Elsevier

Journal of Voice

Volume 13, Issue 4, December 1999, Pages 583-591
Journal of Voice

Aerodynamic measurements of patients with parkinson's disease*

https://doi.org/10.1016/S0892-1997(99)80012-5Get rights and content

Summary

Patients with Parkinson's disease commonly complain of voice dysfunction. Most of these complaints can be attributed to the known muscular control disorders that occur with Parkinson's disease. However, the manifestations of Parkinson's disease muscular dysfunction on parameters of phonation such as airflow, laryngeal resistance, and subglottal pressure necessary to sustain phonation have not been reported. The purpose of this study was to examine the aerodynamic characteristics of flow, laryngeal resistance, and phonation pressure threshold in a heterogeneous population of patients with Parkinson's disease who had varying voice complaints and to compare the data to similar studies for human subjects who have no voice complaints. The studies used a noninvasive method of detecting flow and acoustic signal from the lips, oral cavity and nose during phonation and used an external flow interruption technique to estimate subglottal pressure and phonation threshold pressure. About one third of the patients could not produce phonation at regular and loud intensities that were comfortable for normal subjects. The mean subglottal pressure (SGP) of patients with Parkinson disease who could produce 3 levels of intensity comparable to normal subjects was significantly higher than the mean SG-Ps for normal subjects for the same intensities of vocal production. The mean flow rates measured from patients with Parkinson's disease at the same 3 intensities of phonation was not significantly greater than in normal subjects. This indicated that the mean laryngeal resistance calculated for patients with Parkinson's disease was notably and significantly greater than mean laryngeal resistance calculated for normal subjects at the same intensity levels. The mean vocal efficiency (VE) for normal subjects was not significantly different than the mean VE for patients with Parkinson's disease, because greater pressure was used to generate similar flow and acoustic energy. These findings correlate with the perception of patients with Parkinson's disease that they are working harder to produce phonation. The observation of notably greater laryngeal resistance and phonation threshold pressure in patients with Parkinson's disease suggests that further studies of the glottic aperture in patients with Parkinson' disease may be useful for understanding how this common motor disorder disturbs phonation.

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    2020, Journal of Voice
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    Theories explaining the physiological changes associated with voice impairments in PD have included the existence of glottal insufficiency secondary to vocal fold bowing and/or atrophy, impaired control of vocal fold adjustments during phonation, and dysregulated central motor control underlying an impairment in movement amplitude scaling.4–8 Glottal insufficiency in speakers with PD is a common instrumental finding in published reports.4–6,9–13 However, in speakers without overt laryngeal impairment and those at less-severe stages of disease progression, glottal insufficiency has not been a ubiquitous finding, even in voices with salient perceptual breathiness.4,14

  • The Effect of Parkinson Disease Tremor Phenotype on Cepstral Peak Prominence and Transglottal Airflow in Vowels and Speech

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    This question will need to be pursued in future studies. Interestingly, previous studies have reported no difference between speakers with PD and normal controls on measures of airflow obtained from vowels when using an airway interruption method.39,47 However, these studies did not control for tremor phenotype, which has been shown to influence limb-motor disease progression and severity.3

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*

This paper was presented at the Voice Foundation's 27th Annual Symposium Care of the Professional Voice; June 2, 1998; Philadelphia, Pennsylvania.

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