Rahimifar Parvaneh, Soltani Majid, Rafie Shahram, Hesam Saeed, Yazdi Mohammad Jafar Shaterzadeh, Moradi Negin
Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Speech Therapy, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
J Voice. 2025 Mar 17. doi: 10.1016/j.jvoice.2025.02.042.
One of the earliest impairments in Parkinson's patients is speech motor dysfunction, which adversely affects the phonation subsystem (voice). To date, acoustic frequency-dependent voice features such as cepstral peak prominence (CPP) and cepstral peak prominence-smooth (CPPS) have not been examined in Persian-speaking Parkinson's patients. This study aims to compare the voice quality of Persian Parkinson's patients with healthy counterparts using CPP and CPPS, as well as to investigate the relationship of these metrics with Unified Parkinson's Disease Rating Scale-Part III (UPDRS-III) and disease duration.
This study included 35 Persian Parkinson's patients and 35 healthy individuals. Disease severity was assessed using UPDRS-III. Speech samples (sustained vowel phonation of /ɑ/ and reading of the "Grandfather Passage") were recorded by a microphone. CPP and CPPS were extracted by Praat software.
The results showed that the mean CPP and CPPS in both tasks were significantly lower in the patient group compared with the healthy group (P value ≤ 0.001). Spearman correlation analysis of CPP and CPPS values in both tasks with disease severity revealed a significant negative correlation between CPP and CPPS and UPDRS-III in both tasks (P value ≤ 0.001). However, no significant correlation was observed between these indices and disease duration in any task (P value ≥ 0.001).
These cepstral indices effectively distinguish vocal differences between Persian Parkinson's patients and healthy individuals. Additionally, these indices show a significant association with disease severity, underscoring their potential utility in the early diagnosis and monitoring of Parkinson's disease progression through vocal screening, especially when combined with other medical and neurological evaluations. However, this study found no relationship between disease duration and these indices. The absence of such a correlation may be attributed to the medication regimens of the patients.
帕金森病患者最早出现的功能障碍之一是言语运动功能障碍，这对发声子系统（嗓音）产生不利影响。迄今为止，尚未对说波斯语的帕金森病患者的声学频率相关嗓音特征进行研究，如谐波峰值突出度（CPP）和谐波峰值突出度-平滑度（CPPS）。本研究旨在使用CPP和CPPS比较波斯语帕金森病患者与健康对照者的嗓音质量，并研究这些指标与统一帕金森病评定量表第三部分（UPDRS-III）及病程之间的关系。
本研究纳入35名说波斯语的帕金森病患者和35名健康个体。使用UPDRS-III评估疾病严重程度。通过麦克风录制语音样本（/ɑ/的持续元音发声及朗读“祖父的故事”）。使用Praat软件提取CPP和CPPS。
结果显示，与健康组相比，患者组在两项任务中的平均CPP和CPPS均显著降低（P值≤0.0．01）。对两项任务中CPP和CPPS值与疾病严重程度进行Spearman相关性分析，结果显示两项任务中CPP和CPPS与UPDRS-III均呈显著负相关（P值≤0.001）。然而，在任何一项任务中，均未观察到这些指标与病程之间存在显著相关性（P值≥0.001）。
这些谐波指标能有效区分波斯语帕金森病患者与健康个体之间嗓音的差异。此外，这些指标与疾病严重程度显著相关，突出了其在通过嗓音筛查对帕金森病进行早期诊断和监测疾病进展中的潜在效用，尤其是与其他医学和神经学评估相结合时。然而，本研究发现病程与这些指标之间无相关性。这种相关性的缺失可能归因于患者的药物治疗方案。
