Vocal Emotional Expression in Parkinson’s Disease: Roles of Sex and Emotions
Abstract
:1. Introduction
1.1. Functional Communication Impairment in Parkinson’s Disease
1.2. A Focus on Vocal Impairment in PD
1.3. Expression of Emotional Prosody in PD
Studies | N. Subjects | Years of Disease | Emotions | Main Result | Causes of Prosodic Impairment |
---|---|---|---|---|---|
Scott et al., 1984 [49] | 28 PD; 28 HC | 8 (average) | Only anger | Patients with PD were unable to express anger effectively | Emotional or cognitive processing |
Borod et al., 1990 [40] | 20 PD; 21 HC | NS | Happiness, pleasant surprise, interest/excitement, sadness, anger, fear, and disgust | Patients with PD expressed positive emotions more intensely than negative emotions | Emotional processing |
Blonder et al., 1989 [41] | 21 PD; 17 HC | NS | NS | Monotone speech reported in PD | Emotional and linguistic processing |
Buck & Duffy, 1980 [50] | 9 PD; 10 HC | NS | NS | Patients with PD were less expressive | NS |
Caekebeke et al., 1991 [46] | 21 PD; 14 HC | 5.5 (average) | Anger, neutral, and hesitating emotion | Patients with PD were unable to express anger | Motor symptoms |
Benke et al., 1998 [51] | 22 cognitive intact PD; 26 cognitive impaired PD/18 HC | NS | NS | Patients with PD who are cognitively intact perform better in emotional prosody compared to those who are cognitively impaired. | Mental processing |
Pell et al., 2006 [8] | 21 PD; 12 HC | 3.9 (average) | Anger, disgust, happiness, neutral, sadness, and surprise | Expressions of anger, disgust, and happiness produced by speakers with PD were poorly representative of those emotions | Motor symptoms |
Möbes et al., 2008 [29] | 16 PD; 16 HC | 4.8 (average) | Happiness, neutral, and sadness | Patients with PD showed a significantly lower pitch and intensity range than HC for all emotions | Emotional processing |
Hsu et al., 2016 [42] Alhinti et al., 2021 [52] | 11 PD; 11 HC 3 PD; 21 HC | NS 9.66 (average) | Happiness, neutral, and anger Anger, sadness, happiness, and neutral. | Patients with PD expressed anger with lower mean pitch and narrower pitch range than happiness The results show that patients are able to control some aspects of the prosodic features of their emotional speech. | Emotional processing Motor symptoms |
1.4. The Dynamic Architecture of Emotional Space
1.5. Sex Differences in Prosody Production
1.6. The Present Study
- -
- The impact of speech impairment on the expression of specific emotions;
- -
- The relationship between emotional dysprosody and sex (investigating both intra-sex differences (female with PD vs. female in HC and male with PD vs. male in HC) and inter-sex differences (female vs. male both for patients with PD and for HC);
- -
- An innovative focus on CPPS, that is considered a good indicator of the vocal tract health status and, particularly, a promising measure of dysphonia severity.
- In accordance with Möbes et al. [29] that the impairment in emotional prosody may be explained considering alterations of emotional processing and not only by a motor disease, it is expected that speakers with PD and HCs produce emotional utterances with different acoustic patterns, whereas no differences in the acoustic patterns of utterances produced by patients with PD and HCs are reported for the neutral utterance. Moreover, based on prior evidence [5,7,40,41,42,81,82,83,84], it is expected that the emotional speech of patients with PD is different from the emotional speech of healthy subjects for all the investigated emotions;
- The second hypothesis posits that sex may be another variable that affects vocal emotional speech. In this regard, the pattern of impairment in the production of emotional speech in patients with PD is different not only as a function of the expressed emotion but also as a function of the sex of the speaker.
2. Materials and Methods
2.1. Participants
2.2. Vocal Production Task
2.3. Measures
2.4. Design
3. Results
3.1. Neutral Speech
3.2. Emotional Speech
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Emotion Dimension | Vocal Cues |
---|---|
Arousal (high) | High F0 mean, large F0 variability, high maximum F0, high mean intensity, precise articulation, high frequency energy, slow speech rate, and few pauses. The cepstrum peak prominence is low as well. |
Valence (positive) | Low F0 mean, large F0 variability, low mean intensity, slackened articulation, fast speech rate, and high cepstrum peak prominence. |
Potency (high) | Large F0 variability, large intensity variability, precise articulation, slow speech rate, high shimmer, jitter, and high HNR. |
Variable | PD (N = 15) | HC (N = 15) |
---|---|---|
Age (years) | 69.93 ± 7.12 | 68.13 ± 8.27 |
Sex (Males + Females) | 8 + 7 | 6 + 9 |
Education (years) | 12.20 ± 3.99 | 13.20 ± 3.69 |
UPDRS motor score H & Y | 27.80 ± 10.60 1.7 ± 0.41 | |
Disease duration (years) | 41.80 ± 21.37 | |
LEDD | 174.31 ± 159.18 | |
MMSE | 27.64 ± 1.79 | 27.85 ± 1.32 |
Parameter (Unit of Measure) | Description | Perceptual Correlate | Main Reference |
---|---|---|---|
Mean fundamental frequency (F0) (Hz), standard deviation, and max and min (Hz) | F0 represents the estimated frequency of the (almost) regular pattern found in voiced speech signals. The SD captures the variation of F0 values, while the max and min reflect the highest and lowest F0 values observed. The fundamental frequency (F0) parameters are extracted by analyzing the pitch contour of a voice signal. | Tone perception (from low to high). Two pitches generally have the same tone if they share the same F0. The standard deviation corresponds to variability of the tone. Frequency-related features are commonly considered the most salient in the detection of monotone speech or highly accented syllables. | Pierrehumbert (1979) [91] |
Mean intensity (dB), standard deviation intensity, and max and min (dB) | This group of features is commonly used to capture the voice power in speech. It is the perceived amplitude of a sound. The intensity’s parameters are determined by analyzing the amplitude of the voice waveform. | Loudness of the sound. The standard deviation corresponds to variability of the volume. | Lane et al. (1961) [92] |
Speech rate (syll/s) | Speech rate refers to the measurement of how quickly an individual speaks. To calculate the speech rate, the number of words pronounced within a specific time period is counted and divided by the duration of that period. | The speed or slowness of speech. This perception may vary depending on the listeners’ own speech habits. Speech that is perceived as fast by slow speakers may be interpreted differently by fast speakers and conversely. | Dellwo (2008) [93] |
Articulation rate (sill/s) | Articulation rate (sill/s) refers to the measurement of how quickly an individual articulates or produces speech sounds within a given time frame. To calculate the articulation rate, the number of syllables pronounced is counted and divided by the duration of the speech, resulting in the number of syllables pronounced per second. | Speech rhythm and the style of speaking. The perceived articulatory effort can often be judged as a characteristic of faster speech. | Koreman (2006) [94] |
Number and duration of pauses (s) | The duration of breaks in the speech that are over 200 ms can be extracted. The pauses are identified by identifying segments in the waveform where the amplitude falls below a certain threshold for a specified duration, indicating the presence of a pause. By measuring the onset time, end time, and duration of silent segments, the number and duration of pauses can be calculated. | Interpreted as silence. | Ephratt (2008) [95] |
Cepstral peak prominence smoothed (CPPS) (dB) Harmonic to Noise Ratio (HNR) (dB) Jitter (μs) and Shimmer (dB) | The outcome of taking the inverse Fourier transform (IFT) of the logarithm of the estimated signal spectrum that informs the rate of change in the different spectrum bands. A smoothing process is applied to the cepstral coefficients prior to calculating the peak prominence. This measure estimates the level of noise in speech signals measuring the ratio between periodic and non-periodic components. HNR is calculated by analyzing the spectral properties of the voice signal and estimating the ratio of harmonics to noise. Jitter measures the perturbations of the period durations of the glottal wave while shimmer measures the perturbations of the amplitude of the glottal pulses. Jitter is calculated based on the differences between consecutive F0 values. Shimmer is computed based on the differences between consecutive intensity values. | Measurement of perturbation in voice harmonics and perceived breathiness, i.e., the noise caused by the air passing between the vocal folds even in their occlusion phase. It correlates with the perception of dysphonia: the lower it is, the more the voice is compromised and described from listeners as hoarse and breathless (Theodoros and Ramig, 2011). It is perceived as breathiness or hoarseness. A voice characterized by a low HNR is a dysphonic or an asthenic voice. These measures are perceived as breathiness and roughness. Jitter is related with the lack of control of the vocal folds, while shimmer is related with noise emission and breathiness. | Heman-Ackah et al. (2003) [74] Fernandes et al. (2018) [96] Shama et al., (2006) [97] Teixiera et al., 2014 [98] |
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Gnerre, M.; Malaspina, E.; Di Tella, S.; Anzuino, I.; Baglio, F.; Silveri, M.C.; Biassoni, F. Vocal Emotional Expression in Parkinson’s Disease: Roles of Sex and Emotions. Societies 2023, 13, 157. https://doi.org/10.3390/soc13070157
Gnerre M, Malaspina E, Di Tella S, Anzuino I, Baglio F, Silveri MC, Biassoni F. Vocal Emotional Expression in Parkinson’s Disease: Roles of Sex and Emotions. Societies. 2023; 13(7):157. https://doi.org/10.3390/soc13070157
Chicago/Turabian StyleGnerre, Martina, Eleonora Malaspina, Sonia Di Tella, Isabella Anzuino, Francesca Baglio, Maria Caterina Silveri, and Federica Biassoni. 2023. "Vocal Emotional Expression in Parkinson’s Disease: Roles of Sex and Emotions" Societies 13, no. 7: 157. https://doi.org/10.3390/soc13070157