Speech disorder in Parkinsonism; use of delayed auditory feedback in selected cases.

Abstract

Speech disorder in Parkinsonism; use of delayed auditory feedback in selected cases Sir: Severe alteration of speech, leading to total loss of intelligibility is rare in Parkinsonism but is usually refractory to treatment with drugs and to conventional speech therapy. We have had some striking success in a very few patients with the use of delayed auditory feedback (DAF). This has been previously tested in treating other speech disorders, in particular stammering and was applied to our first patient as his speech difficulty superficially resembled this condition. This patient by the age of 40 yr had already suffered from Parkinsonism for

Delayed auditory feedback and acquired neurogenic stuttering

“…In developmental stutterers, the application of DAF usually results in an immediate and dramatic reduction of the number of disfluencies (Kalinowski, Armson, Stuart, Graco, & Roland-Mieskowski, 1993;. Similar results in neurogenic stutterers were also reported by Marshall and Neuburger (1987) and by Downie, Low, and Lindsay (1981). On the other hand, judging from the observations in our patient and from the case reported by Balasubramanian et al (2003) it would seem that in some patients with neurogenic stuttering the effect may be far less spectacular to even non-existent.…”

“…In a brief communication Downie, Low, and Lindsay (1981) reported the use of the Aberdeen Speech Aid (a body-worn pocket sized DAF apparatus) in a 60-year-old man with Parkinsonism ''whose speech was of the 'festinating' type showing hesitations akin to stammering'' (p. 852). Application of delayed auditory feedback using a delay of 200 ms had no effect.…”

Differential diagnosis in developmental and acquired neurogenic stuttering: Do fluency-enhancing conditions dissociate the two?

“…Together from their studies, Marshall and colleagues reported of marked reduction in dysfluencies with a delay of 250 ms in four people with ANS. Similarly, Downie, Low, and Lindsay (1981) reported of a 60-yearold man with Parkinson's disease who showed remarkable improvement in speech fluency with 50 ms delay in auditory feedback. These authors reported on yet another subject with ANS who showed positive changes in fluency only for about a year.…”

Realimentação auditiva atrasada e tratamento de gagueira: evidências a serem consideradas

“…Positive effects in individuals with neurogenic stuttering were reported by Downie et al (1981) in two patients with Parkinsonism, and by Marshall & Starch (1984) and Marshall & Neuburger (1987) in respectively 1 and 3 participants who developed stuttering after head inury. Balasubramanian et al (2003), on the other hand, observed no effect of 50 ms DAF in a 57-year-old male with acquired stuttering following an ischemic lesion in the right frontal lobe and the pons.…”

“…Marshall and Neuburger (1987), however, observed a return to baseline stuttering levels during the maintenance phase and reoccurrence of stuttering at follow up (3 months) in two of three cases acquired stuttering following head injury. And of two patients with Parkinsonism reported by Downie (1981) the first maintained useful benefit for about one year but by then he appeared to become habituated and the apparatus was no longer effective. The second patient found the apparatus still extremely helpful after two years use.…”