Category: Parkinson’s Disease: Clinical Trials
Objective: This study aimed to evaluate the clinical relevance of effects on voice sound level (Lv) as well as brain connectivity using resting-state functional MRI (rsfMRI) following a novel speech and communication treatment for Parkinson’s disease (PD).
Background: The HiCommunication program for speech and communication in PD is based on principles driving neuroplasticity and has shown high compliance and acceptability  as well as positive results at a group level of the primary outcome measure Lv .
Method: Participants with PD (n=95) were recruited within a randomized controlled trial  and allocated to intervention with either HiCommunication or HiBalance (targeting balance and gait). Speech recordings and rsfMRI were performed pre and post intervention. Clopper Pearson exact 95% confidence intervals for the proportion of participants with a clinically relevant increase in Lv were calculated. Linear regression was used to test if Lv at baseline significantly predicted the change following HiCommunication. Complete rsfMRI data were available from 28 participants in the HiCommunication group. Spectral dynamic causal modeling  and the parametric empirical Bayes  methods were applied to describe effective connectivity changes in a speech related network .
Results: The percentage of participants with a clinically relevant increase in Lv after HiCommunication was 59%, CI [41%, 75%] and after HiBalance 13%, CI [4%, 28%]. It was found that Lv at baseline significantly predicted the change in Lv after HiCommunication (β = -0.332 p = 0.009). Pre HiCommunication an inhibitory effective connectivity from the right to the left supplementary motor area (SMA) was found. Further, the left SMA to the left paracentral gyrus showed inhibitory connectivity. Excitatory effective self-connectivity was found in the left SMA and paracentral gyrus. Post HiCommunication, the inhibitory effective connectivity from the right to the left SMA decreased and was the only effective connectivity found.
Conclusion: The results from this study suggest clinically relevant effects on Lv after HiCommunication. Notably, participants with a lower Lv at baseline showed a larger change in Lv following the intervention. Furthermore, resting-state connectivity was altered after the intervention. These changes could be a result of underlying compensatory effects but need further investigation.
References:  E. Schalling, H. Winkler, and E. Franzén, “HiCommunication as a novel speech and communication treatment for Parkinson’s disease: A feasibility study,” Brain and behavior, pp. e02150-e02150, 2021.
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To cite this abstract in AMA style:H. Steurer, F. Albrecht, A. Razi, J. Körner Gustafsson, E. Franzén, E. Schalling. Effects on voice sound level and brain connectivity after HiCommunication: a novel speech and communication treatment for Parkinson’s disease [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/effects-on-voice-sound-level-and-brain-connectivity-after-hicommunication-a-novel-speech-and-communication-treatment-for-parkinsons-disease/. Accessed September 22, 2023.
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