Carle Foundation Hospital, Urbana, Illinois.
Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth, Texas.
J Voice. 2019 Jul;33(4):580.e11-580.e19. doi: 10.1016/j.jvoice.2018.01.016. Epub 2018 Feb 19.
The physiological manifestations of Parkinson disease are heterogeneous, as evidenced by disease subtypes. Dysphonia has been well documented as an early and progressively significant impairment associated with the disease. The purpose of this study was to investigate how acoustic and aerodynamic measures of vocal function were affected by Parkinson tremor subtype (phenotype) in an effort to better understand the heterogeneity of voice impairment severity in Parkinson disease.
This is a prospective case-control study.
Thirty-two speakers with Parkinson disease assigned to tremor and nontremor phenotypes and 10 healthy controls were recruited. Sustained vowels and connected speech were recorded from each speaker. Acoustic measures of cepstral peak prominence (CPP) and aerodynamic measures of transglottal airflow (TAF) were calculated from the recorded acoustic and aerodynamic waveforms.
Speakers with a nontremor dominant phenotype exhibited significantly (P < 0.05) lower CPP and higher TAF in vowels compared with the tremor dominant phenotype and control speakers, who were not different from each other. No significant group differences were observed for CPP or TAF in connected speech.
When producing vowels, participants with nontremor dominant phenotype exhibited reduced phonation periodicity and elevated TAF compared with tremor dominant and control participants. This finding is consistent with differential limb-motor and cognitive impairments between tremor and nontremor phenotypes reported in the extant literature. Results suggest that sustained vowel production may be sensitive to phonatory control as a function of Parkinson tremor phenotype in mild to moderate stages of the disease.
帕金森病的生理表现具有异质性，这表现在疾病亚型上。嗓音障碍已被充分记录为与疾病相关的早期且逐渐显著的损伤。本研究旨在通过研究帕金森震颤亚型（表型）对嗓音功能的声学和空气动力学测量的影响，来更好地理解帕金森病嗓音损伤严重程度的异质性。
这是一项前瞻性病例对照研究。
招募了 32 名被分配为震颤和非震颤表型的帕金森病患者以及 10 名健康对照者。每位参与者都录制了持续元音和连续言语。从记录的声学和空气动力学波形中计算了倒谱峰突出度（CPP）的声学测量值和跨声门气流（TAF）的空气动力学测量值。
与震颤主导表型和对照组相比，非震颤主导表型的参与者在元音中表现出明显（P < 0.05）更低的 CPP 和更高的 TAF，而震颤主导表型和对照组之间没有差异。在连续言语中，CPP 或 TAF 没有观察到显著的组间差异。
在产生元音时，非震颤主导表型的参与者表现出比震颤主导表型和对照组参与者更低的发声周期性和更高的 TAF。这一发现与文献中报道的震颤和非震颤表型之间的肢体运动和认知损伤的差异一致。结果表明，在疾病的轻度至中度阶段，持续元音产生可能对帕金森震颤表型的发声控制敏感。
