Objective: We develop an analytical description of co-speech gesture production in PD patients.

Background: Communication and expressive behavior problems are frequent in PD patients (Duncan 2004; Miller 2006; Pentland 1987; Pitcairn 1990). Active and Improvisation Theater (AIT) have been use to help people with PD (Bega 2017; Modugno 2010). 

Methods: Analytical description of behavior of videotaped fragments of AIT (aid by ELAN system 4.9.2.).

Participants: 6 patients with idiopatic PD (Hoehn & Yahr 2-4; they participated on their normal medication and “on” period).

Variables: 1. type of co-speech gesture (iconic, metaphoric, deictic and pragmatic/interactive, Clearly 2011; Humphreis 2016), 2. gesture rate (number of  gestures per 30 words), 3. word rate (number of words per 60 seconds), 3. presence of triphasic sequence (preparation, stroke and retraction), 4. synchronization with speech, 5. amplitude (scale from attached to the body to open to the external space), 6. coherence with speech (meaning), 7. fluidity (scale from rigidity to fluidity), and 8. complexity (scale from composed by a single stage to several identifiable stages).

Results: The number of gestures per 30 words was from 1 to 5 and the word rate was from 67 to 30, respectively. The majority of the gestures were pragmatic/interactive; one gesture was metaphoric and 4 were deictic. In general, gestures were composed by a triphasic sequence of acts and showed moderate amplitude. Interestingly, in 3 cases some of the gestures showed a fluidity that was not in accordance with what is expected to observe in a person with PD. Gestures were synchronous and coherent with speech and showed an interesting level of complexity.

Conclusions: We have shown that people with PD are able to generate gestures which have a pragmatic use in interpersonal relations, evince a reserve of fluidity of the body movement, are synchronous and coherent with speech, can be complex, and several can be generated in a brief period of time. We suggest that paradoxical kinesia (Souques 1921) underlie the observed behavior.

The small sample and qualitative nature of the study do not allow us to make generalizations. Despite these limitations, we have show that co-speech gestures in PD patients serve their communication, a function tan can be enhanced by including expressive disciplines in rehabilitation settings. We will continue developing this issue by expanded and controlled studies.

References: Cleary R A, Poliakoff E, Galpin A, Dick JP, Holler J. An investigation of co-speech gesture production during action description in Parkinson’s disease. Parkinsonism Relat Disord 2011; 17(10): 753-756  doi 10.1016/j.parkreldis.2011.08.001.

Bega D, Palmentera P, Wagner A, Hovde M, Barish B, Kwasny MJ, Simuni T.  Laughter is the best medicine: The Second City® improvisation as an intervention for Parkinson’s disease. Parkinsonism Relat Disord 2017; 34: 62-65 http://dx.doi.org/10.1016/j.parkreldis.2016.11.001

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MDS Abstracts - https://www.mdsabstracts.org/abstract/co-speech-gestures-in-parkinsons-disease-pd/