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Parkinson's disease patients with freezing of gait have more severe voice impairment than non-freezers during “ON state”



Speech disorders and freezing of gait (FOG) in Parkinson's disease (PD) may have some common pathological mechanisms. The purpose of this study was to compare the acoustic parameters of PD patients with dopamine-responsive FOG (PD-FOG) and without FOG (PD-nFOG) during "ON state" and explore the ability of "ON state" voice features in distinguishing PD-FOG from PD-nFOG.


A total of 120 subjects, including 40 PD patients with dopamine-responsive FOG, 40 PD-nFOG, and 40 healthy controls (HCs) were recruited. All subjects underwent neuropsychological tests. Speech samples were recorded through the sustained vowel pronunciation tasks during the "ON state" and then analyzed by the Praat software. A set of 27 voice features was extracted from each sample for comparison. Support vector machine (SVM) was used to build mathematical models to classify PD-FOG and PD-nFOG.


Compared with PD-nFOG, the jitter, the standard deviation of fundamental frequency (F0SD), the standard deviation of pulse period (pulse period SD) and the noise-homophonic-ratio (NHR) were increased, and the maximum phonation time (MPT) was decreased in PD-FOG. The above voice features were correlated with the freezing of gait questionnaire (FOGQ). The average accuracy, specificity, and sensitivity of SVM models based on 27 voice features for classifying PD-FOG and PD-nFOG were 73.57%, 75.71%, and 71.43%, respectively.


PD-FOG have more severe voice impairment than PD-nFOG during "ON state".

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We would like to thank all the PD patients and healthy controls who participated in our research.


This research was supported by the National Natural Science Foundation of China (Nos. 81871002, 81471334, 81100981), the National Key Clinical Specialties Construction Program of China and Joint project of Chongqing Health Commission and Science and Technology Bureau (2021ZY024302).

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Correspondence to Oumei Cheng.

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Anonymized data presented in this study will be shared on request to the corresponding author.

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Co-first authors: Xiaoya Zou, Fengying Quan, Zhaoying Dong.

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Yu, Q., Zou, X., Quan, F. et al. Parkinson's disease patients with freezing of gait have more severe voice impairment than non-freezers during “ON state”. J Neural Transm 129, 277–286 (2022).

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  • Parkinson’s disease
  • Freezing of gait
  • Voice disorder
  • Acoustic analysis