Bauer Vladimir, Alerić Zorica, Jancić Ervin, Miholović Vesna
Department of Otolaryngology, General Hospital Karlovac, Karlovac, Croatia.
Coll Antropol. 2011 Sep;35 Suppl 2:209-12.
Parkinson's disease (PD) is well known to cause voice impairments. The aim of this study is to evaluate subjective and objective changes in voice quality in patients with PD in Croatian language speakers. Twenty one patients (11 male and 10 female) with PD and twenty one age-matched (10 male and 11 female) of the control group were assessed. Voice impairment was scored according to Voice Handicap Index (VHI). Patient's perceptual voice analysis was assessed using GRBAS scale including Grade of Dysphonia, Roughness, Breathiness, Asthenia and Strain items. The analysed objective voice parametars were: fundamental frequency, highest frequency, lowest frequency, voice range, jitter, shimmer, maximum phonation time and s/z ratio. In all patients we performed videolaryngostroboscopic examination. Compared with the control group we found the significant differences in VHI, in GRBAS scale (p < 0.05 in all items except asthenia). On videostroboscopic examination, laryngeal tremor was present only in PD group (6 patients), abnormalities of the mucosal wave was found more frequent in PD group (17 versus 8 patients) and also non-closure glottis pattern (11 versus 6 patients). There was no significant difference in the objective voice parametars except in maximum phonation time which was shorter in PD group (15.8 seconds and 23 seconds, p = 0.014) and voice range, which was shorter in PD group (111 Hz versus 147 Hz, p = 0.0465). No one of patients with PD was included in any form of speech therapy. The voice disability in PD is generally well known, but very often underestimated. In this study we found which components of voice were more affected. The voice quality has a significant impact on life quality and potential in assessment for severity of disease state and for the efficacy of treatment.
帕金森病（PD）会导致嗓音障碍，这是众所周知的。本研究旨在评估克罗地亚语使用者中帕金森病患者嗓音质量的主观和客观变化。对21例帕金森病患者（11例男性和10例女性）以及21例年龄匹配的对照组（10例男性和11例女性）进行了评估。根据嗓音障碍指数（VHI）对嗓音障碍进行评分。使用GRBAS量表对患者的嗓音进行感知分析，该量表包括发声障碍等级、粗糙度、气息声、无力和紧张度等项目。分析的客观嗓音参数包括：基频、最高频率、最低频率、嗓音范围、抖动、闪烁、最大发声时间和s/z比值。对所有患者进行了视频喉镜频闪检查。与对照组相比，我们发现VHI以及GRBAS量表存在显著差异（除无力项外，所有项目p<0.05）。在视频频闪检查中，仅帕金森病组出现喉震颤（6例患者），帕金森病组黏膜波异常更为常见（17例对8例患者），非闭合声门模式也更常见（11例对6例患者）。除最大发声时间外，客观嗓音参数无显著差异，帕金森病组最大发声时间较短（15.8秒对23秒，p = 0.014），嗓音范围也较短（111 Hz对147 Hz，p = 0.0465）。没有帕金森病患者接受任何形式的言语治疗。帕金森病患者的嗓音残疾通常是众所周知的，但往往被低估。在本研究中，我们发现嗓音的哪些成分受影响更大。嗓音质量对生活质量以及疾病状态严重程度评估和治疗效果评估具有重要影响。
