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  • 1. Ballard, Kirrie J.
    et al.
    Djaja, Danica
    Arciuli, Joanne
    James, Deborah G. H.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Developmental Trajectory for Production of Prosody: Lexical Stress Contrastivity in Children Ages 3 to 7 Years and in Adults2012In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 55, no 6, 1822-1835 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: Accurate production of lexical stress within English polysyllabic words is critical for intelligibility and is affected in many speech-language disorders. However, models of speech production remain underspecified with regard to lexical stress. In this study, the authors report a large-scale acoustic investigation of lexical stress production in typically developing Australian English-speaking children ages 3-7 years (n = 73) compared with young adults (n = 24).

    Method: Participants named pictures of highly familiar strong-weak and weak-strong polysyllabic words. Of 388 productions, 325 met criteria for acoustic measurement. Relative vowel duration, peak intensity, and peak f(0) over the first two syllables were measured.

    Result: Lexical stress was marked consistently by duration and intensity but not f(0). Lexical stress on strong-weak words was adultlike by 3 years. All 3 measures showed significant differences between adults and children for weak-strong words still present at 7 years.

    Conclusion: Our findings suggest that protracted development of weak-strong stress production reflects physiological constraints on producing short articulatory durations and rising intensity contours. Findings validate treatment that is centered on strong-weak stress production for children >= 3 years with dysprosody. Although intervention for the production of weak-strong words may be initiated before age 7 years, reference to normative acoustic data is preferable to relying on perceptual judgments of accuracy.

  • 2.
    Brunnegård, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Lohmander, Anette
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Comparison between perceptual assessments of nasality and nasalance scores2012In: International journal of language and communication disorders, ISSN 1368-2822, E-ISSN 1460-6984, Vol. 47, no 5, 556-566 p.Article in journal (Refereed)
    Abstract [en]

    Background: There are different reports of the usefulness of the Nasometer™ as a complement to listening, often as correlation calculations between listening and nasalance measurements. Differences between findings have been attributed to listener experience and types of speech stimuli.

    Aims: To compare nasalance scores from the Nasometer with perceptual assessments, for the same and different Swedish speech stimuli, using three groups of listeners with differing levels of experience in judging speech nasality. Methods & Procedures: To compare nasalance scores and blinded listener ratings of randomized recordings using three groups of listeners and two groups of speakers. Speakers were either classified as having hypernasal speech or speech with typical speech resonance. Listeners were speech-language pathologists (SLPs) working predominantly with resonance disorders, other SLPs and untrained listeners.

    Outcomes & Results: Correlations (r(s) ) between hypernasality ratings and nasalance scores for each listener group and speech stimuli were calculated. For both groups of SLPs all correlations between perceptual ratings and nasalance scores were significant at p= 0.01. The correlations between the nasalance scores and ratings by listeners in the SLP groups were higher than those for the untrained listener group regardless of stimulus type. Post-hoc Mann-Whitney U-tests showed that the only difference that was significant was expert SLP group versus untrained listener group. Secondly, correlations between perceptual ratings and oral stimulus nasalance scores were higher when the perceptual ratings were based on spontaneous speech rather than on the oral stimulus. However, a Wilcoxon signed rank test showed that the difference was not significant. A third finding was that correlations between oral stimulus nasalance scores and perceptual scores were higher than those between mixed stimulus nasalance scores and perceptual scores. A Wilcoxon signed rank test showed that the difference was significant.

    Conclusions & Implications: The Nasometer might be useful for the SLP with limited experience in assessing resonance disorders in differentiating between hyper- and hyponasality. With listener reliability for ratings of hypernasality still being an issue, the use of a nasalance score as a complement to the perceptual evaluation will also aid the expert SLP. It will give an alternative way of quantifying speech resonance and might help in especially hard to judge cases.

  • 3.
    Brunnegård, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Lohmander, Anette
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Untrained listeners’ ratings of speech disorders in a group with cleft palate: a comparison with speech and language pathologists’ ratings2009In: International journal of language and communication disorders, ISSN 1368-2822, E-ISSN 1460-6984, Vol. 44, no 5, 656-674 p.Article in journal (Refereed)
    Abstract [en]

    Background: Hypernasal resonance, audible nasal air emission and/or nasal turbulence, and articulation errors are typical speech disorders associated with the speech of children with cleft lip and palate. Several studies indicate that hypernasal resonance tends to be perceived negatively by listeners. Most perceptual studies of speech disorders related to cleft palate are carried out with speech and language pathologists as listeners, whereas only a few studies have been conducted to explore how judgements by untrained listeners compare with expert assessments. These types of studies can be used to determine whether children for whom speech and language pathologists recommend intervention have a significant speech deviance that is also detected by untrained listeners.

    Aims: To compare ratings by untrained listeners with ratings by speech and language pathologists for cleft palate speech.

    Methods & Procedures: An assessment form for untrained listeners was developed using statements and a five-point scale. The assessment form was tailored to facilitate comparison with expert judgements. Twenty-eight untrained listeners assessed the speech of 26 speakers with cleft palate and ten speakers without cleft in a comparison group. This assessment was compared with the joint assessment of two expert speech and language pathologists.

    Outcomes & Results: Listener groups generally agreed on which speakers were nasal. The untrained listeners detected hyper- and hyponasality when it was present in speech and considered moderate to severe hypernasality to be serious enough to call for intervention. The expert listeners assessed audible nasal air emission and/or nasal turbulence to be present in twice as many speakers as the untrained listeners who were much less sensitive to audible nasal air emission and/or nasal turbulence.

    Conclusions & Implications: The results of untrained listeners' ratings in this study in the main confirm the ratings of speech and language pathologists and show that cleft palate speech disorders may have an impact in the everyday life of the speaker.

  • 4.
    Brunnegård, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Normative data on nasalance scores for Swedish as measured on the Nasometer™ II: influence of regional dialect, gender and age2009In: Clinical linguistics and phonetics, ISSN 1368-2822, Vol. 23, no 1, 58-69 p.Article in journal (Refereed)
    Abstract [en]

    This study was conducted to establish normative nasalance values for Swedish speaking children as measured with the Nasometer™ II, and to investigate differences due to regional dialect, gender, and age. Two hundred and twenty healthy children aged 4-5, 6-7, and 9-11 years were included. Group mean nasalance scores for four speech stimuli were calculated and compared. There were no significant differences due to dialect or gender for children in the study. For age there was a significant difference on nasal sentences between the youngest group of children and the other two groups, age 4-5 vs age 6-7 (t = -2.844, p = .006) and for age 4-5 vs age 9-11 (t = -2.888, p = .005). The results from this study have both clinical significance for Swedish SLPs working with resonance disorders, and theoretical significance for linguists studying features of dialects and languages.

  • 5.
    Doorn, Jan van
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Karlsson, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy. Umeå University, Faculty of Arts, Department of language studies.
    Influence of speech task and utterance length on the measurement of pitch variability in the speech of Parkinson's disease patients after deep brain stimulation2013Conference paper (Other academic)
    Abstract [en]

    Parkinson’s disease (PD) affects patients voice characteristics, reducing pitch variability compared to normal controls (1,2). Previous reports have shown an increase in pitch variability due to deep brain stimulation (DBS) of the Subthalamic nucleus (STN) (3). For patients stimulated in caudal zona incerta (cZi), the results indicate no effect on pitch variability in a read speech task{Karlsson:2012jr}.

    The present study aimed at investigating the effects of speech task (spontaneous or read speech) and the lenght of the utterance on overall measures of pitch variability observed in DBS-treated patients. Ten patients treated with STN-DBS and ten patients treated with cZi-DBS were included in this prospective study.

    Utterances produced sponatenously and produced during readings of a standard passage were compared in terms of treatment effects in pitch variability due to STN-DBS and cZi-DBS (Stim OFF and Stim ON recordings made 1,5 hour apart, all in Med ON) 6 and 12 months after operation. The results indicate that pitch variability is affected differently by STN-DBS and cZi-DBS depending on speech task and utterance length. In short utterances (<10 words), an increase in pitch variability is observed for both treatment groups and both speech tasks. For longer utterances, however, a more diverse effect of treatment and speech task is observed. The results therefore suggest that spech task and characteristics of thate utterance should be carefully considered when drawing conclusions on the overall effect of DBS on pitch variability.

    1. Jiménez-Jiménez FJ, Gamboa J, Nieto A, Guerrero J, Ortí-Pareja M, Molina JA, et al. Acoustic voice analysis in untreated patients with Parkinson's disease. Parkinsonism Relat. Disord. 1997 Apr;3(2):111–6. 

    2. Holmes RJ, Oates JM, Phyland DJ, Hughes AJ. Voice characteristics in the progression of Parkinson’s disease. International Journal of Language & Communication Disorders. 2000;35(3):407–18. 

    3. Dromey C, Kumar R, Lang AE, Lozano AM. An investigation of the effects of subthalamic nucleus stimulation on acoustic measures of voice. Mov. Disord. 2000;15(6):1132–8.

  • 6.
    Eklund, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Qvist, Johanna
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Sandström, Lena
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Viklund, Fanny
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Karlsson, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy. Umeå University, Faculty of Arts, Department of language studies.
    Perceived articulatory precision in patients with Parkinson’s disease after deep brain stimulation of subthalamic nucleus and caudal zona incerta2015In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 29, no 2, 150-166 p.Article in journal (Refereed)
    Abstract [en]

    The effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and caudal zona incerta (cZi) on speech articulation in patients with Parkinson’s disease (PD) was investigated. Read speech samples were collected from nine patients with STN-DBS and ten with cZi-DBS. The recordings were made preoperatively and 12 months postoperatively with stimulator on and off (on medication). Blinded, randomized, repeated perceptual assessments were performed on words and isolated fricatives extracted from the recordings to assess 1) overall articulatory quality ratings, 2) frequency of occurrence of misarticulation patterns, and 3) fricative production. Statistically significant worsening of articulatory measures on- compared with off-stimulation occurred in the cZi-DBS group, with deteriorated articulatory precision ratings, increased presence of misarticulations (predominately altered realizations of plosives and fricatives) and a reduced accuracy in fricative production. A similar, but not significant, trend was found for the STN-DBS group. 

  • 7.
    Eriksson, Erik J
    et al.
    Umeå University.
    Sullivan, Kirk PH
    Umeå University, Faculty of Arts, Department of language studies.
    Zetterholm, Elisabeth
    Linneus University.
    Czigler, Peter E
    Örebro University.
    Green, James
    Otago University.
    Skagerstrand, Åsa
    Örebro University.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Detection of imitated voices: who are reliable earwitnesses?2010In: International Journal of Speech Language and The Law, ISSN 1748-8885, E-ISSN 1748-8893, Vol. 17, no 1, 25-44 p.Article in journal (Refereed)
    Abstract [en]

    Factors affecting an individual’s ability to identify people aurally are of forensic importance.This paper investigates how topic, dialect, gender, age, and hearing statusaffect detection of an imitated voice. Two imitations of the same person, but ondifferent topics, were used as familiarization voices. One topic was associated withthis person, and the other was not. Using discrimination sensitivity (d-prime) it wasfound that topic had a significant impact on d’, as did age (but only when the topicwas not associated with the imitated person). Dialect, gender and hearing statuswere not significant. The older group of listeners was less convinced by the imitationsand in particular the one not associated with the person being imitated. These resultsimply that the validity of earwitness evidence is negatively affected by age and topic.

  • 8. James, Deborah G H
    et al.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    McLeod, Sharynne
    The contribution of polysyllabic words in clinical decision making about children's speech.2008In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, ISSN 0269-9206, Vol. 22, no 4-5, 345-53 p.Article in journal (Refereed)
    Abstract [en]

    Poor polysyllabic word (PSW) production seems to mark paediatric speech impairment as well as impairment in language, literacy and phonological processing. As impairment in these domains may only manifest in PSWs, PSW production may provide unique information that is often excluded from clinical decision making because insufficient PSWs are included in speech tests. A 5-stage model of PSW acquisition is described. The model, grounded in optimality theory, expresses a reciprocal relationship between the relaxation of markedness constraints and the contraction of faithfulness constraints from 12 months of age to adolescence. The markedness constraints that persist to the age of 7;11 years are associated with non-final weak syllables and within-word consonant sequences. Output changes are argued to reflect increasing specification of phonological representations with age, liberating information for motor planning and execution, resulting in increasingly accurate output. The clinical implications of PSWs in assessment and therapy are discussed.

  • 9. James, Deborah G H
    et al.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    McLeod, Sharynne
    Esterman, Adrian
    Patterns of consonant deletion in typically developing children aged 3 to 7 years.2008In: International journal of speech-language pathology, ISSN 1754-9507, Vol. 10, no 3, 179-92 p.Article in journal (Refereed)
    Abstract [en]

    Children with and without speech, language and/or literacy impairment, delete consonants when they name pictures to elicit single words. Consonant deletion seems to be more frequent in long words (words of three or more syllables) than in short words (words of one or two syllables). However, it may be missed in long words because they are not routinely assessed and, even if they are, there is little normative data about them. The study aims were (1) to determine if a relationship exists between consonant deletion and the number of syllables in words, (2) delimit variation in the numbers of children using it, its frequency of occurrence and the words it affects and (3) to discuss the application of these data to clinical practice. The participants were 283 typically developing children, aged 3;0 to 7;11 years, speaking Australian English with proven normal language, cognition and hearing. They named pictures, yielding 166 selected words that were varied for syllable number, stress and shape and repeatedly sampled all consonants and vowels of Australian English. Almost all participants (95%) used consonant deletion. Whilst a relationship existed between consonant deletion frequency and the number of syllables in words, the syllable effect was interpreted as a proxy of an interaction of segmental and prosodic features that included two or more syllables, sonorant sounds, non-final weak syllables, within-word consonant sequences and/or anterior-posterior articulatory movements. Clinically, two or three deletions of consonants across the affected words may indicate typical behaviour for children up to the age of 7;11 years but variations outside these tolerances may mark impairment. These results are further evidence to include long words in routine speech assessment.

  • 10.
    Jonsson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    van Doorn, Janis
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    van den Bergh, Johannes
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Parents’ perceptions of eating skills of pre-term vs full-term infants from birth to 3 years2013In: International Journal of Speech-Language Pathology, ISSN 1754-9507, E-ISSN 1754-9515, Vol. 15, no 6, 604-612 p.Article in journal (Refereed)
    Abstract [en]

    Difficulties with feeding and eating are more common among pre-term infants compared with full-term infants. The primary objective of this study was to describe parents 'perceptions of developmental eating patterns and occurrence of eating difficulties in a group of pre-term infants, compared with a control group. A parent questionnaire was administered for a study group (27 pre-term infants born between 28-33 weeks gestation) and a control group (29 full-term infants born between 38-41 weeks gestation). Parents of the pre-term children reported significantly more problems with early feeding, but only half of them reported that their infants received intervention to aid their feeding development during neonatal care. At 3 years of age the pre-term children weighed significantly less than the full-term children, but their parents were more satisfied with their eating habits and portion sizes than the control group parents. This finding may reflect differing parenting experiences between the two groups rather than an actual difference in eating skills. It suggests that parents of pre-term infants would benefit from practical guidance in supporting their premature infants in developing eating skills. Future studies using objective measures are recommended to verify the findings reported here.

  • 11.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Olofsson, Katarina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Control of phonatory onset and offset in Parkinson patients following deep brain stimulation of the subthalamic nucleus and caudal Zona Incerta2012In: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 18, no 7, 824-827 p.Article in journal (Refereed)
    Abstract [en]

    Laryngeal hypokinesia is a common symptom in Parkinson’s disease (PD) that affects quality of life. Deep brain stimulation (DBS) is well recognized as a complementary method for treatment of motor symptoms in PD but the outcomes on patients’ control over phonatory alternation have yet not been clearly elucidated. The present study examined the effect of subthalamic nucleus STN-DBS (n=8, aged 51-72 yrs; median=63 yrs) and caudal Zona incerta cZi-DBS (n=8,aged 49-71 yrs; median=61 yrs) on control of onset and offset of phonation in connected speech. The patients were evaluated in a preoperatively (Med ON, 1.5 times the ordinary Levodopa dose) and 12 months postoperatively (Med ON, ordinary Levodopa dose). The results provided evidence of a progressive reduction in the ability to manifest alternations between voicing and voiceless states in a reading task. Mean proportion produced with inappropriate voicing increased from 47.6% to 55.3% and from 62.9% to 68.6% of the total duration for the two groups of patients between Pre-op and Post-op, Stim OFF evaluations. The medial and final parts of the fricative were more affected than the initial part, indicating an increased voicing lead into the following vowel. We propose that this reduction in phonatory control is be due to either progression of the disease, an effect of reduced Levodopa dosage or a microlesional effect. Patients’ proficiency in alternating between voiced and voiceless states in connected speech remained unaffected by both STN-DBS and cZi-DBS.

  • 12.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Applying the Vowel Formant Dispersion (VFD) method to the study of reduced or alterered vowel productions2012Conference paper (Other academic)
    Abstract [en]

    Formant centre frequencies are regularly used as acoustic measure of vowel quality because of the well established correlation between them and properties of vowel production(Fant, 1960). While it is recognised that it is important transform formant frequencies, as measured from the spectrogram, into relevant psychoacoustic scales when addressing issues of vowel perception, production studies are still largely based on the the raw, Hz-scaled, formant measurements. As a consequence, systematic studies of vowel articulation proficiency due to clinical conditions or effects of treatment are not easily afforded. 

    A number of derived measures have been proposed to capture whole-system effect of vowel production. Previous research has primarily used the calculated total area of formants measured from either [a], [u], [i] and [æ] or only [a], [u] and [i] productions, joined together to form a quadrilateral or a triangle (Vowel space area, VSA)(Kent & Kim, 2003). In the reduced articulatory range of hypokinetic dysarthria, VSA is expected to be reduced by the dysarthria, and increased due to successful treatment the patient’s articulatory range. 

    However, VSA has been proposed to be not powerful enough to capture effects on vowel articulation found specifically in patients with Parkinson’s disease (PD), and therefore not able to establish treatment effects.

    Two alternative measures have been proposed previously that are more focused towards specifically towards finding expansion and reductions in vowel spaces, the Vowel articulation index (VAI)(Roy, Nissen, Dromey, & Sapir, 2009) or Formant Centralization Ratio (FCR)(Sapir, Ramig, Spielman, & Fox, 2010). Both VAI and FCR has been shown to be able to establish significant reductions vowel articulation due to PD. Similar to VSA, however, the VAI and FCR measures do not given any detailed insight into the nature of the change in articulation. Further, all three measures reduces all obtained vowel formant measurements into a single metric, resulting in a substantial loss of statistical power and a considerable reduction in quality of intra-speaker models of articulatory proficiency. 

    In response to the problematic properties of previous metrics, a revised view of formant frequencies more suitable for studies of changes in vowel articulation has recently been outlined, along with a new metric (Vowel Formant Dispersion, VFD). The VFD view of vowel formants are more closely connected to properties of vowel articulation and therefore affords more more detailed interpretations to be drawn concerning speakers’ production proficiency and offers increased reliability of within speaker estimates of this proficiency. This paper presents a detailed view of how VFD may applied to clinical populations where vowel production is affected by the condition (e.g. hypokinetic dysarthria) or where production should be affected (e.g. transexual patients or in successful treatment of dysarthric patients). It will be shown that most aspects of the study of vowel articulation proficiency will be significantly enhanced by the VFD method.

  • 13.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Arts, Department of language studies.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Automatic acquisition of jitter and shimmer measurements across large sets of sustained vowel productions2012Conference paper (Other academic)
    Abstract [en]

    Measurements of jitter and shimmer are frequently employed to quantify laryngeal control and stability during voice production in patients(1-3). Accurate estimates of jitter and shimmer may be obtained from acoustic recordings of sustained vowels produced by patients using computer software implementing algorithms for their extraction (e.g. Praat(4) or MDVP(5)). The jitter and shimmer algorithms do not, in themselves, exclude non-stable productions and are influenced by the inclusion of silence in the analysed intervals. As a consequence, reliable measurements of jitter and shimmer are made by manually opening each sound file and selecting an interval for the computations. 

    The current paper proposes an alternative approach to afford a more efficient estimation of jitter and shimmer across a large set of sustained vowel recordings. Using information readily available in the acoustic signal and a combination of algorithms already available within the Praat program, a reliable method for automatic processing of only the sustained vowel in each recording of a large corpus is outlined. The method further affords the acquisition of multiple, repeatable, measurements of jitter and shimmer for sub-intervals of the vowel’s duration (applying more than one algorithm), which additionally provides information concerning the reliability of the jitter or shimmer estimates for a specific vowel  production. Comparisons with manually obtained measurements are made for the purpose of validation of the segmentation method.

  • 14.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Letter to the Editor2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 26, no 5, 676.e1Article in journal (Other academic)
  • 15.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Arts, Department of language studies.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Vowel formant dispersion as a measure of articulation proficiency2012In: Journal of the Acoustical Society of America, ISSN 0001-4966, Vol. 132, no 4, 2633-2641 p.Article in journal (Refereed)
    Abstract [en]

    The articulatory range of a speaker has previously been estimated by the shape formed by first and second formant measurements of produced vowels. In a majority of the currently available metrics, formant frequency measurements are reduced to a single estimate for a condition, which has adverse consequences for subsequent statistical testing. Other metrics provide estimates of size of vowel articulation changes only, and do not provide a method for studying the direction of the change. This paper proposes an alternative approach. Vowel formant frequencies are re-defined as vectors originating from a defined center point of the vowel space fixed to a basic three-vowel frame. The euclidian length of the vectors, the Vowel Formant Dispersion (VFD), can be compared across conditions for evidence of articulatory expansions or reductions across conditions or speaker groups. Further, the angle component of the vowel vectors allows for analyses of direction of the reduction or expansion. Based on the range of investigations afforded by the VFD metric, and simulation experiments that compare its statistical properties with those of other proposed metrics, it is argued that the VFD procedure offers an enhanced view of vowel articulation change over rival metrics.

  • 16.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Olofsson, Katarina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Pitch variability in patients with Parkinson’s disease: effects of deep brain stimulation of caudal zona incerta and subthalamic nucleus2013In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 56, no 1, 150-158 p.Article in journal (Refereed)
    Abstract [en]

    Objective The purpose of the present study was to examine the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the caudal zona incerta (cZi) pitch characteristics of con- nected speech in patients with Parkinson’s disease (PD).

    Methods Sixteen patients were evaluated preoperatively and 12 months after DBS surgery. Eight pa- tients were implanted in the STN (aged 51-72 yrs; xC=63 yrs). Six received bilateral implanta- tion and two unilateral (left) implantation. Eight patients were bilaterally implanted in the cZi (aged 49-71 yrs; xC=60.8 yrs). Preoperative assessments were made after an L-Dopa challenge (approximately 1.5 times the ordinary dose). All postoperative examinations were made off and on stimulation, with a clinically optimized dose of L-dopa. Measurements of pitch range and var- iability were obtained from each utterance in a recorded read speech passage.

    Results Pitch range and coefficient of variation showed an increase in patients under STN-DBS. Patients under cZi-DBS showed no significant effects of treatment on investigated pitch properties.

    Conclusions STN-DBS was shown to increase pitch variation and range. The results provided no evidence of cZi-DBS having a beneficial effect on PD patients’ pitch variability. 

  • 17.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Arts, Department of language studies. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Olofsson, Katarina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Blomstedt, Patric
    Linder, Jan
    Nordh, Erik
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Articulatory closure proficiency in Parkinson's disease patients following deep brain stimulation of the subthalamic nucleus and caudal zona incerta.2014In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 57, 1178-1190 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE

    The present study aimed at comparing the effects of deep brain stimulation (DBS) treatment of the subthalamic nucleus (STN) and the caudal zona incerta (cZi) on Parkinson's disease patients' proficiency in achieving oral closure and release during plosive production. METHODS Nineteen patients were evaluated preoperatively and 12 months after DBS surgery. Nine patients were implanted in the STN, seven bilaterally and two unilaterally (left). Ten were bilaterally implanted in the cZi. Postoperative examinations were made off and on stimulation. All patients received simultaneous L-dopa treatment in all conditions. For a series of plosives extracted from a reading passage, absolute and relative measures of duration of frication and amplitude of plosive release were compared between conditions within each treatment group. RESULTS Relative duration of frication increased in voiceless plosives in the on stimulation condition in cZi patients. Similar trends were observed across the data set. Duration of pre-release frication and the release peak prominence increased in voiceless plosives on stimulation for both groups. CONCLUSIONS The increased release prominence suggests that patients achieved a stronger closure gesture due to DBS, but that the increased energy available resulted in increased frication.

  • 18.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Arts, Philosophy and Linguistics.
    Sullivan, Kirk P H
    Umeå University, Faculty of Arts, Philosophy and Linguistics.
    Czigler, Peter E.
    van Doorn, Jan
    Faculty of Medicine, Clinical Sciences.
    Acoustic correlates of voicing in a child's production of plosives2002In: Proceedings of the 9th Australian International Conference on Speech Science & Technology, 2002Conference paper (Other academic)
  • 19.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Arts, Department of language studies.
    Sullivan, Kirk P H
    Umeå University, Faculty of Arts, Department of language studies.
    Svonni, Michael
    Umeå University, Faculty of Arts, Department of language studies.
    Van Doorn, Janis
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Wenstedt, Ola
    The acoustic manifestation of consonant gradation in Northern Sami2008In: Journal of the Acoustical Society of America, Vol. 123, no 5 (part 2), 3885- p.Article in journal (Refereed)
  • 20.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Arts, Philosophy and Linguistics. Lingvistik.
    Sullivan, Kirk P H
    Umeå University, Faculty of Arts, Philosophy and Linguistics. Lingvistik.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Clinical Sciences, Speech and Language Therapy.
    Czigler, Peter E.
    Då or Tå, Pår or Bår - Seeing is believing!2003In: Proceeding of the 15th International Congress of Phonetic Sciences, 2003Conference paper (Other academic)
    Abstract [en]

    Several acoustic properties of plosives have been established as correlates of voicing contrast, including voice onset time (VOT), F1 cut-back, aspiration duration and initial F1 and F2 transition. Therefore, acquisition of the voicing contrast for plosives could be viewed as gaining the ability to combine interacting acoustic cues in an adult-like manner, resulting in a large number of possible developmental routes. The presented investigation examined initial plosives produced by one child from ages 18¿31 months that had been judged as voiced in an auditory analysis. The results show that some perceptually voiced and unaspirated plosives (elicited using voiceless targets) were produced with VOT values within the range of voiceless plosives for adult speakers of Swedish, and also had increased duration of high frequency, aperiodic friction after plosive release. It was conjectured that the child was attempting a voicing contrast by using increased VOT and increased duration of aperiodic friction that were not perceptible to adult listeners.

  • 21.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Unger, Elin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Wahlgren, Sofia
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Zafar, Hamayun
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Deep brain stimulation of caudal zona incerta and subthalamic nucleus in patients with Parkinson’s disease: effects on diadochokinetic rate2011In: Parkinson’s Disease, ISSN 2042-0080, Vol. 2011, 605607- p.Article in journal (Refereed)
    Abstract [en]

    The hypokinetic dysarthria observed in Parkinson's disease (PD) affects the range, speed, and accuracy of articulatory gestures in patients, reducing the perceived quality of speech acoustic output in continuous speech. Deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) and of the caudal zona incerta (cZi-DBS) are current surgical treatment options for PD. This study aimed at investigating the outcome of STN-DBS (7 patients) and cZi-DBS (7 patients) in two articulatory diadochokinesis tasks (AMR and SMR) using measurements of articulation rate and quality of the plosive consonants (using the percent measurable VOT metric). The results indicate that patients receiving STN-DBS increased in articulation rate in the Stim-ON condition in the AMR task only, with no effect on production quality. Patients receiving cZi-DBS decreased in articulation rate in the Stim-ON condition and further showed a reduction in production quality. The data therefore suggest that cZi-DBS is more detrimental for extended articulatory movements than STN-DBS.

  • 22.
    Karlsson, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy. Umeå University, Faculty of Arts, Department of language studies.
    Unger, Elin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Wahlgren, Sofia
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Treatment effects in voice onset time of plosives associated with deep brain stimulation of the subthalamic nucleus and the caudal zona incerta2012In: Journal of medical speech-language pathology, ISSN 1065-1438, Vol. 20, no 4, 65-69 p.Article in journal (Refereed)
    Abstract [en]

    The present study investigated the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the caudal zona inserta (cZi) on motor control and coordination in plosives. A total of 2520 plosive productions, recorded during production of alternate motion rate and sequential motion rate tasks, were measured for voice onset time (VOT) when measurement was possible. Failed measurements were classified by the underlying cause. The resulting data were analyzed separately for each place of articulation of the intended plosive and compared with the articulatory properties of plosives not meeting the requirements for VOT measurement. The results showed no consistent overall stimulation effect in VOT regardless of place of articulatory closure. Furthermore, no overall pattern concerning the distribution of factors causing failures to measure VOT was observed. Instead, the results suggest a more complex interaction among place of articulation, speech task, and stimulation target in the determination of treatment effects of DBS in patients with Parkinson's disease (PD). The results further suggest that VOT may not provide a robust estimate of treatment effects in articulatory proficiency related to plosive production in patients with PD.

  • 23.
    Kulneff, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Sundstedt, Stina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Olofsson, Katarina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Deep brain stimulation: effects on swallowing function in Parkinson's disease2013In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 127, no 5, 329-336 p.Article in journal (Refereed)
    Abstract [en]

    Objective: In patients with Parkinson’s disease (PD), deep brainstimulation of the subthalamic nucleus (STN DBS) is well recognizedin improving limb function, but the outcome on swallowing functionhas rarely been studied. The aim of this work was to evaluate theeffect of STN DBS on pharyngeal swallowing function in patientswith PD using self-estimation and fiberoptic endoscopic evaluation ofswallowing.

    Methods: Eleven patients (aged 41–72, median 61 years)were evaluated preoperatively and at 6 and 12 months after STN DBSsurgery. All patients were evaluated with self-estimation on a visualanalogue scale, and eight of them with a fiberoptic endoscopicexamination with a predefined swallowing protocol includingRosenbek’s Penetration-Aspiration Scale, Secretion Severity Scale,preswallow spillage, pharyngeal residue, and pharyngeal clearance.

    Results: The self-assessments of swallowing function revealed asubjective improvement with STN DBS stimulation, whereas the datafrom the swallowing protocol did not show any significant effect ofthe STN DBS treatment itself. The prevalence of aspiration was notaffected by the surgery.

    Conclusions: The results show thatswallowing function was not negatively affected by STN DBS and therisk of aspiration did not increase. Self-estimation of swallowingfunction showed a subjective improvement due to stimulation.

  • 24.
    Louise, Johansson
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Sofia, Möller
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Olofsson, Katarina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Karlsson, Fredrik
    Umeå University, Faculty of Arts, Department of language studies. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Word-level intelligibility after caudal zona incerta stimulation for Parkinson’s disease2014In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 130, no 1, 27-33 p.Article in journal (Refereed)
    Abstract [en]

    Objectives – To investigate the effect of caudal zona incerta-deep brain stimulation (cZi-DBS) on word-level speech intelligibility in patients with Parkinson’s disease, under both an optimal listening condition and a simulated more naturalistic listening condition.

    Materials and methods – Spoken single words were extracted from read samples collected from 10 bilaterally implanted patients with PD pre- and post-cZi-DBS. Intelligibility was assessed through a transcription task performed by 32 naive listeners under two listening conditions: (i) with low-amplitude conversational speech added as background and (ii) with no added background noise. The listeners′ responses were scored in terms of agreement with the intended words.

    Results – Post-operatively, the total intelligibility score was significantly lower when cZi stimulation was switched on compared with off, for both listening conditions (with and without added background noise). Intelligibility was also significantly lower on stimulation compared with preoperative recordings, but only when assessed in the listening condition without background noise. The listening condition with added background noise resulted in significantly lower intelligibility scores compared with the no added noise condition for all stimulation conditions.

    Conclusions – The results of this study indicate that cZi-DBS in patients with PD can be detrimental to word-level speech intelligibility. 

  • 25.
    Lundgren, Sofie
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Saeys, Thomas
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Karlsson, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Olofsson, Katarina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Zafar, Hamayun
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Doorn, Jan van
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Deep brain stimulation of caudal zona incerta and subthalamic nucleus in patients with Parkinson’s disease: effects on voice intensity2011In: Parkinson’s Disease, ISSN 2042-0080, Vol. 2011, 658956- p.Article in journal (Refereed)
    Abstract [en]

    Deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson’s disease (PD) affects speech in small, inconsistent ways. However, voice intensity generally increases. Recently the caudal zona inserta (cZi) has been investigated as an alternate target in DBS treatment of PD. The effects of cZi-DBS on voice intensity have not yet been investigated. The aim of this study was to compare the voice intensity effects of cZi-DBS and STN-DBS in PD patients. Voice intensity during reading and intensity decay during rapid syllable repetition were measured for eight STN-DBS and eight cZi-DBS patients in a pre-surgical baseline and then on- and off-stimulation 12 months after surgery. Voice intensity on-stimulation was larger than off-stimulation for the STN-DBS patients, but smaller for the cZi-DBS patients. There were no significant changes in intensity decay. The results suggest that cZi and STN are involved differently in neuromuscular control of the speech respiratory subsystem.

  • 26. Lövgren, Tobias
    et al.
    van Doorn, Janis
    Umeå University, Faculty of Medicine, Clinical Sciences, Speech and Language Therapy.
    Influence of manipulation of short silent pause duration on speech fluency2005In: Disfluency in Spontaneous Speech Workshop 2005, 2005Conference paper (Other academic)
  • 27.
    Nygren, Mariana
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Tyboni, Mikaela
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Lindstrom, Fredric
    McAllister, Anita
    van Doorn, Janis
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Gender Differences in Children's Voice Use in a Day Care Environment2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 26, no 6, 817.e15-817 e18 p.Article in journal (Refereed)
    Abstract [en]

    Background. The prevalence of dysphonia is higher in boys than in girls before puberty. This could be because of the differences in boys' and girls' voice use. Previous research on gender differences in prepubescent children's voice parameters has been contradictory. Most studies have focused on examining fundamental frequency. Objectives. The purpose of this study was to investigate voice use in boys and girls in a day care environment based on the voice parameters fundamental frequency (Hz), vocal intensity (dB SPL), and phonation time (%) and to ascertain whether there were any significant gender differences. Study Design. Prospective comparative design. Method. The study was conducted in a day care environment where 30 children (17 boys and 13 girls aged 4-5 years) participated. The participants' voices were measured continuously for 4 hours with a voice accumulator that registered fundamental frequency, vocal intensity level, phonation time, and background noise. Results. Mean (standard deviation) fundamental frequency was 310 (22) and 321 (16) Hz, vocal intensity was 93 (4) and 91 (3) dB SPL, and phonation time was 7.7 (2.0)% and 7.6 (2.5)% for boys and girls, respectively. No differences between genders were statistically significant. Conclusion. The finding of no statistically significant gender differences for measurements of voice parameters in a group of children aged 4-5 years in a day care environment is an important finding that contributes to increased knowledge about young boys' and girls' voice use.

  • 28.
    Olofsson, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Kulneff, Linda
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Djup hjärnstimulering vid dysfagi hos parkinsonpatienter: den självskattade sväljningsfunktionen förbättrades i pilotstudie2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 17, 1150-1154 p.Article in journal (Other academic)
  • 29.
    Sandvik, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Rosendal, Åsa
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Birgander, Richard
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Thalamotomy for essential tremor: a very long-term follow-upManuscript (preprint) (Other academic)
    Abstract [en]

    Background: DBS (deep brain stimulation) is currently the golden standard in the surgical treatment of ET (essential tremor). Despite the benefits of DBS, there remain situations where lesional surgery may provide an alternative.

    Objective: To perform a very long-term retrospective evaluation of thalamotomies for ET.

    Methods: Nine patients who underwent thalamotomy for ET during 1972–1999 (follow-up period 20.8 ± 5.2 years) were assessed with regard to tremor scores, side effects, and quality of life, as well as lesion size and location.

    Results: All patients had tremor recurrence, although hand function remained slightly better on the treated side than on the non-treated side. Side effects that could be attributed to the procedure were frequent and did in some cases result in a disability for the patient. Quality of life was poorer in this group than in an age-adjusted healthy population. No correlation between lesion size, location, and long-term outcome could be established.

    Conclusions: In this study population the benefits of thalamotomies were limited, while complications were frequent.

  • 30.
    Sandvik, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Rosendal, Åsa
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    van Doorn, Janis
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Birgander, Richard
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Thalamotomy for essential tremor: a very long-term follow-up2012In: The Open Neurosurgery Journal, ISSN 1876-5297, Vol. 5, 1-7 p.Article in journal (Refereed)
    Abstract [en]

    Lesional procedures in the thalamus (thalamotomies)were introduced in 1954 by Hassler in the treatment of Parkinsoniantremor and were later also used for ET [1]. After theintroduction of Deep Brain Stimulation (DBS) by Benabid in1987, this technique has gradually replaced lesional surgeryand DBS is at present the treatment of choice for ET [2].DBS is considered to be a reversible technique with fewerrisks, especially in bilateral procedures [3]. Disadvantages ofDBS includehardware related complications, the high cost ofthe procedure, and the more cumbersome life-long follow-up[4]. The American Academy of Neurology gives thalamotomyevidence class C (probably effective) in a recent guidelineupdate [5].For these reasons lesional surgery has recentlybeen discussed as an alternative to DBS in certainselected cases [4].We have therefore decided to review thelong-term results of thalamotomies performed at our departmentby scoring the present symptoms and describing thepresence of persistent neurological deficits which might beattributed to the procedure.

  • 31.
    Sundstedt, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Olofsson, Katarina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Swallowing function in Parkinson’s patients following Zona Incerta deep brain stimulation2012In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 126, no 5, 350-356 p.Article in journal (Refereed)
    Abstract [en]

    Objective The purpose of the present study was to examine if there was a negative effect of caudal Zona Incerta deep brain stimulation (cZI DBS) on pharyngeal swallowing function in Parkinson’s patients (PD). There are no former reports on swallowing and cZI DBS.

    Methods Eight patients (aged 49 to 71 years; median 62) were evaluated pre- and postoperatively, at six and 12 months after DBS surgery. Evaluation tools were Fiberoptic Endoscopic Evaluation of Swallowing examinations and patients’ self-assessments of the swallowing function including a visual analogue scale and quality of life related questions. The swallowing protocol included Rosenbeck’s Penetration-Aspiration Scale, Secretion Severity Scale and parameters for pre-swallow spillage, pharyngeal residue and pharyngeal clearance.

    Results There was no clear-cut effect of neurostimulation postoperatively at six and 12 months on any of the swallowing parameters except for pre-swallow spillage which was slightly worsened in the stimulation on condition 12m postoperatively. The answers to the self assessment questions did not vary significantly.

    Conclusions The effect of the stimulation on swallowing function varied among individuals but the overall outcome was that cZI DBS did not seem to have a negative influence on swallowing function in the eight patients studied.

  • 32.
    van Doorn, Jan
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Bergh, Ida
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Brunnegård, Karin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Optimizing stimulus length for clinical nasalance measures in Swedish2009In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 22, no 4-5, 355-361 p.Article in journal (Refereed)
    Abstract [en]

    Standardized passages used for speech nasalance measures may be too long for clinical use with very young or non-compliant patients. The aim of this study was to establish whether nasalance scores from shorter sections of three Swedish speech stimuli were equivalent to those from their corresponding whole stimulus. Nasalance recordings for three Swedish speech stimuli (oral, nasal and oronasal) were obtained from 29 typically developing Swedish children (7-11 years). Cumulative sentence combinations were evaluated for equivalence to their respective whole passages according to two different criteria: one based on t-testing and the other on cumulative frequencies of score differences. Results showed that shorter sequences of sentences could be considered equivalent to the whole passage for the oral and nasal stimuli, provided that the sentences were sequenced in order of increasing difference from the whole stimulus score and that those sentences with scores significantly different from the whole passage score were not included.

  • 33.
    van Doorn, Jan
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Karlsson, Fredrik
    Umeå University, Faculty of Arts, Department of language studies.
    Sullivan, Kirk P. H.
    Umeå University, Faculty of Arts, Department of language studies.
    An acoustic investigation of the Swedish child’s acquisition of obstruent place of articulation2008In: Acoustics'08 Paris : June 29 - July 4, 2008, Paris: Société Française d'Acoustique (SFA) , 2008, 681-686 p.Conference paper (Other academic)
    Abstract [en]

    Speech produced by children in the initial stages of development does generally not uphold as many phonetic distinctions as speech sounds produced by adults. A child's productions of different target words may therefore have similar acoustic properties and result in homonyms being perceived by the adult observer. This study presents a longitudional investigation into the development of place of articulation from non‐distinctive to distinctive productions in word‐initial obstruents produced by 22 Swedish children (aged 18 ‐ 48 months). The data was collected through monthly recordings, approximatelly one year per child. The acoustic correlates analysed were spectral diffuseness, spectral skewness and spectral tilt for plosives and spectral skewness, spectral kurtosis, spectral variance and F2 onset frequency for fricatives. The results show a developmental trend in spectral skewness that is indicative of a increasing number of acquired phonetic contrasts. Spectral tilt change, F2 onset frequency, spectral mean and spectral variance provide evicence of within‐category refinement wich is argued to be caused primarilly by advancements in motor control.

  • 34.
    van Doorn, Janis
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Ahlinder, Annie
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Labba, Julia
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Development of a speech assessment tool (SIV) for use by health professionals who work with DBS patients2013In: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 28, no Suppl 1, S452-S453 p.Article in journal (Refereed)
  • 35.
    van Doorn, Janis
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Karlsson, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Influence of speech task and utterance length on measurement of pitch variability in the speech of Parkinson's disease patients after deep brain stimulation2013In: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 28, no Supplement 1, S448- p.Article in journal (Refereed)
  • 36.
    van Doorn, Janis
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Rosendal, Åsa
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Blomstedt, Patric
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Sandvik, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Thalamotomy for essential tremor: a very long-term follow-up of speech and voice2012In: Journal of medical speech-language pathology, ISSN 1065-1438, Vol. 20, no 4, 121-126 p.Article in journal (Refereed)
    Abstract [en]

    The movement disorder essential tremor (ET) has been treated in the past with thalamotomy, a surgical treatment known to cause dysarthria as a side effect. The aim of the current study was to evaluate speech and voice of a group of patients who underwent thalamotomy for ET more than 10 years ago and to determine whether any problems could be linked to the size and laterality of the surgical lesion. Eight patients treated with thalamotomy for ET from 1981 to 1996 participated in a voice and speech evaluation. Patient audio recordings were analyzed perceptually and acoustically, and the patients also self-assessed their speech. Of the eight patients, three were found to have both speech and voice problems, an additional three had only voice problems, and one had an isolated speech rate problem. Three patients reported subjective symptoms. The pattern of occurrence of impairments showed no clear link to the laterality or size of the lesion. It is argued that impaired articulation was likely to have been a consequence of the thalamotomy. However, the finding of voice quality problems was confounded by the disease itself and the patients' ages and thus was probably less likely to be related to the thalamotomy.

  • 37.
    van Doorn, Janis
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Schalling, Ellika
    Hartelius, Lena
    Asplund, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Stimulation of zona incerta in Parkinson’s disease: a first look at speech outcomes2010In: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 25, no S2, S456- p.Article in journal (Refereed)
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