SLPOtherJournal of communication disorders2021

The effects of a simulated fMRI environment on voice intensity in individuals with Parkinson's disease hypophonia and older healthy adults.

Jordan L Manes, Ellen Herschel, Katharine Aveni and 5 others

PMID 34543846

WHAT IT FOUND

Simulated fMRI noise increased voice loudness in both Parkinson's patients and healthy adults.

Patients started quieter but responded more strongly to the noise, narrowing the gap. Medication status did not change these effects. Clinicians should expect louder voices in scanner environments.

Key findings

01Voice intensity was significantly higher in the simulated fMRI noise condition compared to the no-noise condition for all participants.

02The difference in voice intensity between Parkinson's patients and healthy controls was smaller when scanner noise was present, indicating a stronger compensatory response in patients.

03Antiparkinsonian medication status had no significant effect on voice intensity in any of the recording conditions.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study used only sustained vowel production, so findings may not generalize to connected speech or conversational tasks. Group comparisons were made using off-medication data, limiting the generalizability of the patient-control difference to on-medication states. The mock scanner did not replicate the intermittent noise patterns of true sparse-sampling fMRI protocols. Participants were in early-to-mid stages of Parkinson's disease, so results may not apply to those with more advanced respiratory rigidity.

Declared interests

The study was supported by the National Institutes of Health (N.I.H., Extramural). No other conflicts of interest are explicitly detailed in the provided text.

The easy way to misread this

Do not assume that voice intensity measured in a quiet clinic reflects what happens in the brain during fMRI scanning. The scanner noise forces patients to speak louder involuntarily, and this Lombard effect may engage different neural mechanisms than the voluntary loud speech targeted in therapy.

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