• 말소리와 음성과학
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• 제5권4호
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• pp.3-15
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• 2013

The acoustic analysis of diadochokinesis(DDK) has been used to evaluate dysarthria. However, there has not been an automatic method to evaluate dysarthria. The aim of this study was to introduce a new automated program to measure DDK tasks and to apply this to clinical patients with idiopathic Parkinson's disease(IPD). Fourty-seven patients with IPD and a healthy control group of twenty participants were selected with every DDK task recorded three times. Twenty-five acoustic parameters in the program were developed. The relevant parameters were times of DDK, pitch related parameters, intensity parameters which were analyzed by 2-way ANOVA. Significant differences between the groups were found in the times of DDK, pitch related parameters, and intensity parameters. The findings indicated that the pitch of control group was more stable than that of the IPD. Even though the patients with IPD had a higher intensity value, this phenomenon was caused by the weakness of the IPD group who could not control their speech with a breath.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.80-82
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• 2005

Background: Idiopathic Parkinson's disease (IPD) is closely related to Lewy body pathology. Pathological changes in medullar oblongata and pontine tegmentum have been reported in patients with subclinical motor symptom. Vestibular evoked myogenic potential (VEMP) is mediated by vestibular nuclei in lower brainstem and reflects the function of lower brainstem. The purpose of our study is to estimate the lower brainstem function in IPD patients. Methods: Ten patients with idiopathic Parkinson's disease underwent VEMP test. The patients were divided into Hohn-Yahr (H-Y) stage I (unilateral motor involvement) group and H-Y stage II or more severe (bilateral motor involvement) group. VEMP results were compared between groups using Mann-Whitney U test. Results: Among patients, 6 patients showed abnormal VEMP (unilateral abnormality 2, bilateral abnormalities 4). Between H-Y stage I group and H-Y II,III group, there was no statistical difference in the results of VEMP. Conclusions: We concluded that the lower brainstem dysfunction reflected in VEMP could occur in IPD regardless of the progression of the disease.

• 재활복지
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• 제18권4호
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• pp.237-255
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• 2014

특발성 파킨슨병(idiopathic Parkinson disease, IPD)은 알 수 없는 원인으로 인해 중뇌의 흑질신경세포가 손실되는 대표적인 퇴행성 신경계 질환이다. IPD 환자는 신체 운동 이상을 주로 호소하지만 이들 중 70~90%가 운동저하형 마비말장애(hypokinetic dysarthria)를 동반하는 것으로 알려져 있다. 진행된 심도의 IPD 환자의 운동 증상 호전에 가장 효과적인 치료 방법으로 알려진 시상밑부핵 심부뇌자극술(subthalamic nucleus deep brain stimulation, STN-DBS)은 말 산출에서는 그 효과가 일관되지 않게 보고된다. 이에 본 연구에서는 STN-DBS가 말 산출에 미치는 영향을 살펴보고, 연구에서 어떠한 말 평가 과제가 사용되었는지를 조사하기 위하여 medline을 통해 2012까지 이루어진 연구 논문을 수집하였다. 총 32편 중, 연구대상자들에서 술 후 말 상태의'호전'이 관찰된 논문은 42%,'악화'는 29%,'엇갈리는 결과'는 26%,'변화 없음'은 3%로 확인되었다. 말 효과 간에는 문맥발화(contextual speech)가 연구에 사용된 비중이 높을수록 술 후 말 상태는 부정적인 결과로 보고되었으며, 말 산출 단계 중 일부 단계(예: 호흡 및 발성만, 혹은 조음만)만이 반영된 평가 과제가 연구마다 선택적으로 사용되었음을 확인하였다. 이에 본 연구는 STN-DBS를 받은 IPD 환자의 말 평가는 말 산출 하부 단계를 모두 반영하는 문맥발화 과제를 통일적으로 사용할 것을 제안한다.

• 말소리와 음성과학
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• 제3권1호
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• pp.145-151
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• 2011

In view of the hypothesis that the effects of Parkinson's disease on voice production can be detected before pharmacological intervention, the prosodic features of patients with idiopathic Parkinson's disease (IPD) and a healthy aging group were diagnostically analyzed with the long term object of establishing, for clinical purposes, early disease-progression biomarkers. Twenty patients (male 8; female 12) with IPD (prior to pharmacological intervention) and a healthy control group of 22 (male 10; female 12) were selected. Ten sentences were recorded with a head-worn microphone. One sentence was chosen for the analysis of this paper. Relevant parameters, i.e. 3-dimensional model (F0, intensity, duration) and pitch and intensity related slopes (maxEnergy, maxF0, meanAbS, semiT, meanEnergy, meanF0), were analyzed by two-group discriminant analysis. The stepwise estimation method of discriminant analysis was performed by gender. The discriminant functions predicted 83.9% of the male test data correctly while the prediction rate was 93.1% for the female group. The results showed that meanF0_slope and semiT_slope were more important parameters than the others for the male group. For the female group, the meanEnergy_slope and maxEnergy_slope were the important ones. These findings indicate that significant parameters are different for the male and female group. Gender lifestyle may be responsible for this difference. Dysprosodic features of IPD show not simultaneously but progressively in terms of F0, intensity and duration.

• 말소리와 음성과학
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• 제3권1호
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• pp.103-110
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• 2011

Idiopathic Parkinson's Disease patients' speech is hypokinetic dysarthria and their speech is possibly the consequence of impaired respiratory support. The purpose of this study was focused on the respiratory characteristics of speech breathing in de novo IPD who were not given prior vocal or anti-Parkinson treatment. A total of 40 subjects participated in the study: 20 de novo IPD patients between the ages of 50 and 80, and 20 normal subjects with similar age, height, and weight matches. Forced Expiratory Vital Capacity (FVC), Forced Expiratory Volume in 1 sec (FEV1) and $FEV_1$ as a percentage of FVC (FEV1/FVC) was measured with a PC-based spirometer (Cosmed). In addition, Maximum Phonation Time (MPT), Mean Airflow Rate (MFR), Subglottal Pressure (Psub) and the number of syllables produced per breath were measured with a Phonatory Aerodynamic System (Kay PENTAX). All subjects were asked to read a standardized Korean paragraph and the following measurements were obtained from the task. Results indicated no statistically significant differences in respiratory function (FEV1/FVC%) and aerodynamic function between the two groups, but the number of syllables per breath was significantly lower in the IPD patient group than in the normal group and it could be predicted by FVC and MFR. Therefore, the study shows that the MFR from the lungs during speech in de novo IPD patients is used inefficiently.

• 음성과학
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• 제10권4호
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• pp.221-227
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• 2003

Diadochokinetic (DDK) speech task has been utilized as an evaluating tool for speakers with dysarthria for many years. This study attempted to differently diagnose multiple system atrophy (MSA) from idiopathic Parkinson's disease (PD) using patients' performance of DDK (i.e., alternate motion rate (AMR)). The subjects included 11 cases of pathologically confirmed MSA and 16 IPD patients who commonly presented with parkinsonian syndrome. The speech sample of each patient was analyzed acoustically using the MSPTM(Motor Speech Profile, a module of CSL). The results showed that the average DDK rate was significantly faster in the IPD than the MSA groups in all three syllables (i.e., /puh/, /tuh/. and /kuh/). We propose the average DDK rate variable as a core clinical trait in differentiating the two pathological conditions.

• 지역사회간호학회지
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• 제27권2호
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• pp.153-162
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• 2016

Purpose: Music therapy is a non-pharmacological treatment of the behavioral and psychological symptoms. This study was conducted to contribute to the rehabilitation of patients with idiopathic Parkinson's disease in the areas of functionality, emotionality and sociability. Methods: The study included 35 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression, chronic illness anticipated stigma, and worrying about quality of life. The patients were recruited from the department of outpatient neurology at School of Medicine, D University in B Metropolitan City. Group music therapy was performed for nine weeks. The results were analyzed by repeated measures ANOVA. Results: In terms of stigma, there were significant differences between two groups and time (p<.05). Analysis of the interaction between time and service method revealed significant differences (p<.05). Between time, and the interaction between time and service method revealed significant differences in terms of quality of life (p<.05). Conclusion: The results suggest that group music therapy will be effective on the psychosocial well-being of patients with Parkinson's disease living in assisted and independent living communities.

• 한국독성학회:학술대회논문집
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• 한국독성학회 2003년도 추계학술대회
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• pp.34-63
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• 2003

Idiopathic Parkinson's disease (IPD) represents a common neurodegenerative disorder. While epidemiological studies have suggested a number of risk factors including age, gender, race, and inherited disorder, the cumulative evidence supports the view that environmental or occupational exposure to certain chemicals may contribute to the initiation and progress of Parkinsonism.(omitted)

• 한국환경성돌연변이발암원학회지
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• 제23권4호
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• pp.115-130
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• 2003

Idiopathic Parkinson's disease (IPD) represents a common neurodegenerative disorder. While epidemiological studies have suggested a number of risk factors including age, gender, race, and inherited disorder, the cumulative evidence supports the view that environmental or occupational exposure to certain chemicals may contribute to the initiation and progress of Parkinsonism. More recently, clinical and laboratory investigations have led to the theory that dysregulation of iron, an essential metal to body function, may underlie IPD by initiating free radical reaction, diminishing the mitochondrial energy production, and provoking the oxidative cytotoxicity. The participation of iron in neuronal cell death is especially intriguing in that iron acquisition and regulation in brain are highly conservative and thus vulnerable to interference from other metals that bear the similar chemical reactivity. Manganese neurotoxicity, induced possibly by altering iron homeostasis, is such an example. In fact, the current interest in manganese neurotoxicology stems from two primary concerns: its clinical symptoms that resemble Parkinson's disease and its increased use as an antiknock agent to replace lead in gasoline. This article will commence with addressing the current understanding of iron-associated neurodegenerative damage. The major focus will then be devoted to the mechanism whereby manganese alters iron homeostasis in brain.

• 음성과학
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• 제12권3호
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• pp.19-33
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• 2005

Tremor is a main factor of parkinsonism. Voice tremor may be the first, later or the only symptom of a neurological disease and its frequency, amplitude, and regularity may differ among the diseases of different neural subsystems. Differential diagnosis between idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA) has been difficult. This study included three groups: (1) 6 IPD patients; (2) 6 MSA patients; and (3) 20 ageand sex-matched normal controls. The MDVP (Multidimensional Voice Program) was used to analyze the sustained /a/phonation. The results were as follows: (1) frequency perturbation parameters (jitter, sPPQ, Vf0) and FTRI of tremor parameter of two patient groups were statistically different from those of the controls (p < .01); (2) measures were higher in short-term and long-term f0 and amplitude perturbation in MSA than IPD; (3) however, any acoustic parameters between IPD and MSA were not statistically different; except for the rate of frequency tremor, 4$\sim$5 Hz in IPD, 5$\sim$11 Hz in MSA and (4) the pattern of regularity for voice tremor through histogram indicated that amplitude of IPD was irregular while both f0 and amplitude of MSA were irregular. In conclusion, F0, rate of frequency tremor, and pattern of f0 regularity may be predictors for differential diagnosis. These findings might signify that voice tremor of parkinsonism was resulted from modulation of f0.