No abstract

Objectives-To assess long term (24 months) eVects of the Lee Silverman voice treatment (LSVT®), a method designed to improve vocal function in patients with Parkinson's disease. Methods-Thirty three patients with idiopathic Parkinson's disease were stratified and randomly assigned to two treatment groups. One group received the LSVT®, which emphasises high phonatoryrespiratory eVort. The other group received respiratory therapy (RET), which emphasises high respiratory eVort alone. Patients in both treatment groups sustained vowel phonation, read a passage, and produced a monologue under identical conditions before, immediately after, and 24 months after speech treatment. Change in vocal function was measured by means of acoustic analyses of voice loudness (measured as sound pressure level, or SPL) and inflection in voice fundamental frequency (measured in terms of semitone standard deviation, or STSD).Results-The LSVT® was significantly more eVective than the RET in improving (increasing) SPL and STSD immediately post-treatment and maintaining those improvements at 2 year follow up. Conclusions-The findings provide evidence for the eYcacy of the LSVT® as well as the long term maintenance of these eVects in the treatment of voice and speech disorders in patients with idiopathic Parkinson's disease. (J Neurol Neurosurg Psychiatry 2001;71:493-498)

Some turn this sickness yet might take, Even yet.

The purpose of this study was to evaluate the long-term (12 months) effects of two forms of speech treatment on the speech and voice deficits that occur in Parkinson's disease. Thirty-five patients with idiopathic Parkinson's disease were assigned to one of two speech treatment groups: voice and respiration (The Lee Silverman Voice Treatment [LSVT]) or placebo (respiration) treatment. Vocal intensity data from before, immediately after, and at 6 and 12 months after speech treatment revealed statistically significant differences between the treatment groups. Only subjects in the LSVT group improved or maintained vocal intensity above pretreatment levels by 12 months after treatment. The placebo group had statistically significant deterioration of vocal intensity levels from before to 12 months after treatment during conversational monologue. The LSVT group did not deteriorate to levels below pretreatment in vocal intensity over the 12-month period. This study is the first to document the short-and long-term effects of intensive speech treatment (LSVT), which focuses on the voice, for patients with Parkinson's disease compared with a placebo speech treatment group.

Three hundred and seventy-six subjects with advanced Parkinson's disease participated in a prospective, double-blind placebo-controlled study of the dopamine agonist pergolide mesylate as an adjunct to Sinemet. At 6 months, patients randomized to pergolide had a statistically significant improvement in total Parkinson's score, scores of activities of daily living, motor function, number of "off" hours, Hoehn and Yahr stage, and numerous parameters of parkinsonian function including bradykinesia, rigidity, gait, and dexterity. This benefit was obtained with the addition of a mean dose of 2.94 mg of pergolide, which permitted a 24.7% reduction in dose of levodopa. Adverse reactions were, for the most part, mild, reversible, and not of major clinical significance. No significant cardiac or electrocardiographic abnormalities were detected. This study demonstrates that pergolide mesylate, as an adjunct to levodopa, is an effective antiparkinsonian agent that provides clinical improvement while permitting a reduction in levodopa dose.