Speed of Pitch Change in People with Parkinson’s Disease: A Pilot Study

Velocidad de cambio de tono en personas con enfermedad de Parkinson: un estudio piloto


Objective. To examine laryngeal maximum performance through a novel pitch diadochokinetic (DDK) task in people with Parkinson’s disease (PD) and healthy controls.

Methods. This exploratory pilot study included a total of eight people with PD (seven male and one female) and eight healthy controls. Participants were instructed to rapidly transition or alternate between a chosen comfortable low and high pitch and were instructed to complete the task as a pitch glide. An Auditory Sawtooth Waveform Inspired Pitch Estimator-Prime model was used to first extract the pitch contour and then a customized MATLAB algorithm was used to compute and derive measures of pitch range and pitch slope.

Results. Pitch range and slope were reduced in some participants with PD. Effects of age and disease duration were observed in people with PD: reductions in both pitch measures with increase in age and disease duration.

Conclusions. A novel pitch DDK task may supplement the conventional laryngeal DDK task in the evaluation and treatment of motor speech and voice disorders. Individual variability analysis may provide specific diagnostic and therapeutic insights for people with PD.


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Supraja Anand


Fahn S. Description of Parkinson's disease as a clinical syndrome. Annals of the New York Academy of Sciences. 2003;991(1):1-14. doi: https://doi.org/10.1111/j.1749-6632.2003.tb07458.x

Lang AE, Lozano AM. Parkinson's disease. First of Two parts. N Engl J Med. 1998 Oct 8;339(15):1044-53. doi: https://doi.org/10.1056/nejm199810083391506

Jankovic J. Parkinson's disease: clinical features and diagnosis. Journal of Neurology, Neurosurgery & Psychiatry. 2008;79(4):368-76. doi: http://dx.doi.org/10.1136/jnnp.2007.131045

Duffy J. Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. 3rd ed. St. Louis, MO: Elsevier, Mosby; 2012. 512 p.

Darley FL, Aronson AE, Brown JR. Differential diagnostic patterns of dysarthria. Journal of Speech, Language and Hearing Research. 1969;12(2):246-69. doi: https://doi.org/10.1044/jshr.1202.246

Logemann JA, Fisher HB, Boshes B, Blonsky ER. Frequency and cooccurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients. Journal of Speech and Hearing Disorders. 1978;43(1):47-57. doi: https://doi.org/10.1044/jshd.4301.47

Harel BT, Cannizzaro MS, Cohen H, Reilly N, Snyder PJ. Acoustic characteristics of Parkinsonian speech: a potential biomarker of early disease progression and treatment. Journal of Neurolinguistics. 2004;17(6):439-53. doi: https://doi.org/10.1016/j.jneuroling.2004.06.001

Harel BT, Cannizzaro M, Snyder PJ. Variability in fundamental frequency during speech in prodromal and incipient Parkinson's disease: A longitudinal case study. Brain and Cognition. 2004;56(1):24-9. doi: https://doi.org/10.1016/j.bandc.2004.05.002

Holmes RJ, Oates JM, Phyland DJ, Hughes AJ. Voice characteristics in the progression of Parkinson's disease. International Journal of Language & Communication Disorders. 2000;35(3):407-18. doi: https://doi.org/10.1080/136828200410654

Ho AK, Iansek R, Marigliani C, Bradshaw JL, Gates S. Speech impairment in a large sample of patients with Parkinson's disease. Behavioural Neurology. 1999;11(3):131-7. doi: https://doi.org/10.1155/1999/327643

Rusz J, Tykalová T, Novotný M, Růžička E, Dušek P. Distinct patterns of speech disorder in early-onset and late-onset de-novo Parkinson’s disease. npj Parkinson's Disease. 2021;7(1):98. doi: https://doi.org/10.1038/s41531-021-00243-1

Šimek M, Rusz J. Validation of cepstral peak prominence in assessing early voice changes of Parkinson's disease: Effect of speaking task and ambient noise. The Journal of the Acoustical Society of America. 2021;150(6):4522-33. doi: https://doi.org/10.1121/10.0009063

Goberman AM, Coelho C, Robb M. Phonatory characteristics of parkinsonian speech before and after morning medication: the ON and OFF states. Journal of Communication Disorders. 2002;35(3):217-39. doi: https://doi.org/10.1016/S0021-9924(01)00072-7

Gamboa J, Jiménez-Jiménez FJ, Nieto A, Montojo J, Ortí-Pareja M, Molina JA, et al. Acoustic voice analysis in patients with Parkinson's disease treated with dopaminergic drugs. Journal of Voice. 1997;11(3):314-20. doi: https://doi.org/10.1016/S0892-1997(97)80010-0

Jiménez-Jiménez FJ, Gamboa J, Nieto A, Guerrero J, Orti-Pareja M, Molina JA, et al. Acoustic voice analysis in untreated patients with Parkinson's disease. Parkinsonism & Related Disorders. 1997;3(2):111-6. doi: https://doi.org/10.1016/S1353-8020(97)00007-2

Tanaka Y, Nishio M, Niimi S. Vocal acoustic characteristics of patients with Parkinson’s disease. Folia Phoniatrica et Logopaedica. 2011;63(5):223-30. doi: https://doi.org/10.1159/000322059

Santos LLM, Reis LOd, Bassi I, Guzella C, Cardoso F, Reis C, et al. Acoustic and hearing-perceptual voice analysis in individuals with idiopathic Parkinson's disease in "on" and "off" stages. Arquivos de neuro-psiquiatria. 2010;68(5):706-11. doi: https://doi.org/10.1590/S0004-282X2010000500006

Little MA, McSharry PE, Hunter EJ, Spielman J, Ramig LO. Suitability of dysphonia measurements for telemonitoring of Parkinson's disease. IEEE Transactions on Biomedical Engineering. 2009;56(4):1015-22. doi: https://doi.org/10.1109/TBME.2008.2005954

Zwirner P, Barnes GJ. Vocal tract steadiness: a measure of phonatory and upper airway motor control during phonation in dysarthria. Journal of Speech, Language and Hearing Research. 1992;35(4):761-8. doi: https://doi.org/10.1044/jshr.3504.761

Rahn DA, Chou M, Jiang JJ, Zhang Y. Phonatory Impairment in Parkinson's Disease: Evidence from Nonlinear Dynamic Analysis and Perturbation Analysis. Journal of Voice. 2007;21(1):64-71. doi: https://doi.org/10.1016/j.jvoice.2005.08.011

Cushnie-Sparrow D, Adams S, Abeyesekera A, Pieterman M, Gilmore G, Jog M. Voice quality severity and responsiveness to levodopa in Parkinson’s disease. Journal of communication disorders. 2018;76:1-10. doi: https://doi.org/10.1016/j.jcomdis.2018.07.003

Chiaramonte R, Bonfiglio M. Acoustic analysis of voice in Parkinson's disease: a systematic review of voice disability and meta-analysis of studies. Rev Neurol. 2020;70(11):393-405. doi: https://doi.org/10.33588/rn.7011.2019414

Rusz J, Tykalova T, Ramig LO, Tripoliti E. Guidelines for speech recording and acoustic analyses in dysarthrias of movement disorders. Movement Disorders. 2021;36(4):803-14. doi: https://doi.org/10.1002/mds.28465

Canter GJ. Speech characteristics of patients with Parkinson's disease: III. Articulation, Diadochokinesis, and overall Speech Adequacy. Journal of Speech and Hearing Disorders. 1965;30(3):217-24. doi: https://doi.org/10.1044/jshd.3003.217

Bassich-Zeren CJ. Vocal dysfunction in young-onset Parkinson’s disease [dissertation]. [College Park (MD)]: University of Maryland; 2004. 305 p. Available from: https://drum.lib.umd.edu/items/19bb72f4-918d-4665-9268-b4b23cea7ebf

Renout KA, Leeper HA, Bandur DL, Hudson AJ. Vocal fold diadochokinetic function of individuals with amyotrophic lateral sclerosis. American Journal of Speech-Language Pathology. 1995;4(1):73-80. doi: https://doi.org/10.1044/1058-0360.0401.73

Lombard L, Solomon NP. Laryngeal diadochokinesis across the adult lifespan. Journal of Voice. 2020;34(5):651-6. doi: https://doi.org/10.1016/j.jvoice.2019.04.004

Jafari M, Wong KH, Behbehani K, Kondraske GV. Performance characterization of human pitch control system: an acoustic approach. The Journal of the Acoustical Society of America. 1989;85(3):1322-8. doi: https://doi.org/10.1121/1.397463

Sundberg J. Data on maximum speed of pitch changes. Quarterly Progress and Status Reports. 1973:39-47.

Xu Y, Sun X. Maximum speed of pitch change and how it may relate to speech. The Journal of the Acoustical Society of America. 2002;111(3):1399-413. doi: https://doi.org/10.1121/1.1445789

Haaxma CA, Bloem BR, Overeem S, Borm GF, Horstink MWIM. Timed motor tests can detect subtle motor dysfunction in early Parkinson's disease. Movement Disorders. 2010;25(9):1150-6. doi: https://doi.org/10.1002/mds.23100

Stegemöller EL, Uzochukwu J, Tillman MD, McFarland NR, Subramony S, Okun MS, et al. Repetitive finger movement performance differs among Parkinson’s disease, Progressive Supranuclear Palsy, and spinocerebellar ataxia. Journal of Clinical Movement Disorders. 2015;2(1):6. doi: https://doi.org/10.1186/s40734-014-0015-y

Midi I, Dogan M, Koseoglu M, Can G, Sehitoglu MA, Gunal DI. Voice abnormalities and their relation with motor dysfunction in Parkinson's disease. Acta Neurologica Scandinavica. 2008;117(1):26-34. doi: https://doi.org/10.1111/j.1600-0404.2007.00965.x

Rusz J, Cmejla R, Ruzickova H, Ruzicka E. Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson’s disease. The Journal of the Acoustical Society of America. 2011;129(1):350-67. doi: https://doi.org/10.1121/1.3514381

Tjaden K, Watling E. Characteristics of diadochokinesis in multiple sclerosis and Parkinson’s disease. Folia Phoniatrica et Logopaedica. 2003;55(5):241-59. doi: https://doi.org/10.1159/000072155

Kent RD, Kim Y, Chen L-m. Oral and laryngeal diadochokinesis across the life span: a scoping review of methods, reference data, and clinical applications. Journal of Speech, Language, and Hearing Research. 2022;65(2):574-623. doi: https://doi.org/10.1044/2021_JSLHR-21-00396

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975;12(3):189-98. doi: https://doi.org/10.1016/0022-3956(75)90026-6

Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review. 1988;8(1):77-100. doi: https://doi.org/10.1016/0272-7358(88)90050-5

Boersma P, van Heuven V. Speak and unSpeak with PRAAT. Glot Int. 2001;5(9):341-7. Available from: https://www.researchgate.net/publication/208032992_PRAAT_a_system_for_doing_phonetics_by_computer

Camacho A. On the use of auditory models’ elements to enhance a sawtooth waveform inspired pitch estimator on telephone-quality signals. In 2012 11th International Conference on Information Science, Signal Processing and their Applications (ISSPA) [Internet]. 2012 Jul 2-5; Montreal, Canada: ISSPA; 2012. p. 1080-1085. doi: https://doi.org/10.1109/ISSPA.2012.6310450

Camacho A, Harris JG. A sawtooth waveform inspired pitch estimator for speech and music. The Journal of the Acoustical Society of America. 2008;124(3):1638-52. doi: https://doi.org/10.1121/1.2951592

Camacho A. SWIPE: A sawtooth waveform inspired pitch estimator for speech and music [dissertation]. [Gainesville (FL)]: University of Florida; 2007. 116 p. Available from: https://ufdc.ufl.edu/UFE0021589/00001

Tsanas A, Zañartu M, Little MA, McSharry PE. Robust fundamental frequency estimation in sustained vowels using ensembles‖. IEEE Transactions on Audio, Speech, and Language Processing. 2012.

Shrivastav R, Eddins DA, Kopf LM, editors. What is a better descriptor of dysphonic voices- fundamental frequency or pitch? . Fall Voice Conference; 2014; San Antonio, TX.

Ziegler W, Schölderle T, Brendel B, Amsellem J, Staiger A. Higher-faster-farther: Maximum performance tests in the assessment of neurogenic speech impairment. Folia Phoniatrica et Logopaedica. 2019;71(5-6):261-74. doi: https://doi.org/10.1159/000495784

Lundy DS, Roy S, Xue JW, Casiano RR, Jassir D. Spastic/spasmodic vs. tremulous vocal quality: motor speech profile analysis. Journal of Voice. 2004;18(1):146-52. doi: https://doi.org/10.1016/j.jvoice.2003.12.001

Park H, Kim G, Bae I, Kwon S. Characteristics of oral and laryngeal diadochokinesis in adductor spasmodic dysphonia speakers. Journal of Speech-Language & Hearing Disorders. 2014;23(3):27-34. doi: http://dx.doi.org/10.15724/jslhd.2014.23.3.003

Stemple JC, Lee L, D'Amico B, Pickup B. Efficacy of vocal function exercises as a method of improving voice production. Journal of voice. 1994;8(3):271-8. doi: https://doi.org/10.1016/S0892-1997(05)80299-1

Sapir S, Ramig LO, Fox CM. Intensive voice treatment in Parkinson’s disease: Lee Silverman voice treatment. Expert Review of Neurotherapeutics. 2011;11(6):815-30. doi: https://doi.org/10.1586/ern.11.43

Boutsen F, Park E, Dvorak J, Cid C. Prosodic improvement in persons with Parkinson disease receiving SPEAK OUT!® voice therapy. Folia phoniatrica et logopaedica. 2018;70(2):51-8. doi: https://doi.org/10.1159/000488875

Russell JA, Ciucci MR, Connor NP, Schallert T. Targeted exercise therapy for voice and swallow in persons with Parkinson's disease. Brain research. 2010;1341:3-11. doi: https://doi.org/10.1016/j.brainres.2010.03.029


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