Heightened Sensitivity to Voice Loudness Changes in Parkinson's Disease

Parkinsons disease (PD) affects voice and speech production, often resulting in reduced vocal intensity and monotonous speech. Recent studies have suggested that these changes can be partially explained by altered sensory feedback processing when producing speech. Individuals with PD (IwPD) may fail to monitor sensory feedback from their own voice, impairing their ability to adjust voice and speech when sensory input differs from expectations. In this study, we investigated sensory feedback processing in PD by looking at the sensory attenuation typically observed in event-related responses (ERP) to the self-generated voice. When sensory feedback processing is intact, the P50, N100, and P200 ERP responses to the self-generated voice are more attenuated than to an externally-generated voice. Twenty-three IwPD and 23 healthy controls (HCs) participated in a voice playback study that comprised three conditions: self-generated voice (auditory-motor condition; AMC), externally-generated voice (auditory-only condition; AOC), and motor-only. The AMC and AOC conditions also included an amplitude modulation of the voice (0/+15dB). Linear mixed models assessed group differences in ERP morphology. While groups did not differ in their P50 and P200 responses, there was a significant group-condition- loudness interaction for the N100. Follow-up analyses showed that IwPD displayed much larger N100 error responses for unexpected loudness modulations as compared to HC. This observation suggests that IwPD may process voice modulations differently than HC. The hypersensitivity to loudness changes may underlie IwPDs difficulties in processing and adapting their voice acoustics.