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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients may present with classical symptoms suggesting aphasia following thalamotomy (repetition, comprehension, fluency and naming abnormalities). They may also present with 'freezing of speech', and this symptom should not be considered as a speech disorder or a symptom of Parkinson's disease progression, without careful testing to rule out language deficits, particularly dysfluency. There are important issues related to all language complications of thalamotomy, including (1) the time course of problems following surgery, (2) the impact of preexistingspeech problems, (3) the importance of the size and location of lesions, (4) the potential circuits important in the pathogenesis of a thalamic language disturbance and (5) whether laterality makes a difference (left- versus right-sided thalamic lesions). As more centers switch from thalamotomy to deep brain stimulation, the issues regarding aphasia will need to be addressed.
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PMID:Aphasia and thalamotomy: important issues. 1555 67

Individuals with idiopathic Parkinson's disease (IPD) usually develop a speech disorder characterized by reduced loudness, hoarse and breathy voice, monotony of pitch, short rushes of speech, and imprecise consonants. The inability to effectively communicate impairs their ability to function in society and quality of life. A successful program developed to improve speech in these individuals is the Lee Silverman Voice Treatment (LSVT). A critical component of this treatment is intense daily therapy for 4 weeks, a regimen that is difficult for many elderly patients to complete. Treatment delivered through videophones placed in the homes of individuals with IPD offers an alternative and could improve accessibility of treatment if the results were the same. This study compared the outcomes of LSVT delivered via videophones to the outcomes of traditional treatment delivered face-to-face.
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PMID:Videophone-delivered voice therapy: a comparative analysis of outcomes to traditional delivery for adults with Parkinson's disease. 1911 29

We investigated the validity and feasibility of online delivery of the Lee Silverman Voice Treatment (LSVT) for the treatment of the speech disorder of a patient with idiopathic Parkinson's disease. The treatment was delivered in 16 sessions to the participant's home, 90 km from the speech language pathologist. A PC-based videoconferencing system was used, operating at 128 kbit/s over the public telecommunications network. The patient achieved substantial improvements in vocal sound pressure levels during sustained vowel phonation (6.13 dB), reading (12.28 dB) and conversational monologue (11.32 dB). There were improvements in the duration of sustained vowel phonation (4 s). Improvements were also perceived in the degree of breathiness and roughness in the voice, and in overall speech intelligibility in conversation. The patient was very satisfied with the audio and video quality of the conferencing, and with the online treatment overall. He reported a preference for online sessions for the future management of his condition, rather than face-to-face treatment. Remote LSVT delivery was found to be feasible and effective.
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PMID:Home-based speech treatment for Parkinson's disease delivered remotely: a case report. 2000 51

Abstract In The Netherlands, a web application for speech training, E-learning-based speech therapy (EST), has been developed for patients with dysarthria, a speech disorder resulting from acquired neurological impairments such as stroke or Parkinson's disease. In this report, the EST infrastructure and its potentials for both therapists and patients are elucidated. EST provides patients with dysarthria the opportunity to engage in intensive speech training in their own environment, in addition to undergoing the traditional face-to-face therapy. Moreover, patients with chronic dysarthria can use EST to independently maintain the quality of their speech once the face-to-face sessions with their speech therapist have been completed. This telerehabilitation application allows therapists to remotely compose speech training programs tailored to suit each individual patient. Moreover, therapists can remotely monitor and evaluate changes in the patient's speech. In addition to its value as a device for composing, monitoring, and carrying out web-based speech training, the EST system compiles a database of dysarthric speech. This database is vital for further scientific research in this area.
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PMID:E-learning-based speech therapy: a web application for speech training. 2018 55

An assessment of vocal impairment is presented for separating healthy people from persons with early untreated Parkinson's disease (PD). This study's main purpose was to (a) determine whether voice and speech disorder are present from early stages of PD before starting dopaminergic pharmacotherapy, (b) ascertain the specific characteristics of the PD-related vocal impairment, (c) identify PD-related acoustic signatures for the major part of traditional clinically used measurement methods with respect to their automatic assessment, and (d) design new automatic measurement methods of articulation. The varied speech data were collected from 46 Czech native speakers, 23 with PD. Subsequently, 19 representative measurements were pre-selected, and Wald sequential analysis was then applied to assess the efficiency of each measure and the extent of vocal impairment of each subject. It was found that measurement of the fundamental frequency variations applied to two selected tasks was the best method for separating healthy from PD subjects. On the basis of objective acoustic measures, statistical decision-making theory, and validation from practicing speech therapists, it has been demonstrated that 78% of early untreated PD subjects indicate some form of vocal impairment. The speech defects thus uncovered differ individually in various characteristics including phonation, articulation, and prosody.
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PMID:Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson's disease. 2130 16

Stuttering is a speech disorder with disruption of verbal fluency which is occasionally present in patients with Parkinson's disease (PD). Long-term medical management of PD is frequently complicated by fluctuating motor functions and dyskinesias. High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment of motor fluctuations and is the most common surgical procedure in PD. Here we report the re-occurrence and aggravation of stuttering following STN-DBS in two male patients treated for advanced PD. In both patients the speech fluency improved considerably when the neurostimulator was turned off, indicating that stuttering aggravation was related to neurostimulation of the STN itself, its afferent or efferent projections and/or to structures localized in the immediate proximity. This report supports previous studies demonstrating that lesions of the basal ganglia-thalamocortical motor circuit, including the STN, is involved in the development of stuttering. In advanced PD STN-DBS is generally an effective and safe treatment. However, patients with PD and stuttering should be informed about the risk of aggravated symptoms following surgical therapy.
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PMID:Aggravated stuttering following subthalamic deep brain stimulation in Parkinson's disease--two cases. 2147 5

Although speech disorder is frequently an early and prominent clinical feature of Parkinson's disease (PD) as well as atypical parkinsonian syndromes (APS) such as progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), there is a lack of objective and quantitative evidence to verify whether any specific speech characteristics allow differentiation between PD, PSP and MSA. Speech samples were acquired from 77 subjects including 15 PD, 12 PSP, 13 MSA and 37 healthy controls. The accurate differential diagnosis of dysarthria subtypes was based on the quantitative acoustic analysis of 16 speech dimensions. Dysarthria was uniformly present in all parkinsonian patients but was more severe in PSP and MSA than in PD. Whilst PD speakers manifested pure hypokinetic dysarthria, ataxic components were more affected in MSA whilst PSP subjects demonstrated severe deficits in hypokinetic and spastic elements of dysarthria. Dysarthria in PSP was dominated by increased dysfluency, decreased slow rate, inappropriate silences, deficits in vowel articulation and harsh voice quality whereas MSA by pitch fluctuations, excess intensity variations, prolonged phonemes, vocal tremor and strained-strangled voice quality. Objective speech measurements were able to discriminate between APS and PD with 95% accuracy and between PSP and MSA with 75% accuracy. Dysarthria severity in APS was related to overall disease severity (r = 0.54, p = 0.006). Dysarthria with various combinations of hypokinetic, spastic and ataxic components reflects differing pathophysiology in PD, PSP and MSA. Thus, motor speech examination may provide useful information in the evaluation of these diseases with similar manifestations.
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PMID:Speech disorders reflect differing pathophysiology in Parkinson's disease, progressive supranuclear palsy and multiple system atrophy. 2568 63

It is known that Parkinson's disease is often accompanied by a motor speech disorder, which results in impaired communication. However, people with Parkinson's disease may also have impaired word retrieval (anomia) and other communicative problems, which have a negative impact on their ability to participate in conversations with family as well as healthcare staff. The aim of the present study was to explore effects of impaired speech and language on communication and how this is managed by people with Parkinson's disease and their spouses. Using a qualitative method based on Conversation Analysis, in-depth analyses were performed on natural conversational interaction in five dyads including elderly men who were at different stages of Parkinson's disease. The findings showed that the motor speech disorder in combination with word retrieval difficulties and adaptations, such as using communication strategies, may result in atypical utterances that are difficult for communication partners to understand. The coexistence of several communication problems compounds the difficulties faced in conversations and individuals with Parkinson's disease are often dependent on cooperation with their communication partner to make themselves understood.
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PMID:Multifaceted Communication Problems in Everyday Conversations Involving People with Parkinson's Disease. 2894 14

The prevalence of speech disorders among individuals with Parkinson's disease (PD) has been reported to be as high as 89%. Speech impairment in PD results from a combination of motor and nonmotor deficits. The production of speech depends upon the coordination of various motor activities: respiration, phonation, articulation, resonance and prosody. A speech disorder is defined as impairment in any of its inter-related components. Despite the high prevalence of speech disorders in PD, only 3-4% receive speech treatment. Treatment modalities include pharmacological intervention, speech therapy, surgery, deep brain stimulation and vocal fold augmentation. Although management of Parkinsonian dysarthria is clinically challenging, speech treatment in PD should be part of a multidisciplinary approach to patient care in this disease.
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PMID:Speech disorders in Parkinson's disease: pathophysiology, medical management and surgical approaches. 3022 11

Purpose: To determine the clinical practices of Australian speech-language pathologists in the management of communication disorders in people with Parkinson's disease (PwPD) and their perspectives on service provision.Method: A cross-sectional, mix-methods online survey was conducted. Nonprobability, purposive sampling was utilised to recruit speech-language pathologists who currently work with PwPD. Descriptive statistics and thematic analysis were employed.Result: Ninety-nine clinicians responded. Most offered services for both motor speech and cognitive-communication disorders, but a greater focus on the motor speech disorder was evident. A range of impairment and functional assessments and interventions were reported. Therapy was most commonly delivered one session a week over 4 or 6 weeks. Service, client and evidence barriers in the management of both communication disorders were identified. Most clinicians felt PwPD accessed communication services at stages later than optimal, they recognised a need to improve their services in varying degrees (92.3%), and believed not enough services exist for PwPD in Australia (78%). Cognitive-communication management was the highest requested area for further research evidence.Conclusion: This study captured the current practices of Australian speech-language pathologists in the management of communication disorders in PwPD. Findings may inform future service planning, research on service effectiveness and new management targets.
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PMID:Communication service provision and access for people with Parkinson's disease in Australia: A national survey of speech-language pathologists. 3049 96


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