Communication is often impaired in individuals with Parkinson's disease (PD), typically secondary to sensorimotor deficits impacting voice and speech. Language may also be diminished in PD, particularly for production and comprehension of verbs. Evidence exists that verb processing is influenced by motor system modulation suggesting that verb deficits in PD are underpinned by similarities in the neural representations of actions that span motor and semantic systems.
View Article and Find Full Text PDFPurpose: This study examined the effects of an intensive voice treatment Lee Silverman Voice Treatment (LSVT LOUD) on children with Down syndrome (DS) and motor speech disorders.
Method: A Phase I, multiple baseline, single-subject design with replication across nine participants with DS was used. Single-word intelligibility, acoustic measures of vocal functioning, and parent perceptions of pre- and posttreatment communication function were used as treatment outcome measures.
Preliminary evidence suggests that intensive voice and speech treatment based on activity-dependent neuroplasticity principles holds promise for affecting positive change in children with cerebral palsy (CP) and motor speech disorders. Diffusion tensor imaging (DTI) allows researchers to make inferences about the integrity of white matter tracks and provides a sensitive measure of neuroplasticity. Previous treatment studies looking at the effects of training on white matter integrity have shown positive results, but these studies have been limited to gross motor function.
View Article and Find Full Text PDFEight children (3 females; 8-16 years) with motor speech disorders secondary to cerebral palsy underwent 4 weeks of an intensive neuroplasticity-principled voice treatment protocol, LSVT LOUD , followed by a structured 12-week maintenance program. Children were asked to overtly produce phonation (ah) at conversational loudness, cued-phonation at perceived twice-conversational loudness, a series of single words, and a prosodic imitation task while being scanned using fMRI, immediately pre- and post-treatment and 12 weeks following a maintenance program. Eight age- and sex-matched controls were scanned at each of the same three time points.
View Article and Find Full Text PDFPurpose: The aim of the present study was to validate and extend the evaluation of treatment outcomes following LSVT LOUD® in children with dysarthria secondary to cerebral palsy (CP).
Method: Seven children (5 females, 6-10 years) with spastic quadriplegia and dysarthria received LSVT LOUD. Outcomes included: (a) quantitative and qualitative indices of communication and social functioning representing therapeutic effects and (b) features of the acoustic signal representing physiological effects on the speech mechanism.
Midbrain dopamine (DA) modulates the activity of basal ganglia circuitry important for motor control in a variety of species. In songbirds, DA underlies motivational behavior including reproductive drive and is implicated as a gatekeeper for neural activity governing vocal variability. In the zebra finch, Taeniopygia guttata, DA levels increase in Area X, a song-dedicated subregion of the basal ganglia, when a male bird sings his courtship song to a female (female-directed; FD).
View Article and Find Full Text PDFThis study describes the use of a neuroplasticity-principled speech treatment approach (LSVT(®)LOUD) with children who have dysarthria secondary to cerebral palsy. To date, the authors have treated 25 children with mild-to-severe dysarthria, a continuum of gross and fine motor functions, and variable cognitive abilities. From this data set, two case studies are presented that represent as weak or strong responders to LSVT LOUD.
View Article and Find Full Text PDFCommunication and swallowing deficits are common in Parkinson's disease (PD). Evidence indicates that voice and speech dysfunction manifest early, prior to motor deficits typically associated with striatal dopamine loss. Unlike deficits in the extremities, cranial sensorimotor deficits are refractory to standard dopamine-related pharmacological and surgical interventions, thus the mechanisms underlying vocal deficits are unclear.
View Article and Find Full Text PDFJ Speech Lang Hear Res
June 2012
Purpose: The purpose of this study was to examine the effects of an intensive voice treatment (Lee Silverman Voice Treatment, commonly known as LSVT LOUD) for children with spastic cerebral palsy (CP) and dysarthria.
Method: A nonconcurrent multiple baseline single-subject design with replication across 5 children with spastic CP was used. Auditory-perceptual analysis of speech, acoustic measures of vocal functioning, and perceptual ratings by parents of participants were obtained at baseline, posttreatment, and 6-week follow-up recording sessions.
Expert Rev Neurother
June 2011
Advances in neuroscience have led to an expanded and improved understanding of neurobiological changes associated with rehabilitation and exercise in Parkinson's disease (PD). This knowledge has led to a direct clinical impact of increased referral for early and continuous exercise programs for individuals with PD (physical, occupational, speech therapy and general exercise programs) and an increased research focus on the impact of such approaches in humans with PD. The purpose of this article is to examine the role of speech therapy in the landscape of exercise-based interventions for individuals with PD.
View Article and Find Full Text PDFOur 15 years of research have generated the first short- and long-term efficacy data for speech treatment (Lee Silverman Voice Treatment; LSVT/LOUD) in Parkinson's disease. We have learned that training the single motor control parameter amplitude (vocal loudness) and recalibration of self-perception of vocal loudness are fundamental elements underlying treatment success. This training requires intensive, high-effort exercise combined with a single, functionally relevant target (loudness) taught across simple to complex speech tasks.
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