Voice self-assessment in individuals with Parkinson's Disease as compared to general voice disorders

Francisco Contreras-Ruston; Adrián Castillo-Allendes; Jorge Saavedra-Garrido; Andrés Felipe Ochoa-Muñoz; Eric J Hunter; Sonja A Kotz; Jordi Navarra

doi:10.1016/j.parkreldis.2024.106944

Voice self-assessment in individuals with Parkinson's Disease as compared to general voice disorders

Parkinsonism Relat Disord. 2024 Mar 22:123:106944. doi: 10.1016/j.parkreldis.2024.106944. Online ahead of print.

Authors

Francisco Contreras-Ruston¹, Adrián Castillo-Allendes², Jorge Saavedra-Garrido³, Andrés Felipe Ochoa-Muñoz⁴, Eric J Hunter⁵, Sonja A Kotz⁶, Jordi Navarra⁷

Affiliations

¹ Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain; Faculty of Psychology and Neuroscience, Department of Neuropsychology & Psychopharmacology, Maastricht University, 6229 ER, Maastricht, the Netherlands; Speech-Language Pathology and Audiology Department - Universidad de Valparaíso, San Felipe, Chile. Electronic address: frcontrr7@alumnes.ub.edu.
² Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA; Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA.
³ Institute of Statistics, University of Valparaíso, Faculty of Science, Valparaíso, Chile; Department of Meteorology, University of Valparaíso, Valparaíso, Chile.
⁴ Institute of Statistics, University of Valparaíso, Faculty of Science, Valparaíso, Chile; School of Statistics, Universidad del Valle, Cali, Colombia.
⁵ Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA.
⁶ Faculty of Psychology and Neuroscience, Department of Neuropsychology & Psychopharmacology, Maastricht University, 6229 ER, Maastricht, the Netherlands.
⁷ Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.

PMID: 38552350
DOI: 10.1016/j.parkreldis.2024.106944

Abstract

Background: Individuals with Parkinson's Disease (IwPD) often fail to adjust their voice in different situations, without awareness of this limitation. Clinicians use self-report questionnaires that are typically designed for individuals with General Voice Disorders (GVD) in the vocal assessment of IwPD. However, these instruments may not consider that IwPD have a reduced self-perception of their vocal deficits. This study aimed to compare self-reported vocal symptoms and voice loudness between IwPD and GVD.

Methods: 28 IwPD and 26 with GVD completed the Voice Symptom Scale (VoiSS) questionnaire to evaluate their voice self-perception. Vocal loudness (dB) was also assessed. Univariate and multivariate analyses were used to compare the outcomes from these measures between the two groups. Principal Component Analysis and Hierarchical Clustering Analysis were applied to explore data patterns related to voice symptoms.

Results: IwPD reported significantly fewer vocal symptoms than those with GVD in all VoiSS questionnaire domains. Multivariate principal component analysis found no significant correlations between VoiSS scores and participant similarities in voice measures. Despite experiencing hypophonia, IwPD scored lower in all VoiSS domains but still fell in the healthy voice range. Hierarchical Clustering Analysis grouped participants into three distinct categories, primarily based on age, vocal loudness, and VoiSS domain scores, distinguishing between PD and GVD individuals.

Conclusions: IwPD reported fewer vocal symptoms than GVD. The voice self-assessment seems to be unreliable to assess vocal symptoms in IwPD, at least regarding loudness. New self-report instruments tailored to PD individuals are needed due to their particular voice characteristics.

Keywords: Dysphonia; Parkinson's disease; Self-assessment-loudness; Voice.