Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's Disease

ObjectiveTo observe the effect of high frequency repetitive transcranial magnetic stimulation (rTMS) combined with voice training on voice function of patients with Parkinson's disease (PD).MethodsA total of 30 patients of Parkinson's disease with voice disorder were treated in the departm...

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Main Authors: WANG Xiaowen, ZHU Qingqing, CHEN Yan, QIAN Hong, YUAN Haixin, ZHAO Gang, LIU Jie, ZHANG Fengjiao
Format: Article
Language:English
Published: Editorial Office of Rehabilitation Medicine 2022-04-01
Series:康复学报
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Online Access:http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2022.02010
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author WANG Xiaowen
ZHU Qingqing
CHEN Yan
QIAN Hong
YUAN Haixin
ZHAO Gang
LIU Jie
ZHANG Fengjiao
author_facet WANG Xiaowen
ZHU Qingqing
CHEN Yan
QIAN Hong
YUAN Haixin
ZHAO Gang
LIU Jie
ZHANG Fengjiao
author_sort WANG Xiaowen
collection DOAJ
description ObjectiveTo observe the effect of high frequency repetitive transcranial magnetic stimulation (rTMS) combined with voice training on voice function of patients with Parkinson's disease (PD).MethodsA total of 30 patients of Parkinson's disease with voice disorder were treated in the department of rehabilitation medicine and the department of geriatrics of Shanghai Fifth Rehabilitation Hospital from October 2019 to July 2021, which were randomly divided into the control group and the observation group according to Excel RAND function, with 15 cases in each group. The control group were treated with routine anti PD drugs and routine voice training, including abdominal breathing training, respiratory and vocal coordination training, breathing support ability training, voice real-time stress therapy, tonal training,vocal cord relaxation training, tone quality training,resonance relaxation training, etc.The training time was 40 minutes a time, once a day, continuous training for 30 days.The observation group received high-frequency rTMS stimulation on the basis of the control group. High frequency (5 Hz) rTMS was used to stimulate bilateral primary motor cortex (M1 area). The stimulation time was 10 minutes, 20 minutes a time,once a day, continuous training for 30 days. Before treatment, after treatment (after treatment for 30 days) and follow-up (30 days after the end of treatment), voice function detection and correction instrument, voice function detection and correction instrument were used to detect voice function under the framework of ICF, mainly including voice production index [(maximum phonation time, MPT), (maximum counting ability, cMCA), (fundamental frequency, F<sub>0</sub>), (contact quotient, CQ), (contact quotient perturbation, CQP), (fundamental frequency tremor, F<sub>0</sub>t),(frequency band energy concentration rate,Ec)] and voice quality index[Jitter, Shimmer, (normalized noise energy, NNE), F<sub>2</sub>/u/,F<sub>2</sub>/i/]. Voice handicap index (VHI) questionnaire were used to evaluate the subjective feelings of patients with voice disorders.ResultsBefore treatment, there were no significant difference in MPT, cMCA, F<sub>0</sub>t, Ec, F<sub>0</sub>, CQ, CQP, Jitter, Shimmer, NNE, F<sub>2</sub>/i/, F<sub>2</sub>/u/, VHI between the two groups (<italic>P</italic>&gt;0.05). Compared with before treatment, MPT,cMCA, F<sub>0</sub>t, Ec and F<sub>2</sub>/i/ of the two groups after treatment were significantly increased, F<sub>0</sub>, NNE and VHI score of the two groups after treatment were significantly decreased (<italic>P</italic>&lt;0.05); MPT, cMCA, F<sub>0</sub>t, Ec, F<sub>2</sub>/i/ score of the observation group follow-up were significantly increased (<italic>P</italic>&lt;0.05),and the scores of F<sub>0</sub>, NNE and VHI score of the observation group follow-up were significantly decreased (<italic>P</italic>&lt;0.05). Compared with after treatment, MPT and cMCA of the observation group follow-up were significantly decreased (<italic>P</italic>&lt;0.05). Compared with the control group at the same time, MPT, cMCA, F<sub>0</sub>t, Ec, F<sub>2</sub>/i/ of the observation group after treatment and follow-up were significantly increased, and the scores of CQP, NNE and VHI score were significantly decreased (<italic>P</italic>&lt;0.05).ConclusionHigh frequency rTMS combined voice training can improve the respiratory support ability, the coordination ability of breathing and vocalization, the regularity of vocal cord closure, the forward movement ability of tongue in PD patients; reduce vocal cord tremor, attenuation of harmonic energy during vocal cord vibration,breath sound and self subjective feeling of voice disorder, and its long-term effect is also good, which is worthy of clinical promotion.
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spelling doaj-art-acd2d2c4e1954cc194f8e3d3552feb5f2025-01-14T10:07:46ZengEditorial Office of Rehabilitation Medicine康复学报2096-03282022-04-013215516125504362Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's DiseaseWANG XiaowenZHU QingqingCHEN YanQIAN HongYUAN HaixinZHAO GangLIU JieZHANG FengjiaoObjectiveTo observe the effect of high frequency repetitive transcranial magnetic stimulation (rTMS) combined with voice training on voice function of patients with Parkinson's disease (PD).MethodsA total of 30 patients of Parkinson's disease with voice disorder were treated in the department of rehabilitation medicine and the department of geriatrics of Shanghai Fifth Rehabilitation Hospital from October 2019 to July 2021, which were randomly divided into the control group and the observation group according to Excel RAND function, with 15 cases in each group. The control group were treated with routine anti PD drugs and routine voice training, including abdominal breathing training, respiratory and vocal coordination training, breathing support ability training, voice real-time stress therapy, tonal training,vocal cord relaxation training, tone quality training,resonance relaxation training, etc.The training time was 40 minutes a time, once a day, continuous training for 30 days.The observation group received high-frequency rTMS stimulation on the basis of the control group. High frequency (5 Hz) rTMS was used to stimulate bilateral primary motor cortex (M1 area). The stimulation time was 10 minutes, 20 minutes a time,once a day, continuous training for 30 days. Before treatment, after treatment (after treatment for 30 days) and follow-up (30 days after the end of treatment), voice function detection and correction instrument, voice function detection and correction instrument were used to detect voice function under the framework of ICF, mainly including voice production index [(maximum phonation time, MPT), (maximum counting ability, cMCA), (fundamental frequency, F<sub>0</sub>), (contact quotient, CQ), (contact quotient perturbation, CQP), (fundamental frequency tremor, F<sub>0</sub>t),(frequency band energy concentration rate,Ec)] and voice quality index[Jitter, Shimmer, (normalized noise energy, NNE), F<sub>2</sub>/u/,F<sub>2</sub>/i/]. Voice handicap index (VHI) questionnaire were used to evaluate the subjective feelings of patients with voice disorders.ResultsBefore treatment, there were no significant difference in MPT, cMCA, F<sub>0</sub>t, Ec, F<sub>0</sub>, CQ, CQP, Jitter, Shimmer, NNE, F<sub>2</sub>/i/, F<sub>2</sub>/u/, VHI between the two groups (<italic>P</italic>&gt;0.05). Compared with before treatment, MPT,cMCA, F<sub>0</sub>t, Ec and F<sub>2</sub>/i/ of the two groups after treatment were significantly increased, F<sub>0</sub>, NNE and VHI score of the two groups after treatment were significantly decreased (<italic>P</italic>&lt;0.05); MPT, cMCA, F<sub>0</sub>t, Ec, F<sub>2</sub>/i/ score of the observation group follow-up were significantly increased (<italic>P</italic>&lt;0.05),and the scores of F<sub>0</sub>, NNE and VHI score of the observation group follow-up were significantly decreased (<italic>P</italic>&lt;0.05). Compared with after treatment, MPT and cMCA of the observation group follow-up were significantly decreased (<italic>P</italic>&lt;0.05). Compared with the control group at the same time, MPT, cMCA, F<sub>0</sub>t, Ec, F<sub>2</sub>/i/ of the observation group after treatment and follow-up were significantly increased, and the scores of CQP, NNE and VHI score were significantly decreased (<italic>P</italic>&lt;0.05).ConclusionHigh frequency rTMS combined voice training can improve the respiratory support ability, the coordination ability of breathing and vocalization, the regularity of vocal cord closure, the forward movement ability of tongue in PD patients; reduce vocal cord tremor, attenuation of harmonic energy during vocal cord vibration,breath sound and self subjective feeling of voice disorder, and its long-term effect is also good, which is worthy of clinical promotion.http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2022.02010Parkinson's diseasevoice disorderhigh frequency transcranial magnetic stimulationvoice trainingvoice functionvoice acoustics
spellingShingle WANG Xiaowen
ZHU Qingqing
CHEN Yan
QIAN Hong
YUAN Haixin
ZHAO Gang
LIU Jie
ZHANG Fengjiao
Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's Disease
康复学报
Parkinson's disease
voice disorder
high frequency transcranial magnetic stimulation
voice training
voice function
voice acoustics
title Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's Disease
title_full Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's Disease
title_fullStr Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's Disease
title_full_unstemmed Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's Disease
title_short Effect of High Frequency Repetitive Transcranial Magnetic Stimulation Combined with Voice Training on Voice Function of Patients with Parkinson's Disease
title_sort effect of high frequency repetitive transcranial magnetic stimulation combined with voice training on voice function of patients with parkinson s disease
topic Parkinson's disease
voice disorder
high frequency transcranial magnetic stimulation
voice training
voice function
voice acoustics
url http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2022.02010
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