Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Those with Parkinson's Disease often suffer speech limitations distinct from other neurological diseases and stroke. Symptoms of dysarthria, the clinical term of impaired, uncoordinated, and weakened speech musculature, include reduced volume, breathiness, monotone pitch, accelerated rate of speech, and inability to communicate effectively over the telephone, in groups, and even in quiet one-to-one settings. The author discusses the voice, speech, and related deficits encountered by individuals with Parkinson's Disease and the speech-language pathologist's role in addressing these deficits.
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PMID:Speech pathology & Parkinson's disease in the home environment. 1255 60

Dysarthria in Parkinson's disease (PD) consists of articulatory, phonatory and respiratory impairment. Bilateral subthalamic nucleus (STN) stimulation greatly improves motor disability, but its long-term effect on speech within a large group of patients has not been precisely evaluated. The aim of this study was to determine the effect of bilateral STN stimulation on oral force control in PD. We measured forces of the upper lip, lower lip and tongue in twenty-six PD patients treated with bilateral STN stimulation. Measurements of the articulatory organ force, as well as a motor evaluation using the Unified Parkinson's Disease Rating Scale (UPDRS), were made with and without STN stimulation. Maximal voluntary force (MVF), reaction time (RT), movement time (MT), imprecision of the peak force (PF) and the hold phase (HP) were all improved with STN stimulation during the articulatory force task, as well as the motor examination scores of the UPDRS. It seems that the beneficial STN stimulation-induced effect on articulatory forces persisted whatever the duration of post-surgical follow-up. However, dysarthria evaluated by the UPDRS was worse in two subgroups of patients with a one to two year and three to five year post-surgical follow-up, in comparison with a subgroup of patients with a three month follow-up. STN stimulation has a beneficial long-term effect on the articulatory organs involved in speech production, and this indicates that parkinsonian dysarthria is associated, at least in part, with an alteration in STN neuronal activity. Nevertheless, to confirm the persistence of the beneficial effect of STN stimulation on parkinsonian dysarthria, a longitudinal evaluation is still needed.
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PMID:Bilateral subthalamic stimulation effects on oral force control in Parkinson's disease. 1257 48

Mild changes in voice quality and articulation of speech may be seen in early phases of Parkinson's disease (PD). Voice and speech disturbances in PD constitute a hypocinetic dysarthria or dysarthrophonia and are characterized by monotony and reduced intensity of voice, imprecise articulation and disturbances of rhythm. Favorable results with an intensive method (Lee Silverman Voice Treatment) for the treatment of voice disturbances in PD were recently reported. The main goal of the method is to augment vocal intensity through the increment of phonatory effort. The purpose of the present study was to characterize vocal abnormalities (hoarseness, breathiness, articulatory pattern and inteligibility) in a group of patients with PD and to evaluate the therapeutic efficacy of the Lee Silverman method. Acoustic as well as perceptive-auditory analysis showed statistically significant differences between pre and post treatment groups. Although the articulatory pattern has not considerably changed, the benefits obtained with the improvement in vocal quality positively influenced overall quality of oral communication.
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PMID:[Treatment of vocal symptoms in Parkinson's disease: the Lee Silverman method]. 1271 21

Few studies were made on the intrinsic and co-intrinsic vowel characteristics in neurologic dysarthrias. This work evaluates these parameters in a group of 4 subjects with cerebellar dysarthria suffering from a cerebellar degenerative syndrome and a group of 4 subjects with Parkinson disease suffering from parkinsonian dysarthria. These subjects were compared with 10 control subjects. An intensive speech treatment inspired from the Lee Silverman voice treatment (LSVT) was applied to one of the parkinsonian subjects of the study, with assessment before and after rehabilitation. The acoustic measures assessed the duration and the frequency of the vowels [a, i, ul indifferent contexts as well as their formant frequency and sentence duration. The results show different impairments according to the type of the dysarthria, and some forms of contrast transposition. Speech therapy restores subnormal contrasts.
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PMID:[Intrinsic and co-intrinsic vowel characteristics in cerebellar and parkinsonian dysarthrias]. 1277 65

Phonatory dysfunction is a frequent component of dysarthria and often is a primary feature noted in clinical assessment. But the vocal impairment can be difficult to assess because (a). the analysis of voice disorder of any kind can be challenging, and (b). the voice disorder in dysarthria often occurs along with other impairments affecting articulation, resonance, and respiration. A promising assessment tool is multi-parameter acoustic analysis, such as the Multi-Dimensional Voice Program (MDVP). Part 1 of this paper recommends procedures and standards for the acoustic analysis of voice, including (1). selection of the sample to be analyzed, (2). signal quality requirements, (3). availability of normative data for both genders and different ages of speakers, (4). reliability of analysis, and (5). correlation of acoustic results with results from other methods of analysis. In Part 2, acoustic data are reviewed for the dysarthria associated with Parkinson disease (PD), cerebellar disease, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), unilateral hemispheric stroke, and essential tremor. Tentative profiles of voice disorder are described for these conditions. These profiles may serve as hypotheses for future research. Although several issues remain to be resolved in the acoustic analysis of voice disorder in dysarthria, steps can be taken now to promote the reliability, validity, and clinical utility of such analyses. (1). As a result of this activity, the participant will be able to describe ways in which an optimal multi-dimensional analysis of voice can be performed with modern acoustic analysis systems. (2). As a result of this activity, the participant will be able to apply multi-dimensional acoustic analysis of voice to individuals who have a dysarthria-related voice disorder. (3). As a result of this activity, the participant will be able to identify major sources of normative data on the Multi-Dimensional Voice Program.
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PMID:Voice dysfunction in dysarthria: application of the Multi-Dimensional Voice Program. 1283 87

Diadochokinesis (DDK) for speakers with dysarthria has been described using a variety of acoustic measures. A clinical protocol for the objective assessment of DDK requires a unified approach, however, to facilitate implementation across clinics and laboratories. A protocol for the acoustic analysis of DDK that incorporates temporal and energy measures has been used to describe DDK characteristics for dysarthria secondary to stroke as well as ataxic dysarthria. The current study sought to validate and extend the protocol to a new set of etiological groups, including dysarthria secondary to multiple sclerosis (MS) and Parkinson's disease (PD). The results suggest that temporal measures are more useful than energy measures for distinguishing among dysarthria secondary to MS, dysarthria secondary to PD, and healthy controls. The results also highlight the value of including both alternating and sequential motion rate tasks in the assessment of DDK and of supplementing quantitative measures with qualitative spectrographic observations.
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PMID:Characteristics of diadochokinesis in multiple sclerosis and Parkinson's disease. 1293 Oct 58

The aims of this study were to provide a perceptual speech 'profile' for Cantonese speakers with hypokinetic dysarthria, to examine the reliability of non-expert listeners in perceptual judgements of dysarthric speech, and to investigate cross-language differences in profiles of hypokinetic dysarthria. Participants included 19 speakers with Parkinson's disease and 10 speech-language pathologists who served as listeners. Listeners rated 21 speech dimensions, using seven-point interval scales. Mean intralistener agreement was 94.52% and mean interlistener reliability was 0.88 (Cronbach's alpha). Mean scale values (MSV) for each dimension ranged from 3.37 to 1.36. The perceptual profile of Cantonese hypokinetic dysarthria was largely similar to profiles for English and Japanese speakers; notable differences are discussed. Possible reasons for the relatively high reliability obtained are presented.
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PMID:Perceptual characteristics of Cantonese hypokinetic dysarthria. 1294 1

Research investigating coarticulatory patterns in dysarthria has the potential to provide insight regarding deficits in the organizational coherence of phonetic events that may underlie deviant perceptual characteristics. The current study investigated anticipatory coarticulation for 17 speakers with multiple sclerosis (MS), 12 speakers with Parkinson's disease (PD), and 29 healthy control speakers. V1-C-V2 sequences were used to investigate intersyllabic vowel to vowel effects (V2 to V1 effects), intersyllabic consonant to vowel effects (C to V1 effects), and intrasyllabic vowel to consonant effects (V2 to C effects). Second formant frequencies and first moment coefficients were used to infer coarticulation. In general, patterns of intersyllabic and intrasyllabic coarticulation were similar for speakers with MS, speakers with PD, and healthy control speakers. It therefore appears unlikely that coarticulatory patterns for speakers diagnosed with MS or PD strongly contribute to deviant perceptual characteristics, at least for the current group of speakers, most of whom were mildly to moderately impaired. Anticipatory vowel effects in /k/+vowel sequences, however, tended to be reduced for speakers with MS and speakers with PD when data for these 2 speaker groups were pooled and compared to control speakers. These results were not attributable to group differences in speech rate or articulatory scaling, defined as the extent of articulatory movements, and further suggest that coarticulatory deficits are not unique to particular neurological diagnoses or dysarthrias. Potential explanations for the /k/+vowel results include difficulties with anterior-posterior tongue positioning and the competing influences of minimizing articulatory effort and maintaining sufficient perceptual contrast. Despite this subtle difference in coarticulation between disordered speakers and healthy control speakers, the overall results suggest that anticipatory coarticulation for speakers with MS and speakers with PD is preserved.
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PMID:Anticipatory coarticulation in multiple sclerosis and Parkinson's disease. 1295 75

Articulatory discoordination is often said to be an important feature of the speech production disorder in dysarthria, but little experimental work has been done to identify and specify the coordination difficulties. The present study evaluated the coordination of labial and lingual gestures for /u/ production in persons with Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and in control participants. Both tongue backing/raising and reduction of the area enclosed by the lips can produce the characteristic low F2 of /u/. The timing of these articulatory gestures with respect to the acoustic target of a low F2 was inferred from X-ray microbeam data. Pellet motions of the tongue dorsum and lips revealed the timing of the lingual and labial gestures to be strongly linked together (synchronized), predictive of the temporal location of the lowest F2 within the vocalic nucleus, and scaled proportionately to the overall vowel duration in control participants. Somewhat surprisingly, essentially the same findings were obtained in the speakers with dysarthria. These relationships were noisier among the speakers with dysarthria, but the global synchronization patterns applied to all 3 groups. Further analyses revealed the synchronization to be less well defined and more variable across speakers with ALS, as compared to speakers with PD and the controls. Results are discussed relative to concepts of coordination in dysarthria.
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PMID:Interarticulator coordination in dysarthria: an X-ray microbeam study. 1457 56

The treatment of speech impairment, a factor of loneliness, speech therapy to treat dysarthria in Parkinson's disease is a fundamental aspect of patient management. The impact of medicinal treatment of dysarthria is controversial and surgery appears to worsen the problem. Various speech therapy approaches are relaxation, postural rehabilitation, respiration, phonation, articulation and prosodic re-education. AN INTERESTING METHOD: This overview underlines the fundamental principles of speech therapy in Parkinson's disease and compares the main methods and their results. We particularly insist on the Lee Silverman Voice Treatment (LSVT), phonation re-education method that has been widely developed in the United-States. Our aim is to provide better knowledge on this re-education method in France.
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PMID:[Speech therapy of dysarthria in Parkinson's disease]. 1466 91


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