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Getting Parkinson's patients to speak up

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August 30, 2009

Jessica Huber,left, and graduate student Meghan Moran demonstrate the technology developed...

Jessica Huber,left, and graduate student Meghan Moran demonstrate the technology developed by Huber that helps Parkinson's patients overcome the tendency to speak too quietly.

The sad reality of Parkinson’s disease is that it indiscriminately affects 1.5 million people in the U.S alone, making it one of the most common degenerative neurological conditions with no known cause or cure. In the effort to make one of Parkinson’s many debilitating symptoms more manageable for sufferers, researchers have developed a new technology to overcome voice and speech impairment by playing a recording of ambient sound resembling the chatter of a busy restaurant.

According to Jessica Huber, an associate professor in the Department of Speech, Language and Hearing Sciences at Purdue University, it is virtually inevitable that “at some point in their disease, [Parkinson’s patients] will have some form of voice or speech disorder.” Approximately 89 percent experience voice–related change, a statistic reflecting speech volume, while approximately 45 percent experience speech-related change, which affects speech clarity.

To combat the disease’s impact on patients’ ability to communicate, Huber has created a voice-activated electronic device that automatically plays a recording of background “multi-talker babble noise” - such as the sound of a restaurant full of patrons, minus the clatter of silverware or clinking of glasses - when the person begins to speak. The background sound elicits a well-known phenomenon called the Lombard effect, a reflex in which people automatically speak louder in the presence of background sound. Crucial to the design is a sensor, called an accelerometer, which is worn on the patient’s neck to detect when the patient begins to speak and tells the device to play the babble through an earpiece worn by the patient.

Translating that familiar, slightly embarrassing moment when a room full of people suddenly goes quiet and all but one remaining voice can be heard is precisely the volume that Huber intends to capture in patients who struggle to make themselves audible. Treatment programs that depend on encouragement cues by the therapist have been problematic, especially for patients in later stages of the disease who find it difficult to remember to employ the strategies learned in therapy. Huber found that, when asked or encouraged, patients ‘couldn’t speak 10 decibels louder, but when I turned on the babble noise, they spoke over 10 decibels louder.”

Through Huber’s technology, the objective to speak louder may also cause them to articulate more clearly as it relies on a natural cue in a patient’s own environment. Results are measured by determining how much louder patients speak while wearing the device and without the device after eight weeks of training. Data collected from six patients show significant improvement in patients to speak louder and more clearly. Apart from Huber not recognizing long-time patients who wore the device during telephone conversations, additional benefits include an increase in confidence because “it trains them in their everyday environment—in their homes, with their spouses, in their churches, in their social groups.”

Whether patients continue to improve without the device requires further testing. Additional research will investigate physiological changes such as lung volume, pressure and airflow generated during speech as a means of determining not only whether volume is increased but also how it increases.

Parkinson's patients looking to participate in the study can contact Jessica Huber for more information.

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