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Effects of the Lee Silverman Voice Treatment (LSVT® LOUD) on Hypomimia in Parkinson's Disease

Published online by Cambridge University Press:  13 February 2014

Aleksey I. Dumer*
Department of Psychology, Queens College of the City University of New York (CUNY), Flushing, New York Department of Psychology, The Graduate Center of CUNY, New York, New York
Harriet Oster
The Paul McGhee Division, School of Continuing and Professional Studies, New York University, New York, New York
David McCabe
Department of Psychology, Queens College of the City University of New York (CUNY), Flushing, New York Department of Psychology, The Graduate Center of CUNY, New York, New York
Laura A. Rabin
Department of Psychology, The Graduate Center of CUNY, New York, New York Department of Psychology, Brooklyn College of CUNY, Brooklyn, New York
Jennifer L. Spielman
The National Center for Voice and Speech, Denver, Colorado
Lorraine O. Ramig
The National Center for Voice and Speech, Denver, Colorado Department of Speech, Language, and Hearing Sciences, University of Colorado at Boulder, Boulder, Colorado
Joan C. Borod
Department of Psychology, Queens College of the City University of New York (CUNY), Flushing, New York Department of Psychology, The Graduate Center of CUNY, New York, New York Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
Correspondence and reprint requests to: Aleksey I. Dumer, Center for Enhanced Performance, United States Military Academy, West Point, New York 10996. E-mail:


Given associations between facial movement and voice, the potential of the Lee Silverman Voice Treatment (LSVT) to alleviate decreased facial expressivity, termed hypomimia, in Parkinson's disease (PD) was examined. Fifty-six participants—16 PD participants who underwent LSVT, 12 PD participants who underwent articulation treatment (ARTIC), 17 untreated PD participants, and 11 controls without PD—produced monologues about happy emotional experiences at pre- and post-treatment timepoints (“T1” and “T2,” respectively), 1 month apart. The groups of LSVT, ARTIC, and untreated PD participants were matched on demographic and health status variables. The frequency and variability of facial expressions (Frequency and Variability) observable on 1-min monologue videorecordings were measured using the Facial Action Coding System (FACS). At T1, the Frequency and Variability of participants with PD were significantly lower than those of controls. Frequency and Variability increases of LSVT participants from T1 to T2 were significantly greater than those of ARTIC or untreated participants. Whereas the Frequency and Variability of ARTIC participants at T2 were significantly lower than those of controls, LSVT participants did not significantly differ from controls on these variables at T2. The implications of these findings, which suggest that LSVT reduces parkinsonian hypomimia, for PD-related psychosocial problems are considered. (JINS, 2014, 20, 1–11)

Research Articles
Copyright © The International Neuropsychological Society 2014 

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