1. Lee Silverman Voice Treatment (LSVT)
An intensive treatment program for individuals with Parkinson’s Disease
Presented by: Laura Dinges

2. Characteristics of Parkinson’s Disease
Affects both speech and voice
Exhibits common form of hypokinetic dysarthria
Decreased loudness
Monotone
Vocal tremor
Hoarseness
Rapid rate of speech

3. LSVT background
1st effective treatment for voice and speech disorders of people with Parkinson’s Disease (PD)
Developed in 1987 by Dr. Lorraine Ramig and Carolyn Mead, both speech-language pathologists
Named after one of the 1st patients to receive treatment

4. LSVT background (cont.)
Began as a treatment program for PD, now includes other neurological disorders
Intensive behavioral treatment is 4 days a week for 4 weeks (16 sessions)
Patients also asked to practice at home

5. LSVT techniques
Techniques intended to help patients with PD increase intelligibility and vocal loudness
Program emphasizes ‘loud’ speech
5 basic concepts of program:
Think loud; Think shout
Speech effort has to be high
Must be intensive treatment
Must be able to recalibrate loudness level
Quantifiable improvements over time

6. Additional Information on LSVT
Program targets immediate improvement following treatment and also on developing skills for long-term maintenance.
Must be trained and certified s-lp to administer treatment
400+individuals with PD have been successfully treated in efficacy research studies
Approx. 90% of patients with PD improve from treatment

7. PET brain images and LSVT
Study from Neurology journal by Liotti and colleagues (2003)
Looked at brain activity before and after voice treatment with LSVT using PET images
5 patients with mild to moderate PD and speech disorders; 5 healthy subjects
PET images produced in 5 patients with PD during phonation and reading exercises before and after a cycle of LSVT

8. PET brain images and LSVT (cont.)
5 healthy subjects-images generated during same activities
Before treatment: In patients with PD, motor and pre-motor cortex activated (voluntary effort)
In healthy subjects, automatic circuits activated, especially basal ganglia
After treatment, patients’ images appeared more similar to healthy individuals’ images   

9. Summary 1.5 million people are diagnosed with PD in the US
Individuals with PD often exhibit certain speech and voice characteristics
LSVT-1st effective treatment
Techniques: increase loudness and improve intelligibility
Many people with PD have been successfully treated with this program

10. References
Cleveland Hearing & Speech Center (2003). Fact sheet: Parkinson Disease and the Lee
Silverman Voice Treatment. Received on March 27, 2003, from Fact Sheet.pdf
Lee Silverman Voice Treatment Organization (n.d.). Lee Silverman Voice Treatment
facts. Retrieved on March 27, 2003, from
Liotti, M., Ramig, L.O., Vogel, D., New, P., Cook, C.I., Ingham, R.J., Ingham, J.C., &
Fox, P.T. (2003). Hypophonia in Parkinson’s disease: neural correlates of voice treatment revealed by PET. Neurology,60(3),
Stemple, J., Klaben, B.G., & Glaze, L.E., (2000). Clinical Voice Pathology: Theory and Management. (3rd edition). Singular Publishing.