Medicine and Health Sciences Commons^™

A Comparison Of Voice Amplifiers And Personal Communication Systems In Individuals With Hypophonia: An Exploration Of Communicative Participation, Jessi-Rae A. Schroeder

Electronic Thesis and Dissertation Repository

Hypophonia is one of the most prevalent speech impairments in hypokinetic dysarthria. Unfortunately, behavioral interventions for hypophonia often fail to generalize beyond the clinic. An alternative approach to management is the use of speech amplification devices. This study evaluated how 17 individuals with hypophonia (HP) and their primary communication partners (PCPs) rated communicative participation across three, one-week device trial periods at home. Amplification devices included: a wired belt pack amplifier, wireless stationary amplifier, and personal FM system. Patient-reported outcome measures included the CES, VAPP and PIADS. Results indicated HPs rated participation higher following device use in comparison no device. Further, …

Exploring The Effects Of Spinal Cord Stimulation For Freezing Of Gait In Parkinsonian Patients, Olivia Samotus

Electronic Thesis and Dissertation Repository

Dopaminergic replacement therapies (e.g. levodopa) provide limited to no response for axial motor symptoms including gait dysfunction and freezing of gait (FOG) in Parkinson’s disease (PD) and Richardson’s syndrome progressive supranuclear palsy (PSP-RS) patients. Dopaminergic-resistant FOG may be a sensorimotor processing issue that does not involve basal ganglia (nigrostriatal) impairment. Recent studies suggest that spinal cord stimulation (SCS) has positive yet variable effects for dopaminergic-resistant gait and FOG in parkinsonian patients. Further studies investigating the mechanism of SCS, optimal stimulation parameters, and longevity of effects for alleviating FOG are warranted. The hypothesis of the research described in this thesis is …

Effect Of Levodopa On Eeg Connectivity In Parkinson's Patients, Sepehr Torab Parhiz

Electronic Thesis and Dissertation Repository

Levodopa is a dopamine replacement medication administered to patients with Parkinson’s disease (PD) to alleviate their motor symptoms. However, its long-term use can cause adverse side effects, including involuntary motor movements. We studied 16 PD patients before and after taking Levodopa based on resting-state electroencephalography (EEG) recordings to determine how Levodopa affects the functional connectivity of their brain networks. We used several metrics from graph theory, in particular the minimum spanning tree (MST) metric, and analyzed how they change after subjects take Levodopa. We observed significant changes in the lower alpha band toward a more path-like and less globally efficient …

Investigation Of Visual Perceptions In Parkinson's Disease And The Development Of Disease Monitoring Software, Matthew Bernardinis

Electronic Thesis and Dissertation Repository

Non-motor Parkinson’s Disease (PD) symptoms are substantial factors of PD arising throughout disease stages, yet their diagnosis and monitoring remain a challenge. Sensory abnormalities in PD occur across sensory systems and disease stages, contributing to disease-related impairments. However, the extent of symptoms is unknown, with inadequate monitoring and treatment options furthering disease management difficulties. The current work studies movement-independent visual perceptions of time, displacement and velocity in PD patients across disease stages using levodopa, deep brain stimulation (DBS), or no PD therapy. Perceptual tasks were conducted using a computer-generated graphical device designed with a focus on simplicity and flexibility. Perception …

Effects Of A Unilateral Injection Of Botulinum Neurotoxin Subtype-A In The Subthalamic Nucleus Of A Parkinsonian Rat Model, Olga Khazov

Electronic Thesis and Dissertation Repository

Dopaminergic degeneration in Parkinson’s disease (PD) leads to altered functional activity within the basal ganglia (BG) circuitry, including hyperactivity of the subthalamic nucleus (STN). Treatments restoring the BG functional circuitry often result in improvements in parkinsonian symptoms in patients and animal models. A recent study from our laboratory identified that infusing botulinum toxin (BoNT-A) into the internal globus pallidus provided a transient restoration of motor asymmetry and goal-directed locomotion in a rat model of PD. We hypothesized that infusions of BoNT-A into the STN in a parkinsonian rat model will improve motor asymmetry and locomotor abnormalities. Infusions of BoNT-A into …

Differentiating The Substantia Nigra And Ventral Tegmental Area In Early-Stage Parkinson's Disease Using Iron Imaging, Erind Alushaj

Electronic Thesis and Dissertation Repository

Excessive midbrain iron accumulation in Parkinson’s Disease (PD) contributes to degeneration of the substantia nigra pars compacta (SNc) and ventral tegmental area (VTA). Despite this understanding, there are no validated PD biomarkers. Magnetic resonance imaging (MRI) can localize and quantify brain iron for diagnosis of PD. Seventeen early-stage PD patients and twenty-one controls were scanned at 3T and 7T MRI. Using quantitative susceptibility mapping (QSM) and R2* relaxometry, we analyzed the average iron content in the SNc, substantia nigra pars reticulata (SNr), and VTA. QSM detected significantly higher SNc iron content in PD patients compared to controls at both …

Optimizing Gait Outcomes In Parkinson's Disease With Auditory Cues: The Effects Of Synchronization, Groove, And Beat Perception Ability, Emily A. Ready

Electronic Thesis and Dissertation Repository

This dissertation explores a common, rehabilitative strategy for mitigating gait impairments in Parkinson’s disease (PD) called Rhythmic Auditory Stimulation (RAS). The effects of this intervention on gait in PD are well documented but highly variable, which poses difficulty for appropriate therapeutic application. Part of this variability may be related to individual musical abilities, such as beat perception accuracy, as most RAS interventions involve synchronizing with a beat. However, music is complex and variable. Therefore, factors inherent in the music itself may play a role in these differences, such as how much the music makes you want to move (groove), or …

Investigating The Practical And Clinical Effectiveness Of Applying Current Steering To Deep Brain Stimulation For Parkinsonian Gait Therapy, Daphne Hui

Electronic Thesis and Dissertation Repository

Multiple neural network integration, influence of bradykinesia and rigidity, and bias of upper limb symptom improvement during deep brain stimulation implementation may attribute to the variable responsiveness of Parkinsonian gait therapy. Current steering (CS) addresses variability through fractionating current to fine-tune the stimulation field shape. It was hypothesized that CS would exhibit greater gait improvements and lower the total electrical energy delivered (TEED), which reduces power consumption and battery drainage. Divisions of 70/30 and 50/50 and single-contact stimulation modelled CS and conventions, respectively. Overall ambulation improved with TEED reduction; further, bilateral CS improved step time and length but left CS …

Measuring Community Mobility In Older Adults With Parkinson’S Disease Using A Wearable Gps Sensor And Self-Report Assessment Tools, Lynn Zhu

Electronic Thesis and Dissertation Repository

Community mobility (CM) is an important instrumental activity of daily living associated with quality of life and independence. Measuring the CM of older adults, particularly those with gait disorders such as Parkinson’s disease (PD), is an important way to understand how to help people maintain mobility in the real life setting. CM is measured using self-report measures and emergent technologies, such as wearable Global Positioning System (GPS) sensors. However, the measurement properties of most available assessments have not been compared within a PD population to determine their appropriateness and identify any feasibility issues.

The primary objective of this project was …

Characterization And Personalization Of Botulinum Toxin Type A Therapy For Upper Limb Tremor In Parkinson Disease And Essential Tremor Patients Using Multi-Sensor Kinematic Technology, Olivia Samotus

Electronic Thesis and Dissertation Repository

Tremor commonly affects the upper extremities in essential tremor (ET) and Parkinson disease (PD) patients where many experience functional disability and ultimately seek therapy. As ET and PD tremor features overlap and clinical assessment is challenging due to its highly complex nature, misdiagnosis is common resulting in unsuitable therapies and prognosis. Current treatment options for ET and PD tremor include pharmacotherapy, focal therapy with botulinum toxin type A (BoNT-A) injections, and surgical interventions which provide modest relief of tremor. However, such therapies are commonly associated with significant adverse events and lack long-term efficacy and tolerability. Hence lack of standardized, objective …

Verb Use In Parkinson's Disease, Swati S. Nikumb

Electronic Thesis and Dissertation Repository

Verb-specific impairments in their use and comprehension are well documented in persons with Parkinson’s disease (PD). The grammatical and the motor theories have been proposed as possible explanations for verb impairments. The purpose of this study is to describe the use of low-motion and high-motion content verbs in PD in everyday conversation and to determine which theory best supports these findings. In this cross-sectional prospective study, conversation samples were collected and analyzed from participants with PD and their spouses in a mealtime context. Results indicated that total verb use on a proportional basis was not significantly different between persons with …

Health Literacy Of Individuals Living With Parkinson's Disease, Nicole D. Leblanc

Electronic Thesis and Dissertation Repository

In the past two decades, there has been an increased interest in the development of self-management programs for people with chronic diseases. Fundamental to chronic disease management is adequate literacy and health literacy skills. Research on the health literacy skills of individuals managing Parkinson’s disease (PD) is seemingly absent from the research literature. The purpose of this study was to assess the health literacy skills of older adults managing PD and to examine the relationships of functional health literacy, self-efficacy, social support, and empowerment in this population. Using a cross-sectional design, this study surveyed 33 older adults living with PD …

A Comparison Of Speech Amplification Devices For Individuals With Parkinson's Disease And Hypophonia, Monika Andreetta

Electronic Thesis and Dissertation Repository

One of the most prevalent speech impairments in idiopathic Parkinson’s disease (PD) is hypophonia, a reduction in intensity, which typically decreases intelligibility. Speech amplification devices are a potential solution; however, despite the availability of a broad range of devices, no previous studies systematically compare their efficacy in PD. This study examined the effects of speech task (Sentence Intelligibility Test versus conversation), background noise (no noise versus 65 dB SPL multi-talker noise), and selected devices (ADDvox, BoomVox, ChatterVox, Oticon, SoniVox, Spokeman, and Voicette) for 11 PD and 10 control participants, using outcome measures of speech intensity, speech-to-noise ratio, intelligibility, sound quality, …

Effect Of Concurrent Walking And Interlocutor Distance On Conversational Speech Intensity And Rate In Parkinson's Disease, Cassandra M. Mccaig

Electronic Thesis and Dissertation Repository

This study examined the effects of concurrent walking tasks and interlocutor distance on conversational speech production in fifteen individuals with idiopathic Parkinson’s disease (PD) and fourteen age-equivalent controls. Recent studies of speech in PD have demonstrated that changes in the behavioural conditions and the environmental context can have a powerful effect on the severity of speech symptoms in PD. This investigation focused on changes in speech intensity and speech rate in response to changes in walking speed and interlocutor distance. Results suggest that the introduction of a concurrent walking task significantly increased the conversational speech intensity of both controls and …

Gait Initiation In Parkinson's Disease: The Manipulation Of Cue Expectancy In A Dual Task Paradigm, Derrick Nield

Electronic Thesis and Dissertation Repository

Introduction. This study examined movements of the center of pressure (CoP) during forward gait initiation, in Parkinson disease (PD) patients and healthy controls, in a dual task paradigm with manipulations of cue expectancy. Methods. The CoP trajectory was divided into three periods and, prior to testing, subjects were given instructions as to whether they would receive the cue to initiate gait. The secondary task was a numerical recitation. Results. PD patients demonstrated significantly reduced CoP movements and greater variability in the timing of the vocalizations compared to healthy controls. Both groups demonstrated significant increases in CoP movements when uncertain and …

The Effect Of Multitalker Background Noise On Speech Intelligibility In Parkinson's Disease And Controls, Talia M. Leszcz

Electronic Thesis and Dissertation Repository

This study investigated the effect of multi-talker background noise on speech intelligibility in participants with hypophonia due to Parkinson’s disease (PD). Ten individuals with PD and 10 geriatric controls were tested on four speech intelligibility tasks at the single word, sentence, and conversation level in various conditions of background noise. Listeners assessed speech intelligibility using word identification or orthographic transcription procedures. Results revealed non-significant differences between groups when intelligibility was assessed in no background noise. PD speech intelligibility decreased significantly relative to controls in the presence of background noise. A phonetic error analysis revealed a distinct error profile for PD …