Behavioral Treatments for Speech in Parkinson’s Disease: Meta-Analyses and Review of the Literature

Abstract

Parkinson's disease (PD) results from neurodegenerative processes leading to alteration of motor functions. Most motor symptoms respond well to pharmacological and neurosurgical treatments, except some axial symptoms such as speech impairment, so-called dysarthria. However, speech therapy is rarely proposed to PD patients. This review aims at evaluating previous research on the effects of speech behavioral therapies in patients with PD. We also performed two meta-analyses focusing on speech loudness and voice pitch. We showed that intensive therapies in PD are the most effective for hypophonia and can lead to some improvement of voice pitch. Although speech therapy is effective in handling PD dysarthria, behavioral speech rehabilitation in PD still needs further validation.

Technology‐enabled management of communication and swallowing disorders in Parkinson's disease: a systematic scoping review

“…This finding was not unexpected considering this treatment program has demonstrated the highest level of evidence for the face‐to‐face treatment of the speech disorder in PD to date (Atkinson‐Clement et al . ), and therefore would be selected for validation in a technology‐based environment. As an intensive treatment requiring daily sessions four times per week, the impost on people with PD and their families to attend face‐to‐face sessions with an SLT is considerable and may not be compatible with their physical, psychosocial and mobility status.…”

“…) on increasing speech loudness, and pitch range to some extent, across 30 studies (Atkinson‐Clement et al . ). The multi‐parameter approach to speech treatment in which various aspects of speech output (respiration, phonation, articulation, prosody) are targeted either simultaneously or sequentially in therapy was not supported by the evidence (Atkinson‐Clement et al .…”

“…The multi‐parameter approach to speech treatment in which various aspects of speech output (respiration, phonation, articulation, prosody) are targeted either simultaneously or sequentially in therapy was not supported by the evidence (Atkinson‐Clement et al . ). The effect of LSVT LOUD on the speech of people following deep brain stimulation has yet to be fully explored with pilot studies indicating equivocal outcomes (Spielman et al .…”

Exercise Effects on Early Vocal Ultrasonic Communication Dysfunction in a PINK1 Knockout Model of Parkinson’s Disease

“…These evolving vocal communication deficits often manifest early, prior to hallmark basal ganglia dopamine depletion, and can be difficult to treat because they do not benefit from standard medical therapies such as levodopa or deep brain stimulation [3, 7–9]. However, communication deficits respond to some degree to exercise-based speech and voice intervention [10–14]. Although interventions show promise, they are not optimized due to our incomplete knowledge of the full mechanisms of disease pathology and the heterogeneous nature of PD in human treatment interventions such as dose, timing, and intensity.…”

Movement Disorders Rehabilitation

“…Drug and neurosurgical treatment are insufficient and have variable results for dysarthria in PD [126]. The specific effects of DBS and repetitive transcranial magnetic stimulation and related mechanisms remain unknown.…”