Premotor cortex is hypoactive during sustained vowel production in individuals with Parkinson's disease and hypophonia

Jordan L Manes; Ajay S Kurani; Ellen Herschel; Angela C Roberts; Kris Tjaden; Todd Parrish; Daniel M Corcos

doi:10.3389/fnhum.2023.1250114

Premotor cortex is hypoactive during sustained vowel production in individuals with Parkinson's disease and hypophonia

Front Hum Neurosci. 2023 Oct 23:17:1250114. doi: 10.3389/fnhum.2023.1250114. eCollection 2023.

Authors

Jordan L Manes¹, Ajay S Kurani^{2

3}, Ellen Herschel⁴, Angela C Roberts^{5

6

7

8}, Kris Tjaden⁹, Todd Parrish³, Daniel M Corcos¹⁰

Affiliations

¹ Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States.
² Ken and Ruth Davee Department of Neurology, Northwestern University, Chicago, IL, United States.
³ Department of Radiology, Northwestern University, Chicago, IL, United States.
⁴ Brain and Creativity Institute, University of Southern California, Los Angeles, CA, United States.
⁵ School of Communication Sciences and Disorders, Western University, London, ON, Canada.
⁶ Canadian Centre for Activity and Aging, Western University, London, ON, Canada.
⁷ Department of Computer Science, Western University, London, ON, Canada.
⁸ Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States.
⁹ Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, United States.
¹⁰ Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States.

Abstract

Introduction: Hypophonia is a common feature of Parkinson's disease (PD); however, the contribution of motor cortical activity to reduced phonatory scaling in PD is still not clear.

Methods: In this study, we employed a sustained vowel production task during functional magnetic resonance imaging to compare brain activity between individuals with PD and hypophonia and an older healthy control (OHC) group.

Results: When comparing vowel production versus rest, the PD group showed fewer regions with significant BOLD activity compared to OHCs. Within the motor cortices, both OHC and PD groups showed bilateral activation of the laryngeal/phonatory area (LPA) of the primary motor cortex as well as activation of the supplementary motor area. The OHC group also recruited additional activity in the bilateral trunk motor area and right dorsal premotor cortex (PMd). A voxel-wise comparison of PD and HC groups showed that activity in right PMd was significantly lower in the PD group compared to OHC (p < 0.001, uncorrected). Right PMd activity was positively correlated with maximum phonation time in the PD group and negatively correlated with perceptual severity ratings of loudness and pitch.

Discussion: Our findings suggest that hypoactivation of PMd may be associated with abnormal phonatory control in PD.

Keywords: Parkinson’s disease; fMRI; hypophonia; phonation; premotor cortex; speech; voice.

Grants and funding

F31 DC015717/DC/NIDCD NIH HHS/United States