Darley et al. (3) reported one of the first systematic descriptions of perceptual characteristics of speech and voice in individuals with PD (3,31,32). They identified reduced loudness, monopitch, monoloudness, reduced stress, breathy, hoarse voice quality, imprecise articulation, and short rushes of speech as the most characteristic of the speech and voice disorders in PD. They termed these symptoms hypoki-netic dysarthria. Logemann et al. (2) used phonetic and perceptual analyses to characterize voice and speech abnormalities in 200 nonmedicated individuals with PD. Of these individuals, 89% were found to have voice quality problems such as breathiness, hoarseness, roughness, and tremor and 45% also had speech prosody or articulation problems. Ho et al. (1) used perceptual and phonetic methods to characterize voice and speech problems in 200 individuals with PD. They found that voice problems were first to occur, with other speech problems (prosody, articulation, and fluency) gradually appearing later with more advanced disease. Sapir et al. (4) studied voice, prosody, fluency, and articulation abnormalities in 42 PD patients with speech problems. Of these individuals, 86% were found to have voice abnormalities, which tended to occur early in the course of the disease, and 45% had prosodic, fluency, and articulation abnormalities, which tended to occur at later stages.
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