A Survey on The Impact of Early Speech and Vocal Changes on Young Onset Parkinson’s Disease.

Abstract

Patients with Young Onset Parkinson's Disease may have a long medical journey to receive their diagnosis due to their atypical age. Parkinson's Disease is typically diagnosed in a geriatric population and thus assumed to be a late-onset neurodegenerative disorder. Therefore, when younger people approach clinicians with parkinsonian symptoms, they are typically overlooked as they do not meet the age criteria, and thus the diagnosis may be missed or delayed. In late-onset Parkinson's Disease, a classic primary symptom pertains to voice and speech disorders due to the high prevalence of hypokinetic dysarthria. Thus, a review of speech and voice deficits that are seen prior to or within the time frame of diagnosis can highlight the speech and vocal patterns clinicians may see within a younger population. This could provide an effective tool for clinicians to make a quicker diagnosis for patients and administer medication such as Levodopa without having the patient go through rigorous, time-consuming testing. Furthermore, within neuroscience, little attention is paid to the impact of early speech and vocal changes. Therefore, this study would also like to explore the impact of these changes, highlighting the urge for clinicians not to stigmatise younger patients by age to receive a rapid diagnosis and treatment. This study follows the proceedings of a survey methodology via a formulated questionnaireinserted in a Google Form containing 12 statements, which contained closed-ended questions (Yes/No indicators) and open-ended questions where the participants indicated their answer by filling in a short statement regarding their experience. The statements contained questions about the diagnosis of Parkinson's Disease, the speech and vocal changes experienced, the socio-social effects of the speech and vocal changes on their personal lives and if they found that medication helped their vocal and speech symptoms. The questionnaire yielded a total of 43 participants with young-onset Parkinson's Disease. The results indicated that most of the participants suffered from speech and vocal changes, which resembled the clinical profile of severe hypokinetic dysarthria, typically seen in later stages of Parkinson's Disease in late-onset. In addition, the changes in speech and voice were so impactful that they caused significant distress in the psychosocial domain of their lives. Despite the severity of the speech and vocal changes, most participants struggled to receive a diagnosis, while hardly any received appropriate speech therapy treatment to aid their overall quality of life. Thus, this study concludes that the results of this study are essential to break stigmas and open the conversation in neuroscience and neurology on YOPD. Improvement clinical knowledge of this unique subtype of Parkinson's needs to be stressed amongst clinical practitioners that age of onset does not play a role in managing, treating, and diagnosing Parkinson's Disease.