Sensorimotor speech disorders in Parkinson's disease: Programming and execution deficits

Abstract

Introduction: Dysfunction in the basal ganglia circuits is a determining factor in the physiopathology of the classic signs of Parkinson's disease (PD) and hypokinetic dysarthria is commonly related to PD. Regarding speech disorders associated with PD, the latest four-level framework of speech complicates the traditional view of dysarthria as a motor execution disorder. Based on findings that dysfunctions in basal ganglia can cause speech disorders, and on the premise that the speech deficits seen in PD are not related to an execution motor disorder alone but also to a disorder at the motor programming level, the main objective of this study was to investigate the presence of sensorimotor disorders of programming (besides the execution disorders previously described) in PD patients. Methods: A cross-sectional study was conducted in a sample of 60 adults matched for gender, age and education: 30 adult patients diagnosed with idiopathic PD (PDG) and 30 healthy adults (CG). All types of articulation errors were reanalyzed to investigate the nature of these errors. Interjections, hesitations and repetitions of words or sentences (during discourse) were considered typical disfluencies; blocking, episodes of palilalia (words or syllables) were analyzed as atypical disfluencies. We analysed features including successive self-initiated trial, phoneme distortions, self-correction, repetition of sounds and syllables, prolonged movement transitions, additions or omissions of sounds and syllables, in order to identify programming and/or execution failures. Orofacial agility was also investigated. Results: The PDG had worse performance on all sensorimotor speech tasks. All PD patients had hypokinetic dysarthria. Conclusion: The clinical characteristics found suggest both execution and programming sensorimotor speech disorders in PD patients.

Vocal Emotional Expression in Parkinson’s Disease: Roles of Sex and Emotions

“…In PD, the basal ganglia are affected by the degeneration of dopaminergic neurons [22]. Although it is true that the basal ganglia play a critical role in speech and language difficulties in PD, they work closely with the cortex, cerebellum, thalamus, and the white matter connections to form a fundamental network involved in both motor and cognitive tasks [23][24][25]. For example, disruptions in the loop between the basal ganglia, its projections to the ventral anterior and ventral lateral thalamic nuclei, the mediodorsal thalamic nuclei, and projections to premotor, dorsal prefrontal cortices, and the anterior cingulate cortex are often the reason why PD patients struggle to initiate speech [26].…”

“…The utilization of these simple vocalization/phonation tasks allows for the assessment of diverse acoustic measures and parameters, providing valuable insights into the underlying mechanisms of voice dysfunction in this neurodegenerative disorder. Furthermore, recent research suggests that voice dysfunction may serve as an early indicator of motor impairment in PD and holds the potential for remote monitoring of patients [25]. By further exploring the voice characteristics and acoustic profiles through simple vocalization/phonation tasks, we can deepen our understanding of dysprosody in PD, contribute to early diagnosis, and develop innovative approaches for the monitoring and management of this complex disorder.…”

Parkinson’s Disease and Deep Brain Stimulation Have an Impact on My Life: A Multimodal Study on the Experiences of Patients and Family Caregivers

“…They include fatigue, autonomic dysfunction (e.g., constipation, sexual dysfunction, or urinary retention), neuropsychiatric symptoms (e.g., anxiety, depression, dementia, or hallucinations), sensory symptoms (e.g., pain), and sleep disturbances (e.g., insomnia, REM-sleep behavior disorder or restless legs syndrome) [ 9 , 10 ]. Communication impairment is also common in PD and is associated with both motor and cognitive dysfunction [ 11 , 12 ]. All these symptoms have a large impact on PD patients’ physical and mental health, which can alter their individual and social identities and lead to a loss of autonomy and self-esteem, altered relationships, and social isolation [ 13 ].…”