Abstract
Stereotactic brain surgery to reduce tremor and rigidity in movement disorders is no longer a treatment option of the past. This study documents the effects of intensive voice therapy on the speech and voice characteristics in a Parkinson's diseased subject after bilateral thalamotomies. A review of the literature indicates few scientific studies on voice deficits induced by bilateral thalamotomies nor the responsiveness of these deficits to speech therapy. Using a recently-developed method of voice therapy for individuals with Parkinson's disease, the subject received 16 sessions of therapy. Acoustic analysis of variables collected pre-treatment and post-treatment indicated that the intensive voice therapy was effective. Measures of jitter, shimmer, coefficient of variation of frequency, amplitude modulation, frequency modulation, maximum duration of sustained vowel phonation, harmonics-to-noise ratio, harmonic spectral slope, and intensity all demonstrated statistically significantly improvements following the intensive voice therapy program. The subject also self-rated significant improvement in perceptual characteristics of her voice. The subject's improvement is discussed in relation to hypokinetic dysarthria versus pseudobulbar dysarthria. Further research is suggested for both effects of the surgeries and results of treatment on speech deficits created by these surgeries.

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