Objective: This study investigates prominence marking (highlighting of prominent elements by adjusting speech parameters in the glottal, supraglottal and subglottal systems) and how this ability is correlated with motoric [1] and cognitive abilities [2] in patients with Parkinson’s disease (PwPD).

Background: Dysarthric speech in PwPD affects different subsystems of speech involving phonation, articulation and respiration [3, 4]. It is unclear how much deterioration of these systems is tolerated until PwPD are no longer able to adjust speech parameters. Moreover, little is known about the relationship between cognitive functions and prosodic abilities.

Method: We collected production data from 38 native speakers of German: 19 PwPD (Med-On) with a mild to moderate motor impairment (UPDRS III, [5]) and 19 healthy age and gender matched controls. We recorded target words in two conditions (accented vs. unaccented) within mini-dialogues and analysed the acoustic speech parameters: intensity, pitch and vowel formants. Furthermore, we assessed cognitive functions in terms of executive functioning, attention control and working memory.

Results: Comparisons between PwPD and controls revealed that the vowel space is smaller in PwPD right in the beginning of the developing dysarthria (p<.001). However, both groups were able to mark prominence by adjusting their vowel articulation and by increasing pitch and intensity. For the PwPD we found a relation between executive functions and the modulation of pitch and intensity (p<.01). The more severe the executive dysfunction the stronger intensity and pitch get modulated. Furthermore, the impairment of motor abilities within the PwPD group was accompanied by a decrease of the acoustic vowel space (p<.01). This results in an inefficient way of prominence marking and in a decrease in speech intelligibility and naturalness in an early stage of dysarthria.

Conclusion: Our study shows a link between cognitive skills and speech production in natural sentence production, because PwPD with signs of mild dysarthria overused pitch and loudness in prominent positions, correlated with their level of executive functioning. Furthermore, lingual control decreases with an increase in motor impairment. Our results may be of clinical interest supporting the provision of therapeutic input at the early stages of the disease to preserve communication function.

References: [1] Hornykiewicz, O. 1998. Biochemical aspects of Parkinson’s disease. Neurology, 51(2 Suppl 2), 2-9. [2] Kalbe, E., Rehberg, S. P., Heber, I., Kronenbuerger, M., Schulz, J. B., Storch, A., et al. (2016). Subtypes of mild cognitive impairment in patients with Parkinson’s disease: evidence from the LANDSCAPE study. J Neurol Neurosurg Psychiatry, 87, 1099-1105. [3] Darley, F. L., Aronson, A. E., & Brown, J. R. 1969. Differential diagnostic patterns of dysarthria. Journal of Speech, Language, and Hearing Research, 12(2), 246-269. [4] Duffy, J. R. (2013). Motor Speech Disorders – Substrates, Differential Diagnosis, and Management. St. Louis, Elsevier, Mosby. [5] Goetz, C. G., Tilley, B. C., Shaftman, S. R., Stebbins, G. T., Fahn, S., Martinez‐Martin, P., … & Dubois, B. 2008. Movement Disorder Society‐sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing results. Movement disorders, 23(15), 2129-2170.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/influence-of-cognitive-abilities-on-prominence-production-in-mild-dysarthric-patients-with-parkinsons-disease/