Objective: The objective of this study was to evaluate self-perception of vocal handicap in individuals with Parkinson’s disease at various stages of diagnosis.

Background: The vocal characteristics in individuals with Parkinson’s disease have been well described as monopitch, monoloudness, short rushes of speech and impaired vocal volume (Darley, Aronson, Brown, 1969). Vocal clarity becomes more difficult as the disease progresses setting up the statge for withdrawl from social communication. Patient reported outcomes measures, such as the Voice Handicap Index (VHI), provide important information regarding individual’s perception of their voice, allows clinicians to assess patients’ views of the handicapping effects of dysarthria, can be used to determine if patients should be enrolled in voice therapy and assist in determination of voice treatment goals for individuals with PD.

Methods: Twenty-one individuals with Parkinson’s disease (PD) completed the Voice Handicap Index (VHI). Patients were divided into three groups: Group 1: 0-5 years since diagnosis (n=5); Group 2: 6-10 years since diagnosis (n=10) and Group 3: 11-16 years since diagnosis (n=6). The average number of years between PD diagnosis and the VHI was 8.4. None of the subjects had undergone DBS. The VHI subscales of physical (ex., "I run out of air when I talk"), emotional (ex., "my voice problem upsets me") and functional (ex., "I use the phone less often than I would like") handicapping effects of voice and the total score of the VHI were compared among these three time groups using analysis of variance methods. All tests were done using an alpha of 0.05.

Results: There were no significant differences between perception of vocal handicap on any of the subscales or the total VHI score between the three groups. All three groups scored in the mild category of vocal handicap on the total VHI score.

Conclusions: The results of this study indicate that even patients with early diagnoses of PD perceive changes in vocal quality. Results are considered preliminary due to the small sample size. A larger sample size may indicate that individuals in the later stages of PD perceive a more severe vocal handicap, or that self-perception of sensory feedback such as voice may be impaired in individuals in the later stages of PD. Further studies are necessary to determine perception of vocal handicap in various stages of PD to optimize vocal management, such as timing of initiation of voice therapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/self-perception-of-vocal-handicap-in-parkinsons-disease/