Phonatory and Articulatory Changes Associated With Increased Vocal Intensity in Parkinson Disease: A Case Study This study examined changes in voice and speech production in a patient with Parkinson disease as he increased vocal intensity following 1 month of intensive voice treatment. Phonatory function and articulatory acoustic measures were made before and after treatment as well as 6 and 12 months later. Pre- to post-treatment ... Case Study
Case Study  |   August 01, 1995
Phonatory and Articulatory Changes Associated With Increased Vocal Intensity in Parkinson Disease: A Case Study
 
Author Affiliations & Notes
  • Christopher Dromey
    Department of Communication Disorders and Speech Science, University of Colorado-Boulder, Wilbur James Gould Voice Research Center, The Denver Center for the Performing Arts
  • Lorraine Olson Ramig
    Department of Communication Disorders and Speech Science, University of Colorado-Boulder, Wilbur James Gould Voice Research Center, The Denver Center for the Performing Arts
  • Antonia B. Johnson
    Wilbur James Gould Voice Research Center, The Denver Center for the Performing Arts
  • Contact author: Lorraine Olson Ramig, PhD, Department of Communication Disorders and Speech Science, University of Colorado, Campus Box 409, Boulder, CO 80309.
    Contact author: Lorraine Olson Ramig, PhD, Department of Communication Disorders and Speech Science, University of Colorado, Campus Box 409, Boulder, CO 80309.×
Article Information
Speech, Voice & Prosody / Speech / Case Study
Case Study   |   August 01, 1995
Phonatory and Articulatory Changes Associated With Increased Vocal Intensity in Parkinson Disease: A Case Study
Journal of Speech, Language, and Hearing Research, August 1995, Vol. 38, 751-764. doi:10.1044/jshr.3804.751
History: Received June 6, 1994 , Accepted January 17, 1995
 
Journal of Speech, Language, and Hearing Research, August 1995, Vol. 38, 751-764. doi:10.1044/jshr.3804.751
History: Received June 6, 1994; Accepted January 17, 1995

This study examined changes in voice and speech production in a patient with Parkinson disease as he increased vocal intensity following 1 month of intensive voice treatment. Phonatory function and articulatory acoustic measures were made before and after treatment as well as 6 and 12 months later. Pre- to post-treatment increases were documented in sound pressure level in sustained phonation, syllable repetition, reading, and monologue. Consistent with mechanisms of intensity change reported in normal speakers, corresponding improvements were measured in estimated subglottal pressure, maximum flow declination rate, laryngeal airway resistance, open quotient, EGGW-25, harmonic-spectral slope, and maximum vowel duration. Measures of phonatory stability in sustained phonation and semitone standard deviation in reading and speaking showed changes accompanying increased vocal intensity. In addition, changes were measured in articulatory acoustic parameters (vowel and whole word duration, transition duration, extent and rate, and frication duration and rise time) in single-word productions. These findings indicate that this patient increased his vocal intensity using phonatory mechanisms that have been associated with the nondisordered larynx. In addition, the increased vocal intensity led to changes in articulation that were not targeted in treatment.

Acknowledgments
This research was supported in part by grants NIH-NIDCD #R01 DC01150 and #P60 DC00976. We wish to thank Bruce Smith, Gary Weismer, Donald Robin, Dale Metz, and an anonymous reviewer for their helpful comments on a previous version of this manuscript. We also express our appreciation to Dr. Ellis “Don” Penny, the subject in this report.
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