Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Technická 2, 16000 Prague 6, Czech Republic.
J Neural Transm (Vienna). 2013 Feb;120(2):319-29. doi: 10.1007/s00702-012-0853-4. Epub 2012 Jul 8.
Despite the initial reports showing beneficial effects of dopaminergic treatment on speech in Parkinson's disease (PD), more recent studies based upon valid measurements have not approved any improvement of speech performance under pharmacotherapy. The aim of this study was to analyze the effect of treatment initiation on the progression of speech impairment in PD, using novel evaluation criteria. Nineteen de novo patients with PD were tested and retested within 2 years after the introduction of antiparkinsonian therapy. As controls, 19 age-matched individuals were recorded. Speech examination included sustained phonation, fast syllable repetition, reading text, and monolog. Quantitative acoustic analyses of the key aspects of speech based on Gaussian kernel distribution, statistical decision-making theory, and healthy speech observation were used to assess the improvement or deterioration of speech. A trend for speech performances to improve was demonstrated after treatment mainly in quality of voice, intensity variability, pitch variability, and articulation. The treatment-related improvement differed in various aspects of speech for individual PD patients. Improvements in vowel articulation and pitch variability correlated with treatment-related changes in bradykinesia and rigidity, whereas voice quality and loudness variability improved independently. Using a novel approach of acoustic analysis and advanced statistics, improvements in speech performance can be demonstrated in PD patients after the introduction of antiparkinsonian therapy. Moreover, changes in speech articulation and pitch variability appear to be related with dopaminergic responsiveness of bradykinesia and rigidity. Therefore, speech may be a valuable marker of disease progression and treatment efficacy in PD.
尽管最初的报告显示多巴胺能治疗对帕金森病（PD）患者的言语有有益的影响，但基于有效测量的更近期研究并未批准药物治疗对言语表现有任何改善。本研究的目的是使用新的评估标准分析治疗开始对 PD 患者言语障碍进展的影响。19 名新诊断的 PD 患者在抗帕金森病治疗引入后 2 年内接受了测试和再测试。作为对照，记录了 19 名年龄匹配的个体。言语检查包括持续发音、快速音节重复、阅读文本和独白。使用基于高斯核分布、统计决策理论和健康言语观察的语音关键方面的定量声学分析来评估言语的改善或恶化。治疗后，主要在语音质量、强度变化性、音高变化性和发音方面显示出言语表现改善的趋势。治疗相关的改善在个体 PD 患者的言语各个方面有所不同。元音发音和音高变化性的改善与运动迟缓性和僵硬性的治疗相关变化相关，而语音质量和响度变化性则独立改善。使用声学分析和先进统计学的新方法，可以在引入抗帕金森病治疗后在 PD 患者中证明言语表现的改善。此外，言语清晰度和音高变化性的变化似乎与运动迟缓性和僵硬性的多巴胺能反应性有关。因此，言语可能是 PD 疾病进展和治疗效果的有价值的标志物。
