Effect of speech therapy and pharmacological treatment in prosody of parkinsonians

Azevedo, Luciana Lemos de; Souza, Irene Soares de; Oliveira, Patrícia Marques de; Cardoso, Francisco

doi:10.1590/0004-282X20140193

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Arquivos de Neuro-Psiquiatria

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Articles • Arq. Neuro-Psiquiatr. 73 (1) • Jan 2015 • https://doi.org/10.1590/0004-282X20140193 copy

Effect of speech therapy and pharmacological treatment in prosody of parkinsonians

Efeito dos tratamentos fonoaudiológico e medicamentoso na prosódia de parkinsonianos

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

Parkinsonian patients usually present speech impairment. The aim of this study was to verify the influence of levodopa and of the adapted Lee Silverman Vocal Treatment^® method on prosodic parameters employed by parkinsonian patients.

Method

Ten patients with idiopathic Parkinson's disease using levodopa underwent recording of utterances produced in four stages: expressing attitudes of certainty and doubt and declarative and interrogative modalities. The sentences were recorded under the effect of levodopa (on), without the effect of levodopa (off); before and after speech therapy during the on and off periods.

Results

The speech therapy and its association with drug treatment promoted the improvement of prosodic parameters: increase of fundamental frequency measures, reduction of measures of duration and greater intensity.

Conclusion

The association of speech therapy to medication treatment is of great value in improving the communication of parkinsonian patients.

Parkinson's disease; speech acoustics; levodopa; attitude; speech therapy

Variable	p-value		Average and SD		p-value

	Attitudes x Modalities	Women x Men	PD OFF	PD LSVTa OFF
Amplitude of PT's melodic variation (Hz)	0.73	0.37	23.98 ± 22.68	28.98 ± 25.15	0.06
Amplitude of UPT's melodic variation (Hz)	0.41	0.23	12.66 ± 8.64	16.74 ± 10.56	0.00*
Composition of utterance (Hz)	0.98	0.19	90.76 ± 59.96	102.75 ± 58.93	0.05*
Displacement presence of the PT (%)	0.42	0.84	25.86 ± 43.98	30.17 ± 46.10	0.38
Rate of change of PT's melodic variation (Hz/ms)	0.72	0.58	0.13 ± 0.12	0.20 ± 0.15	0.00*
Rate of change of UPT's melodic variation (Hz/ms)	0.65	0.05*
Female			0.12 ± 0.08	0.22 ± 0.11	0.00*
Male			0.11 ± 0.12	0.14 ± 0.11	0.25
PT's duration (ms)	0.90	0.98	190.50 ± 77.55	145.18 ± 44.43	0.00*
UPT's duration (ms)	0.48	0.36	119.04 ± 59.59	87.72 ± 19.46	0.00*
Utterance duration (ms)	0.62	0.03*
Female			1327.40 ± 401.20	1100.40 ± 191.60	0.01*
Male			1561.90 ± 634.90	1117.30 ± 205.20	0.00*
Intensity variation during the utterance (dB)	0.87	0.12	40.42 ± 5.20	39.77 ± 6.80	0.40
Utterance intensity average (dB)	0.77	0.00*
Female			82.87 ± 7.75	75.54 ± 7.78	0.00*
Male			86.19 ± 5.14	87.60 ± 7.63	0.70
Prolonged vowel intensity average [a] (dB)	-	0.59	81.95 ± 8.86	89.34 ± 5.53	0.01*

Variable	p-value		Average and SD		p-value

	Attitudes x Modalities	Women x Men	PD OFF	PD LSVTa ON
Amplitude of PT's melodic variation (Hz)	0.88	0.78	23.98 ± 22.68	29.05 ± 25.24	0.06
Amplitude of UPT's melodic variation (Hz)	0.74	0.70	12.66 ± 8.64	14.24 ± 10.72	0.17
Composition of utterance (Hz)	0.93	0.33	90.76 ± 59.96	100.09 ± 61.12	0.10
Displacement presence of the PT (%)	0.90	0.65	25.86 ± 43.98	25.00 ± 43.48	0.91
Rate of change of PT's melodic variation (Hz/ms)	0.84	0.80	0.13 ± 0.12	0.19 ± 0.16	0.00*
Rate of change of UPT's melodic variation (Hz/ms)	0.60	0.61	0.12 ± 0.10	0.16 ± 0.12	0.00*
PT's duration	0.95	0.96	190.50 ± 77.55	150.09 ± 45.89	0.00*
UPT's duration (ms)	0.70	0.57	119.04 ± 59.59	90.19 ± 21.65	0.00*
Utterance duration (ms)	0.49	0.05*
Female			1327.40 ± 401.20	1076.50 ± 205.20	0.00*
Male			1561.90 ± 634.90	1108.40 ± 205.60	0.00*
Intensity variation during the utterance (dB)	0.77	0.14	40.42 ± 5.20	41.41 ± 6.15	0.18
Utterance intensity average (dB)	0.54	0.00*
Female			82.87 ± 7.75	76.17 ± 6.33	0.00*
Male			86.19 ± 5.14	86.32 ± 6.39	0.99
Prolonged Vowel intensity average [a] (dB)	-	0.72	81.95 ± 8.86	88.09 ± 6.05	0.03*

Variable	p-value		Average and SD		p-value

	Attitudes x Modalities	Women x Men	PD ON	PD LSVTa ON
Amplitude of PT's melodic variation (Hz)	0.87	0.48	22.20 ± 9.61	29.05 ± 25.24	0.01*
Amplitude of UPT's melodic variation (Hz)	0.48	0.16	11.63 ± 7.86	14.24 ± 10.72	0.03*
Composition of utterance (Hz)	0.87	0.17	81.88 ± 8.50	100.09 ± 61.12	0.00*
Displacement presence of the PT (%)	0.76	0.33	0.24 ± 0.43	0.25 ± 0.43	0.86
Rate of change of PT's melodic variation (Hz/ms)	0.86	0.25	0.14 ± 0.10	0.19 ± 0.16	0.00*
Rate of change of UPT's melodic variation (Hz/ms)	0.69	0.03*
Female			0.11 ± 0.07	0.18 ± 0.14	0.01*
Male			0.15 ± 0.12	0.15 ± 0.11	0.99
PT's duration (ms)	0.99	0.06	150.40 ± 44.00	150.09 ± 45.89	0.96
UPT's duration (ms)	0.90	0.00*
Female			96.82 ± 18.92	84.98 ± 19.02	0.01*
Male			91.38 ± 19.27	95.69 ± 23.02	0.67
Utterance duration (ms)	0.73	0.76	1125.00 ± 222.20	1092.50 ± 205.20	0.24
Intensity variation during the utterance (dB)	0.97	0.73	39.42 ± 5.01	41.41 ± 6.16	0.01*
Utterance intensity average (dB)	0.97	0.05*
Female			82.15 ± 7.38	76.18 ± 6.33	0.00*
Male			89.12 ± 7.91	86.33 ± 6.39	0.08
Prolonged Vowel intensity average [a] (dB)	-	0.33	84.31 ± 8.21	88.09 ± 6.05	0.14

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[1] Correspondence:
Luciana Lemos de Azevedo; Rua Alagoas, 1314 / sala 1313; 30130-160 Belo Horizonte MG, Brasil; E-mail: azevedoll@gmail.com