Hypernasality associated with basal ganglia dysfunction: evidence from Parkinson's disease and Huntington's disease

PeerJ. 2016 Sep 29:4:e2530. doi: 10.7717/peerj.2530. eCollection 2016.

Abstract

Background: Although increased nasality can originate from basal ganglia dysfunction, data regarding hypernasality in Parkinson's disease (PD) and Huntington's disease (HD) are very sparse. The aim of the current study was to analyze acoustic and perceptual correlates of velopharyngeal seal closure in 37 PD and 37 HD participants in comparison to 37 healthy control speakers.

Methods: Acoustical analysis was based on sustained phonation of the vowel /i/ and perceptual analysis was based on monologue. Perceptual analysis was performed by 10 raters using The Great Ormond Street Speech Assessment '98. Acoustic parameters related to changes in a 1/3-octave band centered on 1 kHz were proposed to reflect nasality level and behavior through utterance.

Results: Perceptual analysis showed the occurrence of mild to moderate hypernasality in 65% of PD, 89% of HD and 22% of control speakers. Based on acoustic analyses, 27% of PD, 54% of HD and 19% of control speakers showed an increased occurrence of hypernasality. In addition, 78% of HD patients demonstrated a high occurrence of intermittent hypernasality. Further results indicated relationships between the acoustic parameter representing fluctuation of nasality and perceptual assessment (r = 0.51, p < 0.001) as well as the Unified Huntington Disease Rating Scale chorea composite subscore (r = 0.42, p = 0.01).

Conclusions: In conclusion the acoustic assessment showed that abnormal nasality was not a common feature of PD, whereas patients with HD manifested intermittent hypernasality associated with chorea.

Keywords: 1/3-octave spectra; Acoustic analysis; Dysarthria; Huntington Disease; Nasality; Parkinson Disease; Speech disorders.

Grants and funding

This study was supported by the Ministry of Health of the Czech Republic, grant nr. 15-28038A. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.