Voice characteristics in the progression of Parkinson's disease

TLDR

The study investigated how acoustic and perceptual voice characteristics differ across Parkinson’s disease severity levels. The authors compared voice recordings—vowel prolongation, scale singing, and a 1‑minute monologue—of 30 early‑stage, 30 late‑stage Parkinson’s patients and 30 healthy controls. Both early and late Parkinson’s patients exhibited limited pitch and loudness variability, breathiness, harshness, and reduced loudness, with high modal pitch in males; while some features remained stable, breathiness, monopitch, monoloudness, low loudness, and reduced phonation range worsened with disease progression, and tremor appeared only in later stages.

Abstract

Abstract This study examined the acoustic and perceptual voice characteristics of patients with Parkinson's disease according to disease severity. The perceptual and acoustic voice characteristics of 30 patients with early stage PD and 30 patients with later stage PD were compared with data from 30 normal control subjects. Voice recordings consisted of prolongation of the vowel /a/, scale singing, and a 1‐min monologue. In comparison with controls and previously published normative data, both early and later stage PD patients’ voices were characterized perceptually by limited pitch and loudness variability, breathiness, harshness and reduced loudness. High modal pitch levels also characterized the voices of males in both early and later stages of PD. Acoustically, the voices of both groups of PD patients demonstrated lower mean intensity levels and reduced maximum phonational frequency ranges in comparison with normative data. Although less clear, the present data also suggested that the PD patients’ voices were characterized by excess jitter, a high‐speaking fundamental frequency for males and a reduced fundamental frequency variability for females. While several of these voice features did not appear to deteriorate with disease progression (i.e. harshness, high modal pitch and speaking fundamental frequency in males, fundamental frequency variability in females, low intensity and jitter), breathiness, monopitch and monoloudness, low loudness and reduced maximum phonational frequency range were all worse in the later stages of PD. Tremor was the sole voice feature which was associated only with later stage PD.