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Sprache · Stimme · Gehör 2008; 32(2): 64-73
DOI: 10.1055/s-2008-1077065
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Auswirkungen des Lee Silverman Voice Treatments (LSVT) auf die Prosodie von Sprechern mit M. Parkinson

Effects of the Lee Silverman Voice Treatments (LSVT) on Prosody in Speakers Suffering from Parkinson's DiseaseH. Penner 1 , 2 , N. Miller 1 , V. Uttenweiler 3 , I. Hertrich 4 , H. Ackermann 4
  • 1School of Education, Communication and Language Science, University of Newcastle, Newcastle upon Tyne, UK (Prof. Dr. Wei Li)
  • 2Bethanien-Krankenhaus Heidelberg (Prof. Dr. P. Oster)
  • 3Phoniatrie an der Berufsfachschule für Logopädie, Heidelberg-Wieblingen (Dr. V. Uttenweiler)
  • 4Abteilung Allgemeine Neurologie, Hertie Institut für klinische Hirnforschung Universität Tübingen (Prof. Dr. M. Weller)
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Publikationsverlauf

Publikationsdatum:
07. Juli 2008 (online)

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Zusammenfassung

Hintergrund: Die hypokinetische Dysarthrophonie bei M. Parkinson lässt sich durch medikamentöse oder operative Maßnahmen nur wenig beeinflussen. Als ein logopädisches Verfahren zur Behandlung der hypokinetischen Dysarthrophonie steht das Lee Silverman Voice Treatment (LSVT) zur Verfügung. In der vorliegenden Studie wurden die Auswirkungen dieses Stimmtrainings auf die Intonationsmuster sprachlicher Äußerungen untersucht.

Methode: Eine weibliche und zwei männliche Probanden mit M. Parkinson nahmen an der Untersuchung teil. Nach einer Placebophase erfolgte ein Stimmtraining nach den Richtlinien des LSVT. Als Untersuchungsmaterial dienten 18 Satzäußerungen. Mit Hilfe von Schmalbandspektrogrammen wurden die Intonationsmuster transkribiert, der zeitliche Zusammenhang zwischen betonter Silbe und Grundfrequenz (F0) -Maximum bestimmt und das Ausmaß der F0-Bewegungen gemessen.

Ergebnisse: Unter dem LSVT traten ausgeprägtere Intonationsmuster in Aussagesätzen auf, verbunden mit einem höheren Grundfrequenzanstieg in dem Fokuswort, sowie ein höherer Anteil an Peaks und eine verstärkte zeitliche Anbindung des F0-Maximums an die betonte Silbe in wütenden Äußerungen.

Schlussfolgerungen: Die unter der LSVT-Behandlung beobachteten Veränderungen deuten auf distinkte Interaktionen der untersuchten Sprechparameter hin.

Abstract

Background: Dysarthrophonia in speakers suffering from Parkinson's disease affects all parameters of speech and is not easily influenced by medication or surgery. The Lee Silverman Voice Treatment (LSVT) was developed specifically to target hypokinetic dysarthrophonia. It has not yet been investigated whether the LSVT influences intonation patterns of speech.

Methods: Using a single case study design, a female and two males suffering from idiopathic Parkinson's disease were treated with a word finding placebo therapy prior to application of the LSVT. 18 test sentences (6 neutral declaratives, 6 neutral questions, 6 angry utterances) were investigated acoustically. Intonation patterns were transcribed, the timing of maximum fundamental frequency (F0) in relation to the accented syllable was described and the rise in F0 was measured on the basis of narrow-band spectrograms. Participants also underwent laryngoscopic and stroboscopic examination. Speech rate, maximum intensity, maximum phonation time, minimum and maximum F0, intelligibility, and naturalness were also monitored.

Results: Few unequivocal effects were observed. After LSVT treatment speakers produced more pronounced intonation patterns in neutral utterances, increased the number of peaks in angry utterances, aligned the F0 maximum more often to the stressed syllable in angry utterances and produced higher F0 rises in neutral utterances. The laryngoscopic and stroboscopic investigations revealed high variability within subjects. One speaker improved in maximum phonation time. The other maximum performance measures and intelligibility were not influenced by the LSVT, mainly due to ceiling effects.

Conclusions: The participants of this study showed fewer differences to unaffected speakers in the parameters measured than was expected. This may be due to the discrepancy between spontaneous speech and read sentences observed in hypokinetic dysarthria. The study discusses ways in which speech parameters might influence each other.

Schlüsselwörter

M. Parkinson - LSVT - Prosodie

Key words

Parkinson's disease - LSVT - prosody

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