Eletromiografia laríngea e análise vocal em pacientes com Mal de Parkinson: estudo comparativo

Abstract

Parki nson's disease (PD) involves a progressive depletionof dopamine in the basal ganglia leading to motor alterations. Oral communication impairment occurs in 75% to 90% of patients and has been poorly studied. Aim: to asses laryngeal electromyography (LEMG) patterns and correlate them to vocal analysis in patients with Parkinson's disease. Materials and Methods: This is a prospective study. Twenty six adults with PD underwent laryngeal electromyography. Rest and phonation potentials were analyzed. VOXMETRIA® and GRAM 5.1.6. ® were used in acoustic analysis. Results: The main electromyographic pattern observed in the PD group was rest hypertonicity meaning that patients with PD presented with spontaneous intrinsic laryngeal muscle activity during voice rest, which occurred in 73% of the individuals. Not a case of laryngeal tremor was detected by electromyography, although vocal tremor was detected by VOXMETRIA in 69.5% of the individuals and in 61% of them by perceptive-auditive analysis. Conclusion: Vocal tremor was the main acoustic change in the PD group, with no correlation to LEMG findings.

Idiopathic Parkinson's disease: vocal and quality of life analysis

“…With regards to the perceptual evaluation of sustained vowel (Table 3), the parameters that showed statistically significance difference between PD patients and controls were B (p=0.026), A (p=0.000), S (p=0.002), and I (p=0.006) and such findings are consistent with the literature 8,16,18,24 . One study found 79.2% of vocal deviation in the group with PD, ranging from mild (29.2%), moderate (45.8%), and intense degrees (4.2%) 16 , showing a prevalence of dysphonia in PD similar to the present study.…”

“…Regarding the presence of instability, a research that correlated the perceptual evaluation with the contractile pattern of the intrinsic muscles of the larynx in PD, by means of electromyography, found that the vocal tremor auditory rated did not correlate with the electromyography findings 24 . This suggests that the vocal instability, perceived in the perceptual evaluation, does not have a direct correlation with the standard laryngeal.…”

Objective and subjective analysis of women's voice with idiopathic Parkinson's disease

“…As to the grade, the literature agrees that the voice of patients with PD is more altered than the one of older women [11][12][13] , although studies show that the voice of the elderly often presents mild to moderate changes in the parameter grade 14 , and it was possible to verify that women with PD had more significant changes in this parameter.…”

“…The irregularity references of vocal fold vibration in PD can be explained by the rigidity and hypokinesia of the muscles involved in the speech 11 . In relation to the instability, it is known that the voice of individuals with PD is more altered [11][12][13]15 . In a study that correlated the perceptual evaluation and the contractile pattern of intrinsic muscles of the larynx, it was found vocal tremor, leading to instability.…”

Prosody and levodopa in Parkinsons disease

“…These changes often affect speech intelligibility and can lead to a misinterpretation of the intention of PD patients, contributing to social isolation and negatively affecting their quality of life 4 …”