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Semin Speech Lang 2004; 25(2): 169-180
DOI: 10.1055/s-2004-825653
DOI: 10.1055/s-2004-825653
Parkinson's Disease: Speech and Voice Disorders and Their Treatment with the Lee Silverman Voice Treatment
Further Information
Publication History
Publication Date:
07 May 2004 (online)
Speech and voice disorders are very common among individuals suffering from idiopathic Parkinson's disease. In this article we review evidence for laryngeal, respiratory, articulatory, and velopharyngeal disorders in this population. We present the essential concepts and outcome data for the Lee Silverman Voice Treatment®, a behavioral treatment program that has yielded significant long-term improvement in speech and voice functions in individuals with idiopathic Parkinson's disease.
KEYWORDS
Parkinson's disease - voice - speech - LSVT® - Lee Silverman Voice Treatment®
REFERENCES
- 1 Scott S, Caird F I, Williams B O. Communication in Parkinson's Disease. Rockville, MD; Aspen 1985
MissingFormLabel
- 2 Canter G J. Speech characteristics of patients with Parkinson's disease: III. Articulation, diadochokinesis and overall speech adequacy. J Speech Hear Disord. 1965; 30 217-224
- 3 Canter G J. Speech characteristics of patients with Parkinson's disease: II. Physiological support for speech. J Speech Hear Disord. 1965; 30 44-49
- 4 Logemann J, Fisher H, Boshes B, Blonsky E. Frequency and concurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients. J Speech Hear Disord. 1978; 43 47-57
- 5 Oxtoby M. Parkinson's Disease Patients and Their Social Needs. London; Parkinson's Disease Society 1982
MissingFormLabel
- 6 Streifler M, Hofman S. Disorders of verbal expression in Parkinsonism. In: Hassler RG, Christ JF Advances in Neurology. New York; Raven Press 1984: 385-393
MissingFormLabel
- 7 Hartelius L, Svensson P. Speech and swallowing symptoms associated with Parkinson's disease and multiple sclerosis: a survey. Folia Phoniatr Logop. 1994; 46 9-17
- 8 Aronson A E. Clinical Voice Disorders. New York; Thieme-Stratton 1990
MissingFormLabel
- 9 Ho A K, Iansek R, Marigliani C, Bradshaw J L, Gates S. Speech impairment in a large sample of patients with Parkinson's disease. Behav Neurol. 1998; 11 131-137
- 10 Sapir S, Ramig L, Hoyt P, O'Brien C, Hoehn M. Speech loudness and quality 12 months after intensive voice treatment (LSVT) for Parkinson's disease: a comparison with an alternative speech treatment. Folia Phoniatr. 2002; 54 296-303
- 11 Darley F L, Aronson A E, Brown J R. Motor Speech Disorders. Philadelphia; WB Saunders 1975
MissingFormLabel
- 12 Barbeau A, Sourkes T L, Murphy C F. Les Catecholamines de la Maladie de Parkinson's. In: Ajuriaguerra J Monoamines et Système Nerveux Central. Genève; George 1962
MissingFormLabel
- 13 Svennilson E, Torvik A, Lowe R, Leksall L. Treatment of parkinsonism by stereotactic thermolesions in the pallidal region. A clinical evaluation of 81 cases. Acta Psychiatr Scand. 1960; 35 358-377
- 14 Freed C R, Breeze R E, Rosenberg N L et al.. Survival of implanted fetal dopamine cells and neurologic improvement 12 to 46 months after transplantation for Parkinson's disease. N Engl J Med. 1992; 327 1549-1555
- 15 Larson K, Ramig L O, Scherer R C. Acoustic and glottographic voice analysis during drug-related fluctuations in Parkinson's disease. J Med Speech Lang Pathol. 1994; 2 211-226
- 16 Baker K K, Ramig L O, Johnson A B, Freed C R. Preliminary voice and speech analysis following fetal dopamine transplants in 5 individuals with Parkinson disease. J Speech Lang Hear Res. 1997; 40 615-626
- 17 Yorkston K M. Treatment efficacy: dysarthria. J Speech Hear Res. 1996; 39 S46-S57
- 18 Helm N. Management of palilalia with a pacing board. J Speech Hear Disord. 1979; 44 350-353
- 19 Yorkston K M, Spencer K A, Duffy J R. Behavioral management of respiratory/phonatory dysfunction from dysarthria: a systematic review of the evidence. J Med Speech Lang Pathol. 2003; 11 xiii-xxxviii
- 20 Ramig L, Countryman S, Thompson L, Horii Y. Comparison of two forms of intensive speech treatment for Parkinson disease. J Speech Hear Res. 1995; 38 1232-1251
- 21 Ramig L O, Countryman S, O'Brien C, Hoehn M, Thompson L. Intensive speech treatment for patients with Parkinson's disease: short and long term comparison of two techniques. Neurology. 1996; 47 1496-1504
- 22 Halpern A, Midos C, Ramig L, Spielman J, Bennett I. A PDA-enhanced speech treatment for Parkinson's disease. Presented at: Twealth Biannual Conference Albuquerque, NM; March 2004
MissingFormLabel
- 23 Leanderson R, Meyerson B A, Persson A. Effect of L-dopa on speech in Parkinsonism an EMG study of labial articulatory function. J Neurol Neurosurg Psychiatry. 1971; 34 679-681
- 24 Moore C A, Scudder R R. Coordination of jaw muscle activity in Parkinsonian movement: description and response
to traditional treatment. In: Yorkston KM, Beukelman DR Recent Advances in Clinical Dysarthria. Boston, MA; College-Hill Press 1989
MissingFormLabel
- 25 Baker K, Ramig L O, Luschei E, Smith M. Thyroarytenoid muscle activity associated with hypophonia in Parkinson disease and aging. Neurology. 1998; 51 1592-1598
- 26 Hansen D G, Gerratt B R, Ward P H. Cinegraphic observations of laryngeal function in Parkinson's disease. Laryngoscope. 1984; 94 348-353
- 27 Ackermann H, Ziegler W. Articulatory deficits in Parkinsonian dysarthria. J Neurol Neurosurg Psychiatry. 1991; 54 1093-1098
- 28 Hoodin R B, Gilbert H R. Nasal airflows in Parkinsonian speakers. J Commun Disord. 1989a; 22 169-180
- 29 Ho A K, Bradshaw J L, Iansek R, Alfredson R. Speech volume regulation in Parkinson's disease: effects of implicit cues and explicit instructions. Neuropsychologia. 1999; 37 1453-1460
- 30 Ho A K, Bradshaw J L, Iansek T. Volume perception in Parkinsonian speech. Move Disord. 2000; 15 1125-1131
- 31 Darley F L, Aronson A E, Brown J R. Clusters of deviant speech dimensions in the dysarthrias. J Speech Hear Res. 1969; 12 462-469
- 32 Darley F L, Aronson A, Brown J. Differential diagnostic patterns of dysarthria. J Speech Hear Res. 1969; 12 246-269
- 33 Logemann J, Boshes B, Fisher H. The steps in the degeneration of speech and voice control in Parkinson's disease. In: Siegfried J Parkinson's Diseases: Rigidity, Akinesia, Behavior. Vienna; Hans Huber 1973: 101-112
MissingFormLabel
- 34 Stewart C, Winfield L, Hunt A et al.. Speech dysfunction in early Parkinson's disease. Move Disord. 1995; 10 562-565
- 35 Ludlow C L, Bassich C J. Relationships between perceptual ratings and acoustic measures of hypokinetic speech. In: McNeil MR, Rosenbek JC, Aronson AE The Dysarthrias: Physiology, Acoustics, Perception, Management. San Diego, CA; College-Hill 1984: 103-196
MissingFormLabel
- 36 Canter G J. Speech characteristics of patients with Parkinson's disease: I. Intensity, pitch and duration. J Speech Hear Disord. 1963; 28 221-229
- 37 Metter E J, Hanson W R. Clinical and acoustical variability in hypokinetic dysarthria. J Commun Disord. 1986; 19 347-366
- 38 Fox C, Ramig L. Vocal sound pressure level and self-perception of speech and voice in men and women with idiopathic Parkinson disease. Am J Speech Lang Pathol. 1997; 2 29-42
- 39 Ho A K, Iansek R, Bradshaw J L. Motor instability in Parkinsonian speech intensity. Neuropsychiatry Neuropsychol Behav Neurol. 2001; 14 109-116
- 40 King J, Ramig L, Lemke J H, Horii Y. Parkinson's disease: longitudinal changes in acoustic parameters of phonation. J Med Speech Lang Pathol. 1994; 2 29-42
- 41 Ramig L, Scherer R C, Titze I R, Ringel S P. Acoustic analysis of voices of patients with neurologic disease: rationale and preliminary data. Ann Otolaryngol Rhinol Laryngol. 1988; 97 164-172
- 42 Ramig L O, Shipp T. Comparative measures of vocal tremor and vocal vibrato. J Voice. 1987; 1 162-167
- 43 Ludlow C L, Bassich C J, Connor N P, Coulter D C. Phonatory characteristics of vocal fold tremor. J Phonetics. 1986; 14 509-515
- 44 Winholtz W S, Ramig L O. Vocal tremor analysis with the vocal demodulator. NCVS Status Prog Rep. 1992; 2 119-137
- 45 Smith M, Ramig L O, Dromey C, Perez K, Samandari R. Intensive voice treatment in Parkinson's disease: laryngostroboscopic findings. J Voice. 1995; 9 453-459
- 46 Perez K, Ramig L O, Smith M, Dromey C. The Parkinson larynx: tremor and videostroboscopic findings. J Voice. 1996; 10 354-361
- 47 Luschei E S, Ramig L O, Baker K L, Smith M. Discharge characteristics of laryngeal single motor units during phonation in young and older adults and in persons with Parkinson disease. J Neurophysiol. 1999; 81 2131-2139
- 48 De la Torre R, Mier M, Boshes B. Evaluation of respiratory function: preliminary observations. Q Bull Northwestern University Med Sch. 1960; 34 332-336
- 49 Mueller P B. Parkinson's disease: motor-speech behavior in a selected group of patients. Folia Phoniatr (Basel). 1971; 23 333-346
- 50 Solomon N P, Hixon T J. Speech breathing in Parkinson's disease. J Speech Hear Res. 1993; 36 294-310
- 51 Schiffman P L. A “saw-tooth” pattern in Parkinson's disease. Chest. 1985; 87 124-126
- 52 Vincken W G, Gauthier S G, Dollfuss R E, Hanson R E, Parauay C M, Cosio M G. Involvement of upper-airway muscles in extrapyramidal disorders, a cause of airflow limitation. N Engl J Med. 1984; 311 438-442
- 53 Murdoch B E, Chenery H J, Bowler S, Ingram J CL. Respiratory function in Parkinson's subjects exhibiting a perceptible speech deficit: a kinematic and spirometric analysis. J Speech Hear Disord. 1989; 54 610-626
- 54 Adams S G. Hypokinetic dysarthria in Parkinson's Disease. In: McNeil MR Clinical Management of Sensorimotor Speech Disorders. New York; Thieme 1997
MissingFormLabel
- 55 Sapir S, Pawlas A A, Ramig L O et al.. Voice and speech abnormalities in Parkinson disease: relation to severity of motor impairment, duration of disease, medication, depression, gender, and age. J Med Speech Lang Pathol. 2001; 9 213-226
- 56 Weismer G. Articulatory characteristics of Parkinsonian dysarthria: segmental and phrase-level
timing, spirantization and glottal-supraglottal coordination. In: McNeil MR, Rosenbek J, Aronson AE The Dysarthrias: Physiology, Acoustics, Perception and Management. San Diego, CA; College Hill Press 1984: 101-129
MissingFormLabel
- 57 Forrest K, Weismer G, Turner G. Kinematic, acoustic and perceptual analysis of connected speech produced by Parkinsonian and normal geriatric adults. J Acoust Soc Am. 1989; 85 2608-2622
- 58 Ackermann H, Konczak J, Hertrich I. The temporal control of repetitive articulatory movements in Parkinson's disease. Brain Lang. 1997; 56 312-319
- 59 Caligiuiri M P. Labial kinematics during speech in patients with Parkinsonian rigidity. Brain. 1987; 110 1033-1044
- 60 Conner N P, Abbs J H, Cole K J, Gracco V L. Parkinsonian deficits in serial mulitarticulate movements for speech. Brain. 1989; 112(pt. 4) 997-1009
- 61 Hirose H. Pathophysiology of motor speech disorders (dysarthria). Folia Phoniatr (Basel). 1986; 38 61-88
- 62 Gath I, Yair E. Analysis of vocal tract parameters in Parkinsonian speech. J Acoust Soc Am. 1988; 84 1628-1634
- 63 Hunker C J, Abbs J H. Physiological analyses of Parkinsonian tremors in the orofacial system. In: McNeil MR, Rosenbek JC, Aronson AE The Dysarthrias: Physiology, Acoustics, Perception, Management. San Diego, CA; College-Hill Press 1984
MissingFormLabel
- 64 Netsell R, Daniel B, Celesia G G. Acceleration and weakness in Parkinsonian dysarthria. J Speech Hear Disord. 1975; 40 170-178
- 65 Schneider J S, Diamond S G, Markham C H. Deficits in orofacial sensorimotor function in Parkinson's's disease. Ann Neurol. 1986; 19 275-282
- 66 Schneider J S, Lidsky T I. Basal Ganglia and Behavior: Sensory Aspects of Motor Functioning. Toronto; Hans Huber 1987
MissingFormLabel
- 67 Caligiuri M P. Labial kinematics during speech in patients with parkinsonian rigidity. Brain. 1987; 110 1033-1044
- 68 Connor N P, Abbs J H, Cole K J, Gracco V L. Parkinsonian deficits in serial multiarticulate movements for speech. Brain. 1989; 112 997-1009
- 69 Hoodin R B, Gilbert H R. Parkinsonian dysarthria: an aerodynamic and perceptual description of velopharyngeal closure for speech. Folia Phoniatr (Basel). 1989; 41 249-258
- 70 Koller W C. Sensory symptoms in PD. Neurology. 1984; 34 957-959
- 71 Tatton W G, Eastman M J, Bedingham W, Verrier M C, Bruce I C. Defective utilization of sensory input as the basis for bradykinesia, rigidity and decreased movement repertoire in Parkinson's disease: a hypothesis. Can J Neurol Sci. 1984; 11 136-143
- 72 Diamond S G, Schneider J S, Markham C H. Oral sensorimotor defects in patients with Parkinson's disease. Adv Neurol. 1987; 45 335-338
- 73 Solomon N P, Robin D A, Lorell D M, Rodnitzky R L, Luschei E S. Tongue function testing in Parkinson's disease: indicators of fatigue. In: Till JA, Yorkston KM, Beukelman DR Motor Speech Disorders: Advances in Assessment and Treatment. Baltimore, MD; Paul H Brooks 1994: 147-160
MissingFormLabel
- 74 Fox C M, Morrison C E, Ramig L O, Sapir S. Current perspectives on the Lee Silverman Voice Treatment (LSVT®) for individuals with idiopathic Parkinson's disease. Am J Speech Lang Pathol. 2002; 11 111-123
- 75 Ramig L O, Pawlas A, Countryman S. The Lee Silverman Voice Treatment (LSVT®): A Practical Guide to Treating the Voice and Speech Disorders in Parkinson Disease. Iowa City, IA; National Center for Voice and Speech 1995
MissingFormLabel
- 76 Ho A K, Iansek R, Bradshaw J L. Regulations of parkinsonian speech volume: the effect of interlocuter distance. J Neurol Neurosurg Psychiatry. 1999; 67 199-202
- 77 Curio G, Neuloh G, Numminen J, Jousmaki V, Hari R. Speaking modifies voice-evoked activity in the human auditory cortex. Hum Brain Mapp. 2000; 9 183-191
- 78 Albin R L, Young A B, Penny J B. The functional anatomy of basal ganglia disorders. Trends Neurosci. 1989; 12 366-375
- 79 Penny J B, Young A B. Speculations on the functional anatomy of basal ganglia disorders. Annu Rev Neurosci. 1983; 6 73-94
- 80 Berardelli A, Dick J P, Rothwell J C, Day B L, Marsden C D. Scaling of the size of the first agonist EMG burst during rapid wrist movements in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 1986; 49 1273-1279
- 81 Demirci M, Grill, McShane, Hallet M. A mismatch between kinesthesia and visual perception in Parkinson's disease. Ann Neurol. 1997; 41 781-788
- 82 Critchley E MR. Speech disorders of Parkinsonism: a review. J Neurol Neurosurg Psychiatry. 1981; 44 751-758
- 83 Rigrodsky S, Morrison E B. Speech changes in Parkinsonism during L-dopa therapy: preliminary findings. J Am Geriatr Soc. 1970; 18 142-151
- 84 Wolfe V I, Garvin J S, Bacon M, Waldrop W. Speech changes in Parkinson's disease during treatment with L-dopa. J Commun Disord. 1975; 8 271-279
- 85 Countryman S, Ramig L O. Effects of intensive voice therapy on speech deficits associated with bilateral thalamotomy in Parkinson's disease: a case study. J Med Speech Lang Pathol. 1993; 1 233-249
- 86 Ghika J, Ghika-Schmid F, Fankhauser H et al.. Bilateral contemporaneous posteroventral pallidotomy for the treatment of Parkinson's disease: neuropsychological and neurological side effects. Report of four cases and review of the literature. J Neurosurg. 1999; 91 313-321
- 87 Schulz G M, Peterson T, Sapienza C M, Greer M, Friedman W. Voice and speech characteristics of persons with Parkinson's disease pre- and post-pallidotomy surgery: preliminary findings. J Speech Lang Hear Res. 1999; 42 1176-1194
- 88 Sarno M T. Speech impairment in Parkinson's disease. Arch Phys Med Rehabil. 1968; 269-275
- 89 Allan C M. Treatment of non fluent speech resulting from neurological disease-treatment of dysarthria. Br J Disord Commun. 1970; 5 3-5
- 90 Scott S, Caird F L. Speech therapy for Parkinson's disease. J Neurol Neurosurg Psychiatry. 1983; 46 140-144
- 91 McNamara P, Obler L K, Au R, Durso R, Albert M L. Speech monitoring skills in Alzheimer's disease, Parkinson's disease and normal aging. Brain Lang. 1992; 42 38-51
- 92 Schmidt R A. Motor Control and Learning. Champaign, IL; Human Kinetic Publishers 1988
MissingFormLabel
- 93 Astrand P O, Rodahl K. Textbook of Work Physiology. New York; McGraw-Hill 1970
MissingFormLabel
- 94 Ramig L O, Bonitati C, Lemke J, Horii Y. Voice treatment for patients with Parkinson disease: development of an approach and preliminary efficacy data. J Med Speech Lang Pathol. 1994; 2 191-209
- 95 Ramig L O. The role of phonation in speech intelligibility: a review and preliminary data from
patients with Parkinson's disease. In: Kent RD Intelligibility in Speech Disorders: Theory, Measurement and Management. Amsterdam; John Benjamin 1992: 119-155
MissingFormLabel
- 96 Dromey C, Ramig L O, Johnson A. Phonatory and articulatory changes associated with increased vocal intensity in Parkinson disease: a case study. J Speech Hear Res. 1995; 38 751-763
- 97 Ramig L O, Sapir S, Countryman S et al.. Intensive voice treatment (LSVT®) for individuals with Parkinson's disease: a 2-year follow-up. J Neurol Neurosurg Psychiatry. 2001; 71 493-498
- 98 Baumgartner C, Sapir S, Ramig L O. Voice quality changes following phonatory-respiratory effort treatment (LSVT®) versus respiratory effort treatment for individuals with Parkinson disease. J Voice. 2001; 15 105-114
- 99 Sapir S, Ramig L O, Hoyt P, Countryman S, O'Brien C, Hoehn M. Phonatory-respiratory effort (LSVT®) vs. respiratory effort treatment for hypokinetic dysarthria: comparing speech loudness
and quality before and 12 months after treatment. Poster presented at: Academy of Neurology Vancouver, Canada; October 1999
MissingFormLabel
- 100 Ramig L, Sapir S, Fox C, Countryman S. Changes in vocal loudness following intensive voice treatment (LSVT) in individuals with Parkinson's disease: a comparison with untreated patients and with normal age-matched controls. Mov Disord. 2001; 16 79-83
- 101 Ramig L O, Dromey C. Aerodynamic mechanisms underlying treatment-related changes in SPL in patients with Parkinson disease. J Speech Hear Res. 1996; 39 798-807
- 102 Countryman S, Ramig L O, Pawlas A A. Speech and voice deficits in Parkinsonian Plus syndromes: can they be treated?. J Med Speech Lang Pathol. 1994; 2 211-225
- 103 Schulman R. Articulatory dynamics of loud and normal speech. J Acoust Soc Am. 1989; 85 295-312
- 104 Ramig L O, Dromey C, Johnson A, Scherer R. The effects of phonatory, respiratory and articulatory effect treatment on speech
and voice in Parkinson's disease. Paper presented at: Motor Speech Conference April 1994 Sedona, AZ;
MissingFormLabel
- 105 Liotti M, Ramig L O, Vogel D et al.. Hypophonia in Parkinson's disease neural correlates of voice treatment revealed by PET. Neurology. 2003; 60 432-440
Lorraine Olson RamigPh.D. CCC-SLP
Department of Speech, Language, Hearing Science
Campus Box 409, University of Colorado-Boulder
Boulder, CO 80309
Email: ramig@spot.colorado.edu