A Multidimensional Study on Articulation Deficits in Parkinsons Disease

A Multidimensional Study on Articulation Deficits in Parkinson's Disease

Articulatory deficits are present in most speakers with dysarthria, which negatively impacts their speech intelligibility, yet little is known about the relationship between articulatory movement and speech intelligibility. This study will examine the relationship between articulation measures, both acoustic and kinematic, and their relationship to perceptual measures (i.e., speech intelligibility and articulation ratings) in 30 individuals with dysarthria secondary to Parkinson's disease and 30 neurologically healthy adults of the same age. The findings will have implications for behavioral management.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease; Dysarthria, Hypokinetic
• Intervention / Treatment: Behavioral: Clear Speech; Behavioral: Less Clear Speech

Detailed Description

Dysarthria is a motor speech disorder that affects individuals with various etiologies. Parkinson's disease (PD) alone affects nearly one million individuals in the U.S., with dysarthria developing in approximately 90% of these individuals within the first two years of onset. The dysarthria associated with PD is characterized by reduced movement, which has been supported by findings of reduced lip, tongue, and jaw movement in speakers with PD. However, it remains unclear if hypokinetic dysarthria causes a global reduction across all articulators, or if specific articulators are disproportionally affected by the disease. Further, it is not fully understood what factors contribute to speech intelligibility. Specifically, little is known about the articulatory-kinematic correlates of speech intelligibility. This missing link is vital to understand, as articulation deficits are a universal characteristic of dysarthria, regardless of etiology. The proposed study provides a linked investigation of kinematic, acoustic, and perceptual characteristics in speakers with PD and neurologically healthy speakers.

This research aims to (1) examine the perceptual, acoustic, and articulator-specific movement deficits in speakers with PD and (2) understand the relationship between articulatory movement and measures of speech perception. Specific Aim 1 will examine the group differences between speakers with PD and neurologically healthy speakers using perceptual, acoustic, and articulator-specific kinematic measures. The investigators hypothesize the perceptual, acoustic, and tongue-related kinematic measures will differentiate individuals with PD from neurologically healthy speakers. Specific Aim 2 will model speech intelligibility (Specific Aim 2a) and ratings of articulatory precision (Specific Aim 2b) using selected acoustic and kinematic measurements. The investigators hypothesize that the acoustic measures will be stronger predictors of speech intelligibility than the kinematic measures, as they are both derived from the speech signal. Further, the investigators hypothesize the selected kinematic measures may demonstrate a stronger relationship to articulation ratings than speech intelligibility. This study is a requisite step toward our long-term goal of advancing dysarthria management strategies. The primary outcome will be explanatory models that identify acoustic and articulatory correlates of speech intelligibility and articulatory precision. This study has important implications for developing articulator-specific dysarthria management strategies to supplement universal dysarthria management strategies.

• Study Type: Observational
• Enrollment (Actual): 40

Contacts and Locations

Study Locations

• United States
  • Florida
    • Tallahassee, Florida, United States, 32309
      • Florida State University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

All participants will be recruited via convenient sampling from Tallahassee, FL, and the local community. For the neurologically healthy control speakers, flyers will be posted at local coffee shops, community samples, and via word of mouth. For the Parkinson's participants, flyers will be posted at hospitals, health clinics, and gyms.

Description

Inclusion Criteria:

• neurological diagnosis of PD (for the PD group only)
• diagnosis of dysarthria (for the PD group only)
• native English speaker
• no evidence of cognitive impairment, as indicated by a score above 26 on the Montreal Cognitive Assessment
• able to read a paragraph in 19-point font

Exclusion Criteria:

• Not within the age limits

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Parkinsons (PD) Group; This cohort includes individuals who have been diagnosed with Parkinson's disease.	Behavioral: Clear Speech; This behavioral modification asks participants to speak more clearly, as if they were "speaking to someone with a hearing loss".; Behavioral: Less Clear Speech; This behavioral modification asks participants to speak less clearly, as if they were "in a room with many people and they were mumbling something to the person next to them that they didn't want other people in the room to hear."
Neurotypical (NT) Group; This group consists of age-matched control participants. They are neurologically healthy and do not have any neurological diagnoses.	Behavioral: Clear Speech; This behavioral modification asks participants to speak more clearly, as if they were "speaking to someone with a hearing loss".; Behavioral: Less Clear Speech; This behavioral modification asks participants to speak less clearly, as if they were "in a room with many people and they were mumbling something to the person next to them that they didn't want other people in the room to hear."

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Vowel Space Area	Vowel space area is a measure of the planar area among the four corner vowels /i/, /ae/, /a/, and /u/. It is calculated using the first and second formant resonant frequencies obtained from the acoustic signal, using the software PRAAT.	Baseline
Tongue and Jaw Speed	This is measured as the tongue and jaw speed during the diphthong in "Buy". Specifically, this will be calculated as tongue/jaw movement (measured in mm), divided by movement duration (measured in ms). The tongue and jaw movement will be collected using the electromagnetic articulography (EMA) device used in this study.	Baseline
Acoustic Distance	This is measured as the Euclidean distance between the second formant frequency (F2) onset and offset of the diphthong in "Buy" in an F1-F2 (first and second formant frequency) space. Measured in Hz.	Baseline
Tongue and Jaw Distance	This is measured as the Euclidean distance between the tongue and jaw onset and offset of the diphthong in "Buy" in a two-dimensional space.The tongue and jaw movement will be collected using the electromagnetic articulography (EMA) device used in this study.	Baseline
F2 Slope	Second formant frequency (F2) slope is measured as the rate of F2 change during the diphthong in "Buy." To calculate this measure, first the investigators will obtain the extent of F2 change (max F2 - min F2) from the diphthong "Buy." Then this F2 change is divided by the duration of the diphthong "Buy."	Baseline

Collaborators and Investigators

• Sponsor: Florida State University
• Collaborators: National Institute on Deafness and Other Communication Disorders (NIDCD)
• Investigators: Study Chair: Yunjung Kim, Ph.D., Florida State University

Study record dates

Study Major Dates

• Study Start (Actual): September 9, 2021
• Primary Completion (Actual): July 31, 2023
• Study Completion (Actual): July 31, 2023

Study Registration Dates

• First Submitted: February 22, 2023
• First Submitted That Met QC Criteria: February 22, 2023
• First Posted (Actual): March 3, 2023

Study Record Updates

• Last Update Posted (Actual): August 27, 2024
• Last Update Submitted That Met QC Criteria: August 23, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Language Disorders; Communication Disorders; Speech Disorders; Articulation Disorders; Parkinson Disease; Dysarthria
• Other Study ID Numbers: STUDY00002525; F31DC020121 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The analytic data and code will be shared to the open science framework (OSF) upon completion of the project, expected July 2023.
• IPD Sharing Time Frame: Analytic data and code will be made available in July 2023.
• IPD Sharing Access Criteria: Upon publication to the open science framework (OSF) project page, anyone will have access to the analytic data and code.
• IPD Sharing Supporting Information Type: ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No