Avaliação fonoaudiológica na atrofia de múltiplos sistemas: estudo com cinco pacientes

Knopp, Denise Botelho; Barsottini, Orlando Graziani Póvoas; Ferraz, Henrique Ballalai

doi:10.1590/s0004-282x2002000400019

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…Early and severe dysarthria is considered a "red flag" and a clinical feature of the disease when factored together with other signs of impaired respiratory support and rapid disease progression. 1,7,10,12,23,24 Severe dysarthria is also a sensitive and specific predictor of MSA, 7 yet many of the dysarthric speech features [25][26][27] (Fig. 2) overlap with what is perceived in other forms of parkinsonism.…”

Section: Literature Reviewmentioning

confidence: 99%

The Vocal Flutter of Multiple System Atrophy: A Parkinsonian‐Type Phenomenon?

Mir,

Herndon,

Wagle Shukla

et al. 2024

Movement Disord Clin Pract

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BackgroundEarly features of multiple system atrophy (MSA) are similar to those in Parkinson's disease (PD), which can challenge differential diagnosis. Identifying clinical markers that help distinguish MSA from forms of parkinsonism is essential to promptly implement the most appropriate management plan. In the context of a thorough neurological evaluation, the presence of a vocal flutter might be considered a potential feature of MSA‐parkinsonian type (MSA‐P).CasesThis case series describes clinical histories of 3 individuals with MSA‐P. In each case, vocal flutter was detected during neurological and motor speech evaluations. It seemed to be a concomitant feature with the constellation of other signs and symptoms that led to the clinical diagnosis.Literature reviewThe vocal flutter may be described as pitch and loudness fluctuations during phonation. Different from a vocal tremor, the flutter phenomenon has higher oscillation frequencies. The neuropathological underpinnings of vocal flutter may be related to generalized laryngeal dysfunction that is commonly described in MSA‐P.ConclusionVocal flutter may be a unique speech feature in some individuals who have MSA‐P. Future studies using perceptual and acoustic measures of speech are warranted to quantify these observations and directly compare to other MSA variants, PD, and a control group.

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Section: Literature Reviewmentioning

confidence: 99%

The Vocal Flutter of Multiple System Atrophy: A Parkinsonian‐Type Phenomenon?

Mir,

Herndon,

Wagle Shukla

et al. 2024

Movement Disord Clin Pract

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“…Multiple system atrophy (MSA) is a progressive neurological disorder caused by degeneration of nerve cells in several brain areas. Speech problems (called dysarthria) are an early and disabling feature of both the Parkinsonian (MSA-P) and cerebellar (MSA-C) sub-types [1,2]. They range from harsh and quiet voice and articulation difficulties characterising the Parkinsonian variant to issues of control resulting in irregular motion and uncontrolled pitch and loudness variations in the cerebellar variant.…”

Section: Introductionmentioning

confidence: 99%

ClearSpeechTogether versus standard NHS speech intervention: Study protocol for a single, mixed method, rater blinded pilot randomised controlled trial for people living with MSA-C

Lowit

Beith

Young

et al. 2023

Preprint

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Background: Speech and communication problems are a common symptom of cerebellar Multiple System Atrophy (MSA-C). While recent studies have suggested that these patients can benefit from speech therapy, no properly controlled, large scale investigation of effectiveness has been conducted to date. Furthermore, studies have not focused on how novel, often workload intensive approaches compare to existing standard care. The aim of the current project is to establish feasibility and acceptability of a intensive, mixed individual / group, peer supported speech therapy approach (ClearSpeechTogether) in a group of patients with MSA-C, and to pilot a two-arm RCT comparing it to standard individual therapy. Methods: This protocol outlines a pilot study for a mixed-method registered controlled trial. 24 patients will be allocated in a 1:1 ratio to either existing speech \& language therapy provision or ClearSpeechTogether. Two pre-therapy speech assessments will be carried out followed by 6 weeks of therapy, a post-therapy assessment and a follow-up assessment after 8 weeks. These assessments will evaluate physiological functioning, impairment and participation. Three qualitative interviews will also be conducted at pre, post and follow-up to investigate patients' experiences of the interventions. Discussion: Demonstrating acceptability, feasibility and communication benefits in the current pilot would set the basis for a larger registered controlled trial. If indications of additional benefits of ClearSpeechTogether over existing provisions are found a full superiority trial would be conducted. Trial registration: ISRCTN, ISRCTN44652664. Registered 16 December 2022, https://www.isrctn.com/ISRCTN44652664

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“…4 A AMS é uma doença neurodegenerativa, com prevalência de 3,4 a 4,9 casos por 100.000 habitantes, atingindo 7,8 em 100.000 maiores de 40 anos, sendo mais comum entre aqueles com mais de 60 anos, em ambos os sexos. Após o início dos sintomas, a média de vida dos pacientes é de 6 a 10 anos.…”

Section: Introductionunclassified

“…É denominada Degeneração Estriatonigral, quando predominam os sintomas parkinsonianos; quando os cerebelares são mais comuns é conhecida como Atrofia Olivopontocerebelar e quando os sintomas mais típicos são os autonômicos, denomina-se síndrome de Shy-Drager. [3][4][5] A AMS apresenta o Parkinsonismo como principal déficit motor, sendo muito confundida com a DPI em estágios iniciais. Cerca de metade dos pacientes com AMS morrem diagnosticados como portadores de DPI.…”

Section: Introductionunclassified

Atrofia de Múltiplos Sistemas: gestão de caso complexo em uma Unidade de Saúde da Família

Magela

Santos

Batistela

et al. 2016

Rev Bras Med Fam Comunidade

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A Atrofia de Múltiplos Sistemas é uma doença neurodegenerativa grave, caracterizada por falência autonômica progressiva, com características parkinsonianas, cerebelares e piramidais em diferentes combinações. É a terceira causa de Parkinsonismo, atingindo 7,8% dos maiores de 40 anos, de evolução rápida e com média de 6 a 10 anos de vida após o início dos sintomas. O objetivo do estudo foi relatar um caso complexo de Atrofia de Múltiplos Sistemas acompanhado em uma Unidade de Saúde da Família. Reforça a importância da longitudinalidade para a coordenação do cuidado, o diagnóstico diferencial e a integralidade da atenção. O olhar global da equipe de saúde da família influenciou o manejo do caso, favorecendo o trabalho em rede com a abordagem especializada. Destaca a magnitude da gestão do cuidado praticada na Atenção Primária à Saúde na condução dos casos complexos.

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Avaliação fonoaudiológica na atrofia de múltiplos sistemas: estudo com cinco pacientes

Cited by 6 publications

References 12 publications

The Vocal Flutter of Multiple System Atrophy: A Parkinsonian‐Type Phenomenon?

The Vocal Flutter of Multiple System Atrophy: A Parkinsonian‐Type Phenomenon?

ClearSpeechTogether versus standard NHS speech intervention: Study protocol for a single, mixed method, rater blinded pilot randomised controlled trial for people living with MSA-C

Atrofia de Múltiplos Sistemas: gestão de caso complexo em uma Unidade de Saúde da Família

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