Universität zu Köln

Baumann, Alexander, Nebel, Adelheid, Granert, Oliver ORCID: 0000-0002-0656-1023, Giehl, Kathrin, Wolff, Stephan, Schmidt, Wiebke, Baasch, Christin, Schmidt, Gerhard, Witt, Karsten, Deuschl, Guenther, Hartwigsen, Gesa ORCID: 0000-0002-8084-1330, Zeuner, Kirsten E. and van Eimeren, Thilo (2018). Neural Correlates of Hypokinetic Dysarthria and Mechanisms of Effective Voice Treatment in Parkinson Disease. Neurorehabil. Neural Repair, 32 (12). S. 1055 - 1067. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 1552-6844

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Abstract

Background. Hypokinetic dysarthria is highly prevalent in idiopathic Parkinson disease (PD), and effectiveness of high-intensity voice treatment is well established. However, the neural correlates remain largely unknown. Objective. We aimed to specify cerebral pathophysiology of hypokinetic dysarthria and treatment-induced changes using functional magnetic resonance imaging (fMRI). Methods. We used fMRI to investigate healthy controls (HCs) and patients with idiopathic PD-associated dysarthria before and after treatment according to the Lee Silverman Voice Treatment LOUD (LSVT). During fMRI, participants covertly read sentences with normal (eg, conversation in a quiet room) or high (eg, shouting on a windy beach) intensity. In addition, we tested LSVT effects on intelligibility and different speech features (intensity, pitch, articulation). Results. LSVT effectively improved intelligibility, articulation, and pitch in patients. Covert high-intensity speech compared with covert normal-intensity speech led to increased activation of mainly secondary motor areas and bilateral superior and medial temporal regions. Prior to LSVT, patients showed less activity in several speech-associated areas compared with HCs. As a neural correlate of effective LSVT, increased right-sided superior temporal activity correlated with improved intelligibility. Conclusion. This is the first brain imaging study using a covert speech paradigm in PD, which revealed cortical hypoactivation as correlate of hypokinetic dysarthria. Furthermore, cortical correlates of effective LSVT treatment colocalized with the neuronal network, showing increased activation during high- versus normal-intensity speech generation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Baumann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Nebel, Adelheid UNSPECIFIED UNSPECIFIED UNSPECIFIED Granert, Oliver UNSPECIFIED orcid.org/0000-0002-0656-1023 UNSPECIFIED Giehl, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolff, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Wiebke UNSPECIFIED UNSPECIFIED UNSPECIFIED Baasch, Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Gerhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Witt, Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Deuschl, Guenther UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartwigsen, Gesa UNSPECIFIED orcid.org/0000-0002-8084-1330 UNSPECIFIED Zeuner, Kirsten E. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Eimeren, Thilo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-163300
DOI:	10.1177/1545968318812726
Journal or Publication Title:	Neurorehabil. Neural Repair
Volume:	32
Number:	12
Page Range:	S. 1055 - 1067
Date:	2018
Publisher:	SAGE PUBLICATIONS INC
Place of Publication:	THOUSAND OAKS
ISSN:	1552-6844
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTENSIVE SPEECH TREATMENT; SUPPLEMENTARY MOTOR AREA; FUNCTIONAL NEUROANATOMY; VOWEL ARTICULATION; TREATMENT LSVT(R); INTELLIGIBILITY; VOCALIZATION; LANGUAGE; THERAPY; PROSODY Multiple languages Clinical Neurology; Rehabilitation Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16330