Predicting Intelligibility Deficits in Parkinson's Disease With Perceptual Speech Ratings.

Purpose: This study investigated whether perceptual ratings of speech parameters were predictive of transcription intelligibility in quiet and in noise for speakers with Parkinson's disease (PD). Method: Ten speakers with PD and five healthy controls read 56 sentences. One group of 60 listeners orthographically transcribed the sentences in quiet, and another group of 60 listeners transcribed in noise. An additional 23 listeners judged a variety of speech parameters, including articulation, prosody, resonance, voice quality, and ease of understanding on a visual analog scale. Scores of the visual analog scale ratings were regressed against transcription intelligibility in quiet and in noise. Results: Perceptual ratings of all the speech parameters were lower for speakers with PD. Global speech understanding, indexed by ease of understanding ratings, was associated with transcription intelligibility in quiet and in noise with a stronger effect in noise. Among the rated speech parameters, ease of understanding and voice quality ratings were significant predictors of speech intelligibility in noise. Conclusions: Speech in individuals with PD was more difficult for listeners to understand and was characterized by deficits in articulation, prosody, resonance, and voice quality compared to normal speech produced by healthy older adults. Ease of understanding ratings, even when performed in quiet, predicted intelligibility in noise. Poor voice quality ratings in PD, a sign of phonatory deficit, had a negative impact on intelligibility in noise for speakers with PD.