Treatments for dysarthria in Parkinson's disease

Pinto, Serge; Özsancak, Canan; Tripoliti, Elina; Thobois, Stéphane; Limousin-Dowsey, Patricia; Auzou, Pascal

doi:10.1016/s1474-4422(04)00854-3

Cited by 251 publications

(173 citation statements)

References 135 publications

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“…It also suggests that antiparkinsonian medication reduces connectivity between left GPi and left PMd/LMC in PDN subjects, but not in PDSI subjects. Although levodopa provides effective treatment for motor symptoms in the early to moderate disease stages (Jankovic & Aguilar, 2008), the effect of levodopa on speech production is less consistent (Pinto et al., 2004; Schulz & Grant, 2000). If we consider hyperconnectivity of left GPi and left PMd/LMC to be a disease‐related phenomenon, it is possible that this pathological increase in connectivity contributes to speech impairments in PDSI subjects and is not responsive to levodopa in these individuals.…”

Section: Discussionmentioning

confidence: 99%

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Altered resting‐state functional connectivity of the putamen and internal globus pallidus is related to speech impairment in Parkinson's disease

et al. 2018

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IntroductionSpeech impairment in Parkinson's disease (PD) is pervasive, with life‐impacting consequences. Yet, little is known about how functional connections between the basal ganglia and cortex relate to PD speech impairment (PDSI). Whole‐brain resting‐state connectivity analyses of basal ganglia nuclei can expand the understanding of PDSI pathophysiology.MethodsResting‐state data from 89 right‐handed subjects were downloaded from the Parkinson's Progression Markers Initiative database. Subjects included 12 older healthy controls (“OHC”), 42 PD patients without speech impairment (“PDN”), and 35 PD subjects with speech impairment (“PDSI”). Subjects were assigned to PDN and PDSI groups based on the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) Part III speech item scores (“0” vs. “1–4”). Whole‐brain functional connectivity was calculated for four basal ganglia seeds in each hemisphere: putamen, caudate, external globus pallidus (GPe), and internal globus pallidus (GPi). For each seed region, group‐averaged connectivity maps were compared among OHC, PDN, and PDSI groups using a multivariate ANCOVA controlling for the effects of age and sex. Subsequent planned pairwise t‐tests were performed to determine differences between the three groups using a voxel‐wise threshold of p < 0.001 and cluster‐extent threshold of 272 mm3 (FWE<0.05).ResultsIn comparison with OHCs, both PDN and PDSI groups demonstrated significant differences in cortical connectivity with bilateral putamen, bilateral GPe, and right caudate. Compared to the PDN group, the PDSI subjects demonstrated significant differences in cortical connectivity with left putamen and left GPi. PDSI subjects had lower connectivity between the left putamen and left superior temporal gyrus compared to PDN. In addition, PDSI subjects had greater connectivity between left GPi and three cortical regions: left dorsal premotor/laryngeal motor cortex, left angular gyrus, and right angular gyrus.ConclusionsThe present findings suggest that speech impairment in PD is associated with altered cortical connectivity with left putamen and left GPi.

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Section: Discussionmentioning

confidence: 99%

“…This resulted in a mixed group of subjects relative to PD medication use. Unlike limb motor symptoms, the effect of dopamine treatment on voice or speech is neither robust nor consistent (Pinto et al., 2004; Schulz & Grant, 2000). We thus chose to include both medicated and nonmedicated PD subjects.…”

Section: Methodsmentioning

confidence: 99%

Altered resting‐state functional connectivity of the putamen and internal globus pallidus is related to speech impairment in Parkinson's disease

et al. 2018

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“…The change in duration for the sustained vowel is reported in Figure 6 for each participant. Increases in duration post-therapy were minimal for five participants (3,8,10,11,9) and decreased in seven participants (4,6,12,1,5,2,7). Performance varied substantially across severity groups.…”

Section: Four Of the 12 Participants (4152) Demonstrated Modest Inmentioning

confidence: 94%

“…117,[119][120][121][122] Speech pathology intervention, in combination with an optimal medication regimen, is currently the most efficacious treatment for the dysarthria associated with PD. 10,44,112,123,124 In particular, there is evidence that the Lee Silverman Voice Treatment ® (LSVT LOUD hour per day, four days per week -across four weeks. 128 The treatment tasks are based on principles of motor learning and correspond to some of the proposed principles underlying neural plasticity, including intensity, complexity, saliency, early intervention, and ongoing activity to maintain function and avoid further deterioration.…”

Section: Behavioural Treatments Early Opinions Regarding Behaviouralmentioning

confidence: 99%

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Maintenance of speech in Parkinson’s disease: The impact of group therapy

Edwards¹

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The maintenance of communication in Parkinson's disease (PD) requires a long term management plan, due to the progressive nature of the associated communication deficits.While intensive behavioural treatment has been demonstrated to improve speech intelligibility in PD, the effects can decrease over time. People with PD also experience changes in their ability to participate in conversation and everyday communication.Methods to maintain communication after a primary speech treatment are of interest to clinicians and people with PD. The overall aim of this research was to investigate the outcomes of group therapy as a maintenance strategy following the Lee Silverman Voice There was heterogeneity in the participants' response to Loud and Proud that was not explained by dysarthria severity. Refinements to Loud and Proud were recommended following this Phase I study, to better target intelligibility, communicative effectiveness, and QOL.In Study II conversational data from a purposeful sample of six participants in Study 1 were examined using a mixed-methodology. Recorded conversations between the PD participants and the researcher obtained before and after the Loud and Proud intervention were investigated using Conversation Analysis (CA) as the primary methodology.

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