo del habla. Estos resultados indican que las disfluencias en la EP son el resultado de la alteración del movimiento que afecta a la fisiología de los sistemas de producción del habla.
Speech disturbances will affect most patients with Parkinson's disease (PD) over the course of the disease. The origin and severity of these symptoms are of clinical and diagnostic interest.
To evaluate the clinical pattern of speech impairment in PD patients and identify significant differences in speech rate and articulation compared to control subjects. Speech rate and articulation in a reading task were measured using an automatic analytical method.
A total of 39 PD patients in the ‘on’ state and 45 age-and sex-matched asymptomatic controls participated in the study. None of the patients experienced dyskinesias or motor fluctuations during the test.
The patients with PD displayed a significant reduction in speech and articulation rates; there were no significant correlations between the studied speech parameters and patient characteristics such as L-dopa dose, duration of the disorder, age, and UPDRS III scores and Hoehn & Yahr scales.
Patients with PD show a characteristic pattern of declining speech rate. These results suggest that in PD, disfluencies are the result of the movement disorder affecting the physiology of speech production systems.
Communication problems of Parkinson patients using sign language as their main communication method
2014, Parkinsonism and Related Disorders
Communication changes in Parkinson's disease
2009, Revista de Logopedia, Foniatria y Audiologia
Citation Excerpt :
Precision in stressed syllables may be maintained at the expense of sound realisations in unstressed syllables, which are particularly prone to articulatory breakdown (Ackermann and Ziegler, 1991). Kegl and Poizner (1999) have shown that the same effects are observed in the manual gestures of people with PD who use deaf sign language. As already noted, there is a prominent prosodic disturbance in PD related to the changes to sound pressure level and its variation and alterations to control of fundamental frequency level, range and variation.
Parkinson's disease (PD) is a degenerative neurological disorder. Depletion of dopaminergic nigrostriatal neurons gives rise to alterations in movement. Voice and speech, as dependent on movement of the articulators, are not spared. Non-dopaminergic changes can also affect language, cognition and mood, which can impact on communication.
This article offers an overview of changes to speech and voice that arise in PD and the impact these underlying changes have on speech naturalness, intelligibility and participation in social life. Assessment and treatment are not a focus, but lessons for these areas are drawn from the description of the nature of overall changes.
PD is also predominantly a disease of old age. Many of the alterations to speech and communication characteristic of PD also occur as part of the natural ageing process. Hence the article stresses that understanding communication alterations and their evaluation and treatment must happen within the context of age related changes.
La enfermedad de Parkinson (EP) es un trastorno neurológico degenerativo. La depleción de las neuronas nigroestratiales dopaminérgicas provoca alteraciones en el movimiento. La voz y el habla que dependen del movimiento de los articuladores, también se ven implicados. Los cambios no dopaminérgicos también pueden afectar lenguaje, cognición y humor, lo cual puede influir en la comunicación.
Este artículo ofrece una revisión de los cambios en habla y voz que se producen con la EP y el impacto que estos cambios subyacentes tienen en la naturalidad del lenguaje, la inteligibilidad y la participación en la vida social. El enfoque no está en la evaluación y el tratamiento; sin embargo, la descripción de la naturaleza de los cambios globales permite extraer nociones para estos ámbitos.
A su vez, la EP es una enfermedad predominantemente de la edad avanzada. Muchas de las alteraciones de lenguaje y comunicación características de la EP también se producen como parte del proceso normal de envejecimiento. Por ello, este artículo enfatiza en el conocimiento de las alteraciones de la comunicación, cuya evaluación y cuyo tratamiento deben producirse en el contexto de los cambios relacionados con la edad.

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Supported in part by Research Grants SBR-9513762 and SBR-9729065 from the National Science Foundation to Rutgers, The State University of New Jersey; NSF BCS9996297 to University of Southern Maine (JK); Research Grant DC 01664 from the National Institute of Deafness and Other Communication Disorders, National Institutes of Health; and Research Grant 5 R01 NS36449-02 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health (HP); and 99-ER-0404 from FCAR (Québec) (HC). We thank Patricia Trowbridge, Joanne Lauser, Drucilla Ronchen, Vicki Joy Sullivan, Toni Fuller, Jimmy Challis Gore, Ruth Loew, and the The George Neville Home for their contributions to this research and Bencie Woll for helpful comments on an earlier draft.

Correspondence and reprint requests should be sent to Judy Kegl at the Language Sciences Laboratory, University of Southern Maine, 96 Falmouth Street, Portland, ME 04104-9300.

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Regular ArticleArticulatory Consequences of Parkinson's Disease: Perspectives from Two Modalities☆

Abstract

Brain and Language

Brain and Cognition

Journal of Neurolinguistics

Brain and Language

Acta Psychologica

Brain and Language

Clausal structure and a tier for grammatical marking in American Sign Language

Nordic Journal of Linguistics

A good rule of thumb: Variable phonology in ASL

A phonological analysis of a deaf Parkinsonian signer

Language and Cognitive Processes

The interpretation of dysprosody in patients with Parkinson's disease

Journal of Neurology, Neurosurgery, and Psychiatry

Disorders of prosody in Parkinson's disease

Society for Neuroscience Abstracts

Speech timing deficits in Parkinson's Disease

Journal of Clinical and Experimental Neuropsychology

Motor Speech Disorders

Narrative/Story Structure, Pausing and American Sign Language

Discourse Processes

A physiological mechanism of bradykinesia

Brain

Computer graphic modeling and analysis II: Three-dimensional reconstruction and interactive analysis

Journal of Neuroscience Methods

The interplay between linguistic and spatial processing in a right-lesioned signer

Journal of Clinical and Experimental Neuropsychology

Losing face: Differential breakdown in the production of facial expressions

Society for Neuroscience, Abstracts

Signalyze Version 2.0: Signal Analysis for Speech and Sound. User's Manual

Regular Article
Articulatory Consequences of Parkinson's Disease: Perspectives from Two Modalities☆