Increased vocal intensity due to the Lombard effect in speakers with Parkinson's disease: simultaneous laryngeal and respiratory strategies.
OBJECTIVE
The objective of the present study was to investigate whether speakers with hypophonia, secondary to Parkinson's disease (PD), would increases their vocal intensity when speaking in a noisy environment (Lombard effect). The other objective was to examine the underlying laryngeal and respiratory strategies used to increase vocal intensity.


METHODS
Thirty-three participants with PD were included for study. Each participant was fitted with the SpeechVive™ device that played multi-talker babble noise into one ear during speech. Using acoustic, aerodynamic and respiratory kinematic techniques, the simultaneous laryngeal and respiratory mechanisms used to regulate vocal intensity were examined.


RESULTS
Significant group results showed that most speakers with PD (26/33) were successful at increasing their vocal intensity when speaking in the condition of multi-talker babble noise. They were able to support their increased vocal intensity and subglottal pressure with combined strategies from both the laryngeal and respiratory mechanisms. Individual speaker analysis indicated that the particular laryngeal and respiratory interactions differed among speakers.


CONCLUSIONS
The SpeechVive™ device elicited higher vocal intensities from patients with PD. Speakers used different combinations of laryngeal and respiratory physiologic mechanisms to increase vocal intensity, thus suggesting that disease process does not uniformly affect the speech subsystems.


OBJECTIVE
Readers will be able to: (1) identify speech characteristics of people with Parkinson's disease (PD), (2) identify typical respiratory strategies for increasing sound pressure level (SPL), (3) identify typical laryngeal strategies for increasing SPL, (4) define the Lombard effect.
University at Buffalo, Department of Communicative Disorders & Sciences, 3435 Main Street, Cary Hall, Rm 122, Buffalo, NY 14214, USA. Electronic address: stathop@buffalo.edu.
Elaine T
ET
Stathopoulos
Purdue University, Department of Speech, Language, and Hearing Sciences, 500 Oval Drive, Heavilon Hall 202B, West Lafayette, IN 47907-2038, USA. Electronic address: jhuber@purdue.edu.
Jessica E
JE
Huber
University at Buffalo, Department of Communicative Disorders & Sciences, 3435 Main Street, Cary Hall, Rm 122, Buffalo, NY 14214, USA. Electronic address: kcr2@buffalo.edu.
Kelly
K
Richardson
University at Buffalo, Department of Communicative Disorders & Sciences, 3435 Main Street, Cary Hall, Rm 122, Buffalo, NY 14214, USA. Electronic address: jk362@buffalo.edu.
Jennifer
J
Kamphaus
University at Buffalo, Department of Communicative Disorders & Sciences, 3435 Main Street, Cary Hall, Rm 122, Buffalo, NY 14214, USA. Electronic address: devandecicco@gmail.com.
Devan
D
DeCicco
Purdue University, Department of Speech, Language, and Hearing Sciences, 500 Oval Drive, Heavilon Hall 202B, West Lafayette, IN 47907-2038, USA. Electronic address: mdarling@purdue.edu.
Meghan
M
Darling
University at Buffalo, Department of Communicative Disorders & Sciences, 3435 Main Street, Cary Hall, Rm 122, Buffalo, NY 14214, USA. Electronic address: fulcher2@buffalo.edu.
Katrina
K
Fulcher
University at Buffalo, Department of Communicative Disorders & Sciences, 3435 Main Street, Cary Hall, Rm 122, Buffalo, NY 14214, USA. Electronic address: jsussman@buffalo.edu.
Joan E
JE
Sussman
D000162:Acoustics; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007830:Larynx / Q000503:physiopathology; D008297:Male; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology; D012143:Respiratory Physiological Phenomena; D014831:Voice / Q000502:physiology; D014832:Voice Disorders / Q000209:etiology* / Q000503:physiopathology
Laryngeal; Lombard effect; Parkinson's disease; Respiratory; Vocal intensity