I'm appreciating the works on dosimetry coming from NVCS and others. I am specifically interested in intelligibility and intensity, as well as the effect of cues within the natural environment (my research population is Parkinson's disease and healthy controls, but I don't want to limit my review of the literature to that). I am also appreciating literature on the Hawthorne effect in speech/voice, but wanted to leave this question rather open ended to see what others are feeling is important.
I have PD or, possibly more likely, a form of Parkinsonism. I have no tremor and a good sense of smell but I have a number of other symptoms including those affecting speech, which for me are the most disabling.
1. Festination - I, and the few others I know who have the same affliction, have always had a tendency to speak too fast but could always control it when necessary, even in the early days after diagnosis (2010). Now this is harder but if tap my fingers on a hard surface as I speak each syllable I can control the speed quite well, especially if I close my eyes or look away from a listener whose face shows eagerness or impatience. I can read or recite a list of unconnected words at any speed without difficulty so I deduce that it is the meaning of the sentences that matters rather than the individual words. If I speak in French or Italian it is OK but I am not bilingual and I suspect that the effort of finding the right words is sufficient to slow me down.
It may be a calibration problem because, for example, I find it impossible to maintain a free walking speed > 3 kph or a free cycling speed on a static machine of 8-9 kph for more than a few seconds but I can walk at 6 kph on a treadmill for 30 min without difficulty or exhaustion.
Festination is the cause of my illegible handwriting. This is usually attributed to deterioration in hand-eye coordination but my coordination is fine (I am in the process of making a model aircraft from balsa wood). The results of touch typing are unintelligible but if I look at t keyboard while I type it's slower but much better.
Festination is not affected by L-dopa (Sinemet).
2. Slurring - This is, I think, the result of poor tongue-teeth coordination. It varies a lot, worse when I'm tired. Haven't really tried to test the effect of l-dopa because festination makes it worse and festination varies independently.
3. Breathing (volume) I've done the LSVT course but (trying) to shout all the time is wearing. Rapid shallow breathing can be induced by l-dopa
http://www.ncbi.nlm.nih.gov/pubmed/12112201 (Mov Disord. 2002 May;17(3):524-7) but shallow breathing is common in PD, contributing to pneumonia. This too may be a calibration issue because I can breathe deeply if I make a small conscious effort. Without this, speech is almost inaudible. Even with it I speak very quietly but I can sing at >100 dB and shout at dogs with no problem. Festination makes it worse.
4. Word selection - I often prepare mentally what I intend to say but when I speak fast the brain is not given enough time to find the word that I wanted and chooses another one from the same compartment in the speech database. SInce words are grouped not as synonyms or homophones but by association, the word spoken may be apparently unrelated to the intended word.
I welcome a new researcher into speech and PD and will follow you with interest.
Thank you so much for all that you've written. I'm always interested in hearing the personal experiences of people with PD. Thanks so much also for the movement disorders citation.
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