Feedback and Feedforward Auditory-Motor Processes for Voice and Articulation in Parkinson's Disease
Defne Abur, Austeja Subaciute, Ayoub Daliri, Rosemary A. Lester-Smith, Ashling A. Lupiani, Dante Cilento, Nicole M. Enos, Hasini R. Weerathunge, Monique C. Tardif, Cara E. Stepp
Abstract
PURPOSE: Unexpected and sustained manipulations of auditory feedback during speech production result in "reflexive" and "adaptive" responses, which can shed light on feedback and feedforward auditory-motor control processes, respectively. Persons with Parkinson's disease (PwPD) have shown aberrant reflexive and adaptive responses, but responses appear to differ for control of vocal and articulatory features. However, these responses have not been examined for both voice and articulation in the same speakers and with respect to auditory acuity and functional speech outcomes (speech intelligibility and naturalness). METHOD: Here, 28 PwPD on their typical dopaminergic medication schedule and 28 age-, sex-, and hearing-matched controls completed tasks yielding reflexive and adaptive responses as well as auditory acuity for both vocal and articulatory features. RESULTS: No group differences were found for any measures of auditory-motor control, conflicting with prior findings in PwPD while off medication. Auditory-motor measures were also compared with listener ratings of speech function: first formant frequency acuity was related to speech intelligibility, whereas adaptive responses to vocal fundamental frequency manipulations were related to speech naturalness. CONCLUSIONS: These results support that auditory-motor processes for both voice and articulatory features are intact for PwPD receiving medication. This work is also the first to suggest associations between measures of auditory-motor control and speech intelligibility and naturalness.