Objective: Our aim was to evaluate the impact of voice treatment (LSVT LOUD) and articulation treatment (LSVT ARTIC) on speech and consonant intelligibility in Parkinson’s disease (PD) measured by the Diagnostic Rhyme Test (DRT), the ANSI standard for measuring the perceptual intelligibility of speech, in noise and non-noise conditions. These data were compared with untreated controls (UNTXPD) with PD.

Background: Reduced speech intelligibility in PD has been associated with decreased vocal loudness, imprecise articulation and poor voice quality. LSVT LOUD has been demonstrated to improve vocal loudness in the short (immediately post-treatment) and long-term (24 months post-treatment) and positively impact articulatory precision, however its impact on speech intelligibility has not been established.

Methods: Sixty-five individuals with mild-moderate PD were randomized to three groups (LSVT LOUD, LSVT ARTIC and UNTXPD). Participants read 96 rhyming word pairs of the DRT in a sound-treated booth where acoustic data were collected. Noise was added to the DRT sound files and they were analyzed by trained listeners in three noise conditions: No noise, Mall and Babble. Sound files were presented at a 0dB SNR pre-treatment to assess the impact of increasing SPL on intelligibility. Treatments were LSVT LOUD or LSVT ARTIC, which was identical to LSVT LOUD in all ways except it had a focus on articulatory effort and precision.

Results: Pre to post-treatment changes in DRT scores were significantly greater for LSVT LOUD than for both LSVT ARTIC and UNTXPD in Babble noise (p<.05). Pre to post-treatment changes in DRT scores were significantly greater for LSVT LOUD than UNTXPD in Mall noise (p<.05). UNTXPD had no significant pre to post-treatment changes in DRT scores in any noise condition (p>.05). Between group pre to post-treatment changes in SPL were significantly greater for LSVT LOUD than for both LSVT ARTIC and UNTXPD (p<.05).

Conclusions: These results reinforce the need to assess intelligibility of individuals with PD in the presence of background noise. Intensive treatment that focuses on voice (LSVT LOUD) and increased loudness had a larger impact on improving speech and consonant intelligibility than intensive treatment that focused on enhanced articulation (LSVT ARTIC). NIH-NIDCD R01 DC1150 These data were presented at the American Speech Language Hearing Association Convention in 2016.

References: Ramig L, Sapir S, Countryman S, Pawlas A, O’Brien C, Hoehn M, Thompson L. Intensive voice treatment (LSVT) for individuals with Parkinson’s disease: a two year follow-up. Journal of Neurology, Neurosurgery and Psychiatry 2001, 71, 493-498. Sapir S, Ramig L, Fox C. Intensive voice treatment in Parkinson’s disease: Lee Silverman Voice Treatment. Expert Rev Neurother. 2011, 6, 815-830.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/speech-intelligibility-in-parkinsons-disease-following-intensive-voice-and-articulation-treatments/