The effects of delayed and frequency shifted feedback on speakers with Parkinson disease

Brendel, Bettina and Lowit, Anja and Howell, Peter (2004) The effects of delayed and frequency shifted feedback on speakers with Parkinson disease. Journal of Medical Speech Language Pathology, 12 (4). pp. 131-138. ISSN 1065-1438

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Delayed auditory feedback (DAF) has been assessed as a rate reduction and intelligibility enhancing tool in patients with Parkinson disease (PD) for some time. However, there are contradictory results in the literature regarding the success of this device. Also, little is known about the effects of DAF on speech other than influences on speech rate and intelligibility. Frequency shifted feedback (FSF) is known to produce more natural sounding speech than DAF and to improve the fluency of persons who stutter. However, there are currently no studies reporting how PD speakers perform under FSF. The aim of this study was to investigate the effects of both types of altered feedback on the speech of PD and control participants on a broad range of measures. The performance of 16 PD speakers and 11 control speakers in a reading task under DAF, FSF, and no altered feedback (NAF) are reported here. The results showed that all groups responded to altered feedback in a similar way and showed a prominent reduction of speech rate. The conditions evoked changes in pause frequency (increases), loudness levels (increases), pitch variation (increases), and intelligibility and naturalness (decreases) for all or some of the groups. Few effects could be observed on articulation/pause time ratio, pause duration, pitch range, and speech rhythm. Previous reports on differences in susceptibility of PD speaker to altered feedback were confirmed, and some speakers benefited from the system despite the negative group results for intelligibility and naturalness. In general, FSF resulted in performance closer to the NAF state than to DAF on all variables, and for those PD speakers who benefited from altered feedback, the FSF condition evoked the greatest improvement.