PROCJENA GOVORA I GLASA KOD BOLESNICE OBOLJELE OD PARKINSONOVE BOLESTI
EVALUATION OF SPEECH AND VOICE OF A FEMALE PATIENT DIAGNOSED WITH PARKINSON’S DISEASE

Summary/Abstract: The aim of this work was to examine the fluency of speech and voice quality of a 55-year old female patient diagnosed with extra pyramidal syndrome (Parkinson's disease - PD). For this purpose, spontaneous speech, reading, writing and acoustic analysis of voice were analyzed. In order to evaluate the speech and voice quality, the patient has been tested on two occasions with an interval of four months between the tests. We observed forms of dysfluency, place of dysfluency, duration of vowel prolongation, length ofpauses and percentage of dysfluent words in spontaneous speech and reading. The quality of voice was assessed through speech modules (analysis of a reading recording) and on basis of perceptive analysis. The Multidimensional Voice Program (MDVP, Kay Pentax) was usedfor acoustic analysis. The results showed that there was a deterioration of general motor skills, but also a deterioration of speech, voice, reading and writing. The speech fluency deteriorated. In the second study the patient stuttered in 10% more words than in the first study. The voice quality inferiorated. In the second study the values were decreased (in comparison to the first study) with sPPQ parameters (Smoothed Pitch Perturbation Quotient) and vFo parameters (Fundamental Frequency Variation) which indicates deterioration of prosodial speech characteristics (monotony). VTI value (Voice Turbulence Index) has been relatively increased which might be an indication of incomplete adduction ofvocal cords during phonation. In the second study the values were increased with parameters sAPQ (Smoothed Amplitude Perturbation Quotient) and APQ (Amplitude Perturbation Quotient) as well as the ATRI (Amplitude Tremor Intensity Index) and all three parameters indicate the tendency of increase in voice tremor which is also one of the possible accompanying characteristics ofPD. Increase of parameters ShdB (Shimmer in dB) and Shim (Shimmer Percent) indicate that with progression of illness higher variability in amplitudes also occurs and that the intensity of airflow is oscillating. Grapho-motoric abilities have gone worse and the greatest deterioration is noticed in reading, although it was better than the spontaneous speech. Data provided by this research support the hypothesis on the involvement of basal ganglia in the developmental stuttering. This paper is a contribution to team approach in the diagnosis of PD. Voice and speech disorders often occur before any physical symptoms are evident, and the diagnosis of speech language pathologist may help in early detection of PD, which was confirmed in this study as well.

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