Objective: To examine the effect of LSVT LOUD (Ramig et al., 2011) on facial expressivity in PD as a function of emotional valence.

Background: Research has shown that facial emotional expression is reduced in PD. Of note, a considerable body of literature (e.g., Pitcairn et al., 1990) suggests that individuals with PD are less impaired in producing negative/unpleasant than positive/pleasant expressions of emotion relative to healthy adults. Recent studies have shown that LSVT LOUD increases facial expressivity in PD. In this study, we examined the effect of LSVT LOUD on positive and negative facial expressions in PD to determine whether emotional valence had an impact on improvement in facial expressivity following treatment.

Methods: Participants were 13 PDs (LSVT LOUD; 69% male), 14 PDs (LSVT ARTIC – Articulation Therapy; 64% male), 13 PDs (UNTXPD – untreated controls; 64% male), and 14 healthy controls (HCs; 69% male). They were videotaped pre- and post-treatment while producing positive (Happy) and negative (Sad & Angry) monologues via New York Emotion Battery procedures. Facial expression was rated on a 7-point Likert scale (from minimal to maximal) by 18 male and female raters for emotional frequency (EF), intensity (EI), and variability (EV) and for facial mobility (FM).

Results: Analyses of Covariance (Group x Gender x Time x Emotion), controlling for depression (Beck Depression Inventory-II), were performed, separately, for each facial rating. There were significant or trend-level 4-way interactions for FM, EF, and EI, which were followed up by post-hoc tests. For the LSVT LOUD group, for women, there were significant increases for Sad on all 3 ratings, whereas, for men, there were significant or trend-level increases for Happy on 2 of the ratings. For LSVT ARTIC and UNTXPD, women showed stable or decreased performance, whereas men did not change over time across the 4 variables. For HCs, there were no changes in facial expressivity.

Conclusions: Overall, LSVT LOUD women were more facially expressive post treatment for negative than positive emotions, whereas LSVT LOUD men were more facially expressive post treatment for the positive emotion. By contrast, LSVT ARTIC, an alternative treatment, equal in time and effort, did not have an effect. Future research should use a larger number of both positive and negative emotions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-the-lee-silverman-voice-treatment-lsvt-loud-on-facial-expressivity-in-individuals-with-parkinsons-disease-pd-as-a-function-of-emotional-valence/