Objective: To investigate whether objective acoustic speech parameters are associated with perceived speech-related stigma in Parkinson’s disease (PD).

Background: Speech impairment is common in PD [1]. In preliminary analyses, stigma burden measured by the PD Stigma Questionnaire (PDStigmaQuest)[2] correlated with self-perceived voice handicap measured by the Voice Handicap Index (VHI) [3]. Whether objective speech parameters are related to PD stigma remains unclear.

Method: Data from 66 individuals with PD were analyzed (age 63.7 ± 10.9 years, disease duration 8.1 ± 4.8 years, levodopa equivalent daily dose 1029.9 ± 507.0 mg). Speech recordings were analyzed in medication OFF and ON conditions. Outcomes included PDStigmaQuest total score, the speech-specific PDStigmaQuest item 1b (embarrassment due to voice characteristics), and VHI total score. Acoustic parameters included measures of articulatory rate and regularity, vowel duration, maximum phonation time, voice onset timing during rapid syllable repetition, dysphonia severity indices, and variability of fundamental frequency during reading and spontaneous speech. Associations were assessed using Spearman correlations with false discovery rate correction and linear regression models.

Results: Stigma total scores in recordings obtained in the medication OFF state correlated with VHI total scores (rho = 0.43, p < .001). Item 1b showed an even stronger correlation with VHI (rho = 0.63, p <0.001). No acoustic parameter was significantly associated with overall stigma after multiple-testing correction. In contrast, the speech-specific stigma item was significantly associated with reduced variability of fundamental frequency during both reading and spontaneous speech in the OFF state (rho = −0.41 and −0.46, respectively; p_FDR = 0.0035 and p_FDR = 0.0012). Regression models confirmed that reduced pitch variability was the strongest predictor of speech-related stigma.

Conclusion: Speech-related stigma in PD was associated with reduced prosodic variability, suggesting that reduced pitch modulation may contribute more strongly to perceived speech abnormalities than articulatory rate. Patients may perceive these speech changes as embarrassing in social or professional situations, thereby contributing to disease-related stigma. However, the influence of dopaminergic medication on speech-associated stigma remains elusive and should be addressed in further research.

References: 1 Polychronis S, Niccolini F, Pagano G, Yousaf T, Politis M. Speech difficulties in early de novo patients with Parkinson’s disease. Parkinsonism Relat Disord 2019; 64: 256–61.
2 Stopic V, Jost ST, Haupt J, et al. Validation Study of the Parkinson’s Disease Stigma Questionnaire (PDStigmaQuest). J Parkinsons Dis 2024; 14: 1469–80.
3 Nawka T, Wiesmann U, Gonnermann U. [Validation of the German version of the Voice Handicap Index]. HNO 2003; 51: 921–30.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/prosodic-speech-variability-is-associated-with-speech-related-stigma-in-parkinsons-disease/