Volume perception in parkinsonian speech.

This study contrasted the volume level of speech production with perceived volume. Fifteen idiopathic patients with Parkinson's disease who have hypophonic dysarthria and 15 healthy age- and sex-matched control subjects participated in this study. Testing took place in a sound-proof room. Ability to regulate volume was tested at three instructional levels of loudness: participants were given no instructions regarding volume (to elicit normal default volume) or were asked to read loudly or quietly. Two types of volume-perception judgments were made. First, an estimate of one's own volume, immediately after speaking (that is, immediate perception), and secondly, an estimation of reading volume after hearing one's own voice played back (that is, playback perception). These perceptual ratings were compared with actual speech volume produced in reading and conversation tasks. It was found that there was less of a difference between patients' production and perception of speech volume compared with that of the control subjects. While patients spoke more quietly than control subjects, they nevertheless perceived (immediate and playback perception) their own speech to be louder than did the control subjects. Patients overestimated the volume of their speech during both reading and conversation. The findings raise the question as to whether impaired speech production is driven by a basic perceptual fault or whether perception is abnormal as a consequence of impaired mechanisms involved in the generation of quiet speech.