Effect of Duration of Pitch-Shifted Feedback on Vocal Responses in Patients With Parkinson's Disease

Abstract

Study of the pitch-shift reflex is useful for the investigation of how auditory feedback is used in the control of voice fundamental frequency. The present study was an attempt to learn if the basal ganglia are involved in central mechanisms of the pitch-shift reflex by comparing measures of the reflex in a group of Parkinson's disease patients with those measures in a group of control participants. The effect of varying duration of the pitch-shift stimulus (PSS) on the voice fundamental frequency (F0) response in 10 Parkinson's disease (PD) patients and 10 age-matched unaffected participants was investigated. Participants were instructed to vocalize into a microphone while their voice was fed back to them over headphones. This feedback of the vocal signal was shifted in pitch either up or down, with the duration of this shift systematically manipulated at 100 ms, 500 ms, and 1000 ms. Although the participants were on medication, making interpretation of the results problematic with regard to basal ganglia function, it was reasoned that positive effects could nevertheless suggest basal ganglia involvement in this reflex and motivate further research. Results indicated that both groups responded to increased stimulus duration of the pitch-shift stimulus with increases in reflex peak time, magnitude, and end times. However, PD patients had significantly longer peak times and end times than control participants for stimulus durations of 100 ms. These results suggest that basal ganglia dysfunction may affect mechanisms relating to the execution and termination of the pitch-shift reflex for brief stimulus durations. The results also support hypotheses of impaired sensory integration of auditory feedback in PD patients.