Speech disorders in Parkinson's disease

Wang

et al. 2020

Sci Rep

Dysarthria is universal in Parkinson's disease (PD) during disease progression; however, the quality of vocalization changes is often ignored. Furthermore, the role of changes in the acoustic parameters of phonation in PD patients remains unclear. We recruited 35 PD patients and 26 healthy controls to perform single, double, and multiple syllable tests. A logistic regression was performed to differentiate between protective and risk factors among the acoustic parameters. The results indicated that the mean f0, max f0, min f0, jitter, duration of speech and median intensity of speaking for the PD patients were significantly different from those of the healthy controls. These results reveal some promising indicators of dysarthric symptoms consisting of acoustic parameters, and they strengthen our understanding about the significance of changes in phonation by PD patients, which may accelerate the discovery of novel PD biomarkers. Abbreviations PD Parkinson's disease HKD Hypokinetic dysarthria VHI-30 Voice Handicap Index H&Y Hoehn-Yahr scale UPDRS III Unified Parkinson's Disease Rating Scale Motor Score Parkinson's disease (PD), a chronic, progressive neurodegenerative disorder with an unknown etiology, is associated with a significant burden with regards to cost and use of societal resources 1,2. More than 90% of patients with PD suffer from hypokinetic dysarthria 3. Early in 1969, Darley et al. defined dysarthria as a collective term for related speech disorders. The classification of dysarthria includes flaccid dysarthria, spastic dysarthria, ataxic dysarthria, hypokinetic dysarthria, hyperkinetic dysarthria, unilateral upper motor neuron dysarthria and mixed dysarthria 4. The speech abnormalities of patients with PD are collectively termed hypokinetic dysarthria (HKD). These speech flaws are typically characterized by increased acoustic noise, a reduced intensity of voice, harsh and breathy voice quality, increased voice nasality, monopitch, monoloudness, speech rate disturbances, the imprecise articulation of consonants, the involuntary introduction of pauses, the rapid repetitions of words and syllables and sudden deceleration or acceleration in speech. Speech impairments are caused by impaired speech mechanisms during any of the basic motor processes involved in speech performance 5. The neuromotor speech sequence activates the muscles of the pharynx, tongue, larynx, chest and diaphragm through subthalamic secondary pathways. The anatomical substrate that could result in the abnormalities of PD phonetics may be reduced by the poor coordination of the sound-making muscles 6 .

Section: Discussionmentioning

confidence: 99%

The physical significance of acoustic parameters and its clinical significance of dysarthria in Parkinson’s disease

Wang

et al. 2020

Sci Rep

“…The non-motor symptoms questionnaire also includes questions that may indicate communication difficulties and require further investigation. The Voice Impairment Index focuses on the impact of speech impairment on the patient's quality of life [3,5],…”

Section: Methods For the Assessment Of Speech Disorders In Parkinson'...mentioning

confidence: 99%

“…Dysarthria is associated with the main motor symptoms of parkinsonism, i.e. muscle rigidity, monotonic, hypophonic voice sound, 'prominent' articulation [3]. Bradykinesia has been explained by slowness of response resulting from difficulty in initiating movements.…”

Section: Pathophysiology Of Speech Disorders In Parkinson's Diseasementioning

confidence: 99%

“…Bradykinesia has been explained by slowness of response resulting from difficulty in initiating movements. The tremor may affect the tongue, jaw or mouth [3,4].…”

Section: Pathophysiology Of Speech Disorders In Parkinson's Diseasementioning

confidence: 99%

“…However, speech disorders affect their lives to such an extent that 30% of PD patients describe speech disorders as the most disabling manifestation of the disease [3].…”

Section: Impact Of Speech Disorders On Quality Of Life In People With...mentioning

confidence: 99%

See 2 more Smart Citations

Impact of neurological disorders occurring in neurodegenerative diseases on the conversation process and patients' quality of life

Mielniczek

Lipiec

Kowalska

et al. 2022

J Educ Health Sport

Introduction : Dialogue, or conversation, is the ability to speak as well as listen. It plays a very important role in interpersonal relations.Speech disorders are a group of of disorders that includes various types of speech production difficulties. Speech production depends on the coordination of several motor acts: respiration, phonation, articulation, resonance and prosody. Phonation is the complex activity of producing sound by vibration of the vocal cords. Resonance is the amplification of sounds at specific frequencies through vibration in the chest, throat and sinuses. Prosody includes a set of phonetic features, such as tone, loudness, tempo, and the overall timbre of speech, which are designed to intended to preserve the meaning and character of speech. Disruption of any of these related elements results in motor speech disorders. Material and method : An overview is presented of language disorders in diseases neurodegenerative diseases such as Parkinson's disease(PD) and Friedreich's ataxia (FRDA). Their impact on the conversation process and the patient's quality of life assessment was evaluated. The paper was based on scientific publications posted on the PubMed scientific platform. Results : Speech and language disorders are the main symptoms of FRDA, which significantly affect the patients' quality of life. Patients often present with dysarthria, resulting from causes of central and peripheral and additional primary language disorders. The classic speech disorder in PD is hypokinetic dysarthria, manifested by hypophonia; monotonous, uneven and strained speech; reduced prosody (melodic voice); crowded articulation; inadequate pauses in speech; freezing of speech, unclear articulation. Conclusions : The described disease entities show a significant impact on the deterioration of the process of of conversation by the patient, thus showing a significantly negative impact on the patients' quality of life.

Assessment of non-progressive dysarthria: practice and attitude of speech and language therapists in Lebanon

et al. 2021

Background Non-progressive dysarthria is an acquired motor speech disorder resulting from neurological diseases such as stroke and traumatic brain injury. The evidence base for the assessment of non-progressive dysarthria remains limited with professional practices relying mainly on therapists’ clinical experience. Limited information on the assessment practices of Lebanese speech and language therapists (SLTs) is available. Such information is crucial for the development of adequate therapy services for clients with non-progressive dysarthria. This study aims to explore the assessment practices and attitudes of Lebanese SLTs working with adults with non-progressive dysarthria and to investigate their adherence to the framework of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Methods A cross-sectional study was conducted in Lebanon between March and May 2021. Data was collected through an online survey that included information on socio-demographic characteristics, practices, and attitudes of SLTs who assess adults with non-progressive dysarthria. Results A total of 50 Lebanese SLTs responded to the survey. The majority of SLTs (78%) assessed clients with non-progressive dysarthria across all ICF domains. SLTs reported dissatisfaction with the available assessment tools (64%) and reliance on informal tools (84%). In addition, 68% of the SLTs suggested the crucial need for the development of Arabic formal assessments that can quantitatively evaluate dysarthria and determine severity. The survey also showed that the respondents demonstrated a preference for the use of impairment-based tools. Conclusion It can be concluded that the assessment practices of Lebanese SLTs, generally, follow the international trend and the recommended professional guidelines. Further research initiatives should be held to develop Arabic formal assessment tools for non-progressive dysarthria.